Saturday, October 15, 2011


Heart Ablation Procedure

I had a successful surgery on Tuesday. By successful, I mean they put me under and did unspeakable things to my body poking and rooting around with all kinds of tiny implements of torture and mayhem, and I woke up 5 hours later not dead. Thus it was a roaring success. Did they fix what they intended to fix? That question won’t be answered for two to three months.. I believe that translates into “we’re not going to commit to anything until the bills are submitted to the insurance company and the checks all clear the bank.”

Prior to committing me to the abyss of unconsciousness they did manage to poke and prod me with little mini tortures, kind of a warm up for what was to come. They seem to enjoy putting tape for electrodes and such in not quite the right area so they could slowly rip out small patches of hair. Ordered lab tests were somehow missed or the results  lost in digital black hole of lost patient data. A few more pokes for what seemed a large gauge dull needle and they had the pint of blood to finish their test. I guess they got what they needed and I passed the tests because the continued processing me through the system.

My brother came to help watch the fun and keep Joy company. I think he kind of enjoyed being in the spectators box and not on deck for surgery after his incident of getting his fingers sucked into a shaper. Of course this wasn’t really a surgery, it was a “procedure.” Apparently if no external stitches are involved it is a “procedure” and not a surgery.  They even get their one little section in the hospital, the Procedure Care Unit (PCU).  I said my goodbyes and shuffled off to the elevator, hospital gown flapping in the breeze with my stylish gray hospital socks with grippy traction surface and an arrow pointing forward. I guess the arrow was to remind you forward is the hospital approved safe walking direction. I hopped on the gurney waiting for me and off I went to what must be called a procedure room. Four very efficient people were there waiting for me. Those I hadn’t already met introduced themselves and before I knew it they’d bared my chest shaved a large square of hair off my chest and placed all sorts of electrodes and large square patches on the front and back of my torso for 3D ultrasound and other imaging devices. I barely had time to glance around the room at all the computer screens and equipment before they placed a mask over my face and said you’ll breath oxygen for a couple of minutes and then we’ll start the IV to put you to sleep. That will take 30 seconds. That’s the last thing I remember. The doctor wasn’t in the room, probably stuck somewhere on Interstate 5. They kindly waited until I was unconscious before they subjected me to the final indignities of shaving my groin and putting an IV in my heel, of all places. The heel IV was for heparin, a very strong anti-clotting drug. Then they stuffed a breathing tube and temperature probe down my throat.  Then they started threading equipment up the big veins in my legs. They spent the next five hours or so rooting around in my heart, electrically stimulating various section to try and isolate the bad wiring so they could freeze or burn that tissue out. Kind of like having an auto mechanic locate the general area of a short in your car and then applying a blow torch to that area to fix it.

I woke up in recovery and then everyone kept asking when my birthday was. Apparently they want to throw me a big party. It seemed I must have been quite a hit in the PCU. The nurses all wanted to come by and check out my groin and comment on how good it looked. Some even went so far to say it looked great. I was kind of embarrassed. It seemed pretty forward, and they made all these comments in front of my wife. I was feeling quite proud of my groin too at that point, so I decided to take a peek. I was aghast to find they had given me a pubic Mohawk. They’d also decorated the area with blue green dye the color of teenage girls eye shadow. The only thing that was missing was glitter and hair gel. Not really a look I would go for personally, but apparently it is quite popular with young nurses, or maybe it was just the swelling that impressed them.
 


They wheeled me into my private room on the 7th floor. Virginia Mason Hospital was built in the 1960s and I don’t think they’d got around to upgrading the decor in the PCU recovery area since Carter was in office. The Hilton this was not. Half the buttons didn’t work on the bed. To work the overhead light they hooked a piece of stretchy gauze to the little pull chain that was positioned just out of reach, designed to taunt the patient but never quite allow them to turn on the light themselves. Later I hooked it with my pillow and tied it to my bed frame. The view, however, was spectacular. A big window overlooked downtown Seattle, you could even see a bit of Puget Sound off to the north. On a clear day the Olympic mountains would be viewable.

