I Gotta Have Heart

It began with a blackout and collapse. Yet that chilling event may have saved my life.

What follows here, a tale of bodily intimacies, is meant as a guide for the aging reader and a revelation that some medical miracles have lately become routine.

The story began on a late summer day in 2018. It had been brutally hot and humid. I walked to a market on Orange Street, dragging myself home, lugging cartons of 2 percent and almond milk.

“Take a bath,” suggested my wife, Suzanne. ​“It’ll help.”

And so I did. I remember how calming it felt in the tub. What I didn’t remember to do at the time was to keep the bathroom door open a crack, so that the air could circulate.

I stood up after a 20-minute soaking to grab for the towel. A minute or so later, I awakened in the prone position.

For a moment, I felt a measure of comfort, welcoming the coolness of the bathroom tiles, but then thought, ​“Well, this isn’t right.”

A negotiation ensued. Suzanne was eager to call 911. I assured her I was OK, and just needed rest. She extracted a promise from me to call our primary care physician the first thing in the morning.

The next day I earned an immediate appointment. Sue offered to drive me; I insisted she stay home.

It was a 25-minute trip from New Haven to Westbrook, and I was sure I could manage it. This bullheadedness is evidence that sanity is a casualty in a health crisis.

The journey, however, was without incident. Then my normally amusing primary care physician, who reported after a recent yearly exam, ​“You are fermenting nicely,” refused to crack a smile.

“You mean you drove here yourself?” he said. ​“Are you nuts?”

He didn’t wait for an answer. Instead, he called for an ambulance to take me to Yale-New Haven Hospital’s emergency room in Guilford.

What does one think of during his first ride ever with EMTs? Is it too cold in here? What are all these machines? How will my wife get the car? Is this my day of reckoning? Are my underpants clean?

The Guilford experience was a blur. Within a few minutes I was back in a moving clinic and on the hospital’s main campus in New Haven.

“Cardiac unit,” I heard, as they wheeled me into a room.

“Cardiac unit?” Nobody in my family had ever been wheeled into in such a place. My ancestors were burdened by cancer, not heart troubles.

Soon an attending physician indicated the issue at hand was unrelated. ​“You may have suffered from dehydration. However,” the specialist said, ​“we need to give you some tests just to be sure.” These, I learned, included an echocardiogram. It revealed, alas, that the period of ​“fermenting nicely” had ended.

I had developed a condition called aortic stenosis. Specifically, my primary heart valve was no longer opening properly. Hence, my blood wasn’t reliably reaching its destinations, though at that point the condition was adjudged ​“mild to moderate.”

Fast Forward To 2021

Three summers later, though, another test showed that ​“mild to moderate” had turned into ​“severe,” just one stop from ​“critical.” 

Days later, I met the surgeon in charge of my case. He introduced himself as ​“Mike.”

“Gee,” I thought. ​“I don’t need a Mike. I need a cardiac wizard.”

I knew what Dr. Michael Cleman was doing, putting me at ease. In a way, I was already at ease.

Rather than panic, I felt blessed. At the age of 77, I was way ahead of the game. Living in an agreeable neighborhood in New Haven with the woman I love. Drawing strength from our combined families, and the achievements of the eight grandchildren. Compiling a ​“permanent record” largely without prominent scandal or crushing failure.

Even the idea that Suzanne and I now had a third member of the immediate family, little Lucca, our Italian pooch, provided comfort.

More than that, I was the beneficiary of contemporary medical developments. I didn’t need open heart surgery to replace the valve. I could take advantage of the ​“minimally invasive” procedure, through arteries in the groin, a technique known as TAVR (transcatheter aortic valve replacement), a groundbreaking technique less than 20 years old but common at 20 York St.

When I met with one of the surgeons on the cardiac team, she explained all this, as well as the possible upside. ​“You will likely have more energy afterwards,” she said.

She also reported that the new valve would be crafted from tissue from a pig or a cow, and asked, ​“Do you have a preference?”

I said, ​“My preference is to delegate such delicate decisions to those with expertise. However, if you choose the pig option, please don’t tell my rabbi.”

Such medical authorities explain the risks involved in the surgery – including stroke and worse. I waved them aside. The percentages of failed procedures are minimal. Besides, this was not a case of elective surgery.

Preliminary tests were required: a CT scan, a stress test (which succeeded in giving me considerable stress, as my blood pressure yo-yoed), and an angiogram, in which I was introduced to the idea of slit arteries.

And then the big day. July 20, 2021, at 7 a.m.

Wheeled into the OR, I saw a team of at least seven awaiting me, along with so much medical equivalent that I gasped, ​“All this just for me?”

That’s the last thing I remember was when the anesthetic, Propofol, sent me off into Lovely Land.

When I awoke in post-op, my kind nurse, Dee, who had just started her 12-hour shift, revealed that all went well. Her kindness and expertise were needed for many hours; her shift was almost over before the hospital found a free room. 

During that time, and later, a parade passed through, intent in on examining the incisions.

“Mind if I check your groin?” doctors asked one after another.

In my lingering haze, I heard the same question come from other physicians as well as practical nurses, registered nurses, assistants to nurses, technicians and, I believe, the New Haven Symphony.

I’m sure you are asking yourself right now: ​“the important part of the two-day, one-night vacation went well. But how was the food?”

My answer is, Yale New-Haven has excellent doctors and nurses who know what they’re doing. The kitchen? Well, another story.

For lunch I ordered a grilled cheese, vegetable soup and a fresh fruit cup. This arrived 45 minutes later in the form of Birkenstock-dry chicken breasts and salt-free chicken soup

“I’ve never seen that happen before,” testified Dee. Hours later, taking pity on me, she secured a warm blueberry muffin.

That night, finally ensconced in room 16 in the cardiac ward, I couldn’t sleep, read, or even watch TV. Naps came in 15-minute increments.

In a period of consciousness, I overheard my new nurse talking in the hallway to a colleague. ​“Every morning when I get home, she greets me with, ​‘Good morning,’ and ​‘I love you.’” Her colleague remarked, ​“That’s amazing, considering how young she is.”

When the nurse came into my room to carry out another groin check, I asked her about what I presumed was her precocious toddler. ​“No,” she said. ​“It’s not a child. It’s my dog who says that.”

I thought: This must be the anesthetic doing cartwheels in my brain. But I thought of little Lucca, who during his eight months of life with us has yet even once to inquire, ​“Well, master, how do you feel today?”

The next afternoon, after an echocardiogram confirmed my new valve is living up to expectation, I was released. Exhausted but relieved. Lucky this time. The beneficiary of fate, irony, and a platoon of caring and skilled professionals.

As I write this, it is nearly two weeks later. I am still tired but pain free. My new valve pumps away, though I am still unclear whether it’s kosher or not.

Suzanne and Lucca are here at home, and comforting, though the latter has been lax at proper nursing care. Still, I am happy to see him barking at life as if it will last forever.