Ground Control to Colonel Pal...

Ground Control to Mister Pal…

During heart surgery, the beating of the heart is temporarily stopped and life is maintained through a cardiopulmonary bypass (also called CPB or the heart-lung machine). The heart is stopped either through decreasing its temperature or through the injection of a preservative. The heart-lung machine then keeps the blood pumping through the body, adding the necessary oxygen and nutrients.

I guess, if you consider a beating heart as a necessity for life, I was technically dead for a few hours. I suppose my brain was alive; but if you asked me what happened between the hours of 10am and about 3pm on 2 November – I could not tell you. Those five hours did not exist for me.

But as for the hours surrounding that…

Having just been bumped due to a higher priority heart emergency on 1 November, at about 10pm I had enough of Friday. I brushed my teeth, and readied myself for bed hoping that tomorrow they would fix my heart. I was still nervous. I was also very tired. Almost 24 hours of mental preparation for the postponed operation had left me fatigued.  And though I had a verbal promissory note that Saturday would be the day, as I had experienced today, there were no guarantees when it came to affairs of the heart.

So after asking for a sleep aid – as I figured sleep might be a bit elusive otherwise –  I toddled off into bed after an iodine scrub shower, feeling very pink and very shiny.  And I slept.

I'm here for the surgery...

I’m here for the surgery…

I dreamed that night…and while I do not recall all the details, I do remember that it had a surreal quality to it. Sort of a Beatles animated movie

Clickety-clikey

Clickety-clikey

feel or a Tim Burton feel – alternating between Ringo Starr and Edward Scissorhands as my surgeon. Freaky…

I must have slept well because promptly at 0600 hrs, it was vital signs’ time  and the start of The Wait Part Deux. It was dark and the rest of the ward had not woken up yet. There was a sombre, suspenseful feel to the air  – I can only describe it as that slow motion period in The Terminator when you know Arnold Schwarzenegger is going to come around the hospital corner into the shot, but the frame continues to be empty. I knew what was coming, but I was dreading it slightly.

I contemplated what would happen next – trying to create a mental image of the words I had read and the steps that would happen, much like we are taught to mentally rehearse our actions for specific drills to prepare ourselves for the task at hand. Adding to the surrealism,  I could hear the occasional snort from my roommate who was having a lie-in. He was not on until Monday.

And soon I heard footsteps in the hallway. And no, it was not Arnold.  It’s funny, when you lie in a hospital bed for long enough, you get pretty good at discerning who is who based on their footsteps. Their gait, their strike, their pace, their footwear, the noise of the equipment they are pushing or pulling, are great clues as to whether it is the floor nurse, the ECG technician, the blood work technician, the food lady or the cleaner. In this case, it was neither. First it was my daughter, then the comforting clack-clack-clack was my wife’s, accompanied by my parents and my brother. They made it in at 0630 hrs if I was whisked off promptly at 0700 hrs.

I am glad they made it in. I can imagine nothing worse than not being able to say, “Good luck. See you later. I love you,” as you arrive too late and are faced with an empty hospital bed.

But that wasn’t the case as we settled in to wait the last call for the surgery. Before too long, Dr Payne arrived, offered his good mornings and told me that he had a quick procedure to do first and that I was on for 0930 hrs. I smiled wanly, I had heard this refrain before. But I also saw a determination in his eyes that he had no wish to leave me twisting in the wind. So we waited.

There were no new skills learned overnight that made the wait any more bearable. It was still tense and uncomfortable. We all knew it was risky and invasive. We all knew what could go wrong. But we also knew, as we did the day before, you gotta start before you can finish.

And at about 0900 hrs, a stretcher rolled down the hallway, flanked by the cardiac surgical nurse. My chariot had arrived. I had a nervous pre-game pee, and then said my

Bye Mom and Dad...see you soon...

Mom and Dad…18 hours after surgery. Benefits of a good drug program…

bye-byes to my family. Now while I am an affectionate fellow, the family has demonstrated various degrees of physical affection depending on the circumstances.

Sometimes the hugs can be in short supply.

But on this day, the hugs, kisses and “I love you”s were not held in reserve. I could see worry on my parents’ face, my daughter’s, my brother’s and most sadly, on my

wife’s. They were all being brave. We all know that not showing your fear and worries is the Unwritten Rule in such cases.  I climbed onto the gurney, ass flapping in the breeze, and after another quick round of farewells, I was wheeled to the Operating Theatres, flanked by my wife.

Now a hospital is a maze at the best of times, but I remember thinking, I hope my wife is leaving a trail of bread crumbs, because I have no idea of how to get back. And selfishly I added a personal post-script – “I don’t need to, because I’ll be out of it when I head back this way.”

