#4 We Need to Replace Your Aortic Valve . . . (You're Going to Need to Do *What?!*)
A Cautionary Tale
Okay, this is a column I was going to write and submit for publication around the end
of 2022, but as they say, life got in the way, and I never submitted it and . . . here it is now--a piece of my personal history. I include it in this cavalcade of posts in the hopes it will be informative and entertaining. And know I am writing it from the fairly unique perspective of someone—despite being past his mid-seventies—who had never spent a night in a hospital in his entire life. True'dat. I realize now I have been blessed with Very Good Genes and Concomitant GoodHealth.
What follows is what I wrote several months (early 2023) after my first "sleep-over"
in a hospital . . .
To wit:
As I write this, I am ten weeks past a “corrective surgery” to replace my aortic heart
valve. I had been aware of a condition called a “leaky valve” for the last twenty years, and my doctors had always told me it wasn’t life-threatening, but would probably “need attention” if it started to deteriorate. Yeah, well about six months ago, I realized I was having some big-time trouble walking my dog and traversing the stairs of our 3-storey abode. After such a simple endeavor, I felt like I’d wrestled an Olympic heavyweight or broke the mile record. To say “shortness of breath” does not begin to describe what I had suddenly begun to experience.
Clearly a “WTF” moment. That little voice—the one that occasionally rattles up from beneath that trapdoor sealing off all the Bad Shit at the back-end of our thoughts—said: you better check this out.
Long-short of it, I did.
And the cardio guy said he needed to replace my aortic valve—which basically meant cracking open my chest like a stubborn walnut, hooking me up to the heart/lung machine, and doing amazing things to my stilled heart before inserting a “bovine replacement” in the spot where my worn-out Tom-valve had been.
I must have looked shocked at the pronouncement, which prompted him to offer me some encouragement: “C’mon, you’re going to sail right through this thing. You’re not obese, no diabetes, no respiratory issues, nothing neurological . . . you’re in very good shape for your age.”
I sighed. "Okay, when do you want to do this?" Thinking I was still a few months off from such a disruptive event.
He moused up his calendar, nodded, and said "how 'bout next Thursday?"
Trying to hide my shock of such suddeness, I looked my surgeon in the eye and said "Let's do this thing."
And we were on . . .
1he following week, my dear Elizabeth drove me down to Johns Hopkins Hospital in Baltimore at 6.00 a.m. Now, as I noted previously, by dint of my history of good health all my life (despite slipping and screaming into my declining years), I had not—at the age of 76—ever spent even one single night in a hospital in my life.
Clearly, that was about to change.
After removing all my clothes, a nurse did a pretty decent job of removing all my body hair as well, and the tops of each hand and where they inserted ports through which any and all manner of fluids might pass.
They also created a similar port in my neck so they could mainline other potions into my brain and repaired heart. No idea what sedatives started passing through that pipeline, but by the time they wheeled me into the O.R., I was rockin’ and reelin’ and pretty much ready for anything. I looked around the room crowded with people in scrubs and asked them how they’d all passed that Organic Chem class that I’d failed three times.
That elicited some laughs as the anesthesiologist leaned over me and smiled. “You’re a pretty funny guy, but now, it’s time for a nap . . . .”
Next thing I knew I felt myself rising up from a miasma of confusion and non-localized discomfort that would soon become very localized. I was awake. Alive! And as that thought gained purchase, I realized a few other things—such as there were more things sticking out of me than a porcupine. Tube after endless tube, plus lots of electrodes and wires. Oh, and did I forget to mention the PAIN?
Yeah, there was plenty of that to go around. Just the simple act of taking a breath demanded all my strength and concentration. You see, it felt like someone had taken a minute from his busy day to bury a tomahawk in the middle of my chest . . . then forgot to even yank it out.
A young nurse leaned into my field of vision and smiled.
“Where am I?" I mumbled.
“ICU. I’m going to be one of your nurses. Now, on a scale of one to ten, how high is your pain?”
And you know I had to say “Eleven,” right?
Which marked the beginning of a five-day-and-night stretch wherein I slept in a torturerack-bed (the Torquemada Model 1000) barely able to move, while someone was interrupting my sleep every few hours to take my temperature, my blood pressure, my IV drips, my drains, my urine color and well, you get the idea. I wondered why they needed all the digital probes and monitors hooked up to me if they continued to plague me with all the old analogue bullshit methodologies. In addition, they had me flying higher than a SR-71 Blackbird with the opioids, Tramadol and Delaudid. Five days that felt like one long blur of half-sleep, punctuated by the times they forced me to get up to pee like Secretariat or take ten Passion of Christ steps in the corridor outside my room. I was stunned how weak I had become—so much so that several steps left me breathless and close to vomitous nausea.(What the fuck had they done to me?)
Indeed.
I had no idea what kind of trauma open-chest heart surgery imposed upon the body.
And if I had been some morbidly obese, amorphous, ambulatory bag of suet, how the fuck would have I possibly survived the demands placed on me? I remember feeling truly sorry for those waddling beasts often seen in the aisles of my local Walmart—if I’m struggling to get past this ordeal, surely those poor mooks faced severely reduced odds.
But fear not, dear readers. Even Il Purgatorio has an end, and finally on the fifth day, my doctors proclaimed my recovery so remarkable and successful, they were banning me from their confines—I was going home! The news hung over me like a double-edged (dare I say Damocletian?) sword. Despite being overjoyed to be away from the nightly perturbations of an endless parade of nurses and physicians’ assistants, I was having trouble imagining how I would progress at home with all the stuff still hooked into me (previously noted tubes, probes, and wires).
