In February 2008, I was, as
most teachers were at the time, getting geared up for the final push toward
student state evaluations in April.
Christmas vacation was a distant memory and the routine of school has
already been reestablished. I had noticed
a slight change in my normal morning preparation for the school day. From where I parked my car at Williams
Elementary, it was a fairly distant walk to my class, but having completed the
daily trek for over ten years, it was a routine I scarcely thought about as I
made my walk. The difference was,
however, I found I was becoming quite winded in my walking journey and was
being forced to catch my breath as I walked through our cafeteria. After sitting for a couple of minutes, I was
able to finish my trip to class and get the day started.
On this particular Thursday,
I made my walk to my classroom, but just as I reached for my door handle, I
experienced a severe chest pain which startled me. I made it inside to my desk and sat down, and
in a few minutes the pain subsided.
With the logic that only a person in denial can conjure up, I concluded
it must have been indigestion. I made it
through the day with no further flare-ups, but the next morning, the same event
occurred at practically the same instant as I reached for my door handle. That gave me cause for alarm, but I kept my
concerns to myself. The next day,
Saturday, I decided to wash my two cars in our driveway at home. I did not make it through the first car
ordeal before I had to stop because of the chest discomfort. I walked inside our home and told Shirley of
the events of the last three days, and she immediately demanded I see my
doctor.
I made the appointment for
the following Tuesday, and the first thing Doctor Bernick proposed after
hearing my experiences was an EKG. I
don’t think I did very well, as he immediately took me into another room for a
stress test. I did not last four minutes
before I nearly collapsed with exhaustion.
Needless to say, he immediately scheduled me to see Doctor Salma Challa,
a cardiologist who happened to be my mom’s cardiologist years earlier. A couple of days later he performed a heart
catharization, at which time it was determined that I had severe blockage in
five places in my coronary arteries. I
was referred to The Methodist Hospital in the Texas Medical Center to Doctor Mahesh Ramchandani who would perform
the surgery.
All of these preliminaries
to surgery occurred in a brief flurry of days, during which I also notified Mel
Capelo, my principal at Williams, that I would be out of service for several
weeks and there was a need to arrange for a substitute and coordinated lessons
plans. This all occurred in an almost
surreal atmosphere; I was 64 years old
and had never had a serious health issue, and I went through the motions of
gearing up for a long hospital stint as if I were preparing for someone else. Our church had prayer for me, but I was so
numb with disbelief that I felt like they were praying for another person.
March 3, 2008, I entered
the office of Surgeon Mahesh Ramchandani, whom I soon learned was an Indian,
educated in England, and who quickly set our minds at ease with his easy
demeanor. Well, relatively at ease
anyway…it’s not every day you visit a heart surgeon whom you know will in a few
days have your life in his hands. He
showed us a photo on his wall of his alma mater, Downing College, which
apparently is a sub-college of Cambridge University in England. He asked if our strain of Downings came from
England, but I told him the Downing side of my family is Cherokee Indian. Eventually we settled down to the issue at
hand. He told me that my upcoming
surgery had all the inherent risks of heart surgery, but it was a procedure
that had been proven effective over time.
He told me I would be having off-pump artery bypass grafting, which
meant little to me, but I found out later was the very latest in heart
surgery. As we left his office, I was
pleasantly surprised to see the latest issue of “Texas” magazine and note that
Dr. Ramchandani had been selected the Surgeon of the Year for the past
year. At least I didn’t have an amateur.
At 5:00 A.M., March 11, 2008, Shirley and I
walked into The Methodist Hospital and proceeded to Pre-Op. In a matter of minutes I was whisked into a
private room where I was readied for surgery…i.e.…I was stripped. I was covered with a sheet, then a nurse came
in and proceeded to shave my legs, arms, and torso. This was for the monitors, tubes, etc., he
explained. Anyway, it was an electric
razor that sounded like a lawn mower as it chewed up my skin. Immediately afterward, I was rolled into a
pre-op room where I met my team of surgeons who would be assisting Dr.
Ramchandani. Each in a professional
manner described their function in the operating room and made an attempt to
comfort me in that I was in good hands.
