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Take It from Me: Heart Surgery Is Best Avoided

Folks: take care of yourself now to prevent this agony.

by
Clayton E. Cramer

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August 9, 2013 - 12:00 am
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A few weeks back, I told you the horrifying story of a kidney stone that needed to be surgically removed in the hopes of scaring you into drinking more water. Reader response indicated that it worked.

Unfortunately, “kidney stone” had a sequel for me, one even more terrifying, horrifying, and shocking.

Medical tests during the kidney-stone crisis explained some other symptoms that have been gradually worsening for me over the last several years. The diagnosis was aortic valve stenosis, a stiffening of the valve that feeds oxygenated blood to the rest of the body. This is primarily a birth defect associated with aortic valves that do not have the normal three leaves. This was causing not only breathlessness, but permanent heart damage, and led to something far worse than kidney stone removal: heart surgery.

Please learn from my following medical adventure, to avoid my suffering. (While primarily a birth defect, better diet and exercise programs the last thirty years might have delayed this agony.)

I suspect that most people, unless they know someone who has gone through heart surgery, underestimate how much pain, time, and cost it involves. Search for “double bypass surgery” news stories, and you might almost get the impression that it is not really all that bad — a very common procedure that is just a bit worse than a tonsillectomy. This may be one of the few cases where the news media fail to adequately convey the seriousness in pain, time, costs, and risks of what is a surprisingly common procedure (230,000 procedures a year in the U.S. costing about $144,000 each).

Let me start out by explaining that I was actually pretty lucky on this — I was able to have a “keyhole” aortic valve replacement instead of an open chest procedure.

What did they do to me?

1. Heart-lung machine at the right groin artery and vein. (You don’t think they are going to replace a valve while the heart is running, do you?)

2. Cut a keyhole through the muscles of the chest.

3. Spread a couple of ribs apart.

4. Cut open the aorta through the keyhole.

5. Remove the malfunctioning valve.

6. Sew in a new bioprosthetic valve made of Dacron and (in my case) a horse aortic valve. (Yes, I can now boast of at least being valved like a horse.)

7. Sew up the aorta and close up the keyhole between my ribs.

8. Leave two sharp plastic drainage tubes in the chest that you feel every time you cough, breathe, or move for the next few days. They come out two days post-op, and they hurt when they come out, but at least they stop intensely hurting then.

9. Leave two electrical leads in place for a couple of days in case the doctors decide that you need a pacemaker. To quote the nurse: “Most patients say that removing them feels ‘funny.’” No, there was nothing confusing or ambiguous when the nurses removed them two days post-op; they hurt enormously.

The surgery took five hours on a Friday. I have a few thankfully vague memories of the recovery room, of which the worst was that I still had a breathing tube down my throat and I was gagging. (Yes, my anesthesiologist warned me that this would likely happen.) I don’t remember if I was strapped down to prevent me from pulling it out, but I suspect so.

Saturday was one enormous fog of pain, confusion, and despair. I was aware of my surroundings, but the details made no sense to me. My family was with me for most of this time; the nursing staff at St. Alphonsus’ did a spectacular job of trying to alleviate my suffering, but there are holes in your chest, and every time you move, cough, or inhale, it stings incredibly. Even if you stop breathing it hurts, pain the narcotics only dull but do not eliminate. You are coughing up occasional globs of clotted blood, perhaps from being on oxygen, which dries out your airways. You can’t really sleep, except in a narcotic stupor.

Every couple hours around the clock someone comes by to poke the end of your finger for a blood sugar test. Why? I did not know this: major surgery causes your body to release a flood of sugar, even if you do not have diabetes. This requires IV drips and separate injections of two different kinds of insulin to try to balance it out, because all that blood sugar screws up healing of blood vessels.

Sunday was perhaps the worst day. I was coming out from under the anesthetic fog enough to fully appreciate my pain and helplessness. At the same time, the hurt of breathing, moving, and extreme constipation caused me to wonder if I might have been better off dying on the operating table.

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Top Rated Comments   
when I was diagnosed with CLL 6 years ago I was feeling fine and had a hard time believeing I had just got cancer. After a dozen bone marrow biopsises, a splenectomy, and 11 months of chemo, I was a shawdow of my fomer active health self. Since then I have had to endure having 8 freckles that turned black cut out of me, my splenectomy closure repaired (insisinal hernia), one failed and one good kidney stone removal, my appendix removed, and four lipomas removed one at a time when they have grown through nerves and become too painful to take anymore. This does NOT include any of the side effects that I have to suffer everyday from the cancer, chemo, or side effects from the numerous drugs they tell you are needed to survive.

Since I lost my job, life savings, and ability to work, I was forced to go on medicade and live through that disaster of funding cuts and regulations that always seem to come to the same conclusion: you cost too much!

When I could not afford the poisons they perscribed to me any longer I was forced to quit cold turkey over a dozen medications that I had been hooked on for over 5 years and coming off of those was WORSE that any of the operations that I have listed above, but I survived that too through sheer will power, luck, and the love of my wife who has stood by me through it all.

