Sunday, December 09, 2007

"Why Me?": A New Lease on Life - Tom Glass Recounts His Bypass Surgery and Beyond

My friend, Tom Glass, e-mailed me a piece he had written and asked me to read it. Upon reading his account of his bypass surgery experience, I immediately wrote back and asked for his permission to share what he had written with the readers of The White Rhino Report. During this holiday season, we often pause to reflect on life and the importance of relationships. Tom's piece - a reflection on a life-changing experience he had several years ago - does a wonderful job of focusing attention 0n the things that matter.

________________


“Why Me”
is written for my children, so they may understand what it was like to experience a life changing event. Other folks that have questions or find themselves in a situation similar to mine ,“Why Me” will provide information as to what to do. Better yet, it may give them a clearer picture of what happens emotionally. The intent of “Why Me” is to ease the fear, doubt, and mystery that surrounds heart by-pass surgery.


The best direction or advice , “Be not afraid”, do your research, prepare the best you can, find a Doctor Stephen Michaelson, find a hospital like St. Vincentʼs, and find a surgeon like Doctor Dan Rose. They were all my plus factors.

“Why Me?”

It has been 8 years since I was told I desperately needed heart surgery. The feelings that raced though my mind were of utter disbelief, total denial. The diagnosis couldn't be mine. But the results of the heart cauterization had my name written all over it. How did this happen? Why me? I felt good; I was all set to play golf the following day. But for right now, my world had come to a grinding halt; at least it was put on hold until we (my wife Patty and I) could figure out what I was going to do.

I needed a quadruple bypass. Who was going to perform the surgery? Where would it be done and when? All these questions had to be answered quickly. It was shortly after this life-changing
event that I put pen to paper and recorded my story. And shortly after that I put it into a folder and promptly forgot about it. Then recently, after cleaning out a few old files, I came across the
dog-eared manila folder marked “operation”. Everything came flooding back; the words flew off the pages as if they were written yesterday. Now I realize I have to revisit this episode every so often to bring back the fact that life, as we know it, is extremely fragile. So read with me (and hopefully laugh with me) as I relate a four-day roller coaster ride I like to call “Why Me?”

“Wake up, you need bypass surgery.”

Those words still ring in my head. I couldn’t figure out why I, 57 years young, 6’1”, 210 pounds, a wee bite on the heavy side with a so-so diet needed bypass surgery. I didn’t do sausage, eggs and home fries regularly; occasionally, maybe. Sweets and chips weren’t out of the question, or my reach. (Oh by the way, I’m an adult diabetic, Type 2). The Irish would classify this as “a touch of sugar.” (It’s similar to being a little pregnant.) Stress really didn’t bother me, though I may have just been used to it. I loved my job in ad sales; traveling domestically 24 times a year. The remainder was spent on Metro North commuting into Manhattan. I’m also a Type-A personality: everything seemed important and accomplishing goals regardless of how trivial were a must. Telling aggressive drivers where they should go and how to get there were daily occurrences. So yeah, I guess you could say I had the warning signs. But still, why me? How did my arteries get blocked? Not 100%, mind you. One was 90%, two others 85%, and a fourth 70%. I did have some shortness of breath, but only when I climbed the stairs at Grand Central two at a time. Other than that I felt fine. I just couldn’t come to the realization (or even visualization) that the blood supply to my heart was being interrupted, gradually being cut off by platelets of fat with life-threatening results.


"Let's go to the video tape.” Watching a heart cauterization is fascinating. You enter a well-lit
room in a backless, sanitized green gown. It only comes to mid thigh; a surgical mini-skirt. You’re placed on a gurney and wheeled into surgery. Then things start happening. You’re IV’ed up to a glucose drip next to special wires for a monitor. The rolling bed is placed under several TV screens. A needle is placed into the IV and a fluid begins to rhythmically flow into your arm, providing a warm sensation throughout the body. As you watch in a semi-conscience state, the surgeon makes a small incision in your arm. (Many times the surgeon prefers to make an incision in the upper thigh). He then inserts a miniature series of wires. He works the controls like that of a video game, and maneuvers these little wires into position.