By this time I had received an IV in preparation for sedatives, and upon
completion of all the preliminaries, I was wheeled down the hall to greet my
loved ones en route to the operating room.
It never occurred to me to think that I may never see them again if the
surgery went wrong. God either gave me a
sense of peace or I was just too dazed to understand my situation, I don’t
know. I greeted my family and into the
operating room I went. The
anesthesiologist told me he was going to give me something “to relax me”….and
darkness fell.
My next sensation was that
I was choking…seriously choking, and someone was hollering, “Mr. Downing! Mr.
Downing! Try to relax! Try to relax!” So I made a supreme effort to calm myself,
and as I concentrated on being calm, I was able to control the choking. But then as I relaxed, I would lose my
concentration and start choking again.
The apparent problem was I still had the breathing device inserted down
my throat, and it gave the same sensation as your sticking your finger down
your throat; you have an involuntary reflex to reject it. All this time someone was holding my hand,
and in time said to me, “Mr. Downing, do you think you could breathe easier if
we removed the breathing device? Squeeze
my hand if you think yes.” I crushed his
hand! In a matter of seconds, the device
came out of my throat, and I began to ease.
I still had a hyper-sore throat, but at least I wasn’t choking. Still heavily sedated, I was wheeled into
recovery. I remember asking someone for
a little water. “Later,” she said.
When I began to regain some
semblance of consciousness, I first heard the sounds of nurses apparently
talking to other patients and the shuffling and quiet clatter of moving carts
and shifting trays. A few minutes later,
my guardian angel, apparently a nurse assigned to me, greeted me with a “Well,
you’re finally awake!” and a smile. She
proceeded to check all the gadgets attached to me, and I began to realize that
I had more wires and tubes running to me than your average small engine. According to her, however, I was doing very
well, but I was shocked when I asked her the time….it was after 8:00 P.M. I had been in surgery over ten hours. The anticipated surgery time had been
three-four hours, but there had been a problem with my losing blood, and I had
been kept in surgery until the blood loss could be halted. By 8:00 P.M., however, I had stabilized and
hence my location in the post-op intensive care unit. By now I was becoming more aware of my
surroundings and saw that Post-Op ICU held about ten patients with a
corresponding number of nurses to monitor the situations. The most notable event of Post-Op was when a
bevy of doctors came in. One was
obviously the leader and the others, I would assume, interns. They stopped at the bed next to me and the
leader said, “This gentleman has had quintuple bypass procedures…that what
forty years of smoking will do for you.”
I thought to myself: Now wait…I haven’t smoked a day in my life, and
that patient and I have had the same procedures. What gives?
Anyway, sometime in the
evening, my beloved family was allowed to come visit me, which lifted my
spirits, and preparations began to be made to put me in a private room. Once those arrangements were made, it was
time to unplug me from some of the hardware I was hooked up to….plus two others
I wasn’t even aware of. Apparently I had
a “port,” which is an intravenous device inserted in my jugular at my throat to
allow for fast injections of medication.
My nurse said sometimes when that thing is removed there is a lot of
blood due to one’s blood pressure. She
pulled that thing out and slapped her fingers around my throat to compress the
incision, and I thought she was going to choke me to death. She held her hand there for what seemed like
an hour but was probably two or three minutes.
No blood though, and all was well.
Next, I found out I had a large tube inserted in my abdomen to allow for
internal drainage which had to come out.
She said, “Take a deep breath,” and began to pull. Weird sensation…like someone had attached a
vacuum cleaner to your belly button, except it went inside. Not painful…just….uncomfortable. But in a few seconds, it was out, and we
went through the hand compression routine again to alleviate any blood
loss. All went well again. I was ready to roll out of there!
Around the stroke of
midnight I was wheeled into a private room to settle in for the night. By this time Shirley had joined me for the
duration and (I think) the kids and loved ones had gone home, probably
exhausted. Strangely enough, I was
feeling pretty well and had yet to feel any pain or discomfort. Within an hour or so, however, the labors of
the day began to take hold, and after the nurses had busied themselves with all
their detail, I drifted off to sleep…only to be seemingly instantly awakened at
4:00 A.M. Apparently every day at that
ridiculous hour, every patient in the Methodist system is awakened to have
vital signs taken and weighed…which means being
rousted out of a peaceful sleep and standing up at the edge of the bed on a
scale to get your exact weight. There’s
logic there somewhere, I guess. Anyway,
I drifted back to sleep, and of course, in three more hours it was time for
breakfast.
