One of the reasons I started this blog besides having a platform to talk about tech stuff and other things that interest, amuse, and infuriate me, was to use this opportunity to pass on things I’ve learned throughout my life. A blog is a good forum for that as it’s not a captive media- if something doesn’t interest you then you simply pass it over. But it’s a therapeutic way for me to recount some major events that will make me feel better having told them and might help others at the same time.
Almost three years ago I underwent a life-shaking period that many experience and none are ever prepared for. I had open heart surgery at the way too young age of 45, an event that I certainly was not expecting nor ready to endure. I’d like to chronicle this experience a little at a time and will post it in installments so as not to overwhelm you the reader nor me the storyteller.
Pull up a chair and read on if you wish. Maybe you’ll find something that will benefit you- if not that’s OK. I’m writing it for me.
I had a condition that cardiologists refer to as the "widowmaker" because usually the first symptom you experience is a fatal, massive coronary. You drop dead. Game over with no warning. Well, you could say the warning signs are there even if subtle but there are no genuine symptoms. I was very fortunate to have one symptom that served as a warning and allowed me the opportunity to get fixed. Not fixed like a dog, but repaired as in faulty equipment.
"Mr. Kendrick, can you hear me? I’m Mrs. Reinhard, the patient care facilitator here at Methodist hospital. Are you comfortable? I’ll be making sure your wife and family are OK while you’re in surgery as you’ll be there for a while. Do you want to tell me anything before they take you back?"
I have to think about that one. I’m so cold, it’s so cold in here. How should I respond that won’t conflict with my Southern upbringing. You must be stoic when confronted with the most terrifying thing in your entire life. Scared beyond words that you will never wake up. Scared that they won’t be able to fix your problem. Scared that you’ll never, ever see your beautiful wife and wonderful children again. Terrified that you’ll be an invalid after the surgery.
"Thank you but I’m fine."
"You understand the procedure you’re about to undergo, right Mr. Kendrick? Would you like to talk about it or ask me any questions?"
"No, I’m fine. Tell my wife that I love her and I’ll see her shortly. She doesn’t handle upsetting things very well."
"Well, OK, Mr. Kendrick. Don’t you worry- Dr. Lawrie is one of the best surgeons in the world and you’ll be just fine. I’ll sit with your wife for a while and make sure she knows what’s going on with your procedure. They’ll be coming to take you into surgery in a few minutes. I’ll see you in the recovery room." (What I didn’t know then is that Dr. Lawrie worked for 20 years on the personal surgical team of Dr. DeBakey, the pioneer of cardiac surgery. Sometimes you just get lucky.)
As she walked away I hoped that Sheri would be OK. A single tear trickled involuntarily down my cheek. I suppose it was still there when the doctors and nurses started their work.
To aid in understanding the enormity of my medical ordeal I should diverge into a brief history of the events that led up to my hospitalization. I had worked in the seismic services contract industry for over twenty years, the last ten in executive management. While I was certainly a workaholic in the earlier years of my career I had eventually realized that family and friends were more important than work. I had successfully changed my work attitude to reflect that belief and was enjoying a period in my life with a much lower stress level than before.
My career would be classified as a very successful one by anyone who followed it (basically my family and I) and three years before my heart problem I accepted the position as a Division Manager for the second largest company in my field. This company is headquartered in Paris and my hiring was historical as the first non-French executive at this level the firm had ever hired.
I plunged into this position with gusto as it represented a big challenge on so many levels. I was an outsider as far as the other senior managers were concerned and I would have to prove myself quickly. The US division of this company was experiencing the lowest employee morale I’ve ever seen, the annual revenues were incredibly low for such a large company, and several of the major clients had stopped working with the firm due to bad past experiences.
To summarize the next three years I met every challenge thrown my way. The division’s annual revenues increased 102%, employees began to really enjoy their jobs, and we won back every single client that had been lost before. It took a lot of hard work and solid motivation of a very talented staff but we exceeded everyone’s expectations. I was invited to meet and dine with the CEO numerous times to discuss our success in the US and how it could be duplicated elsewhere in the world, as the firm had almost 100 offices throughout the world.
Things just couldn’t be better. In June of 2001 I received the best employee appraisal of my entire career. We were moving and shaking, and all in the right direction. On July 9 I chaired an internal meeting preparing for a meeting with Royal Dutch Shell, then the largest oil company in the world. This meeting went well and when it was over I heard my name paged by the Executive VP’s secretary. She asked me to come to his office for a brief meeting when I was free. Walking into his office I knew something was wrong. This man that I had come to know so well was as nervous as I’d ever seen him, and the HR Manager was at his conference table.
He read his statement from a handwritten piece of paper: "James, I regret I must inform you that your position at the company has been made redundant, and we have to lay you off as of today." The HR Mgr. was crying and she just kept saying over and over "I hate this job, I just hate this job. This makes no sense." I was given an hour to gather my things and leave. And I did, totally in shock. Later, I came to realize that I was brought in as the fix it man, and was replaced by two French managers. But while driving home that day there was no sense to be made of things.
