Paul's Heart

Heartversary #16 – Part 3, The Grand Finale

Since 2008, April 18th has always been the most difficult day for me to get through. Sixteen years later, it is no different. For sixteen years, no, thirty-five years including my cancer fight with Hodgkin’s Lymphoma, I have dealt with so many health situations, and went through one of the most tumultuous divorces involving the custody of my two daughters, but it is today’s date that remains the most difficult for me to recognize. I know many mean well when they say, “you just have to let it go.” But anyone who has ever gone through trauma even once will tell you, there is no just letting go. You can’t. And as many close to me discovered from my book, including my doctors, there was so much that I kept buried deep inside of me all of these decades. Sadly, there is still so much more. In any case, here is part 3 of my 16th Heartversary.

I never did get to sleep the night before, my thoughts evenly balanced between the surgery early in the morning, and the only thing that mattered to me, seeing my daughters again. Just after midnight, a large figure appeared in the doorway to my room, the hallway behind him darkened, so all I saw was shadow. I was confident that it was not the grim reaper however.

This was Michael Clarke Duncan pictured above in one of his greatest roles, in The Green Mile. The gentleman in the doorway resembled Duncan and at the moment, that was not the only similarities that I was noticing. Although he was not the one being escorted, this man was here to escort me. He would be doing the final preparations with me, like “shaving” me everywhere, and I do mean everywhere. And since comparatively to the picture above, I could be compared to Tom Hanks picture to the left of Duncan. Clearly I would not be putting up any kind of fight.

Once he was finished, I asked him for a huge favor. While I am not an actively practicing man of faith (I really do not care for organized religion, but I do consider myself a Christian), I asked him if he could roll me in a wheelchair downstairs to the hospital chapel before it was time to head to the operating room. He said that he could do that. And I just sat in the chapel meditating for about a half an hour before the orderly was contacted to bring me back to my room. It was time.

It was 5am and I was brought down to a holding area, where I was told to remove everything, and slipping a gown over top of me, but not tied. Once I was moved to the operating room, the gown was removed, leaving me in all my God-given glory for all to see, quickly being draped with several cloths. Extensions of the operating table were opened, which would be used to support my arms, which would be positioned extended and out, as in a cross formation. There was so much activity going on, probably at least a dozen people, nurses and other staff. I had not seen my surgeon yet. Looking around there was so much machinery and equipment. This had finally caused me to become overwhelmed, as this stuff was all for me.

I could not see anyone’s faces, as they were all already prepped for the surgery in this sterile environment. But a nurse, likely seeing fear finally in my eyes began to ask me questions, name, birth date and stuff, then moved on to some relaxing personal questions. Just then, I heard someone else beyond this nurse make the comment, “oh my gosh, he is so young for this.” And that quickly I responded, “I am young. I am only 42 years old. And I have two daughters that I so much want to see again. Please make sure I get through this.”

I do not remember much after that moment. I am guessing my vitals were going bonkers and they sedated me. The next time my eyes would open, my heart would finally be working the way it should be. Though clearly I have no recollection of what happened during the surgery, reading through the surgical report was like reading a Jules Verne science fiction novel like “Fantastic Voyage.” The most jarring of notes, stopping my heart and draining the blood from it, and filling the heart with a cooling fluid to save the heart while the bypass was completed, all the while a heart-lung machine kept my body alive. And then, the heart was filled with warm blood, and the heart was “shocked” to begin beating again. There are a lot more details in the report, but that is the short version of what happened.

I awoke for the first time, in the intensive care unit, completely disorientated. I was terrified as my movements seemed to be limited, I was unable to speak, and all I saw was a darkened room, with lots of machines and tubes, blinking lights, and then finally someone approached my bedside. It was my ICU nurse, Joe. Though I looked around for my family, I saw no one, just Joe. He had explained that the surgery went well, and I was now in the recovery phase. But I was still panicking, which left him having to re-sedate me.

There is so much more to this story, which I go into more detail in my book “Paul’s Heart – Life As A Dad And A 35-Year Cancer Survivor,” which is available on Amazon, so I do not want to bog down the post. But the spoiler alert is, here I am, sixteen years later. I ended up having only two bypasses done, as the doctor felt that with the other two completed, the other (the RCA) would correct itself. Unfortunately, with my radiation history, the RCA did not correct itself, in fact, needed to be corrected eleven years later. There are different opinions on how long this bypass would hold up, but on average it seemed to be between 10-15 years. Well, I am on year sixteen officially, and following my 3rd heart surgery a few years ago for another issue that had been seen originally but not corrected, the status of my bypass is still holding up quite well, and appears that I will have likely at least another ten years or more hopefully.

I cannot stress enough, if you feel any of the symptoms that I described in the beginning of part one of this series, and it does not matter if you had Hodgkin’s Lymphoma or not, do not hesitate and waste time, get to the emergency room. As I mentioned, one of my survivorship issues is PTSD, and it gets triggered each time I hear someone mention the very symptoms I was experiencing. Because I will never forget that. My father, who suffered a major heart attack, was a life-long smoker and had a diet of fried fatty foods. He described feeling the worst unrelenting heartburn and then the worst pain in his left arm. I was not having those symptoms, so I was not thinking about a heart attack. But the symptoms I was having, were bad enough to need medical attention.

