Paul's Heart

When The Body Tries To Warn You – Part 6

The day had come. All of my tubes had come out, and my PICC line was removed. All that remained were the telemetry wires, and a huge patch/bandage over my sternum. I wanted my daughters to come to the hospital. I needed to see them. I know that I did not look perfect, but I no longer looked as bad as I thought. Them seeing me in this bed would not scare them.

It is always the hardest thing, what and how much to tell a child is happening. Of course a lot depends on age. And on top of that, at their young ages, they already had a friend who lost their father to a cardiac incident, so how I explained everything would make a huge difference to them.

I was told that my daughters had arrived at the hospital and were on their way upstairs. I felt a huge swell of emotions as this was all I wanted, to see my daughters again, to know that I was going to have a “rest of my life” with them. In the distance I could hear my older daughter talking, noticing everything as she walked the hallway. And then, there they were, standing in the doorway. It felt like forever. You could see excitement in their eyes to see me, but confusion as to “what happened to you Daddy?”

My older daughter walked cautiously around the bed, of course gravitating toward what was left of the machinery, looking at all the blinking lights and numbers. My younger daughter was a lot more deliberate, seemingly moving an inch at a time.

“Hi Girlies! I am so happy to see you! I have missed you so much! Daddy is all better! The doctors took real good care of me, and I am feeling better. I am going to be better!”

It is often asked, “what and how much do you say to a child when dealing with a serious issue?” And the answer is always, you tell the truth, but you keep it age appropriate. My daughters were 5 and 3 years old, and how I greeted them was all that they needed to know. You could feel the collective relief from all of us.

Maddie was still busy checking things out, but Emmy had found her way, lifted up onto the bed. This was going to be a test. A 3-year old has no concept about a healing breast bone, anything could happen. This would not be a blooper if it did. As she sat by my waste, I grabbed her hand, and told her once again, “Daddy is going to be okay now.” A few moments later, she repositioned herself, now laying her head by my pelvis, nestled, almost as if she were guarding me, keeping me safe. Maddie’s inventory of my room was completed, so now there were 5-year old questions to be answered.

I don’t know how much of the environment sunk in to my daughters. But I could tell the impact of them seeing me, not bouncing all over the place completing activities or playing with them. They knew I was not feeling well. But they also knew that what I told them the other night, that I was going to be better. And that is what they saw.

Now I could say that I was recovered, that I made it through this harrowing surgery. Another day or two in the hospital and I was going to be allowed to return home. There was just one minor task that needed to be completed. I am going to keep this from getting too graphic or detailed, but it was still a major issue. I had not had a bowel movement since my surgery. In fact, with stethoscopes, nurses could not even hear any gutteral noises. Again, without going into detail, I have a complicated system, so while this was normal for me, it was still unacceptable to them.

And in it came, “power pudding.”

Power pudding. I had no idea what was in it, but I was told it was guaranteed to make me go. Later I would find out the ingredients, apple sauce, prune juice, and wheat bran, mixed together until it produces a pudding consistency. Sadly, my medical team was disappointed and the pudding did not produce results.

In spite of me not meeting all of the “unofficial” requirements or benchmarks, I was released and sent home, with the heart shaped pillow as pictured in the beginning and above. Its use was to help me protect myself with sudden sneezes or coughs, or any other kind of movements that would put pressure on my breast bone. I still have it to this day, 18 years later. And also 18 years later, I am still here to witness the many exciting memories to come since I have gotten to see both my daughters grow into adults, now on the doorsteps of graduating from college. Had you told me back in 2008 that I would still be here to this day to see this milestone, even my cardiologist admonished me, “it was not a question of ‘if’ I would have that fatal heart attack, but ‘when'” had I gotten there any later.

There have been many times in my survivorship, when I have heard fellow survivors expressing experiencing that similar sensation that I had. Besides being a major trigger for me, I have not been wrong yet insisting on them going to the emergency room, all facing that “widow maker.” This series of posts was quite heavy, but believe me, it could not be any more important. They call cardiac disease the silent killer for a reason, even with symptoms, either because we are scared of what we think could be happening, or in total denial. And it is much better not to take any chance, go to the ER, and let them either diagnose you, or say there is nothing wrong. Just you don’t make the wrong decision.

