Mar 11, 2012

Adventures in Open Heart Surgery Part 2

The nurses started calling the pharmacy for more meds.  They couldn't seem to stabilize both his blood pressure and his heart rhythm.  I could tell the surgeon was starting to worry.  Suddenly Mark started throwing up and things started to get slightly more frantic.  His blood pressure shot way up then dropped to that the top number was in the 50s and 40s.  They started suctioning him out while still trying to find the right combination of meds to stabilize him. Then they put him on a BiPap machine to force air into his lungs.  He started talking to me.  "I'm scared.  I'm scared."
"I know sweetheart.  You're okay.  They are taking good care of you."
"I don't want to die."  His eyes were open just little slits.
"You're going to be okay."  He was so scared it was just heart breaking.  I couldn't do anything.  The surgeon got the ultrasound tech there to do an echo-cardiogram on the heart.  The nurses kept asking me if I was okay.  I would tell them I was fine.  I felt very peaceful.  I stood by Mark and held his hand.  I continued to tell him everything was going to be just fine.
Mark suddenly opens his eyes wide.  "I see my mom!"
"You see your mom?"
"I see her!  I wish you could see her!"(he later described her as being dressed in white with her hair done and smiling at the foot of his bed)
"She's just here to take care of you.  She's being a good mom."
He nods.  I back off down by his feet while the nurses work on him and rub his feet to let him know I'm there.
Then he tries to sit up, "Danielle!  Danielle!"
I run up by his head, "I'm here.  It's okay."
"I couldn't see you!  I thought you were gone!"  His shoulders relax and he lays back down.
"I'm not leaving you.  Don't worry."
They start the echo.  I heard this strange noise coming from the ultrasound.  I thought maybe Mark was coughing.  I realize that it's his heartbeat I'm hearing.  It has no rhythm and sounds like whooshing, slushing and gushing.  I have never heard anything like it.  The number of nurses is starting to increase.  I see the worry on the surgeons face.  He is on and off his phone.  He is coming in and out of the room, shouting different meds.  I hear him mentioning the OR.  He brings another doctor in to look at the echo.  They seem to be in agreement about something.  SAM?  I don't understand what they are talking about.  I ask the nurse standing next to me, "What is SAM?  What are they talking about?"
"I really don't know.  This is beyond us here.  You'll have to wait until he can explain it to you.  Are you doing okay?"
"Yeah.  I'm okay."  I realize my body is trembling, but I still feel so calm, so at peace.
The surgeon is rubbing Mark's shoulder asking him how he's doing.  He is such a kind sweet man.  He has so much worry on his face, I feel bad for him.   Then he approaches me quickly.
"Mark has this rare heart condition known as SAM.  Did he have one of those 24-hour heart monitors?"
"Oh!  He did!"  he shouts to the other doctor.  "Dang it!  They thought it was A-Fib(atrial fibrillation)!"  He turns back to me, "He has what they call Systolic Anterior Motion or SAM.  This is caused when a person has the extra tissue growth problem, remember when we talked about that?" I nod.  "Okay, well the combination of the Mitral Valve Prolapse with the extra tissue growth causes the flap of the mitral valve to be sucked into the aortic valve, blocking that valve.  Now, he had this before, but it is rare and so easily confused with A-Fib we didn't realize that's what it was.  But when we repaired the valve and tightened everything up it pretty much just made the SAM worse."  I nod, just trying to take this all in.  He talks so fast. Everything is in such a rush but feels like slow motion.
"I need you to come in close," he says.  He gets right up to Mark's ear and I lean in close.  "Mark?" Mark nods.  "You have something called SAM and it's causing the flap of your mitral valve to be sucked into your aortic valve, blocking the valve.  Do you understand me?"  Mark nods again.  "Now, we have to get you into the OR right now.  We're going to have to go in and just replace the entire valve with a mechanical valve.  We just can't risk trying to repair it again.  Do you understand?"  Mark nods.  "I am so sorry you guys."  Dr. Mitchell feels so bad you can see it on his face.
