Category Archives: Surgery

Constipation

I have pondered for more than a week whether or not to tell this tale, and to be honest I don’t know at the moment that I am scratching out a first draft with pen and paper if I will actually complete it. If I end up doing so I will then have to decide if I will publish it. This may not be a story for all readers. My good friends, wonderful people all of them, may feel uncomfortable reading about this experience which I am about to share. If that is the case, please don’t read this. My sole intent is to share information in the hope that anyone who reads this will take precautions to prevent a severely painful situation which I experienced from happening to them, but I value my friends above most things in life and would never want them to feel uncomfortable reading anything that I write.

I never want to publish a story simply to shock, and the story that I have now set out to tell consists of details unsavory enough to shock and gross out many people. I suppose the trick will be to see if my writing skills are adequate to deal with the topic in a way that gives objective information of a deeply personal story in a way that the unpleasantness of the topic doesn’t detract from the point. I will assess upon completion of my first draft whether or not I have achieved my goal. Only then will I push the ‘Publish’ button and send this out to a world which may not even be interested in it at all. We shall see. (author’s note: I obviously assessed this story and decided that it should be sent. As I wrote a moment ago, we shall see).

The title of this tale is simply “Constipation” and, not surprisingly, that is also the topic. And it is a topic that many people do not consider to be serious; the butt (forgive the pun) of an inferior comedian’s potty humor or something that old people in the retirement home speak about often. But when constipation, and I mean real constipation, hits you all of the jokes and laughter fall away and you find yourself praying for some kind, any kind, of relief. Most people can avoid constipation by eating a balanced diet, remaining active, and staying hydrated. Surgery changes all of that however, and it is in the context of a recent major surgery which I underwent that this story is being written.

I recently suffered a heart attack and had to submit to bypass surgery to enable my heart to receive an adequate supply of blood. I was under general anesthesia for over three hours and then given regular doses of a narcotic pain medication for the next five or six days on a regular basis. I tapered off of the narcotics over the next two weeks but still needed them sometimes in order to quell the ache in my chest so that I could sleep. A side effect of the anesthesia and narcotics is that they interfere greatly with normal bowel function, and part of my daily post-surgical physical examination was to listen for the sounds that normal, healthy intestines make. Mine were obviously making normal sounds, so other than a stool softening pill given to me once a day I received no other attention to this potential problem. That would come back to haunt me.

In addition to the effects of the drugs that I was now taking, the other three components of healthy elimination were removed. I was very restricted in my walking around or doing any other exercise by the fact that my split chest was now held together with wires and stitches, and the heart medications given to me made me very light-headed and therefore unable to walk very far or very safely. My appetite vanished after the surgery and even if it had not done so the diet was virtually devoid of fiber, and they wanted me to lose some of my body fluids for reasons I don’t understand so I was put on a diuretic. The result of this perfect intestinal storm was that by the time I was released to go home I had had one small bowel movement and that was all. I was told to be conscious to avoid constipation but not given a plan to do so which fit my new situation.

Returning home was a wonderful thing. I now had the foods which I like to eat and my appetite slowly returned. I ate a lot of salads and other greens, and drank a great deal of water too. I hoped that this would do the trick, but nothing came of it. By day three I began to suspect that I was in trouble, but my preoccupation with safely rehabilitating with my light headedness and healing chest wound, plus the effects of all of the drugs that I was taking, diverted my attention from what should have been a priority. On day four the degree to which it should have been a priority burst upon me with a pain that one could hardly imagine unless one experiences it firsthand, and experience it i did.

I could tell when I arose that morning that things were moving to a conclusion. I tried a couple of times to eliminate but the bolus of stool reached the last centimeter of my digestive tract and then refused to budge any further. I gave up after a while and arose to return to my place on the sofa, but the stool was far enough down to be painful. I hobbled gingerly back to the sofa and sat/lay in a position that caused the least discomfort and waited for something good to happen. Nothing good happened. This was at about ten in the morning.