When The Body Tries To Warn You – Part 5

(image created via ChatGPT)

Again, I need you to read the prior parts of this story so you can appreciate where the next parts of this story are headed.

Once I was taken off of the respirator, I could feel things accelerating. Joe had come into my room to inform me that I would likely be leaving the ICU before the end of the day, heading to the step down level of cardiac care. While it was routine for him to see I am sure, for me, everything was just happening so fast. And I definitely did not feel as if I was “better.”

So it had to be another twelve hours, as Jackie had come back into my room. She was organizing all of the equipment around me a particular way, which I thought was odd. And then she told me, I was being moved from the ICU. Good news for sure, and then she told me how.

“We want our patients out of the bed, and to start walking as soon as able.” Huh? You know I just had open heart surgery, right? I am so weak. I have zero strength. “So, your first walk is going to be to your room. We will follow behind you with a wheelchair in the event you need to sit down…” Sit down? You think? You are out of your mind if you think I can do that. “I will tell you, it is a fairly long walk, especially considering, but I know you can do it. I know you want to do it.” Minutes later, in came a wheelchair and an entire crew or posse.

It took several minutes just to get me to sit up at the edge of the bed, and I was exhausted already. With a group of people all around me, I was asked, let us know when you are ready. As if on cue, one of my greatest defense mechanisms, music started playing in my head. It was the perfect moment, the theme from the movie Rocky was now playing in my head. I was sckooched forward to the edge of the bed, my feet touching the floor for the first time in what felt like two days. And then two of the group stood on each side of me, positioned the wheelchair at the ready, and asked, “you ready?” And I said, “let’s do this.” And the music got louder, more triumphant, more inspirational. I had survived my heart surgery, and these were the first steps I was taking. I stood up from the bed, a nurse on either side of me, supporting my elbows, and then just like in the Christmas special, it was one foot in front of the other. As I exited my room in the ICU, I was given instructions which way to turn. Again, I was warned that I had a lengthy walk ahead of me, the length of two football fields in total.

At the elevator was the halfway mark. As we boarded the elevator, I was encouraged to have a seat in the wheelchair, at least until we got to the next floor. I wanted no parts of that, afraid that once I sat down I would not get back up. Soon the elevator doors opened up, I turned to my right, and there was the next hall. It was definitely a long hallway, and my room was the last one room on the left. Everyone seemed amazed at how well my stamina was holding up. I am certain I was running on adrenaline. Halfway down the hall, one of my nurses explained to me, that I should try to walk this floor at least three times a day, with supervision of course, and then eventually they would have me doing stairs. That was a mistake to tell me as I am a goal driven person, and in spite of how horrible I felt, I knew what I wanted to accomplish to feel better.

By the time I got to my room, I was asked if I would like to sit for a while in the chair or if I wanted to just get comfortable in the bed. I was exhausted. It was a no-brainer. I needed a nap.

I finally had a window, I could see sunshine again. And I could also see what else remained of my Frankenstein contraption with all the tubes and wires. I was starting to figure out which did what and went where. My pain was becoming more managable and more importantly, I got to order my meals off of a menu.

And for the first time, with lesser pain, I began to think of my daughters again. I needed to at least talk to them, let them know I was okay. I definitely was not in any kind of shape for them to see me yet. Oh, how I missed them.

Like I said, things would start to move quickly, especially now that I was in a private room. It was time to remove one of my chest tubes, and the leads in my picc line that measured my heart’s actual blood pressure. The chest tube removal was weird in that my abodmen’s discomfort was because of all of the tubing under the skin. And just like removing my breathing tube, an exhale and the tube was removed and a couple of butterfly strips were applied to close up the hole left behind. Now the leads, that was a different story. I would feel these being pulled from my heart through one side of my body, across the top of my shoulders to the exit of the picc line. It did not hurt, but man it felt weird. And finally, a small electronic box was placed around my neck. It was a portable telemetry device to monitor my heart rate, which was clearly a sign, that I was expected to go for some walks. I did not need to be told twice. But I found out there were going to be some ground rules. I was not allowed to walk alone, for fear of falling. With my chest being split open, a fall would be devastating. The next rule was mine.

