Heart Surgery, Part the Third
Last Friday (9/18), I cycled over to Mount Sinai Hospital, Guggenheim Pavillion, to meet with my surgeon and a Nurse Practitioner. It was the first rather cool day in a long time, and the trip was mostly uneventful and quick with only a hint of angina pain.
Armed with a fistful of questions and items I wanted to cover in my discussions, I of course first had to make it by the person taking my temperature and quizzing me about my possible exposure to SARS–CoV–2. Soon, I was going through the double glass doors into the Coronary Surgery Department at Mt. Sinai. Quite impressive on first sight.
My meeting with the N.P. went quickly. After checking my blood pressure, we discussed some things, mostly about what happens after surgery. I gave him my meds list and list of “questions”, which he took to the surgeon. Not long after that, I was led to a conference room and I sat down to wait for the surgeon. In the next half-hour, I was able to answer some of my questions by reading about open heart surgery in the textbook that was on the table. One would think it was left there on purpose, eh?!
Percy Boateng, M.D. is my cardiac surgeon. He is well experienced, doing many procedures on the heart during any week at Mt. Sinai. Dr. Boateng is a “man of color” — originally from Ghana! We had a wide-ranging conversation, about heart surgery, running, and cycling, among other things. And, of course, we talked about my upcoming surgery.
I was able to view the angiogram, taken during the cardiac catheterization procedure I had. On angiogram, there is little evidence that a left coronary artery even exists — it is either completely occluded or my body has gotten rid of it! Dr. Boateng (and also Dr. Sternheim) concluded that the left coronary artery gradually closed up over a period of time. This allowed the heart to build new blood vessels and reverse the flow of blood in parts of the left ventricle and other places in the heart. As a result, I never had a heart attack, only angina (which I didn’t recognize as such until after I was first diagnosed with coronary artery disease in August). Being active and cycling for moderately vigorous exercise helped.
Our human body is an amazing organism. Its capacity for self-healing and adjustment to injury and dysfunction is equally amazing. But equally amazing is the ability of skilled health care professionals to intervene when the body is unable to self-repair. I have the greatest respect for health professionals; it also helps that I worked as a secretary and word processor for some in the not too distant past at New York University Medical Center. This work has helped inform and guide my decisions about my own health care and feed my ample respect for those who take care of me.
So — I am scheduled for coronary bypass surgery on Monday, September 29. The surgical team will open my chest, hook me up to a heart bypass machine, and redirect an artery under my left pectoral muscle onto the proximal surface of the heart (right on top), replacing the occluded (and possibly missing!) coronary artery. My heart will probably be stopped for all of 15 minutes. (Dr. Boateng mentioned that they could do this with the heart still beating, but I decided, for more accurate placement and suturing of the artery to the heart, that I would like my heart to be stopped during this part of the procedure.)
I am certainly reassured by the skill and knowledge of Dr. Boateng. I’m also assured of a quicker recovery than I thought. My breathing tube will be taken out about an hour after surgery ends. I will be out of bed and sitting in a chair by evening of the same day. The hospital health care professionals will have me walking the next day, Tuesday. And I should be out of the hospital on Friday, or Saturday if they determine that I need one more day of hospital care.
Although cardiac bypass surgery has become quite routine since it was first successfully performed in 1969, this procedure still has its risks. But in my case, death (0.45%) or morbidity (<5.0%) are rather rare. I have confidence that the team from the Cardiac Surgery section of Mount Sinai Hospital are very good at mitigating risks like post-op infection, stroke, aneurism, and others. I am in good hands.
Once I get home, I’m told that I will be able to do a good many things, just as long as I don’t stress my sternum, which is cut through and separated to access the heart. I know from experience with my femoral neck (hip) fracture that major bones take six to eight weeks to heal sufficiently so that they may carry heavy loads again. I can reach, but not stretch. I can carry loads under 5-10 lbs. I can exercise on my bicycle indoors (I have a spinning stand for that), but only put light weight on my hands and arms. I’ve already been advised to begin taking walks every day immediately upon returning home. A physical therapist and a visiting nurse will stop by to check up on me, and they will give me more direction and advice.
It helps that I’m a well-informed patient, asking detailed questions and doing my own research. By doing so, I have been able to clarify issues regarding medication and pre-existing conditions with my surgeon and cardiologist. I am fairly confident that we’ve “covered all the bases”.
Next step is pre-op testing and intake. More about that in my next blog post.
