Paul's Heart

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.

When The Body Tries To Warn You – Part 3

I arrived by 5:30am as instructed for my 6:30am procedure, to have at least one blockage, possibly more, to be stented via trans catheterization, simpler put, fixing my heart through my leg. As opposed to doing this by open heart surgery which would take weeks if not months to recover, this is why Dr. S said he would have me up and going in a week or two.

My nurse’s name was Heather. She took me back to a holding area, for me to get changed into a hospital gown. And then, again probably the most stressful part of my procedures, trying to get an IV into my arm, you want your best tech to have at me, not one who draws the shortest straw. I had gotten real good at warning techs and nurses that I am a hard stick due to my chemo history, that back when I was treated for Hodgkin’s Lymphoma, ports were not an option (so there, here is my PSA… GET A PORT IF THEY OFFER IT TO YOU!!! It is not worth being stabbed repeatedly trying to find a working surface vein.).

Everything was going smoothly, and quickly. Heather would pop back in frequently to see if I was comfortable or if I needed anything (as in to calm down). I cannot say what prompted me, but I brought up a totally unrelated conversation. “This is the first time I am having anything done since I was diagnosed with Hodgkin’s Lymphoma back in 1988.” I had Heather’s interest. “I went through radiation therapy and chemotherapy, and have been in remission ever since.” Heather’s face showed more than a little intrigue, she had something in her thoughts, and it was serious. I assured her that I was fine, the only lasting issues that I had from it, was that I was not able to biologically have kids, my thyroid was messed up, and that I had no spleen from my laparotomy, so doctors need to take extra precautions to make sure I don’t contract any infections. She wrote down that I was “asplenic”, without a spleen. Turns out this was an important detail (as with any surgery for me). Heather said, “that’s good to know because it is important. We will probably get some prophylactic antibiotics into you before starting.” Okay, made no difference to me. They were the professionals and I had all my trust in them.

At that point, I was given a sedative as I remember nothing after that.

When the procedure was finished and I came to, groggily, I was in a private room. There was Dr. S and a friend of mine who had stopped by to check up on me. My head was woozy, so I know it was hard to focus on what Dr. S was trying to explain. Even with newer pictures and a drawing, I could barely make sense of it, not to mention, apparently take it seriously.

“We were unable to do the stents as the cath revealed extensive scarring to the left anterior descending artery, producing a 90% blockage.” Just then, my friend, who happened to be a paramedic and also happened to recognize in plain English what the doctor just explained medically, blurted out, “oh my God, a ‘widow maker’!” Dr. S interrupted, “yes, but we don’t like to refer to it as that. Paul actually has two other blockages to be dealt with as well, so I have him set up for an emergency triple bypass first thing in the morning.”

I kind of heard everything, but understood nothing. Out of the word “bypass,” I got the word “by” out if it, and just started babbling, “bypass? bye-bye. bye-bye bypass…” At this point, I do remember the clock on the wall saying 3:00. Dr. S left the room, and I nodded back off to sleep.

I woke up a little just after 4pm, not nearly as groggy as I was. On the table next to my hospital bed, were the two sheets pictured above, the photo and the diagram. I remembered vaguely what these things represented. Just then a nurse came in. Clearly I was confused as to what was going on. I had pain in my leg where they went in to do the catheterization (and failed). The nurse recommended that I stay in bed until the cobwebs were definitely gone from my head, and the pressure had gone down in the incision in my leg. I asked the nurse what happened and what was going on.

She explained that when they went in through my leg up to my heart, they discovered that my cardiac system had been so badly scarred from the radiation therapy I underwent back in 1989, making it impossible to implant stents to open up the blockages. There was the worst blockage, the one that was 90%, the LAD or “widow maker,” another that was 40% blocked, and the third, with the right coronary artery (RCA) blocked 30%. I was set for an emergency triple bypass at 6:30am. My head may have been clearer from the anesthesia, but still I was not reacting to this news the way I should have been. I was focused on one thing, two actually, my daughters.

