Surviving a triple heart bypass

Let me share with you this letter of a dear friend, Nick Pichay, who is a Palanca awardee

From: Nicolas Pichay

My First Triple Heart By-Pass Operation

By Nicolas Pichay

A medical emergency is like the proverbial 15 minutes

of fame. I had mine a week ago when, on my way to a

regular physical check up, I found myself huffing and

puffing on a constricted chest not able to climb a

flight of stairs from the parking lot to the hospital

lobby. One day and a few ECGs later, an agiogram was

being performed on me. The doctor told me to relax as

he started inserting a fine needle into my groin and

up to my heart. I lay there on the cold operating

table amazed at this simple medical procedure where a

dye is cast to trace the blood flow in the heart. I

looked to my left to view the monitor that recorded

what was happening inside my body. I was 43 years

old, with no medical history of diabetes, cholesterol or

hypertension. I didn’t smoke or drink and went

regularly to the gym. Nonetheless, I knew a damning

evidence when I saw one. On the monitor, my major

heart arteries looked like collapsed water tunnels,

the dye clearly showing the three areas in two

arteries where the blood flow was disturbingly

constricted, the blood collecting before a

bottle-neck like water being contained in a dam. There was not

even time to wish otherwise. I knew even before I was

wheeled out of the operating room that I would need a

triple heart by-pass ASAP.

The procedure for a heart by-pass operation was

pioneered by Dr. Christian Barnard in the late 70’s.

According to the internet, the operation has, since

then, been performed successfully on over 5000

patients all over the world by the year 2000. Due to

the relative ease, success rate and frequency of use

by doctors of the procedure, it is now being likened

to a simple appendectomy. Despite all these

reassuring statistics, I could not get over the fact that the

doctor with a scalpel will, on the day of the

operation, cut a vertical incision parallel to my

breastbone, saw at my sternum, harvest veins from

three places in my body, open my chest, contain the

beating of my heart by putting it in some kind of

trap, and like an uber-modista, graft the harvested

veins onto my heart to build a kind of fly-over as a

means to ease the blood traffic in the clogged

arteries.

My family and I went to four other doctors, all of

whom confirmed the necessity of the procedure. The

doctors explained that the normal heart had three

major arteries supplying oxygenated blood to various

parts of the body, including the heart. The angiogram

revealed that ninety per cent of the flow in the two

arteries in my heart had been blocked and that I had

been surviving on only one artery for at least a year

now. And I was a most likely candidate for aneurism.

That I was still alive was a miraculous feat.

Pointing out small vein growths in the angiogram

images, the doctors also explained how the ever hard

working heart tried to compensate for the blockages

by birthing secondary veins before the areas where the

blood had a difficulty flowing. (I held the image of

my heart as a single mother of three taking extra

jobs because two of her children were sick.)

In the years previous, I had felt of chest pains when

I was stressed doing litigation work, as if a pile of

hollow blocks were placed on my chest for about two

minutes. But the incidents were short and far in

between. In all of those cases I was up the following

day same as usual and thought nothing of it.

What I didn’t know, and I only know now from

hindsight, were the subtle red flags being waved by

my body which I was too busy or to proud to heed. My

poor heart may have been tugging at my sleeve by giving me

perennial morning headaches, which I merely

attributed to lack of sleep and remedied by drinking coffee.

There were also those times when my fingertips would

so numb that I would fingersnap incessantly until the

blood flow returned. At the gym, I did not dare stop

in the middle of a particularly strenuous kickboxing

routine lest the other people think me a weakling.

And besides, I was eating right, was in my ideal weight

for my age and height, didn’t smoke or drink, and on

the average practiced, moderation on all fronts. How

was I to know that there was something secret buried

in my genes? That if bad lifestyle will not get you,

then heredity will?

As a patient in risk, I knew at this point that that

would be given anything I asked for. When I talked to

my anesthesiologist, for instance, I told him I

wanted double doze of everything. He assured me I would feel

>no pain. And since, I would be totally unconscious,

>would he mind piercing my nipples? He categorically

>said no.

Of course I saw the Grim Reaper after the diagnosis.

Well, more like felt “It” than saw an actual

person—the presence of a proximate finality following

me at close range, so really close I could feel its

cold breath on my neck. My insurance was ok so I need

not worry about the funeral expenses at least. Then I

made a list of all my cases and opposite each title,

the name of a lawyer friend who was willing to take

in the cases after me. I looked at where I kept all the

poems, stories, essays and plays I’ve written. Too

late to re-write now. Then, I reviewed my last will

and testament and I laughed. It was not surprising

that there was not enough property to bequeath to all

the people I loved. It seemed that I had more

friendships and laughter and love in my life than

money in the bank, stocks or real estate. If there

was anything I wanted to thank God for, it was that.

In my meditation, I did not barter for extra time in

exchange for future good behavior for some reason

that is not quite apparent to me yet. Was it because I

knew it wasn’t my time? Or that I had so much faith in

God? Nonetheless, on that particularly long day, I

hunkered down to write my epitaph in a small piece of paper,

sealed it in an envelope and wrote in front: “Just In

Case…”

Meanwhile, my family, friends and officemates quietly

moved to schedule some of their time around me. My

sister who is a nurse in America, despite my

protestations, took an emergency leave to be with me.

Cousins told me to be strong and offered resources. A

very good friend from law school made sure I had a

slot with the best heart surgeon. A colleague in the

theatre, announced in the internet my need for blood

donors and another friend responded by ferrying

volunteers from the Batasan (where workers were at an

impeachment rally) to the hospital. Other friends, as

well as writers, also gave their blood, despite one

donor’s fear of being poked with a bigger-than-normal

needle. Another friend gleefully gave his blood

because he was, according to his wife, a reverse

Vampire. Everyday I received text messages of support

from so many places (even as far as China). A

congregation of nuns included me in their daily

prayers. A professor at the university who had

experienced a heart by-pass took the time to call and

talk to me about his experience, and assured me that

“it’s just a small pain and then it’s gone.” How

does one thank these gestures of concern and outpouring of

love? I realized that repayment is not required

because good deeds were meant to be passed forward.

The operation was scheduled at 2 o’clock on September

8, 2005. My family and friends were in full

attendance. When the nurse asked me to take half a

sedative at around noon, I felt an electricity in the

air. A few minutes later, my bed was wheeled to the

operating room. Lying down, I could see the ceiling

lights zoom past my head, like I was in a car moving

in an inverted highway. At the prep room, other

silent nurses started to attach tubes to my arm, including

the anesthetic and strong sedatives. Just a few

minutes after I was transferred to the operating

table, I felt a calm come over me. I closed my eyes

closed and then nothing. Eight hours later, I woke up

in the ICU with a respirator lodged inside my throat,

three tubes running up my chest and other medical

contraptions attached to my body. It was difficult to

breath and my body was wracked with pain. I saw my

sister, Dawn, walk towards my bed. “You will be

alright, Nick.” She said. And again I fell asleep.

The third day, Saturday, was my birthday. The doctors

declared that I was stable, freed me from most of my

tubes, ordered me to stand up and walk a bit, and got

me transferred to an ordinary room. The symbolism did

not escape me and my well wishers. It was truly my

birthday and I was happy to be alive.

This entry was posted on Saturday, October 1st, 2005 at 4:16 pm and is filed under Bing's Journal. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.