Opening My Heart (15 page)

“Is this your first time performing this procedure?” I tease him.

“On you it is,” he says with a wink.

He’s eager to get started. There are about ten of us. Now we’re more like idling cars awaiting test drives, our motors revving.

“Do you have any questions?” he asks before rushing off.

“No. No questions, I just want to tell you something.” He stops to listen. “If something bad happens … If there’s no chance of survival … I don’t want my life sustained on machines.”

“No one does,” he says, leaving me to muse on his true, but cryptic, answer.

When they wheel me into the angiogram suite, it’s so cold that I imagine I can see my frosted breath. If I didn’t know they kept these rooms like a freezer and the reasons – to prevent growth of
bacteria and to minimize bleeding – the sudden chill would be shock. A technician places a heavy lead blanket over me for protection from the radiation.

“I’m going to give you some light sedation,” Dr. Sternberg says.

“I’d rather not have it,” I tell him.
I can’t lose control
.

“I’d recommend it. I’d have sedation if it were me undergoing this procedure,” he says cheerfully while a nurse cleans the area and places sterile drapes over the lower half of my body. I agree to a local anesthetic only and in the opening of the drapes, he finds the right spot and freezes the area. Yes, for a few moments there is an intense pain, but I take it like the spiritual warrior I am aspiring to be.
Push through the pain
, John said.
Breathe
.

At first, Dr. Sternberg has difficulty locating my artery, probably because my pulse is weak.

“Oh, I’ll find it,” he says confidently. “I’ve had bigger challenges than this.”

Soon, I feel the needle deep inside me, where arteries lie, not superficial, like veins. Then, suddenly, on the fluoroscopy screen on the wall to the left of me, I come face to face with my own heart.

Oh, hello there. What a wondrous sight. Tucked away, undercover, out of sight, you’ve been working hard all these years. Taking care of business. Finally, we get to meet. Steady there, old dog. Don’t stop now. Please keep it up
.

Dr. Sternberg keeps up a running patter of commentary for my entertainment and edification. As he injects the dye, he points out the main arteries – the right coronary, the circumflex, and the left anterior descending (also known by its ominous nickname, “the widow-maker,” because if that artery gets suddenly blocked, by atherosclerotic plaque for example, for which middle – aged men are at a higher risk, it causes a massive heart attack and usually sudden
death). But he has left out the most important information – what really matters – can he see any blockages?

“Now I’m going to inject dye into the aortic root to measure your valve. It may cause an
unusual
sensation,” he warns me with a sly grin.

Wow. Suddenly, I am flooded with warmth … down there. It feels like … a hot flash, but
down there
.

He grins behind his mask with a twinkle in his eyes. “I had a patient once, an elderly lady, who said when I did that, ‘I think I’m having an
organism.’ ”

When it’s done, he gives me a partial verdict. “Your valve is point-seven square centimetres. That’s a severe constriction and explains your symptoms. Surgery is indicated for anything less than one square centimetre.”

“Could I suddenly arrest? Am I a walking time bomb?”
Kaboom!

“We all are,” he says quite cheerfully as he peels off his gloves and disposes of them. It sounds blunt, but again, it’s honest and I appreciate his directness and unexpected humour. He gives a huge grin and hustles off to the next case.

They wheel me back to my stall and place a C-clamp on my groin with firm pressure to stop the bleeding from the artery. Nurse Louellen checks my pulses and compares my legs. “The doctor will come and tell you the rest of the results,” she says and goes on her coffee break. A few minutes later, Nurse Zahra, who’s covering for Louellen, comes in to assess and palpate my pulses. She looks closely at my feet and legs and notes some mottling in the right one so she loosens the clamp to ease up the pressure, all the while explaining what she is doing. Why can’t I have Nurse Zahra instead of Nurse Louellen? Both are competent, but Nurse Zahra is fabulous. One inspires confidence and the other not so
much; one communicates well, the other, not. I never realized just how closely patients watch nurses’ every move, hang on to every word. Maybe I once knew, but over the years, it’s easy to forget.

