Wednesday, August 08, 2007
Surgery Day
I've been procrastinating....

We arrived at the hospital at 9:15 the morning of surgery so they could prep R for the 11:15 start time. He had completed pre-registration, so we were whisked into an emergency room style room called "pre-op holding." Off with the clothes, on with the gown and bring on the needles. The first of many IVs were started, and the tech came in to shave him. There's a funny story in this...the tech, according to white board in the room was Anthony, though the guy who came in didn't have a name tag. R has zero hair on his chest, so I really didn't know what they were going to shave. The guy walked in with a disposable razor and said "I'm here to shave you." My sister and I left the room and came back a few minutes later. R was laughing saying the guy shaved him....down there! We giggled saying the guy wasn't even a real employee, just a perv who bought some scrubs and wanders around pre-op shaving men's private parts!

Around 11 O'clock, they came in and told us it would be closer to 1 before surgery would begin. Dr. M's first surgery was taking longer than expected. We waited, more family arrived, and we waited some more. Finally, about 1:30 they said it was time. We walked behind the gurney and paused at the entrance to the surgery wing. I was trying with every ounce of strength to not cry. I held his hand, looked him in the eye and said "I love you." Then, to try to lighten the mood, simply squeezed his hand and said "Game ON." Off he went. And the second the doors closed, I completely lost it.

I have never in my life experienced a more lonely moment than that one. There were family and friends surrounding me, many of whom were touching me in some way - a hand on my shoulder, touching my arm, holding my hand. But I might as well have been the only person in the entire hospital, I felt so alone. I felt cold inside, empty, and completely helpless. It hurt so bad and I felt so selfish for feeling that way. For as bad as I felt, I knew R was feeling the same and yet so much more. I began to talk myself out of it, almost chanting in my head. I can do this. I have to do this. I have to focus positive energy, not selfish energy. Positive energy. I kept repeating it over and over in my head. Feel it. Friends who are not here are sending it to you. Open up and feel it. I did, oh my God I swear to you that I did. As soon as I allowed it to come, it did and I immediately felt better. I used what I needed and I focused the rest right to R. I swear I could feel him all day. Luckily, my sister and my other very close friends who were there that day did not expect much of me. They seemed to know I didn't need them to talk, just to be near me.

There was not room in the waiting room for all of us, so the waiting room attendant gave me a pager-thingie. Picture the square light-up thing you get at a restaurant while waiting for your table. That's what I got. I held it all day and yes, I took it into the bathroom with me! We waited a few hours in the cafeteria and when the waiting room had enough chairs, we moved up there. We had reviewed the surgery with Dr. M several times, so I knew how long it should have taken. I didn't know how long the prep would take, so since the surgery was due to be about 3 hours, I figured it might take 4 with everything. I asked the lady in the waiting room who fielded calls from the surgery wing to relay to the families to be sure to tell me when he's off the heart-lung machine. That it was all I cared about. She let me know at around 2:45 or so that he was on the heart-lung machine. I managed to relay this to everyone without crying too much. But I felt like this was it. The rest was just formality, now - being on bypass - was really the important time. The surgeon wants you to be on bypass for as little time as possible. While the rest of your body is getting oxygen via the machine, your heart isn't. I expected the time on bypass to be only an hour or so. I can't remember if that's what I was told, or if I just made that up in my head.

During this waiting, I walked, I sat, I am sure I carried on conversations - though I don't remember any of them. I held that stupid light-up thing like it was my lifeline. People offered to hold it, but I couldn't let it go. Around 5:30, the lady came over and said "They're taking him off bypass." I cried and cried and cried. Tears of relief, and of joy. She explained that they would be finishing up and took me to a consultation room where the doctor would meet me shortly. She explained that she was supposed to be off at 4:30, but I was so nice that she stayed to keep me updated. Now, I'm not sure if she just assumed from there that all was well or what. Typically, I guess, the surgery suite calls out and says we're taking so-and-so off bypass and then maybe it's only a few minutes to close then to doctor comes out. This was simply not the case for us.

Just before this, we received a call that a family friend was being admitted at another hospital due to minor complication with a procedure for her recently diagnosed cancer. Since the lady had indicated to me that everything was good to go, I sent many of our friends (some of whom are related to our friend) off to the other hospital.

