Saturday, February 27, 2010

Critical Care Notes, chapter 2

Friday, February 19, 2010. It is the day of the “procedure”, the angioplasty. The word comes from Greek words meaning to mould a vessel. The encyclopedia calls in a “non invasive” procedure. Well, it sounds invasive to me.

First, they open up my femoral artery, the one carrying blood from the heart to my right thigh and leg. My thigh bone is the biggest bone in the body, and so it does seem like a big deal. I’ve had part of my groin shaved for the occasion, which makes it a big deal, too.

The party starts at five a.m., when I am sleeping like a log, and getting in some serious shuteye. The nurse comes in to do all my vitals, and the automatic blood pressure cuff springs into life, attempting to pinch off my left arm. It stops its relentless pressure game just in time, in my mind, and starts to ease off.

I apparently need not two, but four IV holes for today’s festivities, so the nurse attacks my left arm, the one that’s been left alone for a few days now, recovering from the first day of onslaught by the IV Special Forces. I still have bandages from their last raid on my veins there. She launches the first wave of needles, and is repulsed by my defense forces. She attacks again, this time in the forearm, and is again repulsed. I want to claim victory, but if I let her win, the needles will stop.

Nurse Ratchet is not to be defeated. She has turned from the sweet nice night nurse, who fluffed my pillows, into this needle armed amazon, seeking blood at 5 a.m. What gives?

She calls for reinforcements, bringing in the professional vampires from the lab. Super phlebotomist arrives, fresh from her patrols of the other wards, apparently, and digs deeper into my cringing left arm. No luck, she moans, and attacks again. She’s passive aggressive, gently patting my arm with her soft hand one minute, then diving deep into the muscles and almost to the bone, with Satan’s needles.

Not quite successful, she elicits a moan from me. I think that’s what she wanted, along with my blood. Again, she attacks, digging into my hand, looking for nerves now, I think. Yes, she’s found them. Victory is hers as sweat breaks out on my forehead, and any memory of a good night’s sleep has fled into the night.

Finally, she attains her prize and my blood fills her needle.

“Ah,” she cries, finally satisfied. She caps the geyser, proud she’s made a few new holes in me, and slinks away before the sun rises, back into her dungeon, where she can gloat on her victory.

“Get some rest now, honey,” my passive aggressive nurse coos. Oh, sure, you first try to squeeze off my arm, then poke it nearly to death, firing up all the nerves in the arm, and then you want me to drift off to dreamland. Right. Yeah, I’m ready for a nap now. Right after all the nerves in my arm calm down and I can quit gritting my teeth.

I can’t order breakfast, or even the insipid decaffeinated beverage they label as coffee, as I am “NPO”. NPO is a code work for these Special Forces. They are planning to starve you to death, and even deny water to a dying man. So, no breakfast, no coffee, no nothing. I vow to be an unhappy camper today. No more mister nice guy.

Amazingly, I drift off and come to life a few hours later, when the nice day nurse shows up, all perky and smiley.

“Hey, I can get you a cracker and some cheese, and a sip of water. How about it? “ she whispers, conspiratorily. “But, you can’t tell anyone!”

I nod, taking any act of kindness since I am now “NPO”. Maybe she can help me escape this place. We can make a run for Starbucks, maybe even a pancake house, for real breakfast. But, I doubt it. All the tubes are still connected to me and to the bed. I’m not going far.

All too soon, the anesthesiologist comes and talks to me about my upcoming “twilight sleep” and how it’s all going to work. I’ve seen the video, how they send a wire up my artery, into my heart, and inject dye. They watch all this with an X ray camera, watching where the dye goes and where it doesn’t. And where it doesn’t is why we are here today, why half my groin is shaved.

They’re on a mission, looking for blocked arteries and how the heart is working. And, I guess they are pretty good at it. They’ve been doing this for quite a while and they have a good team.

My conspiratorial nurse returns, with two Valium and a tiny bit of water. Good. Valium is good, but I really don’t want to be awake when wires are in my heart and they are trying to widen heart arteries. Not that I don’t care. I just want to give up my front row seat. Today is the day for happy drugs, isn’t it?

They are Johnny on the spot and are ready for me before the allotted time, and off I go, down the hallway in my hospital bed, with all my wires in tow. They’ve moved the heart monitor wires to a portable unit, which now shares my bed, and I give my wife a final kiss, at the “kissing corner” in the hallway. She heads left, into the waiting room, and I head down the hall and into a big room.

It’s Alaska in here, chilly and breezy. I’m glad I dressed for the occasion in my thin hospital gown and, … nothing else. Oh, that’s right. These folks get to explore my groin a bit, as they open up an ARTERY. Oh, that’s right, I’ve had Valium. And, something else, right in the vein. I don’t care, too much. All I want to do is sleep, while they open up an ARTERY! And, work on my HEART. Valium is my friend here. I love my Valium.

I get to slide off my hospital bed, onto the two by four they are calling a table. I nearly fall off on the other side, but they are all around me now, all the Special Forces in their surgery scrubs, and I’m not going any where. Some other boards come up and I put my arms on them, and stretch out flat, looking up to a huge array of lights, and a big white box that says “X Ray”.

This must be the place, as Brigham Young said. About time to get into that artery and look around.

Now, you’d think I’d notice if someone was playing around my groin with needles and ready to open up an artery. But, all I felt was a cool breeze, as they lifted up my gown. Something good was going into one of the IVs that I had, and I’m even thinking four IVs is a good thing. That MUST be some good drugs, as I’m having a pretty good time.

“OK, Neal. We’re going to start now. Just relax,” a pleasant voice said, and I almost laughed.

I’m having a good time here. You guys just go right ahead. I’ll wait right here.

The next thing I remember is some guy telling me they found three blocked arteries and they are getting ready to fix them up.

“OK,” I mumble.

Not a big deal. Just fixing three arteries in my heart. You guys go right ahead. I’ll wait right here. Fine with me if you operate on my heart. This cold steel plank feels pretty good. Feels? No, that’s not the word. Good night.
The next thing I know, I look up and recognize the ceiling tiles of my hospital room. I’m back here, back with my day nurse, the one who smuggled a cracker and cheese to me this morning. I see her face, and it’s a good thing.

My wife peers over at me, a big smile on her face.

“Hi, honey,” she whispers.

Oh, yeah. I’m alive. I made it. They said the odds were one percent I wouldn’t. And, once they got in there, they might crank up the music and turn it into a quadruple bypass or something like that, the surgeries where they open up your chest and really get serious with replumbing. But, it wasn’t that way.

I had three blocked arteries. You only get four. Three is a big number in this game. And, I have three stents now. Big metal guys, strong and coated with drugs, so things like blood clots and bad cholesterol don’t want to hang around.
I’m liking my new stents. I better. They are pretty close to my heart.

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