Eyes are glued to the TV screens. (There is no pain but there is very good reception). It’s an eerie feeling. It reminded me of the Denis Quaid movie “Innerspace,” where a miniature person is injected into a human body. Only difference being that this time the video was transmitted from inside Moi. I could see my heart pulsating with spider-like arteries, pumping vital blood to the chamber. There was a synchronized rhythm to what we were all seeing. It was alive and it was me. We watched as a microscopic wire was positioned near my artery. An ink-like fluid was then injected through the wire and into the artery. When the inky molecules flowed freely through their target, the artery illuminated. If an obstruction existed, the dark substance would
plum back out of the artery like a black cloud. With the procedure underway I could hear several murmurs coming from the nurses and attendants. When the fluid was emitted
successfully into the blood vessel, I would hear “OK, fine.” But when we viewed a black cloud no one said a word.

My experience was very quiet, almost grim. My bed was rolled back to the recovery room and I waited. My wife Patty, Dr. Michaelson ( Cardiologist, Chief of Staff at Norwalk Hospital, a neighbor and friend), and I reviewed the film. I couldn’t help but think that this was what a football coach would do to analyze and review that day’s game film: Looking for what went right, what went wrong, and where we went from there. The discussion that followed was very brief and matter of fact.

There were a number of black clouds. Four of them, to be exact. In other words, taking a few pills and saying, “let’s see what happens in a month or so” was completely out of the question.

“You’re a candidate for bypass surgery, four grafts.”

Those were precisely the words from the good Doctor. There were no ifs, no ands, no buts and no passing Go to collect $200. Wow, why me? I asked Steve if he’d mind if I got a second
opinion. He nodded OK.

“You need bypass surgery”, my two-second opinions concurred.

So rather than think the situation to death, I decided I was ready; the sooner the better. Let’s do it. But where and with whom? Minor concerns but essential elements to consider. Should I go to Mass General, a world–renowned facility for cardiac surgery or to Portland, Oregon, where my sister Carol was an assistant to the creator of the Star Heart Valve? I consulted with Steve Michaelson. He didn’t hesitate. He said St. Vincent’s in Bridgeport was a terrific facility for
cardiac care. The hospital also boasted a Cracker Jack doctor named Dan Rose, a cardiothoracic surgeon with a Cornell hospital background. Doctor Rose had a very high success rate. And he had completed more by-pass surgery’s then Jiffy Lube has done oil changes. He was a mild mannered guy who exuded confidence. You felt assured that he knew what he was doing
and how he was doing it. He got right to the point, telling me: “You need a quadruple bypass. How’s tomorrow?”

He was my type of guy. Patty and I then proceeded to complete the admission process: blood tests, X-Rays, EKG’s and medical history. Looking back, it felt like these procedures took more time than the actual surgery. After what seemed like forever, one of Doctor Rose’s assistants told us “we’ll see you at 6:30 tomorrow.”

Wow, hospital protocol had really changed. There were no more nights before surgery spent dressed in a backless mini-gown or chewing on unidentifiable, tasteless food. We drove home. On the way down the Merritt Parkway, I had a brilliant idea: this would be a great time for a sumptuous Italian dinner. Weren’t Doctor Rose and his team going to clean me up and give
me replacement parts anyway? So, why not go for it…in moderation, of course. To our favorite Italian joint Marisa’s we went, and her garlic bread, linguine and clams and salad we ate. But I didn’t want to clog up 100%. I might not make it to St. Vincent’s in the morning.

From past experiences I found that checking into a hospital could be both intimidating and sobering. So Patty and I determined there would be little sense in her getting up and driving to St. Vincent’s to spend the entire day wandering the halls while I had surgery. I wouldn’t have any knowledge of her being there, anyway. So I drove and left the car in in-patient parking. (It was a free pass, me being an in-patient and all). Patty could then go to Norwalk Community College, teach her class and check in on me periodically.