My daughters were only three years old and five years old at this time, but already they had been exposed to the situation of having friends who had lost a parent. Of course, even at their young age, and explained age-appropriately, they still understood the loss their friends experienced, never to see their dad again. And I began to cry. I did not want to die. The nurse tried to console me, eventually giving me something to calm down as I was getting worked up over the situation. There was a lot that was going to happen over the next several hours, pre-op to be done, as well as get my one and only meal in, as I would be fasting as of 8pm for my early morning surgery. The last thing I felt like doing was eating. All I could think about was my daughters.

Just like that it started, in came phlebotomists to draw blood, a wheelchair to take me for an ultrasound of my legs to see which veins or arteries could be harvested for my bypasses. Everything was happening quickly now. And with my head clear, I was also paying attention now to everything being said around me. Up and down both legs they went with the ultrasound wand and a standard thick sharpie, outlining my veins on each leg that they felt were suitable for harvesting. Then it was off to x-ray for a chest pic and an echocardiogram.

I got back to my room around 6:00, food was waiting for me. I did not feel like eating, nor did I think it would make any difference as the next day was going to be without food anyway, well, at least orally. All I could think about was wanting to talk to my daughters. I had to reach them some time before they went to bed. I needed them to know what was going on, what to expect, on a small child level. I had to be careful how I explained everything so as not to scare them, not wanting to remind them of their friend’s father who passed away from a heart attack.

I got ahold of them just before 8:00 when they would be heading to bed. I told them, that I was seeing doctors who wanted to fix me up. They are very nice to me, and have a good plan that after the next day, I will be good as new, and that I would be home a few days after that. Not to worry about me. I was going to be fine. This was the second night in a row I had not seen them, been able to hug and kiss them goodnight. But I let them know how much I loved them and could not wait to see them again soon. The doctors would make sure of that.

I held myself together while I was on the phone with my daughters, and broke down immediately as soon as I hung up. Somehow, I was lacking the confidence that I clearly portrayed to my daughters. A nurse came in and asked if there was anything she could get me, and I said I just had one favor. If there was any chance that I could get a ride down to the hospital chapel. I am not an organized practitioner of religion, but I have my faith. And I wanted to make sure my surgeons were being watched over, and my daughters were being watched over. And of course, if there was anything that could be done to get me through the surgery.

(photo courtesy of IMDB)

At 3am, a huge man, who resembled Michael Clarke Duncan, dressed in green scrubs came into my room. He was there to prep me for my surgery. He would also be my valet to the chapel, and eventually downstairs to the operating room. Just like Duncan’s character in the Green Mile, he was a gentle giant of a man, towering over me. I was beginning to think my age and what I was about to undergo was having an impact on those taking care of me.

5:30am rolled around, and into the room came a gourney instead of a wheelchair this time. Some extra help came into the room, to lift me from my bed onto the gourney. It was go time.

When The Body Tries To Warn You – Part 2

If you haven’t yet, I recommend that you read part 1 of this series, so that you understand how I got here.

I arrived for my appointment on April 16th, early, not out of enthusiasm, but just because that is how I am. An IV was placed into a vein in my hand. This would be used to inject the radioactive isotope for when they would take any pictures for the nuclear scan. Of course, the hardest part of any procedure for me post-cancer, is getting an IV into me or blood draw, chemotherapy having destroyed my veins. Before I would head to the treadmill lab, it was off for my first set of pictures with the isotope having been injected, showing my heart at rest, a.k.a. no stress.

Once that was done, I was connected to telemetry, which would monitor my heart once I got on the treadmill. At this point, there were now four others in the room with me; a nurse, a tech watching the telemetry, and I am not sure who the other two were.

Then it was go time. I climbed up on the treadmill. The “exercise” tech explained to me how the test would work. The test would last approximately twelve minutes (I was definitely confident that I could handle that). Every three minutes, the belt would speed up, and the treadmill incline would increase. This would be done until my heartrate got up to the desired result they needed for the test.

Aaaaaaannnnndddd, go.

