When the Heart Fails but Hope Doesn’t: Inside My Most Dangerous Surgery
Surgeons saw my sternum in half, making their way to tinker carefully with my heart. They’ve put it on a machine to take over my heart’s beats, so I keep pumping as they work, scapulas in hand. Dead tissue lies before them. They expected to meet the damage to my heart, courtesy of a bacterial heart infection, Infective Endocarditis, I had back in 2009. No one realized the extent of the damage it wrought when my heart pretended to be its best since recovering from it. Tissue paper, that’s what my surgeon will call it after. “Brittle and delicate, like tissue paper.”
They hurry to clear away all the dead tissue before them. They’re doing it while repairing more around the area of my valve. More than they thought they’d need to. I’ve been open for a long time as my heart pumps on the machine. The longer things take, the more likely there will be complications before they finish or after. They watch the clock as seconds tick by; time is their enemy. They still need to take out the porcine aortic valve that’s been failing me but lasted well above what everyone expected. For whatever reason, it’s more of an issue than expected. I need blood. Then, more and more. More as that tick-tock ticks away. They continue to give me some, but it’s not enough. I’ve been open for too long.
Surgeons understand that it’s anyone’s game in the operating room. Something complicated can become simple. Something simple, complicated. My surgery was always going to be complicated. It is so complicated that it requires a specific surgeon with specific approvals at a specific hospital because of its specific cardiac unit. The point is there were several specifics. The expected complications are a list of potential specifics, with the expectation of at least a few. Best case. Things are not going best in the direction of the best case or even remaining neutral.
The plan had been to replace my aortic valve with a mechanical one and then, if possible, my mitral valve, which was a real possibility. Finally, a pacemaker to settle the ceiling of all my heart’s electrical issues, or at least my noncommittal arrhythmia. They don’t have time for that. My aortic valve was “making it rain” so badly it caused me to go into heart failure, a line I can’t uncross. Replacing that is a must, despite the clock. The surgeon works meticulously and diligently.
Despite my several heart conditions, including multiple aortic valve replacement surgeries, I’d never gone into heart failure, a badge I’ll wear for life now. It’s incredible how a valve, a single instrument, can bring one to life and mark one for death. I’m not one for the latter. (Okay, I am, but I always come back, and I wasn’t feeling it this time.) The valve is replaced, but then something goes wrong. My mitral valve, which previously only had moderate regurgitation/leakage, takes my aortic valve’s previous position as a gusher. They need to close – now. I can’t survive the bleeding, so the surgeon quickly places a single suture, hoping for the best.
It doesn’t work out.
***
My surgeon had been the best of the best. My surgery was one that several surgeons turned down. They couldn’t handle it. Perform it. Too risky. Not in their wheelhouse. I read the surgical and post-surgical notes. I suspected my surgeon did everything right, including his decision to close rather than repair my mitral valve more. I agreed with everything. Aside from doing everything right with each decision, he walked the line of “as far as humanely possible” without going too far. Had he not closed, I probably would be in a different place.
Unfortunately, my mitral valve isn’t feeling that suture and bursts through within two weeks. Recovering, I feel worse, and I can’t hit the benchmarks I should. I try to walk but fall. Standing is difficult, if not impossible. I feel like a weight is on my chest, and I can’t breathe. Three weeks after my surgery, in a post-operative appointment, my cardiologist gives me a choice: Take a ride in a wheelchair to their cardiac unit, a building next door, or in an ambulance. Either way, I’m back in the hospital to stay, and I remain there for another three weeks, having a second heart surgery to try to keep my mitral valve’s regurgitation/leaking at bay with surgical clips.
I still have them. The surgeon was able to do 50% of what he wanted. Again, he did everything right. To say it doesn’t impact me is ridiculous. I’m still in cardiac rehab, and I push to the brink or a little past it. I’m only at 25% capacity (granted, I broke an ankle between then and now, but it’s healed and only took two-ish months away). I can dance to one song rather than five or six. My steps are 25%, my levels are unintentional, and likely have not changed much, though they have decreased. Grocery shopping is strategically planned in advance. The same goes for any outing. I use “handicap” parking. I have good days and bad. It’s something I keep from most because they want to believe it’s all good days, and I don’t want to be a downer. However, this post says it all.
Initially, this was meant to go live (and it was a little different) yesterday. Unfortunately, the day before, my mitral valve “acted up.” It does this sometimes. It’s when it makes my heart work so much harder that I can’t walk steadily, fall, and sometimes, like this time, makes me so sick I can’t eat or drink. If I can’t do these things, can I follow a screen? Even if it’s a large TV? No, to that answer. Losing the day I was going to finish and polish this post meant posting it yesterday would have been so stressful I’d become someone pulling their hair out while snapping at others or worse. No, thank you.
As much as I believe in this newsletter, I won’t do that to myself and others unless it is urgent breaking news or a time-sensitive call to action. Then, yes, it’s possible, and while this has been a time-sucker, I find it necessary, so that’s okay. It’s not so okay to make my days miserable. We all have boundaries, and that’s one of mine.
This post is less a blend of personal/facts and just personal. It’s a story of valves deciding to call it quits and their impact upon handing in their notice. I posted earlier this week and broke down each valve: what it does, how it works, the level of importance of each, etc. If that’s more what you’re looking for, check it out. Until next time.