My employability was not good- the industry was in a slump and at my level there were few jobs. I spent the next few months looking for opportunities and networking like crazy. I even considered going independent. The weeks stretched into months and financially it was getting critical for me to find something soon. After six months of unemployment I finally was offered a position and accepted it.
The night before I was to start the new job was a quiet one in our house as our three children were all staying with friends and Sheri and I just watched TV and talked, just chilled. We breathed a collective sigh of relief that starting tomorrow things could return to normal. As we sat quietly I began to feel a shortness of breathe I’d never felt before. Not one to complain about my health I figured it would pass and I didn’t say anything. Over the next couple of hours it got worse and worse to the point I was very concerned. I remember the look on Sheri’s face when I told her I was having trouble breathing and I thought she’d better take me to the emergency room. Her face was instantly panicked for she knows me so well and for me to ask to go to the emergency room then something was very, very wrong. If we only knew…..
Time to continue the chronicle of a defining period in my life. Part 2 left off just after my shortness of breathe and I had just told my wife Sheri I needed to go to the emergency room as I could tell that something was very wrong with me.
Sheri has never handled traumatic events very well and the trip to the hospital was very nerve wracking for both of us. It only took us about 15 minutes to travel from our house to Cy-Fair Hospital, the closest hospital to us. We walked into the emergency room and briefly explained what I was experiencing and we were whooshed into a treatment room. The first thing they did was take my blood pressure.
The look on the ER nurse’s face said it all. I regret I don’t remember his name- he was so nice to us during my time in the ER but I just don’t recall his name. There’s a lot of little details I can’t recall but I’ll touch on that later. He disappeared and shortly the ER doctor came in and introduced himself (I don’t remember his name either). He asked me to describe the symptoms that brought me into the hospital. Acute shortness of breathe, tingling in my fingers, slight pain in my left arm. Then he dropped the bomb- "Your blood pressure is 228 over 160. You are a time bomb just waiting to go off and it’s imperative we bring that pressure down before we try to determine the cause."
They started giving me nitroglycerin tablets to dissolve under my tongue about every 15 minutes. They just left the blood pressure cuff on and were checking it every few minutes trying to gauge how quickly the nitro was bringing it down. They must have done this 3 or 4 times before they came in with an injection of nitro to hit it harder. The injection was the very first one I’ve ever gotten in the belly button. Ouch.
While all of this was happening they came in and took blood for a complete workup. The doctor explained the first thing they had to do was determine if I’d had a heart attack. There’s an enzyme that’s released into the blood stream during an attack and it’s totally accurate. While we waited for the results they continued the nitro routine, checking the pressure. The BP was gradually coming down and after the injection it came down pretty quickly. Sheri and I were feeling calmer with things apparently settling down somewhat and with the gradual descent of my BP.
About 20 minutes (a short time that proved to me how serious the hospital was taking this) after taking my blood the doctor came back in with my chart. "The blood results are great news- you have NOT had a heart attack so no damage to the heart has been done."
I felt like jumping up off the gurney and doing a little dance. The relief on Sheri’s face was unmistakable. It felt like we had finished a long journey and were back home again. I wouldn’t get back home for for a while….
Having just heard I had not suffered a heart attack, a fact that seemed to surprise the doctors given the symptoms that brought me to the emergency room and my very high blood pressure, my wife Sheri and I were seeing the light at the end of the tunnel. Well, given the circumstances that’s a morbid analogy.
The ER doctor explained that my blood pressure, while still high, was not dangerous since the nitroglycerin they’d been giving me for about 2 hours had brought it down. But, and that’s a word I would grow to hate in the next few days, every time they stopped the nitro for even a little while the pressure climbed back up. Something was wrong and would have to be fixed. Medication wasn’t doing it.
"Mr. Kendrick, I’ve called in Dr. Cyril Tawa, our cardiologist specializing in interventional cardiology. He’s very good and we need him to examine you and take over your care." That doesn’t sound good to me. Interventional cardiology- what exactly does that mean? Why won’t my BP stay down and what can they do about it?
I should interject here that I now know how lucky I am that Dr. Tawa was the specialist assigned to the ER that fateful night. The medical community in Houston is famous throughout the world for it’s advanced medical care and hospital facilities but even so, sometimes you just have to get a little lucky.
A tall, skinny young man walks into the room and shakes my hand. "Hi, I’m Dr. Tawa and I’m the cardiologist who’s going to make sure you get better. I’ve reviewed your chart and blood work and I have an idea what we’re dealing with. Your blood pressure when you were admitted to the ER was in the critical stage. You don’t realize how lucky you are that you didn’t have a heart attack or a stroke. You’re very stable now that the nitroglycerin has brought the pressure down but it won’t stay down without medication so we have to find out what exactly is wrong and how to fix it."
"We need to scope your heart to determine if there’s blockage in the arteries, or if some other malfunction in the heart is causing your problem. I’m sending you up to intensive care now so we can monitor you very carefully until the Cath(eter) Lab is prepared. What we are going to do is insert a catheter in your groin and run a fiber optic camera up the main artery all the way to the heart. We will be able to see the heart and all the surrounding arteries to determine if there is blockage causing your pressure to be so high."
