Sunday, August 29, 2010

Don't Take Life For Granted--My Personal Cautionary Tale, Part 2

I’m sorry not to have posted lately, but my life has been chaotic to say the least. This is the second part of my story of my husband’s recent open heart surgery. To catch up and read part one first (which I recommend) you can click here. The pic shows my sweetie dancing with me at our niece's wedding several years ago.

Shortly, I’ll be back with a new recipe as well as some writing tips.

The days before Charlie’s surgery we spent alternately preparing and enjoying time together. We arranged for a pooch sitter. Updated wills untouched since our son, now 40, was a child. Ate dinner at our favorite restaurant. Spent a leisurely Sunday with our grandkids.

At the pre-op interview Monday Dr. Yuh—who was disarmingly friendly and looked 25 but was probably 40—assured us that at Hopkins the chances of serious complications from this operation were under 3 percent. (At his mention that his incision would be “only large enough to get in and work safely,” I noted that his hands were less beefy and more graceful than most men’s.) The by-passes would take roughly three hours, he said, then the heart would be re-started and would pump an hour. Then, the team would “close.” Charlie would be in the hospital about a week.

At noon on Tuesday, my son, Dave, and I hugged the patient one last time, and he was rolled off to the OR. We retired to the waiting room to fidget, read, and … wait.

I suspect it’s common for strangers stuck for long, anxious hours in close quarters to chat, commiserate, and bond. The gregarious, surprisingly upbeat family seated near us said the patriarch of their clan had been in another hospital 22 times in two years, and had already been in surgery to repair extensive damage from an infected by-pass graft for 7 hours. We shared Charlie’s story, which by comparison, sounded pretty ho-hum. Time dragged on.

About 5 pm Dr. Yuh appeared and said, “He’s doing fine. Once he’s to Intensive Care, you can see him.” He seemed euphoric as he added, “It was textbook—went perfectly.” I was euphoric, too. Later, before we headed for the ICU, we and the other family earnestly wished one another well. Their loved-one’s surgery was still going on; we never heard how he fared.

Our first post-op visit was a letdown. My sweetie didn’t open his eyes and only responded weakly when I squeezed his hand. He was literally almost as white as the sheets, and tubes and wires ran everywhere, including down his throat. But we’d been warned about all the wiring, and his vital signs were good. The regular monitor beeps indicated normal breathing. After two more hours and two 5-minute visits, the staff persuaded us to go home to bed. Surprisingly, I slept fairly well.

The next morning I was astonished at how he’d bounced back! He was sitting up, alert, and, with the mouth tube gone, could chat and return my kiss. Soon, the nurses had him walking—standard practice to discourage clotting they said. Their trip down the ICU hall was slow and he wobbled; I tagged along, counting each of the 90 one-foot tiles.

That afternoon, after steadier walks, he was transferred to cardiac progressive care. At the advice of several friends who’d had similar surgery, I’d hired a nursing assistant to stay with him overnight and was feeling elated at his progress as I prepared to go home. Just in case, I left my number and told her to call if necessary.

A roller coaster seemed to dip and my stomach dropped as I walked in the next morning. Nobody had called, but Charlie’s heart had gone into atrial fibrillation and was rapidly, erratically fluttering instead of pumping. This condition ups risks of stroke to five times normal. His heart rate, pulse, and blood sugar were all sky high. He was on oxygen and looked ill. A cold, choking dread held at bay for days took over; it felt as if my ticker were malfunctioning.

The nurses said the meds usually restored normal “sinus” rhythm within eight hours. After mindlessly, endlessly watching monitor blips and IV drips, I was finally, mercifully rewarded with the regular tha-thump, tha-thump of his heart in mid-afternoon. Even so, I vowed not to leave him at night again—I’d try to sleep in the fold-out chair by his bed.

I did sleep, but fitfully. I dreamed that Charlie and I were at the NY Blogher conference being held that week (I’d canceled my plans to attend), and somehow got separated. After frantically searching for him for hours, I gave up and tearfully returned to Baltimore alone.

I was relieved to wake and realize it was only a nightmare, but by afternoon felt a new, inescapably real despair: The atrial fib was back. A black, icy, perhaps irrational, fear that my sweetie would have a stroke gripped me. I was so distracted and panicky I got lost on my way back and forth to the hospital cafeteria and worried about losing my memory or mind. At some point Dr. Yuh showed to up to explain that 40 percent of open heart surgery patients experience this problem. “If necessary, he can go home with it,” he said. “It usually doesn’t last more than a month.” This was meant to reassure, but just terrified me more.

Deep in the night the lights flicked on and a nurse burst in to announce, “He’s back in sinus rhythm!” I think it was the sweetest news I’ve ever heard. Certainly the best ever at 3 am! The second bout had lasted a nerve-wracking 16 hours.