Since then I have had the time to investigate BENZINE, which is the LEGAL chemical that gave me cancer I have found out that the food we eat, the water we drink, and the very air we breathe, is chock-a-block full of poisons and most of them are known to cause cancer but our gubbermint does NOTHING to ban these harmful products because of big time corporate donations to our corrupted politicians, so telling people to "eat healthy" and exercise, is a joke because if you don't grow your own food in sertified and tested clean soil with NON- GMO seeds and tested water inside a filtered greenhouse with similar care taken with your feed/food animals, then don't bother because some toxic subsatnce somewhere will invade your body and exploite whatever inherant weakness you have within you. This all happened to me pre-obamacare, now they even charge you for ANY diagnostic images like x-rays, MRI's, or P.E.T. scans.

The best advice I can give to all of you is to live your life to the fullest EVERY day, love, and be happy, because it can all go away in the blink of an eye and once its gone there is no chance to return to the way things were before you got sick.

51 weeks ago
51 weeks ago Link To Comment
All Comments   (41)
All Comments   (41)
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I got confused by your registration process, and hope this isn't a second posting. I know to make a copy of my comment before going off to new screenland ... On July 3rd I had what was termed "major surgery" to remove a benign myxoma tumor from my upper left thigh. I will die before having another major surgery it was so screwed up. Which gets me to a story from a cardiovascular surgeon I was dating who told me that "the evil of good is better". Here would be this heart surgeon, who had performed a perfectly adequate heart surgery. It was "good" enough. Then they started tinkering to make it "better". Every second a patient is on a heart-lung machine, the body is dying. He is struggling to keep the patient alive on a machine, and the surgeon is trying to make a good enough heart surgery "better". He was pretty riled up about it and said a few patients died because of it. Just seemed appropriate for your column. I hope you are feeling better.
49 weeks ago
49 weeks ago Link To Comment
Sorry, I was dating the anesthesiologist, not the surgeon. That's what happens on second drafts ...
49 weeks ago
49 weeks ago Link To Comment
And fitolddog.com motivated me to get back in the game of Life!
50 weeks ago
50 weeks ago Link To Comment
Wow, a cautionary tale for all of us. I never want to go through something like this. My back surgery, losing 1/3rd my colon, and a couple others, were enough for me. I see so many, many obese people, their future is so bleak. Please, recommend everybody you know watch Fork Over Knives (scalpels). Embark on new diet (I prefer vegetarian, check out engine2diet.com), and exercise. Life is too sweet to lose any of it.
50 weeks ago
50 weeks ago Link To Comment
Hallelujah Diet (hacres.com), esp. the carrot juice!
50 weeks ago
50 weeks ago Link To Comment
I hope and expect you will be feeling better day by day, Clayton.

I'm 54, and had mitral valve replacement last November. Not to be competitive, but it involved the full chest-crack; and because the mitral valve is entirely on the heart's interior, they have to slice the heart open to get to it.

Pretty sure it grew out of a congenital issue, not via lifestyle.

It took longer to feel great than I had anticipated, but by about 5 months out I was in pretty darn good shape. Now taking 20-mile bike rides with no problem.

So the surgery's no picnic, but it beats the alternative by a long shot. 40-50 years ago people just lived with these things til their hearts gave way, and that was that.

When it was my turn, I couldn't help but be amazed and moved by what they can do. And "they" are incredibly bright and committed people; I'm grateful for them, and for the patients who suffered during what must have been a learning curve.

Go find the Charlie Rose interview with Alain Carpentier, who pioneered this surgery and the animal-based replacement valves. You may weep a bit, and be touched by the hard work of people who insist on making things better. We gripe and moan about quite a bit, but humanity's really pretty amazing. And this is a pretty good time to be alive.
50 weeks ago
50 weeks ago Link To Comment
I agree with you -- what our much denigrated medical system in America can do is AMAZING! And I have nothing but the greatest warm feelings for the RNs and CNAs who cared for me at St. Alphonsus. They did their best to make a miserable situation as good as it could be.
50 weeks ago
50 weeks ago Link To Comment
" cracking open the rib cage."
In 1999 was the beginning of my lessons when my Mama had her heart opened up.So i keep my stomach a hard six pack at 62 years old so tough no knife can cut it open I want to believe. That year was only the beginning of what I've seen. But for years before that wonder how doctors could give medication to "crazy" people making them 100 to 200 pounds over weight their hair falling out and far worse things
So Now i wish there were sights asking how much money is made from the operation and how many sights can you find that offer a way to avoid going under the knife then staying far way from hospitals wondering if all doctors now are dreaming of becoming plastic surgeons because they can make more money
yet I have found doctors in empathy with me and respect my method of staying far away from the big money maker doctor who must serve the money maker hospital
50 weeks ago
50 weeks ago Link To Comment
The real question to ask is: "Can I fix this problem myself cheaper or more effectively than the highly paid professionals?" The answer, for problems like this, is "No."
50 weeks ago
50 weeks ago Link To Comment
I'm happy you were not my consulting physician, sir. You seem to have had either a bad or experience or incompetent care. Eleven years ago, at age 62, after 40 years of careful diet and supplementation, weight-lifting from age 12 and walking 3-4 miles daily (never had a driver's license), I found myself on a painless downward path and at first thought: this is the start of the geriatric state. After a year of this, I was forced to go to the ER by a neighbor as medically sophisticated as I am. They said I had a heart like a lion and my cholesterol was 130, so it was assumed it couldn't be cardiac. They dealt with whatever seemed to be wrong and let me go that day, but I was tested again and again over a six-week period because it was clear something was seriously amiss, though I had no pain and no specific symptom to which we could point.