Of course as the test began, the belt was definitely slow walk pace, and flat incline. Got to the first three minute mark. And then, the first increase in speed and incline. Almost immediately, I began to get that tightness feeling in my chest and shoulder. But as I was not suspecting anything, I said nothing. I had nine more minutes to go. Then a nurse asked, “are you okay?” I responded, “yes, I am just starting to get that ‘tightness’ that I mentioned before.” The nurse asked, “can you go a little further? We are almost getting to where we need your heartrate.” Confidently with a bit of bravado I answered, “go for it.”

By the time I got to the six minute mark, I had the full tightness and pain in my chest and shoulder as usual. No one was saying anything to me at that point, so I just kept going. And then the belt increased again, and the treadmill raised its angle some more. In less than a minute, the tech said, “stop the belt. Mr. Edelman, you can step down.” All that I heard was that something showd on the EKG, something had happened. I was still oblivious, not connecting how I felt with the result of the EKG.

I was taken back to the lab, for another dose of the isotope, and then back to radiology for another set of pictures, this time, my heart having been “stressed out.” I did not feel any differently, as usual, the tightness and pain had gone away. Once this was finished, the IV port was removed from my hand, and I was told to wait out in the waiting room before being released. In the meantime, I could enjoy something to drink and something to snack on. I was starving.

And then I noticed something. People who had come in to the office after me, were leaving before me. I mean everyone. This was not a good sign. Something did not feel right. Was I forgotten? Then a nurse appeared and said, “Mr. Edelman, will you come with me please. The cardiologist would like to talk to you.” Yeah, this was deja vu, just as I wrote in my book. Cardiologist? Wants to talk to me? There’s nothing wrong with my heart. Right? Riiiiggghhtt?

Dr. S was a young doctor, quite possibly my age, very friendly demeanor, but had a serious message. “I don’t usually put things this way, but I am 100% certain that you have a blockage. The good news is, we can check you right in to the cath lab next door, pop a couple of stents in you, and you will be as good as new in a week or two.”

Blockage? Cath lab? Stents? Couple of weeks? The doctor did not need to tell me what the actual problem was when the Kubler Ross stages had already kicked in. Denial first. And then bargaining.

“Listen doc. I am sure this is serious, but listen, I have a wedding I have to DJ this weekend. How about if I come back Monday after the wedding and we can get this done?”

This was his response, “perhaps you did not understand me, you have a blockage to your heart. Your heart is not getting the blood supply it desperately needs. Time is crucial to get this repaired.”

These are the images that the doctor was looking at. As long as I picked out the right picture from my records, this is a photo of my pending death, or what would like be my demise. Though the doctor did not put it in those words.

Ok, the doctor had my attention. I would forget about arguing about the wedding. The doctor was saying I would be good in a week or two, if I got this done, and doing stents were going to be that easy, I was sure I would still be able to pull off the wedding anyway. But I was still not done tryin to gain some sort of control by bargaining.

“Look, this really caught me off guard. I need to go home tonight, I need to wrap up a few loose ends. Most importantly I need to see my daughters. I’ve never been apart from them, and I need them to know I am fine.” The doctor replied, “okay. Just please, do nothing else at home. Just relax, get here first thing in the morning.” So I replied, “perfect. Nothing but relaxing. In fact, I’ll spend time relaxing mowing my lawn.” His actual response, “are you an idiot? Didn’t you hear me? I said nothing but relaxing.” I interrupted, “but mowing the lawn is relaxing to me.” I could tell from his expression I needed to rethink my idea of relaxing.

It was an hour drive home, and it still really had not hit me, “I’m going to have heart surgery tomorrow morning.” How could that be? I’m too young for this. I’m in good shape, I’m happy, things are going good for me. This isn’t right or fair.

When I put my daughters to bed that evening, I told each of them how much I loved them, hugged them, and kissed them goodnight. I explained that I would be gone in the morning before they headed off for school and daycare, but that I would see them afterwards. We had never been apart from each other, and it was not going to start now.