All during his speech I’m getting nervous and Sheri’s face is getting whiter. When he’s finished speaking she asks the doctor if this procedure is risky. He thinks for a moment and responds "all procedures are risky when the BP is this high but I’ve done thousands of these and there’s nothing to worry about. What you have to realize is how serious James’ condition is until we find out what’s wrong. He is very lucky he has suffered no damage to his heart and he hasn’t stroked out. This is why he needs to be in intensive care while we prepare for the catheterization."
Wow. Since the first time "intensive care" was spoken I’ve gone completely cold. I’ve never heard of anything good coming from the intensive care.
It doesn’t take long before they come down to take me up. I’ve been hooked up to an IV, cardiac monitor, and BP cuff since I got here and it’s a bit of a coordinated dance to get me moving. There was a slight delay taking me up as Dr. Tawa insisted on having a defibrillator on the foot of the gurney before going up in the elevator. That’s one of those electric paddle gizmos for shocking your heart into action after it’s stopped. Any tiny remaining doubt that Sheri and I might have still had about how serious my condition was left when we saw that box. They look exactly like they do on TV.
The trip up the elevator to ICU was slow but uneventful. Thankfully I didn’t get to see the plastic box with the paddles in action. Once they wheeled me into the room in Intensive Care I thought to myself, this isn’t so bad. Since I wasn’t dying at the moment and the private room in the ICU was free the cardiologist had them put me in there until the Catheter Lab was free. I should have realized but I never knew they had private rooms in ICU for VIPs. It sure made it nicer on my wife and I and took a little of the edge off the experience.
I have to admit nerves were beginning to fray at this point. It’s been an emotional roller coaster and I’m really getting tired and scared as this procedure looms nearer. The doctor has told us it would be about 30 minutes before the room was ready for the procedure and the anesthesiologist would be there.
My wife is holding up pretty well but it’s clear the fatigue is getting to her, too. It’s now about 9 in the morning on September 5, 2001 and we’ve been up since about 7 am the day before. We fill the time with small talk because in this situation all talk seems small as we’re watching patients who are obviously dying through the window looking out on the ICU. After about half an hour the anesthesiologist comes in and explains they are going to sedate me enough to experience no pain but I’d be awake for the entire procedure as they might need me to respond at some point. I’m thinking to myself that I’d rather be out cold but no dice.
They give me one of those nice hospital gowns to change into, swab me with some very cold antiseptic solution, and wheel me into "the room". The sign on the door says simply "Catheter Lab" but it looks like a surgical theater to me. They manhandle me onto this cold, narrow metal table that’s roughly in the shape of a cross. I’m not a little guy so this was not a trivial move for them but they made it without dropping me onto the floor.
Once they’re all set to go, which was only about 5 minutes but felt like a really long time to me, they shot some stuff into the IV and I immediately felt pretty good. Very good, actually. Where can I get some of this, good. No pain at all even though I could feel them poking and prodding down in the groin area. But no pain. Dr. Tawa, the cardiologist, has on these glasses with microscopes on the lenses and I remember laughing because he looked like an alien. No, maybe a robot.
After what felt like just a few minutes but I now know was more like 30, the doctor asked me to look up at the computer screen hanging above us all. I’m so doped up that techno-geek that I am I didn’t even notice the screen up there. I could have watched the fiber optic camera as it inched it’s way from my groin to the heart had I known. But right now as he drew my attention to it, I was almost stunned to be looking at my own heart in the monitor. I didn’t have my glasses on as they took them away from me before the procedure but I still could see it pretty well.
You are confronted with your own vitality and mortality at the same time when you are actually looking at your own heart. From the rhythmic beating, fast now, to the arteries running to and from the heart, I am humbled at the power of medical technology.
Snapping me back to reality Dr. Tawa, says "Look here, Mr. Kendrick, we have a problem."
"Mr. Kendrick, we have a problem." Lying on this surgical table, my mind a little fuzzy from the drugs, looking at my heart on the monitor. The doctor points to a spot on the screen that shows the arteries running to and from my heart. "Look at this artery here- see how wide and thick it is? This is a healthy artery with very little blockage. Now look at this one- see how thin it is? This artery is very blocked by plaque. So is this one, and this one, and this one. Four of your coronary arteries are almost totally blocked. You’re lucky because your body tried to heal itself and see all these smaller arteries branching around this clogged one? Your arteries have developed smaller branches to carry the blood around this clog. Because of the "branching" we don’t need to bypass that one. The other three are shot to hell and they will have to be bypassed with arteries taken from somewhere else on the body and grafted onto the diseased ones. Do you understand, Mr. Kendrick?"
I nod yes- I can’t speak at all. From the sheer awe of watching my own heart on the monitor to the cold fear that has just totally gripped me, I just can’t utter a sound. I hear the doctor and nurses saying they don’t think I understand what he’s telling me, interpreting my silence for drugged stupor perhaps. I just lie there and nod.
