Life in the Real Desert: Pilgrim’s Progress

Author photo March 2013
Finishing my first cup of tea and ruminating over the past few days events has left me with an epiphany of sorts. Let me explain: Back in 2012 while I was in Basildon Hospital, in the UK, and recovering from the dual surgery that saved my life, I got a visit from a lovely lady who worked in the medical facility. She warned me that one day, it would all sink in about how close to death I had been. “It is usual for survivors to experience crushing depression,” she said.

Well, it is now over two and a half years since that fateful day; where my universe shrank down to a tiny space of unbelievable pain, and that depression has still not made an appearance. Certainly I do feel down sometimes, these happen at the oddest times as well. Yesterday, for example, had this new desert dweller becoming the recipient of not one, but several acts of kindness. Yet when arriving back home, I was caught up in a blue funk that lasted till sleep.

Most of that was from being overly tired. My only mechanical mode of transport was out of commision for a few days, requiring a back inner tube, so it was two days of attempting to patch said tube and one day of angrily marching a total of 3.5 miles only to realize that by the time I got to the store it would be closed. It was then a much slower trip home as the anger was spent and I was tired, after all the wasted adrenaline drained away.

That walk, although not too hot according to the thermometer, beat the hell out of me and for the next two days I hurt everywhere. Lesson learned: Do not storm off on a moderately hot day in a foul mood.

This pilgrim’s progress has been slow and not just to adjusting to life in the desert here in the southwestern state of Arizona. The reason for this slow acclimation to things since that August day where I should have died not once, but twice, came to me this morning after an odd dream in the wee hours just as the sun was peeping over the mountains in the east.

Sleeping fitfully, I moved between dozing and wakefulness, I thought, all night. As the sky began to light up, I was laying on my left side, half-awake and grumpily cursing the doves and their annoying nest noises; they stomp on the brittle twigs making a sound like people walking on gravel which is very disconcerting when half-asleep.

As the birds settled down and began to make their cooing noises, I felt the cover beside me move. Four little feet made their way to my back and a small warm body then lay carefully next to my upper back. I could “feel” a bushy tail move up near my neck and could “smell” a fusty fur smell. I instantly relaxed, although in the back of my head was the awareness that there are no animals in the place, and felt totally at peace as sleep reclaimed me.

That this was a dream became apparent later when I had an amusing thought that I could well have a wild skunk lying right on top of me and I turned to see what was snuggled against me. I found a rag doll in the shape of pointy nose elf-like creature with a sewn on striped cone hat. We conversed, as one does, with no words but in our heads.

I did actually wake up at that point and found that I was alone and pondered the doll thing that my mind had dredged up. It made no sense, after all why would a two-legged doll walk on all fours to get across my cover. It was a surreal moment and the realization that it was so brought on my epiphany.

Speaking to someone a few days ago, I mentioned the forecast of massive depression from the medical lady in the hospital and said that I was still waiting for that shoe to drop. My “light-bulb” moment this morning was that this will not occur. What has happened instead is a constant state of surrealness, if you will.

I left Basildon Hospital (the cardiac section) four days after one of the most invasive surgeries one can endure, the first surgery should have been so routine that it was boring, and everything, it seems stems from that time. My second surgery took a long time, during which I was “technically dead.”

A machine kept my blood pumping and my lungs breathing while the doc’s stopped my heart to perform the aortic dissection and bypass, this after they whipped a vein out of my right leg, and the estimated time I was “dead” was around eight or more hours. Now, if you had asked me after I recovered from this procedure how long I was “out” or how long I was “dead” no answer would have been available. A lot of remembering had to happen before I could recall and this only happened after I asked my daughter, who had to live through all this.

The point being that from the moment I was moved from ICU to the recovery ward, everything has seemed surreal. You could even argue that my waking up during the first surgery, when they discovered that my aortic arch had been perforated and most of my aorta was split open, and managing to talk around the tube in my throat started the whole thing. This also is the reason, I believe, for the “gravel” in my voice since the surgery.

Sidenote: To the family who were staying in Basildon Hospital with their own medical emergency, “Thank you for the kindness you showed my child who had to deal with all this on her own.”

The epiphany this morning has been that I have never really gotten over the surreal stage of this whole heart attack malarkey. My brain seems to be operating in a sort of fugue state of semi-awareness with small moments of clarity. At times I can almost react to things normally but there is still that feeling of unreality flitting around the edges.

I find myself unable to function properly in social settings. The actor in me puts on a good show, but basic things like exchanging phone numbers while interacting with another person who has just asked for mine go by the wayside. Just trying to remember to thank someone for a good deed or act of kindness is also fraught with inactivity or at least poor responses.