The first day post-op was a
bit of a blur in the sense that I was sleeping a lot with brief but frequent
interruptions by doctors, nurses, aides, custodians, visitors (welcomed), and
family. My one dependable constant,
however, was I had only to say, “Honey?” and Shirley was at my bedside awaiting
my need. I quickly learned that even in
a darkened room I could look over to the dim outline of a couch and see her
curled up there, and it gave me great comfort.
The entire time I was in the hospital, she never left the room, and I am
forever thankful. I rested well, and
looked forward to mealtimes. The
prognosis seemed good, and I still had not experiences any pain, for which I
was thankful. I learned the reason for
the lack of pain was an epidural injection that was placed in my back. It administered a low dosage of pain med on a
somewhat regular basis, and I could even push a button and receive more if I
became uncomfortable. I never did have
the need.
By Friday, March 14, I was
feeling well enough for a therapist to come by and walk me around the hallways
for a little exercise, and I had been disconnected from some of all the tubes and
wired to which I had been attached. In
fact, I was feeling well enough that I was think about home and a hospital
discharge, but that afternoon, my happy bubble burst. The doctors came by for a visit and expressed
satisfaction with my progress, and then announced it was time to remove the
epidural in my back and see what level of pain I may experience. I wasn’t too concerned because I had felt so
good up until that time, so out came the epidural and my umbilical cord to a
pain-free life. That evening, my comfort
level began to drastically change.
The first thing I noticed
was when I lay quietly I could hear my heartbeat clearly. You wouldn’t think that would be distracting,
but I found myself listening to the rhythm, and it seemed to me that after about
every ten beats, it would sort of skip or jump a beat. I mentioned that ability to hear my heartbeat
to a nurse, and she explained that due to the freer flowing of the blood
through the heart after surgery, many patients experienced that phenomenon, but
it would eventually dissipate. At the
same time I was beginning to feel a creeping sensation of pain in my chest that
seemed to increase with each hour. By
the late evening I was most uncomfortable, and the nurse brought in a new pain
medication to give me some respite. I
had a very restless night, as the medication didn’t seem to help very much.
Since I was recovering from
heart surgery, I had been attached to a heart monitor, the data from which was
transmitted to the nurse’s station so they could constantly monitor my
progress. On Saturday morning the nurse
announced that my heart had been acting erratically since around 4:00 A.M. That was not news to me, since I had been
lying there counting the beats and listening with a measure of alarm each time
I didn’t hear a beat when there should have been one. Anxiety breeds more anxiety which seemed to
increase my chest pain. It was decided
that a different pain med would be administered since the first one was
ineffective. About the same time,
another event took place that let me later realize just how poorly I was
feeling. A nurse came into my room and
announced it was time for me to have a bath, and told me another nurse would
come in and help me with my sponge bath in the bathroom. She unhooked me from all my monitors, tubes,
etc., and asked me to wait for the bath nurse.
A few minutes later in walked this young, very attractive nurse who
announced she was there to give me a bath.
Like a docile lamb, I shuffled to the bathroom, took off my gown, and
sat on the toilet, while she gave me an all-over sponge bath…and all the while,
all I could think about was how good the warm soap and water felt. She was most professional, and treated me
like a mother bathing her child. I felt
no embarrassment or unease; I just enjoyed the cleansing water. I must have been really sick.
That Saturday was one of the
more painful days of my life. With the
nurses seemingly unable to find the right combination of pain meds to alleviate
my discomfort, I could only lie there and groan. On top of this, the pain meds begin to affect
me in other ways. I began to
hallucinate, although it seemed real at the time and funny now. Here’s an example: The nurses’ station was outside my door and
to the right maybe 25 feet. The station
was not visible from my bed because of my closet, bathroom, TV, etc. However (I’m not making this up), when I
stared at the wall and squinted my eyes, a hole would appear in the wall, and I
could see the nurses working at their station.