"It's okay," I say.
"We're trying to get the OR prepped as fast as we can.  I don't know if you can tell, but his numbers are just not good.  Let me show you what's going on with his heart."  He walks me over to the echo.  It is immediately obvious to me that this is not what a normal heart looks like.  He explains the problem and I can clearly see what is happening.  I start to feel a little scared, but I still felt calm and peaceful.  It was as though everything around me was moving so quickly, but I was floating there, just watching it all unfold.  I felt this incredible trust in these doctors and nurses.  They were so serious, but I trusted them with everything I had.
I walk over to Mark and hold his hand.  "Mark?  Do you remember what Dr. Mitchell said?"  He nods.  "Are you okay?"  I felt such a spiritual presence around us.  It was so strong.
"I'm scared."  This whole time with the BiPap it was so difficult to understand him.  His mouth was so dry, his voice was really quiet and it sounded like when someone tries to suck in a deep breath while talking.
"You're scared?" He nods again.  "I know sweetheart.  Dr. Mitchell is going to take good care of you.  Everyone is doing a really good job.  We are getting a lot of spiritual help right now.  I feel it."  Mark is fading in and out of consciousness.
"Mark?" a nurse says.  "We are going to have to put the breathing tube back in, okay?  I'm going to give you something to make you sleepy."  I suddenly realize the room is completely full of nurses(I counted 12 or 13 total), the doctor, the surgeon and the ultrasound tech.  I start to back up to give them room.  They have been so kind, they just working around me most of the time.  They look at me and whisper back and forth to each other.
Dr. Mitchell approaches me, "The OR is almost ready.  We've had to bring people in from home so it's taking longer than what we'd like.   He is just having a rough time getting oxygen so we are going to go head and intubate him now, okay?"  I nod.  "Are you doing okay?"
"Yeah, I'm fine."  I really did feel "fine" despite everything going on around me.
"Why don't you go have a seat over there."
"I'm fine."
"Well, a lot of people pass out if they have to see this, so I just want you sit down for this."
I sit down and try to see Mark.  I am telling Heavenly Father to let Mark know I was there.  I start asking my dad to be with me.  Suddenly I know he's there.  My dad is right beside me to my right with his hand on my shoulder.  I look over and it was like my mind and spirit could see him, but my eyes could not.  I could almost see his outline.  I look over at Mark and realize that he, the nurses and doctors are completely surrounded by spirits.  They have encircled the room.  I felt so peaceful.  It was like I was on sacred ground.
The nurses were intubating him and the tube they were using was too big.  They have to try again.  Mark is so floppy.  The top number of his blood pressure was staying in the 40s, it wasn't going up anymore at all.  They get the second tube in and secure everything.  I stand up and walk over to rub his feet again.  Suddenly he starts to throw up again and there are all these crazy beeps.  They frantically stick a suction tube down to suction it all out.  Then he starts to come out of it.  They haven't been able to put restraints on him and he's trying to sit up, reach his arms out and kick his legs.  The nurse have to hold him down.  "It's okay Mark!" they shout.  "It's okay!"
The surgeon runs in, "Okay, OR is ready.  Let's go."  He walks up to me.  "Things are pretty serious right now.  That's why everything is so rushed.  You doing okay?"
"Yeah.  I'm fine.  I trust you completely."
He smiles.  "Thank you.  Now we're going to get in there and replace that valve completely.  You look tired.  Do you want to go sleep and I will just give you a call?"
"No.  I think Mark would want me here."
"Yeah, he probably would," he smiles.  "Since this is an emergency, I won't have the liaison to give you updates, but I will send a nurse out periodically to let you know what is going on."
"Okay.  Thank you so much."
He gives me that comforting smile.  "It's going to be okay.  I'll see you later," and he runs off after Mark.

