CHAPTER TWO

Pulmonary Edema

   The following morning I was really feeling good.  It was less than 48 hours since the operation, and the catheter, which had been placed through my nostril into my stomach, had been removed, and I had been given a small bowl of jello.  “Real food”, I thought, certain that I was getting better and would soon be going upstairs to my own room.  I found myself thinking that as soon as I got out of ICU, I could have a cigarette.  This thought wasn’t too much on my mind, but when I was just lying in bed with nothing to do, I would inadvertently find myself reaching toward the table for my pack of Pall Malls.  Since there is absolutely no smoking in ICU, I would naturally come up empty handed.  No problem – I didn’t really need one right then anyway.  Old habits die hard.

   Since this was Saturday, my doctor had not yet made his rounds.  About 9 or 9:30 am, the doctor came into the room.  While he was looking over the incisions and checking the pulse in my feet, I began telling him how well I was feeling, and how I thought everything was coming along just fine.  Apparently he didn’t care much for what I thought right at that moment, because after concentrating on my right foot for what seemed like long minutes, he said very matter-of-factly:  “I don’t like it.  We’re going back in”.  Then without saying another word, he turned and walked out of the room.

   Almost immediately I found myself on a gurney, being wheeled into this cold, green room.  I did not like this at all.  Things definitely were not going the way that I had planned for them to go.  With two nurses on either side of me, they each grabbed the sheet under me, and with the count of three, all together pulled me off of the gurney and onto the operating table.  A paper was given me to sign, and I was out again – before I even remember being told to count backwards.

   Later I was to learn that the doctor was not satisfied with the pulse in my right ankle, leading him to suspect that blood clots had developed in the graft on that side.  (I was also told that had any of these clots broken loose and found their way to my heart or lungs, my life would have been in serious danger.)

 What he suspected was true.  My wife told me later that the doctor came out into the hallway after the surgery, and the arms and the front of the gown that he had worn for the operation, were covered with blood.

    In surgery, he had re-opened my right groin down to the graft that he had just put in a few days before.  He did find the blood clots there that he had suspected, and was caught in their discharge as he attempted to remove them.  This process is known as a TROMBECTOMY.  A patch graft was placed over the femoral artery as a means of widening the artery for increase circulation.  The incision was then sutured and stapled closed, and I was returned to ICU.

   (The necessity of having to open this graft a second time will haunt me forever. As my medical history unfolded over the next few months, and years, this particular operation proved out to be a “life changing event”.)

   A few more days in ICU and I was finally transferred to a semi-private room on the fifth floor.  My doctor had checked the pulse in my legs and feet regularly since the last operation, and was satisfied with their condition.  I had complete confidence in him, and if he said that everything was all right, then I was satisfied also.

   This doctor was about ten years or so older then I, and had been around for a while.  His reputation was well established as he was considerd to be the Dean of cardio-vascular surgeons in our county, which had a population of around 350,000 people – or more.  A couple of nurses told me later that the doctor had come in to operate on me while he was fighting the flu, and had a temperature of 103 degrees.  They interpreted that as “dedication”.  (Today, I’m not so sure that was the right thing for him to do, but then 20/20 hindsight is easy to come by.) 

   I was just glad that the operations were over, and that everything now seemed to be going all right.  I couldn’t wait to get out of the hospital to try out my newly repaired legs.  I still had a catheter in my urinary tract, but other than that, I was feeling much better – except for a shortness of breath.  “I’ve still got a way to go”, I conceded to myself.  This was all new to me, and if the medical staff didn’t seem concerned about my breathing, then I was sure that it must not have been too important.  I reasoned that I was just weak from surgery – as I reached over to the bedside table for my cigarettes.  They still weren’t there, so I made a mental note to ask my wife to bring them the next time she came to see me.

   The reason that I gave up smoking then, and still do not smoke today, was, and is, primarily for the fact that I don’t want to be a slave to tobacco anymore.  I thoroughly did enjoy smoking and still do – mentally.  But here I was, straight out of two surgeries - with tubes still in my body; and while I’m gasping for breath, I’m still looking for a cigarette.

  Yes, to me that is slavery – or more like insanity!

   About 4:30 pm, that afternoon, my doctor came up to the ward to see me.  He was still very pleased with the pulse in both of my legs, and also with the condition of the incisions.  He did, however, notice my shortness of breath, and the increased difficulty I was having in speaking.  Pressing his toe to the urinary bag on the floor, which collected the contents of my bladder, he commented:  “You’re going to have to release more of that fluid in you”.  With that, he just nodded his head to my wife and walked out of the room.

   After the doctor left, my wife and I were concerned about my shortness of breath, but we seemed to be the only ones that were, so we dismissed it for the time being as something that soon would get better.  I also forgot to ask her to leave my cigarettes again.  “Oh well – I’ll get them later”, I told myself.

   The shelf by my bed was full of cards, balloons and stuffed animals, which prompted my wife to remark later that she wished that the hospital had left me in one room. Each time that they moved me, she had to collect everything and take it all down to the car until I was resettled in my new room, and then bring it all back again.  These items did cheer me up though and I certainly appreciated her efforts.

