My Once Broken Heart

This should have been published November 23, Thanksgiving day. I slack.

Six months ago, 180 days, my heart was not beating. My blood was being diverted through a machine. My lungs were made to function by a machine. I had two large tubes running into my body. More would be added later to *remove fluids the other two were allowing in.

Sixish hours later I was in the recovery room. I would find out later that the procedure itself was text book success. My mitral valve was functioning like new. Woo-Hoo! The post-op complications that came later, as soon as the next day were another thing. Think; ‘The surgery was a success but the patient died’ sort of thing. No, I did not die, all the way anyway.

There was one part in particular that I wanted to share about. I was told this would happen by one or the PAs that work alongside the surgeon. In recovery, they will use medications to wake you and check that your brain is functioning. A cognitive test. Apparently, you can throw a blot clot during surgery and have a little stroke or something, damage your brain. The thing is, they wake up while you are still intubated. That tube is there, down your throat so a machine can breathe for you. When you are awake, it feels more like it is choking you than helping you. A LOT more like it is not helping. They do this, leave it in, in case you are damaged and then they can quickly knock you out again. Faster and easier than re-inserting the tube.

This is an AWFUL sensation. My remarkable ICU nurse Britany was trying to convince me I was OK. How? buy saying repeatedly, “You’re OK. You can breathe, just take big gulp-like breaths.” It works. Taking a gasping breath in gets you air.

The logical, front part of your brain understands this. The little reptile portion of your brain that is responsible for reactions, for keeping you alive by initiating the flight or fight response to things, that makes you pull your hand away from things that can burn you, etc., that part of your brain doesn’t know or care. To it, you are choking to fucking death and it is filling you with adrenaline and fear. I recommend not experiencing this if at all possible.

This part went on for far too long. Long enough in fact I was able to curtail my panic and laugh, as much as possible with a tube down my throat while gasping, gulping for air. I do not recall now what was funny, only that amazing nurse Britany said to someone, “I think he is laughing at you.”

They removed the tube and rolled me off to Cardiac ICU out of recovery. I had passed the test. I wanted to say the first test but I do not know if it was the first one or not. Just the first one I recall. The next test came the following morning and it did not go so well.

I was woken up at 5am by the X-Ray guy and his portable machine. This became a regular thing for the days I was there, both in the ICU and regular room. It becomes important later but, I am ahead of myself.

Nurse Britany came in doing her nurse thing a couple hours after my X-Ray and informed me “We are going to sit up, see how you feel.” Sounded good to me. I was comfortable. No pain or discomfort at all. Also, not feeling drugged at all either. Felt normal except for the big tubes below my rib cage, I could feel those.

Now, it is important to know that there were two IV ‘towers’, one on each side of the bed. There were several little grey boxes on each one with a different medication in each. There were at least eight and maybe more, I did not count. They all fed into a big tube at my collarbone. (This is my recollection. I think they left that one in place until I left ICU.)

The time to sit up had arrived. She explained this cool way to put my elbow on the bed, make a fist and push down on it with my other hand. Sounds odd and I explained it poorly but, it works great! A small push and I was sitting right up. Feet over the side if bed, pretty decent posture, zero pain or discomfort. Then the alarms started.

I heard them but at that same moment, other things distracted me. I was suddenly covered, head to toe, with a cold sweat. My entire body got cold, clammy, and damp. The sensation you feel when you are about to vomit. I did not feel sick. I was going to comment to Britany that I did not feel right when everything started to go dark. From the outside in, my field of vision was collapsing in on itself.

Now there were more people in the room. One of the was telling me I needed to lay down. I could hear her but could not move. I had t turn my head to see Britany. It looked like I was looking through the tube from a paper towel roll, somehow with both eyes. The dark was closing in. Britany was moving her hands quickly around the array of boxes on the tower. I do not know but assume someone else was at the other tower.

The person that had been telling me to lay down had their hands on my shoulders pulling and pushing me gently to try and get me down. I had heard her but could not move. The weird sweat felt gone but the darkness was still spreading. The alarms were off and I was flat looking up at a very small part of the ceiling. I felt myself gasp, take a very big breath, like I had been underwater for too long.

My vision was coming back. Two people left the room. My surgeon walked in. “What happened?” Nurse Britany said, “His pressure crashed.” Doc, “How much?” Britany, “70 over zero.”