St. Vincent’s had a wonderful system for keeping spouses informed of the patient’s progress: When you told the hospital your telephone number, they called back with updates. The first call announced that you were on your way into surgery. A second happened when the surgery starts. The third call came when the surgical team was halfway done and a final call (sorry, we better make that the fourth call) was made when the patient was brought into the recovery area. This method was far less stressful for the person waiting and wondering alone in a stark room. It’s proactive rather than reactive and adds a nice human touch to a normally difficult
process.

6:15 AM Oct. 7 1999:

I pulled my car into the parking lot of St. Vincent’s Hospital. After locking up, I grabbed a few things and walked to the patient admitting building. Within minutes a nurse arrived. She took me to a small, non-descript green/gray room. It had a single bed with a gray tinge to it and drab gray wraparound curtains. She handed me a bag, the same color as the room. It looked like the hospital-purchasing agent had gotten a deal on color during some one-stop shopping. Along with the bag came that lovely green backless gown. You would think by now there’d be a better design. Have you ever tried to tie the little string on the back into a bow? It’s virtually impossible. Finally, I was together and ready…well somewhat.

As I lay on the sanitized rubber bed my mind raced. It played the “what if” game. “What if I don’t make it?” “what if I don’t come to?” My anxiety level was ratcheting up. As if on cue, an intern walked in to take my blood pressure. I was told it was rather high, but considering the circumstances, that was understandable. A friend of mine had sent me a tape. According to Doctor Herb Benson (from Harvard’s Life Science, Mind, Body Medical organization, a noted authority on stress), listening to his techniques and applying a series of recommended breathing
techniques would help lower my anxiety. Dr. Benson suggested listening to the audio the night before my surgery and then again before entering the operating room. I had suggested listening to the tapes while driving to St. Vincent’s, to which Herb suggested absolutely not. I gathered from his reaction that listening while driving was not such a good idea. So I followed his advice.
The soft, calming words followed by breathing slowly and rhythmically through my nose then exhaling slowly from my mouth seemed to work. The process became somewhat hypnotic
and eventually very relaxing; it created a real feeling of serenity.

The intern came back for yet another test. This time my blood pressure was lower. He actually asked if I was given a sedative. When I told him no he was surprised. Herb’s techniques had
really worked. To be honest, I thought the whole tape thing was going to be a bunch of B.S. But I actually felt confident as I was rolled into surgery. Thank you Doctor “B”.

Just before I left my little gray cube, a nurse took my bag and belongings. Now I was given a real sedative. Groggy and slightly disoriented, I was wheeled down green/gray hallways, staring at fluorescent ceiling lights, a nurse in front guiding the bed and one at my head pushing, everything in slow motion. As we arrived outside the operating room, the doors electronically opened and a blast of the Arctic hit me. (The temperature in the room was much colder than the hallway). I also noticed that everyone was dressed in green gowns and masks; a real surgical fashion show. The sedative was now taking more of an effect. Just trying to say a few words was difficult. The sounds that came out were slow, labored and awkward. Each letter took forever to say. Everyone’s movements were slurred. Their speech came from a tunnel.

The IV that hung from an aluminum post at the side of the gurney had several plastic bags attached to tubing that extended downward into my arm. An anesthesiologist seemed to be
smiling behind a green mask. He asked if I was feeling OK. Before I could get a word out my
world turned hazy. Then there was nothing.

I began to stir in what seemed like nanoseconds. Doc Rose had warned me about coming to: “Your hands will be gently tied down at your side.” I was on a breathing apparatus and my first reaction was to yank it out. My secured hands prevented that. My eyes blinked several times as I became aware of my surroundings. Pain emanated from every fiber of my body.
Panic started to set in. I remember what they had said and tried to relax. Then the room and everything in it went dark.

I’m not sure how long it was but my eyes blinked again, slowly. The same feelings rushed back. My hands were still tied and I started to have that panicky feeling. I still couldn’t breath through my mouth. The apparatus was continuing to breath for me. I couldn’t move. God, the pain was non-stop. The nasal gastric tube in my nose and mouth made my throat dry and raw.
It was impossible to swallow. Voices said, “You’re in recovery. The surgery was successful.”
I saw a very blurry vision of my daughter, Tracy, and then Patty. They were fuzzy. I was hurting, everywhere. I couldn’t talk though I tried. Tubes were attached to virtually every orifice of my body, including some places where there were no openings. There was a tube in my neck and I’m quite sure there was no opening there. I desperately needed something to ease the rawness in my throat. The tube was causing an extremely painful irritation. Ice came to the rescue. The cold melting liquid hit the raw area and it felt like never before. Then a shot of morphine released into the IV tube and I slowly floated back under.

