RESTORED, RETOOLED, RESPLENDENT

July 25th, 2013

 

That was my toast to my husband last Christmas morning.

 

I could have used a few other R words, like rejigged, recovered and repaired. But we were 18 months out in our medical odyssey surrounding his heart back then and those three fit the bill.

 

We were cavalier when his cardiologist said his aortic valve was wearing out faster than predicted. In fact, it needed replacing five years sooner than expected. But in many ways, we felt relieved that his episodes of fainting and shuffling and puking would end because his new valve would let his overworked heart shrink back to normal size and his irregular heart rate would click back into a normal rhythm.

 

We were also cocky in thinking that surgical procedures can effortlessly fix the cumbersome physical failings of our aging bodies.

In short, there wasn’t one iota of apprehension about Bob’s basic fitness, wellness or will to be made whole again. Indeed, my man defines willpower.

 

Like much in life however, the surgery went well; the aftermath, not so much.

 

First his heart rate failed to take note that there was a brand new titanium valve in place and within hours of leaving the surgical intensive care unit at the Peter Munk Cardiac Centre in Toronto, he was hurried back into the unit with a much more sinister arrhythmia.  In fact, his heart stopped beating for an estimated two and a half minutes.

 

After two more days of cardiac teams adjusting dials on his monitors and me spending nights down the hall in the visitors lounge, a pacemaker was sewn under his left chest wall. For most of that time Bob was blissfully ignorant of any problems other than recovering from having his chest ‘cracked’. We gratefully came home, sprung from the hospital almost at the predicted time and feeling that the worst was behind us.

 

But as John Lennon said: “Life is what happens when you’re making other plans.”

 

I had blithely thought that his recuperation would unfold at our cottage through the spring. I assumed that walking then running would roll out much as it had 20 years earlier when we decided to train for a marathon. It was something that you set your mind to do, read up about it and did.

 

But six weeks after his surgery as he was being dismissed from the surgeon’s care he was felled once again with the original arrhythmia- episodic, unpredictable atrial fibrillation.

 

When I say “felled,” it was exactly that. He toppled over on his way down University Avenue to a meeting. The attack was so severe that once he got to the ER he announced he was having a stroke because as he recounted from his ER bed “ What else could it be?”

 

Stating that you are having a stroke gets instant attention, which is perhaps a good thing to remember should you find yourself entering one of the country’s busiest emergency departments.

 

Once it was clear what we were dealing with – massive a-fib attacks — a chain reaction ensued that within a month had him on 13 different medications and almost paralyzed with fear of an attack that would leave him nauseated, bedridden and unable to do even simple tasks.

 

In July, when I left home to be the camp doctor at a girl’s camp he was feeling so unsafe that friends came by daily to walk with him, almost arm in arm. That is, if he went out at all. He called camp five times a day, agitated if I didn’t pick up, afraid of loosing vital contact. He wouldn’t go into the subway and once threatened to check into a downtown hotel because it was only 100 yards from Toronto General Hospital.

 

By the end of the summer, he was booked for a cardioversion – basically, being tasered while under an anesthetic — in an attempt to get him back into a normal heart rhythm.

 

His medications made his saliva so thick that he would slur his words and that, combined with his fear and loss of self-confidence essentially numbed him into inactivity.

 

My medical partners knew him well and we held an impromptu conference about what was now clearly a depression.

 

Like the shoeless cobbler’s child, the spouse of a physician is late to receive what for most others else would have been an easy diagnosis. Not that he was ready for yet another pill. “I’m not depressed” he retorted, “I’m just sad!”

 

It turns out that a third of patients undergoing heart surgery will suffer a major depression. In fact, most patients headed into surgery are already depressed because heart surgery is a final step rather than a first step like it was with Bob. Most have lost physical capacity for a long time, not to mention their inability to be capable providers or caregivers.

 

But Bob started the antidepressants, the cadioversion was successful and life slowly reasserted itself.

 

Nine months after his surgery Bob went to his office to begin to rebuild his business.

 

In many ways it allowed him a different approach. Starting over from scratch gave him an opportunity to focus his attentions on what he was truly passionate about but had never quite had the time to nurture. His energy returned, we began to breathe easier, even talking about reducing his medications so he could exercise more.

 

One year later we undertook the trip we’d postponed for his surgery and hiked in the tiny Asian kingdom of Bhutan to an altitude of 14,000 feet.

 

I was content, but I began to realize that Bob was just getting started. On his return from the Bhutan trip, he went back to the dietitian he’d visited four times over the last 20 years, each time losing 20 pounds, but slowly gaining it back again.

 

This time however, he kept on going down- a further five, then ten pounds. With great rigor he removed fat from his diet, resulting in an inverse rise in my guilt quotient about my own fat consumption. He is not a big man and spying him down the street one day in the late fall, I appraised him as a tiny stick man with an outsized Scot’s head.

 

He used to run marathons. But now he took up road biking and that bike became his tool for setting longer and longer distances to cover on the weekends. He acquired a FitBit [www.fitbit.com] and quickly realized that 10,000 daily steps were easy, so he upped the ante to 15,000.  The same device also reassured him that he was an extremely efficient sleeper and he now sleeps less than I do, even though I have the notorious reputation as a bad sleeper.

 

His work habit of 10-hour days, seven days a week bounced back full force.

He weaned himself off his antidepressants and was able to reduce the amount and decrease the dose of his medications.

 

And then he wrote a newspaper article called Measuring the Time Left in Your Life. It was one of the best pieces he has ever written, about taking the measure of your life when it’s clear that life has been re-gifted. The article highlighted two apps available to estimate the time you have left [www.deathforecast.com and www.deathclock.com] and titillated the reader’s curiosity to do the quiz.

 

As it turns out Bob’s 79 years and my 83 years are not far off the actuarial tables but what the tables don’t account for is the quality of that time.

 

And that awareness was the spark for my acknowledgement of Bob’s transformation. He truly now is ‘better, stronger, faster’; retooled for a newer version of a finely honed and well-crafted creative process. But and most meaningful for me, after 20 years of marriage and certainly looking forward to the time left, he is a man newly alluring, captivating and indeed resplendent.

 

And that is saying a lot at 70.

 

Dr. Jean

Marmoreo

 

Doctor. Writer. Athlete.

Advocate. Adventurer.