Paul's Heart

Life As A Dad, And A Survivor

Going Home

It was a surreal feeling. I was being discharged from the hospital, back in April of 2008, after having a life saving emergency double bypass for a “widow maker” blockage of my heart. I was 42 years old. This was when my life, and my health, would change forever.

I was too young for this to happen. Everyone was saying it in the operating room. I heard them before I fell asleep from the anesthesia. When I awoke, I was attached to several machines, one of which was doing my breathing for me. As time would pass, and I would be expected to begin moving around, I discovered that in less than 48 hours, I had lost all of my strength from being confined to the hospital bed. I had countless people making a fuss over me, from techs taking blood, nurses monitoring vital signs, and of course, plenty of visits from residents, and therapists, physical and mental. My life would never be the same.

A hospital chaplain had even come into my room the day I was discharged, not to preach to me or spread Gospel, but just to prepare me mentally for the possible emotional waves I could (and did) face, to understand they were real, more importantly, normal.

It may sound cliche, that as I was rolled out of the hospital in a wheelchair, climbing into my car, as a rare passenger, not the driver, but I did feel as if I had a new start. Physically, at least as far as my body and looks, they were still the same, but everything else about me felt different. Though not consciously doing it, I could tell that things were appearing to me differently, giving me a new sense of appreciation. I was noticing details on the ride home that I had never seen before, or had not remembered in a long time. I guess this would be where the reminder “remember to smell the roses” would apply.

I could walk. Clearly I was weak physically. My mind was clear. I knew that I was about to die, and the steps it took for the doctors to save my life. And I wanted to do all I could, to recover fully, and quickly.

I had not seen my golden retriever Pollo in almost a week. We had never been away from each other. On an average day, upon my arrival home from work, he would get up on his hind legs, front legs on my shoulders as if to give me a hug hello when I came in the door. I had no idea what to expect when I walked in the door for the first time at that moment, but I was definitely concerned that I could not survive a full-on “where the hell were you” excited ambush from him. What I got instead, surprised me, but then solidified the best friend I knew that I had in him. As the front door opened, he stood in the kitchen doorway, perhaps with that “look, (where were you?)” which quickly turned to “glad you are home,” as he calmly walked up to me, circled around me, and then just stood against my left leg. He “knew” something had happened and was not right.

From there, I positioned myself on our couch, and my (then)wife turned on the television, so she could catch her daily soap opera. I have seen these two shows in particular over time, when I could not avoid it, and this was one of those occasions. I never pay attention because the story lines are all the same, for some reason, until now.

In this particular episode, one of the characters, a woman, was having open heart surgery. Very quickly, it became too much for me emotionally. I lost it, completely breaking down. My wife came rushing into the family room, “what is it?” I could not even get the words out, just pointing to the screen, but even she was not able to understand what I was trying to get out. I had never felt this way. But seeing on television, albeit in lesser detail, what had literally just been done to me, was too soon. I had my first flashback from the surgery of many. Welcome to the world of PTSD, post traumatic stress disorder. As I found out, PTSD did not just affect soldiers of war.

My first few weeks at home, I had a visiting nurse, documented my vital signs and weight, and as instructed, went for daily walks. Unfortunately, as I went for those walks, which happened to be along a main road which led to where I worked, and would now be out sick for a lengthy period of time to recover from my surgery, several of my co-workers spotted me. They decided to notify management that they had seen me, that I looked “great,” and were frustrated that I was not back at work yet, clearly “milking my absence” according to them.

Now it should be clear, the orders to return to work, were 3 to 6 months post surgery, and that was between me and my doctor, and the health services/HR department at work. This was day 3. While cardiac wise, an average patient might return to a less physically demanding job in three to four weeks, I had a very physically demanding job. And with one major issue that complicated my healing process, a history of radiation therapy to the chest area, and a freshly cracked open breast bone for the surgery, that breast bone would take additional time to heal. I knew that because my doctors told me that. Evidently some of my co-workers felt they needed to know this information as well. But even then, they were judging me on my shell, what the only thing they could see about this situation, since my heart and breast bone were internal, I looked great on the outside, now get back to work.

