A Slowly Breaking Heart

Surprisingly, the first thing I thought of when they told me that my heart was broken was Niles Crane.

For those not well versed in mid-90s television situation comedies, Niles is the younger brother of Frasier Crane, a neurotic, obsessive hyper-intellectual who one could describe as a “lovable dandy,” if one were inclined to use such terms. In one particular episode, due to a series of extremely unlikely coincidences that occur to and around him, Niles becomes convinced that a minor pain is actually referred pain caused by a serious heart condition. Eventually, our paranoid protagonist convinces himself that he should seek medical attention to finally refute his extraordinarily unlikely assumption. Even as he is apologizing for wasting the doctor’s time with such obvious nonsense, it is predictably revealed that Niles is facing an immediate medical crisis after all.

This was not at all dissimilar to how I felt when I asked my general practitioner to refer me for some routine heart-diagnostics tests, only to discover that I have a serious genetic defect and will likely undergo open-heart surgery this summer.

I have a bicuspid aortic valve with moderate regurgitation which has caused a 4.4 cm ascending thoracic aortic aneurysm. In normal person terms, this means that the doorway from my heart to my aorta doesn’t close properly, and so as a result the hall just beyond that doorway bulges out as if Neo had just discovered that he is The One inside of it. As you may or may not suspect, “bulgy heart bits” is not generally considered a desirable trait; worse still, it’s something that will only ever get worse. Put bluntly, my heart is blowing a very troublesome balloon out of my aorta, and eventually the most critical part of my circulatory system will do what every balloon does when you fill it with too much air (or blood).

If I do nothing, eventually this will kill me.

What is surprising to me is how easy it was and even is now to absorb this information. I really would have expected far more personal histrionics upon realizing that a surgeon was going to crack me open like an oyster and shut down my heart for a few hours while he pokes it with metal things. Instead, it was such a departure from what I had expected that I have been more or less befuddled by it. It feels a bit like walking in for a flu shot and having someone fire a bazooka at you instead. It’ s just too big to process immediately.

You have to understand that I’ve never gone to the doctor really expecting anything to be meaningfully wrong—and until now I’ve batted 1.000. The worst thing that’s ever happened to me is discovering the hard way that I am significantly allergic to a number of particularly foul-tempered flying insects. Even that has always felt more like an inconvenience than a serious medical condition. Other than that, I have to be openly blackmailed into going to the doctor for anything less than major trauma.

Now, I’m coming to terms with the fact that echo cardiograms, medication management, CT scans and all manner of unpleasant prodding are going to be a fundamental part of the rest of my life. And even that assumption is built from the foundation that everything will go perfectly for the doctors who will be rooting around in my exposed chest cavity, which still seems like a pretty strange assumption to be putting into the ‘given’ column.

I suppose if there were a reasonable chance that I might get better, or even that there was a better procedure on the horizon, I would consider waiting. But there isn’t, and there’s very little appeal in the thought of walking around for a few years waiting for my heart to spontaneously burst open like a pizza roll left too long in the microwave.

What’s been of particular interest to me has been the wide variety of reactions from friends and family. In truth, it’s obvious that my “condition” is affecting some of those closest to me far more at this point that it seems to be impacting me. Never will you so quickly see ordinary people turn into militant optimists than when you divulge a life-threatening condition. Following a brief moment of shock, most of the people I’ve told have pulled down the shades and put on a tone that says, “I don’t even know why you’ve mentioned this, because it is so obviously going to be completely OK—so OK that other things that are just-kinda-basically-OK are going to be jealous.”

There’s something very hard about seeing people be so scared of what’s happening to you that they can’t even face the prospect of worrying openly about it. I know how they feel, because even if I completely overcome this thing, it’s likely that one or both of my kids will have to go down this same road. I really haven’t even allowed myself to start thinking about that yet.

So, yes, I guess it’s affecting me as well. I suppose if you read the paragraphs above, you’ll see me doing basically the same thing those around me have been doing. Thing is, when it comes to something like open-heart surgery, worry is a black hole: You have to stay as far from the center of it as possible, because you know there is an invisible event horizon, and if you cross it you’ll plunge hopelessly into inescapable panic. I mean, when it comes right down to it, how do you deal with the fact that someone is going to stop your heart for a while?

Maybe you know, but I don’t.

So, I will be an outside observer to what is happening to me, for now at least. I will look at it clinically, wash myself in the numbers (thousands of cases per year, a 1% mortality rate, roughly 5% chance of serious, life-changing complications, a day in the ICU, a week in the hospital, a month of suffocating exhaustion, a pill a day to keep my blood pressure in check, 3 months to the next CT, a lifetime of blood thinners). I will create something in my mind that I can examine empirically instead of in terms of uncertain fears and an infinity of what-ifs.

That works—most of the time. It’s no surprise that late at night, as I’m drifting into that living-death of sleep and I hear the echo of my heart beat in the springs and coils of my bed, when the whisper of blood is loud in my ears, I see the knife cut into my chest. I feel the break in my rib-cage. I envision the spinning machinery of the heart-lung machine that cycles my blood, and I see my exposed and unplugged heart suddenly stop.

And I listen to the sound of the beat in the coils. And I wait to make sure the rhythm of my life doesn’t stop.


I'd get a second opinion...they may just be after the plasma rounds or other useful items which Dead Space teaches us are often hidden in that area.

But seriously...my thoughts and prayers will be with you. I can certainly relate to the consternation at discovering you need something as drastic as surgery. Heck, I was blown away when I was told that I had a hole in the muscular tissue in my inguinal region, through which my intestines were poking, and there was nothing for it but to go in and patch it like an old tire. I mean, this is me we're talking about! And as everyone knows, I'm way too macho to require any sort of maintenance!