After a couple of tries I had moved things along another millimeter or two, which only sufficed to lodge a bigger chunk of clay-like stool right at the porthole of freedom, where it was as painful as it could possibly be. It was like having the gnarled, knobby end of an Irish walking stick or the spiked ball of a medieval mace stuck in my rear end. After a few more tries I sent my wife to the store to purchase a laxative, which is precisely what I should have done four days earlier and would have it I had been properly (in my opinion) counseled upon discharge. The bad news, I later learned, was that the laxative was great for future bowel movements but would be of no use for the problem at hand.

Time after time I returned to the toilet, and each time the pain increased but no relief was obtained. I was beginning to get desperate. The pain was intense and offered no prospect of diminishing anytime soon. My wive later told me that she was approaching the point of taking me back to the Emergency Room, such was my physical discomfort and her emotional anguish from watching as I suffered. I finally found myself praying to God for relief, even though I suspected that God is not in the business of giving colonics. I knew that God, when He was with us on Earth, suffered greatly too and that He understood my pain, and that gave me some comfort although I confess that it wasn’t much.

By four thirty in the afternoon I clutched at my final straw. I asked my wife to go to the store and purchase an enema. When I was a kid we had one of those in the house, although I cannot remember ever seeing or hearing of it being used. I didn’t even know if they made the things anymore but as luck would have it, they do. My wife returned with my last best hope, and after about twenty minutes of assembly and test runs, we put this final plan into action.

At this point I will cease with close descriptions of this drama. They are gross and embarrassing. The procedure itself was painful in the extreme and not immediately successful. Repeated attempts, each one introducing a little more of the warm water which I hoped would loosen things up, resulted in having to clear and clean the nozzle while I waited in almost breathtaking pain so that I could try again. Finally, after the third attempt, while the nozzle was once again being cleaned and prepared for use, all hell broke loose.

I could hardly believe that my ordeal was over. I simply said to my wife “it’s out”, but she could scarcely believe it either. She continued to clean the nozzle and I repeated “it’s over. I got it out.” Finally she allowed herself to believe it, and we just looked at each other; her standing by the sink and me sitting there doing my own interpretation of “Game of Thrones”. The relief washed over both of us and we went about the business of cleaning me and the bathroom up.

I returned to my sofa, but this time in considerably less pain. It would still be the next day before the fire down below was finally extinguished. At this point I began to take the laxative, drink glasses of prune juice, and a glass of water containing a tablespoon of psyllium seed husks every day, plus up the fiber in my diet even higher. It was and continues to be my intention to never go through that again.

If anyone is still reading this tale of my scatological nightmare I would like to reiterate why I wrote it. I did not expect to need bypass surgery. We never know when such things will overtake us. Anyone reading this may find themselves tomorrow faced with a difficult and painful surgery in their immediate future and if, heaven forbid, that is the case you might find yourself in the same position that I was. If I have properly utilized this opportunity to tell one person this messy and embarrassing tale, and if it in turn results in that person avoiding the dreadful situation that I endured, then I will understand why I had to endure it at all and will celebrate that I was able to help that one person avoid the pain.

There is my story. I urge you, reader, to take it to heart and make of it what you will.

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Serious As A Heart Attack: Epilogue

Home at last. Home, where I can lie in my own bed, eat food of my liking, sleep in front of my cheesy old movies and relax while my body knits itself back together. At last I can truly heal, because I am home. At least that is what I thought. The reality however is that I have never before had my chest split open and sewn back up and been put on blood pressure and antiarrhythmic medications, so I really had no basis for expecting anything. And the unexpected is exactly what I got.

My appetite and enjoyment of the taste of food did not return right away, and although I ate much more than I did while in the hospital, and ate much better stuff, there was little joy in it. A persistent light headedness continued and continues to make walking difficult, and the slightest hill of any sort will exhaust me almost instantly. The combination of less food and a lower sodium intake than before my surgery, plus my various medicines, led to dehydration which for one night put me back into the hospital. What a scare that was, as one of the possible causes of my problem could have led me back into the operating room to be opened up again. I think I would have preferred to slip into God’s arms rather than to do that. Fortunately for me, my problem did not need to be addressed in that manner, and I will always be grateful for that fact.

