Cracked Armour

It’s been a while since my last post. In some ways there wasn’t much to write about: The slow progression of recovery isn’t all that interesting. But more than that, I wanted my final post to talk about things in the past tense. But now that I’m here, that feels a bit weird. Is it really all behind me? Sometimes I forget about it all and slip back into normality, but mostly I’m still absolutely defined by it.

But I’m getting used to that ambiguity. When I think about the whole mess that was the last 3 months, I’m just confused. I don’t know where to shelve it: Does it go on the top shelf to be filed under “Life Changing” or closer to the middle, in the more mundane “Challenges Met” section? The whole thing just remains this shapeless event whose contours I’m groping for, but can’t find.

People ask me how I am, and I blurt out something like “I’m grand”- which I am- but I’m also not. I don’t know what to make of it all. It’s too big and I haven’t managed to string together a neat narrative that I can just fall back on. So I’m left floundering: “How am I? I don’t know”

None of this is new to me. I was 14 when I had heart surgery before and looking back I see that I hadn’t a clue. My 14 year old self was ill-equipped to deal with the debris of open heart surgery. Not knowing how to think, I didn’t; and instead just parked it all in a safe place for time to take care of. I went back to worrying about getting girls to like me and stopping the opposition scoring goals on me. But it changed me, I realise that now.

I remembered recovery being a slow process. But this time round, its pace has surprised me. Other than a small bald patch on the back of my head-  caused by the pressure of lying on the table for so long- a person meeting me on the street wouldn’t know anything had happened. Recovery is not a binary procedure, instead it’s a drawn out spectrum of mile stones: Get out of bed; start walking; get home etc. But it can be hard to see it that way. Once you start getting out and about it’s easy to think it’s all over, and so after one or two general questions, the concern for a bizarrely large number of people is “so like, can you drink?” (I can.)

It’s amazing how far I’ve come. During the first days and weeks you’re a radically different person. The person who walked into hospital with such arrogant ease shuffles out, eight days later, humbled by the four steps at the door. But as the days meld into one another you walk a little farther, stretch your arms a little higher and speak a little louder. Slowly the spectrum of recovery turns from dark, to grey, to the full colour of life. But even then you are still dogged by a hundred reminders. The shuddering vibration of your heartbeat will take years to get used to, and wearying pain will occasionally wrap itself around your chest, draining you of energy: Minor idiosyncrasies of the surgery’s legacy that will become part of the background noise of your life.

***

But I’m looking ahead, not behind. Excited for better times. I was lucky. Anyone who has stayed in the Republic of Critical Condition for longer than “visiting hours” permits belongs to an unfortunate club. But unlike my fellow citizens I wasn’t a permanent resident. I didn’t have to battle cancer year after year, or wait endlessly for a heart transplant that might not come. I didn’t fall from a collapsing balcony, facing god knows what for the rest of my life. Many who cross the border into that grim nation don’t get the chance to come back. Compared to them I was a short stay resident. Knowing that health and normality was a matter of “when”, rather than “if” was a huge mental crutch.

So when I think how little I’ve suffered compared to others I wonder why the hell I’m still writing this blog. I mean, isn’t it a bit embarrassing to be still going on about this 10 weeks later? My former compatriots, still stuck in the bleak land of illness don’t write blogs or articles. They just get on with it.

Is this just a ploy to exploit a relatively rare and dramatic sounding experience for attention? Have I hijacked this as a vehicle to air my personal grievances?

And yet, it is personal; deeply personal. A few weeks ago I stumbled across an interview with Robin Williams. I hadn’t known he went through a similar procedure and it was amazing to hear him talk about it: Stripped away from his protective layer of whizzing genius he described how “they cracked the armour”.  Hearing someone like him, who lived such an enlarged life talk like that, helped me. It allows me to give myself permission to acknowledge that yeah, this was a big fucking deal.

Because they do crack your armour. Your rib cage- literally your heart’s armour- is cleaved open, leaving you feeling horribly vulnerable for months after. But it goes beyond that. The heart isn’t just a mechanism, it’s a symbol. There’s a reason, I think, why “Heart” is synonymous with “Core”. Our deepest truths are “known in our heart of hearts”; we have “sweethearts” and “broken hearts”. There’s “Braveheart”; and a “kind heart”; even the title of this blog! Doctors look at the heart as an impressive engine, but it can never be just that for me. I mean it’s my heart they stopped! They cut open my heart! There are stitches and scars on my heart and there are people in this world who have literally looked into my heart.

So, I suppose when I think about that, it’s probably ok for me to store it up there, on the top shelf: “Life Changing”. But even writing that I’m still squirming a bit. (“Is he still going on about that?”)

But even aside from all that, I’m reluctant to let this go. I’m scared that if I do I’ll lose what I learned: To be more sanguine about life and its capricious arbitrariness. Twice I agonised about decisions: Move to Ecuador? Study in Amsterdam or Toulouse? It was driving me mad. Between getting in and out of the shower, I’d change my mind three times, and then, after all that stress and worry, a few tiny bacteria made my worries stupidly irrelevant.