Doc came over to me, “How are you feeling?” Me, “Fine now, but…” and I proceeded to tell him what I felt happened. Then I asked him, what was that, what happened. Doc, “You died a little.” He turned, talked a bit to Britany, and left.

Well, that made perfect sense. I had all the exact same “You’re fucking dying!!” alarms going off as I did when they had woken me up while intubated. Only this time, I could not move, react. I was kinda paralyzed. I was absolutely terrified. I knew I was dying. I felt like I was dying. I was watching everything fade to black.

I asked amazing nurse Britany, “What the fuck was that? What did he say?!” I was feeling pretty normal by now. As normal as possible considering.

She explained to me that dying, the process of, is basically your blood pressure going to zero. What mine was trying to do just a few minutes before. (This whole thing was 4-5 mins) So, she says, “Yes, you were trying to die, did kinda die a little. But, I had you, was ready with the drugs!”

It did not really hit me, sink in for a few hours. Maybe the meds, I was not processing the best.

I had “Died a little.” The day before my heart was not beating. I was not breathing for myself. Then, I tried to die for real.

That was the first of a few post-op complications, including trying to, dying a little about six hours later. I will share those stories in other posts, this had gotten bothersomely long.

It’s been too long!

The last time I was here I wrote about my broken heart. Something discovered before I had a spinal fusion procedure done. (L4-S1, not a lot.) I had intended to write about that a lot. Pre, Post, Recovery, all of it.

Not much to say though. I spent one night in the hospital. After one night at home, I had debilitating muscle spasms develop in my upper back and neck. Go to the ER two times kind of bad. They could not find one fucking Valium in that whole hospital!! Not one!! (Did you know Valium is a pretty good muscle relaxant too?) 48 hours of what I will unashamedly call MISERY.

If you are having any surgical procedures, I suggest not doing it anywhere near a long weekend – especially New Year’s Eve. NO FUCKING BODY IS AROUND IF SHIT GOES SIDEWAYS!

Tuesday the grocery store pharmacy opened at 9am. Had a 10 mg valium in me before 10 am. Another four hours later. (supposed to take every six, I know.) Six hours later took a half. Problem solved. Never too another pain pill after that. No big ones anyway, perhaps half a dozen Tylenol that first month.

Was terribly bored and frustrated by all the restrictions and the really brutal winter we were experiencing. The medicos told me to walk as much as I could, wanted to. They also told me, do not fall down. If you do, and you break the very fragile bones in your spine where we put those big screws, there will be nowhere to put new ones and then I would be really screwed!

I am fortunate that I work from home. Dull desk job thing. One of the other no-nos, to avoid blood clots in legs, is sitting too long. So, every thirty minutes I was up and walking, like a fucking hamster, back and forth along that thirty-six feet for twenty laps. Then, back to work. All. Day. Long.

That was the worst of it. The procedure itself went well. No problems there. I felt fine from the moment the spasms stopped. No back pain, at all. Not leg pain or numbness anymore. Barely notice the loss of flexibility. Then again, I have not done much in the way of rehab because whenever I tried to get into it hard, the fucked up heart valve intervened. Was pretty discouraging.

Well, this post was supposed to be about something entirely different. The back surg stuff only to get you caught up on me. However, it got long and messy and dull. So, I will end this one here and make the other another post altogether.

I say this a lot but, hope to live up to it now. I will be writing more, posting more.

Peace-Out-Boy-Scout!

Ant-Knee

Death By Interaction

There exists in nature a variety of heavy metals that, with repeated exposures, can build up in the body and become life-threatening. Arsenic, Lead, and Mercury are a few examples. While exposure to a lot of one may be immediately harmful, the slow build-up can be as bad if not worse. This is why eating too much tuna is bad for you. Or making hats in the 1800s. Eating paint chips for much of the 1900s.

I believe the same is true for me and social interactions. I posit that when I was conceived there was a preset number of human interactions my body was going to be able to withstand before it failed.
Depending on your outlook, it may have been a good thing my family was not very demonstrative. Myself, as far back as I can recall I did not like to interact with them much, physically, socially or in any other way. Was just not a family kinda kid, youth or adult.

The day will come however when the total number of interactions reaches its terminal quantity. The straw that breaks the camel’s back if you will.

