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.

Comments

Best wishes for a speedy recovery good sir. For someone who's watched his father go in for dramatic heart surgeries every 2 years now for the last 6, I can assure you that what you're describing is a relatively routine operation for a heart surgeon. You may want to ask if he can tighten up the graphics while you're under.

Also sending vibes for a quick and uneventful recovery.

I can't add anything personal like others who have nice specific information but there seems to be some great practical tips in this thread.

I will add that the scar is going to look pretty cool. Does this mean you'll have to have regular waxings now to make sure it stands out clearly in perpetuity?

(linked for brief NSFW language)

Good luck, Sean. Thanks for sharing this with all of us, and stay hard-boiled about it.

Shoal07 wrote:

Good luck Sean.

What made you walk into the doctor's office to have your heart checked in the first place?

That would be me.

Sean's mom has the same issue, and she inherited it from her mother. She told me about it, and I nagged him until he agreed to mention it to his doctor. She felt it was worth running the diagnostic tests to rule it out.

The weird thing was, both of us felt certain it would be just that - ruling it out. Neither of us really believed he had any problems with his heart. He's always been the picture of health. He never even had a cavity! So it's been a big shock, and we're still trying to adjust to this new state of things.

The support from the Goodjers means so much to us. Anyone who thinks the internet is always a bad, hostile place hasn't been to GWJ. Thanks, all of you, for your words of encouragement. It means a lot to Sean, and to me.

Shoal07 wrote:

Good luck Sean.

What made you walk into the doctor's office to have your heart checked in the first place?

LarryC wrote:

An angel, Shoal07.

Elysia wrote:

That would be me.

Angel, Goddess. Same thing, right?

Great story, tho, Mrs. E. Good way to remind everyone that sometimes hunches and checking into things "just because" turns out to be far, far more important than we could have ever imagined.

So if Sean's Niles, does that make Shawn Fraiser? If so, who's Martin, Daphne, Roz, and Eddie?

Elysia wrote:

The support from the Goodjers means so much to us. Anyone who thinks the internet is always a bad, hostile place hasn't been to GWJ. Thanks, all of you, for your words of encouragement. It means a lot to Sean, and to me. :)

That means a lot coming from a Minnesotan.

Now I'm conflicted, though. Excuse me while I don every bit of Bears and White Sox clothing I own. I may even need to grab some Packers and UW swag.

Best of luck, Sean. Thoughts and prayers are with you guys.

Parallax Abstraction wrote:

Y'ARR, matey! Give me best to your family for me as well.

Made that even more piratey for you.

il dottore wrote:

More importantly, I'm sad that we won't hear you on the CC for a while around the operation!

Forget that...a doped-up Elysium on the podcast, you say? Internet GOLD!!

Best wishes to you and your family, Sean.

Sean, I want to add to the chorus in thanking you for sharing something as large and as personal as this.

Secondly, I'm sure I'm not alone in admiring the decisions you've made in how to think about this, and how to respond.

-I hope all goes well from here forward.

Elysia wrote:

The support from the Goodjers means so much to us. Anyone who thinks the internet is always a bad, hostile place hasn't been to GWJ. Thanks, all of you, for your words of encouragement. It means a lot to Sean, and to me. :)

Ain't that the truth.

While this isn't exactly the most fun thing to go through I'm glad to hear you kept the pressure on Sean. Sometimes things have a way of sneaking up on us and I'm glad this was caught before it was too late. As I said before your family is in my thoughts.

Rat Boy wrote:

So if Sean's Niles, does that make Shawn Fraiser? If so, who's Martin, Daphne, Roz, and Eddie?

Martin - Rob Borges
Daphne - Koree
Roz - Lara
Eddie - Don't know, he's a little quiet.

MrDeVil909 wrote:
Rat Boy wrote:

So if Sean's Niles, does that make Shawn Fraiser? If so, who's Martin, Daphne, Roz, and Eddie?

Martin - Rob Borges
Daphne - Koree
Roz - Lara
Eddie - Don't know, he's a little quiet.

I think Stan has to be Eddie..

Tanglebones wrote:
MrDeVil909 wrote:
Rat Boy wrote:

So if Sean's Niles, does that make Shawn Fraiser? If so, who's Martin, Daphne, Roz, and Eddie?

Martin - Rob Borges
Daphne - Koree
Roz - Lara
Eddie - Don't know, he's a little quiet.

I think Stan has to be Eddie..

Perfect!

Best wishes. A friend of mine's father who is retired and not a picture of health recently had a similar procedure, and he is quickly returning to form.

Crap, you may have to eat hospital food.

I feel for you, man.

Wow, that's some heavy news.

Wishing you the best.

I'm beaming good thoughts your way.

On second thought, 'beaming' might not be a good idea. You know, with the radiation and stuff, I might have to rethink that. :-/

Best wishes to you, Sean, for a simple procedure and a speedy recovery.

In situations like this, I am inevitably in the militant optimist camp. Bottom line is - there is absolutely no point in acting differently.

Ely, I love you man. Hang in there and never allow the smile to leave your face.

I will make sure I have a beer handy to enjoy while reading your first article after the surgery.

Best wishes to you.

My wife works as a Nurse Educator in a Coronary Care Unit, so I hear about these things very often. I am sure you will be fine - them seem to have this sort of procedure down to an almost assembly line level of precision. Still, best wishes and hope all goes well for you.

A lot of stuff heart related these days gets done in the catheterisation Lab - instead of cracking open your chest to have a good look and fix stuff, they go in with a flexible Catheter inserted via an opening in the femoral artery in your leg. They can then see the inside of the heart, takes measurements etc. Then if they want to fix things they can zap things or insert something called a stent - basically a metal strengthener for the artery. Doesn't sound like you are a stent candidate though unfortunately, presumably because they may need to do a valve replacement.

Just think of the absolutely totally manly scar you will have at the end of it - nothing says "I am super f*cking tough son" like having your sternum opened up and then put back together. Stories involving how you got into a fight with an axe wielding barbarian can be told to the grandkids.

Doesn't sound like you are a stent candidate though unfortunately, presumably because they may need to do a valve replacement.

Nope, I'm not. It's the valve replacement, and also the location of the aneurysm. Both mean that I'm not a candidate for this.

Best wishes mr. Sands.

Glad that they caught this early. Good luck.

I'm going to add my voice to the "Best of Luck" chorus Sean!

I know that GWJ would be a much colder place if you shuffled off this mortal coil...so y'all take care of yourself now, hear?

Sean,

The good news in all of this is that they found the problem. We lost a close friend and would be family member due to an undiagnosed cardiac condition. Cardiac care is light years ahead of where it was 10 years ago. Although the procedures are complex, your chances for a great outcome are very high.

Keep us posted, we'll all be thinking about you.

Oh no.
I am saddened by the news of your condition.
I wish you good luck, sir.