Dr. Tawa tells me they’re going to finish and take me back to the ICU room in a few minutes. He’ll stop in and explain to my wife and I what the options are after the anesthesia has cleared from my head. All I can think of is how very cold and terrified I am. The next thing I remember clearly was back in the ICU lying in the bed and Sheri asking me if I hurt. I didn’t hurt at all but there was now a bandage on my groin where they had inserted the catheter. Since it went into a major artery they wanted to make sure the bleeding stopped completely according to the nurse on duty.
The doctor came in a short while later and laid out the options. I had to have a triple bypass as soon as possible since the risk of having a heart attack soon was very high. One of the arteries was 100% clogged, one 90%, and the third over 75% clogged. He was also very concerned about strokes- when the brain doesn’t get enough oxygen bad things happen. Given what he’d seen of my arteries the likelihood was high I would have problems. After discussing it with him a while we agreed there really wasn’t any choice to make. Either have the surgery or probably die pretty soon. It’s amazing how difficult that decision was for me even given those choices. I had seen what bypass surgery entailed on one of the cable channels, the Discovery channel or another channel like that. I have always been interested in medical technology and how it has revolutionized health care and about a year before there was a show on the tube of a bypass operation. Right now I wish I’d never seen it. Usually I want to be informed about things like this so I would have no surprises but at this point I wish I did not know what they were going to do to me in the operating room. Lucky for Sheri she didn’t know exactly what would happen during the surgery. I felt pretty sure she would freak out had she known and she later admitted that was true.
Coronary bypass surgery involves making an incision down the center of the chest, about 7 inches long. They cut open the breastbone with a saw and then using rib spreaders they open the ribs wide to create a workspace for the surgeons. A heart/lung machine is attached to the major arteries which takes over the circulation of blood and oxygen. This is essential because to work on the heart they have to stop it. Completely. The heart is stopped for a while and the machine keeps the patient alive. Veins are taken, usually from the legs, and are surgically grafted onto the good part of the coronary artery, and a new blood path is created bypassing the clogged area. I have an uncle in his 70s who had a bypass operation a couple of months before and in his case they had trouble getting good veins from his legs to use for the bypass and as a result he had incisions on the inside of both legs from the calf to almost the groin. Creating a bypass with grafted veins is repeated for each artery that has to be bypassed. Once the grafts are in place and done, the doctors restart the heart with medication. If there is a problem restarting it, and there sometimes is, they use drugs and possibly mechanical means to get it going again. This is the trickiest part of the procedure according to the cardiologist and often where they lose patients who don’t survive the operation, according to the documentary I had seen. When everything is done they wire the breastbone back together and close the patient up. The patient then recovers for an hour before being moved up to the ICU, as the hours immediately after the surgery are the critical ones.
Dr. Tawa said he wanted to move me to Methodist Hospital in the medical center district. They have one of the best cardiac programs in the world and he was waiting for confirmation that the surgeon he wanted to do the operation agreed to take me on. He left to try to reach this doctor and I started to get really anxious as it was now sinking in what was going to happen. Like I said- I knew what the surgery entailed. He came back in the room too quickly for me, and said that Dr. Gerald Lawrie had agreed to operate on me the next day. He emphasized that Dr. Lawrie was one of the best cardiac surgeons in the world and I was extremely lucky to get him for my bypass. There we go again talking about luck but in this case it was absolutely true. I would be hearing for weeks how good Lawrie is at heart surgery. Right then it just wasn’t registering at all.
The doctor told us that there were no free beds in the cardiac care wing of Methodist Hospital and they couldn’t move me until they had a confirmed room for me. I was to remain in the ICU at Cy Fair Hospital until the time to move me. I should recap the chronology of all the events that had happened to this point so it makes sense and I have to admit I’m having to rely on Sheri to keep the timeline accurate. The timing of events would be jumbled in my memory for some time to come. We had arrived at the ER at around 10 PM on September 4, 2001. It took the ER doctors and Dr. Tawa until 8 am on September 5 to get my BP down enough to move me to the ICU. The catheterization took place in the early afternoon on September 5 and we waited for hours until the word came that they were ready to move me to Methodist. The move commenced at almost midnight.
An ambulance had been ordered to transport me to Methodist Hospital so I could try and get a little sleep before they prepped me for surgery. The bypass was scheduled for 3 PM the following afternoon (Sep 6) and there was a lot of medication and prepping to do before it was time. They also wanted to make sure there was time for my family to come to the hospital. Oh man. No turning back now.
