Serious As A Heart Attack, Part II

“Good morning Mr. Durd— oh, Glenn! What are you doing here?” Serena was in my room to pick up the next patient for the cardiovascular catheterization Lab and had no idea that the patient in question was me. We had worked in close proximity for years and were friends, but she had never learned my last name. It’s all right, really. I don’t know her last name either. “I was bored so I thought I’d come visit you guys” I replied, and after being disconnected from my bedside I.V. and monitors. I climbed aboard the gurney where I was reattached to portable monitors and was whisked away to the prep area in the Cardiovascular Observation Unit.

Prep for a catheterization procedure, or simply a ‘cath’ as we medical types call it, does not permit a patient any modesty. Human hair is about as dirty an item as one can get and the prevention of infection will be almost obsessive-compulsive in any hospital worth going to. Therefore, the hair had to go and Serena, with a coolness and professionalism that helped to diminish the awkwardness of the moment, exposed my altogether naked groin and gave the family jewels a buzz cut. The duration of my stay in CVO was short and I was glad that I had no visitors. Because of the Privacy Act hospital workers must be very careful to respect the privacy of patients, and since I have worked at the same hospital which was now taking care of me for 26 years I know almost everyone there at least a little. The close association and familiarity bred comfort and discomfort in equal measures, and I was glad to be left alone while I awaited my procedure.

I did not have to wait for long. Hardly a few minutes passed by before my escorts reappeared to roll me into the cath lab itself. I noted instantly as I rolled into the room that it was cold as a tomb. Hospitals usually seem cold but I went from snug to shiver in about 30 seconds. After exchanging greetings with the staff I slid over onto the table and issued my first complaint as a patient about how cold it was. I knew that my complaint would do no good but it seemed obligatory that I should register it, and so register it I did. A technologist placed a thin drape over me and the anesthesiologist injected a fluid into my IV. I felt nothing different and in a moment the cardiologist appeared and briefly reaffirmed what she would try to do; an angiogram, of course, and a stent if the problem was found and could be repaired in that manner. I agreed once again and the masked, hatted face of the anesthesiologist reappeared. With what seemed to be wrinkles of smile about the corners of his eyes he said “goodbye”.

Goodbye wasn’t the half of it. “Enjoy your de-existence” or “happy annihilation” would have been closer to the truth. In what seemed like an instant of time a catheter was inserted into my right femoral artery, threaded through my heart, and to the origins of the arteries which supply blood to the heart muscle itself. The dye was injected, the narrowing was found, the possibility of a stent rejected and the catheter withdrawn, all while I blissfully spun somewhere out between Alpha and Proxima Centauri. At some point I awoke sufficiently for the cardiologist to show me the images and explain that surgery would be needed, and then I was rolled back to CVICU to await my date with the knife.

This is the point at which my timing comes seriously into question. I had my heart attack on Tuesday July 1, went to the ER Wednesday July 2, and had my cath on Thursday July 3. Can you guess what comes next? July 4! National holiday! Emergency procedures only. My condition was very emergent to me but in the grand scheme of things I was considered stable. I couldn’t go home I was told but instead would await the next normal working day for my surgery, and that day was four long days in the future. I asked my wife to bring me books and writing utensils, and settled in to wait out what, except for the four-a-day blood draws, was one of the most boring 96 hours of my life.

Of course I got a lot of reading done, wrote several letters (I love snail mail) and wrote the vast majority of “Serious As A Heart Attack, Part I”. I also entertained visitors. I especially enjoyed the latter. All of my nearby family came and stayed for hours at a time with me, as did friends from church and work and a reading group of which we’ve been a part for 15 years. I loved those visits and, although there are people who would rather not be bothered with excessive human contact if they were in the same position as I was, I think that visiting friends who are confined in the hospital is one of the kindest things that a person can do.

I did have one scare during my wait for surgery. On the day after my angio I got tired of using a plastic urinal while lying in bed and asked if I could walk into the bathroom and pee like a normal man. It was more than 24 hours after my procedure and all looked well so Nick, my nurse for that day, agreed to affix all of my medical accoutrement to a mobile IV pole so that I could accomplish that task. The first effort went flawlessly and I shortly arose to do it again. While I was standing before the toilet in midstream however I began to feel a twinge in my right groin which grew rapidly into a nice burn. I instantly knew what that could possibly be and hobbled back to my bed so that I could call Nick. Upon his arrival he immediately put pressure on the bulge which had popped up under the bandage over the site where the catheter had been inserted the day before.

What I had feared is called a pseudo aneurysm. When an artery is punctured it is necessary to put a great deal of pressure at the puncture site for a good long time to be sure that the small hole left behind clots off. Doctors and technologists and nurses are good at making this happen but sometimes the hole in the artery wall pops open again and blood flows out of a narrow channel through the muscle tissue, forced by the pressure of arterial blood, and ends in a sort of pouch or balloon farther out in that same muscle tissue. These hurt very much and usually are repaired by advancing a needle under ultrasound guidance into the neck of the pseudo aneurysm and injecting a substance to cause the blood swirling in the pouch to clot off. The trick or course is to place the needle in the pseudo aneurysm and not in the femoral artery, as injecting the clotting agent into the main artery of one’s leg, well, isn’t usually regarded as a good thing. I have guided many of these procedures myself and had no interest in being on the receiving end of one, and the prompt intervention of my nurse prevented what was almost certainly the beginning of a pseudo aneurysm from happening. I spent the rest of that day and all of the next two flat upon my back, gratefully peeing in the plastic urinal and counting my blessings.

At last the final visitor who was probably my wife, an angle sent to this planet solely for the purpose of getting me through this ordeal (and helping me make a couple of wonderful kids and a few other things too), kissed me good night and it became time to prep me for the next day’s surgery. The surgeon had earlier counseled me that I might want to shorten my beard as it drooped down into the area that soon would be open like the hatch on the old space shuttle. It seemed as if he had gotten resistance on this idea from previous patients but I told him “It’s not spiritual, Doc. It’s a beard. Whup it off”. The idea of an infection in an incision extending from the surface of my chest to my very heart was entirely without appeal to me, so off it came and off I went to sleep until they would come for me at five thirty AM the next morning to begin my march to the next leg of this medical drama.

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