Sanjay's Story

Chapter 3:

As if waking from a sleep deeper than any previous in my life my surroundings felt hazy and blurred, not just because I’d had my glasses removed before the operation. The first face I saw was my wife’s, peering quizzically at me then smiling when she saw me awake. My throat felt parched and dehydrated and I asked for something to drink.

That was the sum total of my conscious actions first time of asking after the operation until I flitted out of my sleep, borne of fatigue and anaesthesia, then I recall seeing my kid sister vaguely before she somehow metamorphasized into my wife’s little sister, possibly a hallucinatory side effect of my medication. I was to learn later I repeatedly asked for a drink (orange juice was on offer and I developed an irrational, almost desperate, craving for it) and would constantly bat at the oxygen feed attached to me with my right hand and hold out my left hand for someone to hold even though I don’t recall any of those things.

There was one thing I recalled oh so very vividly, my first chance to survey the wreckage of my body after my abdominal bisection. The angiogram probe feed still into my right groin, large cuts on my left thigh, where a vein had been taken for one of the grafts, drips feeding in via my throat and left arm and lastly the blackcurrant stained bandage snaking from chest to stomach.

The last evidence of surgery I recall seeing was on my father; when it was his turn for a bypass (although ten years earlier time wise, he underwent this procedure more than twenty years later in life than me, as he neared sixty). It seemed to me the surgeon was consistent in his work as our chest bandages seemed to be of identical length and positioning, when it came to how we wore our chest bandages it was clearly like father, like son.

As well as the obvious signs of the cardiac surgery morning shift’s work on me there were a liberal scattering of bruises and cuts here and there, each new additional laceration and bruise announcing itself when I leant on them as I squirmed in bed, trying to rest after the battering I’d received.

It would be another day till I’d left the post operation recovery part of the ward by which time the inconvenience of my immobility began to grate. I was no fan of bedpans but thanks to the considerable yardage of pipes and tubes entering and leaving me I’d have to stay confined to bed. Paranoia and resentfulness were easy emotions to accommodate at that point…”Why didn’t they take the angiogram probe out, they don’t need it now do they? They’ve forgotten about me. Why can’t I go to the loo like the other guy has been allowed to? Again, because they’ve forgotten about you.”

After a cycle of juice and sleep the registrar arrived to talk about the operation itself, the bare facts were I undergone a quadruple bypass, with two chest grafts and two from my left leg; the operation lasting around five hours. As before I was assured of the routine nature and execution of the operation. For now it’d be a case of observation followed by the first stages of rehabilitation in the next five to ten days, once I’d left the post op section of the ward.

At that stage I was aware of my surroundings enough to recognise one Malaysian orderly who seemed to be on a marathon shift – he was there day and night for days. As he’d gotten me a drink and helped remove some of my probes I decided he was my friend even though the removal of the catheter from my groin lost me lots of blood and he was involved there. My pyjamas took on a distinctly blackcurrant hue from then on. Showering with all my drip and sensor related attachments was a trifle unwieldy but a necessity as soon as I could.

I can’t recall how much longer I remained in post op, but it seemed to have been for at least another night and then some time during the daylight hours of the following day I was moved to the main art of the ward, sharing a six bed portion with three other patients, all with spluttering coughs of varying decibel levels and demeanours of varying levels of brightness and morbidity. I was still afforded a pleasing view of the Thames in spring, although the cold snap meant mornings came with frosty starts giving no hint of the spring supposedly round the corner.

Conversation with my fellow patients was limited due to our exhaustion and need to sleep and recover our strength, some of the others requiring regular oxygen doses, and cushions pressed against their chests when coughing, to ease their condition. No coughing fits for me, again I was lucky in that respect; I was trying hard to find reasons to feel at lucky about anything.

A steady stream of family and work friends would visit; all trying to be upbeat and able, to some extent, in masking the shock of seeing my condition from their faces, some more successfully than others; one work colleague almost looking he’d seen the living dead, a fact which I used to tease him about months later.

Sleep wasn’t easy to find in the first few nights after the operation, not just for reasons of a morale that was teetering on the brink of a downward spiral, but because the patient opposite me would cough/wheeze his way through the night thereby keeping, a notoriously light sleeper like me, awake and resulting in me feeling rather sluggish during the day. As part of the rehabilitation we were expected to walk up and down the ward a number of times a day, but my largely sleepless nights meant I had little enthusiasm for that; unfortunately a ward nurse noticed that.

“ We can only help you to get better so much. YOU’VE got to help yourself by making sure you walk at least three times a day for at least ten minutes up and down the ward. If you don’t want to help yourself we can’t help you” she roundly admonished me when some of my family were visiting. Part of me wanted to defend myself by pointing out I was exhausted due to the persistent cougher keeping not only myself awake but also my fellow patients. In fact one of them had surmised, about the cougher, “he’s the only bugger that don’t need a sleeping pill – he’s keeping us lot up!” However as the nurse continued her chastisement of me I was feeling strangely aroused; in itself a good sign as my morale was, therefore, not as low as I feared and my libido still intact.

A few days later it was time for the “stairs routine” part of the rehabilitation where a physiotherapist would put some of the recovering patients through their paces using flights of stairs – and our ability and to climb them - to measure their recovery. Again I was a thirty something a group of fifty-five plus men except for a forty three year old man. Bespectacled and slightly tense looking he mentioned how he was a triple bypass case where one of the grafts began to leak and he was therefore under the knife for more than six hours.

