Patient Stories

I Awaken to Glory

18 September 2006

Distinguished delegates, look at me! I am nearly sixty years of age. I do not smoke, very rarely drink to excess, and have never attended a first class football game in my life. But I enjoy the fresh air, I sing in a choir and am happily married with two teenage daughters, so would not describe myself as sedentary.

I was made redundant at 50 and was obliged to carve out a new career, assisting our new Eastern European partners achieve equivalent status with us in the field of public administration. I have resolved problems, found solutions and given training sessions to Lithuanian civil servants on public procurement and contracting. My daughter tells me that I should have become a computer games tester for Sony Playstation or Nintento, if I really wanted to get a life. Since my childhood, I had only once before been a hospital in-patient, so I always considered that I was in excellent health.

It began one blustery October morning when I was walking the dog. The chest pains, sweating and the sudden transition from good health to poor led to my first visit to a cardiologist, and the joys of angioplasty. Yes - I had a problem. The aortic valve was showing signs of wear and as a precaution I started taking statins to control cholesterol, and something else to aid the flow of blood. So I continued for three years walking the dog with no further problems indicated at my annual check up.

Last year, during a short bout of flu, the pains returned with a vengeance, along with a worrying lack of stamina. Walking up stairs became a major chore. A return visit to the cardiologist and another angioplasty followed. The arteries were still fine, but the image of the valve under the gel of an echo-scan revealed a snowy ridge on its lip, resulting in raised eyebrows on the face of the doctor. I was dismissed and later informed that the committee discussing my case had decided that a new valve was essential.

At this point I have to wax lyrical and praise the efficiency, professionalism and kindliness of the staff at the St. Elizabeth hospital in Brussels. It was like dealing with a superior travel agent arranging a luxury holiday on a paradise island, or a conference organiser intent on securing the attendance of a VIP speaker of the highest quality – me! The cardiologist had transformed into a white-coated booking agent, assuring his client of a trouble-free journey to restored well-being.

Having checked “Heart Valve Replacement” on Google, I discovered that I was signing up to an anaesthetic procedure close to a US execution by lethal injection, which would stop my heart; a man with a Black and Decker sawing me down the middle and opening my chest like a book, followed by the replacement of my aortic valve by a plastic and carbon fibre apparatus that looked like a miniature ball cock assembly. When all that was done I would be sewn and stuck back together and emerge with a vast array of tubes, drips, drains and monitors protruding from my body, including holes specially drilled for the occasion. “You’ll feel fine in three days and will be able to go home in ten” was the response by the cardiologist to my British understatement of slight concern. “And by the way,” he added, “we do not use Black and Decker.”

And so it was. Exactly as it was described. Upon arrival at the operating theatre, in awe at the collection of pulsating technology assembled for the near death experience to come, I was invited to jump on the table under my own steam to avoid the embarrassment of being dropped on the floor, and that was that.

Some hours later I awoke strapped down in an intensive care bed surrounded by smiling faces and a rainbow assortment of blinking and bleeping lights and computer screens. To my surprise, I immediately knew where I was, even though my heart had stopped for 51 minutes, and was in no pain. I tried to say hello but was unable to owing to the plastic piping occupying my entire nose, mouth and throat. Later when this was removed I still could not speak, but was told to stay awake and breathe normally to get my lungs working again. In order to entertain me, headphones were clapped over my ears conveying the simply ghastly noise of a baritone straining through an entire CD of sickly Flemish love songs accompanied by a heavenly choir and romantic strings. I can assure you ladies and gentlemen, these were by far the worst moments of the entire stay in hospital, apart from those spent in combat with the surgical tights I was expected to wear.

My wife told me that seeing me in intensive care was her worst moment.

Sedated into a twilight zone in a half-awake half-asleep condition, the three days passed quite comfortably, although with a lack of appetite. I was able to use my vocal chords again after a few hours, and each day more and more pipes and tubes were removed. The aquatic burbling, like a Japanese garden water feature situated somewhere under my bed, fell silent. Finally, more or less unplugged, I was wheeled downstairs to normal hospital life.

In no pain, and only slight discomfort from the saw cut, I was able walk around from the very beginning. It was very encouraging to rediscover mobility. For occupational therapy I was given a plastic toy containing three balls in tubes which I was expected to raise by sucking hard, and a rolled blanket to brace my chest when coughing. And apart from daily visits by the cardiologist, surgeon, physiotherapist, nurses, cleaning staff, priest, family and friends, I was left in peace.

One friend connected with the medical profession kindly presented me with a book on the history of anaesthetics called “I Awaken to Glory”. After seeing this on my bedside table I think the nurses increased my dose of sedatives. I found that watching golf on TV was very relaxing and therapeutic in the sense that I began using my brain to calculate their winnings. Other friends found the sight of me walking around and behaving reasonably normally so shortly after a major operation quite disturbing. They would have been more reassured if I had remained connected to a life-support system and communicated via guttural croaks.

On the last day the surgeon came to remove some stitches, but had forgotten his glasses. Until rescued by a nurse, his fumbling created a scene of high comedy which caused me to laugh out loud for the first time. That hurt! I now better understand the phrase “to split one’s sides laughing”.

As promised, after ten days I was home again. Apart from being easily tired, I was able to function reasonably although I was not allowed to drive or walk the dog. My throat was still sore from the pipes and tubes, but I was in no pain. The scar dividing my chest was very noticeable. The audible ticking of the artificial valve reminded me of the alarm clock inside the crocodile chasing Captain Hook in “Peter Pan”. After a further two weeks the cloud finally lifted and to my delight I declared myself fully recovered and to luxuriate in my restored health, took a further two weeks before resuming work. The whole process had taken six weeks. I will take anti-coagulation medicine for the rest of my life, and must take a moderate approach to self-indulgence, but this is of little consequence, when considering the alternative. The forty-minute walk in the forest with the dog now takes thirty, since the uphill part can be completed without any difficulty or shortness of breath. The dog now trots beside me, but I confess I do not trot beside the dog.

Today the scar left by the saw is scarcely embarrassing. Thanks to a very well connected friend I was able to obtain a demonstration model of the artificial valve from the manufacturer, similar to the one which is ticking away merrily inside me. I keep it on my desk to remind me of the science, skill, experience, sympathy and kindness that I was fortunate to have available in my hour of need. I also make it my business to offer encouragement to those whom I encounter, who are possible candidates for heart surgery, to reassure and help them overcome the fear of the unknown.

After the excesses of this conference, some of you may wish to have a word.

John Hills

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