"Valve Job," Or How I Learned to Take Surgery Seriously
By Robert Chianese. October 23, 2019
I was doing my work out, walking up hills, puffing a bit, waiting to hear when my busted shoulder would get repaired—rotator cuff and partially detached bicep—when I told myself, wait a minute, I have shortness of breath, not referred shoulder pain. An echocardiogram showed stenosis of my aortic valve. I could see it if I twisted my head to glimpse the screen: white dots on what I took to be my valve, which are calcium deposits that can wreck any part of the body. The taciturn tech wouldn’t let on but the cardiologist came in and said you need a valve replacement. Holy cow, or pig, your choice.
I freaked, but then was calmed and reassured by friends who said it was just a valve job; they do them all the time. Okay. I became a realist about it. And with hardly any symptoms, I asked if I could delay surgery, since I had a conference paper ready and a symposium to conduct mid-June. The cardiologist said take it easy but it would be okay since my case was chronic and not acute, which passed for what was good news at that point.
And then I wanted to attend a slew of grandson birthdays bunched together and pushed the operation back again. And then I wanted to spend one more week in our cabin in the high desert, reflecting on life, mortality and modern health care. I did that and then wanted to finish up pending projects around the house and get a book of my poems and photos off to the printer before who knew what. I was ready.
Then I ran into the August vacations of surgeons and other health providers. Woody Allen laments all the nuts walking around New York in the summer while their therapists are on vacation. So, the end of August then.
And I was totally ready for it. I looked at it bravely and accepted it as a price for aging. Folks wanted to insinuate blame for it—diet, poor exercise regimen, sitting at a desk for forty years of professing. They tried to be helpful by offering remedies—omega-3, turmeric, magnesium water, hot yoga, meditation, veganism. The cardiologist said it was from genes and stress, and I am a stress machine. The food thing is about clogged arteries, of which I had one at this juncture, requiring a small bypass. (Piece of wisdom—offer sympathy, not advice.)
I fully accepted the operation. Looked forward to it actually, as other heart patients told me about the burst of new energy I would experience when repaired. I would simply go through with it, eyes wide open, accepting whatever came my way, would heal and get on with the rest of my life.
I was told by a friend who actually had the surgery that it was like getting hit by a truck. Okay, I’m in the fast lane of the freeway and an F-150 barrels into me and I fly onto the center divider. Big deal. They gather me up and put me back together in no time.
Spouse Paula and son Alex accompanied me at 3:00 a.m. to Kaiser Sunset in Hollywood: no traffic. I felt very happy getting prepped, only mildly sedated. I was shaved from neck to ankles and the clump of graying hair looked like a fuzzy rodent. The surgeon came to offer perfunctory reassurance and off I went at 7:00 a. m. to the operating room, or should I say theater?
I was still ebullient. I joked about the outer-space look of the room. Cavernous with deep blue walls and the shiniest stainless-steel equipment everywhere under the brightest cold-white ceiling lights glaring off the machines. There must have been ten people in the room in masks and head bonnets. I went out.
What must have been six hours later, I woke up with a tube down my throat that jiggled my lungs and was told by a distant voice to breathe, breathe. I struggled like being under water gasping for air. Everything appeared dark, ominous, alien, the spookiest part of the experience.
Wheeled up to my room with Alex and Paula nearby I felt the first zings of pain. Just laying back caused a ripple of compressed anguish across my chest and I grasped the comfort pillow for dear life. I then had to arch my back for the x-ray plate and that hurt like hell. I winced all the time, and my poor wife, a life-long nurse, turned away and my X-ray tech son, in the operating rooms every day, couldn’t watch me grimace. Get the number of that truck.
I was assured everything went okay with good prospects for returning home soon. But I had to start walking the next morning. I don’t remember that night except I was surrounded by hovering angels—a team of super-competent, caring nurses who were at my side almost every moment.
Getting upright was itself an ordeal. I had three chest tubes draining into plastic boxes, small wires under my skin over my heart in case it needed a shock, a pic line in my wrist, monitors, and lots of other body-machine accessories. How to walk?
Each connecting tube or wire had to be disconnected then reconnected and draped over a metal pole on wheels and dragged through the halls of the unit with me steadying myself on a walker. Once launched, the issue was dizziness, fatigue, and shortness of breath. What happened to me? Oh yeah, a simple valve job.
Then more news. I had four complications. They don’t mention this, but it’s almost standard to have a few. I had extremely high blood pressure—250 over who knows what and a pulse racing at 200 beats per minute. The angelic crew, drugs, and my own heart rhythm calmed things down. Then I couldn’t urinate—Old Man Prostate strikes again. They took an echo look at my bladder that measured the volume in the reservoir and said I would be okay.
But then some very bad news. I had “Dead Bowel Syndrome.” It seems like shocks to the body, like being sliced and pried open and having machines breathe and circulate blood for you, can cause other systems to shut down. I felt a hard innertube under my navel that spanned from one side of my abdomen to the other—my upper bowel swelled with air. Oh dear. If they couldn’t deflate it I would be carted back to surgery for a worse operation. They took an x-ray. Showed it to me. I could see a long transparent balloon with other things shining through—my spine? They threaded a small tube down my nose and into my stomach and bowel, with me helping guide the tube by a gagging voice away from the trachea and lungs into the esophagus. They hooked this into the wall with a suction port and the bloating began to shrink.
I was out of the woods, off the freeway, and now entering the rough part of valve replacement —recuperation. I loved my nurses, even when they flashed frequent needles that bruised my elbow creases even more purple. They talked to me, reassured me, repeated instructions and insights about my condition over and over so I did get what I was supposed to do. I was to walk, sit up, and suck on a breathing device that measured my improving lung capacity ten times during the day. I couldn’t do it at first. Each day I inflated my lungs a bit more.
I was to eat real food in the hospital and had the tastiest little bowl of cornflakes with cold milk one morning. I won’t go into detail about a heroic moment when the room filled with foul air—my bowel was working. Clap for the baby! And, what with this and that so-called hospital gown, I was told modesty has no place in a hospital.
Paula and Alex were by my side two whole days, administering to me, comforting me, talking to me, and then they went back to Ventura, but Paula was soon called to take me home—four and a half days after surgery.
I thanked the nurses, each one with that special talent to treat, comfort, and explain, and I wept a lot, the discharge nurse telling me that men weep more than women, got wheeled down to the patient pickup circle and felt the blast of hot dry air on that Friday of Labor Day weekend. I had to put a thick blanket between me and the safety belt, since an exploding air bag could bust open my sternum.
That state-of-the-art medical center has sixteen buildings around sleazy Hollywood Boulevard. They do eight valve jobs a day—a health theme park that gave me one of the grandest rides of my life.
During the operation I must have had my arms spread wide for hours. That worsened my shoulder pain, as if something—my humerus?—has been shifted, since something now painfully pokes in front of my clavicle. It’ll be months before I can have another major operation—something nasty called a “reverse shoulder replacement” and maybe in a sling for months. But I’m ready for it, I think.