After being diagnosed with terminal cancer Christopher Hitchens wrote: “To the dumb question ‘Why me?’ The cosmos barely bothers to return the reply: Why not?”. I like that, because it reminds you how little is actually under your control. You can work to load the dice in your favour, but they’re still dice.

Unfortunately that’s easier to remember when you’re sick. Normal life has a way of crushing that kind of perspective. That’s scary, because that new outlook is a knot of solidity in an otherwise hollow event. It reassures that although the last three months were awful, I am the better for it.

So, it hasn’t been all negative. The opportunity to catch up with old friends has genuinely been lovely. I also got the opportunity to find and flex a writing voice I had long suspected existed, but never had any reason to use. I often wanted to write, but about what? Here was a ready-made experience that almost wrote itself. Writing was cathartic, but it was also liberating: It gave me a sense of self-worth when I had nothing else.

***

You’ll probably have noticed this is already longer than the other posts. If you’ve stuck with me this far, I hope you’ll indulge me just a bit more, and let me stretch your patience a little longer. I owe a debt of gratitude to a lot of people.

Nurses are the infantry of healthcare, they’re in the trenches everyday and it’s a hard job. In every ward I got incredible attention, but the two nurses on my cardiac team were particularly caring- they were almost instinctive in their work.

I could never be a nurse, but I have a lot of respect for people who are- we should probably pay them more.

I got a new job back in May. I was there only six weeks before getting shipped off back to hospital. But despite my short stay, they’ve been amazingly supportive. I ran out of ways to say thanks.

My thanks must also go to everyone who read, commented, liked or texted. I tracked the various statistics on WordPress and Facebook obsessively. I read every comment, savoured every message and counted each “Like”. To those who visited: Mostly you were an unwelcome effort that I never felt like making. But every single time- without exception- after someone visited me I felt less alone, more normal and happier.

Finally, my Family. With the stress and fatigue of the last 9 months our house can sometimes be a bit of a powder keg, but through all our dysfunction and tension I think we did pretty well. They were a source of immense support. My mom, a nurse herself, was a force of nature on the wards. She knows “hospital-speak” and was able to keep up with doctors when their jargon left the rest of us behind. Often we’d turn to her for a translation after another confusing consultation.

I’ve absolutely no patience for her often unrestrained maternal worry. But I know it must be incredibly difficult to see your child go through something like this. She’s suffered a lot.

My Dad too, is a man for a crisis. Straight away, he’s on the phone sorting things out. When the present is so overwhelming that the future becomes irrelevant, my dad is there, planning ahead.

My brother talks a lot; my whole life he’s driven me mental with how much he talks. But when I needed it, he shut up, and he listened. Having someone to just say  “yeah, that sounds shit” is a million times better than them trying to understand. Speaking bluntly like that, and helping me laugh at myself kept me more sane on those wards than any psychologist ever could.

Finally, my editor. Other than these last few paragraphs my little sister has read absolutely everything before it’s been published. I’ve come to rely heavily on her opinion: Does that sound a bit dramatic? (“Yes”) Which word is better? (“They’re both the same”) Is this funny? (“Not really”). But she was also a dependable source of help: Fixing my pillows, bringing in things from home, keeping my jug filled with ice. She knew what I’d need and helped ease the incredible frustration of not being able to look after yourself.

***

It’s about three months now since I started this blog. I thought because I’d had heart surgery before I’d know what to expect; turns out I hadn’t a clue. I don’t know why this was so much harder than last time, but it was. Even now I’m smiling at how naive I was. I didn’t know how bruising it would be. I didn’t know that this would be, by far, the hardest thing I’ve ever done. I didn’t know that there would be many times when I’d just slump, struck by the clarity of the apparently obvious idea: “Give up!” and for a split second I’d relish the relief. But I kept going: Not because I was resilient, or strong, or determined; I kept going because there was literally no choice in the matter, if there had been, I’d have thrown in the towel long ago.

But I’m here now: Ten weeks on with my “top shelf experience”, my new clean heart, my blog all done. It’s tempting to finish with some fancy flourish, a snappy line that hints at a new inspiring insight into “Life” – but that’d be nonsense. I didn’t know anything about “Life” before all this and I don’t know anything now.

But that somehow doesn’t matter as much anymore. Maybe its because I’m proud of how I’ve gotten through this challenge. And maybe if I can do a decent job of getting through heart surgery, then surely I can manage to blunder through whatever else “Life” will throw at me.

That’s good to know.

One Foot in Front of the Other

I used to go hiking a lot. In fact, it was probably the most intense exercise I got for the first few years after my first surgery. I loved the sense of independence in the wilderness. There were four of us and we achieved a sense of adventure that’s probably pretty rare among 15 year olds. Often we didn’t talk as we walked, but there’s nothing quite like being on the spur of a mountain, rucksack fitted tight but snug; boots well worn, keeping your feet warm and dry and enough layers to protect against the blustering cross winds that threaten to exploit any misplaced step. Hat, hood and scarf, properly combined, left only your eyes exposed, but they were treated to a feast and greedily ate up the view.

With two of the lads in front and one behind we might walk for an hour or two like this; too cold to stop, too windy to talk. Afterwards we’d sit down for lunch, using a huge boulder to shelter the feeble flames that heated our soup. Then, just as we’d start to stiffen up, we’d pack our things away and get going.