One thing that I mentioned earlier was the threat of constipation, the result of anesthesia plus pain medication plus heart medications. I ate salads and veggies galore and other high fiber foods, drank a lot of water, and still fell afoul of constipation. To a great many people that seems like a minor problem, a humorous side-note, a potty joke. It was none of those things. Constipation is a vastly painful condition which is exacerbated when in the context of major surgery, which left me in agony for at least six hours and almost sent me back to the Emergency Department, so awful was it. I feel constrained not to describe my pain or the difficult and messy manner by which my constipation was resolved because I believe that the story should be told in detail with proper prefaces so that the reader will understand from the very beginning that there is nothing in that story meant to be funny or gross or shocking or anything else. If I ever write that story it will be because I hope that at least one person will read it and take it to heart so that they never have to go through what I went through that day.

And then there’s the sweating. I would wake up in the middle of the night with bedclothes, sheets and pillows drenched in a cold sweat. I assume all of the medications I had taken plus the anesthesia had to work their way out of me, and also my improved eating which replaced what was already a fairly good diet was probably liberating toxins stored up in fat cells which were now melting away. I have lost nearly fifteen pounds since my surgery and the junk stored in those fat cells has to get out one way or another. My wife was kept busy washing clothes and sheets and pillow covers every morning for much of the first week that I was home. This has now subsided and I hope is at an end, although I deep protective coverings over my bed just in case.

Still, there have been many things at home that have lived up to my hopes. I cannot go into my garden but I can see it from the deck or a window, and I can eat out of it. I would love to pull the weeds creeping amongst my rows and beds and lift the drooping tomato plant branches and support them with cloth slings tied to wooden frames that I have build around the plants, but that is not to be for now. Instead I can watch my wife and my son water and tend and harvest my vegetables, and that counts for a lot.

So it’s been two steps forward and one step back; one step forward and one step back, and so on. My recovery is very likely to take the whole three months that I have been given off from work, and I still wonder if I will have the energy to return to what can be a physically demanding job. I’m not overly concerned about that as we could probably do all right if I was to retire, but I did not want to do that yet and it would be a hardship of sorts if I should have to. I will continue to pray for healing and be comforted to know that I have family and many good friends praying for that end as well.

Now it’s time to tell other tales and lighten the mood. No matter what happens from this point on, my life has still been an interesting one, to me at least, with many stories to write and hopefully many laughs to share with my readers. And from now on when I am tempted to respond to somebody’s question of ‘seriously?’ by saying “I’m serious as a heart attack”, I believe that I will catch myself and ask “was I really that serious?” My guess is that the answer will be that I am not quite that serious after all.

Serious As A Heart Attack, Part VI

“Good morning Glenn. How are you feeling today?” Kim, my new daytime nurse, was smiling and active, even perky. Nothing could have been more diametrically opposite of how I felt. I had been awakened two or three times the night before by a nurse taking vital signs or a phlebotomist drawing blood or somebody sticking a needle into my belly injecting something, insulin I think. I still felt light headed, as I had since I awoke from surgery, and I was still without any appetite at all.

“Today we are going to walk a little, and if you want you can take a shower. Your urinal is in the bathroom; if you need it, call and we’ll help you walk to it. Your breakfast will be here in a few minutes. Is there anything else I can do for you now?” I assured Kim that I was all right for the moment and she left to perform other duties, leaving me in bed to ponder my new stage of recovery. I did not feel at all like eating OR walking, and even though I knew that both would be good for me my body recoiled at the thought of it. As Kim had promised, my breakfast did arrive within minutes of her departure.

Diane, a nurse assistant, brought in my breakfast tray and set it on a bedside table. “Come on, Mr. Durden. It’s time to get into the chair.” I grudgingly complied, grasping a pillow against my sundered sternum and allowing Diane to get her arms around me so that she could help me up to a sitting position on the side of the bed. Using my own arms to push myself upright was forbidden, as the muscles of the arms are leveraged against the muscles of the chest which attach, among other places, to the sternum. I did not need the muscles attached to either side of my sternum pulling in opposite directions, separating that bone which was now cut into two pieces and wired back together. One surgery was enough; I had no need of another to rewire my sternum.

