Music'al Notes

Heart

I am awake.

Not a slow-opening-of-my-eyes awake. More a slap-in-the-face awake. My eyes open wide and I see the nurse standing over me.

A few days before this, I had awoken feeling lousy. It was a depressing feeling with some tightness in my chest—not severe enough to indicate anything serious, more like a bad case of indigestion. I ignored it and spent the day working. The following morning, feeling just as badly, I drove over to the gym. During the session I had little energy.

“Roy, you don’t look well,” my trainer said. “Maybe you should get checked.”

I didn’t want to go to the emergency room but as my cardiologist was nearby, I decided to go there instead. I explained my problem to the receptionist and the cardiologist saw me immediately. He did an EKG and told me to wait. He soon returned saying I was booked into nearby St. Francis Hospital for an angiogram and probably angioplasty.

St. Francis Hospital in Manhasset, NY is wonderful. Most local hospitals in my area are great but the emergency rooms are noisy, crowded and tension-provoking. St. Francis, run by nuns, is calm and reassuring. Checked in and vitals taken, I was told to wait (what turned out to be around six hours) until my procedure. I was given a bed in a cubicle with a curtain betwixt me and the other occupant.  She was an elderly woman who kept shitting herself and stinking up the place. The waft was so terrible that, not wanting to die before my procedure, I moved to a chair in the hallway for the rest of my stay.

That evening I was wheeled into the operating room. A catheter would be inserted in my groin and moved up through my arteries to remove the blockage. I awoke sometime later and a doctor told me I had three obstructions, which couldn’t be unblocked. Therefore I was scheduled for open-heart bypass surgery on Monday morning. This was Friday night.

My pre-op stay was mostly uneventful save for the afternoon before surgery. My wife Rita invited some friends over for a visit. In addition to good food, Rita produced two bottles of wine and it turned into quite a raucous affair. I shared the room with another patient who was recovering from oral surgery and had a bandaged mouth so he couldn’t say a word. At some point the ward sister appeared, looked at the empty wine bottles and said angrily,

“What are these doing here?”

We eyed her and laughed. I said something about lack of signage re: alcohol. This enraged her even more and I thought she was going to rap my knuckles with a ruler. She stormed out of the room, saying that she was going to call my surgeon and report me. One of our friends said as he was leaving the room, “This was best hospital visit – ever.”

The next morning I asked the surgeon how he had responded to the sister.

“Wouldn’t you want a drink or two before you had open heart surgery?” he said, smiling.

That same night, the eve of Passover, a nun visited me who, knowing I was Jewish, asked if I would like to speak to the Jewish chaplain.  I declined, as I am defiantly anti-religious. We did talk god a little but then she told me that I was in god’s hands.

“I prefer to be in the surgeon’s hands, not gods,” I said.

“He is a great surgeon because god had blessed his hands,” she said.

As she was leaving she said to me, in Yiddish, “A Zissen Pesach” (a sweet Passover).

I was rolled into the vestibule of the operating theater. A very charming aid shaved my whole body from my neck to my toes. Every hair was removed. The anesthesiologist introduced himself, said that there was a delay, and asked if I would like a Valium.

“Sure, why not?” was my reply.

I later learned that I was so stoned that every 10 minutes or so I would try to expose myself to my wife and daughter and ask, “Do you know that they shaved me all over?”

The surgeon was amazing and I woke up with some tubes sticking out of my chest but no pain. The operation had gone well. Before going in, the doctor had advised me to try to walk as soon as possible. I asked to get up and accompanied by the nurse, my wife and an array of tubes attached to machines, I shuffled my way forward. I didn’t have much energy but walked a little. I repeated this process six times in the first day, venturing deeper into the recovery area of the hospital. This impressed the doctors so much that next day they deemed me healthy enough to be moved to the regular ward. Before leaving, the two tubes attached to my chest had to be removed. One drained the heart, the other, the lungs. The nurse removed the tape and then, while pressing on my chest, she started tugging. For the first time ever I felt an alien object moving inside of me. The tube was ribbed like a bendy straw and I squirmed as it slowly pop, pop, popped out of me. This was repeated and of all the procedures I have experienced thus far, this was the most gruesome.

I was discharged a few days later. Home stay was somewhat boring. Rita was a great nurse and did whatever she could to make me comfortable but apparently—and I have no memory of this—I was a terrible patient. I constantly complained about her cooking, and the fact that I was housebound and stuck staring at the clock drove her crazy for a while.

I couldn’t drive for the first three weeks, in case there was an accident and the airbag deployed—this could rupture the stiches and titanium wires inside my sternum. I was thus relegated to the back of the car, clutching my red heart-shaped pillow given to me by the hospital. (I do admit to sneaking out one day and driving to get beer. This caused another fight.) I clutched the pillow to my chest whenever I coughed, which happened often.

I really hated the opioids given me for pain so my daughter suggested I smoke some pot for relief.  Stupidly, I tried this and it started a coughing jag, which was excruciatingly painful. Clutching my pillow I coughed for about 10-15 minutes, hoping my chest wouldn’t explode. When it was over and I had calmed down, I found that my lungs were now completely clear and my breathing was deeper. Who says marijuana isn’t medicinal?

I continued walking as much as I could and in week six I signed up for the hospital’s rehabilitation program. This was a three-month program consisting of three one-hour sessions every week.

 The De Matteis Center for Cardiac Research in Greenvale, NY is an amazing place. Basically, it’s a gym with nurses and a doctor on staff. It caters almost exclusively to cardiac patients recovering from heart surgery. A short while after orientation I paid my first visit. The routine was the same every time: attach three electrodes on your chest, plug in a transmitter, have your blood pressure taken and move. Three laps around the gym, five minutes on a machine, three laps round the room, etc., for a whole hour. At first it was exhausting  just walking, but rather quickly I found it more doable. As my strength increased, the staff assigned me to different machines. At the beginning most of the machines were operated by foot power but as my chest healed up I graduated to machines that used my arms and chest muscles. Most of my fellow inmates were like me: recovering with a desire to get well as soon as possible.

But there is always the exception. Josh was in his sixties. A triple bypass patient with a bad knee that forced him to use a cane. Every morning, Josh would come in at eight, pour himself a cup of coffee, open a brown paper bag, remove a bagel with about one inch of cream cheese on it and proceed to eat it. This ritual took about half an hour, after which he would finish his meal, clear the table, then stagger to the nearest machine to slowly pedal for a short while. Full recovery was just a dream for him.

Halfway through each session someone would check my blood pressure and if it was okay, I could continue. Only once I was stopped from leaving as my heart rate was more than 10 beats faster than when I entered. I had to wait a few minutes until it calmed down.

I cannot stress how much the staff at this facility helped me to recover. I was assigned a nurse who regularly discussed my progress and medication. At one point, as I felt the beta blocker I was taking was slowing my heart down and inhibiting my recovery, she suggested I call my cardiologist to reduce the dose. I did this and it made a huge improvement.  On my last day I felt back to normal, fit and very much alive. My nurse asked me to give some advice to a new patient who was just starting that day. He looked frail and nervous. I smiled and said, “Stick with the program and do what you are told. You’ll be healthy in no time at all.” And I meant it.

Many patients and their families suffer depression after surgery. The specter of death and the uncertainty of the outcome adds enormous stress to a pressure-filled time.

Fortunately, this did not affect my wife or me. My father had died from his second heart attack at age 63 and other members of both our families had suffered from heart disease. So, when I got sick, I wasn’t surprised. I realized that I had been waiting all my life for this moment. Both of us felt that death wasn’t an option; that this was just a repair.

Which it was.