The two guys in the ambulance crew showed up and if the Keystone Kops had an EMT department these guys would fit right in. They were both really big guys with one of them topping 300 pounds easily. They moved me over to the ambulance gurney and started wheeling me away. Sheri asked them to wait so she could follow them in her car as she was parked pretty far away and she didn’t want to lose sight of where I was. It was nice of them to wait for her to appear behind us just outside the emergency room and it was so comforting to look out the back window of the ambulance and watch her slide in behind us. I watched her all the way to Methodist Hospital, a ride that took about 25 minutes. The EMT guys couldn’t get the electrical system to work very well at first and the interior light kept going off and on and the emergency lights on top of the vehicle wouldn’t come on. They debated for five minutes when we were just getting ready to leave Cy Fair Hospital whether they should call for a different ambulance or not. In the end they decided we’d make it OK and we took off and headed for the freeway. I watched Sheri out the window all the way to the hospital and got panicky when they switched lanes and I couldn’t see her for a while before she slid back in behind us. We made it in one piece and due to construction around the ER entrance at Methodist they had to offload me from the ambulance a good 100 feet from the door and literally push me down the street. Finally we get settled into a room for some rest. I’ve now been up for over 24 hours and it’s 2 AM Sep 6. I’m so scared I can hardly sleep and I’m starving but they won’t give me anything but ice chips pre-surgery. It would be 2 days before I got to eat and then that would be from a straw.
As you might recall from the last installment in from the heart I have just arrived at Methodist Hospital at about 1 am on September 6, 2001. I am scheduled to have a triple coronary bypass at 3 pm this afternoon and my wife Sheri and I have been up for almost 24 hours, the last 10 of which were in the emergency room at Cy Fair Hospital. I am scared, tired, hungry, and have a jumble of emotions that dance around in my head like a bad dream. Sheri is not faring much better than I and to complicate things for her our three kids are at home alone awaiting word from Sheri. The oldest one is 12 so there’s no problem leaving them home alone but it worries her just the same on top of everything else going on. They are at home scared stiff because they’re too young to understand exactly what’s going on- they just know that it’s bad. Part of my decision to write this chronicle is for them to have an account to read when they’re older so they will be able to comprehend this dark period.
This part of the story is the one I have been dreading the most- it’s the most painful for me and I have been putting off the telling of it. But if it can help someone it’s worth it and it’s important for me to confront it.
Methodist Hospital is one of the most advanced hospitals in the world and the cardiac care facility they have is second to none. I am so fortunate to live in Houston, the center of the medical world for many years. Upon arrival at Methodist it is only a few minutes before I am in my private room. We decided to spring for a private room anticipating the many long hours Sheri would be sitting with me and it was a good decision. It was a very good thing the company that had laid me off a few months before had a policy that employees over 40 received free family health insurance for six months after being laid off. That policy would end up costing them in six figures in my case. Serves them right.
The morning of the surgery is kind of a blur for me. So many emotions running rampant in my mind. To try and describe them would seem trite, let’s just say I was terrified, and leave it at that. Late in the morning an orderly was sent in to prepare me for the operation. He was a very nice older gentleman and I wish I remembered his name. His job was to shave me so all possible surgical sites were hairless. They usually take the veins from the legs but they can’t tell in advance how easy it will be to find good candidates so I was shaved from my neck to my feet. I have never been so smooth in my life and it felt, well, strange.
In the middle of the afternoon they came to take me to surgery. I thought Sheri was going to faint or something and I wasn’t feeling too well myself. They whisked me to the surgical preparation room where I was at the beginning of this story- part 1. I don’t remember the operating room at all so I was either already drugged when they took me in or I just can’t recall it. The next thing I knew it was very early in the morning.
I’m sure I came out of the anesthesia over time but it felt like I wakened all at once. I remember distinctly being totally aware of the area I was lying in. Hospital bed, ICU open all around me, lots of noise from the many monitors hooked up to me and the other patients. I couldn’t move and that concerned me. At first I thought I was tucked into the bed so tightly so I wouldn’t move but I found at later my hands were restrained. I was miserable because I had a big tube down my throat and it was gagging me. I felt like I was drowning, and the tube was slamming against my vocal cords which hurt like hell. I couldn’t stand it, constant choking and gagging which made me move around and that hurt like hell, too. The ICU nurse that was assigned to me was instantly at my side talking soothingly, telling me where I was and that I was doing well. Like I’m going to believe her with this constant choking. It made me reflexively swallow continually and that hurt even more as the ventilation tube jammed my vocal cords.
In spite of the pain I whispered to the nurse to please take the tube out- "I’m choking, I can’t stand it!" She told me I would only have to have the tube for a little while longer but it couldn’t come out yet. I remember crying for a couple of hours, it hurt so bad and the feeling of constant gagging and choking was just too much on top of everything else. I couldn’t speak above a hoarse whisper because of the tube and I just begged her over and over to take the tube out. Finally she said "Mr. Kendrick, one of your lungs collapsed during the surgery and we have to leave the tube in just in case it happens again. Believe me, you don’t want us to intubate you while awake so you’ll just have to wait a while longer." I’ll never forget that statement as long as I live. I had never heard the term "intubate" before but I’d never forget it now.
Sheri had finally gone home when I got out of surgery around midnight the night before. They told her I did really well and since I was going to ICU she couldn’t visit me anyway so they sent her home. She would have stayed anyway but the kids had been alone so long and were so worried that she decided to go and return early the next morning. She called and asked the ICU nurse how I was doing first thing in the morning. The nurse told her I had a very restless night and kept trying to take the ventilation tube out so they restrained my arms. This is why I couldn’t move in the bed even a little. Sheri asked the nurse when they would take the tube out- she didn’t think she could handle seeing me on the ventilator. They told her it would be coming out soon so she should come on in.