I felt like crap, my chest hurt, my groin ached, my back was killing me and they wouldn’t let me move my legs or even lift my head off the pillow for an agonizing two hours. A few checks of my groin and blood pressure I was given the green light to have them extract the catheter up my wiener. I have now a new found empathy for anyone who has a urinary catheter. It feels like someone let a Gardner snake crawl up the end of you wiener and then left it to die.  The nurse deflated the balloon in my bladder and gave me the Laurence Whelk countdown, “a one and a two and a YOW!”  That felt like you just peed hot coffee and lemon juice. After I caught my breath Edit, my nurse, asks me if I can stand. I stand and sway like a tree about to fall. She has me sit back down and checks my BP, 84/64. After a couple minutes of sitting up I’m better and shuffle off to the bathroom. The catheter  gives you a strong urge to pee. Now you feel like you just spent the weekend in a Tijuana whore house and have a bad case of the Clap. The burning dribbles make me what to scream like a girl. I resist the urge to bare down try and purge the lemon juice some sadist must have injected into my bladder, remembering the warning that it could risk of blowing fresh seals in my veins causing me to bleeding out in the john.

Despite the fun I was glad to be no longer tethered to the auto-BP cuff and the wiener snake. I had Joy order me up a chocolate shake from room service. I was alive, no complications, and I thought I should have a milkshake to celebrate. At about 9:30 PM Joy returned to the hotel room in the Virginia Mason Inn attached to the hospital.  I watched a little TV and read before trying to fall asleep. The nurse offered a night cap of either Percocet or morphine if I wanted. I opted for a couple acetaminophen. That took enough of the edge off to allow me to sleep for about 10 to 15 minutes at a time.  At 4 AM I gave up and called for a Percocet. Between my own discomfort, moans from the other rooms, beeping equipment, and big ticking clock on the wall, sleep had become impossible. Just one little Percocet took the edge off like about a ½ a bottle of Jack Daniels. I slept in a narcotic haze for ½ hour intervals until after 7:00 AM.  By 8:30 then next morning I’d passed all the required tests, I could walk and pee, had no fever and wasn’t oozing puss out of anywhere. I was discharged and walked, not rolled, out of the hospital. The doc, who I saw for about one minute in recovery, says it went great and he’s optimistic I’ll be symptom free in a couple months.

I’ll spare you who read this all the way to the bitter end any more details. I think I may have already crossed the TMI line several times. Thanks for all thoughts, visits, well wishes, calls, text messages and emails. I really appreciate it. Suffice it to say, I’m rehabbing at home and feeling very close to normal. Sorry about that, but that’s as good as it gets. I’ll be walking with our Running buddies on Saturday, back to work on Monday and will be able to do start running, biking and swimming again by Tuedsay or so.

   




Heart Rewiring - Let the Doc do it or Do-It-Yourself

I’m going in to get my heart overhauled on Tuesday. It’s pretty standard maintenance for an increasing number of baby boomer endurance athletes.  According to my logs, my odometer rolled over this year. I’m pretty sure I crossed the 100,000 mile mark for run, bike, swim if you throw in unlogged cross country skiing, kayaking, back country hiking and climbing miles.  Apparently the area around 4 or 5 pulmonary veins in my heart are trying to take over the pace making duties like an evil mother-in-law taking over the wedding planning at her son’s wedding. The fancy name for this is Paroxysmal Atrial  Fibulation.