Mar 10, 2012

Adventures in Open Heart Surgery Part 1

Mark had really wanted his surgery to happen soon.  He was getting out of breath just getting halfway up the stairs.  His hands started swelling so that he couldn't get his ring off anymore.  He started to cough a lot due to the fluid starting to build up in his lungs.  The idea of having the surgery in less than a week was so overwhelming to me.  I felt that I had so much on my shoulders.  My mom and Christian were coming to Utah to drop Christian off at the Missionary Training Center.  Mark argued that it would be terribly convenient.  I didn't want to inconvenience anyone.  I just did not feel ready.  I called my mom and asked for her input.  She said that if Mark was feeling crummy then we should just get it done.  I gave in.
Originally, the plan was to come in at about 5:45, but they called and asked if we would come in later, at 8am.  We got to sleep in a bit more.  There was so much stress and apprehension around everything it was so difficult to sleep with this all on my mind.  I got about 2 hours of sleep.  At that point I had had a migraine for about 4 1/2 days.
When we arrived at the hospital they had Mark dress in a funky gown that had a heater that could be attached to it.  We were both feeling nervous and felt like the wait was an eternity.  Mark's awesome sister, Jeanette, came with her daughter to wish Mark well. She was able to meet the surgeon, Dr. Mitchell, and ask questions with us.

We said our goodbyes and they started wheeling Mark away to surgery.  Jeanette went home and I went to the waiting room with BFF Kari.
Kari had lost her father the year after I lost mine.  Her father died from lung cancer and had a difficult ending to his life.  We sat and talked about our dads and cried and hugged.  I was so glad she decided to be with me, I don't know how I would have handled it without her.
They started the surgery at around noon.  They had a liaison who would come about every two hours or when something big was happening to give us updates.  About an hour or so into the surgery she came to let me know that they had stopped Mark's heart and that he was currently on the heart/lung bypass machine.  This was strange, surreal and difficult to hear at this point.  I knew that he did not currently have a heart beat.  I just started crying.  It's just an uncomfortable thing to think about that aspect.
After about 2-3 hours they let me know that he was still on bypass and that the surgery was going really well. They had told me before the surgery that, because it was a repair, it would take about 5 hours just to do the surgery itself.  I knew that if the repair didn't work then they would go ahead and do the replacement as we had discussed.
Around 5pm they cam to tell me that he was off of the bypass machine, his heart started right up and they were checking for any leaks and such.  They wanted to be sure that it was a good repair.  Once they were sure they would close him back up.
Around 6:30pm the surgeon came out to meet with me.  He looked tired, but happy.  He told me that the repair was very difficult.  He said there was a tiny little leak but everything looked good and it went very well. I was so relieved to hear this.  I was so excited and anxious to see him.
At about 7:40pm I was able to go up and see him in the ICU.  They called me to let me know to come right then if I was to get the picture Mark wanted of himself with a breathing tube(yes, he is strange, but that's my Mark!).  I got up there, took the picture and just looked at him.  He was started to come out of the anesthesia a little bit.  He was pretty swollen(to be expected), but I was just so happy to see him alive.  They had me step out while they took out his breathing tube.  I still watched him through the window because I was just happy to be able to see him.  Kari stayed with me and we hugged and cried.  Then we decided that I would be okay and she could head home to be with her family.

I came and stood by Mark while the nurses got things situated.  I grabbed his hand and he squeezed back.  It was such a nice feeling.  After a little bit I started to notice his heart rhythm was a little off.  The nurses seemed calm so I didn't think much of it.  Then I noticed they started talking about his blood pressure.  A healthy blood pressure is about 120/80.  I didn't notice what the bottom number was, but the top on was in the 70s.  Another nurse came to join.  The surgeon came in and they started discussing his heart rate and blood pressure.  I asked one of the nurses if this was a fairly common thing.  She said, "Ummm, well...iiit happens from time to time."  Not really an answer that comforted me.  I felt really calm still.  Everyone seemed to now what they were doing.  Things started to change though, and change quickly...