The path ahead almost always looked worse than it turned out to be. Looking at the steep sections you’d have genuine doubt as to whether you could really haul your rucksack up the incline.

But no matter how hard the climb was (and they could be pretty hard- some of us felt it worse than others, we couldn’t all turn out to be army officers) I was always surprised when I looked behind or in front: The steepest bit, the part I had been dreading, was actually under foot. I was already there, already half way up. What had earlier looked like an impossible task, I was already half way through.

The key to hiking, I realised, is to not look up. As tempting as it is, the longer you delay checking your progress, the more pleasantly surprised you’ll be when you do look up. Better off to keep the head down, keep plodding along, put one foot in front of the other and think of something else.

I have already summited the highest peak of this ordeal. That was the sprint of acute care, now it’s the slog of recuperation. The gradient is gentler, but my stamina is drained and my legs are heavy.

In fairness, the progress I’ve already made is pretty incredible. On Thursday I’ll be four weeks out of theatre. Only one of those weeks was spent in hospital, the other three I’ve been home, and in that time I’ve slowly begun to recover the ability to function normally. I’m now able to make myself lunch, my walks can legitimately be considered actual walks (albeit very short ones) and half way down the stairs this morning I realised I wasn’t even holding the banister.

Those who have visited or promised to visit have played no small part in all this. I’ve rarely felt in the mood for having people in, but every single time I’ve been more upbeat after a visit. Being with friends lends a degree of normality to this situation and offers a chance for me to untie myself from the knots of my mind.

I’m usually not really that tired when I’m hanging out with people, but after I’m overwhelmed by an all-encompassing exhaustion. Connecting words to thoughts is challenging and the stairs to my bed suddenly become a task to be reckoned with again.

Overall, I am making solid and steady progress. I’ve seen my surgeon and cardiologist and both are extremely satisfied with my progress. That is both a relief and encouraging. It’s time to stop acting like the patient and begin to put this behind me. That’s not an easy process and one that won’t be done overnight, but it’s time to start.

I crave normality. As the pain subsides and the medical issues dissipate, impatience and frustration will naturally grow. But I know that if I keep the head down, put one foot in front of the other and focus on getting through today, maybe tomorrow I’ll look up and be surprised that the hill is no longer rising.

If I Could Leave this Broken Body

If I could leave this broken body, just for a while
I’d swap it for a new one (or even my old one),
and I’d stretch; reach high and then wide; unknotting and decompressing.

 

Next I’d sleep; oh jesus I’d sleep.
I’d sleep for the Ages! For the Gods! For the Heroes! Or,
Just for a night, a full night:
Without interruption, intermission or pain-killer intervention.

 

I would walk. Straight.
And go for runs;
Stretch my legs and my lungs.
After, I’d enjoy the strain of my muscles doing press ups:
Feel their confident strength give way
to buckling sinews
And for the rest of the day
I’d relish the fatigue of my worn out arms,
Which are still strong enough to lift a jug of water
That I’d gulp down, in a pint glass, all in one go.

 

I’d eat and drink at the same time,
And take the stairs two at a time.
I’d cough without fear of reprisal,
And laugh without having to stifle.

 

I’d roll and roll and roll and roll around my bed
Knowing that where I settle can be revised,
And that my options for sleeping are not just comprised
Of left and right, with a gulf of pain between the two.

 

I’d drive,
And then I’d dive
Into waves
And feel their rush and crash as they broke above my head.
And as the water cascaded around me,
I’d feel its invigoration and life-affirming energy
And remember the excitement of the implicit threat of the ocean
Like when you look at the sky, and get the notion
That you are both connected to- and separated from-
Something bigger.

 

I’d travel: Hitch up my rucksack and go.
To Cambodia and Cuba and Costa Rica.
And somewhere along the way,
I’d find a patch of the sun’s warm glow,
And a bar,
And sit, and get drunk.

Surgery Part 2

Nothing is free. Not in Recovery.

Each step of progress has a price, every decision a trade-off. In the first 36 hours an almost unlimited amount of morphine will dull the pain, but you’ll pay for it: If your vision hasn’t turned into something resembling your grandad’s TV with a hanger for an aerial, you’ll certainly be stuck in an endless muggy stupor.

The drainage tubes offer a very tight trade-off margin. Three in total, under the ribs; one left, one right and one in the middle. The sickening pull as they are touched by blankets, or caught by other tubes, or moved in any way, is likely to be the most warped, wrenching and unnatural feeling you’ll ever suffer. But if their removal promises freedom from that sensation, you’d do anything to have them out. The problem is getting them out. Although quicker than I remember from last time, feeling those tubes get dragged from inside your chest is indescribably horrific.

The decision to adjust your pillows is also one to to be weighed carefully. How much to you really need to move that pillow? The promise of extra comfort comes at the significant risk of becoming  more uncomfortable. And regardless of the outcome, moving your weight, liftiing your head (with your hands, no strength left to do it with neck muscles) and moving your arms will all cause pain. But the real problem is you just don’t know what’s comfortable. Comfort is a process of trial and error: We roll, stretch, shift and pull, those luxuries aren’t an option now.

