Saturday, October 12, 2019

Thankful for Every New Moment - My Heart Bypass Story


The last weekend in January, I took a few days of vacation to run the Arizona Rock ‘n Roll Half Marathon in Tempe, Arizona. I raised several hundred dollars for St. Jude’s Childhood Cancer research. My time was a bit slower than my normal, but I figured maybe I was just a bit off from having flown in the day before.

The second weekend in April, I drove down to Kansas City and finished the Garmin Land of Oz Half Marathon. By the end, I was dragging. I finished nearly a half an hour off of my best time. I’ve finished 15 Half Marathons, 13.1 mile races, and one Marathon, 26.2 miles, over the past 5 years. Six in the calendar year, when I finished the race in April. Though, I wasn’t exactly setting land-speed records, I thought I was in pretty good cardio-vascular shape.

When I go to camp, in July, I take some time to run. This year, I tried. I could run for a bit, but mostly had to walk. I thought I had bronchitis, which I probably did. My doctor called in a prescription for anti-biotics and soon my cough went away.

A few days after I returned to Des Moines from camp, we flew to Orlando, to Universal Studios, for a family vacation. We walked all over the parks. Probably six miles a day. I had to rest every now and then, but we rode just about every ride, including going on some of those “People with Heart Problems are discouraged from riding this ride” roller coasters multiple times in row. Yes, I am a roller coaster fan. The faster and more time spent upside down the better!

We went to Volcano Bay, Universal Studios waterpark, and of course, I had to go on the fastest, most intense water slide, right away. Over 200 steps up and a straight vertical drop for a couple of seconds. You reach the bottom pool in seven seconds. I had to stop and rest to catch my breath about ¾ of the way up the stairs, each of the five times that I climbed them. Since, I’ve been running long distances, I have gotten fairly used to never being tired unless I’ve been doing something fairly intense. I was a surprised at being tired.

We were back in Des Moines for a few days and then we flew to North Carolina for my wife’s family’s reunion. With a brother in Japan and nephews in France and Switzerland as well as in a couple of different US states, it isn’t often that they’re all together. As it is, one of the French nephews couldn’t attend.
One of the things one does in the mountains is hike. When we went hiking, I found myself winded pretty easily. I couldn’t keep up. I started to suspect that a medicine that I had been taking for a while might be preventing my heart from working as fast as it needed to work. I didn’t feel bad, just tired, and I was fine after I slowed down. I called to set an appointment to meet with my doctor about it after I got back. The appointment was a couple of weeks out.

We got back to Des Moines in time for the state fair. I went three times. Each time, I was tired pretty easily walking around. I never went up the hill this year. On the way back to the car, the second time I went, I had to stop several times to catch my breath. Again, after resting a bit, things seemed okay. That night I was winded walking up a flight of stairs at home.

Now, I was quite concerned. It’s scary to not be able to breathe.

I didn’t want to wait for my scheduled doctor’s appointment, the next day. I called and asked to see whomever was available. I got in with a different doctor that afternoon.

My EKG was normal. My heart sounded normal. My blood pressure was slightly up, but not high. My cholesterol was good. He wasn’t sure what was going on, but said, “If this is only happening when your system is under stress, we should get a stress test. It might be something electrical. The stress test would show that.” The first available stress test was nearly a week out on Wednesday.

The next day, we went to the fair again, on our 25th wedding anniversary, we went to see our favorite comedian perform. Again, I had to stop several times on the way back to the car. It felt like I was under water too long. But again, after resting a bit, things seemed okay.

The day before the stress test, I drove three other local Jewish professionals to Cedar Rapids, over 2 hours each way, for our Iowa Jewish Professionals meeting.

The next day, Wednesday, I took my stress test.

They started off giving me an EKG, which was again clear. They did an Echocardiogram as well, which looked good. Then they had me get on the treadmill. It was fairly clear fairly quickly that something was wrong. My heart rate needed to get up to 90% of my max, but well short of that my EKG started to get wonky. They stopped the test and had me lay down to do another Echocardiogram. A few minutes later, I was downstairs in the cardiologist’s office.

They did another EKG then, which came back normal.

A few minutes after that, the doctor came in to see me:

I think it fairly certain that you have a blockage and I’m fairly certain that it’s in a pretty bad location. You need an angiogram. They’ll inject dye into your veins and that will show them where the blockage is. My guess is that you’ll need a stent and probably will have to stay overnight at the hospital. Normally, I’d ask you which doctor and which hospital you want, but you’re lucky. You get to have the first available appointment! As long as your EKG stays normal, you can go home tonight, but if you feel like you have felt when you’ve been short of breath, don’t call your wife or me, call 911.

On Thursday morning, I went downtown for the angiogram. They explained what they were going to do and all the risks. If they found something, which they anticipated, they would put in a stent if they thought that would work. Otherwise, if things were bad, they’d stop and we’d reassess for treatment another day. Then the nurse put in the IV line. They wheeled me into the OR and I was out like a light.

