Heart of Gold
This was only my second “procedure,” but I’m already feeling less anxious about being in the hospital. Things are starting to feel familiar: wristband, birth-date quiz, silly gown, needles (one in each arm this time), and long periods of waiting and wondering what comes next. Ann came this time, and having someone to talk to made it easier.
An angiogram is a way to get an indirect look at the coronary arteries. They inject dye into the arteries, and take x-rays, and can see if any arteries are blocked. In order to get the dye where it is supposed to go, they thread a tube through an artery in the wrist, up your arm, and into your chest. The wrist arteries are relatively small, and according to my nurse, in about five percent of cases they can’t get the tube in, so they have to go through a bigger artery in the groin. Just to be prepared, they shaved everything from my belly button to the bottom of my pockets. Fortunately the manscaping turned out to be unnecessary.
Still in the waiting area, they gave me a handful of pills to swallow, and within a few minutes I had what felt like a two-beer buzz. A “nurse practitioner” came in to introduce herself, and to explain the procedure to me and Ann. The explanation included a list of unlikely but possible outcomes, such as kidney damage, heart attack, stroke, excessive bleeding and death. She actually rushed through this part, mumbling, as if it made her uncomfortable. The effort it took for me to follow what she was saying through the pleasant haze of the drugs just caused it to have more of a negative impact. “Wait, what?” But I signed the consent form anyway. They had me by the short hairs, you might say, except that they had shaved them all off.
A new nurse came, lively and cheerful, and wheeled me away. In a room with a giant x-ray machine mounted to the ceiling, the “team” was assembling. There was another nurse, whose first name was the same as mine. After some discussion we agreed that I would be Pete and he would be Peter. There were others, maybe five or six altogether, with the doctor being the last to arrive. The atmosphere was collegial and animated. The doctor asked me a few questions, then someone cranked up the drugs, and I could feel my wrist being cut and the tube being inserted. The x-ray machine was lowered, part of it right in front of my face, blocking my view for the majority of the procedure.
Back in the waiting area, inside the curtain, the nurse practitioner returned to go over the results. They had found a blockage (or perhaps just a narrowing?) in a small artery. It didn’t seem to be of great concern, as they could see other unobstructed vessels nourishing the same part of the heart. Later, when my cardiologist called me at home, he told me that it wasn’t worth trying to fix it during the valve repair surgery. This was good news. But because of the arterial narrowing, I was now considered high risk, and was prescribed daily aspirin and Lipitor. The angiogram doctor wrote the prescription, and the Lipitor dosage seemed high, based on my extensive googling. My “regular” cardiologist surprisingly agreed, and prescribed a lower dose. I keep the two pill bottles on my nightstand, and take one of each at bedtime.
I’ve developed a little apprehension around bedtime, but not because of the pills. The frequency of waking up and gasping for air is increasing, and on a bad night it seems to happen a lot. I ran across the phrase “air hunger,” and decided that it perfectly describes the feeling that jars me awake at night. Oddly enough it seems to happen more often when I’m lying on my left side. After nights like these I wake up tired and grumpy, and have what feels like a hangover, only it is focused in my lungs instead of my head.
Despite all of this, some days I feel great. Sometimes I forget that I’m a patient, with faulty parts and a “regular” cardiologist. Oh, and thank God, or at least my former employer, for good health insurance.
In less than a week I will finally get to meet the surgeon. I assume I will leave that meeting with a date for surgery. I intend to prep by writing down some questions. I’m curious to know how many operations he’s done like this, and what his batting average is. I want a better understanding of the recovery timetable. With my fully functioning valve, will I be able lift weights again? Is it true, as a friend has pointed out, that my chances of surviving open heart surgery are better if it’s done in the afternoon? The surgeon has a relatively meager online presence, but I learned that he attended Brown University Medical School. I wonder how he feels about the fact that it was ranked #21 by the U.S. World and News Report? What kind of music does he play during surgery? Does he have any superstitions or quirky rituals for game day?
What else should I ask? What would you want to know from the guy who is going to be holding your heart in his hands?