Anyone who has ever stayed in a hospital, knows that there are constant interruptions all hourse of the day and night. I think I was on my 3rd night (like I said, I lost my sense of time in the ICU), and finally getting some good sleep. It was around 4am, and someone came into my room, and told me that I needed to get up out of the bed, I needed to be weighed. Riiiiiiggggghhht, at 4am? “Ok, but since you are getting me out of bed, I think I may as well knock out my first walk of the day.” The tech was like, “you can’t do that, you need to be accompanied by someone.” And I said, “right, that would be you.” And she said, “I can’t, first I am not supposed to, and second I don’t have the time.” So I replied, “then we are going to have a problem. If I get out of this bed, at 4am, I am making it worth my while and going for a walk, with or without someone.” And with that, she walked out of the room, and I went back to sleep. My sleep was never disturbed again the rest of my stay, or at least they were more quiet and gentle about it.

The next day, my remaining two chest tubes were removed, as well as that catheter. And let me tell you, that was a weird feeling, and as much catheter tubing that was up the old man plumbing, I don’t even want to think about how they got it all the way up there. All that was left was my picc line. For a brief moment, I thought it was going to come in handy. I had begun to run a fever. Following heart surgery, this is a pretty good sign I was dealing with an infection. So, in came the blood tech and I was all brave like, “okay, here you go, this will be easy with the line,” making reference that they would not have to deal with my difficult veins having this line. “I’m sorry sir, but to do a culture, we need a clean site, in fact two separate clean sites.” I responded, “then you better get a whole lot of help.” I was not kidding, the first draw took 9 attempts and three techs. The second stab did not take as many attempts, but was still stressful.

I was bored. I had already gotten two walks in so far for the day, and I would likely get more in. But located next to my room, was a stairway. And I remembered that I was told that sometime during my recovery, they would have me do the stairs. Well… I was feeling pretty good, bored, but no one was around for me to bug to let me do the stairs. I wasn’t plugged in, so I could just get out of bed with the telemetry box. As I peeked out of the room, I didn’t see anyone in the halls at all. Ok, I wasn’t going to take that much time. I just wanted to see if I could do a few stairs. Into the stairwell I went. I took my time, one step at a time, and found it was actually fairly easy for me. And I kept climbing. Next thing you know, I was at the top of the first landing. I wanted to go further, and so I began climbing the next set of stairs. I got halfway up the next flight, and I heard a door slam open. “MR. EDELMAN! ARE YOU IN HERE?!?” Busted. “Mr. Edelman, please stay right there. You aren’t supposed to be in here, let alone by yourself… blah blah blah.” She was overlooking the obvious, I did it! And it felt good!

And that was how my room got moved to directly in front of the nurse’s station. But even that did not stop me from getting scolded some more. April is hockey playoff month. And the Flyers, my team, was pushing for the playoffs. I had been put on a “no sports” watch for fear of my heart rate or blood pressure going crazy. But I thought, if I kept the volume down, they would never know if I was watching. Right? Riiiigggghhht? After all, I can watch a game calmly and reserved. I was betrayed by my heart, as a nurse came rushing in with my heart rate over 110 as I was laying in my bed. Off went the TV. I had heard the Flyers won anyway.

I was finally starting to feel human again. I was feeling better, and felt I was getting stronger. I was getting back to myself. There was just one more thing I needed to do.

My daughters.

When The Body Tries To Warn You – Part 4

I had been placed onto a gourney to begin the trip to the operating room. My upper torso was at a slight incline, just enough to see where I was heading. I had nothing else on other than the hospital gown and a warm blanket covering me. Through swinging door after door, got onto an elevator, got off the elevator, through some more swinging doors, finally arriving at my destination.

