My heart journey: the rest
On July 28, 2017 I underwent an ablation surgery for my heart. In my last post (“My Heart Journey”) I shared how I discovered my condition and the long road towards this surgery. Many times leading up to it, I was at the end of my patience with health insurance & the uncertainty of when I could finally put it out of my mind. At times, I even cursed my body, resentful and angry that it was this way.
It’s since been months since the ablation surgery, and I’ve asked myself,
"Why hadn’t I written about it yet?"
Friends had sent me concerned messages or seen me back home this week and asked me, with concern, if I was okay. I felt guilt for not immediately updating friends & those who had followed my story online … until a day, when I lay on the floor of a yoga studio, contently breathing, resting in the dimmed light after a long class. It had been a good day, one of those when you feel you are radiating positivity and joy. As I lay there, I noticed how each exhale felt so satisfying, and I wished that I could just exhale. No inhale. Those weren’t as satisfying.
...But we all know how it works.
During this reflection of such an instinctual action as breathing in and out, I realized something so simple.
To breathe out, I had to breathe in… whether I liked it or not.
Similarly, to give anything to others, it feels good, but I had to take in.
The weeks (& unexpected months now) of recovery post-surgery had been my inhale.
It didn’t feel like I was giving back to those who cared for and loved me, and as I regained strength, I also felt bad for not being able to share my story with others. To somehow give back the love they had sent me.
It’s taken me a while to realize this, but I do not feel this guilt any more.
Not after that day on the yoga floor.
I did not need to feel guilt, for who should feel bad for inhaling?
Now, I am ready to exhale.
To tell you the rest of my heart story, with the hope of giving you something – patience or resilience for that which you may curse silently:
or maybe even yourself.
Chapter 1: The Big Day
We had spent 5 days in San Francisco, Phil working, while I enjoyed spending my days meeting up with friends, sight-seeing, and snapping photos as all 1st time visitors would. This was our last full day – the big day.
I had already been to the hospital UCSF for the pre-operation appointments the day before, so I felt as comfortable as one could at the check-in time of 6:30 am. I had even asked Dr. Dawg how long ablations usually took. “A couple hours,” he casually replied.
“8:00am start of surgery,” I estimated, “plus a couple hours… I’ll be done by noon for sure. Easy. Dinner reservations are ON!”
The check-in was easy, hospital blankets warm & nurses extraordinarily friendly, as they individually came over to my bed to introduce themselves. The IV insertion was not as easy, but I am used to this, since my blood pressure is so low that I’ve been effectively banned from donating blood anymore. (It’s fine) One of the anesthesiologists eventually got the IV connected, and during all this time sticking needles around, we learned a few interesting things.
Chapter 2: A few interesting things
1. Phil is totally squeamish about needles, while I have no problem.
2. Phil should have eaten breakfast because he nearly fainted while watching me get pricked.
3. We absolutely could not & would not get on our 8:00am flight tomorrow morning.
That’s right. The nurses asked when we were headed home & we sheepishly said, tomorrow morning… 8:00 am. They immediately gave us a look – “UM, NO.” They said it politely but made it clear that it wasn’t going to happen that way. They might need to keep me in the hospital overnight.
I couldn’t barely keep my own “UM, NO” attitude checked, as I told them this was never once mentioned. It was supposed to be a same day procedure.
Well, yes, they conceded, but the in-hospital recovery time of 4 hours could be something that needed to be extended, based on my condition.
Phil (the ever-skilled planner & one to follow advisories) changed our flight to the following day. However, the thing was that about 7 months ago, we had decided we would spend a few weeks of my summer vacation with family in Australia. We booked the flight from HNL --> SYD and even managed a 5 day stopover in Fiji on the way back home to Hawaii. Our Sydney flight left early Monday morning from Honolulu. Our new flight from San Francisco back to Honolulu was Sunday morning… meaning just about 20 hours to unpack + repack for a Sydney Winter and a stop in Fiji. Oh, and that night in Honolulu we had a music gig.
Not ideal, but it worked.
None of this was on my mind at the time, as the nurses prepped me to go to the operating room. Phil had whole-heartedly volunteered to take care of it all as he sat in the hospital waiting room, telling me not to worry about it.
Chapter 3: This is fine
Now I was being wheeled to the operating room.
I was surprised at the amount of large-screen computers that hovered above my body, and at the fact that there was a control room for the doctors. I guess I had envisioned a traditional setting of surgeons working over their patient.
Here they would be in another room, in front of a row of screens, toggling controls and pressing buttons, while I lay with catheters lacing into my legs up inside my heart. Once inserted, these catheters would enable the surgeons to create a map of my heart, find the cells conducting the electrical brain impulses that create my irregular heartbeats (or PVCs), and zap them.
( Take a look at these images below. Dr. D was kind enough to have shared them with me, now that it's all over. It is crazy to know that on the other side of that glass behind the computer, I was laying in the operating bed. )
Photo left: Catheter wires laced up into my heart
Photo right: The map of my heart created by the cardiologists in this control room, using the catheter wires to find the areas that are causing the irregular heartbeats (PVC's) ... & ablate / zap them.
Anyway, on with the story...