No need to worry, on the morning of my scheduled departure, a horde of nurses and P.A.s descended on me to literally disconnect me from all the stuff sticking out of me. Removing the EKG sensors and the IV ports (even the one on my neck) proved to be mildly irritating compared to the moment when a physicians’ assistant arrived with the news she was there to remove my drains.
Ah yes, the drains . . .have I failed to mention them in any detail?
Okay, so imagine, if you will, three lengths of flexible tubing—no, not tubing, but rather hoses which appear to have come from Home Depot and the only thing missing are their big old nozzles—and these are jammed into your body cavity for the express purpose of sucking out all the excess fluid build-up in your body cavity and the pleural sac around your lungs. To say they are big and ugly and causing big holes in your chest is . . . well, exactly that.
Yeah, those drains.
I remember thinking of those auxiliary supply apparati connected to the early NASA first-stage liquid-propellant rockets . . . .
“Is this gonna hurt?” I said with more than a modicum of trepidation.
She managed a poorly constructed smile. “Well . . . some people say not so much, but others, well, they say ‘yes’.”
As she hovered over me, replete in her mask and surgical gloves, I said: “So, do you take them out one at a time . . . or all at once.”
“Good question, but trust me, you’re going to want them all out simultaneously.”
I was getting to ask her “Are you sure?” when she pre-empted the query by managing to grasp all three drain hoses with just two hands, and with a practiced move that combined a choreographed lift of her forearms and a leaning back, up and away from my prostrate form, she yanked the collection of protuberances out of my chest.
The equivalent of that old Dive! Dive! klaxon from the old WWII submarine movies suddenly alarmed through my skull and my thorax. What I felt at the moment of extraction couldn’t have electrified me more than a ride on Joliet’s Old Sparky. I mean— HOLY SHIT!
That wasn’t pain, that was simply a whole other dimension of PAIN. I literally saw those stars you see in the cartoon panels and I wavered on passing out. But hey, I guess that's what you’re supposed to feel like when someone pulls your entire innards out through a garden hose . . . .
But wait . . . as they say in those cheesy late-night commercials, there’s more!
As I watched the physicians’ assistant consign the drains to a place beyond my field of vision, I drifted my gaze to the place below my sternum to see what looked like three distinct entry wounds from at least 9mm full metal jackets. Time for another “Holy shit!” from me as a nurse leaned in and says “It’s really okay, they look really clean,” as she applies a think layer of antibacterial ointments followed by layers of gauze and tape.
Then, thankful the ordeal finally over, I saw my wife emerge from the outer corridor with my street clothes in her arms. She’d been waiting outside my room, not wanting to see the ritual removal of the drains. The nurse gave her a quick lesson on how to clean and dress all my chest wounds and she proclaimed my daughter and son-in-law, Mike Palmiotto would be doing most of that because she is not good with that sort of stuff and knows her limitations.
And with that, they slowly disrobed me of that awful ass-open hospital gown, pulled me into some loose-fitting sweats, and lowered into a wheel chair for that long-awaited ride into the elevator down to the parking garage and home.
And when I arrived at said home, I remained as weak as a newborn bird for a week or so, relegated to a reclining camp-chair in front of the gas fireplace and a cheezy Vizio flatscreen.
That would be my world for the next two weeks as I gained strength and moxie.
Within a week, I blew off the opioids and took nothing but Tylenol for the pain—no way did I wish to become dependent on any kind of drugs. With each day, my will to overcome the outrageous body-trauma of heart-valve surgery trumped any pain or temptation to whine and whimper.
Fuck that.
Each day, the pain grew less debilitating, and each day my strength and determination grew stronger. I think I tapped into the same inner reserves that had powered me through the early years of my writing career when every new day brought with it a new freight-load of challenges threatening to derail what I needed to accomplish in my life.
So if you’re thinking: is this guy trying to tell us he’s a tough mo-fo?—you are Fucking-A right I am . . . .
Long story even shorter: I am way past the heart valve surgery, and I can honestly say I wouldn’t wish the experience on even my most despised adversaries. The procedure might be routine, but the recovery is a Bataan death-march, trust me.
So if any of you are facing this, I don't want to scare you—just preparing you for what's in your future. And if you got the right stuff, you're gonna be just fine.
Tom M signing out. But just for now.
Yowza. A terrifying story - well told!
Welcome to the club! I remember finding out (about the same time that you did, actually) that I was about to become the recipient of a bovine valve too. After my ticker woke me up at 1 a.m. hammering my backbone, followed by a month of wearing a monitor and other tests, the cardiac surgeon scheduled a video visit. His first words were, "OK, here's the deal. Without a new aortic valve, you won't live another two years. With the new valve, you can look forward to a normal lifespan."
I took option 2.
And yep, you pretty much nailed the after-I-woke-up scenario. When they took the two electrical leads out of my heart (I felt the leads coming out of the muscle), the nurse said, "Did that hurt?" My response: "It didn't hurt, but it felt REALLY weird. Let's not do that again." And the drain tubes weren't too bad. But they had pre-sutured the drain sites so when the Home Depot Hoses came out, they immediately pulled two sutures on each site and closed them up on the spot.
The nurse said, "There will be just a little sting." Yeah. And Godzilla is a lizard with a thyroid condition.
The high point? The day after the surgery the surgeon came by, did his post surgery tap dance, and asked if I had any questions for him. "Actually, I do. They brought me a pretty decent hamburger for lunch. Does that make me a cannibal?" He looked at my wife and said, "Three more days and he's your problem."
Glad you made it!