Every move can be measured and paid in Pain Pounds (PP) and Discomfort Dollars (DD). Changing t-shirt will cost 1,000PP. The muscles invloved are so sore they feel like broken bones, the range of motion of my arms is limited to a few degrees, my neck impossibly stiff. Discomfort dollars are paid pretty much constantly. There is no escape, no relief; I’m continually uncomfortable. I feel like a pillow stuffed into a case that’s too small. Crimped, knotted and tight. The front of my pillow case has a red snake-like seam from the bottom of my neck to the top of my belly. I’m repulsed by it. Not in any cosmetic sense, of course, but it’s just too raw, visceral, sickening.

One of the highest tolls you’ll pay is to re-engage your lungs. After lying deflated for hours while a machine infused oxygen into your blood, your lungs will not automatically bounce back into full action. Making sure they are fully re-inflated is another horrible task, especially when a deep breath means pushing on the tubes below. However after a few days the exercises they provided me with to increase my lung capacity became redundant, because I was hit by many bone crunching coughing fits.

They could be triggered by a simple sip of water (to relieve my constant, unquenchable thirst) which might go to the lungs instead of the stomach. These were the most infuriating and most discouraging. Every time I drank I was liable to start coughing, it was constantly a risk, each sip taken carefully and fearfully. The other way I’d start is for a little phelgm to catch in my chest. The first time I managed to cough up this mucous I punched the air in triumph. Five days later and those hollow victories became hollow defeats, each spluttering fit costing too much.

Looking back over previous posts I’m struck by the naivety of what I was facing. I’m not sure how I was so blind, given I’ve been through it all before, but this is far worse than anything I imagined. True, this time the procedure was more complex (which is saying something); I lost a lot of blood and was lying immobile under general anaesthetic for over 24 hours. I suppose all of these work together to multiply the severity of the trauma.

It was a blessing I suppose, but things I wrote before seem almost cringe worthy in their Boy Scout-like optimism- “Next week I’ll wonder what all the fuss was about”: In fact a week after I wrote that I was in the Step Down ward, across the corridor from Intensive Care with a morphine pump in my hand- definitely not wondering what any fuss was about. And the “unexpected sereneity” never materialised either; only confusion, partial blindness and pain.

Writing about the brutality of this experience is not easy. It forces me to face memories that might, at least for the moment, be better forgotten. But more than that I’m wary of boring my readers with cries for sympathy. That’s not my intention here. I tend to self-censor- probably too much- to avoid sounding sensationalist or melodramatic. This has always been about writing an honest and unpolished account of what I’m going through. Getting the balance right is hard.

But last week I was very sick. My previous post did not reflect that, instead I (correctly) focused on the main point: Everything was a success. But with this post I wanted to set the ledger right and show at least some of the other side of the coin.

Surgery Part 1

Dublin taxi drivers have a well earned reputation of talking with academic authority on topics they know absolutely nothing about. At the same time though, they’re also known to have an uncanny ability to sum up things just as they are; hit the nail on the head.

Such was the case a couple of weeks ago, when my driver asked why I was heading into the hospital from town. Shocked at what I was about to face he simply said “it’d knock the bollocks out of you”. No doctor could have summed it up better and I couldn’t have imagined how true his pronouncement  would turn out. In short, it’s been a horrific week: the turmoil of pain and the tumult of emotions have been hard to battle.

But it has not been for nothing: The surgery was a complete success. It was an incredibly complex procedure that had me on the surgical table for 10 hours. Importantly too, there is no trace of the infection that caused all this in the first place. If there remained any shred of that bacteria after they stitched me back up, it would have likely left them with no choice but to operate again. Avoiding that nightmare scenario is something I’ll be endlessly and forever thankful for.

It’s a week today since the surgery and really it is incredible how quickly the body recovers. Yesterday I walked up two flights of stairs! After only 5 days I was clear of (almost) all tubes, pipes and machines.

But I’m getting ahead of myself: Last Wednesday was strange in how normal it was. I switched hospitals via taxi and even had an afternoon snooze. I was very aware, of course, of something menacing looming on the near horizon. But how do you get yourself in the headspace for heart surgery? My past experience provided no guidance. Instead, as the afternoon wore on, I just became numb to the prospect. I was in fairly good spirits too, which were certainly boosted by receiving a big parcel of letters from old friends in Munich and a brand new Macbook Air from my family! I decided it’d just make things all the stranger if someone stayed over with me, so I took a sleeping pill, turned on Netflix and had a relatively peaceful night.

I found showering the following morning a bizarre and somber experience. I suppose it was one of the last everyday things I would do with ease and normality. My family were with me, but all too soon I was wheeled to the ‘Theatre Department’. Being no more than 10 metres from my room, it wasn’t the epic last journey I expected- at least it would be on another level, I’d thought. But then it was time for me to go on alone. I was still pretty numb, but I imagine it must be an awful thing for my parents to go through. It was busy and cold on the other side of the other side of the double doors.

People were going round like they were about to start a busy morning at the office- which, I guess they were. I don’t remember details of what I or they said during these (maybe) 15 minutes, but I remember meeting the consultant anaesthesiologist, a big friendly and reassuring man. I was then pushed through another set of double doors into the pre-op room.

