Open Heart Surgery and Me

Wow, where do I begin? I'm sitting here in my recliner a mere week after open heart surgery, starting down the road to recovery, and trying to pull together the events of the last couple weeks here for posterity.

I had first noticed some chest pain and discomfort when I went walking for any extended period of time... out for a walk on my lunch break, walking into church carrying Nathan in his carseat, and walking around the neighborhood while Beth pushed Nathan in his stroller. I felt pressure at the base of my neck, which tended to radiate out over my collarbones and sometimes up into the back of my head. At first I thought it was some strange new muscle pain since I had just started being active once the weather warmed up outside. After a few days though it didn't take much to bring on the pain. Just walking from my car into my desk at work brought on a mild headache. The final straw was on a Tuesday trip to WalMart on my lunch break. I barely made it into the store before feeling chest pain and barely made it back to my car to sit down and call the doctor. I took the afternoon off work, went home, and had Beth bring me to the clinic for a mid-afternoon appointment.

Despite my young age (29) and lack of normal heart disease risk factors, my doctor took it seriously (which I'm told doesn't always happen). He ordered an EKG, a chest x-ray, and some blood work. All of these tests came up normal, so a stress echocardiogram (stress test) was ordered. We called the hospital and set it up for the following afternoon.

I went into work Wednesday morning and felt pretty good overall since much of my time there is spent sitting down with my body at rest. My boss was very understanding and helpful having dealt with his wife's heart issues in the past. We brought one of my coworkers up to speed on my big projects so they could move forward while I was out yet another afternoon. Little did I know I wouldn't be back for quite awhile.

The stress test was pretty straight forward. Record some ultrasound video of my heart at rest, walk on a treadmill until I hit 162 beats per minute, and record more video of my heart beating at that point. Getting to that point was a painful process, but I could appreciate the usefulness of the test... being able to re-create the problem for the medical staff who would be investigating. Like I had experienced before, chest pain set in fairly soon and got worse the longer I went. I kept telling the technicians about what I was feeling, pain level, etc. It was really tough. Once we hit the target heart rate I got back on the exam table and they took more video of my heart. After a few minutes of rest I was back to normal again. At that point I had my own cardiologist.

The cardiologist came in and described what they saw in the test. They could see in the video that some portions of my heart valves weren't opening and closing properly. This is usually caused by a blockage in one of the arteries of the heart. In my case, they were 90% certain there was a blockage in the Left Anterior Descending Artery. Needless to say Beth and I were shocked to be hearing this, and yet took some comfort knowing what was causing me so much pain and what could be done about it. The plan was to go in on Friday for an angiogram (test to locate the blockage) and possible angioplasty (implanting a stent).

After Friday's angiogram the terms "incredibly rare" and "incredibly lucky" were thrown around a lot. The blockage I had was not normal. It was called a Spontaneous Coronary Artery Dissection, meaning that the inner lining of the artery had torn and blocked the flow. This is very rare and there isn't any specific cause. Had the blockage happened only a quarter-inch "upstream" it would have most likely given me a heart attack and/or killed me. Because of the location of the blockage, a stent was not recommended. I would need open heart surgery to perform a bypass using an artery in my chest to bring blood flow below the blockage. The surgery would be a bigger ordeal and would require a longer recovery but in the long run would be better for me than dealing with the issues associated with stents. I stayed in the hospital Friday and Saturday waiting for my surgery on Sunday. My family set up my CaringBridge site to spread the news and keep everyone informed on how I was doing.

Thanks to my mother in law, our son was being taken care of, and I got to spend much of my time with my wife which made all the difference. She was my partner and friend throughout my hospital stay, and my second set of eyes and ears since I wasn't always able to focus on what was going on. Saturday night and Sunday morning were busy with surgical preparations. The last thing I remember before surgery was being wheeled down to an anesthesiology prep area with my family.

My first memory post-surgery was a half-conscious haze with a breathing tube in my throat. I was listening to my family talk to me and managed to talk back by writing messages in the air with my hands. I spent the rest of Sunday and part of Monday in the Intensive Care Unit, and moved up into my room on the 4th floor. Somehow I managed to get the best view of the downtown skyline from the corner room. Recovery in the hospital was rough, but it was the best place for me to be. Having Beth there much of the days really helped. My nurses and nurse assistants were very good to me, helping me when I needed it, and keeping an eye on my vitals. Sleep was ok, but never great. They also taught me some basic exercises I could start doing until I got my strength back. Progressively I got my various lines removed, and finally had my drainage tubes removed from my chest on Wednesday morning.

Thursday I got to go home from the hospital. A volunteer brought me down in a wheelchair while Beth brought the car around. It was a beautiful day and good day to go home. Each day since has been difficult in it's own way, and great in it's own way. Each day gets a little better. My muscle soreness has been getting better, my breathing has gotten better, sleep has improved, etc. My chest incision has been looking better, as have my drainage tube incisions. The recovery process has its own regimen to it. Right now I need to make sure I take all my medication, do my exercises, and take three 10-minute quarter-mile walks each day. As time goes on I'll e taking longer walks but right now that is about as much as I can handle. Everything happens slowly and I tire easily, but I can feel that getting better. Next week I start regular outpatient rehabilitation 3 days a week at the hospital.

It's going to be strange being home for 2 months without being able to lift or move anything over 10 pounds, but in the end, besides having a healed breastbone I think I'll come out of this a much stronger person.