Paul's Heart

“Hooper, We’re Going To Need A Bigger Boat”

It is early morning, April 17th, 2008. It is considered a cakewalk, routine surgical procedure. Insert a camera into my groin, obviously not a Sony DVD cam, but a tiny camera that would traverse through my body to locate exactly where any blockage, or blockages would be, and then place a stint to open the blockage(s).

It had been nearly twenty years since my last surgery, a laparotomy for staging my Hodgkin’s Lymphoma, but this was not going to be anywhere near as invasive or disruptive. In and out, on the same day, perhaps just a little sore.

That was how it was supposed to go.

I woke up from my anesthesia at 3:00, to see Dr. Chris at the foot of my bed, telling my (then) wife as well as a friend who stopped by to visit me, “we have your husband set up for emergency bypass surgery tomorrow. He has three confirmed blockages, but the most important one is the LAD. It is blocked 90%.” Then my friend blurted out, “Oh my God, it’s a widowmaker.” Dr. Chris recognized the term and quickly chided her saying, “we don’t really like to use that term, but yes, you are correct.”

The main artery going to my heart had grown damaged over the years from the major exposure of radiation therapy, nowhere near what is used today. Dr. Chris put it simply, I have to be the luckiest man alive. It was not a question if I was going to have a fatal heart attack, but when. Four months I had the symptoms and ignored them.

The next several hours flew by, as I was rushed from pre-op test to pre-op test. Finally around 11pm I was allowed to be left alone, but in four hours, I would begin to be prepped for the biggest surgery of my life.

Lace ‘Em Up!

So it is April 16, 2008. I am supposed to report to the cardiologist’s office to do a treadmill exercise and have some imaging photos done. I have still not made any kind of connection to the chest tightness, being in a cardiology office, and an imaging study. I was not in excruciating pain like most others that I have heard having a heart attack. I was one of the first patients in the waiting room. I was starving and definitely sleepy with no caffeine in my system.

The first thing I had to do for this test, was to go back to a prep area, where a catheter was inserted into my arm so that a radioactive dye could be injected for the imaging part of the study. Once that was completed, it was off to the x-ray table where the first set of photos were taken, without any stress upon my heart (again, I still had no idea that is what was being looked at).

With the first set of photos done, it was off to the treadmill. I was not sure what to expect. I had all kinds of wires hooked up to me to allow for an EKG to be done during the “walk” and a blood pressure cuff had been placed on my arm. It was explained that every three minutes the belt would speed up, as well as the incline would increase. I did not know how long the test would go. But it did not take long to stop the test.

Something happened on the EKG with my heart. No one would explain what, but after just two minutes the test had been stopped. Of course me being naïve, thought, “hey, this wasn’t so bad.” I was taken back to the waiting room where I was allowed to have some milk and crackers, and wait for another round of pictures. Another shot of dye pushed through my veins, up on the table I went, and then sent back to the waiting room again, to be told that I was done for the day. That is not what happened.

Instead, as time went on, I watched one after another, who came in after me, leave before me. Now my cylinders were clicking. Something was wrong. And just like that, a nurse called out to me, and took me back to an exam room and said that the doctor wanted to have see me.

I will call him Dr. Chris for the purpose of his privacy, came in and introduced himself. He offered me this – “I don’t usually guarantee something like this, but I am 100% certain you have a blockage.” I was like “a blockage of what?” And that calmly he told me that the pictures showed that during the treadmill test, blood was not reaching my heart as the dopplar colors had shown. But he was confident in his diagnosis and what he wanted to do. “I want you to check in next door right now into our cath lab, and we will set you up for tomorrow morning, pop in a couple of stints and you’ll be good as new in no time.”

I was really confused now. Basically there was a blockage in one of my arteries somewhere, and they would insert a catheter into my groin with a camera to locate the blockage and place a stint to open the artery. Not something that a 42 year old male was expecting to hear. Of course, the alternative was not an option, possibly a heart attack or something else cardiac related.

But just as the Kugler-Ross stages of grief, I went right to bargaining. “Look, I need to go home and take care of a few things. I will come in tomorrow morning, but I need to go home tonight.” He told me that he really did not think it was a good idea, but had no issue as long as I just went home and relaxed. Of course, my idea of relaxing, “great, I just wanted to get my lawn mowed anyway.” Dr. Chris just looked at me and asked if I had poor judgment issues. Mowing the lawn may be relaxing for me, but definitely not what the doctor had in mind.

Dear Mr. Franklin,…

Ben Franklin is given credit for the quote about two things in life are certain, “death and taxes”. Well, today of course is D-day for income tax filing and if you were one of the many rushing for the post offices by 6pm, I hope you made it.

For me, although as of late I have been an income tax procrastinator, today’s date means something more to me, and yes, it is the other certainty spoken of by Ben (as I used to call him as he walked the amusement park that I worked for back in 198whatever – Dorney Park), death.

You see, in the beginning of April of 2008, I made a telephone call to my family practitioner. She kind of knew who I was (only kidding, having been my physician for decades, she knew who I was, but I was a very rare visitor). I had been having an uncomfortable feeling in my chest during my workouts, mowing my lawn, and at work. It was a tightness that would only last approximately forty-five seconds to a minute, and then go away. And off I would go, continuing my workouts for the next hour and a half, mowing my lawn for two hours, or continued pushing and pulling 1000 pound pieces of equipment (it was on wheels, I am no Adonis).

But this symptom had gone on for well over four months when I made that call to my doctor. It had finally annoyed me enough to make that call. It was unusual for me to make any kind of complaint about discomfort as I have a high tolerance for pain. And it was for that reason, unbeknownst to me, that my doctor made the call herself (or her nurse) to set up a “nuclear stress test”. I had not idea what it was for. I just knew that I was to prepare for it on April 15th. I was told I would be exercising on a treadmill so I needed to have workout clothes and comfortable shoes, and definitely no caffeine.

For the second time in my life, I was being led down a path, which I did not know the direction, nor was I suspicious.