Un-Break My Heart
Things are happening quickly. Yesterday I had my first meeting with the cardiac surgeon. It was a fairly long meeting, and never feeling rushed, I asked a lot of questions. He reviewed the basic anatomy of the heart, with videos. He showed the view of my mitral valve from the transesophageal echocardiogram. He repeatedly showed the film clips from my recent angiogram, and something caught his eye.
It was the narrowing of the vessel that my cardiologist had spoken to me about. He'd said that it wasn’t big enough or significant enough to warrant complicating my valve repair procedure. But the surgeon didn’t seem convinced. He looked up the notes from the doctor who did the angiogram, and he watched the film clips at least a dozen more times. Finally he decided that he needed to have a conversation with the other doctor. The consequences are big. If he doesn’t have to bother with the artery bypass, then he can make his access from the side, using a smaller and less traumatic opening. But if he needs to do both the valve repair and the bypass, he’ll go in through my breastbone, resulting in more time in the hospital and longer overall recovery.
Either way, he said he had 97% confidence that he'll be able to fix my leaky valve. The main problem seems to be that one or more of the muscular cords that provide support for the valve have broken. He speculated that it happened several years ago, snap, and it probably manifested in the guise of a bad cold with a persistent cough. He will replace the broken cords with Gore Tex thread. Maybe I’ll hit them up for a sponsorship later. To assuage his 3% of doubt, I had to choose between a mechanical replacement that would require a lifetime of finicky and high maintenance medication, or a biological replacement that would likely wear out in about 10 years. I chose door number two, but have my fingers crossed for the Gore Tex.
He asked me when I wanted to have the surgery. I suggested, half joking, that we walk to the OR right then and there. He looked at his schedule and suggested Thursday. That meant only one day to prepare, only one day to worry, and only one or two nights to stare at the ceiling. It was a huge gift. And yet, as I write this, only hours away from surgery, I still don’t know where he plans to make the hole.
I am extremely grateful to be living in a time and place where the science and technology exist to give me high odds of living a long and healthy life despite my heart’s tendency to snap a guy-wire. My surgeon was visibly proud of the fact that he had operated side by side with the physician who pioneered the minimally invasive approach that he hopes to take with my body tomorrow. But the fact that he isn’t sure yet, the fact that he and another cardiologist may not agree on the relative importance of a tiny partially blocked artery in my heart, one of thousands, is a useful reminder that this isn’t all science. There is still room for artistry. I sensed that my surgeon relished that space of uncertainty. He even swaggered in it a little. At least as much swagger as a diminutive middle-aged Asian man who wears bow ties and spring heeled shoes can muster. I was impressed as hell.
After that were more meetings, and they continued into today. Anesthesiologists, nurse practitioners, nurses, intake clerks. X-rays and more blood tests. Pamphlets and more pamphlets. We asked lots of questions, and everyone answered them patiently and thoroughly, but a sense of uncertainty remains for me. We had to buy a thermometer, a blood pressure monitor, and a chair for me to sit on in the shower. I paid bills, some a couple of weeks ahead of time. I picked up some ice cream for after my last real meal in a while.
We need to report at 5:30 tomorrow morning. That seems ridiculously early, and yet not a moment too soon.