This post comes from the VERY well written Tim Nichols.
SYMPTOMS
“Last autumn I was leaving on a weekend trip to Pennsylvania to celebrate my mom’s 85th birthday. Along the way I couldn’t shake a nagging concern that I was having really really mild chest pains. I was about 90% sure that I was imagining the whole thing and it felt like a histrionic hypochondriac to stop and do anything about it. But I started thinking about the fact that if I did ignore it and had a heart attack on the way down I could kill other people on the road besides myself. I stopped at an urgent care center and paced around the parking lot, still not wanting to go in until I noticed that my right arm was also numb so finally did. A short time later I found myself having my first ever ambulance ride to a nearby hospital. To make a long story short, they couldn’t find anything, my heart function was fine and a few hours later they sent me home.
Was God trying to tell me something? And if so, what?
As a follow-up to that episode, my conscientious primary care physician sent me to have a stress echocardiogram (“Let’s just have it checked to be on the safe side.”) So a few weeks later I found myself lying on a hospital bed with a very pleasant nurse talking softly and running a sonogram device across my chest to get a baseline reading before beginning the stress component. After a bit she asked “Has your doctor talked to you about this murmur?” That was the first I’d ever heard of it. When I said I knew nothing about that she said “I think I’d like to have cardiology listen to it before we continue.” Someone from the department came down and started running his stethoscope across me. “Do you hear it? the nurse asked. “I think I could hear it just by putting my ear to his chest,” he exclaimed, and then added “I don’t think we want you on the treadmill yet, don’t, let’s have you come back and see the cardiologist tomorrow.”
He told me it was one of the most severe cases he’d seen and couldn’t believe that I hadn’t come in with a walker and oxygen tank.
The next morning, still not especially alarmed I left for work, and tried to think of what I would fix for dinner that night when I got home. I assumed the cardiologist visit like the ER visit a few weeks earlier would be nothing. I’d vaguely heard of people having heart murmurs before but didn’t think it was anything very serious. But my chat with the doctor was very brief, he listened to my chest (I had no idea yet then how many stethoscopes I was to encounter across the next two months) and said “I’d feel better if we admitted you and did a heart catheterization.” So the nurse walked me down to the ER, I called friends to bring me my phone charger and pick up my car. My aunt went over to take care of my pets. I sat in a little examining room for a long time and the nurse apologized for taking so long and said, “your ride will be here soon though.”: “My ride?!” I asked, “where am I going?” “Didn’t anyone explain?” she asked, “A ambulance is coming to take you to Strong Hospital in Rochester, you need a more elaborate cardiology department than we have here.” For the first time it started to sink in that perhaps this was going to turn out to be more serious than I’d anticipated. I called the school to say I wouldn’t be there the next day and called my family to let them know what was going on.
Later that evening I found myself on my second ambulance ride on the two-hour trip to Rochester. I was hooked up to monitors and a blood pressure machine. After I got admitted the first thing I started to notice was that it was about 10pm and I hadn’t had anything to eat since a cup of soup for lunch at school about 11 hours earlier. I was feeling a little out of sorts until a pizza delivery man arrived with dinner ordered for me by my wife and kids.
TESTS
The next morning I got, for the first of several times, a conscious sedation drug which I actually really liked! Apparently I was awake but it made the 90-minute catheterization feel like 10 seconds.
That afternoon a member of the cardiology team came up to give me the results. Severe mitral valve regurgitation. He told me it was one of the most severe cases he’d seen and couldn’t believe that I hadn’t come in with a walker and oxygen tank. He said I would need open heart surgery as soon as it could be scheduled. Until you’ve had the phrase “open heart surgery” used on you, it is fairly hard to imagine the fear that it strikes. Then he began an even more terrifying explanation of the alternatives of a mechanical valve or a tissue valve replacement and to discuss the fairly serious downsides to both alternatives, complete with their impact on my life expectancy. I could hardly believe my ears. Wasn’t it only yesterday I was teaching school, living a normal life, and had never even heard of a mitral valve? Three years earlier I’d been diagnosed with prostate cancer and survived that. Was God trying to tell me something? And if so, what? I sure didn’t want a third lesson.
If my valve problem hadn’t been caught when it had, it would quite likely have ended my life.
They sent me home with instructions for no driving, no going to work, no exercising, no doing anything really except sitting and lying until surgery. I felt like a ticking time bomb. Pretty quickly I reached the decision with go down to Virginia where my wife and two of my kids are (long story) and have the surgery there so that they could care for me during my long recuperation. My wife identified Sentara Heart Hospital in Norfolk, Virginia and she and my daughter jumped in the car and drove to NY to pick me up. As I wandered around the house that night, packing, anticipating a 6-7 week absence and trying to come up with lesson plans for a sub to finish the semester for me, I found myself wondering if I’d even make it back to my house, my dog, my students alive. Would I still be around for Christmas? The surprise diagnosis had really knocked me for a loop.
