After spending the better part of last Friday at the University of Michigan’s Frankel Cardiovascular Center in Ann Arbor, I’m pleased to report that another item has been checked off my to-do list: pre-op visit.
It was the usual stuff, including bloodwork, an EKG, chest X-ray and the dreaded “tiny camera down the throat” TEE echocardiogram. Let’s discuss.
* * *
The shadow knows
Funny thing about chest X-ray results, sometimes nipples show up as dark spots and look like something bad when it’s not. It’s just your nipples. And not only in women. Men, too. So, before a chest X-ray, they provide tiny, round plastic things called nipple markers to stick on your, well, nipples.
Who knew? Not me. So I asked Bowtie Ed about it.
“The markers are a useful technique in the evaluation of densities overlying the expected position of the nipple on a chest radiograph,” said the dapper X-ray technician. “Not uncommonly, a small round opacity projects over the lower thorax, also known as a nipple shadow.”
OK, that’s enough.
The “pastie de resistance”? (You know I couldn’t let that go.)
Inside the changing room, there was a typed note on the wall dotted with trashed nipple markers and additional instructions: “Do not reuse.” As if.
* * *
Amazing relief
Next up was my health history and physical examination with Nurse Practitioner Kat, who specializes in cardiac surgery.
“I love fixing patients,” she said, explaining everything from soup to nuts about what to expect at my May 29 heart valve surgery. “You’ll have MVR and a possible TVR with a maze.”
Translation: A mitral valve repair and, if needed, a tricuspid valve repair, along with a maze procedure to fix atrial fibrillation, a.k.a., “A-fib.”
She compared A-fib’s reach to a pebble hitting a pond’s surface, causing widening patterns of concentric circles. Could be why I feel a twinge in my chest every now and then. Or maybe it’s just bad Chinese food.
The surgical maze procedure creates a pattern of scar tissue (think corn maze) across your heart’s surface. Essentially, the A-fib gets stopped in its tracks. Amazing what they can do.
There’s more. As they say in the newspaper business, I buried the “lede” on this one, because it has weighed heavily on my mind since I learned I needed open-heart surgery. Crocodile tears of relief flowed when I heard the best news of the day: No chest cracking.
This means they won’t do a sternotomy and break my chest bones. Instead, my surgeon will go through the right side of my chest wall, spread some ribs and perform a thoracotomy. It’s considered less-invasive but still a major surgical procedure that allows access to the heart and lungs.
No big deal. Just ask Nurse Kat.
“You’re not special. I mean, you may be special to your family and friends, of course. But to us, you’re not special in the sense that you don’t see us all excited running around here because you need a heart valve repaired,” she said. “We do these every day.”
Perspective is a wonderful thing, isn’t it?
* * *
Just shoot me
Warning: Don’t try this at home.
For one solid minute, gargle a viscous lidocaine liquid that tastes a lot like something you’d use to start your car. Don’t stop, unless you need to breathe, which, of course, you must. Then, swallow it.
Such is the nasty numbing prep for a transesophageal echocardiogram, “TEE” for short, but not even remotely amusing or tee-hee funny.
“Just shoot it,” said Nurse Perky, chewing the remnants of her sandwich. She obviously knew nothing about me and booze. I do not shoot. Ever.
Sitting upright on a gurney wearing hospital ready-to-wear tied in front, I glared at this bossy broad who had way too much product on her dirty blonde head.
“I don’t do shots,” I said, suddenly craving a Dewar’s on the rocks even though it was barely afternoon. But I did it like a pro, shooting it all the way back in my throat, pausing to gurgle air between gargles. Then after 60 interminable seconds, I let it flow into the far reaches of my gut.
Then came the chaser. Sudden, multiple sprays of a lidocaine aerosol administered with a 6-inch plastic syringe by Dr. I.M. Stiff. Before I could say WTF, the intravenous cocktail of Fentanyl and Versed sent me into blissful conscious sedation where I dreamed I was dating Gayle King.
When I woke up, Dr. Stiff was in the corner on a laptop typing up my chart.
“So, where did you come from today?” he asked.
“Downstairs,” I mumbled, and Nurse Perky nearly blew her lunch.
See you in post-op.
(Copyright 2018)
