Four months since my last post and only one person has wondered why I haven’t blogged in such a long time. Apparently I am not much missed, something that shouldn’t surprise anyone in this digital world of fleeting contacts. But I’m back. I am updating this post tonight and will resume my earth science blogging activities.
So what happened?
On March 31 of this year my husband suffered a small heart attack. He is in his mid 70s. He had a small heart attack 18 years ago after which he underwent heart catheterization, from which it appeared that there was little or no damage to the heart. At the time he was in a stressful job. He was put on a blood thinner (aspirin) and did a stress test each year which never gave any reason for concern. He was prescribed cholesterol medication for a mildly elevated cholesterol a few years later. He was always physically fit and didn’t smoke. He quit the stressful job almost instantly and retired 6 years later. Since that time, he kept up his fitness through regular walking, swimming and bicycling. We have disgustingly healthy eating habits and live a happy life.
So we were surprised when it happened this time. Surprised and a little angry: how can you get a heart attack when you live so healthy and are so happy? The cardiologist in the local hospital told us that my husband simply wouldn’t have lived this long if he didn’t have these very healthy habits. He did a couple of tests and determined the need for a heart catheterization, after which he expected that a balloon and stent procedure would solve the problem.
These procedures take place in the heart centre in the city hospital. A week later, my husband underwent the procedure. Surprise number two: his arteries were toast. There was nothing to send a balloon-and-stent through. He needed triple bypass surgery. We were shocked and scared, but were assured that this was routine surgery and that he was an excellent candidate for the surgery given his good physical condition and the good condition of his hear. The heart clinic has an excellent reputation and his surgeon would be one of the best of the clinic.
The bypass surgery took place nearly a week later, two weeks after the heart attack. By this time, he had been in hospital for about two weeks. Despite having walked around as much as possible, he had of course been rather inactive and had also been on a significant dose of blood thinners. As the surgeon said later: “that is excellent medication, but when we do surgery, it becomes our enemy”.
Then he drew the short straw: as the heart was lifted from the chest cavity to remove and replace the arteries, there was “a tear” at the back of the heart where it is attached to the back of the chest wall by membranes (if a medical person reads this and concludes this is not the proper way to describe it, please correct me). And since the heart is a vascular organ, full of blood, the flood gates opened: bleeding, serious bleeding. Instead of 5 or 6 hours, the surgery lasted 9 hours (yes, I had a friend with me during that agonizing wait). Nine hours on the heart-lung machine: the heart is stopped, the lungs are collapsed and the blood runs through the medical equivalent of a sewage treatment system, getting supplied with enough oxygen.
After nine hours, the sternum having been wired together again, he was moved to the Intensive Care Unit and we got to see him briefly. Of course, he was still sedated, intubated and mechanically ventilated. His hands were swollen, the skin tight. It was scary and very emotional. We went home, it was 1:30 am.
Three hours later (no, I had not been able to sleep) my phone rang: “your husband has to go back”. Go back? What does that mean? The only thing I managed to say was “should I come?”. The kind person asked me where I was: in the house of friends, not 10 minutes from the hospital. “you should get some sleep, we will call you”. Well, I didn’t sleep, of course and at 9 am, my phone rang again, he was back in the ICU. When I went to the hospital, I was told that they had to bring him back in because there was too much bleeding for the regular wound drain (so yes, the wires in the sternum were loosened again, he was opened up, back on the heart-lung machine). At this time, I didn’t know yet about the tear, I just knew there was ‘bleeding’.
He stayed sedated and ventilated another 24 hours and was then allowed to wake, but still ventilated. So he couldn’t speak, but he could squeeze my hand. Mostly he slept. The next day they removed the tubes, but he struggled to re-inflate his lungs properly: he was too weak to do it himself. Another day later he was again intubated and put on the ventilator. By this time he had not eaten anything in nearly a week. I was assured “his digestive system doesn’t need it, he gets nutrients via the drips”. But the ventilation was torture: his mouth was unbearably dry, but he was so confused that he refused the sponge to help moisturize him and the confusion (and frustration, I assume) made him aggressive, so they actually had to restrain him. It was terrible. He only left the ICU a week after the surgery and I had barely exchanged a word with him then.
During the next week he was in the ‘step down unit’, where the care is somewhat less intensive. They made him sit in a chair, where he would consistently fall asleep immediately. They tried to convince him to eat, they tried to feed him, but next to nothing went or stayed in. They began to try to walk him, but his legs simply buckled. He couldn’t keep his eyes open for more than a half a minute, he was confused (at one point he thought he was part of a movie set), he had no energy. Not until nearly two weeks after the surgery did he first speak a few lucid sentences (this for a man who is brainy). It was a scary period.
Three weeks after the surgery, he was allowed to be transported back to the local hospital, where he stayed another two weeks. All this time, I tried to get him to eat healthy food. Hospital food is terrible but I don’t blame the hospitals. The majority of patients isn’t used to healthy and wholesome food and many patients have difficult dietary restrictions. Thankfully, hospitals have patient kitchens. I have never spent so much time trying to prepare food that I would hope he would like (under normal circumstances, he is a good cook and does a lot of it) but most of the time, it went uneaten. He had no appetite and the thought of food revolted him. He had no energy to read or talk, he slept – most of the time.
He finally came home four and a half weeks after the surgery. He could only walk 50 meters, he still barely ate. He was completely deconditioned: his muscles had atrophied. I had rented a hospital bed and put it in my study. That was a life saver: he needed the height, he needed to adjust his position frequently, and I don’t think I would have been able to sleep next to someone in his condition.
That was two months ago. He now walks 2 kilometers each day and eats normally again. The hospital bed was here three weeks. The first few weeks I walked with him twice a day up and down the sidewalk. I pushed a borrowed walker, which he didn’t use, but he used it as a seat at the turnaround point or at any other point in time when he felt exhausted, which was often. Getting dressed was a major exercise. Taking a shower was the equivalent of running a marathon: he needed a serious rest afterwards. Fortunately, our house is ideal: a former bungalow, we kept our bedroom on the main (ground) floor after the renovation more than a decade ago. He has a studio (he is a photographer) also at ground level so no matter where he was, he didn’t feel isolated in an upstairs bedroom. Our house has an amazing view, which is nothing but therapeutic.
I read a lot about our “failing health system”. We didn’t experience anything as ‘failure’. The specialists (cardiologist, cardiac surgeon, residents) were expert and their communication skills were excellent. The nurses and physiotherapists were nothing but amazing: helpful, always there, always friendly (even when he was growling and angry and confused and frustrated), ready to talk to me at any time of the day or night. The pharmacists had all the time for our questions. The family doctor sees us regularly and takes his time, never rushing us out. And – this is Canada: we haven’t seen a single bill. We pay taxes, we don’t mind.