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Emails to my Therapist

Turning Point: First, The Heart Trouble

My blog has a new name and wider focus, this change being part of some mysterious personal turning point. The blog is getting much more personal.  The new title:

EMAILS TO MY THERAPIST:  Here’s the first of these emails, this time a saga of the heart:

Dear Nicholas

This change didn’t start in the emergency room. It was already pulling at me. But what happened has sure speeded up or deepened the process.

Bob and I were eating supper at La Farm; it was a “date night,” December 13. He was pretty quickly ready to go, saying his jaw was hurting. We were in separate cars. When I got home a few minutes after him, he was standing in the kitchen, asked me to drive him to an urgent care.

I was surprised.  Didn’t know he’d been hurting that bad — and he’d never made such a request before. We headed out — it was after 9— discovering along the way that all those places were already closed. We ended up at the Wake Med hospital ER in Apex.

When he’d described his symptoms to the receptionist at the front desk, she said to me in a tone of surprise, “He’s very calm.”  We both were, hadn’t seen any reason to be worried. Several tests and almost four hours later, the doctor came back in, sat down beside Bob’s bed.

“I’m going to draw you a picture,” she said. She drew a heart with an aorta coming up out of it and a bulge in that artery.  Turns out the problem is called aortic dissection in the ascending arch: a tear on the inside layer of the vessel and blood pooling between the layers and pushing against a weak spot in the outside layer. An aneurysm. As we later learned: It could burst at any moment.

I remember leaning my forehead over to touch the top of Bob’s head. We were both stunned, yet still not fully taking in the seriousness.

After multiple phone calls, the doctor said a surgeon was waiting at Duke Hospital and Bob would probably be transported by ambulance.

“Ambulance?!” Bob said. Doc said, “It’s that or helicopter….This is an emergency…It’s a big deal.”

We were starting to get the idea. I drove home to pick up a few items for a hospital stay, got to Duke at 3:30 a.m. He was in a dimly lit hospital room full of doctors and nurses making preparations. The anesthesiologist said to him, “Sounds like you’re going to have a little something done.” He answered with his own wry good humor.  The “little something” was, of course, chest-cracking open-heart surgery. He was not happy about this prospect, but the only question I recall him asking was how soon he’d be able to go back to work.

Full of bravado, I told him I’d see him in a few hours for lunch.

I felt pretty okay as long as I was with him in the room; he seemed his usual self.  But then his bed was wheeled out toward Surgery and I saw him twist his head back to try to make eye contact one more time. Too late. The bed was rolling away too fast.  That was when tears started plopping from my eyes, on my face and dress and the floor. (Tearing up again now, writing this.)

I carried the plastic sack of “patient belongings” and the quilt I had brought from home out to the waiting room to wait.  The sun was just coming up and from that glass-walled room on the 7th floor, I could see such a wide sweep of the world: the roof and tower of Duke Chapel, trees, more buildings, a huge plaza criss-crossed by already-busy sidewalks around a Christmas tree lighted in white.

I’d asked the medical folks not to come out and tell me about stages of the cutting as is sometimes done. I didn’t want to picture it. I said, “Just come out at the end and tell me everything’s fine.”

Rolled up in my quilt on a sofa, I also prayed, sending messages to my father who didn’t live long enough to meet Bob: “Daddy, if you see him, send him home.”

Seven and a half hours later, I woke up in early afternoon and within minutes the surgeon appeared and sat down with me. He said, “He’s alive….” But then he told me about the crisis on the table, when the aneurysm collapsed as soon as it was touched and he’d had to slow blood flow to everywhere but Bob’s brain and that any of several of his body’s systems could have failed. He might not survive. If he didn’t wake up today, it would be “a bad sign.”

This good doctor looked so exhausted and unhappy, said he’d done what he could. As he stood up, I said, “What do you expect?” He said, “I don’t know.”

In the time before I was allowed to see Bob, I made a few phone calls. My brothers headed for the hospital: Harry from Raleigh; Franc, three hours away, from Wilmington. Mainly then, I cried; felt pierced by the sight of one of Bob’s shoes that had slid partway out of the bag of his stuff. Finally I covered it up.

When I was let into the ICU, I was glad to see all the tubes and blinking machinery attached to him, breathing for him. It meant he was still alive. Two surgeons sat at his doorway, there if they should be quickly needed. Nurses beside the bed were calling his name, “Robert, Robert,” trying to wake him.

“He goes by Bob,” I said. We all shouted “Bob,” trying to get him to respond in some way, to move a hand, squeeze a hand. In only a few minutes he did.  Then he moved a foot, then the other foot. So we knew he wasn’t paralyzed.  Within half an hour he opened his eyes and within an hour he motioned that he wanted something to write with (he couldn’t speak because of the breathing tube.) I gave him what I had handy, a Wal-mart receipt from my pocketbook. He made some marks on it.