As my cardiologist would put it, “it was not a question if you were going to die, but when.” In retrospect, I was able to recall that I was having those symptoms for at least four months, the same symptoms, chest tightness for 30-60 seconds, then relief, but an out of control heartrate. I was mowing my lawn, shoveling snow, moving equipment at work. I felt this feeling every time.

So when I see someone post these similar symptoms on my news feed, I immediately tell them they need to go to the ER. Four of my fellow long term Hodgkin’s survivors were faced with these symptoms, and all four ended up with the same emergency bypass surgery, some with more bypasses, some with less. But I do believe that their lives were saved, just as mine was saved, because the right person, like my doctor, made the right call, as unusual as it was for someone my age (and the ages of those four survivors), because of that call. Any further delay could have been fatal.

But here I am today, getting to experience so much with my daughters, sixteen years later, my daughters now adults, doing adult things, me getting to watch.

Though I hope you never find yourself in this situation, if you do, I hope you remember my advice and warnings, to get help if you feel any of those warning signs. Thank you for reading “Paul’s Heart.” Your support and encouragement in my survivorship means so much to me.

Heartversary #16 – Part 2

As I promised Dr. S., I arrived at the cath lab on April 17th, 2008, before the sun even came up. My daughters were still asleep when I left the house, but I made sure to explain to them the night before in details appropriate for a three and five year old to understand, “daddy was just going to be away overnight, and would see them the next day. Though the procedure was expected to be routine, just the mere thought of doing anything with the heart, let alone going up through the leg to fix it, was quite overwhelming. I hugged both of my daughters as long as I could without losing control of my emotions, with the fear of “what if” something went wrong.

The cath lab was nothing remarkable, a typical medical environment, meant for outpatient or simple overnight stays. As I was taken back to the holding area to slip into hospital garb, my nurse, Heather, began asking me pertinent questions about my health, oddly things I had not thought about or discussed in a long time, things related to my Hodgkin’s Lymphoma nearly eighteen years earlier, like not having a spleen or my chemo and radiation therapies. I have no memory of anything else, until I began to come to in a different room. Even under the fog of anesthesia, I could tell I was no longer in the cath lab.

At the foot of my bed, was a family member, a friend who had stopped by to check up on me, and Dr. S., my cardiologist. As my vision came into better focus, and my ears became unmuffled, the first words I heard were, “a major blockage of the main artery, the left coronary artery is blocked 90%.” Just then, my friend, who happened to be a paramedic, spouted out, “oh my God, a widow maker.” To which my cardiologist responded, “yes, but we don’t like to refer to it as that. We have Mr. Edelman set up for an emergency triple bypass at 6:30 in the morning tomorrow.” All that I managed to get out of that was the word “bypass” to which I joined in the conversation, “bypass? Bypass. Bye Bye. Bypass.” I was clearly still “flying.”

(this is what I refer to as the actual photo of my “death”, showing where the actual blockage was located and just how bad it was)

(this was the diagram my cardiologist used to explain how bad my situation was)

My cardiologist went on to explain that as soon as I was more alert, I needed to undergo preparations for the surgery the next morning. They would need to do an ultrasound of my legs to determine an artery to use for the bypasses, among other testing. I was obviously still not understanding what was about to take place.

Approximately two hours later, around dinner time, I only know this because I was approached with a light offering of food, I was encouraged to eat as I would be fasting for the surgery as of 8:00pm. But with the fog in my head now clear, and realizing what I was now up against, eating was the last thing on my mind. I did not want to die which was now clear, was a possibility from the situation itself, or quite possibly from the open heart surgery.

But there was something bigger on my mind, my daughters. They were only five and three years old at the time. We had really just begun our lives together. And as much as I did not want to lose them, I did not want them to have the pain of losing their father. I had never been apart from my daughters since they were adopted, and this night, would be the first of several, that I would be away from them.

I was getting upset, mostly for my daughters. I wanted to hug them, see them, tell them I was going to be okay. But I could not. They were more than an hour away, and I did not own an I-phone or I-pad that I could even see them. I could not give them one more hug that I so desperately wanted to give them. The best I could do, was talk to them on the phone.

Following my “dinner”, everything started moving quickly. I was lifted into a wheelchair and taken to various rooms for bloodwork, ultrasounds, x-rays, and CT scans. It was getting late, and I began to get upset, not because of the looming surgery, I wanted, no, I needed to at least speak to my daughters before they went to bed. I needed to assure them that I would be okay.

“How was school today?”, I started off. “I miss you. I’m sorry that I could not see you after school but I have something very important to tell you. Daddy’s heart is broken and is getting fixed. I’m going to be in the hospital for a few days, which is kind of like a hotel but with a lot more helpers in it, until I get better, and I will. The doctor will make everything better. And then you can come in and see me. And then I get to come home.” I needed to keep it on an age-appropriate level, but they also needed to know what was happening. They took it in stride. I had always been there for them. “Ok Daddy,” they both said.

“I love you Maddie. I love you Emmy. I love you both so much. I will see you both really really soon.”

It was now around 10:00pm, and there were more preparations for the early morning surgery. Everything was happening so quickly. Oddly, I was not scared. The biggest threat to my life, death, was imminent, as well as the possibility of not surviving the surgery. With the way everything was happening, I had no time to dwell on what was going on or about to happen. In a way, that was a good thing. I have seen so many others have to wait weeks or even months for their surgeries, torture, waiting for the time to come. My life would never be the same again, in less than eight hours.