Sure enough, though...and the surgery itself, relatively minor as mine was, went exactly as Ravenlock described, except that I was conscious when they wheeled me into the OR. I had time for two thoughts as I looked up at the big lights over the table: "Wow, this looks exactly like most movies portray it," and then, "If I'm still conscious when they lean over me with the scalpels, I've got to be ready to cause some real trouble in thissssszzzzz..."

Next thing I know, I'm coming to in the recovery room (which felt exactly like waking up from a particularly deep sleep, slowly becoming aware of sounds around you until you're curious enough to open your eyes) and thinking how much of a non-event it seemed like from my perspective.

All that to say, while it's true that all surgery should be taken seriously and you should absolutely prepare as such, physically speaking...it turns out they make those doctors take, like, a special class or something before they let them perform those operations, and as fantastical as the process sounds to us laymen, it's all in a day's work for those guys and gals.

Thank you, Sean, for your honest thoughts on a very personal subject and thanks for helping create a place where it's safe to share those kinds of thoughts.

Good luck, Sean.

Best wishes, Sean. Modern medical science is awesome, though. You'll be so fine 2000 grain sandpaper is gonna go, "Damn!"

Best of luck to you!

Good luck to you and your family, Sean.

I can't wait to tell people I know someone with a baboon heart.

Mytch wrote:

All that to say, while it's true that all surgery should be taken seriously and you should absolutely prepare as such, physically speaking...it turns out they make those doctors take, like, a special class or something before they let them perform those operations, and as fantastical as the process sounds to us laymen, it's all in a day's work for those guys and gals.

I wanted to say this, but don't have Mytch's experience to back it up. But +1 anyway, and best of luck to you. As the husband of one, I hope you get some stellar nurses to look after you post-op.

Hang in there, get healthy and keep positive.

If you need some heavy-lifting help in the interim, I'm over in Burnsville and willing to lend a hand!

I hope that 'a lifetime of blood thinners' also includes alcohol.

Best of luck!

Keep me posted so I know when and where to send the Get Well Soon flowers:

Ah, Niles. What a silly...

*record scratch*

Balloon heart stuff?

That's wild Elysium, my thoughts are with you. Good thing they found the problem in time. Sounds like you're maintaining a healthy attitude and your odds seem decent.

Good luck Sean! My thoughts are with you and your family.

Best wishes to you and your family.

To help keep your spirits up, think of all the recovery time you'll have to play games.

I can only echo your thoughts and the sentiments of many posters here about how important it is to stay positive and logical.

Thanks also for sharing with the community.

Keep me posted so I know when and where to send the Get Well Soon flowers

Forget flowers. How 'bout "Get Well Soon" Steam gifts!!!

The news is shocking, but I am determined to remain upbeat. Wishing you the best, Elysium!

Certis wrote:

I can't wait to tell people I've shared a bed with someone with a baboon heart.

Yoyoson wrote:
Certis wrote:

I can't wait to tell people I've shared a bed with someone with a baboon heart.

Well played.

And get well soon, Sean. How about the rest of us drop by your place to cheer you up and recover? Your house can hold a couple hundred Goodjers, right?

May your aorta be strong, and your valves be mighty.

Sean, I suppose a sunny side to this is that one of your favorite things is playing video games, which can generally be done with little actual physical activity.

In an unrelated story, my wife and I had a hamster named Sean a few years ago. He was kind of stupid and eventually swallowed a nut that was too big to digest (instead of hiding it in his cheek). Soon after he was put down because of it.

The lesson there is... watch out for big nuts.

Thoughts are with you and your family sir.

Good luck Sean. As someone who is irrationally fearful of doctors and medical procedures, I feel for you.

Good luck, Sean! May your recovery be swift and astounding to medical professionals everywhere. Promise me you won't play any scary or stressful games too soon post-op. : )

As someone with a few genetic "surprises" waiting in the wings myself, knowing is so much better. There's a little bit of fear there, but mostly there's a sense of preparedness that makes these afflictions less frightening and more manageable. Thank goodness for screening tests and procedures. Modern medicine is a beautiful thing.

Gorammit sir, that's a heap of news. I am glad you found out about this before it was a show stopper! Best wishes on this journey you are on.

Best of luck to you and your family, man.

Amoebic wrote:

Modern medicine is a beautiful thing.


Yowza. I'm glad they found that early. Best of luck.

As a stage three colon cancer survivor, I have had a similar experience. I experienced little worry before, during, or after the surgeries and chemo. I accepted that what was happening to me was beyond my control, and concentrated on working on the things I could.

It also helped me to remember that what cannot be cured must be endured. I entered each surgery knowing that there was a chance it could go badly, and I might never wake up, but that the chance of surgical disaster was out of my hands, and therefore not worth worrying about.

Best wishes to you and yours in the coming times of discomfort. May all your procedures go as well as mine did.


Edit: On the plus side, I'm no longer terrified of needles.

Have they made no recommendations to avoid strenuous activities that would raise your blood pressure, such as physical exercise or playing Demon's Souls?

Sean, your unique writing voice and personality serve as a shining star in the depths of internet blackness. We're all pulling for you.

Thankfully we live in an age where this kind of surgery is even possible and is very successful.

Hopefully when you recover not only will you not have to worry about this anymore but you will find that with a working ticker you will have more energy than ever before.

Live long and prosper my friend.

On the plus side, you'll probably have a pretty bitchin' scar from the surgery.
Also, you should ask your doctor if they can install an arc reactor at the same time.

Wait... Once you get through this and out the other side, does that mean you'll be upgraded to Elysium version 1.5?