Anyway, I waited in the consultation room with my sister, sister-in-law, and father-in-law. And we waited. And waited. I felt like I had been waiting all of my life. I began to realize that something was wrong. But by this time, the lady in the waiting room had gone home and I had no way to contact the surgery suite. Friends and family kept calling, or coming by the consultation room wondering why we hadn't seen the doctor yet. I had no answer for them and was beginning to panic a bit. I felt something was wrong. I started chanting again in my head. Focus. You can do this. Breathe. Focus. Use your energy for good. Anything to calm myself down. Two hours later, the doctor arrived. Yes. I waited in the consultation room for two hours. Two hours after the lady said it would be just a few minutes. Two hours.

I've told you before that Dr. M was exactly who I needed and these next few minutes were sure an example of that. He came in, looked me square in the eye and the first thing he said was "He's" So, he was able to let me know right away two things - 1. He was okay. and 2. I was right to be feeling something was wrong.

He went on to explain that he successfully replaced his aortic valve just we planned. He said, though that he found an anomaly in his right coronary artery. That he saw it immediately and that it was very serious and he knew we would be in for a long day. This anomaly is another birth defect and is sort of difficult to explain. Basically, the left coronary artery (LCA) originates from the left side of the aorta and the right coronary artery (RCA) originates from the right. With R's heart, however, both the LCA and RCA originated from the left side. The RCA then was wrapped around the aorta and partially fused into the aortic wall. Also, it was diseased and not functioning. At all. This condition alone is reason for open heart surgery and has horrible horrible side effects if not treated. Why R was still alive prior to this surgery is not exactly known, to be honest.

So, Dr. M went on to explain, he repaired this anomaly, replaced the aortic valve and did it all perfectly AND all within a mere 3.5 incision. It was a very complicated surgery and it went supremely well. At this point in the procedure, they un-clamp the heart to remove it from the heart-lung machine (I'm guessing the lady said all was well at that point.) Normal patients' hearts, when un-clamped and blood flow restored, begin to beat unassisted within seconds. R's heart did not start beating. Even with the use of a pacemaker, it would not beat on it's own and when it did beat it looked "terrible." This went on, according to Dr. M for twenty five minutes. The doctor told me he actually said out loud in surgery "Something is horribly horribly wrong." It could have been anything. After 25 minutes, he said he simply had no choice but to extend the incision the entire length of his sternum (8 or 9 inches) so he could visualize the entire heart and find out what the hell was going on. Immediately after doing so, the lab reports came back and his potassium had shot up to 8. There is no real medical reason for this, but it happens. They treated it and almost immediately, R's heart was beating normally and unassisted. After a little bit of time watching, to be sure, they closed him up and moved him to recovery.

I can tell you, when the doctor admits to freaking out a little, well, things I'm sure were not good in there. I'm sure more happened and I'm sure it likely went on for more than 25 minutes. He said it was a good surgery, but R sure gave him a scare when his heart wouldn't beat. We talked some more, ran through it again, he drew me some pictures and sat with me (us) for a few minutes. He was so great in the way he explained everything. He made sure I was okay before he left and said he would see R the next morning to explain everything so I didn't have to.
We went back into the waiting room and began to tell everyone what happened.

The nurse came to get me so that I could see R and she said all of us could go. No one else wanted to go back with me. Everyone was afraid to see him all hooked up, still asleep, still on the ventilator. It was now 8:00. Six and a half hours. I hadn't seen R since 1:30 and it felt like years. It was, quite simply, the longest day of my life. I walked into the recovery room and was taken to see him. His face was turned away from me and he was covered with a heated inflatable blanket that looked like a pool lounger. He was covered in iodine and had tubes coming out of so many places I lost track. I felt the tears falling down my face as I looked at him. For as long and horrible as the day was, he was alive and finally, finally, I felt like I could breathe again. You aren't allowed to stay in the recovery room, so I had to go. I don't really remember getting home, though I think my mom brought me. I remember her offering to stay with me, but I declined. The nurse told me he'd likely be coming off the ventilator in a couple hours and I should call around 1:30A.M.

next: Day 1 - Movin' on up to a regular room



Blogger Kizz said...

You got yourself a really good doctor there.

Anonymous Organic Mama said...

Wow! I have to tell you that I am weeping now that I have finished reading that; it was marvelously descriptive and I felt I was there with you through your many trials on that impossible long day. I'm so happy your doctor was a fabulous as that and that things are now going to be WONDERFUL.

Anonymous Anonymous said...

Reading that helped me to better understand what you were going through that day and I have to give you some mad props for not letting it get the best of you. I spoke with R on Friday and he sounds like he's coming along wonderfully, that has a lot to do with YOU!


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