A Heart Stopping Tale

 It was just going to be a completely non-invasive stress echo test.  Nothing more. 

I have never consented to the angiogram test, when a catheter is threaded into the heart and a dye released.  The angiogram, considered the gold standard for heart disease diagnosis, carries a mortality rate of one in a thousand.

 “Oh, my God!” the doctor exclaimed when he viewed my echo test.  “We can’t let you leave the hospital!”

 I knew then that the angiogram would be the next proposal from the doctors.

 “I am leaving the hospital,” I said.

 “Not unless you sign these papers.”  The cardiologist brandished in my face what appeared to be a ream of forms.

 An armload of papers -- the “hold the doctor / hospital / everyone else harmless,” kind – looked like it could take longer to read and sign than it would to actually take the test.

 So I took the test.

 It revealed two blocked vessels; each one showed blood vessel walls narrowed by 80% to 90%.  No heart attack.  No damage to the heart muscle.  I could still leave the hospital if I signed those forms.

 But they would not let me drive.

And they had my pants.

So, this is really a test of whether you believe in doctors – and in preventive measures.  If you don’t accept the surgery, you may never have a heart attack.  After all, statin drugs might stabilize or reduce the blockage, and collateral vessels may form around the blockages to lessen the damage . . .

We used to joke at the University of Minnesota about the definition of a double blind study:  Two surgeons studying an angiogram.  You could almost always find blockage in a sample of America’s population for whom 500,000 coronary artery bypass grafts are performed every year.

“So, assuming I go ahead with this procedure, who will be my surgeon?” I asked.

“Dr. Sara Shumway.”

A magical name in surgery.  She and her father, Dr. Norman Shumway, pioneered the technology of transplant surgery together with the brothers C. Walton and Richard Lillehei at the University of Minnesota.  The drug cyclosporin made transplant surgery feasible and safe  (by taming the body’s urge to reject a foreign organ), and the drug was originally found in the beautiful fjord of Hardanger, Norway – my home country.  I knew of the Shumways’ contributions and their reputations as doctors, researchers and pioneers. 

Having the surgery now implied that my mortality rate would be 1 in 100: I could  be part of that 99 % who survive the surgery.

“Okay,” I said.

And that’s how I found myself undergoing a five-hour operation, during which, by the old definition of death, I had to be “gone” (i.e.:  on the heart/lung machine) for one full hour.

Afterwards, I felt like I had been hit by a Mack Truck.

It hurt to cough.  It hurt to laugh.  It hurt to move.

Being macho about painkillers means that you cannot focus on much of anything except pain.  I had a lot to focus on after this procedure.  So I relented and took the pills.

Climbing a staircase for the first time after the surgery was like being kicked in the chest by a mule.  It took half an hour to get my heartbeat back to normal after climbing just ten steps.

I suppose I’m sharing this because it could very well happen to you.  At least twelve million Americans are currently suffering from heart disease, and more people die from heart disease than any other cause.  Although drugs like statins and beta blockers have succeeded in halting – and even reversing – trends in sudden deaths from heart attacks, the population is getting heavier, with more diabetes, more hypertension, and more rising lipid levels than ever before.

With this bypass operation, I guess I’ll have to start worrying about cancer, since we all have to die of something.

I come from long-lived stock.  An uncle of mine, in his 90^th year, simply refused his medications for pneumonia and died peacefully yesterday.

But I regard this no differently than did former President Clinton, or Jack Welch, or all the other Americans for whom this was just a minor break in their busy lives.

Except I’ll spend more time with family and friends.  And I will write more.  And do more of the things I like to do.

You will too, won’t you?

Or, if not, maybe you’d like to take a completely non-invasive echo stress test?