One day, there I’ll be, in the grocery, knocking on a melon trying to determine its readiness to be eaten when, a random acquaintance will come up from behind me, place their hand on my shoulder and say, “Hey, Anthony, how have you been?!”

And, that will be it. I will simply expire, both the melon and I falling to the floor. That touch will have been the final touch, the one to take me to the predetermined number of interactions I am allowed. Kaput.
Maybe even just the greeting could do it; I am not sure.
“Hey, Ant-Knee!” and boom, dead. Clean up in produce, isle 2.

There is of course no scientific way to test this. It is just one of those gut feelings. I’ve had them before regarding other things that were dead-nuts accurate. Also had them that were completely incorrect. Some have yet to be proven right or wrong.

Are gut feelings subject to time limits? Topic for another time.

All I know is, if I should suddenly and without explanation simply die sometime, please make it part of my obit, “Whoever you were that saw him last, you are not to blame. You were simply the last of an unknown number. You were the Ka in the inevitable Ka-Boom of his time.”

Wouldn’t it be ironic if the recovery room nurse were my Ka?

Peace,
Ant-Knee

My Broken Heart. (really, it is!)

The whole of 2022 I have spent with doctors, nurses, physical therapists, lab technicians and, of course, billing departments.

The problem with the back has progressed to the point that surgery is required to make life livable. I’ve heard a million and one horror stories about how surgery made things worse. Having had one successful one already, I am hopeful that this one will be as well. Do what the doctor says and do not do what he says not to. Do the rehab, the way and at the pace told to. It worked last time.

I did over the years not always do things the way I should have and allowed my sorry ass to get out of shape while not keeping core and back muscles strong and limber. I 100% own the condition I am in. Well, my back anyway.

During the run-up to surgery, there are a few things one must do. “Pre-Op” testing. Usually pretty basic stuff. At first, I thought I had ‘passed’ it all with only a false positive hiccup. Not so.

The heart murmur was cause for further testing, not necessarily concern. Did the chest X-Ray and sent me off for an echocardiogram. A simple, non-invasive procedure to see how the heart is functioning. Aside from the cold stuff they put on the wand, easy thing to get through.

I received an email that my results were in and I could check them by logging into my records account. A new and handy thing. I thought. 

One paragraph, three sentences with the most important part being “results are within normal ranges”. 

I thought I was good to go. Just kick back and count the still very many days before the procedure date. 

I thought wrong! Very wrong.

Call from the surgeon’s office, “hey, you are on hold until we find out about this bad heart valve situation”.

“Excuse me?! What bad valve are you talking about? My report said, all good.”

Why they got the info and I did not was on my mind but not at all what I was interested in knowing at the moment. Suddenly I was much more interested in the report they got. What does it say, exactly? What does it mean, exactly? DuFuq is wrong with me, EXACTLY?!!

Well, they of course refer me back to my primary who reads the report and I am no closer to knowing anything than before because I do not speak doctor. As to what it means for my surgery, he does not know either. Has to get it in front of a cardiologist to review. 

A day goes by. Cardiologist “You can have your procedure but, once that is done, you need to come to see me so we can discuss a course of action.”

What I know is this: I have ruptured Chordae tendinae. These tiny things are responsible for closing (maybe opening too) the Mirtal Valve. If they are ruptured, the valve does not close all the way and you get regurgitation. Blood going back the way it came through the not-closed all-the-way valve. I get it. I understand it. But…

How did this happen?! How is it that after no less than 8 times I was checked out, with a stethoscope, this year, the last time was SEVEN DAYS before the day doc says, “Oh, how long have you had a heart murmur?”

How did no one hear it before then? I asked the doc and he says, “Well, we don’t know when they ruptured.”

OK, fair point. So, what causes these to rupture then? 

There is a list of things, not too long and not too short either. 

NONE of those happened to me in the seven days prior. Not. One.

In an effort to not stress myself out over something I literally have zero control over for now, before my surgery to repair my spine, I stopped looking into whats, hows, whys and whats to comes. 

All I know is, my heart is broken. No one can tell me how it broke when it broke or why it broke. Just another thing to look forward to once my back surgeon signs me off. To meet with a heart surgeon. And start the pre-op shit all over again. 

Because we are Mortal now.

