If you were told several times that they were going to cut you open and even saw through your sternum to get to your heart, I wonder what would disturb you most?
Ok. I confess. I’m terribly squeamish. I shut my eyes during a lot of TV. I avoid needles like the plague. I don’t like people “doing medical things” to me, however necessary they are.
So, the worst case scenario for me was a consultant sitting beside me following a series of minor heart-attacks and an angiogram saying the fateful words: “I’m meeting with the surgeons at lunchtime today and I’m going to recommend you for a bypass.” And here’s the laugh. He added: “And because you are young and healthy (dear reader, I am 63 and have had five heart-attacks), they will all be fighting to do you.”
During the course of the next few days I awaited the appointed hour. I pretended to read the booklets that explained everything, and signed the consent forms saying they could do whatever was necessary and keep any bits they found (anonymized, of course) for research. I listened to the senior specialist nurse, the anaesthetist, the junior doctor, the surgeon all tell me the same things over and over again.
They would open my rib cage. They would take bits of tubing from my leg and from behind my heart and use that to replace blocked tubing on three or four arteries to my heart. I would wake up in Critical Care with a breathing tube down my throat, a catheter in, a tube in my neck, tubes in my arms, an oxygen mask over face, and three tubes coming our of my chest. I would probably find it difficult to focus my eyes. My “harvested leg” would have significant bruising and a long scar on the inside. My chest would have a large zipper scar down most of it. Eventually some insertions would be removed and I would be placed on a surgical ward. Most people left hospital between five to ten days later.
The squeamish me spent three days trying not to think about the operation, fighting hard to ignore the details. Looking back (celebrating my three-week post-operation anniversary), the operation itself was a “mere technical inconvenience”. The post-operation experience was far, far worse, and something that I had not even contemplated before the surgery.
Of course, the operation itself was, in an obvious sense, a hugely significant event for those concerned. It involved a surgical team in five-and-a-half hours very skilful and risky work that would determine whether I lived or died, and whether I had an improved quality of life in the next few years. I am genuinely grateful for the work that they did. However, I hope you will understand what I mean when I say that in a sense, other than being a body, I was not involved in that operation. I remember the anaesthetist “knocking me out” in seconds, and I remember waking up, what felt like five minutes later (but which was, in fact, 15 hours later) in Critical Care. It was, at that point, that I became involved in the process again.
Looking back, there are things that I did not anticipate that have caused me surprise, and in some cases considerable distress. I list them below in the hope of bringing some enlightenment to anyone about to undergo major surgery.
- Being put under a general anaesthetic takes days, if not longer, to recover from. It has the effect of relaxing as much of the body as possible. When you add the effect of pain killers, it can take a long time to feel that you have got control of your body back. So moving muscles, focusing eyes can be difficult and require conscious effort at first.
- Following my bypass operation I found it difficult to move for days. My “harvested leg” was painful and would not bend easily. Because my rib cage was still trying to heal and “knit together” I could not put any pressure on my arms. I had effectively lost the use of three of my four limbs. Hence, any movement was difficult – even adjusting position in bed. Initially standing was near impossible. The phrase “dead weight” takes on a new meaning. When I left Critical Care 24 hours after the start of the operation it took three nurses and a special lifting device several attempts over 20 minutes to get me out of a wheelchair and into a bed.
- Because of the difficulty in moving I developed a pressure sore, which, despite regular dressing by Community Nurses, I still have to this day.
- The combination of pain killers and inactivity lead to bowel blockage, and bowel stress can be fatal for heart patients. Remedies, while necessary and effective, can be dramatic, messy, and humiliating.
- Progress will feel very slow and is marked in very simple ways: successfully passing urine after the catheter has been removed; being able to stand up by yourself for the first time; using both legs to climb and descend stairs; walking a very short distance.
- Beware of any medical professional who says, “Ok, after three. One … two …” Three is always more painful than they tell you.
What has been your experience? Do tell me.