It actually got worse with my employment as time went on. Although I was protected by both the Americans With Disabilities Act and the Family Medical Leave Act, that did not stop me being sent a termination of employment notice less than the minimum three months ordered by my doctor, unless I returned to work, as the protection of the FMLA had expired. Though I knew my legal rights, and was prepared to fight them as hard as I could, that would not help me in the short while, if I were to lose my income. Knowing that I could count on a handful of workers to watch out for me, and help me as needed, I needed to convince my doctor, to go against his own recommendations, and release me back to work, knowing full well, I risked either reinjuring my rib cage, or worse, impacting my heart and recent bypass. I still needed to complete my cardiac rehab, but without my job, that rehab would never happen as I would have lost my health benefits.

In the end, nobody won by my early return to work. A bitter management failed to dump the perceived dead weight and an adversarial advocate for his co-workers, and as for me, my health continued to decline, perhaps even quicker. Had I to do the whole recovery over again, I am not sure I would have wanted my doctor to let me go back to work sooner than I was ready.

Which brings me to a story many of us have been following since it occurred more than ten days ago, Buffalo Bills’ Damar Hamlin. Collapsing on the field of a regular season football game with playoff implications, going into cardiac arrest, which normally would lead to death, on national Monday Night Football, on January 2nd, Hamlin, was transferred from an Ohio hospital to a Buffalo hospital a little over a week later, and after completing some more tests, was sent home for the rest of his recovery.

Anyone watching the final season game of the Bills last weekend, saw the opening kickoff returned for a touchdown by the Bills, clearly building from the emotional lift given by communications directly from Hamlin himself to his fellow players. Any fan who has seen a serious football injury, and to be given inspiration by that player, or just as in the movie “Rudy,” inspiration is definitely a powerful thing. The Bills won that game, and now the playoffs begin.

Of course, all of the chatter has been, will Hamlin be able to return to football? Should he return to football? What about the playoffs? If there is anything you read in my situation, you can make no mistake, if Hamlin had his way, he would be suiting up for the Bills playoff game against the rival Miami Dolphins. But also, just as in my situation, there is likely a lot going on through his head, though I am sure he wants to return, even with the cliche “lightning does not strike twice,” will not ease that shadow hanging over Hamlin if he decides to return. As a football fan, I have seen plenty of players reinjure themselves or have their play impacted worrying about a reinjury.

Make no mistake, what happened on that football field January 2nd to today, is nothing short of miraculous. I know I was not allowed to watch hockey games in the hospital because of what it did to my heart rate, so I was really surprised, though not really, he was allowed to watch the game this past weekend. But I am sure he will be watching this Sunday, even more so, wishing he was able to play. I think no one would begrudge the Bills getting more emotional inspiration from Hamlin during the playoffs.

Most football injuries are serious, but this is the first time, the NFL almost had a fatality during an actual game. If Hamlin wants to come back, it should definitely be on his own terms, and definitely when he is ready.

Did He Really Ask That?

The news this morning for anyone following the health situation of Buffalo Bills safety Damar Hamlin, who collapsed on the field following a tackle, suffering cardiac arrest, having to be actually revived on the field, is GREAT! After being treated in the intensive care unit, sedated while in critical condition, this 24 year-old “kid”, is awake, and communicating. In fact, as of yesterday, he spoke with his teammates via Facetime, after the breathing tube had been removed, a truly astonishing moment, something both fans of sports and non-fans had been hoping to see for this young man.

Two days ago however, while Hamlin was still intubated (connected to a breathing machine), Hamlin was still able to communicate, via writing, and it is what he “asked” that left some scratching their heads as to his priorities, others thinking “that’s who he is,” and others wondering if there was anything wrong. You see, the last thing Hamlin remembers is playing a football game. No one has mentioned if he remembers the play that almost killed him. But he does remember he was playing a game. Though I am sure it is gently being explained to him, where he is, and why, I am certain, there was a lot of mass confusion for him when his eyes opened.

