"How Do You Mend a Broken Heart?" Part Two: Ablation

"Damn, there's a lot of y'all people up in here." 

That's what I noticed first, the size of the team. Nurses and techs and anesthetists and people staring at screens and one big hulking dude whose main job, I assume, was to muscle me off the table and back onto the gurney when the time came. And that was just in the operating room, before the electrophysiologist made his appearance.

I arrived via Lyft at around 6;00 AM. Registration went smoothly. They accepted a comically small payment on a bill that will be around for many years, as will I. A lady with terrific looking hair (everybody I met had such great hair,) walked me to the room that would be my home-base for the day. Another strip down. Another robe. Another pair of those fuzzy socks with the rubber stripes on the bottom. A tiny lady with great hair came in and took my vitals. Put on stickers for an EKG. Fitted me with a disposable blood pressure cuff. Then, in a voice that was just perky enough, "OK, Mr. Johnson. I'm going to shave your groin, now." I knew this part was coming and I had been dreading it, not out of modesty, but because I knew how brutally itchy this site was going to be in a few days. She covered Little Bob with a towel, which I thought was a kind touch, and used an electric shaver on my thighs, groins, and lower belly. As she finished up, the nurse who would be looking after me all day, whose real name was Barbie, came around the curtain with a toss of her hair and a stack of papers to review. We went over my list of drugs and my medical history. She told me how good Dr Ross was and how I was going to do great.

Then the great man himself made his appearance. We had met once in his office, the day he scared the shit out of me by describing all the things that could go wrong during the surgery. I remember how his face fell when I told him I had a fiter installed into my inferior vena cava after my blood clot during cancer treatment, 12 years ago. The IVC filter could pose a real problem. If they couldn't get their equipment around it, they would have to stop and try again later by opening my chest. The possibility haunted me all week. By Thursday night, I was twisted up in knots only a drunken boy scout could have tied. A friend posted this on Facebook for me:

     Yes, it's scary as hell to think about what they're doing, but so is the thought of a potentially lethal arrhythmia that stops you dead in your tracks when you least expect it. 
     It’s good that you have an “easily” curable problem that should be a thing of the past after you awaken from the nightmare that exists before tomorrow at 6:00AM. Go to sleep and rest well tonight, knowing that you have the blessing of making a choice.
     Cruel as these words may sound, they’re not meant to be. My prayers will include you tonight, Bob.

I'm not sure what Mike imagined might sound cruel in his words, but they gave me just the courage I needed. I had a choice. I could choose life, something so many other people I've loved and lost did not have the chance to do. I really was blessed.

So I was feeling relatively peaceful on Friday morning as a young anesthetist with a bald scalp and an African accent as comforting as warm sorghum talked me through the procedure for the hundredth time. He checked out the site of my cancer surgery and my throat to make sure there would be no trouble intubating me. He gave me a long list of drugs they would pump into me to let me sleep and keep me from being nauseous after. He also warned me that I would be flat on my back for four hours after leaving surgery so the incisions on my groin could have a chance to close up a little bit. (That was where they would be inserting the catheters that would carry all the cameras and sensors and magic wands that would do the work inside my heart. Hence the shave.) 

I'm sure I had lots of other visitors, but the last one I remember was a young woman whose name escapes me, but whose form reminded me why so many boys harbor fantasies about nurses. She was wearing a surgical gown and head cover, but I'm sure underneath it, her hair was perfect. She disconnected me from the monitors and rolled me down the hall, then asked the question I had been fearing most of all.

"Have you ever had a Foley before?" For you surgical virgins out there, a Foley catheter is a tube that the run up into your urethra so you can pee into a bag while you are unconscious. Mercifully, they don't put it in till you are asleep. But you will never be as awake in your life as you are when they remove it. 

But I am ahead of myself. As we rolled down the hall, through the hundredth set of automated doors, I was feeling a little flirty toward my shapely Florence Nightingale, and joked that I felt like the title sequence of Get Smart. No response. "That doesn't mean a thing to you, does it?" 'I've heard of it,' she replied sweetly, "but I never saw that movie." God  love her. My shoes are older than she is.

Once in the surgery, there was nothing but action al around me. People were focused and professional, like I imagine the team that gets an astronaut strapped into the capsule before lift off. One guy seemed to be the morale officer and we just sort of joked back and forth as he shaved my chest to place more stickers. A voice over my shoulder warned me, "OK, Mr. Johnson, I'm going to give you something now that may make you feel tingly or you may taste metal. It won't last long." She lowered an oxygen mask over my face. I felt someone arrange my left arm beside the gurney. "What do you know," I thought, "that tastes like..."

Then I woke up."You're done," Barbie said. "You did great." Dr Ross came in and told me that everything went according to plan. The IVC filter barely slowed them down. He'd see me in a week. I realized that he wasn't wearing a mask. I had never seen his face before. He had a goatee.

