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diyAudio Member
Join Date: May 2002
Location: Where Germany, The Netherlands and Belgium meet
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An unusual birthday present
An unusual birthday-present
A couple of weeks ago I was looking forward to get together with a few friends to celebrate my birthday. At that time I didn’t really feel birthday-ish, but I thought I just had a mild flu; everyone around me seemed to have one. But during the night things got worse, I just didn't seem to be able to breath. Slowly my world got smaller and smaller until the only thing left was heave, heave, heave to get air. I live some 3 miles from our hospital so at around 3 AM I decided I needed help and drove to the hospital. Before I was registered etc and the first doctors started to show up it was some 9 AM on Easter Sunday. They were straight. The first one was a lung surgeon, who got his stethoscope all over me. Then he looked me in the eye and said, "Mr. Didden, I'm a lung surgeon, I don't know a lot about hearts. Also, I am somewhat deaf. But you got heart problems, and serious ones. This is no kids play". Well. That made me sit up, let me tell you that. Never been in an hospital in all my life, regular check-ups, never a hint on any problem at all. Next was the cardiologist, then an infection specialist. They seem to evolve around several issues, having to do with heavy infections of the lungs, the heart, or both. They ran me all over the hospital it seemed, putting me through all kinds of scanners and ultrasound equipment.
In the mean time, I was definitely getting worse. My world got narrower and narrower, and ceased to exist outside of heaveheaveheave, even with 10 liters of pure oxygen per hour through my nose, and later through an oxygen mask. By the time it was 11.00 PM on Easter Sunday, I definitely thought I was going under.
"no air need machine help me". One of the doctors said, "We have a breathing machine at the intensive care reanimation unit. You don't want to go to Rea. Lots of machines, lights, sounds. Running people, shouting, talking. An industrial environment. Unless you feel really, really bad. You feel really, really bad?"
yes
They got the Rea guy down. Ran his stet all over me, glanced through the stack of pictures and scans around me. Competently looking guy, I liked him. "Look", he said, "you don't want to go to Rea. Lots of machines, lights, sounds. Running people, shouting, talking. An industrial environment. Unless you feel really, really bad. You feel really, really bad?"
yes
"OK, I'll get back in an hour. You still really, really bad, I'll take you in". They left, all of them, and I felt as if they had given up on me. After half an hour, I had the feeling that I was able to just keep up with the oxygen demands of my body. All that medication seemed to take hold. Just before midnight the Rea guy came back. "You still really, really bad?". not. that. bad. Smiling, he gives me two thumbs up and leaves. Three minutes later, I make my birthday.
It was just a delay. Later that night, they decided that my situation was very unstable, and they didn't have a clear picture yet of the problems(s). They moved me to Rea out of precaution.
It's funny to be in Rea as a kind of guest. Most people come there to be kept alive, to be stabilized and then move to a regular treatment unit. Rea really is the frontline of medical care, that's where the battle is won, and occasionally lost. I spend there almost a week, and my respect for and appreciation of those frontline fighters grew enormously. These are no sissies. Their job is to keep you alive, and if they need to punch a hole in you to check something inside, they punch a hole in you, unceremoniously. At the same time, they are very well aware that you are a human being, and treat you with respect. This may sound contradictory, and it is not easy to explain, but that's how I feel about it.
After a few days, the team looking after me seemed to converge to a common opinion. I had a very heavy bacterial infection of both lungs. There were large spots showing that, but those spots could also be pools of liquid from what seemed a defective heart valve at the lung/heart interface. Turned out both was the case. The bacterial infection had gotten through to my heart and the bacteria attacked one of the smaller valves. That particular valve had been ripped off its hinges for more than a third of its size. It wasn't opening and closing, but just flapping around like a flag in a breeze. So I had a pump that was leaking, and lungs that only had a fraction of their capacity. No wonder I couldn’t get enough oxygen to my body parts and organs.
First step: get rid of the infections. Surgeons really hate to operate in a bacteria-infested landscape. Because they were a bit in a hurry (the heart could give up any moment unexpectedly), they decide to give me the strongest antibiotic they could find. "You may actually feel it get into the intravenous feed", they said euphemistically. I felt it run as a line of fire, and actually could trace a red line from the feed over my arm into the armpit. I am not kidding you. My only consolation was that these bacteria had it coming to them, hah!
It worked. After 3 days, the anti-body count had dropped so low that, had they detected the infection at that point, they wouldn’t even bother with the antibiotics. Two more days to prepare me for the cardiac operation. They did a full test of the coronal arteries and veins, because if there would be a reason for bypasses now or later, they would just do that at the same time. (“See Mr. Didden, we have this special offer. You get a valve repair, and we throw in one large or two small bypasses for free”. Just kidding). Turned out that there was no reason whatsoever to consider any bypasses.
I spend half an hour with the cardiac surgeon on the strategy of the repair. Basically, there were two options. Either repair the valve, or replace it with a biological/mechanical part. These are quite small parts, max size less than an inch. Either way would be good for another 40 years, and it was unlikely that I would worry a lot about it after that point in time. The only drawback of the replacement strategy was that I would need to take medicine for the rest of my life. Not catastrophically, but a nuisance. We decided on a step by step approach. He would do the repair as best he could. Then, temporarily halting the operation, they would insert an ultrasound probe down my thorax. These are normally used to look at your thorax and stomach, but can very well be used to look to the heart from the inside, as it is. After taking a good look at the repaired heart in real-time operation, he would decide to continue with the repair or switch to the replacement mode.
The operation was set for Friday morning 8 April. The infections were gone, I was still fit and healthy, and all indications were green. I looked at my surgeon, realizing that the quality of my next few decades in life depended a lot on his proficiency. He smiled, confidently. You’ll be OK, he said.
Saturday morning around 10 AM I called a friend. Hey, she said, I thought you were going to be operated yesterday? “I was, but I thought I’d not call you too early, I know you like to sleep in Saturdays”. The operation was a 100% success. The repaired valve set worked flawlessly, the heart beating strong and regularly. The ECG was perfect. To say that I felt pretty good must be the understatement of the year.
That was one week ago. This morning they ripped out the last couple of thin wire pairs terminating in female 2mm jacks, that were still dangling from my chest and could be used for external heart stimulation should that have been necessary during or after the operation. Next week I will embark on an extensive rehab process, to get my cardiac and lung capacities back to what they were before the operation. It will be several months before I get to that point, but I can already function independently, with some caution.
I will also do a lot of thinking, and replay the thoughts I had during the first few days when everything appeared to go down the drain. Life is very, very brittle, and I want to restructure mine to enjoy it as much as possible, more today, leave less for tomorrow. Also, this period has shown me clearly who my real friends are, and I want to intensify my social life with hem.
Why do I tell you guys all this? I’m not sure. One reason probably is therapeutic, to get it off my chest. Another reason is that I feel that we at DIYaudio are somehow family, and these are the things you tell family about. I felt I also needed to explain my long silence since I had a few private discussions going on, which I will pick up again at the course of next week.
Thanks for listening, and have a nice day.
Jan Didden
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