“Up we go.” And up we went. I sat on the edge of the bed for a minute or two, getting my balance, and then stood up, once again using my legs instead of my arms to push me erect. The chair was only a few steps away and I carefully sat down in it, still pressing my stiff pillow tightly against my chest. “There you go” said Diane. “Now lets see what we have for breakfast.” What we had was oatmeal with raisins, a small fruit bowl, a cup of cranberry juice and something else, the memory of which escapes me now. I looked upon my feast with a relish approaching that with which a taxpayer looks upon the approach of an IRS auditor.

“You have to eat to get your strength Mr. Durden” said Diane, and I knew that she was right. So I lifted my spoon and began first to work on the chunks of canned peach and pear and a few bits of melon which might have been fresh, and washed it down with my juice. That didn’t amount to much but it added up to more than I really wanted. Now I dipped my spoon into the oatmeal and began to mechanically chew. It was like asking a T-Rex to eat tofu. I rolled each spoonful from one side of my mouth to another, chewing and chewing and finally swallowing, just to get rid of the noisome stuff. I probably ate no more than a quarter of the bowl and then pushed the button that would alert my caregiver that I was finished. Diane quickly arrived and swept away my tray.

“I’d like to get back into bed now” I said. “Since you’re already up, why don’t we get your weight and take a little walk” Diane replied. I groaned but nodded my approval. Clutching my pillow I once again arose and walked unsteadily about ten feet to where a large scales awaited me. I stepped onto it, Diane recorded my weight, and then we headed out of the doorway and into the hall. I really didn’t want to do this and so I set out to get it done as quickly as possible. I probably went thirty feet down the hall, and at a faster rate than I should. I turned around to make my return trip and the distance to my room looked like miles to me, so I quickly pushed on, wanting to get this ordeal over with and back into my bed.

At last I did get to my bed and carefully fell back into it. I could feel my heart pounding with the exertion and my nurse quickly made an appearance. Kim took my vital signs, felt pulses, listened to heart and lungs and then disappeared for a few minutes. When she returned she injected a medication into the central line that was still in my neck. It turned out that the exertion caused my heart rhythm to go into atrial fibrillation, and the result of that was a new medication taken each day to ensure that my heart stayed in what is called a ‘normal sinus rhythm’. I still take that pill every day and will probably continue to do so for another month or two to come.

This pattern of activity dominated the rest of that day and the next two and a half days to come. I finally got my shower the next day, and not a minute too soon. I had worked and hurt and sweat for four days by then and I could draw my fingernails across the back of my neck and scrape up an opaque bit of dirty oil underneath them. A chair was placed in the shower and I sat on it while I sprayed myself with a hand held shower nozzle. I have never felt better than when I emerged from that shower.

Thursday and Friday were a monotonous progression of walks and meals (which nearly made me throw up) and blood draws and finger pricks and belly injections and attempts to have a bowel movement. Anesthesia, pain medication, and even some of the heart meds that I was taking have the unpleasant side effect of causing constipation, and when you have had your chest cloven in two any sort of straining is to be discouraged. My central line was removed from my neck (a very strange sensation if I do say so myself) and a final few wires in my chest were extracted. It felt good to finally be free of all technologies which had invaded my badly beaten-up body. Friday was proposed for my discharge, but my doctors, nurse, and ultimately I felt like one more day would do the trick.

Saturday arrived and I initiated my final round of unappealing meals and walks around the hallways of the sixth floor. I took another shower and brushed my hair, and for the first time in a week and a half put my baseball cap on my head. My wife appeared at about ten thirty and we waited as a depressing series of doctors and pharmacists and dietitians made their final interviews with me. Finally a cardiologist cam into my room, spoke with me for a few minutes, and pronounced me ready to go home.