Before I knew it they had a few lines into my right wrist, all tightly taped up so that it almost looked like I was putting on boxer’s wraps. To my left was an entire wall of pipes, tubes, drips, jars, cylinders, pumps. An incredible maze of machinery. I remember being surprised – I mean how difficult is it to put someone to sleep? I think I remember the consultant putting the gas mask on my face. Did it feel very squishy around the edges Did I breath in deeply? I think so, really could have made that up though.

It’s been pretty tiring writing this, and difficult too. My fingers are mushy, and my mind mushier. Typing is difficult, I keep writing the wrong thing (‘me’ instead of ‘my’), or just leaving out whole groups of words altogether.

Your thoughts and texts have all been amazing. I’ll try get part II up over the next few days, till then thanks to everyone and keep the good vibes coming!

Songs of Surgery: Eminem, Madonna, Robbie Williams and What I Remember

Songs, like smell or tastes can be powerfully evocative. Over the years a few have become indelibly fused with a very specific time, place or person. And like everyone else I usually enjoy these moments of recall. But there are some songs which stir memories I don’t enjoy; songs that I have, in fact consciously avoided over the last nine or so years. These songs bring me back to a very specific moment in my life when, as a 14 year old, I suddenly found myself in a position very similar to the one I’m in now.

Strangely enough that time was both more expected and more panicked than this. For months we’d known I’d be having the surgery; the question was waiting for a valve to become available. But when one finally did become available, we were in Sligo at my Granddad’s funeral. I think the weight of the situation first became apparent- at least for me- when my dad politely suggested that “Thursday wouldn’t really suit” because of our bereavement. The response was sympathetic, but there really wasn’t much negotiation to be done.

As we rushed home I remember leaning my head against the car window. It was a horrendous day to drive: Sheets of rain lashing down from endlessly grey skies and little rivulets of water streaming horizontally across my window.

A friend had recently burned a copy of Eminem’s Curtain Call album for me and I distinctly remember feeling lonely as “When I’m Gone” blared from my earphones in the car. A little melodramatic maybe, but it was probably the best my 14 year old self could come to hearing some sort of articulation of what I was feeling. Ever since, upon hearing that song, I am involuntarily hurled back to that anxious, grey day.

A few days later, during the exhausting boredom of post-op hospital recovery, I remember being haunted by a never-ending loop of Madonna’s “Hung Up”. The refrain Time goes by so slowlyis repeated six times before the song even begins! And the synth-pop of the rest of the song is barely an improvement. Having that stuck in my head during interminable days and sleepless nights was hellish.

The last song is by far the most powerful. It was also the most infuriating and the song I’ve heard least since. Robbie Williams, of all people, is guilty for plaguing me with this devil. Having heard it for the first time just a couple of weeks before I was admitted, I knew only patches of the lyrics of “Advertising Space”.

With no way to look them up (2006) all I could do was strain my memory to fill the gaps. Over and over I sat in the bed and sang this nauseating bittersweet tribute to Elvis. Why Robbie Williams felt it necessary (or even appropriate) to write such a depressing and fawning song I don’t know, but it drove me fucking crazy.

Today was probably only the third or fourth time I’ve heard that song over the last 9 ½ years; and it was definitely the first time I’ve heard all three songs together since I left hospital. I can’t really describe what it feels like to listen to them again, mainly because I honestly don’t know. They’re definitely irritating, although that’s at least as much to do with them being terrible songs as anything else. But from the first beat of each song I wanted to stop listening, I automatically recoiled a little from the recollections they sparked. There was good reason I avoided them over the years.

Please don’t think this means I’ve got some deeply buried or unresolved emotional trauma. It was a big and unpleasant experience; but not a damaging one. The memories were always there, I just chose not to visit them very often- I had more interesting things to think about.

That’s not to say I haven’t played the “Heart Card” at opportune moments. That scar has served me well over the years: “Heart Boy” I was called by a girl I liked in the year above less than a year later- My friends were livid. On another occasion, having impressively showed my scar to group, a friend commented: “You’re defined by that scar”. It wasn’t even remotely true, but I liked that gravitas of the statement and relished the solemn effect it had on my audience.

But that scar was hard won. My first memory post-op is an awareness of a bright light shining through my eyelids. Thinking I was still in surgery the only logic that could penetrate my mushy brain was first to scold myself for being awake, and second to get back to sleep as quickly as possible, lest I felt something (I didn’t).

Of more substance- although still milky- is the memory of coming round and feeling slightly irked that nobody was there to witness my triumphant awakening. God knows the poor nurse probably took a two-minute break having watched me all night. My first firm memory, though, is from the following morning (I think), when the surgeon came to check up on me. After talking with my nurses (or was it my parents?) he turned his attention to me. He firmly grasped my cold foot and said “you did great”. I had, in fact, done absolutely nothing other than lie on a table, but that didn’t (and doesn’t) stop me from swelling with pride.

The following hours and days were marked mostly by pain and discomfort: Reclaiming your bodily functions from machines is a wildly unnatural and grisly experience. I remember these moments very clearly, but won’t bore you with the details. Better not to dwell on them anyway.