Anyone who has known me well can tell you that I have a radar that can tell when a person is on the level or not to be trusted almost seconds after meeting them. That ability seems to have been left on the operating table along with some of my common sense. How else can I explain being taken in by a con artist so completely that I moved in with the bugger, and his wife, and only woke up after it seemed I was about to be made a patsy? (And upon learning that he was a “wanted” felon.)

There are a long list of things that all point to my mind still existing in this surreal state. A place where my subconscious is attempting to get round surviving back in 2012 and despite my resolute marching forward to this new beat of the drum, I am struggling. Not desperately, but just enough that my thinking is affected.

Everything happens for a reason. I firmly believe this, just as I believe that my “pilgrim’s progress” here in the desert is needed at the point in time. A step back from busy society and a chance for me to get my soldiers back in step. This quiet time is needed to help me get back on an even keel, or at least recognize that moving back to the foreign country I left so long ago is either my new “normality” or just another turn of the screw in my current directionless journey.

Time will tell and at least now I can realize where my “head is at.” Even if it took a two-legged dream doll to point me in the right direction.

19 May 2015

Michael Knox-Smith

Matters of my Heart…

English: A thoracic surgeon performs a mitral ...
English: A thoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. Slovenščina: Kirurgi med operacijo. (Photo credit: Wikipedia)

It’s odd. I’ve been sitting here wondering about the bypass surgery and how they went about it. Oh I know what goes on I just don’t know the specifics. *And before you say anything, yes this will be the last time I write about the adventures of my heart…maybe*

After the surgery and before I was allowed to go home, we had a briefing from a lovely lady who was a cardiac specialist. She motioned for  me and my daughter to sit down and then after setting herself down  looked at us and smiled.

“Are you ready for your new life!”

She then went on to say that after the first few weeks, my diet did not have to change one iota. When I questioned this she smiled and said, “You are in recovery mode right now. You can eat whatever you want  and as much as you want. After that the ‘new rules’ will come into being, but we’ll talk about that a little closer to the time. Welcome to your life changing event.”

That  whole somewhat surreal conversation got me thinking then. All sorts of random thoughts swirling around in the  nooks and crannies of my doped up mind. The lady did ask us if we had any questions. I didn’t bother. I was high as a kite with all the ‘feel-good’ stuff they had me on and I knew  that I’d never remember any answers to anything I might ask.

It was only later that, in between pain medication doses, that I started wondering about the whole process and what it ultimately might mean. I know, for instance, that at one point in the procedure they stopped my heart and used a machine to breathe and pump blood for me while they worked on my heart.

Does that mean that, technically at least. I was dead? If I was ‘dead’ would I now be able to ‘see’ dead people? Or go on the road telling fortunes  like some sort of fairground gypsy?

Leaving the fanciful questions behind for a minute, how about when they ‘pulled’ my ribs apart? Did they use some sort of fancy gleaming chrome bolt cutter thing that would look more comfortable in a Slasher movie or something else. Staying with the ribs for a moment longer, how did they ‘wire’ them back up? Did they use some sort of super-glue, or did they use some sort of titanium wire?

When I look at my body I see a mass of stitches and swelling and different shades of bruises. I look like the survivor of a plane wreck or like a chap who went two seconds with Mike Tyson when he was on form.

Mike Tyson: Main Event
Mike Tyson: Main Event (Photo credit: Wikipedia)

The whole time I was in hospital the staff kept telling me how great I looked and how wonderful my colour was. If that was true, why do I now look like a 95 year old anemic albino who is tottering slowly towards the gate to the afterlife. Were they exaggerating wildly so that I would check out early and let another customer in?

I can see them now waving at the car I was being driven away in, their other hand over their mouth and giggling uncontrollably. “Can you believe he fell for that!”

Apart from the more immediate events (surgery, re-hab, et al) I also wonder about the long term affects. For example, I had a friend who had his gall bladder removed. No real dramas here, but, ten years later after complaining of an internal pain that the doctors could not pinpoint at all. They opened my friend up for some explorative surgery. They found a set of forceps and a few sponges in his cavity. Not surprisingly,  the pains stopped soon after.

I once met a chap who swore that his grandfather had something similar happen to him. Back in the days when surgery was more of a ‘by-the-seat-of-your-pants practise than today, his grandpa had his appendix removed.

Now grandpa was a big fellow. Tall and big-boned he had worked for years as a circus strong man. His appendix was really causing him some pain, so surgeons quickly got him under knife and had the troublesome organ removed.  Everything was fine at first. Then Gramps began to get hot flashes, hear voices and feel little tremors in the area of his operation.

Doctors admitted that they were puzzled about what was causing these mysterious symptoms. Explorative surgery was quickly set up for the next day. The old circus strong man came in and got ‘prepped’ for surgery.