Words are inadequate to express how I felt as I rode in my wheelchair down that elevator to the first floor. My wife had moved our car to the front entrance and we rolled out to it. I rose up out of my chair, sat carefully in the back seat, said my goodbye to Diane, and my wife fired the car up and rolled away from the hospital and out onto the street. I relished seeing the blue sky and the familiar houses as we crossed the five blocks or so which separate my house from the hospital. People were out working in their yards and at one house a small child played at it’s dad’s feet while dad puttered around the garage. The beauty and rhythm of the life I watched as we drove home were healing medicines all by themselves.

In a very few minutes we rolled in front of our house. My wife pulled slowly up the driveway and I looked out of the window at the abelia and hyssop that I had planted years ago. I saw that the white, pink and coral flowers were crawling with bees, and it looked good and natural. I also saw that the hyssop needed water. Hyssop has more shallow roots than abelia and must be watered more frequently. “That’s OK” I said to myself. “It’s all right now. Daddy’s home.”

Serious As A Heart Attack, Part V

Day number three after open heart surgery dawned in a fog, much as day number two had ended. My nurse had configured my bed in such a way that I was semi-upright all night, and for some reason that helped to control the pain which had run riot in my body the day before. As always I slept most soundly in the later morning period, so I slumbered pretty much right up until breakfast arrived. I was transferred to my chair and waited for my breakfast tray to be brought over to me.

I don’t remember what it was that was brought to me for breakfast but I do remember my response; I grabbed the nearest plastic bucket – they kept one within my reach at all times – and threw up explosively into it. I had hardly anything in my stomach so the volume was low, and I felt a good deal better when that was done. I had no interest in breakfast however and asked them to remove it from me. It would be several days before I would have any desire to eat again.

Nobody had arrived to visit with me yet and so I remained in my chair for a while with my eyes aimed in the direction of the television screen but with no real recognition of what channel it was on or what they were saying. Time passed in this manner as people slipped into and out of my room, some to draw blood from the central line in my neck, others to poke my fingers to monitor sugar, and still others to give me some kind of injection into the fat around my belly. Most merciful was the nurse who came in to push another syringe full of Dilaudid into my central line. More than that is only a blur and I would not be able to accurately describe it.

As the morning wore on the various doctors taking care of me stopped in to check on me. First was the Family Medicine general practitioners, usually consisting a trio of Dr. Manning and two residents who are not yet licensed to practice on their own. Dr. Manning and I have known each other for years and he is a lover of history as I am, so we usually ended his visits by giving each other a history challenge question. “What was the Beatles’ album which changed the course of rock music?” (Answer: Sergeant Pepper’s Lonely Hearts Club Band), or “Which WW II battle took place in May of 1942 and changed the course of the war?” (Answer: Battle of Midway), and so on. On this day I was in no kind of shape for such banter and Dr. Manning could sense that. A brief examination by the residents ensued and I was returned to my bed because my exhaustion was now becoming more of an issue than the pain.

My wife appeared at this point and took up her position by the bed, stroking my forehead or brushing my shoulder, completely unable to reduce the pain but communicating clearly that she would do anything in the world if she could to take it away, and there was comfort in that. We passed an hour or so I think in that way until the next group of doctors made their appearance.

Dr. Willis is with the surgical group of which Dr. Grossing, my surgeon, is a partner. He was checking on me that day along with Rachel Lenz, the physician’s assistant who was involved with my actual surgery. They examined the incision site on my chest and declared it to be infection free so far and healing nicely, and then they knelt down by the bubbling canister at the foot of my bed. “Take a breath and bear down on it Mr. Durden” said Ms. Lenz. I drew a breath and bore down on it as much as my stoned stomach muscles and screaming chest would allow. “That looks good Mr. Durden. How would you like to have your chest tubes out?”

I had been told that the tubes draining grunk from my chest could be a major source of the pain I had been experiencing for the last day and half so I jumped at the opportunity. In a flash the tubes were gone and after a little puttering around on my chest, which probably represented suturing the holes where the tubes had been, I was finally free of the tubes and the urinary catheter which they removed at the same time.

The improvement in my pain situation was almost instantaneous. There was still pain aplenty but the Dilaudid was more than adequate to keep that down to an acceptable level. I could finally lie in my bed and enjoy my wife and son, who appeared a short time after one in the afternoon, and carry on a conversation with them between naps which tended to remain on point more or less. I would describe that afternoon as pleasant, at least as pleasant as one could expect it to be under the circumstances.

