Angioplasty

It’ll all be fine.

That’s what they always say. Medical professionals. They’re always keen to reassure their patients that all will be well. They don’t want the patient to freak out and do anything crazy like killing themselves or canceling the procedure out of fear of the procedure. That is so not me; and I am way, way beyond the ability for comforting words to assuage any fears or disquiet.

Nope, I’m already certain that the end has come. I’m gonna die on the table. That’s the worst possible outcome. The next most likely outcome is that I’m going to wake up with a zipper chest like so many of my relatives have. Of course, I don’t tell anyone else that, not even the Wife. At least I don’t say that in those specific words. The Wife knows my mental acrobatics. She helpfully exclaims to the cardiologists nursing staff,

See what I have to put up with?

I know my own genetic history. I know what is in store for me because it is what happened to my direct genetic ancestors. My maternal grandfather had a heart attack when he was about my age. They cracked his chest open and sewed six bypass arteries into his heart in order to keep him alive. The procedure was successful. He lived for another thirty years before his gut killed him. When I started getting that weird sensation in my chest, I knew what that feeling meant, I just couldn’t jump to conclusions about what it was. No, I had to go through the experts and ge their opinions. I could have been wrong, but I wasn’t wrong. This time.

The feeling? It was like two solid objects rubbing against each other in the area around my heart. I’d never felt anything quite like it before in my life. After the sensation repeated itself several times during exercise, I decided I probably should take it seriously. So I did. I cancelled the physical therapy appointment I had the next day and booked an appointment with my cardiologist for as soon as he could see me.

He’s the one who offered the platitude it’ll be fine after saying the word angiogram and then watching me pale. What he didn’t know was that I have had nightmares about things crawling through my veins for most of my life. it’s part of my fear of needles and why I nearly faint every time someone sticks me with something. An angiogram is exactly that fear come to life.

I cringed every time an older relative would go in for one of the procedures. The Wife’s foster father had one done back in the dark ages, back in the 1980’s when an angiogram was still experimental. His was the first one I had ever heard of being done. They went in through his groin. They went in through that artery in the thigh that if cut you can bleed out in a matter of seconds. Not minutes, seconds. That artery. The femoral artery.

The catheter that they introduce into the blood system through the artery allows them to run a camera up through your arteries to study blockage from inside your body, and they can use it to introduce dye into your blood system, near the heart, so that they can use x ray imaging to study blockages. Which is what they wanted me to agree to. We’re going to slice open an artery and run tubes through your bloodstream. But don’t worry, we do this all the time.

They don’t know that worry is what I do eighteen hours a day, every day. If I’m not worrying about something, then I’m probably not actively thinking at the moment. I even worry when I dream. This is why driving a car every day of a working life is a special kind of torture for me. Anything more than a half-hour of driving, and I’m already worrying a hole in my stomach. I gave myself an ulcer inside of six months when I briefly flirted with driving for a living, bringing to an early end any kind of career driving trucks or test cars.

Over the course of the next week, while waiting for the procedure to happen, I say my goodbyes to everyone and make sure my karmic debt is paid off. I don’t want to be surprised in a potential next life by being reborn as a cockroach or anything. Just covering my bets. When the day finally arrives I’m under so much stress that if you scared me I would probably have a heart attack on the spot. That’s me trying not to worry.

Luckily I wasn’t going to be awake for the procedure. I made sure of that before agreeing to it. No, I do not want to be awake. I want the good drugs. The kind of drugs that keep you from remembering anything. I definitely do not want to be reliving the memory of crap crawling through my veins when I go to sleep for the rest of my life, if there is a rest of my life. Knock me out, or as close to out as I can get and still be responsive to commands or questions.

The doctor showed up early. He checked my wrist to see if it was large enough to get into easily. He was planning on accessing the radial artery rather than the femoral artery. I was initially thrilled at the notion that I wouldn’t have blood shooting out of the artery next to my junk the first time I went to the bathroom after the procedure. Then he left the room to allow the prep nurse to get to work. They prepared both the femoral artery area in the groin (so much hair!) and the right wrist as possible surgery locations. Had I known they would need to shave my groin anyway, I could have used the trimmers on it beforehand. Manscaping is a foreign concept to me. If hair grows somewhere on my body (on your body, even) it probably grows there for a reason. I see little need to trim hair that no one sees but me and the Wife. If she doesn’t like the hair, it usually gets snatched out by the roots anyway.

