As I look back on my 2015 cervical spine surgery I’m still distressed with what a heart stopping experience it was. Really!
Thinking of images of my late wife Shearlean’s brain surgery and the concept of them operating on my spine through my throat from the front of my neck were unnerving enough. But in preparing me for cervical surgery, they told me they were going to stop my heart, but just briefly.
I had arrived at Rancho Mirage, CA’s, Eisenhower Hospital at 8 a.m. for my “Anterior Cervical Corpectomy with Fusion and Bracket at vertebrae C4, C5 and C6,” according to the surgery order. It was 2:30 p.m., though, when I finally got into surgery because of the severe heart arrhythmia they discovered and treated.
I had this arrhythmia my whole life. I always thought it was the consequence of anxiety, stress or panic. I thought if I calmed myself down, with deep breathing and soothing thoughts, my heart’s rhythm would return to normal, which it had done for 79 years. But on November 24, 2015, I learned it wasn’t as simple as that this time.
I had been cleared for surgery six day earlier by my surgery pre-registration procedures, which included ECG, chest x-rays, blood tests, etc. And I had no medical history of cardiac problems.
So I was in my cute little hospital gown, on a sporty Stryker gurney and in my sterile curtained cubicle being readied for the morning’s first surgery when my anesthesiologist’s head popped through the curtain and she said, “We’ve got a problem.”
Oh no, I thought, they’ve screwed up the scheduling they’ve been working on for 40 days and now they are canceling the surgery.
“Your heart rate is too high” the anesthesiologist said. “It would only go higher with the stress of surgery. Your heart is beating 140 times a minute, but should be between 80 and 100. We’re discussing it now,” she said as she whipped the curtain closed. Over the next hour or so I had up to seven people in my cubicle. They did another ECG. Two people listened to my heart and lungs.
I kept repeating that I’d been trying to get this neck surgery since June 22 and couldn’t keep waiting. I was scheduled for this surgery 40 days ago, I exclaimed. I’m desperate to get some relief from my neck pain. I WANT MY NECK SURGERY! TODAY!
Finally a cardiologist arrived. A big brooding man who would have been smoking a pipe in previous hospital years. He listened to my heart and muttered and mumbled to himself or perhaps someone close enough to hear him.
He put his stethoscope away and leaned down to my ear and said, “Just relax, this won’t hurt.” I tensed immediately. Then he locked my neck into some sort of half-Nelson wrestling hold and began to expertly chock me in the area of my carotid artery just below my left ear. He watched the heart monitor flashing numbers behind me. Suddenly he released me with the comment, “Well, that didn’t work.” I eventually learned that manually closing the carotid artery from my heart to my brain might shock my heart into reestablishing its normal rhythm.
There was more consultation among seven people in my tiny cubicle and they all nodded in agreement. Then I heard a nurse say she would get “it” STAT. Who? Me? I’m STAT?
On TV medical shows STAT means emergency. I felt great but I continued deep breathing trying to calm my heart rate down to normal.
To no one in particular I shouted, “I came here for cervical spine surgery, not to become a cardiac patient.”
Then the cardiologist shambled over to me again and said, “What did they say when they saw this?”
“They? Who is they?” I asked anxiously.
“When they’ve seen this in the past,” he said in his rumbling dry throated voice. “They,” he emphasized.
“Oh,” I said suddenly getting it. “This has never been seen in a medical setting before. There is no they.”
“I’ve always had this condition,” I said. “My whole life.”
Then everyone left my cubicle.
“Shit,” was all I could think of to say.
The anesthesiologist’s head popped through the curtain again. With a bit of a sad expression she said a few words, which I didn’t comprehended (if she did indeed say what she must have said.) It was something about stopping my heart or stopping surgery, or stopping the high heart rate or stopping something.
From the sound outside my curtain I heard a crowd gathering. Someone pushed an ECG machine through the curtain and immediately started applying sticky sensors
on my body. Someone else came in carrying what looked like a consumer product box that was marked defibrillator. Others followed to observe while a nurse replumbed my intravenous catheter with a new accessory.
