Heart Strong - The Sequel

"A well adjusted person is one who makes the same mistake twice without getting nervous." - Alexander Hamilton

It is ten o'clock at night and I am trying to drink as much as I can.  As of midnight, I'm cut off.  Tomorrow is heart surgery - the sequel.  I am nervous.  I don't know how I will cope with the pain of another surgery.  Today I went for pre-op testing.  I had a long chat with a nurse practitioner.  She gave me a book about life after defibrillation implant and told me to read it so I could ask whatever questions I may have tomorrow.  It struck me as bizarre.  The lifelong implications of the implant are significant.  It seems to me, they should have talked to me about them before they put it in my chest.  Nonetheless, I am an educated patient.  I've already read volumes about the procedure and the ramifications.  It is the procedure I wanted to avoid and just opt for having my pacemaker upgraded to a biventrical device.  But after a lot of reflection and discussion, I could not ignore that my three cardiologists agree, the chance of me having a heart attack is just too high. So here I am, the night before another surgery, fretting about the coming day.

I asked the nurse practitioner to remind the surgical team that the local anesthetic I had for my last two procedures did not work.  In both events, it took them three tries to elicit a reaction.  In both procedures, the anesthetic wore off before the end.  The pain was breathtaking.  I get that it is better for me to avoid a general if I can, but there is something seductive about the idea of going to sleep and waking up four hours later with the procedure done.  Four hours is a long, long time to lay wide awake, immobile on a table.  At my last pacemaker surgery, they administered a sedative to help me at least be groggy.  I did not respond.  They tried again.  I did not respond.  They didn't bother a third time.  And while they normally administer a sedative during an angiogram, given my history and serene demeanor, they didn't bother at all.  The procedure was only supposed to last an hour and a half.  It lasted three and a half and I had a vasovagal incident in the middle of it from the pain.

I am tired tonight and I want to go to bed but it is too early.  I need to keep hydrating.  The more dehydrated I am, the more difficult it will be to get the I.V. into my already fragile veins.  The more times they need to stick me, the more pain I will have.  The nuclear scan I had in November took seven tries.  God help me.  I can barely face tomorrow.