Cabbage. Pt 2.'Cabbage' medical jargon for Coronary Artery Bypass Surgery
When I sprung it on relatives, colleagues and friends that I was planning to have bypass surgery, the first response tended to be reassurances as to how healthy I looked, and questions as to how long I was ill. Funny, because I never considered myself ill at all. After all, all I had experienced was a bit of breathlessness and a little tightness in my chest when I exerted myself. I could swim laps indefinitely, as long as I used commonsense and didn’t try to break records. And after all, I was sixty-nine, no spring chicken in anyone’s language. How was that to be equated with illness? I was never ill a day in my life. Never missed a day of school or university or work. Ill indeed, I thought indignantly! In fact, quite honestly, I was really only proceeding with surgery prophylactically, because the genetic scales were so heavily weighted against me. Was I just going to sit around and wait for those obstructed coronaries that I had looked at on the angiogram to totally plug and kill a huge chunk of my myocardium, or even me. I was determined to get those obstructed coronaries before they got me. So I carried on going to work every day, waiting to hear from my surgeon’s office as to when I would be having my surgery. Meanwhile, I was daily fielding a litany of phone calls from relatives and other well wishers, including dutiful nephews and nieces who no doubt were responding to their parents exhortations gracefully and did their duty. I could tell they were impressed when in response to their questions I told them I was having a quintuple bypass. That was rare at the time - the only other case of a 'quintuple' that I knew of was Bill Clinton!
Thursday - the day before Surgery. After a fairly normal day at work during which the objective was to keep as busy as possible, and to keep my mind off the following days ordeal, I headed home. At least, I consoled myself, as I manipulated my Honda along the dark, wet slippery country road, against a continuous steam of giant SUVS, nothing I was going to encounter in the next few days was going to be more dangerous than this. A serious martini and a light supper followed by a sleepless night, rounded off the day.
The nineteenth of Nov 2004 - day Zero! Up at 5 am and son David picked us up at 5.30 for our morning appointment. I remember, in a gentler more civilized era when patients were admitted the night before surgery, rested, worked up, sedated and assured of a good night's sleep . In the olden days, we used to think that getting the patient as relaxed and stress free as possible had some bearing on the patient’s subsequent progress. But that was before we had a Health Care Industry. Getting the patient up at 5 am is hardly conducive to survival, let alone surgery.
At 6 am I was through the admitting area, hardly noting all those other poor souls with their problems small and great, but none I was sure, as great as mine.
A kiss goodbye; a word of encouragement from Irene and David; clothes deposited in a plastic bag and on to the OR . Although over the years, I had spent many hours in operating theatres, this one seemed so small and so crowded with people and equipment that I wondered if there was enough room for me.
The Anesthesiologist greeted me as I was wheeled in the door.
"So you're Dr. Smith?'' He smiled, effortlessly sliding the IV needle into a vein.
"Yes, that's me,” I tried to smile back and think up a clever witticism I could throw out.
The lights went out.
I opened my eyes. The anesthesiologist was gone; it was all over, and I was surprised at how little pain I had. Just like my niece had said of her anesthetic - 'light off, light on. Like flicking a switch!” She had also added that it had made her a little less fearful of dying, and as I reflected on that particular piece of philosophy, I found I was in agreement with it.
Now I had to get the damn tube out of my throat. My God, I couldn't talk! I made as much noise as I could to attract attention and look as though I was really suffering - maybe that way I could get rid of it! The Nurse leaned over me.
“Are you having a lot of pain?” she asked sympathetically.
I shook my head - no, but harrumphed and coughed as much as I could to make it quite clear I wanted this damn tube out of my throat. Maybe if I coughed enough I'd manage to propel the thing across the room.
I could hear the machine behind me, but couldn't see anything. Where was I anyway? Alive, at least, and no sign of any stroke or paralysis or anything else horrible as far as I could determine. I seemed as sharp as ever! I tried to cough up the tube. The nurse injected something into the IV tubing in my arm and I drifted into some pleasant place.
I woke up with vague pain everywhere, and a horrible nauseated feeling. The lCU nurse slouched by. “Something for the pain?” she said, pulling her drooping sweater up around her shoulders. She deftly deposited a little cardboard container with two pills in it, in my hand, and propelled them into my mouth. I swallowed them and soon dozed off again.
“Are you on these pills too?” I politely asked the woman just to the right of my shoulder. I couldn't figure out why she was wearing a pretty bonnet right there, in the ICU. I managed to twist my neck around, to get a better look at her and saw this was an electric fan somehow managing to look like a woman's face, framed in a bonnet. I gave a little chuckle to myself, as I realized what I had done- no wonder the poor old geriatrics got wingy after a few days on narcotics. I had at least one other similar encounter and resolved I’d have to cut back on the pain pills. I looked at the clock, 11.10, but was it night or morning?. I drifted off to sleep again, and had a long deep sleep. I woke up again, thought I had slept for hours, and looked at the clock. 11.20! I couldn't decide if I had slept right around the clock and it was 11.20 twelve hours later, or just ten minutes had gone by. Then I noticed people all hustling around and going somewhere! Something was wrong, I was going to watch what was going on very, very carefully It looked like some sort of a set from the movies, something funny was going on here. Everyone seemed to be leaving. My last thought before drifting off to sleep again was that they really needed to have windows in these places, or everyone would end up disoriented and crazy.
Someone woke me up and was offering me pills again.
“I think I'm going to throw up,” I said.
“Hold on a minute,” the nurse said, a large basin appearing from nowhere.
I felt horrible, retched and threw up a large amount. The relief was immediate and wonderful. I closed my eyes and drifted into a deep sleep. When I looked at the clock a long time later, it was only 11.30 pm.
I was watching the Iraqi war on the television. A bullet in the chest. Must feel something like having your chest cracked open, I thought.
“Rate the pain with a number" a nurse asked. "if 1 is very mild pain and 10 is the worst pain you’ve ever had."
What does that mean? Depends on who you are and how much pain you have experienced. Where is 10 if you’re lucky enough to never to have had much pain? I rated my current pain at 5 - a nice median number!
"There's a button attached to your IV that will give you a pre-set dose of morphine whenever you press it to relieve the pain if you need it."
"Thanks," I said. I used it about twice and it made me feel worse than the pain! At least I don't have to worry about becoming a morphine addict!