I knew that in order for my irregular heartbeats or PVCs to be found, I would not be put under with anesthesia. I needed to be awake.
This was fine in theory, but when the catheters were inserted through my leg…
it was another story.
I have a high pain tolerance. This, however, was enough to leave me mentally coaching myself to breathe through the pain and calm my mind, as tears slid down my face.
It wasn’t until the anesthesiologist walked closer to find me silently crying that she compassionately chided me for not saying anything. She immediately pumped more pain meds through my IV. From there, it was a bit of a blur. I was in & out of consciousness amidst the glowing screens and nurses that hovered over me.
Chapter 4: Six hours is more than a couple
When I finally fully came to, I groggily awoke in disbelief that I had been put under. I would have cried from relief if I hadn’t been so groggy from the pain medicine when they told me it was done. They did it.
They did it.
I faded back to sleep.
A glimpse of Dr. D entering the room.
His Wu Tang Clan sweatshirt & scrubs.
My groggy laugh and thankful sounds.
A glance at the clock – 2:00pm
Back to sleep
“Dinner reservations tonight,” I slur insistently
Overhead words: Stitches in catheter wounds.
This would help.
Time passes. I don’t know if I’m awake or asleep now.
I was slowly awakening, this time without the warm dizziness and comfort of the pain meds. Was it my back, from laying in the surgery bed for 6 hours? Was it the catheter wounds? The stitches? I couldn’t tell, but as each minute passed, it grew to be
I couldn’t calm my mind & my body began to shake uncontrollably.
I still don’t know if it was the pain, the cold of the operating room, or a reaction to the anesthesia wearing off.
The nurses responded incredibly, hurrying to surround my entire body with fresh, warm blankets and wheeling my bed quickly to the recovery area, where I would spend the next 4 required hours.
Chapter 5: Recovery room
I lay there, still reacting to the pain, as they pumped more pain medicine through my IV, telling me that my body sure does metabolize pain meds fast. The shaking was lessening and the nurses’ attention was constant, but I found myself crying.
At the time, I didn’t understand it.
Why was I overreacting?
The pain was lessening & I was being fully taken care of. Now, I understand that I think I cried from shock.
Stephanie, an angel of a nurse, never left my side, offering water, apple juice, tissues. She asked if I wanted her to bring Phil from the waiting area. I was a tearful, snotty mess. I knew Phil would feel panic from the helplessness of seeing me in this way.
I waited until my face was a more normal shade of “I just cried” pink,
then they brought him in.
He told me with a smile that he’d met my grandmother.
Or rather talked with her for the first time.
I was completely confused.
My grandmother lives on a tiny island off the coast of Washington. (Admittedly, I look up this island’s spelling as I write now.) I haven’t talked to my grandmother in a while. Phil recounts that, after seeing my blog post on “My Heart Journey” through social media, she called the UCSF hospital front desk & earnestly wanted to speak with me. I was in surgery at the time. The hospital staff found him, and he took it from there, calling her back to calm her worries and also introduce himself officially. I think she appreciated it, considering her voiced disdain for the lack of real communication as enabled by the advent of social media.
I also learned that so many more loved ones had also reached out in concern, knowing that it was the day of my surgery. As Phil listed off the names, I was so amazed. I couldn’t believe these people were all thinking of me,
an ET-shaped bundle wrapped in blankets,
still fairly snotty-nosed and pink-faced.
The 4 hours of recovery room time passed quickly and I slowly gathered my things to leave. It was 6:00 pm – a full 12 hours from when I had arrived at the hospital.
"Well, good timing for some dinner reservations," I thought.
We arrived back at our place on Guerrero Street and Phil convinced me to lay down. I unintentionally fell asleep, despite my insistent desire for dining out, and woke to some of the most gratifying Vietnamese take-out that I’ve ever had. It was also the 1st meal in 20 hours for me.
It was some pretty outstanding Vietnamese food.
Chapter 6: Post
After a day more in San Francisco & a brief 20 hours home in Hawaii to pack, (Phil managed the gig alone due to my lingering chest pain) we were on yet another plane.
Ten hours to Sydney, Australia.
Again, not ideal considering possible blood clots, but it worked.
The flight was fine & I was happy to spend time in recovery and reconnection with loved ones, some whom I hadn’t seen in 4 years and others only briefly a year before in June, during the final stages of my grandmother’s illnesses.
Since last June, we lost my grandfather also, quite suddenly. It was disorienting to return to this void, and I knew the whole family felt it.
But with Phil and I visiting 1 year out from our upcoming wedding, it created enough hope to lift my family from their somber moods, to come together for dinners and spend time together that had been spent in quiet isolation since the family’s loss.
We went on walks, visited wineries, explored lots of new cafes…
It was exactly what I needed to heal
& now that I reflect, I don’t think I was the only one in recovery.
After Australia, Phil and I flew back to Hawaii, stopping over for 5 days in Fiji. While our time with family was nurturing, Fiji offered an absolute peace that we rarely find even on our own tropical island home of Hawaii. Empty beaches and hours to spend picking giant shells from the sand or lazing in the sun. I even got doctor’s approval to go on a scuba dive! (Thanks, Dr. D)
It was my first time scuba diving in open ocean, and the shapes of the coral were other-worldly.
