Randy E. Richmond
MY VETERANS DAY, 2006
I guess I could say that my preparations for Veterans Day 2006 started in the spring. That was about the time I really began to notice that I was not the young man I once was. Oh don’t get me wrong, I still had the same sense of adventure I’d always had. Loved to be able to stand in a boat with a fishing rod in hand, walk the hills in the woods with my cousin looking for the elusive and tasty morel mushroom, or playing outdoors with my grandkids. It was just that this spring, I would get so very tired and winded much sooner than in my younger days. Most often I’d shrug it off with an overused comment such as, “getting older ain’t for wimps.”
I noticed too when tending my little garden or mowing the lawn, and sometimes just sitting on the deck between small chores, a little nagging pain that seemed to originate in my belly and manifest itself in my chest as reflux or heartburn. Funny thing is, as I would continue mowing or whatever pursuit I was engaged in, and the longer and harder I worked at it, that pain would completely disappear.
I had it pretty much figured out but knew it was something that I shouldn’t simply ignore so I visited my family doctor. After explaining my thoughts to him, I had some blood work done and was scheduled for one of those treadmill type stress tests. The result of that showed nothing out of the ordinary, although they couldn’t quite get my heart rate high enough due to a medication that I’d been on for some years that prevents vascular headaches and lowers the heart rate also. The results of my blood tests however, showed my ‘bad’ cholesterol to be too high and the ‘good’ to be on the low side. The doctor’s recommendation was to try to get those in line with diet and exercise if I could and if not he would prescribe a cholesterol lowering medication. He also told me at the time that should any of my symptoms worsen, that he could order a chemical type (nuclear) stress test. So off I went, armed with the incentive to get myself into better shape and to drop some of the extra weight I’d been carrying (I wintered very well).
I didn’t make many changes in what I ate, but did make it a point to practice portion control with my meals, especially meat. I also purchased a treadmill of my own and began working out vigorously for 45 minutes 3 to 4 times a week and even doing pushups and crunches every day… and it was working! By September my weight was down by 25 lbs. And my cholesterol was down to acceptable limits, albeit the high side and that little gnawing pain that I would get for the first 10 minutes or so of strenuous activity? It wasn’t as bad but still there so I went right out and bought a box of Prilosec, tried them for a time, and was so convinced that they made a difference that I asked my doctor to prescribe more.
Then early in November it was back to the doctor for my follow up. I was so proud to step on the scale a full 30 lbs. now lighter than I had been in the spring. Doc was impressed too, then I shared with him that although I felt so much better and had come so far, that little nagging heartburn, although somewhat diminished, was still present. He then scheduled me for the above mentioned chemical stress test explaining the procedure to me. In my mind, I was kind of glad that we could begin to put this to rest and free me from some of the concerns I’d been having of my choice to ‘work it off’.
The test itself was quite an experience. They take what look to be cat scan type pictures before and after stressing your heart. And stress it they do! It only takes 4 minutes for that part, but it is 4 minutes of a very hot flushed feeling in the face, shortness of breath, heaviness in the chest, and just a very uncomfortable feeling which ends just as quickly when the injection is removed.
Then it was home to await the results that usually come in days or a week at best.
The call came the very next day… this cannot be good! Seems something that was cause for concern was discovered and I was to see a cardiologist (Dr. Li) the following day. Jan and I, along with our worried daughter, listened as this doctor explained that the pictures showed what seemed to be pretty severe blockage in an artery on the heart’s front side. So much for my somewhat faulted self-diagnosis of acid reflux. He said he wanted to take a better look with an angiogram to see if it would be possible to place a stent and thus open up the blocked area. He shook his head when asked of the chances of that happening and left us with no illusions that he was optimistic for that outcome. Two days later, as I lay awake looking at the screen of a monitor along with my family, that lack of optimism was confirmed. The blockage was almost total (99%) and was so long that it would have taken 3 stents in a row. That in addition to the fact that the proximity to the junction of an even larger artery could cause irreversible complications later on meant that the only option now was open heart bypass surgery. Looking back now, I can almost chuckle when he referred to me as a ticking time bomb and think how many times over the years other Vietnam vets have unjustly received the same designation. For a much different reason though… makes me wonder why more effort wasn’t put into diffusing the bombs then rather than just standing back with fingers in ears waiting for the self destruction that was sure to come.