She withdrew a needle from the top of a tiny bottle of amber liquid, shot a tiny stream of liquid toward the ceiling and came over to my IV obviously intent on administering the syringe’s contents. Above the general muttering she said, “This might make you feel funny for a little bit.” Then there was total silence while the crowd stared at the monitor behind me. There was a gasp of disappointment and then silence again. Meanwhile, I was looking from face to face to get a hint of what was going on.
“Try 12,” the cardiologist said. The small crowd parted to let the nurse refill the syringe and return to my gurney side. She looked over her shoulder at the cardiologist for a moment and then administered the dose. I could feel my face flush hotly and this weird sensation passed through my whole body. As though they were watching a stadium jumbotron replay, there was a mild cheer and someone clapped.
“There it is,” someone said with obvious pride. “80. Just what we want.”
So I gathered I was cured or something close to it and that my surgery was back on and everyone dispersed.
Only the anesthesiologist remained and she was beaming while still watching the monitor. “We know now we can control your heart rate in surgery if it rises too high again,” she said.
“How’d you do that,” I asked so innocently?
“Oh, we stopped your heart from beating and forced it to reset to normal heart rhythm and rate. We’re sinusoidal again,” she said cheerily.
She saw my expression and added, “It was just for a second.”
So all of this drama, process and procedure had taken about six hours and I was finally cleared for surgery. I was in the queue to be next on the table and under the knife.
While I was elated I was simultaneously devastated. It was like your parents telling you late in life that you were adopted. Anytime, throughout my life, my heart could have blown up. It seems that when nodules on the upper and lower chambers of my heart get out of sync it sometimes causes this form of arrhythmia and the signal becomes an endless loop that keeps my heart beating fast. If my heart tired of this pace, the blood supply to my body would decline and the heart would be signaled to run still faster to meet demand and up around 160 beats per minute it would break down; a heart attack.
While getting into surgery was full of drama and discovery, the cervical spine surgery itself was a breeze – in hindsight.
I went to sleep in an operating room crowded with people and jammed with equipment from floor to ceiling.
Next thing I knew I awoke in another crowded room full of equipment, but with other patients whom I could hear but not see. Except for struggling to clear my vision and test my consciousness, I had no particular sensations or feelings.
About 15 minutes after becoming conscious I was wheeled from recovery directly to my room, with no need to go to ICU. And by the time I got to my room I was already informed I would be discharged the next day.
From check-in to discharge was 36 hours. I dutifully produced abundant feces and impressive quarts of urine (I knew if I didn’t I wouldn’t be discharged promptly).
Surgical pain was mild, more an ache than sharp pain. The incision was 1 ¼- to 1 ½- inch long, to the left of the center-front of my neck and just above my collarbone. It was closed with five butterfly sutures.
By far, swallowing was the most difficult and dangerous aspect of surgery. Since everything in my throat had to be moved aside to reach the surgery site, my trachea, larynx and whatnot were bruised, dislocated and then returned to their original location and configuration. To make matters worse I was put on a ventilator during surgery because surgery prevented me from breathing on my own. The ventilator caused additional tissue battering and irritation.
It was nothing obviously dangerous unless you considered possible aspirational pneumonia, caused by inhaling foreign matter.
As I complete writing this, it is day five since my surgery. I must crush oxycodone pills because swallowing the large, dry tablets is still impossible. Coated pills would be easier to swallow. Uncoated small pills I take with a spoon full of yogurt. I choke daily on food and beverages, and so must be very careful. I always keep a glass of water and a straw nearby.
It is also difficult for me to talk for the same reasons. Additionally, my mouth and throat are continually dry and I sound a bit like the Godfather speaking.
I am also on a high dose of oxycodone, which also dries me out by eliminating saliva and muddles my brain causing me to think and speak slowly.
Modern surgery demonstrates the accomplishments of today’s healthcare system and as an alert and involved patient I was able to be a fully functioning participant in my care and treatment rather than merely the passive object of a procedure. I urge anyone who’s able, to be actively involved in his own surgery. There’s no need to be passive or subordinate.