   My wife had left the hospital for her return trip home about 8:30 pm that evening.  By 9:00 pm it had become such an effort for me to continue breathing. I began ringing for the nurse.  I knew that I had to get more oxygen in my lungs somehow.  After a few moments, the light that goes on over the bed when the nurse is called went out, indicating that the call had been received.  But, no nurse came.  I waited a few minutes and pushed the button again – and still no nurse.  On the third try, a nurse finally appeared.  She immediately admonished me for disturbing her.  She said that she was busy down the hall, and could not be interrupted at this time.  When I gaspingly asked for some oxygen, she placed the oxygen tubes in my nostril, but did not turn on the valve, stating that she did not have the authorization to give me any.  I tried to argue with her, but she had already left the room.

      “What the hell is gong on here?” I called out in my weak voice.  “I need help now!” Nobody heard me.

   The next twenty to thirty minutes were to be the most frightening experience of my life.  I spent three years serving with the United States Army many years ago, and have also walked down a few dark alleys, in my younger years, that I hope to never see again, but this was the closest that I feel I have ever come to a slow, lingering death.

   I laid in the semi-darkness, literally making my lungs work.  Picture yourself, taking as deep a breath as you possible can – holding it tight for just a moment, and then, without letting any of the air out – try to breath in more air.  That last attempt to inhale more air would be similar to the amount of air that I was able to inhale by this time.

  My chest felt as if it would burst wide open at any second.

  After what seemed like an eternity, I pushed the button for the nurse again, only to have the light go out as before, and like before, no nurse.  This time however, I was not going to take “no” for an answer.  I believed that my very existence on this earth demanded that I got help immediately.  And, as it turned out, I was right. 

   When the nurse didn’t appear – again, I began grabbing whatever I could find on the table beside me, and threw it out the partially open door into the hallway.  This door was only open about 6 inches. To this day I have no idea how I managed to throw anything through that small opening. In addition, God only knows where I got the strength for this. Angels were definitely watching over me that night - and all of the nights and days since.

   Almost immediately, the door opened and another nurse came in to see what all of the commotion was about.  Within moments I was being given oxygen, as my room became a buzz of activity.  A portable x-ray machine was brought into the room - followed in a short while by my doctor and then a heart specialist.  The next thing I knew, I was back in ICU, except that this time instead of the INTENSIVE CARE UNIT (ICU), I was in the CARDIAC CARE UNIT, (CCU).  My lungs were filled with fluid.  My body had been drowning itself and my heart wasn’t pumping the fluid out.

   PULMONARY EDEMA is what the heart specialist called it.

   By the next morning, I was breathing much more comfortably.  The doctors and their staff, had been able to remove the fluid from my lungs and my body was taking care of the rest on it’s own as it was designed to do.  I asked the intern that had been one of the first to arrive in my room the night before, just how close I had come to not making it.

   “You didn’t come close”, he said, adding, “You were there”.  He left the room, shaking his head and saying something about a case of will power.  I personally think that any power to save me came from a much higher source than just my will.  

As for the nurse that had been too busy to take care of me – I was too emotional over this experience for six months to talk about it.  I finally told the doctor what happened and let him take it from there.  I was just grateful to be alive.  (Today, in writing this story, the tears and emotions still well up.

   In the science fiction move “Alien”, which was popular some years back, there is a scene in which a monster incubates in the stomach of a human, and is born by bursting through the walls of his abdomen.  When I got home and looked at the incision down the front of me, I would occasionally think of that scene.  My wife said that I had a sick sense of humor, but it was just my way of dealing with something that I did not like.

   I did not like the idea of an artificial “thing” buried deep in my body, carrying my life sustaining blood.  It hadn’t proven itself to me yet, and I was unsure of just how it would perform over a long period of time.  I wanted my body whole again - not torn up with foreign pieces in it.  I wanted it back the way that it had been for over 51 years – except that I also wanted my legs to work without hurting.  I would just have to get used to the idea of my new arteries.

   During the weeks that followed, my small pillow was to be my constant companion, which I carried in front of me, clutched to my abdomen, to protect the healing new wound.  Although I was weak for some time, I forced myself to get around as much as possible.  Especially to the small market in my neighborhood, where I went to buy more candy bars to feed my insatiable hunger, that replaced my cigarettes.  I put on a good twenty-five pounds in no time at all.

   On one occasion, I asked my son-in-law, and my two grandsons, to take me to J. C. Penny’s to buy some sweat pants.  (Levi’s definitely were not for a tender abdomen.)  When we got to the store, my nine year old grandson placed himself right in front of me, and walked so slowly that it made it difficult for me to keep up a pace without running into him.  With a degree of irritation in my voice, I asked him; “Why are you walking so slow?”  This nine-year old boy turned to look at me and said; “I’m just staying close in case you need to hold on to me, Grandpa”.  Perhaps the word “boy” was not exactly accurate.  What could I say, except; “Thank you” – and then to make sure that I needed to “hold on”, from time to time.

   During the following months, the healing continued right on schedule, and my physical strength slowly returned.  By the middle of January, a walking shoe replaced my cowboy boots, which had been my standard footwear for many, many years.  Most every day, I could be found down at the marina, walking around the walkway while admiring the boats.

    I started off with a half a mile and gradually increased it to one, two, and sometimes three miles a day.  My son-in-law and grandsons usually accompanied me on these walks, and sometimes we would all race to the top of the observation tower, which overlooked the harbor.  Of course, I lost, but just to make it up those three flights of stairs without my legs calling for more oxygen was an accomplishment.

   I was whole again, and I could again walk without the familiar pain in my hips, buttocks or calves.  I have even come to accept the foreign bypass in my body as something that I could depend on.  Life, as I had known it in my earlier years, was slowly returning. 

   I was finally getting back to normal - or so I thought.