Looking back, this probably occurred the time the nurse brought in a
container of pain med for my IV that was supposed to be dispensed over a period
of hours, and somehow I received the whole bottle in a matter of minutes. I began to have involuntary muscle
contraction, tremors, and extreme shaking.
When the nurse realized what happened, she ran outside and there was a
conference as to what to do, but the deed had been done. They thought I was having hard chills and
threw all sorts of blankets on me, but I wasn’t cold, I just couldn’t lie
still. At the height of the problem, the event occurred which I described in my
blog “Is Healing Overrated?” Shirley
called Kimberly over to the bed and said, “Let’s pray.” They began to pray, and as they were praying I
took a couple of deep breaths, quit shaking, and fell asleep. I do believe in God’s touch.
Early Sunday morning, I
roused out of my sleep and took an inventory of my heartbeats. The arrhythmic pattern was still there, and
in the silence of the darkened room, my heart seemed to be pounding. By now I had garnered a dread of the early
morning, post-midnight hours. In the
quietness, listening to an erratic heartbeat, and wondering if I was ever going
to get out of that room, I probably endured the lowest point in my recovery. The pain in my chest had subsided a bit
thanks to a better combination of pain meds, but the pain and the arrhythmia
gave me little promise of a bright prognosis.
My only comfort during these early hours was that I could turn my head
to the right and look at the dim shadow of my wife as she no doubt
uncomfortably slept on that hospital sofa.
Just knowing she was there gave me a considerable amount of peace.
By midday Sunday, my
condition began to improve, as the right combination of pain meds had been
discovered, and I was able to do my walks with the therapist and entertain a
fair number of visitors. My only problem
was my 4:00 A.M. heart arrhythmia was persisting, and my doctors made it clear
that I would have to have a full 24 hours of nice, smooth heartbeat before I
would be released to go home. Well, that
increased the tension, because for the next few days, I invariably awoke at
4:00 A.M. and started listening to my heartbeat. Sure enough, I would note a skip or feel a
flutter in my chest and I knew I was condemned to another day in the
hospital. The early morning report on my
nurses’ station heart monitor would confirm my suspicions. That was enough to depress me for the
day. By Monday, my chest pain was pretty
well under control, and I was feeling fairly strong. I was doing physical therapy by walking
around the hallways a couple of times per day, and I was getting increasingly
anxious to go home.
About this time, the nurse
replaced my bandages on my chest, and I was amazed to see that I had no
stitches or staples. I can remember when
Dad Creel had his heart surgery in 1975 he came home with staples in his chest
the size of box staples, but I was astounded to learn that I had been glued together! Underneath the skin, the breastbone was wired
together, but the surface skin looked just like someone had laid down a bead of
silicone glue and glued the two sides together.
The nurse said the glue would wash off in a few days and that would be
it. Thank God for modern medicine.
Wednesday night I
experiences my first arrhythmic-free night, and it was announced that if I made
in through Thursday night, I could go home Friday. I sent up a few fervent prayers, and avoided
exerting myself in any way, and sailed through Thursday night without a
hitch. Friday morning, May 21, 2008, I
was given my discharge and release papers, and packed up, ready for the
checkout. That’s when I found out no one
was in a hurry for me to leave except my family, because I didn’t get wheeled
down to patient pickup until after 6:00 P.M.
Didn’t matter, I was going home.
Bobby and Shanna were there to drive us, and when we rolled into 405
West Archer, the old home never looked more beautiful. If I had been able to, I would have gotten
out and kissed the ground.
Saturday was spent just
enjoying being home and making adjustments for my recovery. I found that our regular bed was too flat for
me to lay there for an extended time, and a “zero gravity” reclining lawn chair
was placed in the bedroom for me to try.
I could adjust the angle of reclining and balance my position. For the next few weeks, I alternated sleeping
in my bed and then switching to the lawn chair every few hours during the
night. I’ve always been pretty restless
at night anyway, and the different positions for sleeping helped a great
deal. I was able to re-appreciate
sitting on our rear deck, feeling the fresh air and seeing something besides
hospital walls…and just being home.
Sunday I still wasn’t strong enough to go to church, so it was a repeat
of Saturday. The kids visited, and
things almost seemed back to normal…except I wasn’t very active. At least I was home, and feeling pretty
comfortable with minimal pain. The only
thing I noticed I seemed to be short of breath.
