“Use that toilet over there, to void your bladder. Then take off all your clothes and put them in this bag. Then put on this skimpy gown, and I’ll tie it in the back,” she instructed. Thus began the humiliating process of my surgery.
Why tie it in the back? It doesn’t reach completely around, so she’s going to see the crack of my ass anyway. But it’s de rigueur. I suppose it’s so I can put on a pretense of modesty. But in truth, there ain’t no modesty in a hospital.
She walked me down a hallway in my flimsy gown, my bare ass greeting any and all hospital personnel who might have glanced back at me. Then into a room with a large, white, highly technical-looking machine, called a fluoroscope, where I was ordered to sit on the operating table.
A beautiful, young Asian woman quickly untied my gown, that had just been tied about a minute earlier, and proceeded to apply all kinds of sticky, cool electrode patches to my naked back, chest, and thighs. Her touch was supple, and felt sensual, soft, and soothing. If my wallet hadn’t been in my clothes bag, I would have tipped her.
Her next step involved giving me a shave. This would require a great degree of concentration, on my part.
But before she could get the razor out, the damned anesthesiologist slammed an oxygen cup over my face and told me to inhale deeply. I felt a caustic poison burn its way up a vein in my right arm, from the IV. I wondered if this is what it feels like to be executed by lethal injection. If so, it’s cruel and unusual.
The ceiling started swimming away from me, and then it was off to Dreamville. Or Deathville.
The next thing I knew, I was hearing jumbled voices. I realized I was being wheeled to the Recovery Room. My stomach felt like it had been kicked by a jackass, and so I tried to turn over on my side, to alleviate the pain. Hands grabbed me and ordered, “No, no, sir! You must stay on your back! Keep your legs down and straight, or your sutures will come out!”
My head was whirling and I could hardly breathe, due to my aching belly. My throat felt raw, also. That’s because the preliminary part of this catheter ablation involved a Transesophogeal Echocardiogram (TEE). That’s where the surgeon drives a train down your esophagus and into your stomach. There, the train sounds it’s horn loudly, and the echos that result produce an image of the Left Atrial Appendage (LAA) of the heart.
The LAA is where blood clots can form, from Afib events. It must be free of blood clots before an ablation can be safely performed. Otherwise there’s a danger that a clot could be dislodged and travel to the brain or elsewhere, causing a lot of damage.
Having found no blood clots, the ablation procedure got the green light. The train utilized a roundhouse in my stomach, chuffed back up the tunnel of my weasand, and choo-chooed out my mouth, knocking a tooth loose in the process. But this is only what I can surmise after-the-fact, as I was asleep during the TEE procedure.
Next came the ablation. One-quarter-inch incisions were made at the top of each side of the front of the groin. The surgeon rammed thin catheters through these incisions, then guided them, with the help of the fluoroscope, up through my femoral veins and into my inferior vena cava, and then on up to the right atrial chamber of my heart.
There, the catheters burrowed through my atrial septum like flesh-eating worms, to reach the left atrium, and slithered up inside my pulmonary veins (which receive oxygenated blood from my lungs). In each of the four pulmonary veins, one of the catheters threw a party, and inflated a balloon. This balloon was supercooled to sub-zero temperatures, and it pressed against the inside walls of the veins, and gave them frostbite.
The frostbite damaged the veins, which will create a ring of scar tissue when healed, similar to ringing a tree. Scar tissue does not conduct electricity well. Now, if my Afib is the most common type, then overactive cells on my pulmonary veins have been sending stray electrical signals to the left atrium of my heart, making it fibrillate. The scar tissue will act as an insulator to block those signals, thus preventing future Afib events.
This procedure works very well on 70% to 80% of Afib patients. My doctor is gambling that I’m one of them. But if not, he’ll have to try this again, and look for the source of the stray signals elsewhere in my heart.
In the Recovery Room, my mouth felt dry as a chalkboard. My tongue was a stick of chalk. I felt a desperate need to swallow, but could not. You need saliva as lubricant, to swallow, but there was no spit in my mouth.
I found that screeving my chalky tongue over the insides of my chalkboard mouth, I could stimulate a few precious drops of saliva. But it was arduous work, like drilling for oil. I ran my tongue along the gumline of my bottom front teeth, and managed to conjure up a few more soothing drops.
