Pumphead

It’s a few short weeks until I celebrate the first year of the second half of my life. While it’s true enough that I’m closing in on forty next year like a police car chasing an underpowered golf cart, it’s not the number of years between today and 1973 that puts me in this frame of mind. No, it is the fact that I am closing rapidly in on the one-year anniversary since undergoing heart surgery.

If you are thinking to yourself, “Oh God, not this again,” then I can sympathize with if not accommodate you. Frankly, I’m a little sick of hearing myself talk about it too, and trust me — my internal monologue has been nothing short of prolific, having been given a year to ponder mortality.

But the truth is that physically my recovery could not have gone any better, and I feel generally far healthier over the past six months or so than I have since my late twenties or early thirties. Or most of the time I do, and then out of nowhere some lingering after-effect will manifest and remind me that part of me is still broken, that I am firmly out-of-warranty, and just like that I am thrust back now nearly twelve months into a frame of mind that feels the cold press of too many days.

So, I promise this is my last “oooh, my heart done broken,” post, at least as long as nothing else jumps, jives and wails in my wire-stitched chest. Consider it an epilogue.

I have a scar on the bridge of my nose now to join the nearly faded, and surprisingly untroubling, one on my sternum. It was perhaps the first serious illness I had after my surgery, a stubborn if traditional cold that woke me up in the middle of the night. Feeling miserable, I rose from the bed, walked around toward the bathroom door for purposes private, felt a cold chill run the length of my body like being dipped in tingly ice water, and then my wife was crouching above me in a near panic.

“You’re bleeding!”

“No, I’m not,” I said stupidly and with a complete lack of understanding of the situation. “What’s wrong!” I demanded, still firmly out of sorts having not at all processed that the hard surface under me was not a mattress. My body was only just beginning to inform me that it had a number of pain points to go over with me in an upcoming meeting. I tried to sit up. It was, in retrospect, a rash decision, and I could only muster a brief and half-hearted attempt before my muscles and my wife simultaneously came to the same conclusion that I should stay put. It was only at that point that I began to suss out the interruption that had just taken place with this whole consciousness thing.

I was still washed in the icy bath of cold internal tingles, and they seemed to now be having a delightful Mardi Gras parade up and down my body. Sweat suddenly burst from my skin in earnest, and I finally put my hand to my nose. It came away wet with blood.

We never quite put together exactly what happened. My wife had been sound asleep and by the time she could get to her senses, I had already collapsed, crashing into a number of very sturdy pieces of furniture on my way down to a crumpled heap. We have concluded to some degree that I owe some kind of karmic debt for not shattering my nose or a couple of teeth.

But not all of my recovery surprises have been quite so dramatic. No, the one that troubles me most is in very many ways only in my head.

They call it “pumphead," and honestly I have no idea for sure whether I’m suffering from a relatively mild case or not. I don’t really think I want to know exactly, because I’m not sure an answer either way would satisfy me in any comforting way. The short version is either I am experiencing a not uncommon, lingering after effect of spending hours on a heart-lung bypass machine, or I’m experiencing a very mild cognitive issue for some other reason. Either way, if I was cognitively at 100% in June of last year, I’m maybe 95% of that this year. Maybe slightly less.

Postperfusion syndrome, to be referred to from here on out as “pumphead,” is, according at least to Wikipedia, “a constellation of neurocognitive impairments attributed to cardiopulmonary bypass ….” In simpler terms, it’s a whole range of messed up brain fog that can happen in the aftermath of being hooked up to a machine that is kicking your blood around your body and into your brain. There’s all kinds of nifty symptoms like personality changes, motor function issues, attention deficit disorders.

If I do have it, then it’s not so bad. I’m just ever-so-slightly slower, duller, foggier than I was before. Words are farther away when I need them. It’s a little bit harder to read. Names of people I’ve known for a year will suddenly fly away.

You know that feeling you have when you see someone in a movie, and you know that you know them, but for all the money in the world at that moment you can’t say their name. You just stammer, “You know — that dude who was married to the skinny girl from Friends!”

“All of them were skinny.”

“No the one from the Springsteen video and Ace Ventura. Her husband.”