Gibberish was what it looked like, which scared me. I said, as if in ordinary exasperation, “Bob, I can’t read this,” and threw it aside.

My brothers took it over to a stronger light and studied it like a treasure map and reported: “It says ‘water.’ …He wants water.”

Not gibberish at all. He was making good sense.

Well, from there it was all good. The next morning, he woke me up, pointing out that it was quarter to nine. I’d spent the night in his ICU room on the “loved one” bed under the window. He asked me to please hand him his laptop and then he proceeded to email his patients, explaining the situation and canceling appointments. I was astounded. It felt truly miraculous.

A strong recommendation: If you ever need any tricky emergency work on your aorta, go to Duke Hospital, where every person we met was so extraordinarily competent and so kind to us, and get Dr. Ryan Plichta to do the operating. He accomplished what he wasn’t even certain was possible. The Apex hospital ER folks did a life-saving good job too.

We finally learned what a close call we’d had. One of the medics told Bob, “Most people who have what you had don’t make it to the hospital….This is the most dangerous thing we get here.”

After a week at Duke and about five more at home, Bob and I  returned this past Monday to a close approximation of our lives before. The main difference is a near-continuous sense of wonder that we get this chance.

Other differences are emerging too, for one thing, the part this experience is playing in a turning point for me that I don’t yet fully see or understand.  I’ll tell you more about that — as much as I know — on another day.

Peggy

(Note to reader: Even though my posts now are “emails to my therapist,” I welcome comments from you as well.)

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Comments

  • N
    February 3, 2017 at 2:44 pm Reply

    Very compelling!

    • Peggy Payne
      February 3, 2017 at 2:52 pm Reply

      Delighted that the first comment is yours, N!

  • John Rosenthal
    February 3, 2017 at 2:52 pm Reply

    Very moving. I’m glad the outcome was so positive.

    • Peggy Payne
      February 3, 2017 at 4:12 pm Reply

      I’m still trying to take it in, John. I sorta hope that process will last. Thanks for your comment.

    • February 4, 2017 at 10:10 pm Reply

      Thanks John ! , We saw some of your beautiful photographs on the hall wall near the clinic when we went to see my new cardiologist. May they bring as much power and beauty as I felt seeing them to all who are lucky enough to
      see them. bob

  • Marsha P-J
    February 3, 2017 at 2:57 pm Reply

    Peggy, I have tears in my eyes while reading your account of this cross roads event in your lives. So very thankful that things turned out as they did. And I really appreciate your emotional stamina to share your experience. The accompanying photo of you and Bob is a nice touch. Great picture but more importantly it captures your shared happiness. Love to you.

    • Peggy Payne
      February 3, 2017 at 4:12 pm Reply

      We thank you, Marsha!!!

  • February 3, 2017 at 3:01 pm Reply

    You are reminding me of my own open heart surgery in Nov. of 2014. Mine was not as serious a condition, but the pain and emotions were similar. I am so pleased that it was caught in time and that he seems t be doing well. BRAVO!! I would suggest that cardiac rehab (if it was suggested to Bob) be followed. It helped me so much.

    • Peggy Payne
      February 3, 2017 at 4:11 pm Reply

      Thanks, Judy. Yours in 2014 wasn’t so long ago — I expect the memory and feelings are still pretty fresh for you too.

  • Jim Maney
    February 3, 2017 at 3:07 pm Reply

    All I can say – after several long pauses and deep breaths – is WOW. For your strength, for your ability to keep it all together while everything was happening, for your ability to tell such a traumatic story in such a calm, compelling way. Glad to hear that Bob – and you – are doing well. And now I can go back to looking at your new website.

    • Peggy Payne
      February 3, 2017 at 4:10 pm Reply

      Thanks for the wow, Jim. I keep re-reading my own account and turning over the experience in my head. Rereading it brings it back maybe more than writing it– while writing it’s necessary to think somewhat about wording and such.

  • Amey Miller
    February 3, 2017 at 3:44 pm Reply

    Peggy, this is a real gift email to receive this morning. You are a person with a heart and soul, who also writes about what they go through, and gives it out to share. Love to you both, Amey

    • Peggy Payne
      February 3, 2017 at 4:08 pm Reply

      Many thanks, Amey. You have a fair amount of heart and soul yourself!

  • Jane Levy
    February 3, 2017 at 4:03 pm Reply

    I have been through a similar experience with my husband……..so identify with you all the way….Our crisis lasted longer–July 4, when my husband had massive heartbattack. — to October 15,2004, when he had a heart transplant. It is now
    twelve years later, and he has survived that crisis. We are both immeasurably thankful for the years he has been given.

