Heart Stuff

Existential changes

I’ve been writing about the death of my friend Greg, whose treatment has been the foremost thing on my mind for the last five months. During that time, I got reacquainted with the complications of our medical system. Nothing is simple. Finding the best specialists to treat you is hard, as they may not be covered by your insurance plan, or they may not be available, or you may run into different opinions about who you should see. Schedulers are overworked and can be brusque or downright rude. You can’t call anyone directly, so you play the auto attendant game until you are blue in the face. Then you likely have to wait — wait for your appointment, wait for lab results, wait for your team to interpret the information. Greg and his husband went through all of this, and did it while feeling lousy, did it while sick from chemo, did it while dying. It was not pretty.

So now it is my turn.

My wife has bugged me for months to get a $49 heart scan, the kind that lets you know if you have plaque in your arteries. One of our relatives had one, and they sent him directly to surgery. It saved his life.

My scan showed that while I have clear arteries, I have something called an ascending aortic aneurysm. Basically, one of the biggest arteries in my body has stretched like a balloon, which could be very dangerous if that stretching continues. Aneurysms can burst, which can be fatal. I think of it like a bulging spot on a tire — if you don’t fix it, you might have a blowout.

I’m in the middle of my first waiting period. After that first scan, I was told I needed a better CAT scan, but it wasn’t available right away, so I have it scheduled for two weeks away.

Meanwhile, I’m consulting with Dr. Google and Dr. YouTube, who tell me that none of this is good news. It seems that the experts have decided that aneurysms that measure 5 cm or larger (about 2 inches) should be surgically repaired. They reported mine right at 5 cm. There is some discussion about the size criteria — some say 5 cm, some say 5.5, and some say even smaller. So the exact size matters, which is why I’m getting a more accurate scan.

The surgery is serious. It is open heart surgery, where they crack the chest and use a heart-lung machine to keep the patient alive while they replace the defective artery. The procedure takes 4-5 hours. I used to be the chaplain on a heart unit, and I know how arduous the recovery is. It takes weeks, and months more before the return of strength and energy.

My reactions to this have been all over the map. We tell people that the most common reactions to a severe stressor are fight, flight, or freeze. My reactions to this have been laugh, cry, or feel faint. I’ve been praying a lot, but I’m not clear about what to pray for. I’ve been thinking about death, and whether I’m closer to it than I thought. I’ve had thoughts about all the things I would still like to do, and all the people I love. I’m a little on edge. (Scratch that. I’m a lot on edge. I got mad at Lisa for the way she loaded the dishwasher.)

Thinking about dying is scary, but it’s not really death itself that bothers me. It’s the pain and embarrassment and weakness and yuckiness that is involved in the process of dying. I want to be independent. I don’t want to get to the point where I can’t think straight, or I need help to do normal tasks.

I also know that this is part of life. There are no guarantees. Greg had cancer, I’m going this weekend to visit a friend who has ALS, and I’ve seen hundreds of others struggle with various illnesses and conditions over my career. Every one of us is on a countdown timer. My aneurysm is opening my eyes to all the ways I love life, and what a blessing it is to be alive. I guess I’ll be wrestling with my heart stuff for a while. I’ll write about it as it develops.