Strangely enough I remember experiencing a kind of unexpected serenity. Granted I was on a lot of drugs- but I have vague memories of being propped up on what seemed like an endless amount of pillows, so weak I was absolutely unable to move. Utterly helpless; but wholly trusting in my carers. Like a baby wrapped up in a onesie on a cold day, I didn’t have much say in where I was going, but everyone else seemed to know, so best to leave it to the experts.

Thursday is looming fast. Too fast. Next week I’ll look back and wonder what all the fuss was about, but like everything else it’s the waiting that’s the worst. The pre-op plan is beginning to swing into gear, won’t be long now!

Medicine for Dummies

At this stage, I’ve probably spent more than my fair share of time in hospitals. It’s never a fun place to be, but at times it can be interesting. I’ve learned a lot over the years, so here’s a few of things I’ve picked up along the way.

 

The Heart

In my opinion the heart is pretty cool and if you’ve ever wondered how hard it’s working here’s a back-of-the-envelope estimation you can do. For every Kilo you weigh, your heart pumps about a millilitre of blood. I weigh around 86 Kilos, so my heart pumps about 86 mils at every beat. Each minute my heart beats around 70 times, which means my heart pumps just over 6 litres per minute- every minute. That’s 360 liters every hour and almost 9,000 liters a day.

Imagine somebody had to design a machine that turned on just as your heart started beating (before you were born). From the moment your heart started beating till the moment you die this machine had to pump 9,000 litres every single day, without fail and (apart from the likes of me) without maintenance. That’s what your heart is. That’s amazing.

 

Carpet Bombing Antibiotics

Choosing the right antibiotic can be a tricky business. Anyone who’s had a serious dose prescribed by their GP probably knows how draining they can be. The antibiotic they have me on- a fairly high caliber drug- was liable to wreak havoc. I was warned about all sorts of unsettling side effects, which I mostly managed to escape. But it is sapping me of energy: Everyday I do less and am more tired as a result.

The reason antibiotics can cause such exhaustion or sickness is because they are more or less indiscriminate killers- every morning a carpet-bombing raid is drip-fed into me, destroying all bacteria in its path. Sure the bad bacteria are destroyed, but good bacteria can also get caught up in the cross-fire.

 

Anaesthetic

Something I found crazy (and slightly unnerving) is that how general anaesthetic works is more or less a complete mystery. Local anaesthetic is pretty straight-forward. Basically we inject chemicals that prevent the electricity carrying the pain signal from travelling along your nerves to your brain. It’s like cutting a wire and putting a plank of wood between the two ends. General anaesthetic is a whole different ball game: local stops the signal making it to the brain, but general shuts down the brain itself.

There’s a whole Wikipedia page devoted to the various theories of how general anaesthetic works. But the guys from “Stuff you Should Know” have a brilliant podcast on anaesthesia which is well worth a listen. (I had to skip a few bits towards the end).

It’s incredible that we just don’t know how it works: We know it does work, but not how. The specific mechanisms are literally beyond the scope of human knowledge.

We mightn’t know how it works, but we do know the history of anaesthesia, and it’s pretty bizarre. It started off with ether- a natural, highly flammable addictive chemical. Apparently it was really popular in Ireland where it was seen as an acceptable alternative to drink (Ether boils at 32’C…normal body temperature is 36’C which would make for some interesting burps). Until 1890 17,000 gallons were consumed…then it was classified as a poison. Johnny Depp does a pretty good job of describing Ether in Fear and Loathing in Las Vegas.

Ether is the ancestor to many modern anaesthetics and was first discovered by a doctor whose friends had been inhaling it for fun. Apparently one of them ran into a door and cut his head open. The doctor noticed he couldn’t feel a thing and decided to investigate.

Another guy tried to demonstrate chloroform and nitrous oxide as an effective anaesthetic. Unfortunately he under- dosed his patient, causing him to cry out in pain. The doctor’s reputation was ruined and after becoming addicted to chloroform he was arrested and thrown in jail where he committed one of the most ironic suicides in history: He was so high on chloroform he was completely anaesthetised when he cut himself and never felt a thing.

Another common anaesthetic is propofol- That’s the drug that Michael Jackson’s doctor was prescribing to help him sleep.

This will be my third time going under general anaesthetic. Usually patients only remember the first 15 seconds of going under. But what a 15 seconds! You go into the pre-op room, freezing with nothing but the flimsy hospital gown to keep you warm, but the injection (or is it the gas?) fills your body with a delicious warmth. I always try fight the sleep- just to see how long I can- but it’s blissfully overwhelming. Gone is the anxiety and the cold, you just lie there in sheer contentment and then. Dark.

 

The Awe of the Body

As far as I can remember there’s isn’t any link between the falling asleep and the waking up. But once you do wake up there isn’t much time to reflect on things because the doctors are keen to remove the various tubes as soon as possible.

The key to recovery is Business as Usual. Rip the band aid off; get out of the way and let the body get to work- and the less tubes the better. When it comes to major surgery you really get a sense of the reluctance with which doctors do their job. There is always a hesitancy to meddle with such a well-balanced and customised system.