The hospital orderlies arriving at my bed to take readings and samples still came, but at a slowly diminishing rate, which together with satisfied demeanours indicated my recovery progressed at a satisfactory rate. Day by day I lengthened my walks up and down the ward and my appetite returned. The day before I was discharged I was ordered to have a chest x ray which meant being wheeled to a lower floor to the X-ray department and waiting with out patients for my turn. I was kept waiting for nearly three hours in the end as I had a name identical (except not having the last letter of my almost name sake and not being female) to another patient sent down from the cardiac unit. As I waited and waited I saw the less patient people waiting for their x rays start to become more profane I their complaints at the delay. Of course I was in no rush, in a way glad to have a change of seen from my bed.

When discharge day duly arrived I was handed lots of leaflets to guide me through the recovery process. Advice for the journey home was not to open doors or reach up for high shelves, as this would disturb the fusing of the breastbone, which was in two pieces. I clearly hadn’t listened properly to the registrar when he had advised me on the dos and don’ts of recuperating at home as I believed my breastbone was not secured together. I subsequently found out a metal pin secured the sections of breastbone over which the bone would fuse; I thought a sudden movement was enough to dislodge the two parts! So much so that days later when I had hair cut I’d asked one of the staff at the barbers to open the door for me so mindful of the risk of separating the two sections. A curious, perplexed look had been on her face as she opened and shut the door.

It would be symptomatic of one of the reasons I’d become a heart patient that the day of my discharge, I later gathered, there would be another flare up of family tension – all because of a mix up over who was to bring me my trousers for the day! It was a precursor to future incidents that would continue in the manner they had before my bypass.

It was agreed that I would take the option of using the hospital volunteer cars, accompanied by my father, to get to my parents house where I would stay for a week or so; my two young sons would not create a restful atmosphere for me as at six and eight years old they couldn’t be expected to behave in any way other than normal six and eight year old boys would behave – boisterously.

After another wait, it would have been churlish to complain about a wait for a volunteer, our driver arrived, registering only mild surprise that I was the patient and not my father.

The streets and traffic for the next hour felt noisy and the air cold and sharp compared to the overly warm/recycled air I’d been accustomed to. On arrival at my parent’s house I unpacked my things in a ground floor room, steps being seen as an unnecessary hazard in my state. Having been used to sharing my living and sleeping space with four strangers on the ward any personal space felt a blessed relief.

Being waited upon was not a natural state yet in view of what had happened the week before I could see my parents would expect me to be in a fragile state. Thanks to the pain killers I was advised to stay on – for at least a few days – any such internal pain I may have been feeling was masked although I reduced the dose as quickly as permissible and was taking only my statins, beta blockers and dissolved aspirins within a few days.

I stuck to both the walking side of my rehabilitation and my stretching exercises rigidly, reasoning that the advice I’d been given in these two respects must have been carefully formulated so for the best results they should be adhered to exactly. This being as I was influenced by the approach of Arsene Wenger in training the Arsenal team, each exercise would be timed exactly, not a second more, nor less.

The walking was a struggle as I still had some stitches in my left leg causing me to hobble like an old man, for example at pelican crossing when the green man interval was not of long enough duration for me to cross, as BMW drivers revving their engines impatiently would remind me of my elderly gait. I vowed to show more tolerance of anyone I’d previously have accused of dithering. Once a kindly nurse - paid me a home visit to remove the stitches my mobility eased and I cold walk for longer and up steeper inclines as the days wore on.

By then it was the early stages of spring and my morale would rise as the days lengthened and the sun shone more. So much so that I felt I should get out of the house and experience a change of environment, it was by then four weeks since the operation and a family friend was having a get together I’d been invited to.

My condition was an ice-breaker that none could say they’d heard before – quips like “I thought I’d grab myself four by passes in case they ran out” and “ I beat my dad to something by more than ten years!” just came to me instinctively, so much had I missed socialising to any degree.

Secretly I would enjoy trying to make light of the life-saving operation so I could watch the shocked faces look back aghast at my apparently cavalier attitude. It was even more fun to tell them about pulling out the remainder of my stitches - a one centimetre section had been left in my leg by the nurse – without any help, I was that tough! That kind of distraction I needed as during the night, or when I was alone I’d feel low, very mortal and unfairly picked upon by fate.

I would sleep on my back, convinced my rib cage could not stand the pressure of me sleeping on my side, so convinced of my fragility. To this day I instinctively lie on my back as soon as I get into bed, unable to shift/roll sideways for at least ten minutes as that reflex is now engrained in me, a permanent reminder that I’ll always be a recovering heart patient. Perhaps in the same way reformed drinkers are always recovering alcoholics. A bleak view maybe however one that finds credence during the despondency that I’d feel on the dark days I would occasionally encounter.

The good news was that my chest hair did not grow back stubbly, so all was not lost.

Soon I attended cardiac rehab classes at my local hospital, my first return there since the day of the treadmill test and ECG that triggered off the sequence of events that was to make my transition from average thirty something to a state that was out of the ordinary. One fellow classmate had a traumatic night before his bypass – his ward neighbour was carted off in what he called “a tin box” before he could be operated on. If that had happened to me on the night before my surgery any such positive mental attitude I’d engineered would have evaporated fairly sharpish. The bending and stretching moves I learnt there I still use to this day for my twice/thrice weekly visits to the gym for cardio vascular work outs.

As my absence from work was cleared for another two months a week’s holiday in Spain seemed a good idea. The only reminder of my condition being when, walking by the hotel pool, two elderly french ladies frowned at my chest scar.

My return to the operating hospital the following month re united me with the registrar who assisted on my bypass and allowed me to delve into the mechanics of the operation, for example the extent of my arterial blockages – ninety percent blocked in one case, clearly the origination point of the warning sign I felt that cold January morning.

How far had I come since then.

How much further I’ll go – time will tell.

Sanjay

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Sanjay's Story

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