Dr. Sternberg moves down the row of patients, giving his reports. Some patients need to have angioplasty to open up narrowed arteries and others are getting stents, an artificial device used to keep the arteries open.

“Partially blocked,” he tells an elderly man in the bed beside me, “but no surgery at this time. We’ll keep an eye on it. Diet, exercise … same as last year.”

Then it’s my turn. Dr. Sternberg appears at the foot of my stretcher with my results. “Your arteries are perfectly clear. No blockages.”

I sink down in a huge exhalation, peacefully jubilant, quietly ecstatic, containing my happiness. “Thank you,” I say, as if he’s responsible for the results as well as the procedure. I clasp his hand. “Thank you,” I repeat. “Thank God,” I say softly, putting it out there, testing it out.

“You’re welcome.” He says goodbye, leaving me to muse over which of my thank yous he was accepting.

Yes, if I knew how to go about it, I would offer up a prayer of gratitude. You can’t go through something like this and not
occasionally
think about God because if you want to give thanks, who are you thanking? Personally, I don’t allow myself to pray for specific outcomes, but I do feel moved to say “thanks” from time to time. Until now, gratitude felt impossible, but now it’s here. I’ve spent these past three weeks being worried and now this is hope. No wonder everyone wants a piece of it.

I am beginning to think I actually might make it, but still, I take nothing for granted.

Nurse Louellen brings me a cheese sandwich. Peeling off the plastic wrapper, I’m suddenly ravenous. I take a bite into what is
quite possibly the most delicious thing I’ve ever tasted. I feel myself turning a corner. I’m feeling great, relishing my state of quiet rapture until a new worry occurs to me – one I hadn’t even thought about. How long will I have to wait for surgery? I’ve heard stories of long wait times for urgent procedures, even surgeries, and like every patient,
I want it now
.

I ask Nurse Louellen about this and in answer she hands me a brochure about a cardiac surgery hotline I can call if I have any concerns. “The cardiac care network ensures that all cardiac patients receive the best and most timely care,” it states in the brochure. Even though wait times for cardiac procedures have improved over the past few years, it’s easy to fall through the cracks and get missed, but like a good citizen, I’m determined to play by the rules. I don’t want special treatment and refuse to pull in my connections. I’ll let it play out as it will. I am counting on being able to trust that I’ll get what I need when I need it.

In preparation for me to go home, Nurse Louellen lists the warning signs for complications post-angiogram over the next twenty-four hours but stops with a laugh. “Why am I telling you? You’re an
ICU
nurse? You know all of this, don’t you?”

“Tell me anyway. It calms me down to hear you say it.”

Suddenly, we hear a cry from another bed. “Nurse!”

“Someone will go to him,” she says, handing me more pamphlets about heart disease, heart healthy diets, and cardiac rehabilitation programs.

“Nurse!” the voice calls out again from a stretcher behind a closed curtain. A cardiac monitor goes off. It could be nothing or something, but Nurse Louellen goes to the nursing station to finish her charting. Sitting there, she keeps glancing at her watch to see when her shift is over. No one is going to the patient.

“Nurse!” the voice calls out again. “I need help.”

Nurse Louellen says to another nurse – I can read her lips – “Not my patient.”

That phrase should be banned
.

The clamp is now off my groin so I get up and hobble over, pushing my
IV
pole. An old man needs a urinal. He looks at me in surprise and I assure him that I’m a nurse in real life and his nurse is busy. I pull back the covers, position everything in place, and wait for the tinkle in the metal jug. “It’s hard lying down, isn’t it?” I often say to my male patients. “It’s easier for us women.”

I think of all the years I’ve been a nurse and the thousands of patients I’ve cared for. Why should I stop now? In these few minutes helping that man, I am freed from my worries. As a nurse, I feel powerful and capable; as a patient, I feel weak and vulnerable. Maybe my inner nurse can see me through this. It’s time to be that good nurse to myself.