As I came to again, still very groggy, nurses were removing the breathing tube. It wasn’t painful at all; I just had a weird sensation that something was being taken out of my body, through my mouth, like a garden hose being removed from my stomach. The feeling could best be described as getting onto a moving bus through the windshield. But my hands were no longer tied and my eyes were focusing a little better. Ice was continuing to ease the rawness in my throat. My chest, however, felt like someone had just landed a 747 on it. Dr. Rose had performed four bypasses, taking three veins from my left leg and one mammary artery. Three veins through three one-inch lateral incisions. One just below the left knee, another slightly above it and a third
near the groin. The procedure was relatively new. It took longer because each vein had to be delicately extracted through small openings. Two years prior and the incision would be made below the knee and extend to the groin. It was susceptible to infection and the recuperation time was much longer. Still, many surgeons continued to use this procedure.

I was really hurting. I didn’t want to shift my weight in bed or even breathe deeply. However, the recovery team wanted me to sit up and, if I could, stand. Helping hands came from all
directions to assist in my sitting and standing. God I was dizzy. Everything began to spin. My stomach was starting to erupt, my muscles ached. I was nauseous and loaded with gas; not a good combination for sitting on the edge of the bed. I really didn’t want to move, let alone stand up. As I got to edge of the bed, with all my tubes, wires and monitors attached, it dawned on me again: my ass was hanging out. I didn’t really care anymore. Then I erupted. A projectile of water flew in every conceivable direction. The team got the message. I wasn’t standing tonight.
I placed my head on the rubberized pillow. It felt great. Things stopped spinning. Twisted in wires and tubes, IV swinging in every direction and totally soaked from my eruption, I was wiped out. The end of Day One.

Day Two was a different story; not that I was full of piss and vinegar, mind you. I was far from it. It’s just that the second day felt much better than the first. There were far less tubes to
contend with, breathing was my responsibility, not the machine’s, and the anesthesia was pretty much winding down, though not completely. My eyes were focusing better even though my day had started at 5:30 AM. I was able to recognize more of what was happening and I was getting to know my surroundings. And as an added bonus, I had a new toy: An oxygen bottle with a tube that attached to my nose. This contraption was the size of a big thermos. It carried a warning, printed in large red letters: “Combustible/ Flammable.” It advised me that anyone within a three-block radius should not smoke or light any combustible material, unless they would like to experience a rather large and noisy mushroom cloud. I then noticed a
rectangular bandage that spanned my entire chest. It was approximately 4 inches wide and covered the incision, among other things.

After a series of blood tests, pokes and prods, breakfast arrived. The tray held six dishes containing more sugar than I’d seen in years: whole milk, juice, sugarcoated cereal, Jell-O, fruit and coffee (with sugar). The nurse advised me that this was OK. They were monitoring my sugar levels very closely and would give me insulin if the levels got too high. This breakfast had the capacity to blow the lid off the insulin bottle. Confident in her guidance, I dug in and devoured everything. Afterwards, I lay back and relaxed. Then it was time for another blood test. Leno, a young intern, stopped by and introduced himself. He had just passed his written medical exam and was waiting for an appointment to take the verbal portion. When this part was completed, Leno would fulfill a life long dream and become a doctor. I didn’t realize it at the moment but I was one lucky camper. I couldn’t have asked for a better person to help me along the recovery path.

His first instruction to me was: “Let’s stand and then take a few steps.” Fat chance! I was still dizzy. Leno said it was the effects of the anesthesia. It was giving me a feeling of seasickness. He left and returned a moment later with a little blue pill. “We’ll be ready to go in ten minutes.”
He was right; in no time at all I was sitting on the side of the bed and nothing was spinning. In a few more minutes I was standing, aching, wobbling, ass hanging out, my IV hooked up and in hand, pulling my oxygen bottle attached to a wheeling apparatus, ready to go. One foot placed in front of the other (not an easy task), and with Leno keeping me balanced, we strolled down the 6th floor hallway, ass out and all.