By the time we returned back to Hawaii, I was confident that my required 3 weeks of healing post-surgery had had completely worked.
I felt 100%.
I was mostly excited to return to exercise, having been disallowed it during the 3 weeks.
(Trust me, the couple times I tried to sneak in a sit-up, I suffered plenty of pain the next day)
As soon as we arrived home, both Phil and I returned to work, and I hit the yoga studio almost every day, having gained several vacation pounds. As blissful as vacation was, my routines brought me joy, after a blur of a summer.
Phil, however was not done with traveling, as he had yet another trip to complete for a work conference. “1 week?” I thought, “no problem.”
I was back in my routines, feeling good, & would definitely be fine for that short amount of time.
It was not quite fine.
I still don’t know what it was: the daily yoga classes or residual surgery pain that somehow manifested 4 weeks post-ablation?
One thing was certain.
It was heart pain...
and not the dull general ache that I felt after the surgery. I could mentally accept that.
This pain was sharp, and to be honest, shook me.
I was scared in a deep way & Phil wasn’t there to rationalize it with me. Up until this point, I had thought I had completed my healing.
3 weeks, post-operation.
I did it.
This sudden and alarming pain crumbled any semblance of confidence I had in my healing. There was no explanation, and even with Dr. D’s assurance that I shouldn’t worry too much about it, there was no way that I knew what was going on. It was too early for a post-operation appointment and tests, and who else could tell me what this pain was?
There was nothing to do but wait, stop going to yoga every day, and take it easy.
Chapter 7: Don’t worry about it
I went through my days, teaching and easing back into the swing of things. When Phil returned from his conference, we happily decided to have a night out to see some local music, where friends would be on a Friday night. It was good to see familiar faces after so long. With every greeting and hug came the question:
“How are you?”
I knew this wasn’t the usual “Hey, how are you” greeting. These close friends sincerely wanted to know how I was… considering, well, you know. The thing was, on that Friday night, amidst the roar of the crowd and music, I only had silence.
I did not know.
I had no answer to their question.
“How am I?”
Each time I said those words
“I just… don’t know”
the knot in my throat grew, until I could not hold the tears back. They streamed down my face, as I collapsed onto a friend’s shoulder.
I had been holding onto a fix, a time frame, an answer … up until now.
Fear overwhelmed me.
This was supposed to be done
Phil wisely and gently suggested we leave, and on the walk back to the car, I continued to shed cathartic tears, realizing that I had never actually told Phil the parts that he didn’t see, the parts I hid from him in the moment, to protect him that day after the surgery:
the pain I experienced as I woke from anesthesia,
the uncontrollable shaking,
the emotional and physical shock
the overwhelming fear and uncertainty
Phil did not understand why I hadn’t told him these things, and why I so urgently needed to recount these on a downtown street corner, as we sat in front of a darkened bank building.
It was important,
It was & is part of me now, and I needed him to see the whole me, or rather the un-whole me. Understand me, the me that was apparently not healed.
And love me.
Now, I believe this is also why I continue to write my story. Even though it has taken weeks and now months…
Pages and paragraphs…
So that you, reader and friend, may see the whole / un-whole me. Understand me.
And more importantly, so that I also may see the whole / un-whole me.
See me, understand me
And love me.
3 weeks, 4 weeks, or 20 weeks post-surgery.
Healed or not healed.
Pain or no pain.
Chapter 8: I understand
It has been 20 weeks, or about 4 months since the ablation surgery on June 28th.
Last week I finally had my post-operation appointment.
I got the test results from the echocardiogram & holter monitor I did in late September. Previous tests showed I did have a few PVC’s remaining, but on the day of this appointment, the EKG showed...
(You remember, those extra heartbeats that cause possible heart damage over time and weaken heart function)
I couldn’t believe it, and even now it’s as if it still hasn’t sunken in.
Dr. D says my heart function has improved – my heartbeat used to push out 40% of the blood in the heart & now is able to push out 50%.
(Ejection Fraction, for all you medically inclined)
A normal heart would do 60%, on average.
This is good he tells me. It is much better than before, and there’s no saying that the ejection fraction will stay at 50%. It may continue healing to show even more improvement in the future. We’ll do tests to check up in the future, but for now,
here I am.
I still don’t know if I have the words or wisdom to sum it all up in a grand life lesson, but I do know this. I rest easier knowing that I have told my story. I understand myself more for it.
While I hope my journey has given you something… patience, resilience, compassion… that thing that you might need today or in 10 years time, I know that this difficult exercise of writing this has indeed given me all these & more.
It has raised a lot of hurt, but it has also developed in me a deep gratitude for this life…And a continuous sense of wonder at something as small as the heartbeat I feel within me now.
Though I still wake with dull pain at times, I am grateful that each night as lay, I am lulled to sleep by the soft and steady movement beneath my chest, the rise and fall of each breathe, reminding me that there is no part of me (or you) that is not pure miracle.
I don't know if this is the end of my heart story, but as all journeys go, you never truly know what's the end after all.