We’ve had more ups and downs during Charlie’s recovery, but nothing else as frightening as the arrhythmia episodes. Throughout, he’s been cooperative, uncomplaining, even-keel, and openly thankful for everyone providing his care. The future’s looking much more certain and bright.

As for what lessons I’ve learned—mostly not to take the good in life for granted, which of course sounds clich├ęd and trite. I need to mull things over longer and may have some thoughts to share another time. For now, it’s just nice to be together back home. I’d love to hear if you have an experience of your own to share. ###

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Sunday, August 8, 2010

Heart-Healthy Italian Garden Orzo Salad--Plus a Personal Cautionary Tale

There’s a big reason I’m serving up this heart-healthy recipe today. And why I haven’t posted in a while: The bottom recently dropped out of my busy-busy, never-miss-a-beat little life.

The first seemingly ho-hum sign that my train was about to derail occurred when Charlie, my s-pie (aka sweetie pie) for more than forty years, went for a stress test. He’d had no pain, breathlessness or any of the usual unpleasant symptoms of heart disease, but his cholesterol and triglyceride numbers had been high since the 1980s, so his primary physician wanted the test anyway.

Afterwards, my sweetie said it had gone “just fine—no problem at all.” We agreed that in his case the high numbers were apparently just an odd anomaly. I went back to feverishly working on my cookbook (due Sept. 1--yikes!).

Two days later, our doctor called to say the test had revealed an “anomaly” (that word again) at the highest exertion level. He referred Charlie to a cardiologist, who ordered a CAT scan. The results astonished us both: a major artery was partially blocked! This had (fortunately) happened gradually, allowing smaller vessels to grow up around the main one and compensate somewhat for the “occlusion.” (I was picking up medical lingo I’d never expected to learn.)

Less than a week later, I was at Johns Hopkins, waiting for an “interventionist” surgeon to come discuss the results of Charlie’s three-hour catheterization. (Dye is injected so blood flow can be tracked through the circulatory system.) We’d been told that “depending,” a stent might be inserted and I’d have to leave him there overnight. But we were optimistic about avoiding that annoying inconvenience.

I was buoyed when Dr. Herzog appeared and matter-of-factly said, “No stent.” But at his next words I suddenly seemed to be free-falling from a very high cliff. “No point—he’s got one totally occluded artery, and two with a 60 to 70 percent blockage. He needs by-pass surgery.” I just stared, thinking (hoping) I’d misunderstood or that this was one of those weird, twisted dreams I sometimes have.

Once Charlie came to, we were briefed on the horrific-sounding details of the open-heart procedure to come: The breast bone would be sawed apart. The heart would be stopped. A pump would circulate the blood. Veins from his body would be harvested for the by-passes. Blah, blah, blah…. My head swam, and I’m sure Charlie's did too. This wasn’t happening….

We spent the rest of the afternoon numbly following through with cardiac surgery pre-admission paperwork and exams. He was still a little woozy and I was still in shock as we headed toward the recovery room door. “Now you take care and don’t overdo it, Mr. Baggett,” the discharging nurse admonished. From her tone it was clear she viewed him as gravely ill.

In the blink of an eye, our comfortable, decades-old image of him as a man healthy, vigorous, and fit enough to walk up the five flights of stairs to his office each day was shattered. The shards of a reality we’d always taken for granted lay strewn around our previously orderly lives.

To continue to part 2, click here.

Italian Garden Pasta Salad

Colorful, fresh-tasting and quite hearty-healthy, this pasta salad makes a nice addition to a warm weather meal. The vegetables add a pleasing crunchy-crisp texture and the lemon vinaigrette dressing adds a light, zesty flavor. The recipe can be prepared up to several days ahead, if desired.

Tip: If you don't have orzo (a small rice-shaped pasta), substitute whatever small pasta shape you have on hand.

1 1/4 cups uncooked orzo (about 8 ounces) or other small pasta shape
1 cup each diced carrot and celery
1 cup each diced red and yellow sweet peppers
1/3 cup chopped green onions or finely chopped fresh chives
1/4 to 1/3 cup fresh lemon juice, to taste
1/2 cup chopped fresh parsley leaves
3 to 4 tablespoons olive oil, preferably extra virgin
1/2 teaspoon dried marjoram leaves
1/2 teaspoon finely grated lemon zest (yellow part of peel)
Black pepper and salt to taste

Cook orzo according to package directions until just al dente. Turn out into a colander. Rinse until cold water; drain well.

In a large serving bowl, stir together carrots, celery, sweet pepper, and green onions. In a small non-reactive bowl, mix 1/4 cup lemon juice, parsley, 3 tablespoons oil, marjoram, lemon zest, pepper and salt until well blended. Pour dressing over diced vegetables. Add orzo to vegetables, tossing until thoroughly blended. Add more lemon juice, oil, and salt and pepper, to taste. Refrigerate at least 30 minutes and up to several days, if desired.

Makes 5 to 7 servings.

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