I felt great. Walking a few steps was an accomplishment, especially the morning after major
bypass surgery. It’s amazing how your world becomes reduced to a few tiny steps. Little things really matter. At that point, thoughts of accomplishing anything larger took a back seat; they
just weren’t important. After what seemed like a very lengthy walk, I was back at bed, exhausted. A stuffed little teddy bear was there to greet me. He came with a note. Clearly, he had a purpose, and it centered on my recovery. “TAG,” - the bear’s name and my daughter’s initials- was there to make sure I performed a series of directives. I was to squeeze him against my chest, breath deeply and cough. This was to break up the mucus congestion in my lungs. Much easier said than done, of course.

My first attempt was wimpish; it hurt like Hell. To help me there was a gray (again with the color discount) cylinder, a breathing apparatus, made of plastic. It had a tinyball, the size of a marble, inserted, so when I exhaled the ball ascended to the top of the tube. After exhaling deeply 10 times into the tube I felt the mucus start to break up. I quickly grabbed TAG and squeezed him tightly, then coughed. The congestion broke up. TAG’s instructions were to complete this process 5 to 6 times daily or more. All day long it was bing, bing and a cough. It was the new version of marbles for adults, mostly men. On night two sleep came easily. I was totally worn out from walking the hall and the marble game. Dinner was off the sugar chart again and I needed another insulin shot. My ass really hurt. They also reduced my pain medication to 4 little beauties. I saw how one could easily get addicted. They really packed a wallop and got you to a state of ‘I don’t care’ in no time at all.

On Day Three, 5:30 AM arrived quickly again, as did the blood tests, needles and temperature gauges. The night crew put together their report and had to make sure they prodded, poked
and stuck me before leaving. They also happened to be a great bunch and really professional. After they completed their procedures, I found there was not much to do. I was totally awake and sore. I was glad to have TV but the programming sucked at that hour. I think there should be a channel just for hospital patients at 5:30 AM, considering all the baby boomers and their illnesses and such. There would be a captive audience with nowhere to go, nothing to do.
Breakfast arrived at 7:30 AM with more calories and sugar than dinner. I had been told I needed to build up my strength. My glucose levels were high (180/220) and insulin shots became the order of the day. My weight was down to 200 lbs.

I was feeling much better and ready to stroll again with my IV and oxygen bottle when a resident appeared and informed me that today was drain removal day. The large bandage spanning my chest and covering the incision also covered three drain tubes inserted during surgery. They were located about three inches apart directly below my rib cage; their purpose was to remove the fluids that had been accumulating there. The tubes were plastic and hidden beneath the 4X8 bandage. They really didn’t hurt and only one-third of the tubing was visible. Rachel, the resident, slowly and meticulously removed the tape. As I watched Rachel work, I asked her what I could expect in terms of pain. Without lifting an eyebrow she said: “I promise it’ll be quick, so take a deep breath when I tell you, and yes, you will feel pressure.” As the bandages were removed exposing the vials, I noticed they were all connected by a single piece of tubing. Rachel looked at me. “Are you ready?”

I felt her yank the connecting tube. The sensation was indescribable. Pressure was an understatement. It felt like someone took a vacuum cleaner hose and inserted it into my
body cavity under the ribs, then sucked out the insides. My mouth opened and all the air in the room was sucked in. Then the whole room turned white. I felt like I was losing it and falling into
a white hole. My tear ducts opened and water flowed down my cheeks; at the same time wax came out of my ears. Slowly, I came back into the now. Rachel was holding a torturous-looking
device. Each tube was approximately 6 inches long, covered with blood and attached to a single drain tube. She blurted out: “I’m sorry, but there was no other way to describe it beside
pressure.”