It’s crazy that we mostly take our bodies for granted, until something goes wrong. Like when the skin peels around your nails, or you get a paper cut, one little broken cog can upset the whole system. Or how one little bacterium, latching onto a valve in the heart can cause all this mess.

“…imagine if I was actually sick again…”

Update: The surgery has been put back from this Monday. It will now likely happen next Thursday, possibly in a different hospital.

***

A question I’ve been asked a lot over the last week is what exactly happened; How did you end up in hospital? It’s a question I asked when I suddenly found myself wearing a hospital wrist band last Tuesday night. It took the place of the Body & Soul wrist band I had been wearing less than two weeks before.

When I sat down after seeing the triage nurse, I looked at that band with a mixture of disbelief and disgust. The absurdity of being back in hospital! I  was unable to suppress one of those giddy nervous smiles I sometimes get and remember joking with my sister “imagine if I was actually sick again, how shit would that be?” She gave me a withering look of mock sympathy- she’s a firm believer in my hypochondriac tendencies- and checked us in on Facebook with “#seansbroken” and “#prayforsean”.

But to understand how I ended up in that situation last Tuesday night, we should start from the start: 24 years ago. It has become part of the folk of the story my parents tell that it was a GP who, by chance discovered my condition. My parents brought three year old me to him worrying about a cough, and left worrying about a heart condition. When we went to the children’s cardiologist for the first time, he asked how old I was. “I’m a big three and a half” I replied with dignity.

What followed were annual check-ups. I loved those adventurous days off school, I felt special and always got treats. Eventually I was told I’d need surgery when “I was 18”. It was a scary prospect, but the fear remained abstract because the idea of actually being a 18 was incomprehensible.

During all this time I didn’t really suffer from my condition. The biggest frustration was not being allowed to “push myself” running etc. I frequently flaunted this and even made it onto my 6th class Santry Relay Team (no big deal). But I was directed into goalkeeping, which, to be fair, probably extended my career as a useful footballer far beyond what it otherwise would have been. On my day I could perform any number of improbable heroics; on a bad day the ball was just as likely to roll between my legs as it was to go over my head.

In late 2005 I went for the normal check-up. Everything seemed fine, but the final word- as usual- would come with the follow-up letter, written after the various scans were examined. The news was not good. We saw a surgeon soon after, and in January 2006 we were told a valve had become available and I had the surgery.

Other than annual appointments with my doctor I was free to live my life after that. There were a couple of rules: No weights and no jaegerbombs. It’s always been odd explaining to people over some sticky bar counter that I’m not doing Jaegerbombs because “I’ve got this heart thing…”

I finished college and decided I was going to teach english in Ecuador. I got my vaccinations back in early January of this year and I remember being surprised at how quickly they took effect. Already that evening I didn’t feel great. For the rest of the week I was miserable working my bar job. I was knackered all the time, full of aches and pains and waking up every morning with the sheets soaked from night sweats. I had a trip booked to London and so off I went with little idea that my blood was teeming with bacteria. We played Croquet though (it’s actually class!).

I lasted three weeks in total, thinking I just had an averse reaction to the vaccinations. I don’t usually consider myself a stupid person, but convincing myself I was fine, is up there with the most idiotic things I’ve ever done. I mean, I was so cold I wore a wooly hat in bed.

After six weeks of antibiotics it began to look- against all the odds- that I wouldn’t need surgery. As time went by and I felt stronger and healthier- not a wooly hat in sight- we thought I’d made it. Blood tests were consistently clean, so when I saw my doctor last Monday every shred of available medical evidence pointed to one conclusion: Somehow I had come through without needing surgery. One of the blessed. The lucky few.

The next morning I woke with a couple of tell-tale endocarditis signs (basically like a flu). I’d had an absurd debate with my Mom on the usefulness of thermometers the previous evening, so although alert to the symptoms, my first priority was that she didn’t see me slip the thermometer into my jacket pocket. Every half hour in work I took my temperature. It got higher and higher and I felt shitter and shitter. Achy; lethargic; tired. Feeling like a bit of a wimp I decided to take the afternoon off and confidently told my colleagues I’d see them in the morning.

I slept for hours in the afternoon and when I woke my Mom took my temperature (no debating anymore)- it was high. She was worried. So was I. There was a growing pain just under my lower left rib, which seemed strange, but was mild. Then ensued a family debate over my sister’s CAO choices. The heated discussion distracted me until I abruptly realised I was in unbearable pain. I sat contorted, unable to breath properly and for the first time it was me, not Mom that decided to go to hospital.

And so we found ourselves waiting in A&E. The pain subsided and I wondered what the hell was I doing there. Just as we were about to give up, the nurse called me and hooked me up to a heart monitor- as a precaution. The pain grew and grew. All of my stomach muscles seemed concentrated in a small knot in my left abdomen. My legs were clamped around the edge of the chair and my back was drenched with sweat. I spoke in pale whispers and could hardly breath for the pain. I was scared. When the doctor came, I had no energy or breath to answer her questions. All I could do was mentally plead with her to put me asleep and remove whatever the hell was about to blow up inside me.

Three doses of morphine – “a surgical amount”- later and I was able to get a little rest and go for a few scans. The pain it turned out, came from my lung after some bacteria detached itself from my heart.

