CHAPTER 1
Are You Kidding? A Lesson in Denial
"Having a hard time getting through there?" I muttered as I lay partially naked on the cardiac catheterization table.
Doctors and technicians were bunched near my right groin, all of them wearing surgical gowns, their faces covered by masks. My question ignored, there was absolute silence in the room except for the regular chirping of my heartbeat on the monitor above my head. Everyone appeared to be frozen and speechless, as all eyes were fixed on the x-ray monitor that was well visualized by the group huddled around my groin, where the catheter to my heart arteries had been inserted. My own eyes were fixed on the monitor as well. In fact, I was surprised at how easy it was for me to view the x-ray images from my vantage point. The image of the blocked artery, after dye was injected into it, was not pretty, but the drugs I was being given suspended my angst.
The catheter tip was abutted up against an obstruction in one of my coronary arteries. Every time the doctor tried to burrow through it, I felt a gnawing dull ache in my chest. At that very moment, I felt impending doom; and yet I also felt very detached, as if at a movie theater watching someone else's possibly fatal experience, not my own. In retrospect, the doom was from my heart rhythm being disturbed from blocked blood flow through the affected coronary artery caused by the catheter burrowing into an already severely narrowed blood vessel. The changes in heart rhythm caused my blood pressure to transiently fall, leading to the pressure/pain in my chest and the feeling of impending doom. The cause of the artery narrowing was critical plaque buildup that caused a near-complete blockage of my coronary artery from processes of long-standing vascular inflammation.
In spite of this drama, the drugs made me not care much about what happened to the catheter. I was more or less an inquisitive bystander. My thoughts turned to a synopsis of my life as I knew it. In snapshot moments, it passed before me: my childhood, medical school, my family, my patients. It was as if I was suspended in animation, as my mind wandered aimlessly to the best thoughts of times past. And then, suddenly, the room went dark, and my consciousness abandoned me. I sank into a dark space, a black hole, as if in a deep sleep. I was out. Was this death knocking?
I woke up in a large well-lit room filled with noisy chirping monitors and surrounded by pulled curtains. I had an IV in my left arm, a blood pressure cuff on the right arm, an oxygen cannula in my nose, electrodes all over my chest, and a dull, pervasive ache in the right groin. I felt as if I were strapped onto the bed, as I could not move because of all the paraphernalia. Bewildered, my first thought was, Where am I?
Relief followed, as I realized that this room could not be the afterlife, which I was not prepared for. With some additional passage of time, I began to be aware of gnawing pressure and pain that centered on the right groin: a large heavy bag of some kind rested there.
I yelled, "Can someone get this bag off my groin?"
A nurse, businesslike but friendly in her demeanor, came to my assistance, quickly checked the groin bag, and with a smile explained, "The bag is there to keep the hematoma from getting bigger. Things went well; you are in the recovery room." With that, she left as quickly as she had come, closing the curtains as if I required isolation.
Mission not accomplished. The bag stayed, and the pain increased. Recovery was not all that it was cracked up to be.
All voices outside the curtains were drowned out by the incessant chirping of the monitors around me.
The next time the nurse poked her face around the curtain, I blurted, "I'm hungry. Got anything to eat around here?"
Amused, as if I was some type of drunken sailor rather than a doctor, she gave me a Mona Lisa smile. After once again checking my groin, she politely said, "Once you get to your room, you will get some lunch. Not too much to eat here."
I had completely lost track of the clogged artery and the intervention that had just transpired. Eventually, with postanesthesia amnesia fading and having been transferred to another floor and room, I came to understand that a stent had been placed where the critically narrowed coronary artery would soon completely occlude--and which would have likely caused my death. I was spared the details of what actually happened to get it open. The plaque that I had in the left anterior descending coronary artery of the heart is known as the "widow maker." Translated, this means that if completely occluded, absent blood flow through this artery would cause the heart to stop beating and result in sudden death.
That said, changing rooms did not improve my bed-bound dependency or capacity to move, as I was still hooked up to monitors, IV drips, oxygen, blood pressure cuffs, and the large uncomfortable bag in my groin. That night, still with groin pain, I had a glass of wine and a sleeping pill. My next conscious moment was to say hello to my cardiologist in the morning.
"How do you feel?" he said briskly, appearing rushed as he quickly perused my chart. Clearly, he did not expect me to answer with anything short of "fine." "I will let you go home today," he continued. "But you have to take it easy and let the hematoma in your groin heal. Continue the Crestor as well as the aspirin. You will need to take Plavix to keep your stent open. See you in a week."
Without giving me a chance to respond, he scurried out of the room almost as quickly as he had come. Although the exchange was curt, what he didn't say caused relief. The "to do" list that he rattled off was short, and I was going home. The medications I was to take included Crestor, a statin drug used to lower low-density (LDL) cholesterol, as well as Plavix and aspirin, which are blood thinners, to prevent the stent that was placed in my coronary artery from clotting.
Case closed. Or so I hoped. Could my life as I knew it continue? Was this just a bad dream?
As the cardiologist left, a parade of nurses and aides followed, checking my groin, unhooking the IV, and leaving me a lukewarm breakfast consisting of eggs and soggy toast.
Unbeknownst to anyone, with the door to my room closed, I decided to test my newfound freedom. Staggering out of bed with my swollen groin, somewhat dizzy and light-headed, I got to the shower, fumbled with the water controls, and eventually let the hot water pour over my fatigued body. I felt totally hungover.
After several minutes, the hot water relaxed me but did nothing for my fatigue. In slow motion, I stumbled out of the shower and...