As I managed to take a breath, I suggested she tell her next victim that it’s like having your insides sucked out by an Electrolux. Needless to say, my walk was delayed until I could
determine that my ass was still attached to my body. And, sure enough, it was hanging out the back of my green dress. The walking and rehabbing soon became easier. My 6th floor strolls were longer, faster and unassisted. My cumbersome IV was retired. Now it was my oxygen bottle, my green dress and me. I received a lot of encouragement from the staff and other
patients. I heard remarks like, “keep it up”, “stop it, you’re making us look bad” and “what are you doing, practicing for the marathon?” They all lifted my spirits and pushed me to continue.

I must have been on the road to recovery because it dawned on me I hadn’t taken a shower in 4 days; I was starting to smell ripe. Even the teddy bear was avoiding me. The only thing that
remained constant was the pain. It was a reminder that I just gone through a life-changing event. Doctor Rose stopped by to inspect his handiwork, then explained (in layman’s terms), what he and his team did. He said the procedure was successful and the recycled parts should do very well. From now on it was up to me. Exercise, diet and stress reduction were a priority and my progress would depend on how diligent I was at executing his directives. I didn’t hesitate to ask him if there was a lifetime guarantee and if so, could I get it in writing? Doc Rose smiled and said: “If you take care of yourself these parts will last a long time, in fact they
should last your entire life.”

He also had more good news: I would be going home later that day; Day Four. As he waved goodbye, I thought back to what this man had done in just four days: sawed open my chest, split my ribcage, removed four large veins (including a mammary artery), surgically grafted them to my heart, sewed me back up and said: “Go home!”

It was inconceivable.

I was taking a shower when Patty came to get me. She had taken care of the paper work and billing details. As I was getting into my street clothes, I was still wondering why that damn green dress was backless. It had to be that it was an easy bull’s eye for needles. I walked to the elevator and out the first floor door into a bright sunlight autumn day. Thank God there was no mandatory wheelchair with escort; standard operating procedure in years past. I took a long deep breath of the crisp air, just as doctor “B” had suggested. God it felt great to be alive. I strolled though the patient parking lot holding a teddy bear with a grin on my face a mile long. I wasn’t going to drive today and probably wouldn’t for some time. However, knowing that I was on my way home with Patty made me feel terrific and very fortunate.

It would take a month to recoup at home before I could think about going back to work. All the time I would walk, starting with a mile, then two and eventually getting to four and five. I added
some weight training to my weekly schedule and my diet, well, like most things, it could have been better and is still a work in progress. My weight is 188 lbs. I’ve been able to keep that extra 22 pounds off by taking better care of myself. And as far as stress is concerned, I solved that; I retired three years after the bypass. Thirty-five years at one company was long enough.
In today’s business world I would be considered a dinosaur and they eventually became extinct.

I am truly grateful to have a family that cares and that I love deeply. I’m grateful to have a friend and doctor like Steve Michaelson, to have had a skilled surgeon like Doctor Dan Rose
perform his magic on me, to have Doctor Herb Benson and his tapes to aid me and help reduce my stress levels and to have a resident like Leno be my guide to recuperating (I sincerely hope
he is the doctor he always dreamed he would be).

I am fortunate. If I were diagnosed with heart disease years ago, I would not be typing on these pages. Life is too short and very fragile. It’s the little things we take for granted that make up who we are. We have a tendency to reach for the brass ring and tackle the next big thing, when if we just take care of the little things the big things will take care of themselves. John Lennon said it best: “Life happens when you’re busy doing something else.”

Patty, Dave Tracy…I love you guys!

The results: today Iʼm able to walk and run four to five miles at least four days a week and build stone walls, the old fashion way. I even started a small consultancy firm, attend culinary classes, take courses in photography and video editing, travel extensively and still find time for an occasional round of golf. My weight is where it was when I entered college and the diet is very much improved, although it could use adjustments now and then. Exercise is a regular part of my daily routine and stress, well my resting heart rate is in the mid-fiftyʼs. Given everything that happened I'm one luckily guy. Several years ago you more then likely would not be reading this piece, because I wouldnʼt be here to write it.

__________

Tom,

Thank you for sharing your heart with us - in every sense of that phrase! May your story inspire each of us this holiday season to live life to the fullest and to express our love and gratitude to the important people in our lives.

God bless.

Al


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