CABG, or as they call it, "Cabbage" (LONG post)

There is a quadruple bypass open heart surgery in my future.

Last Thursday, Aug 31st, I went into the ER due to minor chest pain and shortness of breath after walking my dog. The indigestion-type chest pain happens to me quite a bit, and usually it just feels like mild gas. Because I have this digestive issue, it doesn't normally bother me, but on Thursday the chest pain was a bit more intense than usual.

I had no other symptoms. No spreading of pain to arms or jaw, no sweats, no nausea, no light-headedness. In fact, I drove myself to the hospital because it started subsiding in minutes. In the ER they took my vitals and did some blood tests (there's an enzyme test that can detect heart issues). The ER doc wanted to admit me for more testing, but my dog Roscoe was at home alone, so I had to arrange for someone to take care of him. The doctor was very serious about calling 911 if I had any recurring symptoms. When I left, I told the nurse I felt bad, like I was betraying the doctor somehow.

Friday morning, Sep 1st, I awoke with a slight shortness of breath. I arranged for a neighbor to take care of my dog, and I headed right back to the ER. Bottom line for me is that I have just about every possible risk factor for heart disease you can think of, so I wasn't going to ignore any symptom. The ER did the usual battery of triage, including the enzyme blood test, which was negative again. I was admitted to an observation ward and scheduled for more testing.

After a chemical cardiac stress test and a radial (through the arm) heart catheter angiogram and coronary artery exam, I met with Dr. Bose, a thoracic surgeon, who told me I would need Cardiac Artery Bypass Graft (CABG, or "cabbage") surgery. Four of my subsidiary cardiac arteries are significantly blocked (one 100%, others 80-90%). The main arteries are okay, and one of them has no problems at all.

Given that I suffer from general anxiety disorder and major depressive disorder, I did not react well to this news. Unfortunately, the hospital I went to, despite having outstanding cardiac and pulmonary departments, has no mental health facilities at all, apart from a chaplain. So, I called the VA crisis line and talked with a lovely person who got me calmed down and set me up for a follow-up within 48 hours.

Later in the evening on Labor Day, Dr. Bose returned and said that based on examining the results further, he wanted me to stay for observation and a few more studies, and based on the results of those, would decide what to do next. He said it was likely we would schedule the surgery for later, and I would go home to lose some weight and prepare for post-op recovery.

So... mental crisis averted. All of the above happened over Labor Day weekend, so the hospital was a bit short staffed, and they were dealing with a lot of ER patients and surgeries.

On the 5th day of my hospital stay the studies ordered by Dr. Bose were done: an echocardiogram and a thorough ultrasound of both carotid arteries and both femoral arteries. Dr. Bose wasn't available until the next day to consult on the results. He came by early on the 6th to let me know I would be going home after a day of observation, and I would follow up with him on the 19th.

So.

I had no cardiac symptoms whatsoever for my entire hospital stay. I was prescribed two new medications, one (isosorbide mononitrate, brand name Monoket) to relax blood vessels, the other (empagliflozin, brand name Jardiance) which both helps control blood sugar and reduces risk of heart failure. I have been taking a beta blocker and a calcium channel blocker for hypertension for years.

All of this wasn't much of a surprise for me. My diet has never been very healthy, although in the past couple years I have seriously reduced how much fast food I eat. I've lost about 45 pounds from my weightiest weight of 295. I do try to stay active, though, and I get plenty of exercise walking my dog multiple times per day. That's about 30-45 minutes of walking per day, and Roscoe keeps up a brisk pace without stopping much.

I really didn't think it would catch up with me at age 61 (62 next Wednesday!). Interestingly, my father also had a quadruple bypass surgery as a result of chest pain, but it was in his early 70s. Also, the same doctor -- Dr. Bose -- performed my father's CABG. Dr. Bose is something of a celebrity in the cardiac surgery world, as he was part of the team who created the artificial heart. He has a ridiculous amount of experience doing heart operations: transplants, valve replacements, CABG, you name it.

My biggest concern right now (besides getting in shape for the surgery) is post-op recovery. I live alone, and CABG patients require assistance for some time. CABG recovery can take weeks or months, depending on the condition of the patient. To complicate matters further, the VA only handles recovery for patients treated by VA doctors, so we will need to work with them to find an in-network provider. On top of that, I'm waiting for my case worker to let me know if the VA will even cover the surgery by Dr. Bose.

I'm pretty stressed out right now, but my entire life is focused on preparing for the operation and taking everything one baby step at a time. I have to be in the moment, focused on the present at all times, or my stupid brain will spiral into depression, or spin up into panic, or maybe even both at the same time.

Anyway, apologies for the novella, but I wanted to let everyone here know. If you made it this far, thank you for reading, and we shall see what happens next.