For the next four hours, it was just me and Barbie. She brought me ice water. Ordered lunch for me: Fruit salad and an indigestible grilled cheese sandwich. She brought me more blankets when I got cold, and more water when I got dry and I was so grateful for her kindness that I forgot to notice her hair. 

Speaking of hair... The time finally came for her to remove the dressings and take out the single stitch that held each incision closed. "Oh dear," she said. They've stuck tape right into your pubic hair. I'm sorry. This is really going to hurt. Better to just get it over with. RRRIIIIPPP! 

You know the sound a puppy makes when you accidentally step on it's tail? Yeah. I made that sound. I'm pretty sure my eyes watered a little bit, too. Oh, did I mention that I have two legs? RRRIIIIPPP!!!

St. Joseph's Hospital has a delicate silver crucifix hanging in every patient room, and I was glad to have Jesus so close by so I could beg for a quick and painless death. It may have been the Fentanyl, but I'm pretty sure he was laughing at me. I mean, it wasn't like i was nailed to the wall or something.

Barbie snipped the stitches and pulled them away. She replaced them with two, more carefully placed dressings. Then came the awful moment.

"You're going to take it out now, aren't you?"

"Yep."

"I hate this part."

"It isn't fun."

She held Little Bob tenderly in her gloved hand and began to slide the catheter out. I don't know why they would make them out of salty barbed wire, but that is the only explanation for the way that jagged fire hose felt as she pulled twelve feet of it through the tenderest part of my tenderest part.

This time, Jesus was definitely laughing.

"I'm pretty sure I'm still peeing."

"No, you're not. But I'll get you a urinal, just in case."

After that, everything happened pretty fast. A nurse at the desk outside my room threatened to chew her leg off if they didn't let her go home soon. A young nurse in scrubs and hair styled to the same salt and pepper ponytail as my own leaned over the counter and whispered something about someone, probably the funny old man in room seven who kept cussing out Jesus for laughing at him. Barbie brought me lots of papers to sign, one of which was a paper warning me not to sign any legal papers for the next 24 hours. I got dressed. Ordered a car. Salt and Pepper girl escorted me to the door to wait for my Lyft driver.

"Do you all get your hair done at the same place? Everybody here has such great hair."

"Wow, thanks," she glowed. "That's really funny."

Just then, and I swear this is true, a big-bellied fellow in a bright orange safety vest and hard hat came out of the door and approached us from behind.

"I just wanted to tell you," hand to God, this is what he said, "I really like your hair. It's very striking."

She laughed a laugh that made me notice how good the spring air smelled as she replied, "That's what he just said!"

Big belly looked at me with a smirk and an eye roll. "We're idiots."

As he walked away I noticed that his own ponytail could use a little touch up with a brush. I was back in the outside world.

I don't remember the ride home. Or dinner. Sophie the cat and I curled up and slept all the sleep I had missed the night before. 

Today?

Today, I have started to itch on my legs, my crotch, and my chest. It's just about time to remove the dressings from my groin. 

I have a sore throat from the breathing tube. And a foggy head from what I can best figure was four hours of surgery under anesthesia.

And hell's fire it hurts to pee. 

But at least I have a choice now. Lots of them. I'll raise a glass of cranberry juice and try to make some better ones.

Peace, y'all.

Pennsy

"How Do You Mend a Broken Heart?", Part One: Cardioversion

 We've known for a couple months that something was wrong. My heart rate was getting really high on my runs, but quite low on my off days. My blood pressure was no longer responding to the meds, so when my doc ran out of ideas, she referred me to a cardiologist. The cardiologist added fists full of pills and they finally started bringing the numbers down.

Meanwhile, a routine blood test indicated anemia, so my doc ordered a colonoscopy to look for a bleed. Nothing unusual except one benign polyp. Then came the endoscope to check out the upper bowel. No bleeds, no goblins which left one more magic trick. 

There is this thing called a pill-cam. It's a big, big capsule with a light on one end and a web-cam inside that you swallow and carry around for a day. It talks to a belt pack that records what must be the most boring video in the world. It takes a couple weeks for some poor schmuck to assess the whole thing. No troubles found, no answer to the continuing mystery of the anemia. On the other hand, you get to keep the camera. I elected to simply let that opportunity pass.

But part of the prep for this robot magic was a sonogram. We had to be sure i had no blockages that would trap the camera. They found none. But what they did find, by accident, I suppose, was a weird little hop in my heartbeat. The report caught my cardiologist's attention, and her EKG revealed that I had developed atrial fibrillation or A-fib. It's a skip or flurry in the rhythm of your heart that makes all kinds of evil stuff much more likely. Stroke. Heart attack. Embolism. She immediately put me on blood thinners and scheduled an appointment for something called a cardioversion procedure. This was several weeks ago, so my memory may be blurry, but here is what I remember.