“Did we win the game?” That is reportedly one of the first things Hamlin was able to communicate with assistance. While all of us watching, are worried if he would even recover, Hamlin was worried about the game result. But again, there are factors here to understand. Sure, the game mattered to Hamlin, and he likely had no idea how serious the situation was. But his brain has likely not processed everything either as to what has happened.

The truth is, we have likely seen a situation ourselves like this before, though hopefully not as severe.

Both of my daughters required tubes placed in their ears as infants/toddlers for relief of chronic ear infections. My older daughter woke up with no issues from the anesthesia. But my younger daughter came to with a confusion that left her confused and hysterical, not waking up where she last knew she was (the recovery room as opposed to the hospital bay where she fell asleep). Her reaction could not have been any more terrifying to her.

I have my own experience as well, and a bit more detailed. In general, I handle anesthesia fairly well. But when I had my emergency double bypass for my LAD blockage, caused by the damage from my Hodgkin’s Lymphoma treatments decades earlier, that was a different story, and somewhat similar to Hamlin’s situation.

I was just coming out of anesthesia that was for a simpler procedure, a catheterization, that was just going to place some stents where the blockage was. The surgeon was explaining it could not be done after all, that instead, I was set up for emergency bypass the next morning at 6:30am. Though my head was foggy, I remember most of the conversation. In fact, I remember much of the activity the rest of the evening as all kinds of tests were being done on me to prepare for the early morning surgery. I remember the large, burly orderly sent to “clean me up,” and take me downstairs. He was the size of Michael Clark Duncan in The Green Mile, definitely not getting any struggle from me.

My last memory of that morning, was laying on a table, completely naked with a blanket covering me. My arms were being secured in a position to allow the surgeon to perform the bypass. I saw so many people walking around, preparing all kinds of materials and equipment I assumed was for me. Then the last thing I remember, and it was a comment made, “he’s so young, too young for this,” referring to me being 42 years of age at the time, but nearly 20 years after my treatments. And then I was out.

I awoke temporarily, evidently panicking, unaware of what all had been done to me, which I recall barely, and was put back out again. The medical staff could not risk anything with my newly repaired heart. After a time, I came to again, this time, a nurse was standing in front of me. I could not see around her. I also could not move. I could not talk. But I could hear her.

“My name is Jackie. I am your nurse. You are doing great Mr. Edelman. I want you to remain calm, and I will tell you everything you need to know. Your surgery is over. Everything went well. You have a tube down your throat which is helping you breath, so you are not able to talk. That tube will come out sometime soon. You will hear a lot of machines, they are all monitoring you. For now, you can communicate with me by blinking your eyes, once for “yes” and twice for “no” as I will only ask you “yes or no” questions. Do you understand me?

I blinked one time. I made it. I survived the surgery. I have no idea what happened, as nothing was explained to me prior. Actually there was no time. I nodded back off to sleep. Obviously, I had been given more pain medication, as it is likely my heartrate was getting to high again.

When I woke again, Jackie had been standing by my bed, performing her care tasks for me. I reached her with my right hand, giving a slight tug on her nursing uniform. She smiled and told me again, everything was okay. I was doing great, as expected. This time, however, I was able to motion, back and forth with that same right hand, finger pointing, as if something was of concern to me. Very much reminiscent of Hamlin. Like him, I had something on my mind prior to my cardiac event.

If you go back to my story “CABG, Not Just A Green Leafy Vegetable,” I had a “priority” of a wedding I was to DJ for. I never had the chance to notify the bride what was going on, and that she would need to find another DJ, just days before her wedding.

I began to make a motion with my right pointer finger, it should be noted I am left handed. I started drawing on my bed with that finger, Jackie realizing I was trying to communicate with her. She soon realized I was trying to write numbers. And then, she recognized I was giving her a phone number. My “then” wife, was nowhere to be found, at least by my bedside, Jackie wrote down the numbers she believes I wrote, and asked “is this a phone number?” I blinked “yes.” “Would you like me to call the number?” Again, I blinked “yes.”