(photo created by Chat GPT)

The operating room was not much larger than this. There was an ante room just off to my left, where I believe all the participants would wash up before entering the arena. Then things got uncomfortable, and quickly. I was hoisted onto the operating table, stripped of the blanket, and then stripped of the gown, laying completely naked in my glory, and definitely cold. And that is not a Seinfeld punchline. Just then two assistants began positioning me and securing me, with my arms spread out in crucifix position. Now my nerves were working overtime. This was really happening. But I could not get any words out. I wanted to change my mind. Soon, both arms were secured and I could not understand why, especially since I would be out cold for this surgery. I began to scan the room for answers, and all I saw was more tools and more supplies, including a coiled up roll of plastic tubing. What they Hell was that for?

Just then, I heard a soft voice off to my right, “my God, he is so young.” As if on cue, I was finally able to speak and blurted out, “I am young! And I have two daughters that are counting on me getting through this. Please don’t let me die.” I could see everyone’s expressions, their genuine concerns and care. And then a voice came through speakers in the ceiling. Off to my right was some sort of control room, and there at a microphone was my surgeon. “This is Dr. P, and I am calling a ‘time out.'” The “time out” is what the doctor does to verify that they have the right patient, and what the patient was going to have done. Now I understood why I had not been sedated further. I needed to acknowledge to the doctor who I was and what he was going to do to me.

As soon as I answered, I went to sleep. I am only aware of what happened and was done, by reading the surgical report, a fascinating detailed report of the extraordinary process to save my life. I was to have a vein or artery harvested from my left leg, and a triple bypass was to be completed. There had been no time to explain to me how this was all to be done, or what to expect afterwards. On one hand, I consider myself fortunate that I did not have to stew and sweat waiting for this to happen, as I have seen plenty of patients having to wait weeks, even months, having to worry and stress about this surgery. I definitely take the “no notice” approach.

(photo created by Chat GPT)

My eyes began to open slowly. My body felt like it had been hit by a Mack truck. I could not move my head, my arms, nothing. I was not able to talk or call out for help. Soon, my eyes began to adjust. My eyes would flutter left and right, trying to make sense of where I was, what happened to me, and why I couldn’t move or talk. Of course, this panic, elevated my heart rate, which brought in my nurse. She could see I was struggling and confused. As I looked around the room, I saw so many machines and heard so many bells and small motors for these machines. I could see that I was also alone and could not understand why.

Her name was Jackie. She was very young, and what an important position she had in her career. Jackie was soft spoken and soothing, but at the moment she could only do so much. “Hi Paul, my name is Jackie. I want to tell you that you are fine. Everything went the way it was supposed to, and you are now recovering in the ICU. I am your nurse. I need you to relax. I am going to explain some things to you. But I want you to try and remain calm.”

Jackie continued, “your surgery went great. You still have a tube down your throat, which is why you can’t talk. It is to help you breath. It will come out soon enough. Your arms and hands are secure to keep you from accidently pulling and tugging at all the wires and tubing. Again, this is temporary. I need you to do a couple of things if you can, using your fingers, answer with one finger for yes, two fingers for no. I positioned one finger and she acknowledged that, and said that she would get me something for the pain. I continued to scope the room, and could not see anyone waiting for me, with me. At this point, my heart rate began to escalate, prompting Jackie to ask me to focus on calming down while she gave me something to help do that, as well as help with the pain. And I was out cold once again.

I am not sure how long that little nap lasted, but when I woke up, there was Jackie taking care of the many bags of fluids that were hanging by my side. She looked and saw my eyes were open, and asked how I was feeling at that moment. I remembered that I was only going to be able to communicate using my fingers, something happened, and was so me.

I took my right pointer finger, and began tracing on my bedsheet. Jackie asked if I was trying to spell something to her and I pointed one finger for yes, and went back to air drawing on the bed. She asked me to start over while she grabbed a paper to write down what I was drawing. Soon she realized, it was a phone number. Jackie asked, “does this number need to be called”, thinking it was a family member, and again I answered with a single finger.