Surgeons had not even finished their first incision when a pair off hands shot out of the freshly made hole and started pulling the edges apart. The anesthesiologist and two nurses screamed and passed out. The surgeon watched in disbelief when a small medical technician came clambering out of grandpa.

It turns out the the technician had fallen in while over stretching him self to retrieve a clamp. Before he could raise anyone’s attention the surgeon had sewn the circus strongman back up. The hot flashes were from the small tech’s lighter. The sounds of voices had been him screaming for help and then talking to himself. The tremors were from the same technician who kept attempting to climb his way out.

Physically the man’s grandfather recovered well from the surgery. Mentally he did not make out so well. As he got older, the old man had developed the odd habit of screaming and cursing at his stomach if he got a touch of indigestion or heart burn.

So I’ll wait to see what, if anything, was left in my body after my operation. I haven’t got quite the girth of grandpa so I think that small medical staff don’t stand much chance of being trapped in me.  Although I do at times feel like I have a tray or something in my chest after the operation.  So I might have a medical tool tray in there.

Or nothing at all. Medicine has moved on after all.

From a B grade Slasher Film
From a B grade Slasher Film (Photo credit: n8k99)

Don’t Go Breaking my Heart…

Bypass graft.

So come to find out, the hard part of my surgery was the bypass bit. Hard to perform and harder to recover from. When we arrived at Basildon Hospital and the local experts explained what would happen and how long it would take, I can remember very little. A general air of Bonhomie and an industrious feel about the whole thing was what I remember best.

With my daughter’s help, I can reconstruct the series of events. It would take at least the two of us anyway. Meg was in a bit of shock and I was so stoned from the pain medication that I made Keith Richards‘ look tee-total.

The first decision was easy. From my view point it was, “Blah, blah, blocked artery, blah blah, Stents, blah, blah, easy surgery.” It was all very relaxed and ‘Pip Pip cheerio old man’ we’ll be done in time for a cuppa tea and some biscuits.

Meg was able to get a bit more out of the conversation than I could in my drug induced euphoria. Her job (at least she felt it was her job) was to listen to everything they said and try to digest what was happening. She heard, “We’ve had a look. He’s got a blocked artery and we can put in a couple of stents. Very routine and it will take no time at all.”

Of course after this straight-forward and relaxing briefing, it went nothing like that at all. While putting the stents in they found another couple of problems. Sewing me up quickly they withdrew me from the ‘routine’ surgery room and I was ‘prepped’ again.

They asked me if I had a better leg for veins. Which leg had the least amount of varicose veins. But, like the earlier conversation, all I heard was, “Blah, blah, Veins. Blah blah, Bypass, Blah blah Tear.” Again Meg had to listen and pass the information on when I was less ‘doped up.’

It seems that I had a ‘dodgy’ vein and they would have to replace it with one from my right leg. There was also a ‘tear’ in The Aaortic  Valve that could turn nasty. This was all emergency bypass surgery and the bit that ‘kicked my butt.’ The valve would be watched throughout the surgery as this might have to be replaced with a ‘fake one.

The vast majority of this information is very much after the fact. Repeated conversations with my daughter has allowed a better piecing together of the events.

The bypass surgery bit I knew very little about. The stents I understood as my dad has had them a couple of times. I’d had an uncle who’d had a Triple-bypass surgery done when he was a couple of years older than me. He used to carry nitroglycerin tablets with him. He would be out cutting the hay and stop and put one of these tablets under his tongue.

I am going in this afternoon to get stitches removed by my local surgery’s nurse and start my first real steps to recovery.

It is all very different this surgery. I was sitting here thinking  back to my major back surgery in 1999. It was long and for the most part uneventful. It did not fall into the realm of ‘life threatening’ at all.

Of course neither did my ‘blockage’ operation until they discovered that I had deeper problems than they initially thought.

If you or a loved one (family, partner, spouse, et al) are due for bypass surgery, which is the one that requires the most work and ‘down time’ for the patient. Google it. If you are lucky you’ll know way before hand that you need bypass surgery and what that all entails.

I was wonderfully lucky. I had a team of top-notch professionals who knew what they were doing and were careful to let us know as much as possible about what was going on in the limited time they had.

So the bypass surgery was an emergency surgery, but, the recovery time was not. Despite having to check my torn Aortic Valve regularly I never felt that did not care about my recovering or that they were ‘put out’ by having to do a ‘running’ check on me.

A lot of people moan about the National Health Service (NHS), me included. But this is twice in my life that the NHS has stepped out smartly and taken brilliant care of me.

In the USA as far as I know they are still fighting for an American version of our NHS. Well let me tell you something mate, I’ve  had health care under both existing systems and I can’t say one negative word about the NHS.

If I do, they might want their stents back.

This little stent went to market…