Louise's heart surgery, February 2004

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During the week of Louise's stay in hospital for heart surgery, I e-mailed "updates" every evening to a number of people. Rather than posting these seven lengthy updates on the forum, I have attempted here to extract the most relevant parts to create a single document. I apologize for the jerkiness inherent in putting these e-mails together rather than writing a new document from scratch.

Day 1: Thursday, Feb. 19

As most of you know, Louise's surgery has been in the works for some time, delayed by SARS among other things. Two weeks ago we got the date for the surgery--Feb. 20. We had a big scare last weekend (Feb. 14/15) when Louise thought she was developing a bladder infection. She saw her family doctor on Monday; the doctor sent a urine sample to the blood lab to test for an infection. It was touch and go whether the result would be available by Wednesday; if it hadn't been available then, the surgery would have been cancelled. Early Wednesday afternoon we received the good news that the test result was negative and the surgery could go ahead!

What is the surgery? Her mitral valve is leaking and will be repaired or replaced. The Maze procedure will be carried out to eliminate (it is hoped) Louise's atrial fibrillation. And she'll probably have to have a pacemaker installed.

The surgeon is Dr. Tirone David, who is recognized world-wide for his expertise in just this type of surgery. It's amazing the high regard everyone in the medical profession has for him. And such a fine person and personality is extremely rare.

Day 2: Friday, Feb. 20

Now an aside.

Some of you may remember Louise's and my story about my emergency heart surgery exactly 10 years ago this spring. For years before that I told Louise frequently that I liked doing dishes and always asked her to let me do them as a favour. It didn't take much to persuade her but she often would say to me--you can't really like doing dishes. I'd say that she was wrong--I really like doing them. I couldn't convince her. In desperation, I said to her a few times: if you don't believe me, ask me on my death bed. Well, when I landed in the emergency and was being prepared for surgery (the surgeon finally saying he had to take me in or I would be dead in 15 minutes), Louise took the opportunity and asked me: did I really like doing dishes? To which I answered: certainly! (Ever since, Louise has felt very guilty about having asked that question! And, by the way, I continue to enjoy doing dishes.)

Why this aside? Well, it's to explain what happened next, today, in the pre-operative holding area. The last thing that Louise said to me before she was wheeled in to the OR was: "I really *don't* like doing dishes!" I suspect that she was saving this up for weeks; she obviously still had her wits about her just before surgery.

Once Louise was gone I went off to have breakfast. Then at about 10:30 one of the doctors assisting in the operation gave me a report--the operation was going well, Dr. David was very fast, and the surgery would be over before noon (less than 3 hours). Sure enough, not long after 12 noon, Dr. David came to me and said the operation had gone well, Louise's mitral valve had been repaired, the Maze procedure (scarring the heart to break up the electrical patterns which were creating atrial fibrillation) had been done, and an artificial external pacemaker installed. It remains to be seen (over the course of a week) whether the heart's own pacemaker can take over. He was doubtful of that. If not, then an internal pacemaker will be installed in the chest so Louise can go home. He said it will take longer (several months) to determine if the Maze procedure has been successful.

With such tremendous news I went off to lunch and then about 2 p.m. was able to see Louise in the intensive care unit (exclusively for cardiovascular surgeries--about 25 beds). It wasn't the overwhelming scene I had been led to expect. Louise looked good (not puffy) and of course was asleep. She had a breathing tube in her mouth, which was otherwise taped shut. There were easily a dozen lines and tubes attached to her body and many computer monitors arrayed around her. The external pacemaker lay at her feet.

Day 3: Saturday, Feb. 21

Louise stayed on in the ICU since a bed on the regular ward was not available.

Day 4: Sunday, Feb. 22

Louise returned to the regular ward. The best news of the day was that the surgeon, Dr. David, said that Louise's own pacemaker was active and he thought there was some chance that she won't need an implanted artificial pacemaker. We'll have to see.

Day 5: Monday, Feb. 23

The doctors seem to be concluding that Louise won't need an artificial pacemaker. Her own pacemaker seems to be working fine. Final decision on that is probably a couple of days away. And with luck Louise will be home by the weekend.

Day 6: Tuesday, Feb. 24

Louise was cross this morning when she phoned me at home, both because I wasn't up yet, but mainly because there had been a fire alarm during the night and there hadn't been any nurses around. I was shocked when Louise told me that she had got up and wandered in the corridor (carrying her pacemaker and telemetry). It was only the second time she had walked and this time she was walking alone. Eventually one other patient joined her and they shared a walker that they found! It must have been quite a scene. I was relieved to hear that she realized she couldn't go down stairs! And I also realized that Louise's recovery had proceeded very rapidly so that she could have such an adventure.

In fact, later in the morning, her artificial pacemaker was removed. Totally unexpectedly, her own pacemaker has returned to its normal function after being stopped during the operation.

Day 7: Wednesday, Feb. 25

Dr. David visited Louise late Wednesday evening (after I had left). He said Louise's recovery was fantastic, she no longer fibrillates, and the valve has mended perfectly. He said he did not expect such an outcome! So excellent is the result that he thought it possible that after three months she might not need to remain anti-coagulated (with coumadin). Before I had got home that evening, Louise had left me an excited phone message with this information. I'm going to save this audio tape.

Day 8: Thursday, Feb. 26

Louise was discharged on Thursday morning. Louise is elated and says she has "a new heart". She's naturally unhappy with the slow pace of recovery, but is already starting to do some things on her own. I'm elated with the successful surgery, too, and relieved that the stress of waiting for it is over.


-- Anonymous, March 04, 2004

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