“David Arquette?”

“YES! Thank you!”

Regardless of the entirely legitimate question as to why anyone would be working that hard to come up with David Arquette’s name, I feel something very akin to that phenomenon a half dozen times every single day. And, it’s in odd moments and places. Mid-sentence at work describing a process I can normally do in my sleep, all of the sudden it’s like when the lights flicker during a thunderstorm. There is this odd pause while everything just kind of resets. It’s a very brief — maybe a heartbeat or two — moment that is not entirely unlike waking up on the floor with your nose nearly broken.

Then it’s gone, and I’m back. Mostly.

That’s really how I feel a lot of the time. Back. Mostly. And don’t get me wrong, I would by far take “mostly” over a “not back at all.” And I still feel like what I think is me, though I have to manage my moods a little more deliberately than I’ve had to before. I don’t actually think most of the people who know me, who work with me every day, see much of a difference. If they do, they have the kindness not to point it out.

But there are times, moments with the quiet snap-click of my heart echoing through my neck in the middle of the night while everyone else is asleep, that I feel the difference in me. I am keenly aware that, as I had suspected, my life is never going to be quite the same. It’s almost like I can feel the rough edges of where part of me used to be, and now just isn’t.

In these moments I find myself probing the odd ridges in my sternum that I assume are wires that once held my body closed, and it’s like I’m trying to find a way in — to look for what’s missing. Snap-click.

And then, it’s gone. And I’m back.

Mostly.

Comments

Good article. But are you sure it isn't just age (we're the same age)? I sometimes feel the same way and have never been under the knife. Or self abuse? I usually blame the time I spent in college smoking pot not the time I currently spend drinking beer.

Nevin73 wrote:
I usually blame the time I spent in college smoking pot not the time I currently spend drinking beer.

Yeah, I was going to point out that he really doesn't need the Corona IV he wheels around with him everywhere. The lime floating in the bag is not really an efficient delivery system for vitamin C.

But are you sure it isn't just age (we're the same age)? I sometimes feel the same way and have never been under the knife. Or self abuse? I usually blame the time I spent in college smoking pot not the time I currently spend drinking beer.

It's certainly possible. But I feel very different just over the past year. It could be coincidental, of course. Or it could be that I'm being hyper-sensitive.

Fog or no, your writing gets better with each essay, and I admire the guts you show in throwing your contemplations of mortality out for the world to see. You're doing much good, Mr. Sands.

Jeb wrote:
Fog or no, your writing gets better with each essay, and I admire the guts you show in throwing your contemplations of mortality out for the world to see. You're doing much good, Mr. Sands.

This man is speaking the truth. I had my open-heart surgery (aortic valve repair and a graft to replace a bulging section of my aorta) in 2008 at age 28, and it was literally years before I fully felt myself again. Every once in awhile, even now, when I take a deep breath I can feel the heartbeat go across my sternum in a way I never could before.

It's a scary process, and you're a brave man to write openly about it. Thanks.

Dammit Elysium, now I have a new thing to worry about for my son, I'd never heard of pumphead before.

Also...is bad that this was the first thing I thought of when I saw the title of the piece?

IMAGE(http://68.169.81.135/RedPenisPump.JPG)

Nevin73 wrote:
Also...is bad that this was the first thing I thought of when I saw the title of the piece?

IMAGE(http://68.169.81.135/RedPenisPump.JPG)

Not bad at all. Made me chuckle

As usual, you've made me feel bad about laughing at your funny writing. : /

Jerk.

Nevin73 wrote:
Good article. But are you sure it isn't just age (we're the same age)?

I'm around the same age and feel similar effects. For me it feels like someone has spread a thin layer of vaseline over the world, everything is just a bit foggier and harder to get a hold of. I attribute it to my anxiety issues for which I am prescribed Xanax. When I take a dose it clears the fog and the world is back to sharp clarity, for a while.

I have heard of doctors prescribing Xanax (or a drug like it) for patients dealing with heart trouble. You may want to ask your doctor about it.

First up I'd like to say that I enjoy reading about your experiences with the surgery. I'm sure it's sh*tty to go through, but your writing is just so engaging I find it fascinating.