Dad and I were talking over dinner the other night, and figured Mr. Fixit and I could do the job ourselves and help keep the cost of health care down. We figured all we needed was a pocket knife, a soldering iron and a bottle of Jack. I downloaded the schematic we need off the web. All we have to do is get me liquored up on the jack and have Dad cut down into my left atrium, find the bad wiring area that keeps making my heart race, and burn it out with the tip of the soldering iron. First we had to clear up an argument we had on what side was the left side. I think I convinced him it was my left not his. Just to be safe, I pulled out a felt marker and put a big X on the correct spot. Just when we had it all worked out, we realized we need someone to hold the flashlight. Joy balked at this, blowing all our plans. So much for being a supportive wife.

So now we have to drive all the way to Seattle so some fancy smanshy “electro-cardiologist” and a room full of strangers can knock me out, pull out all their fancy toys, and have their way with me. First they want to shave my “groin” to prepare the area. That right there made me nervous. What a way to introduce yourself to a room full of strangers. Once they’ve got that done I imagine they throw a blanket over me, pull out the Group Health Visa card, and spend the next hour or so shopping online with the windfall of money everyone gets to split after the house, Virginia Mason, takes their cut.

Then they get back to me shivering unconscious on the table. They crank up the music, hopefully not the oldies, and throw back the blanket and cut into both sides of my groin. Here’s where I hope they’re careful, whipping sharp objects around my nether regions poking things into the plumbing. Hopefully they’ll cover up the goods, between the cold and the fact that I’m in a chemically induced coma, the shrinkage will be embarrassingly severe. I wouldn’t be surprised if my little turtle pulls his head all the way back into his shell. Then they’ll thread a bunch of equipment up the big veins in my legs that are reportedly the diameter of your thumb. They’ll be snaking up all kinds of crap into those veins. A HD fiber optic camera, fancy flashlight, a couple of tools, I think one tools a cutter, joy buzzer nerve stimulator, and one has a balloon on the end of it..  When I first heard about the balloon, I was taken aback. What do they need a balloon for in there? Something to create a little party atmosphere? Perhaps it’s a contest to break the Guinness Book of World Records to see how many balloons you can inflate inside a patient’s heart. Apparently this isn’t a conventional balloon. It’s a cryogenic balloon used to freeze the bad mother-in-law tissue to death and send the bitch packing.  Unlike a party pack of balloons you get a target for $.79 for a hundred, I’d imagine this freezy balloon costs about 15 cagillion dollars. They’ll thread all the tools into the right side of the upper chamber of my heart and they punch through the tissue separating the left and right sides and continue threading the gear they need into the left side to do their business.

They’ll stuff some kind of temperature probe down my throat to make sure they didn’t take a wrong turn somewhere and are working in the wrong area and freeze or burn through the back side of my heart and into my esophagus. They will use the fancy joy buzzer they threaded into my heart to stimulate my diaphragm in little pulses to make sure they are not freezing or burning my breathy nerves. I’m assured that the risk of either of these things is very very low but if it happens it is very bad. I didn’t really want any details about what “bad” means. The whole time they’ll be using ultrasound to see where they are at. Complication happen in something like 1 in 1,000 patients. This is one time I hope I’m not that “special” one.

When they’re all done, they’ll pull the snakes out of left atrium, the hole they made will seal up in a couple of days, then it all exits the way it came in. A couple of high fives and everyone is out in time to make their tea times on the golf course. The whole party lasts between 2 and 5 hours. They’ll wheel me back to recovery and then into a private room where Joy can laugh at me and whatever gibberish comes out of my drug addled brain while I come out from the happy drugs they used to knock me out. One night in the hospital and home again the next day. A couple days of taking it easy and I’ll be able to ease back into my exercise addiction activities. Over the next 2 to 3 months we’ll see if the procedure worked. If not, they get to go back in and give it another shot. Stats show a 70% success rate on the first shot, and roughly 90% if they have to go in again.

I’m hoping the first time’s a charm. I hit a new age bracket this year. Maybe I’ll try to qualify for another Boston Marathon. I missed racing this year. After my heart acted up in the Tucson Marathon in 2010 I figured why pay the money for a race only to have a wacky heart act up and have to get another DNF (Did not Finish).