As we continued the long trek into the bowels of the 2nd floor operating theatres, I couldn’t help but look at the passing fluorescent ceiling lights and hear the clickety-click of the gurney without thinking I was in some cheap grainy made-in-Canada TV special. It was like I was watching a bad movie.

We arrived in the operating waiting room and I was greeted by the Chief Surgical Nurse, Tammy, who checked my identification and files and bracelets and asked me questions to determine if I was of sound mind and right body, and briefly explained that in a few minutes we would head off to the operating room and meet the remainder of the team. When she had finished reviewing the huge red binder that was my hospital life, she left my wife and me alone for a few minutes to say bye. There were no violins, no tears – at least that I could see or feel – and with a hug and a kiss, off she went.   I hoped she could find her way back to the Family safely.

And I began another four-minute roll to the operating room where my heart would see the light of day – or at least the fluorescent lights of KGH OR.

The next five minutes were a dizzying flurry. In a rapid series of staccato 5-second introductions I met the anaesthetist, the heart-lung machine maestro, the artery harvester, the surgical resident, the head surgical nurse, the second assistant and a couple more people who I have no idea about. I was asked rapid fire questions about my health and my weight and some other general questions. I was befuddled – who do I answer first? Let me think, dammit!

We're reaaaaaaaadyyyyyy...

We’re reaaaaaaaadyyyyyy…

All these questions!

I was asked to move from the gurney to the operating table – which let me tell you – is not built for people with girth like mine. I felt like I was going to fall off at any moment. Soon my arms moved to my side in the crucifix position and I felt pokes and prods and pushes. Checklists on bodily function, equipment readings, drug solutions, IVs, telemetry outputs were being read out confidently and rapidly, and confirmed and repeated by assistants. Soon a confident reassuring voice, probably coming through a smile if I could see past the surgical mask, said,

“Pal…it is time. We’re ready. Are you?”

In that five minutes it had taken for the team to get everything ready, they had overwhelmed me and stunned me into mental paralysis. Between the sedatives to ease the anxiety, and the questions to keep me distracted, I had not even thought of what was going to happen now – man, they are going to harvest arteries from my arm, then cut my chest open, then saw through my breastbone, then crank open my ribs, then retract my chest to open the cavity, then transfer all my breathing and blood circulation to a machine, then stop my heart and then sew things to it, and then close me up. I had not had one negative thought or forgiving during that entire time that I had entered the operating room to the moment that I was going to be rendered unconscious. Man they were good!

And with a last look at those cheery eyes, I went under the knife.

Now I could jump to the post-operation recovery, but that would not be fair to my family, who had to find ways to occupy the better part of 5 hours. Thankfully it was early, so they all could while away a few hours eating a Fat-Boy special breakfast. And that they did. They also walked around Queen’s looking at preparations for the Science Formal that my daughter and her boyfriend would attend later that day. Apparently the 3-story castle the Engineer students built inside the Hall was magnificent.  But even after that they waited over another three hours…reading…napping…drinking bad coffee…making lame jokes…and mostly worrying and worrying. As for how they felt, you will have to ask them. I cannot imagine it was positive energy.

And then I surfaced. So I am told. I was wheeled into critical care, past my family, who depending on their personal desires, wanted to see me right away, or wanted to wait until I was looking more human and less machine.  My wife and my brother came in right away – I do remember playing charades, unable to talk through the intubation – and mimicking I was cold. My reward was a nice pair of winter socks. They felt grand.

Still freaks me out...

Still freaks me out…

And then I fell under the spell of the anaesthetic and the pain  killers, and drifted in and out of consciousness. I vaguely remember the intubation being removed, I foggily remember my Mom kissing my forehead, my Dad looking stunned and pleased at the same time. But these could be just things I made up because like David in the minivan, I was not sure it this was real. But, as I was in for a long day and night of slipping in and out of consciousness, the family had a last word with the Surgeon before calling it a night.

Dr Payne was extremely pleased with the surgery – it went very well – despite my stubbornness in allowing him access to my harvested artery (which he apparently had to dig for like gold) and that my rib cage was tighter than a drum. Thank goodness he was a strong man, he needed every bit of his anaerobic strength to crack me open like a walnut! And while we had known that I needed a double bypass, in the end, he decided to add 50% free, just to save us the pain of cracking me open again in 10 or 15 years.

I was good to go again, completely re-tooled with clean hoses and valves, enjoying one-on-one nursing in a quiet, clean and calm intensive care hospital room with calm lighting. One little whimper, and the nurse was at my side with pain killing support and a reassuring word.

All that was left was the recovery. And thought at the moment, life was beautiful. I should have enjoyed it more.

Because, in less than 24 hours I was going to fall off my nice, soft, fluffy cloud and realise just what trauma my body had experienced…

End of Act Six

Later,

ASF

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