chapter 45: Pencil Me In(capacitated)

on march 25th, i was faced with a dilemma.  for financial reasons, i needed to have my surgery as soon as possible.  i had quit my job for the operation, which meant no income for the entirety of my journey into frailty.  the soonest available date in Phoenix was 2 weeks away; but there was a catch:  Dr. S would be leaving town the day after my procedure; so if there were any complications, he’d be out of reach.  i had chosen him because he was the best in the world; wouldn’t i want the best in the world to be there if something went wrong?  according to his office, when he’s in town, he visits his patients each day, sometimes even on weekends.  my initial thought was, i want Dr. S every second i can get him.  but in order to have him there to that degree, i’d have to wait an extra week to do The Deed.  i was stressed beyond belief due to pressures which i won’t reveal here, demands to take the first available slot.  it was the closest i’ve come to a complete breakdown during all of this.  nevertheless, i chose to stand my ground.  i committed to a date 3 weeks away–April 14th, regardless of the opinions of anyone around me.  i wasn’t going to risk my health any more than was necessary.

as i waited, something unexpected occurred on March 29th–my original day for brain surgery.  that evening, my sister in Alabama was hurting.  in her jaw.  and arm.  and chest.  finally, she called 911.  minutes later, the paramedics arrived and gave her nitro-glycerin tablets.  upon their recommendation, an ambulance was soon delivering her to Brookwood Medical Center.  while in the room at the ER, her heart flew into an erratic rhythm.  her eyes rolled back in her head.  her bladder emptied.  and her heart stopped.

flat line.

for a few moments, she was dead.  in another time, she might’ve stayed that way.  in another place, she might never have returned from beyond.  but the defibrillator employed by the emergency medical staff shocked her heart back into a life-sustaining rhythm.  the next day, she had an ICD–Implantable Cardioverter Defibrillator–inserted into her chest and wired to her heart.  terrified, she was accompanied constantly by my father; my mother picked up her 3 children from the ER, before they could witness her traumatic episode.  they stayed at our parents’ house for the duration of my sister’s hospital stay.

this was the 29th–the day my parents had planned to be in Phoenix.  two days after their initial plane ticket was to take them there.  my father had been virulently angry at my change of dates, my choice of an extra week for the benefit of Dr. S’s presence, the resultant airline fee he was charged for a rescheduling of his flight, and even what he incomprehensibly perceived as my inability to keep from developing a sinus infection.  but now, a new light was shed on the situation.  if i hadn’t gotten an infection, he and my mother would’ve been 1700 miles away during my sister’s time of need.  they would’ve had two children in the ICU at the same time–a son dealing with the success or failure of brain surgery, and a daughter who had flatlined, whom they couldn’t get to or help.

there was also another implication, a less obvious ramification of my sister’s discovery of illness, eventually pointed out to me by an internal medicine doctor:  my sister had an apparent heart defect, having experienced “torsade de pointes ventricular tachycardia;” my dad, who’d had his aortic valve replaced a year before, was also a lifelong sufferer of paroxysmal atrial tachycardia.  my sister’s incident shed light on what was very possibly a family problem, an arrhythmic genetic heart disorder which i may very well have.  and, if it were a certain kind of congenital defect, it could be provoked by drugs commonly used during and around the time of surgery.  another common trigger was brain surgery itself.  in addition, depending on the specific malady, if my heart jumped ship, the medications normally used to revitalize or stabilize it could instead actually kill me.

by the time this news reached me, my surgery was just around the corner.  i called Phoenix, and they made it clear i would not be welcome in the operating room without a thorough investigation of my ticker.  on March 7th, i made myself sick over a 4 hour period, while i searched for cardiologists in Los Angeles who could see me immediately for a pre-op cardiac clearance.

i couldn’t find a doctor or lab which could see me right away.  amidst the pressure, the stress was exhausting.  my small window for break-neck-speed appointments was working right up against time to leave for Arizona.  all i’d wanted, all along, was a week of peace and reflection before surgery.  during the first week-before, i’d worked as many pick-up shifts as i could, which kept me too busy and too little rested.  and now, in the final days before the Grand Opening of my head, i was going insane trying to find out if i might go Code Red in the OR from my heart if not my brain.  i had enough problems already; this was not a welcome addition.  at one point in my mad dash to find a doctor, i wanted to throw my phone away, and collapse on the couch.  ’til August.  but i kept at it, and i secured a meeting with Dr. Y at USC Cardiology the following day.

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