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Heart attack, Part 7: All the king’s horsesBY: Bob Levin 07.03.2012
If attitude were the determining factor, I told myself, no way would I need more surgery. But no matter how far I’d come, I thought, the world could undo me any moment.
The cake also rises:
Seventh in a series of articles about the author’s heart attacks.
Adele brought me home from open-heart surgery on September 11, 2011. Our bed embraced us like an old friend. Our TV held all the entertainment we could stand, from Jean Arthur’s movies to Alan Ladd’s. We fed ourselves from our refrigerator – nonfat yogurt, vegan cookies, turkey bacon. Our joy, Adele said, outweighed our fears.
But it took her urging to get me on my feet. The slightest ache or tweak in my chest frightened me. I grew dizzy when I stood. To reduce the chance of falling, I showered sitting on a bench and peed in a commode beside the bed.
I slept in disposable shorts because I lacked bladder control. I wore support stockings to prevent clots. I couldn’t bathe or dress myself.
I had lost 35 pounds since my first heart attack. I went out only for doctors’ appointments or walks. And when I walked, I rested every few minutes. But I rose and walked again.
Nurses and occupational and physical therapists visited so often that I felt like Humpty Dumpty attended by all the king’s horses and all the king’s men. (I hoped, though, for a better result.)
Victoria, the supervising nurse, voiced encouragement. She termed my heart “steady,” my lungs “clear,” my surgical scars “more like paper cuts than incisions.”
‘You answered the doorbell’
My walks increased from ten to 15 to 20 minutes. At our health club I did ten-minute stints on three different aerobic machines. The staff in my surgeon’s office cleared me to exercise with two-pound weights— one arm at a time, and working up to five-pounds in each hand. They approved my carrying a ten-pound bag of groceries, then a 20-pounder. They said I could drive if I avoided wet roads, stop-and-go traffic or anything else that might increase my chances of smashing my chest into the steering wheel.
Adele and I ate out once a week, then twice. I sipped my way from a half an espresso to my accustomed double.
One morning, instead of driving, I walked to the café. My route was downhill, 30 minutes, redwood-shaded. The sun sliced the fog into illuminated ribbons. The grab-bag architecture of the houses in Berkeley– brown shingle and stucco and Victorian– delighted me. Their yards’ adornments – ceramic frog, wood burl bear, tuna fish cans carved into fish – entranced me. Each garden fought to out-marvel its neighbor – through shrub and flower, succulent and creeper – in color and design.
“Life is good,” read a fountain sprinkling a rock display.
Oklahoma! and Dylan
I said “Hello” to everyone I passed. I sang snatches from Oklahoma! and Bob Dylan. I murmured my “blessed-healing-loved” mantra. The penumbra of all I had been through enriched each moment.
Taking a curbside table at the café, I smiled at the assembled patrons– artist and musician, old lefty and ex-academic, carpenter and crazy. I didn’t know if my repaired heart was enhancing my brain with increased oxygen or if my Lexapro was talking. But I felt: If attitude were the determining factor, no way would I need more surgery.
After Thanksgiving, I returned to cardio-rehab. The first time I had been carried out on a stretcher. The second time surgery had tackled me before I reached the finish line. The third time…
Pam, the orientation nurse, said I looked great. But then I’d never heard a nurse tell a patient he looked like shit.
“You may not feel normal for a year,” Pam added. “The heart adjusts to a faulty valve, so it must relearn how to behave. Since your malfunction came from a sudden event, rather than a long, gradual decline, yours may rehabilitate sooner.”
So I remounted the treadmill, the stationary and recumbent bikes. Weekly, my speed and effort level increased. I felt confident. But Adele confessed that every time she dropped me off, she worried that an ambulance would be waiting when she returned. “I’m still afraid I will lose you any moment,” she said.
“It’s not ‘chest pain,’” I corrected the admittance clerk. “It’s a pain on my chest.”
He rushed me in anyway.
“No good can come of this,” I said to Adele, as they wired me for an EKG.
But after reviewing an X-ray, the doctor diagnosed “a migrating wire,” which he sad was “common after surgery. The pain will resolve, once scar tissue forms around it.”
Clearance to swim
But what about when the season changes, I thought, and it wants to return whence it came?
On a Valentine’s Day walk with Adele, I realized I could “Go! Go! Go!” My breakthrough was not of Jack Kerouac caliber, but I no longer automatically checked my watch or block count when I reached each curb.
My blood panels and blood pressure readings improved. My body added ten pounds of muscle. My surgeon cleared me to swim and lift weights, “provided you act like you’ve never been in a gym before.”
About those risk factors….
With two weeks left to rehab, I had already met the original goals. Pam said I was the first person in the six months she’d worked there to have zero risk factors for heart disease, “including a Special Forces guy. Isn’t that great?”
“But I probably had zero risk factors before my first heart attack,” I said.
George, an epidemiologist on the adjoining bike, laughed. “You may be right. Over half the people who suffer M.I.s have no apparent risk factors.”
“Which means,” I said, “having no risk factors may be a risk factor.”
“But taking care of yourself pays off,” George said. “The survival rate, post-heart attack, for those who did is much higher than for those who didn’t.”
I looked at the people pumping away. I thought of gray-complected, saggy-bodied Fred— who, at his first session, declared this not for him and never returned. I thought of Teddy— who, though shorter than I, weighed twice my weight. He professed awareness of the program’s importance, yet he missed half its sessions.
Fear of backsliding
I remembered Veronica’s mention of silver bullet-seekers. I had been dealt a gene that brought one heart attack and a drug resistance that brought another, but I held some aces too.
I hadn’t known if I would finish rehab, or what I’d be like if I did. Nothing guaranteed that pacemakers, transplants or whatever they came up with would not be in my future. But, so far, things were good, and I didn’t want to lose what my year had taught me. I was determined to repel backsliding.
On the other hand, yelling “Fuck you” at a Volvo trying to beat me out of a parking place later that afternoon felt good, too.
My next concern was an echocardiogram ordered by Dr. M., my cardiologist. “What is important is how you feel and what you do,” she had said, “not what the test shows.”
But I viewed anything that might read differently as a threat. I didn’t look at the screen’s numbers. I read no significance into the tech’s remarks. No matter how far I’d come, I thought, the world could undo me any moment.
But Dr. M pronounced herself thrilled. “Your prognosis had been so bad,” she said. “Now you’re like a homemade cake into which much effort and many ingredients have been poured, so it now smells and tastes good.”
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