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.
July 24th, 2006 00:11
This is day three after Jeff’s triple by-pass. He had experienced shortness of breath for about ten days before I could get him to the doctor .. . he was convinced that it was nothing .. a stress test was scheduled 10 days later . . not because of the symptoms (which were minor) or his physical condition (which was excellent) but because he father had experienced a heart attack years before.
During the stress test, Jeff collapsed, CPR was administered followed in rapid succession by medical waivers, cath lab, balloon pump insertion and triple by-pass within 18 hours.
He was lucky and by all accounts he will return to normal within 3 months . . I know that we have much to learn and many lifestyle changes to make . . but he is alive and I am about to go to the hospital to see him .. I could not ask for more today . . life is good.