So, pre-surgery assessment day – at least the medical, hospital-bound portion of it, is in the books.
I was up at 5 a.m. to be in Halifax at the QE2 Health Sciences Centre for 7 a.m.
The first two hours and change was filled with the very standard fare for anyone who has been through any kind of surgery before.
Sharing my full medical history and undergoing a physical. Meeting with an anesthetist to discuss my history with anesthetics and what sort of side effects I can expect. Blood work. A discussion with a clinical nurse about the self-prepping I have to do before tomorrow’s scheduled surgery, including washing myself down with an extra special germ-cleansing solution.
Stop all medication – no problem, I, somewhat miraculously, haven’t been on any since 2001.
By 9:45, all of those various items had been checked off the list. It was now just a matter of waiting to speak with my surgeon, Dr. Stacy O’Blenes, about my surgery.
An hour passed.
Then two.
Then three.
Now, the staff at the pre-admissions clinic were, of course, beyond good to me. The would frequently poke their heads around the corner or suggest I go grab a bite to eat. I was able to keep myself entertained between texting with the outside world and slipping out my netbook to enjoy a few minutes of Will Farrell’s classic, Anchorman.
By early afternoon, I was on the cusp of dozing in the waiting area.
I was the last remaining relic among the outlay of patients and admittees who had materialized first thing this morning.
Mid-afternoon, Dr. O’Blenes emerged, fresh from a procedure he was performing at the IWK Children’s Hospital down the road.
We talked about the procedure that was coming in the morning and, for the first time, I received word from the artist himself of exactly what the decided course of action will be.
Dr. O’Blenes confirmed that he would be replacing my aortic valve and that, with my consent, his preference was to put in a metal valve. A tissue valve (from an animal) would have a lifespan of about 10 years before it began to wear out. Not wanting to see me again, he strongly recommended the synthetic valve.
A metal valve, of course, comes with its own issues. They are imperfect devices. They tend to cause blod clots, which can cause strokes. I will be on blood thinners for the foreseeable future, until the next great leap forward in medicine comes along. What’s even more complexifying (yes, let’s make that a word) is the fact that my diet can alter the effectiveness of those blood thinners. Details to come on that.
The other big reveal from the good doctor is that he is anticipating widening the scope of the initial planned procedure. Not only is the part of my aorta below my existing Dacron tubing enlarged, but so, too, is the section above the tube, through the ascending aorta to the arch.
Dr. O’Blenes said that his preference, assuming that the wall is thinning where the enlargement is taking place, would be to replace that section of my aorta as well. Because of its proximity to the aortic arch – and its vessels – it is a riskier procedure.
My body will be cooled, my metabolism slowed, my brain supplied oxygenated blood through other vessels while the flow through my heart is completely cut off and isolated for roughly 20 minutes while the doctor stitches my new, larger Dacron tube to the foot of the arch.
As long as that sounds, there is still time to spare … they can keep me under, keep me alive without risk of damage for as long as 45 minutes using this technique.
While not completely confirmed, my feeling from what Dr. O’Blenes was saying is that he will, almost certainly, opt to replace the larger swath of the aorta, rather than just do a smaller piece and the valve and leave the upper section to nature.
The whole experience is loving referred to as the Bentall procedure.
So, where are you, Pat?
As happy as I am that I have a surgeon willing to take a strong and aggressive approach to a longer-term solution (I do love playing the long game), the increased risk of stroke associated with cooling me down does have me … anxious.
Not being blessed with beauty or a full, sexy head of hair, my brain is one of the true attributes I have working in my favour. I don’t like the thought of even risking starving it of oxygen.
But …
… if there is a chance that I can do this in one shot and maybe … maybe … avoid having to go through this life-wrenching process again for perhaps decades …
… I have to do it.
It’s in my nature.
After all, safe is death.
So gear me up, boys … I always thought steampunk, Victorian-era replica clockwork stuff is cool … what better gift than a ticking, flicking clockwork heart?
aorticroot 