I went to the cardiologist's office, was escorted to a dressing room where I stripped and put on a robe. A nurse put an IV port in my arm, drew blood, and after a brief consult with the the docs who would be knocking me out and running the show, I was rolled to a lab that looked an awful lot like somebody's office. There was a desk at one end, and several nurses were placing pads around my torso, while several others had a fairly animated conversation about schedule changes and the length of their shifts. Finally, the big cheese came in and explained once again that they were going to try to shock my heart back into rhythm. Somebody injected something wonderful into my IV and I heard an electronic voice advising the team to connect the pads. It was the same fellow as the one in the AED we use at the Y when somebody had a heart attack. "What a gig," I thought, "doing voice overs for machines that save people's lives." I wondered how long it would take the drugs to knock me out.

Then I woke up. "All done, Mr Johnson." No wonder people take drugs for fun. 

Everything went fine, just like it was supposed to. I was back in rhythm and as soon as the glorious chemicals wore off, I took a cab home.

The next few days went wonderfully. I had meds to keep my heart on the beat. I had energy, My depression lifted. People in my classes noticed that I seemed like my old self. Then on a Tuesday night, I started to drag. I finished teaching my last class and was gasping at the front desk waiting to close down the Y when my Apple Watch buzzed. My A-fib had returned.

The cardiologist said it was time to meet the electrophysiologist. The next step? Cardiac Ablation. That's what they did to me yesterday morning. I will tell you that story in Part Two.

Island Living

What is grieving? It is losing. It is being without. It is the longing for what once was and the dread of living without it. Grief is a cycle, a puzzle, a wall, and a prison.

Grief is an island.

Here on the island of grief, we wander alone. On those rare occasions when we do catch another's eyes, we nod knowingly and move on in silence. What use would speaking be? Words echo like stones skipping on the water, then sinking to the silt below.

I have sat on this shore, beneath this tree for hours, days, weeks on end. I watch the river flow around and past, carrying its cargo of life and death. Branches blown loose by a storm. A lost doll. A pair of kayaks paddling silently in the sunshine. There is laughter out there. Tears of Joy. Weddings and births and graduations and all the tiny, daily celebrations that the mainlanders take for granted. I hear them, but they are more like a memory than a moment. Grief segregates me from today. 

There are daily tasks to be done. Floors to sweep. Dishes to wash. Laundry to fold. A stranger I barely recognize moves quietly around my island home, doing the chores that will keep life moving until I am ready to live again.

What is it to grieve? It is cursing in the middle of a half-dialed number. A million "can't wait to tells" or "wish they could sees." It is knowing what it means to die alone and that seven last words are far too many but not nearly enough. It is the pain of meals unshared and hands un-held. The days that feel normal until the sight of a cardinal or the smell of mown grass pulls the rug out and your are digging your nails into the back of your hand to try to hold back the sobs again.

The visits are hardest. Visitations, maybe. You play music or the television so you aren't alone with your thoughts. Impossible sounds wake you in the night, long gone voices calling your name that sound so real you have to reach across the bed to make sure. Dreamed faces that smile and comfort or accuse and blame. The twilight moments before waking when you'd swear that thieves came in the night and emptied your chest. The glare of sunshine on an unfilled chair. 

Here on the island, we grieve things stolen and things wasted. Opportunities missed and regrets unforgotten. We are waiting for redemption. We are waiting for the courage to forgive God.

What is grieving? It is losing. It is being without. It is the seam between light and shadow. Between now and then. Grieving is Holy Saturday all year round. "He descended into Hell" they taught us in church. And so he did. And here we are. On an island. In a river. Under a tree. Waiting for the stone to roll away in the morning.

Crawl Bob, Crawl

 PROLOGUE

Been a long time since I felt like writing. Hell, I havent felt like doing much of anything for a long time, to be honest. Years ago, Run Bob, Run helped me to navigate through some rough seas in my life. I guess I'm hoping writing might do that for me again. At least it will help me to create something besides belly fat.

I caught myself preaching to a friend about grief today and realized that I'm the last person to pretend to have any insight into that old monster. It seems like all I've done for months is to grieve or to bury my grief in empty activity and empty calories. None of that is helping me to heal and my physical and mental health both show signs of fatigue and failure.

In future posts, I'll dig more into all that has happened, is happening, may happen in my world. You may find it engaging. I may find it useful. Or it may turn into an exercise in self-indugence we can both do better without. If all I can do is moan, i'll moan to my cat, Sophie. She's a good listener and isn't afraid to set clear boundaries. I could learn a lot from her. Whatever happens, it feels like a step forward today, and that is a direction in which I long to travel.

Too soon to run. Maybe Crawl Bob, Crawl will be a good working title for a while.

Peace, y'all.

Pennsy