Friday, February 20, 2009

Heart aches 6

It has now been three weeks since the operation, and I thought I ought to update you on the current situation. For some odd reason, three weeks after the fact, I am in more pain in my upper body than at any time since the first awful night. Why this should be so I cannot imagine. I would have thought that the natural progression of the recovery would have been significant pain at the beginning, subsiding over the following weeks into insignificance. The reverse is true. After the immediate onslaught of pain, which, of course, is to be expected, the pain subsided for a time, and then recommenced, rising again almost to its initial level.

Now I think part of this may be due to the fact that I had been in the habit of working out heavily at the gym five or six days a week. I did a lot of lifting in the chest area to prepare myself for the surgery (doing 100 to 150 flies and presses with dumbbells each session), and it now appears that this was a mistake. What I suspect has happened is that, having conditioned my body to do such hard work in the chest, and then having, in effect, stopped cold, I set myself up for this kind of rebellion. I find that stretching and doing very light upper body exercises loosens up the muscles and relieves the pain a good deal.

It now appears that I have reverted to atrial fibrillation, which all this was meant to cure, which means shortness of breath and fatigue after even the most mundane of activities. It may be necessary to do another cardioversion, a procedure in which the heart is subjected to electric shocks to restore its normal rhythm. I had one of these back in August, and it did buy me some time to arrange the surgery. But what thousands of volts of electricity will do to the new valve and the bypasses I can only guess. I dread it as I have dreaded everything else in this process, but I am resigned to it, as I have resigned myself to everything else.

You may be asking whether anything good has come out of this experience. The answer is: very little. The defective valve has been replaced (with tissue taken from a pig, I note in some horror) and the arteries, which I was solemnly promised were blocked, have been bypassed. But the maze procedure seems to have failed, and, as I have noted repeatedly, many of my core values have been violated.

I will say that the experience of being in a major university hospital was revealing. It was a very cosmopolitan place, staffed for the most part by people from around the world. Needless to say, most of the nurses were Filipino (they seem to be acquiring a monopoly on the nursing profession), and as for the doctors, technicians, trainees, therapists and other employees, I think that among them I met only a very small number who were white Americans whose first language was English. Among those who who attended me were people from China, Taiwan, Japan, Korea, Indonesia, India, Nigeria, Mexico, Honduras, Peru, Armenia, Serbia and Russia. As someone who has always been intrigued by and drawn to foreigners, I found this enjoyable, and I am glad that our society still welcomes professionals of every nationality who are willing to come here and work hard. This, I suppose, was the best part of the experience.

Beyond that, the experience continues to be a form of waking nightmare. It has added a good five years to my age (which accounts for about half of the longevity I was promised), and has debilitated me to the point where I remain dependent on others for the simplest tasks, like putting out the trash cans and changing a ceiling light bulb. I am simply not used to being so dependent, and I caution anyone who is contemplating the procedure to reflect upon the fact that, in the first month or so at least, you will not be able to do much of anything that you formerly took for granted.

I never realized how many physical activities put pressure on the breast bone. Opening a jar, for example, or putting on a shirt, or turning a steering wheel or a screwdriver, or lifting a bag of cat food. All are painful once the sternum has been severed; and turning over in bed or finding a comfortable position in a recliner are practical impossibilities. When attempted, they produce the keen sensation of the breastbone shifting, of its two wired halves rubbing against each other like tectonic plates beneath the earth. And as with such subterranean movements, the effect is felt on the surface - a kind of electric shock of tingling pain across the chest which sparks and shimmers from one side to the other.

Three weeks out, coughing remains an ordeal, and I still have to press against my chest when I feel that I am going to cough, to prevent the sensation that my sternum is unhinging again. The incision, while not so livid as before, remains a hideous reminder of the experience, and I can only hope that the regrowth of chest hair will help to hide it. The three holes where the tubes were inserted seem to be healing, and I hope that they will leave no more trace than would have occurred if I had suffered some accidental injury. The scabs on my legs show no sign of abating.

These are the realities as I am experiencing them, but the worst of it, I continue to say, is the mental, moral, emotional and spiritual toll that has been taken by the opening of my chest, and the handling of my heart by strangers, no matter how good were their intentions. Yes, it is wonderful, even miraculous, what medicine can do, and what the skills of surgeons can achieve. And if we were merely machines the parts of which could be repaired of exchanged without cumulative effect, this would be unqualifiedly true. But we are not, and it is not, and the wounds incurred in those misty realms of our humanity may never be healed.