Talking to the surgery nurses is the last thing I remember before the procedure. I remember that both arms were strapped down (we don’t want you moving. Yes, I understand) The surgical shields were put in place. They were cold, but in place. The nurse said they do these kinds of procedures eight times a day on a normal day. They wouldn’t be doing eight of them on that day because the cardiologist I had been referred to had already dealt with two emergency procedures before he got to me in the mid-afternoon, and I had been scheduled as the first cardiogram of the morning when I walked in that day. He’s a busy guy. He earns his pay, without a doubt. He definitely earned it working on me that day.

The good drugs started when the doctor entered the surgery and verified everything I’d agreed to for about the fourth or fifth time (the thoroughness of modern medical procedure is reassuring if slightly tedious) and I don’t remember much after that. I remember the imaging system suspended over my chest like the upper hammer in a forging hammer press. I remember voices, but not words. I do vaguely remember something rounding the corner in my shoulder at one point, but I definitely do not remember the amount of work they had to do once they had done the initial scan.

…because it was as bad as I imagined it was. I didn’t die, so the worst outcome was averted. They didn’t have to crack my chest, something that would have been required had I been undergoing the procedure even ten years ago. Second worst outcome avoided by simply being born in the place and time that I was. No open heart surgery. Just three stents. Three stents, in three different arteries, and then the second set of tests to make sure that blood flow was restored to the blood starved areas of my heart.

What would have been weeks of bed rest and a lengthy hospital stay reduced to overnight observation and three months of cardiac rehabilitation. I’m a big fan of science-based modern medicine. It has once again kept me alive to see another day. From that perspective, what is there not to like about it?

I start remembering things after I’ve been in the recovery room for a bit. I remember the Wife’s usual amusement at my slowly dwindling confusion. I remember the cardiologist (now my favorite person in the world) visiting to let me know what they found while crawling through my arteries. He also let me know that I needed to stay for observation for at least a day to make sure that there were no complications. I also remember sitting in the recovery room until they had a hospital room ready for me, sitting there waiting until the cleaning staff was impatiently waiting for me to leave so they could clean up and shut down the surgery wing for the day. At least I had Looney Tunes to keep me company.

The pressure bandage was removed from my wrist at some point during the wait, and then there was a brief panic while I bled through quite a bit of gauze before the nurses got the bleeding to stop. Nurses pressing on the fresh surgery site to stop the bleeding, that was the most intense pain I endured that day. A mercifully brief pain considering the amount of pain that open heart surgery entails. Pain for months on end.

NPR – Invisibilia – The Fifth Vital Sign

I could bitch about the inability to get my betahistine cleared through the hospital administration while I was laid up at the hospital for the night, but that seems pretty trivial in the scheme of things. We’ll just pretend I didn’t take the betahistine anyway because that would be against the rules. Did you know you aren’t allowed to bring your own drugs into the hospital? It was news to me. If you have drugs that aren’t available in the US unless they are compounded, you probably should get your drugs approved by the hospital you might be staying in before you find yourself stuck there with no treatment for your weird diseases. It will save you the frustration. In my case, it would have kept me from requesting a Xanax from the staff in order to keep the vertigo at bay. They didn’t want to give it to me, but I convinced them they didn’t want to see a full blown drop attack in the middle of the night. Really, I’m not complaining, I’m just a problem patient. Ask the Wife.

The only real surprise I experienced post-recovery was that I didn’t expect to be one-handed for such an extended period of time. Had I realized that the bruising would hang around for as long as it did, I would have told them to go in through the groin. I would have missed a wedding anyway, as it turned out (thunderstorms will do that) But I could have done everything else I normally do while laid up in bed for forty-eight hours. Not having two hands meant I missed raiding in World of Warcraft for two weeks. But the worst part was not writing. Not writing much of anything for nearly three weeks. Slow torture for anyone who loves to write. As I said previously, I watched a lot of television.

This brings us to today in this little story. Today, where I’m stuck in the near-endless repetition of cardiac rehab three times a week. Exercising while wearing a heart monitor with nurses always hovering nearby. Me and a whole lot of people twenty years my senior sweating as a group and wishing we could be somewhere else. I’m beginning to understand what it means to be handed the short end of the genetic stick now. What it means to have a cholesterol problem that can’t be treated with a Statin because of dangerous side effects. I hope to survive my genetic handicaps long enough to see a crispr application that will fix what is ailing me, whatever that is.

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