And that’s when I noticed that my #24 central incisor was loose. It posted back and forth with each touch of my tongue. And so I had to avoid this area, in my search for saliva, lest my tooth wiggle completely free. And this made the oil drilling all the more challenging.
After they wheeled me into the Recovery Room, I looked to the right and saw a big, round, white, institutional clock hanging on a distant wall. The little hand was past the 10, and the big hand was near the 37 hashmark. It was 10:37. I looked to my left and saw a similar clock, hanging on the wall close to me. And it too read 10:37.
And so I calculated that my surgery had lasted about two hours. A little later I wondered what time it was, so I looked to my right, for the clock. There was no clock, just curtains that surrounded the bed next to mine. So I looked at the wall immediately to my left. And again, there was no clock. Just a big computer monitor displaying my vital signs.
I guess I had been hallucinating the clocks. And yet, it checked out that my surgery had lasted two hours, and that I had been wheeled into the Recovery Room a little after 10:30. Weird.
I felt cold, and began shivering. Soon the shivering turned violent, and nurses started piling warm blankets all over me. But it wasn’t enough, and the shivering and shaking persisted. This was similar to what happened to me about ten months earlier, when I’d been taken by ambulance to an Emergency Room, with an Afib episode.
Apparently, my body was going into shock, because when you’re in shock you feel extremely cold. I guess I go into shock easily. I’d probably never survive a major car accident.
Finally the warmth from the blankets managed to permeate my body sufficiently to stop the shivering. But now there were so many blankets I felt like I was suffocating under the weight. I managed to flag down a nurse, and she removed about half of them. That felt much much better.
On a scale of 1 to 10, with 10 being the best I could feel, I felt like a zero going into the Recovery Room. Three hours later I was up to about a 2, when the charge nurse decided I was well enough to go home. And so I was 86’d from the hospital, via wheelchair, and tossed to the curb, where my wife picked me up and drove me home.
The doctor instructed that I was to rest, and not to lift anything, or exercise for a full week. And yet here I am, the day after surgery, lifting my fingers to type this stupid post. And my blog, of course, is an exercise in futility.
Worse than that, my wife fixed a bowl of chicken noodle soup for me after I got home. I advised her that since I wasn’t allowed to lift anything, I could not lift the soup spoon. She would have to feed me. But she lifted her eyebrows and refused. I guess this was her way of practicing tough love. She wants me to be as independent as possible, so I had to lift that dangerously heavy soup spoon all by myself.
But seriously, my wife has been an indispensable help to me throughout the past week. This reminds me how invaluable it can be, when we have a spouse who loves us.
As I write this, the surgery was yesterday. Today I have a badass headache, from a severe cold I contracted at the hospital. And my throat feels like it’s been run over by a train. I’m moving around a little more, but am finding it hard to concentrate. I must follow the doctor’s orders, and rest. And so I will keep this post short, and go back to bed now.
Although I wrote this the day after my surgery, I continued to revise it throughout the week, following my recovery, as my mind cleared up and shifted into damage control.
During this past week, I developed bruising, swelling, and soreness on my right wrist, where the IV had been inserted, that hurt like a son-of-a-gun for a few days, and that is still somewhat swollen and sore.
I also developed bruising above and below my left incision, but while ugly, it has been painless.
My throat remained sore for about three days following the surgery. My tooth is still a little loose, but seems to be tightening up. And I caught a severe cold at the hospital, but it’s much better now.
I’ve had one arrhythmia event, that lasted for an hour, on Sunday. These are to be expected during the so-called “blanking period.” Inflammation and irritation of the heart, due to the surgery, can trigger arrhythmias for up to three months following the surgery. This is why it can’t be known if the surgery was a success until after three months.
However, I was having arrhythmia events nearly daily, prior to my surgery. So I consider it a good sign to have had only one short one, this past week. I will also note that I feel more mentally clear and alert than I’ve felt for years, in spite of all my aches and pains, and this cold. I’m hoping this is also a sign of success.
Thank you everyone, for your well wishes and yes, even your prayers. Knowing that there are people out there who care about me, has helped me get through this.