This was the worst time of the entire ordeal for me- helpless, scared, and the choking. I literally thought I would lose my mind- I just couldn’t take it anymore. Finally, after what felt like an eternity, she came in and said "All right Mr. Kendrick. The doctor said we can take the tube out now." Bless him, bless him, bless him. A little discomfort when they pulled the tube out but, oh wow, such instant relief! My throat was so dry and so sore from the tube and I quickly found I still could only whisper when I asked for water. I felt sure my voice would come back soon. Actually it would be another five weeks before I could speak.
Intensive Care Unit at Methodist Hospital in Houston, Texas, approximately 8 am on September 7, 2001. Having finally gotten the ventilator tube removed from my throat I am finally able to breathe and concentrate on my body after the surgery. I am recovering from a triple coronary bypass surgery that ended late the previous evening. I am able to move a little as the restraints that held me motionless have been removed by the nurse. I would find out later that I had been trying to remove the ventilation tube from my throat during the night and had to be restrained to prevent that from happening. I am coming out of the anesthesia and my awareness of the surroundings is surprisingly good. At this point I am very thirsty and my throat is totally dry, no doubt from the tube. My throat is hurting worse than anything else and I’d love a drink of water. The ICU nurse is hovering around me, constantly checking the monitors I’m hooked up to, checking my blood pressure and making sure I’m comfortable. I’m lying in the bed, mentally assessing what’s going on around me, watching the other patients in the large open room.
The ICU is basically a very large open room, with beds in a circle around the outer wall and the nurse’s hub in the middle. Each bed contains a patient and all beds seem to be occupied. Each patient has a nurse assigned so there is a lot of activity in the room all the time. Most of the patients are critically ill, that’s why they call it Intensive Care. I saw one patient die, and several apparent close calls. It’s not a pleasant place to be but I can’t tell you how thankful I am that I am there. There are no visitors- visitation is strictly enforced and only one family member at a time can come in and only at preset times so most of the time it’s just patients and nurses. I remember noticing that none of the patients were speaking- the only voices in the room were doctors and nurses.
I should give a little background on me so you can understand my mentality in the recovery process I am beginning. I have always been healthy, seldom sick and have always been able to recover quickly from illness and injury. I’m just lucky that way. I have recovered from back surgery on two separate occasions, difficult recoveries normally but my body rebounded very well. The hospital experience I gained from those surgeries is coming into play already now, and as I lay in the bed I am mentally mapping out my strategy. That sounds strange but hey, I didn’t have anything else to do.
The ultimate goal for me right now is to get out of the hospital. Hospitals are not nice places to be, it’s impossible to truly rest there, and it’s just so much more comfortable to be in my own home. It’s amazing but I remember this thought process so clearly even now, to say I was focused would be an understatement. I start by trying out my body- I want to know how messed up I am by the surgery. I know I’m obviously pumped full of pain killers so how bad can moving a little be? Very dumb question, as I find out by stirring in the bed a little. I feel like I’ve been hit by a Mack truck. The bed sheets are pulled up almost to my neck as they’ve tucked me in really tightly to minimize my movement and as a result I can’t see what they’ve done to me. I want to see my chest, and I want to see my legs. I remember my uncle showing me his scars on his legs from his similar surgery a few months before and I really want to see how badly they cut my legs to get the veins for grafting. He had scars all the way from his upper thighs to his ankles and it was the worst part of his recovery, at least the way he told it. I’m trying to get mentally prepared for what I’m going to endure and to be fore-warned is to be fore-armed, at least that’s my mindset at this early stage.
I gradually get myself worked out from under the bed covers, it takes a while and hurts like hell but I do it. Such a sense of accomplishment for this minor success but I have to take it a baby step at a time. I really need water now, I’m so dry and my throat’s really hurting and irritated. I call out to the nurse but nothing comes out. I mean, not even a sound. My vocal cords are just not working at all. Maybe it’s just that I’m so dry. I finally get her attention by waving my right arm around and she comes over and I finally get out my request for water in a very low, hoarse whisper. She tells me I can’t have water yet, something about possible nausea from the anesthesia. Of course. No water for me. It takes me a long time as I can only whisper for a few words at a time but I must have made a strong enough case as she brings me a Styrofoam cup with a teaspoonful of ice chips in it. I remember looking at it and thinking- how am I supposed to be satisfied with THAT? She tells me I have to take it slow and just dissolve them in my mouth a little at a time because I can’t have any more. But I’m so thirsty it lasts all of 30 seconds. I literally badger her for a good while until she finally brings me a half cup of ice chips but again tells me not to take too much or I’ll be sick. What she doesn’t know that I do is that I’ve had surgery before and never had problems with anesthesia after-affects. So wisely or not I’m not worried about it. Those ice chips last maybe two minutes, I can’t gulp them down quickly enough. And swallowing really hurts but the truth of the matter I am focused on the ice as the first part of my recovery. One step at a time.