And so, Jackie dialed the number into her phone. Someone on the other end of the line answered. Jackie asked the other person on the end, “do you know a ‘Paul Edelman’?” The person clearly answered as I could see the shock on Jackie’s face, and then she repeated what was said to her, “he is your DJ for your wedding this Saturday? (just two days away)”. I gave the “ok” sign with my hand to tell her it was okay for her to tell the person on the phone, I was not sure if it was the bride or the groom she was talking to, what had happened to me.

As Jackie was doing this, I tugged again at her, and again began to “draw” with my pointer finger. Jackie asked the other person to hold as she tried to interpret what I was writing. I actually wrote another phone number, this one for a competitor DJ who I felt might be able to bail me/us out. Jackie asked if I wanted them to call the number, and I blinked “yes.”

Once the tube had been removed, and I had been moved out of the ICU, I reached out to the newlyweds, apologized profusely for the inconvenience, which they were totally understanding about. They were shocked I had the wherewithall, to reach out to them, evening having the phone number of a competitor in my memory, given what I was going through.

So for me, it came as no surprise, that the first thing that Damar Hamlin was concerned about, and when able to convey, was “did we win the game?” This was definitely a huge sign that he was hopefully on the road to a full recovery. Though there are no details about what he actually remembers, from the tackle, to the collapse on the field, to finally coming to in the ICU, he clearly is able to recall what he was doing, playing a football game. And depending on what had been explained to him since his awakening, he is focused on getting back onto the field. Which for the fans, his teammates, the teammates of the team he was playing against, and the NFL, the game was the furthest thing from everyone’s mind, except for Hamlin.

We do not know yet, what Hamlin’s recovery will be, nor, any lingering effects from the event. As a cardiac patient and survivor myself, the days ahead are crucial to be careful, and to pay attention to every detail. Some are beginning to ask if he can ever play again, much like Chris Pronger of the NHL continued to play for years after he took a puck in the chest, dropping him, much like the way Hamlin went down. Who knows Hamlin’s future? But what we do know, that the preparations by the team medical staff made a life and death difference that day, resuscitating Hamlin on the field. His chances of survival and recovery are so much more better because of the Bill’s trainer.

Many of us have been on the other ending when it comes to the failure of the heart, especially with someone so young. And we wish there definitely could have been a different ending, and would do anything to bring back that loved one. That pain we feel is all the more reason, we need to find comfort and joy, that Hamlin’s story appears to be going in the right direction. 42 years was “too young” for what I went through? 24 year-old Hamlin was too young for a cardiac event like this. But it happened.

It’s About The Human, Not The Game

This morning, many of us, are getting an unexpected anatomy lesson of the heart. Though the catalyst occurred as an injury during a professional football game, the discussion around most breakfast tables and office water coolers is much more consuming.

Last night, the Cincinnati Bengals hosted the Buffalo Bills, in what was considered an unofficial “playoff game” with the end results affecting playoff positions for each team. In what looked like a normal tackle that football fans had seen thousands of times before, would soon become an event that no one would ever forget. Upon completing the textbook tackle, Bills Safety Damar Hamlin got up, as if to prepare for the next play, and suddenly fell backwards, unconscious. Hamlin is just twenty-four years old. And I use the verb tense “is”, because although reports claimed he went into cardiac arrest following that tackle, and needed CPR, and was revived on the field of play, he is currently being treated, in critical care. Everyone is concerned for this young man, and hopefully his full recovery.

Young man. Heart issue. Where have I heard these two phrases together before? Oh, that’s right, as I laid on an operating table at the age of 42, preparing for emergency bypass surgery for a fatal condition I was unaware I had, caused by treatments for my Hodgkin’s Lymphoma eighteen years prior. Since 2008, I have had two more additional heart surgeries, and will likely undergo more in the future. My purpose for stating this is not to say I am an expert, as I am not, is not to compare the situations, as they are not similar, but to say, I understand what is being explained as to what happened to this young football player.