After a transesophageal ecocardiogram, it was discovered that I had five blocked arteries, not from bad habits but from covert black mold from a flood in my apartment. I was hospitalized at UNM Hospital for a week before surgery, and what was supposed to be a four-hour procedure wound up at ten. All the surgeons but the chief turned down the case, intelligently so. Of course, my sternum was cracked. So I was put into a three-day narcotic coma to avoid painful coughing from the heart-lung machine effects and from the pain it would cause the broken and now wired sternum. I didn't come out of the coma for 12 days. I couldn't walk on my own and the only pain I ever experienced was from the claw my right hand had become from strokes during surgery.

I had three weeks of full-time intensive rehab. I regularly attend cardiac rehab at the same superb hospital (which one does not expect in a poor state like New Mexico). Ten years later, my heart is normal, my hand is not a claw and I keyboard at 85 wpm, down from my more youthful 100 wpm, but I am 72. I am told by lay and medical people that I look 20 years younger than my age. I used a cane as a precaution for eight years, but that was from muscular weakness induced by statins that I ultimately declined. I audit courses at the university, despite my previous two graduate degrees and need doff my hat to no one in the classes.

Had I taken your well-intentioned advice, I would no longer be among the quick. When I suggested chelation therapy instead of surgery, I was told I would not live long enough to enjoy its benefits because of my advanced degeneration.

I know you mean well, but I would suggest you don't know what the hell you are talking about or you don't have competent medical care, despite their genteel behavior. I would counsel anyone in your position or mine -- I always ate sensibly and was no cheeseburger junkie but disasters can still occur -- to check out in advance possible care facilities. Stick to your lathe, sir, lest you bear the burden of needless deaths from your wretched advice.
50 weeks ago
50 weeks ago Link To Comment
Sounds like you are very bitter about your experience. I wouldn't take the advice of anyone off the net so I would like to thank the author for informing us of his experience and no two people are the same. You putting your experience on top of his and chastising him is slightly bizarre. I will give my opinion it sounds like you are having PTSD from the trauma and to take it out on the author will not change your experience, cure you, but perhaps you feel a little better venting. Best of luck.
49 weeks ago
49 weeks ago Link To Comment
I think you might not have read all the way through the article. Surgery is best avoided by lifestyle choices that reduce the risk. Sometimes you don't have that choice; mine was the result of an apparent birth defect.
50 weeks ago
50 weeks ago Link To Comment
I would also advise any of you: Avoid Multiple Myeloma if you can. In spite of being in superb physical health, cancer; (MM) beat the Hell outta me. Compressed vertebrae in my back and with a dependency on chemo-drugs for the foreseeable future. MM is not curable...yet.

2.5 years of chemo, steroids, Revlimid (which I still take) cause my GI tract to rebel. It's a constant balancing act of Immodium type pills along with the poison that is chemo. In spite of my best efforts, fresh fruits & vegetables, some of my favorite things, turn to liquid inside of me now. Costs to date: $300,000 and counting.

I'll say this: I went from suitable for framing in Joe Boxers to a wretched cripple in a wheelchair for months to being almost (almost) all the way back except for the f'ing cancer.

Everyday I am, still here is filled with incredible beauty. Life is a miracle. As Warren Zevon used to say: "Enjoy every sandwich."
50 weeks ago
50 weeks ago Link To Comment
Clayton, thanks for your article. If anyone thought it was magic, or fun, I hope they learn from your story. OTOH, my grandparents died before age 60 because they neither knew to watch their diet and weight, nor did they have today's medicine available. OTOOH, what I hear is that there are many cases with far worse outcomes than yours, where the patient lives but is never the same. In the best of cases it takes on the order of six months to return to what is ever going to pass for normal.

Just today my cousin is in for some fixup a month after breast cancer surgery and the following reconstruction. That has not been fun, either. Both she and her husband are medical professionals, but when it's your turn, well, there you are.

My take on this is the error rate for everything that goes on in hospitals, so that whatever the technology is capable of in theory, one wonders how the results turn out in the real world, in practice. If you get out of the hospital and have a reasonable chance at recovery, you've already beaten the odds somewhat. Keep rolling your lucky dice!
50 weeks ago
50 weeks ago Link To Comment
It can be even worse yet. My wife recently reconnected with a good friend whom she had not seen for years. They were getting along well and catching up on old times when her friend went in for what was supposed to be routine heart surgery.

About two hours after she had the surgery her heart stopped. They rushed her back into surgery, opened her back up and massaged her heart. She recovered, but died a few days later. It was verry sad.

I think the lesson is, there is no such thing as routine heart surgery.
51 weeks ago
51 weeks ago Link To Comment
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