I recall in the Palmetto Health Heart hospital before my surgery studying the wall chart posted across from my bed. Excellent Candidate for CABG. That translates as Coronary Artery Bypass Graft. Wow, for a guy that has spent the better part of three decades floating about the world as a journalist and freelance writer that was uncommonly good news.
Heart bypass is believed to be the most common surgery in the world — an estimated 253,000 Americans have the operation each year. Traditionally, the surgery is done while the patient is hooked up to a heart-lung machine which takes over the job of circulating blood while the beating heart is stopped. That “on-pump” method makes it easier for surgeons to attach new arteries or veins to create detours around clogged arteries.
But the heart-lung machine carries a small risk of complications, including stroke. In the 1990s, surgeons began doing off-pump surgery — without the machine but with devices that stabilize the beating heart. However, some lives are never lived with a stable heart; there are many people born with wild and restless hearts. I know about this non-medical status.
Dateline Phnom Penh. It was almost six years ago that I posted a letter from Cambodia to a former love, Deborah. I was writing about the Chinese dams that were impeding the flow of the Cambodia’s important riverine system. There the mighty Mekong River flows steadily all the way from its source, the Tibetan Plateau winding its way through China’s Yunnan province, Burma, Thailand, Laos before spilling along the broken down borders of Cambodia and into Vietnam. I sat quietly on the verandah in the Foreign Correspondents Club, watching that fast moving current, carrying dreams, desire and death.
Deborah and I knew one another three decades earlier in Washington, DC when we followed our young restless hearts, at least for a year, before reality interrupted our dream. She returned to the security of marriage and I drove out to California following my version of manifest destiny.
In my letter to her written while gazing at the Khymer river of life and dreams, I wrote, “drop me a letter in care of The Washington Times and they will forward to me somewhere out here floating along the mighty Mekong.” She eventually wrote back to me after many months at a time when her husband, Patrick was dying from a brain tumor.
Her letter was postmarked from Aiken, South Carolina an Espicopalian and equestrian dominated community. “ Maybe reunion with the chance to get it right this time is a possibility. Maybe with enough time I can get over the fear of being deserted and you can get over the sense of being trapped.” Her expressed need years ago walking down Connecticut Avenue in Washington was to create an Ozzie & Harriet family life mixed with a dash of situation comedy proved all too successful and painful. Meanwhile, our correspondence continued. She wrote.
“ You know one of the wonderful things about your re-emergence is that I have looked at my world as if I were showing it to you (maybe that’s why I felt a need to “see” your life) –it has been a great gift.
We all have this place, it is in the heart, where we hold all that is most precious and even sacred to us. It is from here that all of us issue our kisses and our tears.
The heart memories hurt far more than the physical pain associated with the use of the Stryker sternal saw to gain access to the chest cavity by slicing through the sternum before the CABG surgery is performed. There are over 200 surgical instruments used during a standard bypass surgery.
No one is ever prepared for the flood of emotions that race from the head and back to the heart before or post cardio surgery.
According to the Heart Surgery Forum and thoracic surgeon, Dr. David Harris, “ A small thoracotomy for CABG or Mitral Valve Repair is in my opinion the best minimally invasive incision. For an MVR you can do it all under direct vision (without robot or VATS) with excellent exposure. These patients also have less bleeding than sternotomy, and less pain if you use an indwelling paravertebral catheter, and close using sutures which are placed through drill holes in the lower ribs, instead of around the lower ribs. In the past we have shied away from the thoracotomy approach thinking that there is more pain, without tackling the causes of pain.”
Does anyone completely understand that love is a lot like a puzzle? When you’re in love, all the pieces fit but when your heart gets broken, it takes a while to get everything back together and the surgeon can never unclog those plaque-laden emotions which always lead to loss.