If there is an upside, it is that I never had a lot of time to think about it. After laying there with a sandbag on the catheter insertion area for like 7 hours, the decision was made to do the surgery beginning around 11:00 that very night and ending in the pre dawn hours on Veterans Day 2006 morning. I thought about the fact that it would be Vets Day between the times of being prepped and so many of my family and friends stopping in to offer their best thoughts, wishes, and prayers for me. I thought at the time, I am a poet… I should be at home doing what I always do on this day or on Memorial Day, sitting in front of my computer composing a tribute of some kind for my brothers-in-arms who have given their all or in sharing that same brotherhood with my fellow survivors of war. I think it was at that time that I resolved to write something of this day no matter how boring and windy it may seem to some. Not the tribute or recognition I would like to have offered but a story of one vets Veterans Day…
So… I opened my eyes on that Saturday morning after the surgery was completed and was in a morphine induced fog for a time. A ten-inch incision on my chest from the base of the throat down, and another eight-incher on the inside of my thigh. And with two brand new bypasses, I was all mended! I was aware of Jan saying something and others of my family and friends, along with nurses hovering over me, many monitors, bells, wires, and activity. Remarkably, I wasn’t aware of much pain or discomfort… that would come later.
I remember, only later in the day, thinking Wow, I made it! I discovered too what a truly phenomenal circle of support and love I had around me after being told that there were 51 people occupying one of the waiting rooms, some for most and most for the entire time of my surgery, which ended as I said at like 4:30 that morning! Many of these wonderful folks, who I thank God for every day and will always be grateful, had even decorated their arms, hands, and faces with magic marker reading “Team Randy”.
I remember after a day or so in the intensive care and after having some of my many wires and machines being removed, being moved to a private room on the cardiac floor. As they wheeled me out into the hall, I also recall my grandson’s (little Randy) tiny face peeking around the corner from up the hall and running to inform the still full waiting area that he had just seen his Poppa coming… I love you buddy!
Now I’m in my own room, settled in and becoming more uncomfortable by the minute. I had pain pills available to me but had to ask for them. I was told by more than one nurse that when the time came for another, or two, that I should request them… there are no medals given out for ‘toughing it out’ or for machismo, turns out this was excellent advice and also aids in the steps you must take toward recovery before being discharged. These steps include walking the halls, bathing, and even feeding your self, all seemingly minor feats that on the first day on the floor seemed weeks away!
I still, to the chagrin of my surgeon Dr. (Tony) Otoadese, had many visitors. Too many in his opinion but the fact is I like company and there were many there to see the spectacle of my neck and upper chest swelling in a matter of minutes to nearly twice its normal size with air and my voice sounding as though I’d swallowed several balloons full of helium. Needless to say this was an immediate concern for all of us and the staff. For the most part not life threatening, the phenomenon (can’t remember the correct name) can manifest itself also in the lung and become very dangerous. This fact meant I would receive an additional chest x-ray for the next three days. This is also called the ‘rice krispie effect’ and is unusual enough that many of my nurses and staff, along with many friends and family, would have the opportunity to squeeze my neck and throat and feel and hear the snaps, crackles, and pops that would result. I was glad to be able to provide that little bit of entertainment to help them pass their time… NOT. It was three full days before I was anywhere near normal in that respect.
So, laying there kind of catching my breath and enduring shots in the belly and butt for this and that, pills for the other things, and unending questions that seemed to be the same ones over and over again, came the query, “have you had a bowel movement since before your surgery?” I responded that I hadn’t and was asked to be sure to let them know when I did. I assured them that they would be the second to know.