My wife Sheri comes in to visit at some point and I’m eating ice chips and totally coherent which surprises her. It’s literally been just a few short hours since my heart was stopped on the operating table and repaired and yet here I am moving around a little, talking to her and eating ice. Doctors come in and say everything is going very well and I’m promised I’ll be up in a room soon so I can rest. I fell asleep and don’t remember much else of the ICU. I vaguely remember being moved to a regular room and promptly falling back asleep. My wife is there and my Mom and brother, and as I drift in and out of awareness someone says "that’s what he needs is sleep". It would be later before I could take stock of exactly what they’ve done to my body.
If you’ve been following from the heart you know that part 8 left off with me sleeping in my hospital room in Methodist Hospital. I pass into and out of sleep for a while, I don’t have any sense of time at this point. I don’t know if it’s day or night, and while I’m sure the medication that I’m pumped full of must be playing a part in that there’s often a sense of timelessness in a hospital bed.
I finally begin waking up in earnest after a few hours. I woke up all at once again and just looked around the room. My wife Sheri was dozing in one of those recliner chairs that you never ever see outside of a hospital. You know, those chairs that look like they’d be very comfortable but it doesn’t take long to disprove that theory once you sit in one.
The room is very dark and the blinds are pulled tightly to keep all light out. Man, I’d love to see the sun. Sheri looks so tired but oh so nice sitting up in that chair. This has been so very hard on her. I’m wrapped up in the bed sheets again- what is it with these people? It’s as if they don’t want me to move at all, I’m tucked in so tightly. I stir a bit gingerly to free my arms. I want to see what they did to me. My mind is fuzzy and clear at the same time if that makes sense. I know exactly what’s going on and what I want to do but the thought process is fuzzy. I can’t explain it any better than that but the doctor soon would.
I’m so thirsty again but I don’t want to wake Sheri up so I wait a little while. A nurse soon comes in all chipper and when she does Sheri wakes up. We try to talk a little but my voice just doesn’t work- I still can’t speak. I can whisper a little though and it’s so good to be alive. Truly and deeply good to be here.
The nurses pass in and out, constantly taking my vitals and generally making sure I can’t rest at all. As you can see my sense of humor is beginning to come back to me. Several different doctors come through the room, too. The surgeon and the cardiologist both assure my wife and I that I am doing really great and that everything went very well. They indicate I will be in the hospital 5 or 6 days if everything goes well.
Those first few hours in the room I am finally able to check my body and get a feel (ouch) for what’s been done. I get the sheet off and lower the little peekaboo gown they put you in and have a look. I’m surprised there is no bandage on my chest- just a gash about 7 inches long with metal staples closing it. I look like Frankenstein and Sheri looks a little pale at first when she sees it. On my left side there’s a plastic tube that’s been inserted into my abdomen through a little hole they made. There’s another tube on the lower right part of my abdomen through a bigger hole. The surgeon said they were to drain any fluid or blood accumulating in the abdomen as a result of the surgery. They go to a little bag hung on the bed that seems pretty empty. I am very glad about that.
At some point I send Sheri to go get something to eat and check on the kids. She’s been in that room so long she needs to get out desperately. I had an ulterior motive though, I wanted to check my legs. As soon as she’s gone I check out what they’ve done from the waist down and I find a wonderful surprise waiting for me when I look. No, get your mind out of the gutter. I have a catheter that was inserted in the operating room so I won’t need to go to the bathroom but that’s not what makes me so happy.
My legs have been a concern since before the surgery and they are much better than I expected. It’s a testament to how good my surgeon, Dr. Lawrie, really is. I search everywhere but there are no big bandages. There are only 4 small 3/4 inch cuts on the legs. There are two on each leg- one on the inside thigh and one on the inner calf. He was able to extract all the veins he needed for the graft through these tiny cuts. The cuts are so small they are held by simple butterfly bandaids.
I am so relieved and so thankful and just so overwhelmed at everything that I just cry. I don’t know how long I did, but it felt really good.
Those of you who have been following the "from the heart" series may have assumed that I had finished the recounting of my heart surgery experience since I haven’t written another installment in a while. I’ve just been busy and on vacation but I’m back now and it’s time to finish the story. Parts 1 – 9 told the story from my first appearance in the emergency room through just after my open heart surgery. I have just awakened in the private room and checked out all the damage done to my body. Having determined as previously stated that my goal is to get out of the hospital and go home as quickly as possible the next few days I focus on just that.
My surgery took place on September 6, 2001 and the next few days would be pivotal for me, but not for the reasons I expected.
The next few days of recovery in the hospital are somewhat a blur to me. The doctors have warned me that short term memory loss and confusion are both common side effects that patients experience after being on a heart-lung machine such as I was during the surgery. Something about oxygen going to the brain. I find I can remember most everything that happened during those days but rarely in the chronological order they actually occurred. It took a few "arguments" with Sheri before I resigned myself to the fact I would never remember the actual order in which things happened. So, I am going to gloss over those few days and ask you the reader to understand.