I woke up a while later and the doctor came in to see us. “We had to stop. You have several major blockages. You need bypass surgery.” Another doctor told me that one of the blockages is normally discovered by the forensic pathologist and that I was extremely lucky.

They weren’t going to let me go anywhere. Rather quickly, I was given a room and put on a blood thinner. They scheduled the surgery for Monday, an expected Triple Bypass, but told me that if anything happened in the interim, I’d be going to surgery right away.

My cardiologist came in and told me that I’d had this condition to a pretty severe degree for a very long time. My heart had created natural bypasses, collaterals, veins that went around the blockages. Those were what was enabling my heart to perform okay on a resting EKG. They just weren’t providing enough blood flow to allow my heart to do anything more than that at this point, because blood flow was so limited.

That Saturday, I walked a little in the hallway with my IV pole in tow. I could walk about 100 feet before I was very tired. I was afraid that I would need the surgery right away; that I wasn’t even going to make it to Monday. But I did.

People kept asking me if I was afraid about the surgery. I really wasn’t. I had been afraid all of those times when I couldn’t breathe. I was upset that I had made my family stress out. When I started running in early 2015, I did so because I wanted to prevent exactly this sort of thing. I wanted to get myself healthy and thought I had done a pretty good job of it, shedding weight and getting my heart in shape. I didn’t know that by that point, most, if not almost all, of the damage was already done.

I just kept thinking of all of the times, running dozens upon dozens of examples through my mind, when the worst could have happened. I thought about how miraculous it is, in fact, that it didn’t happen, all things considered. How many times had I gone on long runs? How many trips had I been on? Several times to Israel. Long drives in the car by myself? Those times when I was running by myself on the sports’ fields at camp while everyone else was at lunch. No one else around for an hour. And on and on.

No, I wasn’t afraid of the surgery so much as relieved for having made it to surgery and hopeful that it would be fixed. One doctor told me that with decent blood flow to my heart, I would likely find myself able to do far better at my running than I had before. I was hopeful.

I ended up having Quadruple Bypass surgery, which they tell me, went extremely well.

Recovery isn’t and hasn’t been easy. I have been able to get moving a little easier than most people would. The rest of me was in pretty good shape. But coughing and laughing hurt for a while. Sneezing, hurt a lot. And a week after surgery, when my kids decided to play some funny videos on their phones and were laughing, it hurt when I joined in. I had to ask them to stop making me laugh and I love to laugh.

It’s was especially hard for me not to be able to do all of the things I would like to do with my family and friends over the past few weeks. No, I am not going to be running the Des Moines Half Marathon again this month. I deferred my entry to next October. It’s also been difficult for me to not be able to be there for you as rabbi as much and in the ways that I would have liked since this began. Being tired while recovering is a real thing.

What has made it all better for me is the tremendous amount of support that my family and I have received. So many people have reached out in concern. Again, your support has meant a great deal. Thank you.

Today, Yom Kippur, it is said that we Jews rehearse our death. We contemplate what will happen when the end comes. What will be accrued to our benefit? What to our detriment? Have we had a positive impact on people’s lives? Can we do better? If we heard eulogies about us, what would they say?

Over the past couple of months, I have had the opportunity to hear some of these things about me. Thank you for all of your beautiful sentiments, heartfelt thanks and concerns, and wishes for a full and speedy recovery.

I have also had ample opportunity to imagine not being here today. To not have been here, to not have experienced so many wonderful things over the years, to not have been able to be there to help others either. It’s been quite a time of Cheshbon Nefesh, of an accounting of the soul.

This morning, we read, “Atem Nitzavim hayom kul’chem lifnei Adonai Eloheichem,” “You stand this day, all of you, before Adonai your God.” It is a passage that reminds us that today, we should humble ourselves, recalling the dictum of the rabbis, “Da lifnei mi atah omeid,” “Know before whom you stand.” Think about what it means to be where you are. For me, this is not just about before whom, but how and why.

Why are we here today? What has our journey been to reach this place? Thinking not only of physical movement, but of thoughts and feelings. Am I appreciative? Do I want things to change? Am I willing to do what is necessary to bring about the changes that I would like to see? In my life, what do I stand for? How did I arrive here at this moment? Would I like to be in a different place physically, spiritually, mentally?

This afternoon, during our Healing service, I will come up to stand before the open ark thanking God for allowing me to reach this day, for the many miracles, far too many to count, that have enabled it to come to pass, for the skill of my healthcare providers, for loving family and friends who lifted my spirits and may well have given me a lift in their cars to go out as well, and for all of those whose thoughts and prayers helped bring me healing of spirit as well as body. It will be all the more meaningful a service this year and every year going forward for me.

I have come to realize that every moment is one deserving a Shehecheyanu:

Baruch atah, Adonai Eloheinu, Melech haolam, shehecheyanu, v'kiy'manu, v'higiyanu laz'man hazeh.”

“Blessed are you, Adonai, our God, Ruler of the Universe, for keeping us alive, sustaining us, and enabling us to reach this moment.”

L’shanah Tovah tikateivu v’teihateimu.
May we all be inscribed and sealed in the book of life for a good and healthy new year.

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