Oh, and the food… I have always loved to eat and here it came, three meals a day and in between snacks and I was completely disinterested… looked good, smelled ok, and there was plenty… but… I couldn’t eat. Maybe a nibble of one thing and a small sip of something else and I had had enough. This never changed during my stay and was probably a big reason after that first day for my answer of ‘no’ when again queried about a successful bowel movement… sigh
On that second day, after finding it impossible to lay in a bed with any degree of comfort at all and having a nurse commandeer a recliner of sorts (they are a hot hot item on the cardiac floor) I was just catching my breath once again from a triathlon (actually a 20 foot round trip to the urinal), I was given the twice daily scoop shovel full of pills, a blood draw, and daily shot in the belly for a blood thinner and then told that I would today start my four times daily lap around the floor. On hearing this I thought, “What? Look at me… you want me to walk”?! And walk I did, the Tim Conway shuffle but with a nurse on each arm and my head tilted in a way that was reminiscent of the old movie ‘Hunchback of Notre Dame’… four times a day. I thought for a brief moment that I was walking ‘toward the light’ but was somewhat relieved to discover that it was only my oldest sister taking snapshots of me as I approached the finish line. I remember hearing several times on that first half-marathon, “You’re doing very good” and thinking “oh c’mon!”
Jan stayed with me those first couple nights and I was more than happy to have her there, but of course that meant that she wouldn’t rest any better than I would. At least I would have her to guide me toward the restroom on the never ending quest for the elusive bowel movement. While still into the second full day I remained unsuccessful in that quest. The response of the nurse today was immediate and dire… “If you can’t go on your own, we’ll have to give you something to help, and you will NOT like it”. I shuddered inside and made up my mind that tomorrow, if need be, I would LIE!
And so it went, dignity still A.W.O.L., I endured those three full days on the cardiac floor. Accomplishing far more than I could have imagined while knowing I still had, and have, a very long way to go. I never was able to eat, but I eventually walked with head held as upright as I could (still very reminiscent of the Tim Conway shuffle). I practiced my breathing exercises religiously, showered using a separate washcloth for each incision, and pretty much did all that was asked of me. And on the morning of my late afternoon discharge, was asked again by THE nurse, “Have your bowels moved yet?” I must say that I answered in the affirmative AND left my honesty and credibility intact… Whew!
Still, when after only five days in the hospital my nurse came in and asked if I was ready to go home, I thought to myself, “Look at me… are you serious?” She was, and truth be told I was looking forward to being home. Not to the trip home… BEING home.
Let’s see… it is now almost three weeks since I arrived home… a loooong three weeks but I have come quite far. I have followed all of my instructions, had home health nurses visit regularly, and been a burden to my dear wife (without whom I very simply would not have made it half this far). My incision is just now showing better sign of healing, my breath has returned enough that I can shave, shower, and brush my teeth without needing breaks between. I have also begun the first two of my 36 cardiac rehab sessions that will last for a total of 12 weeks. I’m still a bit tentative, but have regained much strength and improving daily.
Before closing, I want to say a few things… As tough and as scary as this has been for me, I have to say that I was blessed the entire way by God’s grace and by having the loving support of an absolutely wonderful, large group of family and of friends the world over! And, I am fortunate enough to also have a fantastic family physician (Dr. Daniel Glascock) who remembers what transpires from visit to visit and stays on top of things.
In addition, the cardiac team at the hospital where I was treated is by all accounts one of the very best in the region, if not the nation. The after care and expertise of the entire staff is also to be commended. This particular procedure is now refined to the point that it has become routine and much less risky than it was in the beginning and that is largely why the after care is so superb and the reason they can get us home and well down the road to recovery much sooner.
I want to add though that no matter how routine it becomes for the medical professionals, that they should never lose sight of the fact that for the individual patient, it will always remain an intensely personal and fearful first time experience.
The last thing I want to mention, and one that goes a long way toward being at much at ease about the entire experience as one can be is insurance. I have also been blessed with having worked for a company that offers full health insurance benefits to its workers and to its retirees and wasn’t faced with the added burden and worry of how we would be able to pay for a life saving operation such as this.
So you see that I had quite a lot going for me from start to finish… I’d like to end with a request to all to take every opportunity and all within your power, large or small, to ensure that one day every veteran… indeed every American, can expect nothing less if the need arises than that which came to me. And please, please remember to have regular checkups, don’t self diagnose yourselves or write off those little signals as ‘just getting older’… tell your doctor and let him or her carry the ball.
God bless us all!
©Copyright December 5, 2006 by Randy E. Richmond