So now it’s a waiting game. Thursday seems like the Big Day- plenty to write about before then.

Life in Limbo

It’s been a bizarre few days. By night I’m the cardiac patient, propped up on my hospital pillows. By day I’m normal; not hospital normal, mind you- just normal. My doctor has given me “hours out” which does exactly what it says on the tin. Once I get my morning dose of antibiotics and my temperature hasn’t spiked I’m good to go. On Saturday I got my hair cut in town and relaxed at home; today I walked the beach and enjoyed Momma’s best home cooked Sunday Roast (chicken, if you’re interested).

During the day I’m surrounded by the trappings of normality and the only outward sign of anything wrong is a bandage extending from my right elbow; which could just as easily be a muscle compression bandage. Am I a hospital patient, or an overenthusiastic tennis player? It turns out that hay fever also doesn’t care that you’re on the verge of major surgery. I was sitting in my garden, careful not to get too much sun because the antibiotics can change skin pigmentation(!), making me liable to burn, and there I go: Sneeze after fucking sneeze, eyes watering; the works. All because of pollen.

Inwardly though, I am aware of a slow decline- driven mainly by the antibiotics. If you’ve ever had a throat infection treated with antibiotics you know the feeling- just generally shit. I feel a bit groggy, mildly uncomfortable, sore mouth. I can also get headachy or feel a little sick for no reason. What’s taken me most by surprise, though is how tired I get: Things that I wouldn’t have given a second thought to last week- walking through town, or along the beach- now define my day’s activities. It feels pretty pathetic that walking now counts as exertion.

It’s all just a weird experience. I mean, who wakes up in hospital, spends the day lounging around at home, feeling pretty much just hungover, and then heads back into hospital to sleep? How do you get your head around that?

But, for the most part I’m still in good spirits. I have my own room now which is fantastic. Writing and thinking about this keeps me occupied; and when I’m not doing that, just keeping up to date with those poor feckers in Greece is easily as good as watching Netflix (except the West Wing- obviously).

I’ve a meeting with my surgeon and my family early in the morning and should know more details of what is to come by then. He knows me well, having performed the original surgery- Neither of us expected to meet again quite so soon.

It is what it is.

Your Reactions, My Impressions

Well that was Unexpected…

I’ve been putting off writing this all evening. After the reaction of the first post, I don’t want to fuck it up by writing something crap.

I’m really not sure how to respond to the scale and the generosity of the reaction to all this: So many times today I was touched by your words. I’m not usually that kind of guy- normally I say thanks to be polite and to acknowledge the sincerity of the well-wisher. But then go back to ruminating on what I have to face. Not this time.

Maybe it was that I was literally, physically, overwhelmed: There wasn’t enough time between notifications to even see who was writing to me. Maybe it was the generosity of your concern and the pro-activeness of your care. Maybe I’m just more sentimental than I admit to myself, but I don’t think so.

I can’t describe the difference in my mental state between today and yesterday, so instead, I just want to say thanks.

Thanks.

Settling Into my New Life:

By all accounts many of you are curious about life as a patient. I’ll try my best to describe my first impressions here.

The first thing you realise as a patient- which is not obvious as a visitor- is that we’ve all been plucked from our normal lives and thrown into this jumble together. Patients aren’t just immutable anonymous gowns shuffling along with an infusion stand for support. We’re normal people, with normal lives: Today is Thursday- two days ago I was an ordinary person: Getting up for work, commuting, hanging out. Now I’m an inmate in a Big Brother House cum hotel cum asylum- with several nice cafés to take the edge off things.

The second thing to notice is that you’re a cog in a very, very big machine: I don’t wake; I get woken: At 6 am. I’ve also lost sovereignty over meal times: Breakfast is served at breakfast time, lunch at lunch, dinner at dinner and tea at tea time. Same as yesterday, Same as tomorrow. Shift change around 07:30; doctors and consultants do rounds a little later (around breakfast time). Charts are filled with blood pressures, oxygen counts, temperatures and heart rates at regular intervals. The drug trolley comes round at its set times, as does the newspaper stand.

11:04- lights out.

But this is no prison regime. The weird juxtaposition is that everything is done on routine, while nothing is done on routine. It’s a chaotic mix of guzzling oxygen nebulisers; porters delivering and collecting patients; shouting; cursing; stinking; laughing; moaning; farting; burping and even some flirting. Nurses and patients quickly build rapport with a foundation of care and trust supporting banter and wit. It’s a strangely electric atmosphere that makes me feel antisocial every time I put my headphones on to concentrate on writing.

Amongst the patients, a common brotherhood forms quickly. We’re all in the same boat and to my own surprise I’m enjoying the solidarity of my new broken hearts club. The nurses in their turn, are the same I’ve always experienced them: patiently abrupt, unremittingly practical and imperturbably upbeat.

In my room things are quiet now, but in the corridor outside, the nurses’ station bustles like it is midday, rather than midnight. Chairs scrape, drawers and presses bang, and there’s a steady babble of voices, which if you close your eyes tight enough might just sound like the first of the Friday revelers in Sweetman’s or Toner’s.

My fan is whizzing away, my comrades snore and cough and I’m waiting for my last painkiller.