My life has been an accumulation of many experiences altogether to many of which were physical injuries. A great majority of those were all my fault. From falling into, out of, off of, onto or any combination of those. I have been damaged. For as long as I can recall I have liked to go fast. For the same amount of time I have not been good at one essential part of that; stopping.

From minor cuts, scraps, bruises to stitches, broken bones, bad sprains and strains I have been tended to and repaired many many times.

In mid-1996 I had to have a back injury repaired with surgery. At the time I was concerned about two things only: 1) will this make the pain go away and 2) how will it affect my racing, how long will it keep me off the bike? There was zero thought as to how will this affect my quality of life. What are the chances this will lead to the end of my life? Not an unreasonable question. Surgery is always a potential killer. Just a fact. But, not one I even considered for one second. Not one.

I woke up, I did what I was told and I got better. I did not go back to racing and I have always regretted that but it has nothing to do with my injury/surgery/recovery. Still mad at myself about that.

Now, when you have a compromised skeleton, there are things you should try to avoid. And, you will avoid them, if you are not a complete dipshit. I, however, am mostly a dipshit. I did not keep in the shape I should have nor did I avoid the things I should have.

Now, 26 years later I am slated to have another back surgery. This one will be more invasive, more corrective, more limiting to my function afterwards. Just, MORE. Hardware, artificial discs, my bone and cadaver bone ground into a paste. Just, MORE.

Sitting with the surgeon we go over the what to expects and the what coulds.

What to expect number 1. “This will help with the major pain and problem you have been having. However, as far as your back pain overall, we are hoping for a 75% improvement. Could only be 50%”

Hmmm. I have been used to a fucked up back for many years already so, if the crazy sharp pain and falling over because my leg will not hold me is fixed, even 50% is OK with me.

2) “This is not the same surgery you had before. It is MORE. (see above). Although the recovery time is essentially the same, something tells me that is just the basic recovery and the real-time will be longer. Again, I’m OK with that. I have at the time of this writing been down for four weeks and have five more to wait before the procedure.

3) “Fusion will limit your mobility, forever” I knew that. I get that. I just do not know what that actually will translate to. Only two levels, L4-S1 but how much do those levels bend, twist, move when you do things like, tie your shoes, trim your toenails, put the cat food bowls down? I guess that is an unknown.

There were other what to’s but none to write home about. Oh, “You will have a drain in your incision, held in by one suture, you will need to have that taken out after a week.” I need to find someone to do that for me.

Then we went on to the what could happens.

First, all surgery comes with the risk of infection. This is why the pre-op test included MRSA. That shit will fuck you up right before it kills you. Embolisms are another one. Accidental injury to the spinal cord. Oops! Lots of could happens.

Anaesthesia. He was very quick and direct. “Risks of anaesthesia, heart attack, stroke, death.” Good talk.

After my surgery in ’96, the doctor limited me on sitting. Very little time allowed to sit daily for six weeks. He even suggested I find a ride home in a vehicle I could lie down in. I assumed it would be the same for this one too. And, I made a plan for it.

I happen to be well acquainted with the mortuary owner here in my small town. I asked if he would mind making the 100-mile drive in the hearse to pick me up. I have this visual of being rolled out in the requisite wheelchair to the front door, getting up, then laying down on the body cot (he is also Deputy Coroner and has a couple of those) then being slid into the back of the hearse for a flat ride home.

My surgeon laughed a lot and said, if I do it, he wants to be there. Several people actually want to be there to see, document it.

Then, something funny happened. It crept up in my mind that, the same man that would make my exit so very funny would also be the same man, with the same cot, would be there if any of the coulds happened. After all the pre-op tests came back good enough to proceed, any one of those coulds could still happen. And I would be riding back here flat, in the back of one of his vehicles.

For the first time I can ever recall, I was intimidated by a possibility. By a what if. By a maybe. By a could. I confided in a friend, my best friend about it. I was confused and alarmed by it. This is just not me! DaFuq is going on?

His reply, “Because we are Mortal now.”

I don’t know when it happened. Somewhere between July 4th 2022 when I was drinking and blowing shit up with no worry at all and a week after I turned sixty, I began to think I was mortal. I have an expiration date. I have always known that but, now, for some reason, I actually knew it. Accepted it. Expect it.

A profound and simultaneously subtle change has occurred. And I do feel different now. I look back on so much, and it is all so different now.

Because we are Mortal now.