The next day we drove to Virginia and went straight to the Emergency Room. They determined to admit me and keep me on a monitor until my surgery could be scheduled. They repeated the tests I’d had run back in NY and added a couple more, so lots more amnesia drugs. I had to have a tooth extracted, and along the way, to my relief, I met my brilliant young surgeon, Dr. George Dimeling. He turned out to be a real expert in his field and a real godsend for me. He set my mind at rest and told me that he would try his best to do a repair rather than a replace (the previous hospital had thought that a replacement valve was inevitable. For the first time in several days I felt like I could breathe again. They scheduled my surgery for Nov. 20 – eight days after I was admitted. Once I was safely in the hospital, hooked up to monitors, and actually feeling just fine, I ended up being able to more or less enjoy my hospital stay. The staff at Sentara was absolutely lovely, the food was great–it felt more like room service. I had a million channels to watch including one that showed “Scrubs” all morning. The booming hospital was adding 4-5 additional floors onto the roof and I could watch that, the Norfolk navy harbor and the heliport for the hospital right outside my window.
Along the way, I learned several interesting and surprising things about my situation:
- My arteries were entirely clear, I had no coronary artery disease whatsoever (I’m a vegetarian)
- Doctors explained to me that if my valve problem hadn’t been caught when it had, it would quite likely have ended my life.
- The chest pains I’d experienced back in September were unrelated to my valve problem – whatever they were, they had served as a lucky break, getting a sharp doctor and sonogram technician to catch my valve problem.
- My good health and exercise regiment had probably been what saved me.
- One of the doctors asked if he could bring a class of student doctors in to listen to my prolapse. “Yours is SO pronounced, it is even easier for them to hear since you are young, lean, and fit. (Uh, could I have that inscribed on a trophy please?) A whole roomful of stethoscope-wearing young doctors came in the next day to take a tour of my chest.
SURGERY
Finally my surgery day rolled around. I hadn’t slept at all the night before, besides nerves, the nurses came in to help me with a disinfecting shower and a full-body shave (yes, even there) I took one last look at my unopened chest, knowing it would never look the same again. I couldn’t have anything to eat or drink after midnight. I was getting used to that as it had also been the case for my various tests and procedures. Dr. Dimeling said it would take 4-5 hours and that he’d come out and brief my family when they got to the halfway point. I don’t remember very much for at least 24 hours after the anesthesia started to work. The one thing I do remember grasping through the fog of anesthesia was that Dr. Dimeling had been able to repair rather than replace.
After surgery I had trouble with “bradycardia” (an irregular heartbeat – slow) so I stayed for three days in ICU before being transferred a coronary care floor. The bradycardia cleared up only to be replaced by atrial fibrillation. They monitored me for several more days and at one point the doctor managing my case came in and told me they were making plans to give me a pacemaker the next day. I could barely stand the thought of another setback, another surgery, and another complication. I thought (incorrectly) that a pacemaker would make me even more infirm and at risk. Why did I feel like an 80-year-old man all of a sudden? But when Dr. Dimeling stopped by he said “No, I don’t think you’ll need one. I think your heart is still going to right itself. It is still recovering from the trauma of surgery.”
I spent another 11 days in the hospital after surgery, including Thanksgiving Day. I kept going into A-fib. The first time it happened a swarm of nurses and orderlies rushed into my room to hook me up to monitors. A week later we were all just yawning when it happened. Then one morning, much to my surprise, Dr. Dimeling stopped in and said“We’re sending you home today!” “What about the A-fib?” I asked. “Oh, that has gone away.” he replied. I wanted to kiss him in gratitude but I contented myself with asking for a picture with him and having him autograph my heart pillow. I’ll always be grateful to him for saving my life, he’s a real hero in my book.
RECOVERY
By the time I got back to my wife’s apartment on Day 12, the worst of the recovery was behind me. I started trying to walk a little each day, I couldn’t believe how much better I felt at the two-week mark (just as Dr. Dimeling’s PA had told me.) The regiment of pills and worrying about keeping my sternum safe and learning to sleep on my back were probably the hardest part of those early days. They’d sent me home from the hospital with some strong painkillers, but I never needed them.
I wasn’t sure if I’d ever get home at all, let alone in time for Christmas, but by 30 days after surgery they’d told me I was fine for the drive home as long as I stopped and walked every two hours. So my wife and I drove home to NY. I’m a Christmas nut and was a little sad that I’d done no shopping, decorating, cookie-baking, or cards. But when we pulled up to my house, my kids had come in early and decorated the whole place – inside and out. I’d never seen a more beautiful sight in my life!
I went back to work at seven weeks, started Cardiac Rehab and directing the spring musical at school at ten weeks and now I’m writing this three months out of surgery. I feel great, I’m grateful for my new friends in my Facebook support group, I’m forever grateful to the family and friends who cared for me and gave me so much encouragement. I’m forever grateful to the doctors and nurses at Sentara, and most of all I’m happy to have my life back. It would be a great honor and privilege to be able to help any of you out anytime with any advice or encouragement. “
You can find the online support group Tim mentioned HERE.
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