A big change occurred at about five o’clock however. A gurney appeared and it was time for me to leave the CVICU and transfer to the sixth floor where less critical patients continued their recovery. I knew right away that I would miss the staff in CVICU. They had been very kind and attentive and I felt very well taken care of. I want to visit them very much when the time comes that I can walk and move about with more ease than is currently the case.

The sixth floor was an entirely different place with an entirely different mission. Once deposited (lovingly) like a sack of potatoes in my bed in room 6102 I was in the care of people who’s mission was to get me ready to function at home again. Because I arrived in the afternoon, rather close to shift change, I had a grace period where I could lie quietly in bed with my thoughts and narcotic dreams. My new nurse and her team of two assistants introduced themselves and then that was all that I saw of them that night unless somebody had to take vitals, take blood, give me pain meds or empty my urinal. The evening was passed in broken sleep, but the morning came soon enough and my new recovery plan took off in a big way.

Serious As A Heart Attack Part IV

The second day of recovery began when I emerged lazily and with some difficulty out of a fog of anesthesia, narcotic pain killers and sleep. My wife was beside me, as she almost always was, and as the fog cleared she was asking if I wanted to sip some chicken broth. The doctors had explained that it was important that I resume eating and drinking in order to speed up my recovery. There was nothing I wanted more than a speedy recovery, so I was eager to comply.

The broth was listed as low fat, low sodium. I guess that this is standard for hypertensive cardiac patients, but I thought that low taste, low interest would have been a good deal more accurate. Still, an order is an order, so down the hatch it went. I drank a cup of cranberry juice as a chaser and relaxed back into my bed to continue my nascent healing process.

I knew that my urine was draining out from my bladder through a catheter and found the convenience of that arrangement comforting. All of the peeing in a urinal that I had been doing before my surgery had now been taken out of the picture, and I didn’t miss it. I was actually mildly disappointed when the catheter was removed the next day, which will illustrate as clearly as possible what a lazy man I truly am. I also had one or two surgical tubes protruding from my chest and coursing into a bubbling container. Why the container bubbled is a mystery to me. Those tubes were draining blood or air or anything else which might be in my chest post-surgically but didn’t belong there. I was practically unaware of those tubes at first, but that would change.

My nurse, who was one more wonderful person in a parade of wonderful people, was constantly flitting in and out of my room taking vital signs, checking IV fluids, and generally making me feel as comfortable as possible, and the latter duty involved administering periodic doses of a pain killer called Dilaudid. The dose was prescribed to be given every three hours as needed through a catheter threaded into a vein in my right neck.

My son made his first post-surgical appearance that day and I greatly enjoyed chatting with him, although the pain killer had the exceedingly weird effect of loosening my grip on reality. I have an active if somewhat shallow mind and it is not at all difficult for me to slip in and out of a daydream at any time. Under the deluge of Dilauded which was pouring down my central line I was no longer slipping into daydreams; I was now jack booting down the door and commandeering the residence.

A conversation might go something like this. WILL: “I’m going to go to the house tomorrow and water your garden. Are there any special instructions that you have for me?” ME: “Yes. Use the sprinkler on the onions and just lay the hose at the base of the tomatoes. Don’t worry about the dog (author’s note: I don’t have a dog), he stays in the shade and will fix the bicycle tire himself if you have a…. Wait a minute, that didn’t make sense, did it?” WILL: “Some of it, Dad. You told me to sprinkle the onions and just put the hose in the tomato beds.” ME: “Yes, that will work. Do the same with the cucumbers and squash and don’t worry about the asparagus because they take care of themselves since they moved out of the house and haven’t had much trouble except that one time that the police….” It was like that all day.

As morning moved into noon the pain in my belly began to grow and by lunch had come to dominate my consciousness. Hospitals like to use a pain scale of zero to ten, with zero being no pain and ten being agony. Those scales are highly subjective of course, and for me skinning my right foot and plunging the raw flesh into salt would be about a three. By noon I was at five or six. I sat up in my chair and tried to eat, and the pain seemed to subside a bit, but I was not able to eat much and soon returned to my bed.