Nurses are notorious for not taking good care of themselves, only others. My long-time colleague Maureen springs to mind. She’s an incredibly skilled nurse, but I came upon her one day in the supply room, taping up a raw, irritated poison ivy rash on her arms with the medical equivalent of duct tape. She would never dress a patient’s rash without cleaning it first, applying soothing cream and a comfortable, soft bandage, but she didn’t do that for herself. Nurses don’t offer themselves the same care and attention we offer our patients. It’s been said you can’t treat yourself, but why not? It will only help me to stay nurse, even to myself. Why should I give it up now, just because I’ve become a patient? After all, I have used my knowledge and skills to help others, why not myself, too? I would never treat a patient like I’ve been treating myself! I have always prided myself on being a patient advocate, speaking up for patients, looking out for their best interests. I have always used my words to encourage and give hope, not to scare and create fear, as
I’ve been doing to myself. What if I decide to treat myself with the same compassion that I have for my patients? If I stay nurse and actively participate in my own care, I won’t feel helpless and as if things are being done to me.

As Kevin at camp asked, “What can I do to help myself feel better?” I’ll let that question guide me, too. All the ways I’ve encouraged patients, given hope, and bestowed dignity on others, I will do those very things for myself. I have been so gentle, even loving, with patients; now I will do that for myself. I want to get myself in the state of wanting this surgery. To do this, I need to come over to my side; to move from adversary to partner, from passive victim to strong nurse.

It will take courage to make these changes and to be this way to myself. It will be a choice to be more positive and stop generating endless negative thoughts of all that could go wrong, completely ignoring the fact that mostly things go right. Most people do their jobs properly. Most patients get better.

It’s going to take determination and courage to make these changes. Courage takes practice, effort, and
courage
itself. (I will fake it in the meanwhile until it feels real.) Thinking these new thoughts, I feel a lifting of my mood and an upswing in my outlook. It’s time to make new choices. I don’t want to go into surgery kicking and screaming. I want to want this. I will have to put my whole heart into this project, pun intended.

Two days later, when my kids tumble off the bus from camp. I take them into my arms – Max, who lets me, and Harry, who pulls away. I am out of breath from simply hugging them. At home, they beg me to play basketball on the driveway, as I used to do, but after two dribbles I’m done, panting and short of breath.

“Are we going to get a puppy, Mom?” they ask. We had talked
about getting one this summer, when they got home from camp.

I’m too weak and tired to even answer them, much less entertain the possibility of having a dog in the house and attending to all that that would entail.

I can’t continue like this anymore. I will go forward; I will choose life.

In my new-found state of nearly nirvana, high on this huge epiphany after the cardiac angiogram, I feel confident I can deal with what’s ahead.

Three days after my angiogram, Dr. Drobac calls to tell me he’s referred me to a cardiac surgeon. “Dr. Tirone David. Have you heard of him?”

In my world, who hasn’t? The surgeon with the movie star name and sexy good looks is a rock star! Having him operate on me would be like having Rembrandt paint my portrait or Mozart compose me a symphony, yet I’ve ridden with this legend on hospital elevators and waited with him in the line for coffee at Tim Hortons. We have even discussed patients together. And, yes, from time to time I did wonder whether my defective heart would ever be so lucky as to land in his gifted hands. But it will probably take months to get an appointment and I am adamant that I won’t ask for special treatment. I want to be treated like everyone else and
find out if all the dire reports and criticism I hear in the media and testimony from dissatisfied patients will be true for me. I’m hoping to keep my faith in the health care system and I am curious how it will go for me.

Admittedly, my little sociological “experiment” is biased from the get-go by my insider hospital status and privileged demographics – urban-dwelling, English-speaking, middle class, and well educated – all of which will likely garner me quicker, better care. In theory, Canada’s universal health care system provides equitable access and treatment to all, but the reality is that it works more efficiently for those who know how to navigate through it. Yet, despite all the problems and inequities, from what I’ve seen, most people get what they need. We have it pretty good in Canada.

Two days go by, then three, then a week. How long will it take? I am starting to panic.
This is unreasonable!
Now that I want this surgery, I want it now.

Another day goes by and I’m freaking out. I call Mary to gripe about the excessive wait I’ve been forced to endure and our underfunded, inefficient health care system. As soon as I hang up the phone the red light is flashing. It’s a message from Dr. David’s secretary. Would I like to see Dr. David tomorrow?