Standing by my bed, Jackie dialed the number, it rang several times, and then someone answered. I’m sure it had to feel awkward what was happening. Jackie spoke, “my name is Jackie and I am a nurse at the hospital. Do you know a Paul Edelman?” I could hear the voice on the other end, “yes, he is my DJ for my wedding this weekend.” If you recall in part 2 of this saga, I mentioned that I had an obligation. Somehow, with all that had happened to me, this was what was at the forefront of my mind and was worried about, and I needed it taken care of. I spelled out a phone number for the nurse to call, and yes, that was from memory. Jackie explained what was happening, and while I could hear the concern from my client, I began to draw again on my bed. Jackie asked my client to hold on a second, and realized I was spelling out another phone number. She asked if I wanted my client to call the number, and I held up one finger. The number my client was going to call, was a competitor DJ, that I knew had multiple DJ’s and would likely be able to help her by replacing me. That was what I was thinking of. Now I could get back to my recovery.

I was remaining calm, though still struggling with pain. I was given heavy duty stuff, as lesser meds would not touch the pain. But pain management is key at this point. Pain equals stress, and the last thing I needed was stress. Jackie felt it was time to explain some more details to me, and that I would be able to handle it. Of course she explained all of the wires to me, telemetry monitoring my heart. I had three drainage tubes coming out of my abdomen and chest, and I had what was called a PICC line coming out of my neck (boy am I glad I was out when they put that in). This line did several things such as delivering meds and drawing blood. This also provided the ability to monitor my blood pressure directly in my heart. I also had a catheter, since I could not get up to go to the bathroom. And then of course, I had the breathing tube, for the respirator, helping me with my breathing. Jackie got done explaining everything and told me, that soon, things would start getting removed as my vitals and symptoms improved. I would probably stay in the ICU anothe day yet. There were no windows so I did not even have a concept of how long I had been in the ICU.

Just then, someone was coming into the room. From the shadowy figure in the doorway, I could tell it was female. She she got closer, I could see it was a familiar face. It was Heather, my nurse from the cath lab. Heather had heard about my surgery and was coming to check in on me and how I was doing. This would not be the only time that she did that. Jackie took the opportunity having the extra hands in the room, to re-position me. Heather went back to work, and Jackie went back to monitoring. The chair in the corner of my room, remained empty.

Of course, anyone who has stayed in a hospital knows what it is like spending time in the hospital, constantly getting disrupted hour after hour for blood or other tasks. My first interruption was a doozy, a chest xray needed to be done. I was still intubated. An army of people came into the room, two people on each side of me, raised the upper part of my bed, securing me at the same time, and once at the proper vertical position, leaned me forward a smidge, but enough to hurt like Hell, got their xray, and then lowered me back down. Jackie gave me something for the increased pain I was in, and back to sleep I went.

This time when I woke up, I had a different nurse, Joe. So without windows to tell time, or even daylight or night time, I can tell 12 hour shifts. Joe informed me that my condition was continuing to improve and that pulmonology would be coming to take me off the respirator. Literally I was going to breathe a sigh of relief, that I had indeed was going to survive this surgery. In the meantime, Joe was tending to my chest incision to change the dressing and make sure the incision was still stable.

I was not awake when the catheter was put into my “plumbing,” when the picc line was put into my neck, when I was intubated, or when the drain tubes were put into my abdomen. This would not be the case when everything had to come out. First on the to-do list, was getting me off life support, the respirator. I’m sure my eyes were bulging out of my head in fear as in HTF (expletive) is this going to happen? And just like that, I was told to take a breath in, and blow out through my mouth, as I did that, the tube was pulled out. Yes, a very weird sensation, not painful, but a relief on so many levels. My throat was sore, but at least now I could talk. More imporantly, I was one step closer to stepping down, out of the ICU. I could be moved now.