The pain began again to cresendo and soon I was begging for more of the pain medications with the result that I became even more stoned but not one bit less in pain. I had maxed out my Dilauded dose and still I was crawling up to an eight-and-a-half. My nurse was truly sorry for my pain and tried anything she could think of to bring it down, including exchanging morphine for Dilaudid a couple of times, but nothing worked.

The nurse’s instructions were to get me up in a chair as much as possible so that the changed position would keep fluids moving and allow me to inhale as deeply as I could on a device designed to help me gain greater expansion of my lungs. I groused about having to move in my pain but complied. It slowly began to register with me that I really did feel somewhat pain-diminished when I was sitting up. Not pain free by any stretch of the imagination, but pain-tolerable. My nurse noticed this as well, and I stayed in my chair until it was time for visitors to go home and for me to try to get some sleep.

“There’s no way that I will be able to sleep if I lay down” I told my nurse. “I know” she replied. “That’s why I’m going to turn your bed into more of a chair.” With that she began to fiddle with buttons and my bed began to move like a Transformer. The head began to raise up almost like the back of a chair and the foot of the bed dropped down towards the floor, leaving me a shelf to be seated on with feet dependent and head upright, then she tilted the whole thing back so that I was reasonably in a kick-back mode. In that bed I passed through the night. The pain level stayed down at a four or so and sleep, with the help of the Dilauded and a benedryl capsule, stole over me and I enjoyed something which approached acceptable comfort the rest of the night.

That second day was one of the worst of my life. I have suffered physical and emotional pain before and this day stands out from all of the others by a long shot. The pain in my belly felt like the larval stage of “The Alien” was eating his way up from my intestines through my liver and diaphragn and into my chest. It was hard to breathe and I performed very poorly on the device through which I inhaled in order to expand my lungs. The pain was almost like a physical entity; a beaked, taloned and tentacled monster from one of the ‘B’ sci fi movies of the 19650’s that I loved so much as a kid

Only there was no love here on this day. The tentacles embraced me with a power which refused my lungs the ability to inflate. The talons dug into my flesh and denied me the opportunity to shake my monster off in any way. The beak ripped and tore through bone and cartilage and muscle to feast on the crying organs at my core. This monster came to stay, and none of the tricks and devices which became available at the end of the ‘B’ movies to enable the humans threatened with destruction to escape the final victory of the monster was becoming available to me. I was the captive of PAIN. I would remain that way. Tough luck, Kiddo.

The pain meds, which no doubt prevented me from shrieking at the top of my under inflated lungs even if they seemed to not be working at all, also kept my mind in the fog that I mentioned earlier. It was a humorous side note to the day when I would prattle on to my family and then stop, both of us knowing that I was not speaking of anything real at all. But there were those times when I was not speaking, when I stared vacantly at the television or at the ceiling or simply into the pain which gnawed at my belly, and they were not humorous. They were dead, or at least deadening. They robbed me of what is peculiarly me and replaced my me-ness with a stoned, mentally wandering imitation of me.

I am not a narcissist by any measure, but I have grown over the years to like myself. I am glad to know that I have some good points and I can clearly see the bad ones and work towards their correction without self-loathing. I have managed with the help of God to be a blessing – a mixed one to be sure – to a wife of thirty seven years, two children whom I adore and three grandchildren. I short, as the saying goes, I’m ‘comfortable being in my skin’. The drugs blurred my self awareness and I became ever so slightly not me. The sensation lasted most of a day and a half and never came to wholly dominate the real me. It tried however and it was not pleasant, and I was eager to cut down on the narcotics as quickly as the pain would let me, which I am told was a great deal more quickly than most people who have undergone my surgery have done. That process would become easier by the events of the next day, which will have to wait for my next post.