Second, a year already? Holy crap but time flies.

Third, pumphead sounds truly awful. Does it clear up over time, or is it likely to last permanently?

I have not undergone open heart surgery and I can't possibly have pumphead, since I have never been on bypass. It's likely enough that this is actually A Thing and totally legit; there are some current issues being hashed out regarding general anesthesia in general that may or may not reduce cognitive function (and I have been under the gas), too.

That said, even an actual stroke can be recovered, so I'm optimistic that with cognitive retraining and relearning of things, you can be back to your old self in no time, Elysium.

The thing is, I have experienced a loss of "self" in the transition from young adulthood to adulthood. I lost my visual acuity and with it, I lost eidetic recall - I could no longer just look at a page and then "read" it in my mind a few days later.

For a long time, I felt like I had lost a vital function - some part of me that used to be was missing, and that I wasn't me anymore. Without my key skill, and without the compensating skills my colleagues used to cope with school work, my academic power and standing simply collapsed.

But it gets better. After a while, you forget what it was like to be that self you used to be and grow into the self that you become. I still don't have eidetic memory, but I have greater empathy, I can remember faces better, and my pattern recognition is greatly improved.

Ultimately, you will become who you strive to be, and who you live to be on a daily basis. If you pick up chess, you will become a chess player, and forget being a Rock Band player (or something). If you practice to master memory skill, you can become a master of recall. If you play Gods and Kings, you will become a God. Or a King.

It's never too late to start living the life of the person you want to be.

IMAGE(http://realresultsfitness.com/wp-content/uploads/2009/08/jeffry_life_baa.jpg)

Jeb wrote:
Fog or no, your writing gets better with each essay, and I admire the guts you show in throwing your contemplations of mortality out for the world to see. You're doing much good, Mr. Sands.

I'm a bit late here, but Jeb's got the right of it, I think on all counts.

Ahhh Ely. You and I are the exact same age (at least born in the same year that is). Don't fret too much... I don't think its a deficit from your surgery, I have the exact same things in my own "foggy" way every day now.

My younger brother came and visited us a couple weeks ago.... yea that brother, the one everyone wants to meet at your mother's funeral cuz he fly's cool planes and stuff. Anyway, we were coming back from mountain biking (oh, and he f-ing kicked my ass btw and he lives at sea level all the time... humph) and I had to ask him:

"So... have you noticed at all that as you're getting a little older, that you might have to pay a bit more attention to what you're doing? I mean, you have to be at the top of your thought process with what you do everyday... do you notice that at all?"

And in his own self confident way he replies "huh? No way".

What I'm getting at is, I have noticed over the past couple years that I really have to pay attention when I'm driving, mountain biking, playing hockey, working or doing anything that requires concentration. Not that its "difficult" per se, but before, I never even THOUGHT about "doing" something correctly whereas now I actually think to myself "You better not look at that sign because you're in the middle lane and if you stray a bit to the left or right you'll bump one of those cars on either side of you".

I forget things that I need to do an awful lot more and have to really write things down or else POOF, can't remember. Waking up is WAY harder than it used to be (might be due to the 19 month old) but even going to sleep is WAY harder as well.

The reason I bring up my brother is because he is pretty much the epitome of physical fitness and he has to be due to (his own words) "Pulling a lot of G's can really kill you if you're not fit for it". He's also about 5 years younger than me and again, I didn't start noticing these "things" until a little over a year ago. And although his answer isn't absolute proof, I do believe that it helps validate that these issues I am noticing are probably due to me getting older.

So alas, what I'm saying is, you're getting older man. And we're all thankful that you ARE getting older and not ... well, you know

PAR

Elysium wrote:
Words are farther away when I need them. It’s a little bit harder to read. Names of people I’ve known for a year will suddenly fly away.

par wrote:
I forget things that I need to do an awful lot more and have to really write things down or else POOF, can't remember.

These are apt descriptions of what ADD is like. You have to actively think about what you're doing most of the time and it's hard to call certain pieces of memory right when you need them.

Great article Sean. I always love reading about your experiences because you describe them so well. You are to daily life, what Tolkien is to fantasy. I mean that as a compliment