These days were spent trying to get out of the hospital- not breaking out, mind you, rather in conditioning myself so the doctors would let me go home. The day after my surgery I got out of bed, and very slowly made it to the visitor’s chair. I sat there for a good 30 – 45 minutes before pain and fatigue forced me back into bed. I really can’t describe just how tired I was. It seemed the slightest exertion could tire me out. But over the next 3 days I was able to start walking in the halls. This was quite a spectacle since I was hooked up to an IV, and still had the two drain hoses in my abdomen that drained into a plastic bag which was hung on the IV "tree". I wasn’t fast walking around the halls pushing my tree but I pushed myself as far as I could and soon was wheeling all around the floor. I walked and I walked until I felt faint, returned to the room and rested, and then walked some more. I REALLY wanted to go home. One time I walked down a tunnel leading off the floor and it took me out of range of the wireless heart monitor I’d been wearing since the surgery. The nurses didn’t find it funny, but I did.
A few days after the surgery Dr. Lawrie, the surgeon, came in for his daily visit and said it was time to remove the two tubes in my abdomen. He told me the first one would be the most "uncomfortable" to remove and he would count to 3 so I could be brace myself for the removal. It wasn’t bad when he pulled it out, in fact it felt kind of weird, like something being pulled inside my gut. He said he’d count to 3 again for the other tube but that it wouldn’t be as bad as the first. He counted 1, 2, and yanked the tube out before I expected it. It was quickly apparent he lied about which tube would be the worst. From the way the tube felt coming out it was in my abdomen quite deeply and all I can say is it really hurt coming out and almost made me faint. But then it was done and I had another tether removed on the road to home.
On the fifth day after the surgery I was sitting in the chair watching Good Morning America with Sheri and hoping the doctor would come by this morning and send me home. He had seemed less positive about that the day before but I was keeping my hopes up. Whether I got to go home that day or not I would remember the events with utmost clarity. The TV show broke for a special report from New York and both Sheri and I turned our attention to the tube. Her sister lives and works in New York so our concern was immediate. Live video was showing the aftermath of a plane that had flown into the side of one of the World Trade Towers. With both of us glued to the TV I remember we talked about how tragic an accident this was and how spooky to be watching it on TV. We watched as the camera rolled on and a second jumbo jet flew directly into the side of the Tower. I turned to Sheri and remember clearly saying these words: "My God, it’s deliberate!" And in those few seconds of horror my own troubles were far away as the tragedy unfolded in front of the entire country. September 11, 2001 would forever change the United States and all who live here.
I got to go home that day, 9/11. Not because I was ready to be released but because all hospitals in the Houston Medical Center were put on alert for possible terrorist activities in the Houston area. Houston is considered a prime target for the cowards that do these dastardly deeds and the hospitals had been told to release all patients not considered to be in a life threatened state. So the one thing I had been shooting for all week finally happened, but it was bittersweet having witnessed the unnecessary suffering and death in New York. Like everyone else in the US I was forever changed by that day. I remember it felt like my soul hurt and my own troubles were so insignificant.
Looking back on that day and returning to my wonderful home, I know now I wasn’t ready to come home. The trip home was very difficult and tiring, and made me realize I was not recovered as fully as I led myself to believe. But I survived it and grew stronger over the next few weeks. Sheri admitted to me much later that I was so pale when I came home that she was scared to death I was going to have trouble. The next few weeks were difficult, especially at night. The trauma to the breastbone was severe and I could not lie down on my back or side, and sleeping was very difficult. I was taking heavy diuretics during the recovery which made me go the bathroom several times during the middle of the night and I came to dread it. Getting back in bed hurt like hell, and trying to get to sleep was hard. But when we have to endure we do, that’s the human spirit, and so it was with me. I started a new job six weeks after my surgery. The pain in my breastbone went away about a year after the operation. My voice returned five weeks after the surgery. The tube had damaged my vocal cords and I spoke in a hoarse whisper until my voice returned.
I have recovered fully due to the excellent medical care I received, the love of my wife and family, and the oversight of someone above. I now know the likely cause of my heart problems was diabetes. I had apparently been an undiagnosed Type 2 diabetic for who knows how long before my trouble brought it to light. I had been given insulin the entire time I was in the hospital (I found out later) as my glucose level was way too high. I now take oral medication for that and to keep my blood pressure and cholesterol levels down. A normal glucose level is between 80 and 120- the day I saw the endocrinologist the first time a few weeks after my surgery my glucose level was 480. 600 is coma. Undiagnosed diabetes is the number one cause of heart attacks in the United States.
I hope this account is helpful to anyone who might be confronted with a similar situation. Trust your doctors and ask lots of questions- it’s the unknown we tend to fear most. Please ask your doctor to check your glucose level occasionally. It’s very treatable with medication now but also deadly when left unchecked. I would like to thank Dr. Cyril Tawa, Dr. Gerald Lawrie, and the countless staff and nurses at CyFair and Methodist Hospitals. Finally, I would like to thank my wonderful wife Sheri. The care she gave me is the reason I made it through this trying time, as surely as the fine medical care I received. She was my eyes and ears with the doctors when I couldn’t do it myself and I wouldn’t have come through this without her. I love you, baby!