Serious As A Heart Attack, Part III

“Good morning, time to get up.” Sandra, my nurse for the Big Morning, had actually let me sleep for a half hour longer than the plan had called for, but now it was time to get the ball rolling and she was all business. My surgery was the first case of the day and if anything delayed me, the whole rest of the day would be thrown off as well. “Let’s get you unplugged and into the shower.”

Sandra removed my IV lines and covered both sites with plastic to keep them dry, and snatched off a half dozen EKG patches, removing a little bit more of what hair I had left. She then led me to a large shower where I scrubbed down from head to toe with some kind of special soap. After toweling off and re-gowning I was led back to my bed where more blood was drawn, more pinpricks were made in my fingertips to assess glucose, and both IV sites were declared to be too old to risk going to surgery with. I did not realize that IV sites had a useful lifespan, but it turnes out that they do and mine had outlived theirs thanks to my prolonged wait through the Forth of July holiday. In a flash both of those sites were removed and a new plastic needle, but thankfully only one of them, was inserted into one of the few veins on my arms that remained at that point untouched.

That accomplished, my new site was again covered with plastic and once again I was in the shower scrubbing myself down with the anti-microbial soap. And once again I was toweled off and re-gowned and led back to my room to await the transporters who would move me to the Operating Room. The wait wasn’t long. After double and triple checking of my name and surgical procedure I slid sideways from my bed onto the gurney.

I can’t really tell you what I thought as I rolled through those unfamiliar halls. Wait a minute: Unfamiliar? How could that be? For 26 years I had passed through those halls, looking at the linoleum or carpet, the artwork on the walls, the co-workers whom I would pass and acknowledge. This time however it was very different. This time I was looking up at the sound-deadening ceiling tiles interspersed with banks of florescent lights that passed monotonously by my vision. I probably thought of the life that I had lived up to this point, the highs and the lows, and I probably thought about what life would be like afterward, although I had no way of knowing what life would be like afterward and I knew it. One thing was clear. I have assisted with open heart surgery before and I knew exactly what that would be like, and therefore made the choice to not think about that at all.

We entered the O.R. and I did a repeat of what I had done in the cath lab four days earlier. Same freezing room, same process of identification of patient and procedure, same slide onto a hard table and same wraith-like gowned, masked, and hatted doctors and nurses and techs puttering around the room preparing their instruments and equipment for the surgery that was imminent. Soon the anesthesiologist was injecting some fluid into my IV and soon I was once again somewhere out in deep space. Somebody else was occupying that space between Alpha and Proxima Centauri so I sped by them to take a gander at what was happening out near Sirius.

My next twelve hours are pretty much lost. Surgery lasted about three hours and at some point I was rolled into my new room with my breathing still controlled by a respirator and with more tubes and hoses sticking out of me than an automobile engine. I remember very little of the rest of that day, but two events stand out. With a big, fat tube running into my lungs communication became a challenge, but I still wanted to express myself to my wife and there were several instances when I successfully did that. Two occasions which I actually remember of accomplishing that feat went this way. By engaging in creative hand signs I asked my wife not to cry, and later asked her to pray for me which she did. Shortly after that event my body remembered how to breath on its own and that really nasty tube was removed from down my throat.

The rest of the evening I can barely remember. My wife was there the whole time and my daughter arrived at near 7 PM. I don’t remember the daughter’s visit more than as a shadow but I do remember the visit by her husband which followed. He had been reading about the early Christian Church leaders and their relationship with the Roman Empire. He rattled on about Ambrose of Milan in the West and John Chrysostom in the East, and their beef with the Emperor Theodocius and so on. This is the stuff we both like to talk about, but my participation this evening was sketchy at best. I was later told that I would drift off, then return with a comment which was actually pertinent to the topic, and then drift off again. The presence of my son in law and wife, and their familiar chatter, were immensely comforting and it was around 11 PM that they left and I finally lapsed into an exhaustion and drug assisted sleep.

This concludes Part III of my story. It is a short segment because there was so little that I was consciously aware of. There has been much told to me which would flesh out my story but my interest here is to record my own sensations and perceptions. I did not live the other stuff, even if I was involved in it. My true recovery did not begin until the next day, and that tale deserves a Part IV all by itself.