I did not have to take very many steps before I seemed to become very
winded and had to sit down, but I attributed the problem to standard recovery
from heart surgery.
By Monday morning, however,
my breathing problem was becoming more acute.
Since I had no other symptoms, I tried to ignore it, but as the day wore
on, I reached the point that even standing for 15 seconds brought a struggle
for breath. Finally I asked Shirley to
call Doctor Challa and describe the problem.
His nurse made an appointment for me for the next day, but by the early
afternoon, I told Shirley I didn’t think I could make it till the next
day. She called Dr. Challa’s office, and
we were told to come in immediately.
While Shirley changed clothes, I decided I needed to take a quick shower
before we left, but I knew I would need to hurry because of my lack of breath. I ran for the bathroom, dropped my clothes,
jumped in the shower, grabbed a bar of soap, and……that’s all I remember.
I was not aware of what happened in the
next few minutes because I was unconscious.
Somehow Shirley pulled me out of the shower and determined I had gone into respiratory
arrest. She called 911 and began to
administer CPR. Apparently I had no
heartbeat or pulse for several minutes.
The paramedics arrived and began to do their life saving work, and a
pulse was reestablished. How they got me
on that gurney in that narrow hallway I’ll never know, but apparently I was
rolled out our front door, down the side walk, and out our driveway to the
ambulance. Sometime on the way to the
hospital, I regained consciousness and became aware of feeling sort of a cool
breeze. I learned paramedics do not take
time to dress the patient in such emergencies. At the same time, I realized I knew
one of the paramedics. I guess he wanted
to relax me for the trip because, in reference to my coming out of the shower,
he told me, “Well, Brother Downing, at least you were dressed for the trip!” They had easy access, anyway.
I was rushed into San
Jacinto Methodist Emergency and after a quick analysis and x-ray it was
determined that a large amount of fluid had built up around my heart to the
point that the fluid had compressed my lungs to a quarter of their normal
size. The fluid needed to be removed
immediately, so I was sat up on the side of the gurney in preparation for a
large needle to be inserted into the chest cavity from the back. I still had no clothes, and although I was
still groggy from the shock, I asked for a blanket or some kind of
covering. By then I had been given a
sedative, and an area of my back was anesthetized in preparation for the
needle. The doctor said, “You may feel
this,” which is never a good omen, but due to the sedatives or shock, I can’t
remember any of it. To make a long story
short, 3.9 liters of fluid were removed from my chest….that's just a little over a
gallon. But I was able to breath.
Once the immediate crisis
was over, I was admitted to San Jacinto for observation to make sure the
situation did not reoccur. For the next
couple of days there was a constant repeat of EKGs, x-rays, and blood
tests. I was having a little chest
discomfort, so I was administered some kind of pain sedative that affected me
like the pain sedative at Methodist Downtown.
This time I could not see through walls, but I could conjure up my lap
top computer anytime I wanted by just staring straight at the ceiling. My laptop would float by, and I found I could
push the keys by just looking at each key.
I stared at the “r,” then “o,”, then “b,” then “e,” and all the other
letters until I signed on and I could access the internet! People kept coming in and stacking boxes in
my hospital room, and I would ask Shirley about the boxes. She would say that there weren’t any boxes,
and I would get out of bed to show her, and as soon as my feet touched the
floor, they would all disappear. I could fly, too, but I’m not sure where I
was. It wasn’t the hospital, but I could
zip through a wall like it wasn’t there.
I wish they sold that stuff over the counter.
By Thursday, March 27, my condition had
stabilized and no more fluid seemed to be accumulating. I spent a restful next two days, and on
Saturday, March 29, I went home from a hospital for the second time. Thankfully, from that day on I have had no
more heart/chest problems. The next
three months were spent regaining my strength.
I was able, thankfully, in the latter part of May to go back to school
and close out the school year. I had
only one challenge for the future: My doctor wanted to do a few more lab tests
of my blood to try to determine why the surgeons had such a difficult time
stopping my bleeding during my heart surgery.
I was scheduled to visit an oncologist in the latter part of July. But that’s another story.
Posts