Again, the play itself looked fairly routine, even if a bit more high energy, because it looked like a big play was being stopped. But as powerful as the heart is, its activities are often silent, or unknown to us. We go through our daily activities without giving the beat of our heart a second thought. It is something that just happens. But as myself, and plenty of other long term survivors of Hodgkin’s Lymphoma will tell you, there is so much more to the beat of a heart, and the various conditions that can exist. Unlike the normal and healthy human being, and perhaps the unknowing human, we are more aware of our heart’s condition.

I am not going to get too technical, as even I will get lost. But the heart has a basic rhythm as pictured above. There are five components, called waves, labelled P, Q, R, S, T. I honestly do not understand the mechanics, but I do know, that if there is an abnormality on your EKG, you will get attention. I do know that in my case, and ALWAYS gets a lot of attention from doctors unaware of my condition, that I have what is called an “inverted T” wave. As you can see from the picture below, compared to the one above, this is not a normal condition.

This “inverted T” wave can be a serious issue, as it is often a sign of what is called “ischemia”, a blockage, or what would likely result in an event of a stroke. Again, not going too deep into the weeds with this. Just know this, this inversion, shows that there is a potential effect on the blood flow through the heart. And this is where Hamlin’s tackle comes in to consideration.

It has been explained by various medical experts on various news programs, that a potential hit to the chest area, during this “T wave” part of the heart rhythm, could impact the flow of blood through the heart, and yes, causing cardiac arrest. While it has not been specifically stated by the Hamlin’s doctors, the speculation is that this “perfect storm,” the tackle and the stage of the heart beat, is what happened. There will likely be more discussed on this, days from now.

Nonetheless, the horror of watching any athlete collapse to the ground, is something we as fans just do not get over. But this time is something different. I recall watching the game where Washington Redskins quarterback broke his thigh bone during a game. I was watching both Jets and Lions games, when Dennis Byrd and Mike Utley were both paralyzed following collisions with their helmets (separate games). Even recently, with all the concussion injuries, these titans still manage to convey to us, usually with a “thumbs up” as they are carted off the field, this situation was different. Whether at the game or watching it on TV, this was different. Hamlin was unable to communicate with us. Everywhere you looked, fellow players, on both teams, were in tears. These seemingly tough guys, though trained to play through all kinds of pain and conditions, were suddenly witness to something, no one could have prepared for.

Of course, the conversation has begun on safety and just how common a situation this might actually be, even if occurring for the first time with the NFL. One news network actually stated a more common occurrence among teenagers aged 14 to 15, involving either a baseball or hockey puck to the chest. Stop and think about that, we hardly, if ever, hear about that. This situation can also occur during an auto accident. This cardiac phenomenon is called “commotio cortis”, caused by a sudden impact to the chest leading to cardiac arrest.

There are plenty of movies that innocently, and often times comedically show a recipient of a chest punch, gasping for air, with the assailant explaining “you will be alright in a few minutes.” One has to wonder with all of the boxing and MMA fights, we have not seen or heard of this before. I know with my own situation, a wired breast bone from my open heart surgery, I have always been sensitive to any impact to my chest for instance, wearing a seatbelt, knowing that in an accident, my breast bone could snap and damage my heart. And do not get me started on the act of CPR on me, if necessary, as it was explained to me how common it is, for ribs to get broken while CPR is being performed.

But this was such an unusual occurrence, and tragic. Hopefully Hamlin will recover fully, only time will tell. And unlike in 1999, when professional wrestler Owen Hart fell to his death from a rapelling accident during his entrance to the ring, and the WWE continued its Pay Per View after Hart had been taken out, the NFL did the right thing, and postponed the game.

We do not know if Hamlin had any other cardiac issues. Like me at 42 years old, why would anyone suspect a 24 year old to have any heart issues? Why would any of us suspect to have anything wrong with us? But the truth is, it can happen, and depending on the circumstance, that is when we find out there is a problem. And for some it can be too late.

My thoughts are with Damar Hamlin, his family, and his teammates and wishing for a full recovery.

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