    • Peggy Payne
      February 3, 2017 at 4:08 pm Reply

      Twelve years + is indeed a wonderful gift, and from such a radical surgery. I’m glad for you both, Jane.

  • Lee Grohse
    February 3, 2017 at 4:23 pm Reply

    I had communicated with Bob by email, so knew the bare bones of this. Thanks so much for being willing to share the details and what it was like for you. So very happy for you that you will have more years with your love! Happy for me that my friend is still alive and well again. Look forward to reading about the turning point for you and what it brings to your life.

    • Peggy Payne
      February 3, 2017 at 4:28 pm Reply

      Thank you, Lee. And I’m hoping to know, at some point, what I mean by this underground shift that I can’t quite grasp yet.

  • Christina Askounis
    February 3, 2017 at 4:23 pm Reply

    Reading this with an ache in my own chest. Sharing your gratitude and relief at making it through the valley of the shadow. Among many other things, your experience reminds us all of the truth we prefer to ignore nearly all the time: that we carry on day to day under the illusion that we will go on more or less as usual, when in fact anything can happen at any moment to transform our lives irrevocably and completely. When I was 18 and my mother died suddenly, I plunged through the thin ice we all walk on, mistaking it for solid ground. I’ve never been able to fully ignore that reality since that moment. But how to maintain an awareness of our precarious position without subjecting ourselves to hyper-vigilance and fear of what could but may never happen? Maybe gratitude offers a way because it inevitably anchors us in the present moment–and is only enhanced by our awareness of the ephemeral nature of all that we so easily take for granted.

    • Peggy Payne
      February 3, 2017 at 4:31 pm Reply

      I’ll bet your dad being in Vietnam at the time made that even more of a life-changer, Christina. I’m currently grateful to remember about the thin ice; I think you’re right (funny, I just spelled that word “write” at first) that gratitude is the solution.

  • Peggy Payne
    February 3, 2017 at 4:52 pm Reply

    Had an email from a man who went through something similar to Bob’s experience. He wrote: ” as I was recovering, I found a verse in the
    Psalms—-Psalm 57:7 (King James Version):

    “My heart is fixed, O God. My heart is fixed.”

    Yes, I know that the modern translation says “My heart is steadfast.” But— I think “fixed” is more apt for my heart.
    And maybe for Bob’s heart too.

  • Betty Palmerton
    February 3, 2017 at 4:54 pm Reply

    How beautiful a story, Peggy. Happy and relieved with you!

    • Peggy Payne
      February 3, 2017 at 9:35 pm Reply

      Many thanks, Betty!

  • February 3, 2017 at 4:56 pm Reply

    Peggy, I admire your courage and your strength. I know what those long hours in surgical waiting rooms are like with the anxiety of hoping for good news and knowing it may not come. I am so glad Bob’s surgery went well. You and he are truly blessed.

    • Peggy Payne
      February 3, 2017 at 9:34 pm Reply

      Thanks, Sally. What’s coming across to me now is how many folks know — have known for a long time –about those waiting rooms.

  • Virginia Ewing Hudson
    February 3, 2017 at 6:22 pm Reply

    Beautifully expressed, particular and universal at the same time. I, too, am grateful to a surgeon for saving my husband’s life: Dr. Sankar Adusumilli, colo-rectal surgeon. He was splendid and kind. I’m so glad for the strong outcome in Bob’s case (as is true for my husband also) and look forward to your further contemplations.

    • Peggy Payne
      February 3, 2017 at 9:33 pm Reply

      I remember when you were going through this, Virginia, and it wasn’t so long ago. I’m glad it worked out so well for y’all too!

  • RonPerk
    February 3, 2017 at 7:09 pm Reply

    Peggy- struck by your description of events. I would be interested in knowing if Bob ever felt he was in a life or death struggle. I think that something in us protects us from that grim prospect. I suppose we all respond differently, but I think the patient is able to focus on the moment to moment treatment without forecasting a result. It is the loved one(s) who are contemplating the enormity of the situation. I have often said that my obit should not say I tapped out after a courageous battle with heart disease. I just do what the medical folks tell me. How courageous is that? In any event, I feel your your anxiety and yore relief and gratitude. I am happy for both of you.

    • Peggy Payne
      February 3, 2017 at 9:31 pm Reply

      You’re right, RonPerk. Bob was not thinking about the possibility of death. He didn’t seem to get the full picture of how close he came until he’d been awake for a day or few. But when he suggested to one of the staff that daily blood tests were an awful lot, perhaps more than necessary. She told him right emphatically that most people who get his heart problem don’t even make it to the hospital. He said, “Say that again?” Thanks for your good wishes. Don’t tap out any time soon!

  • Bill Starling
    February 3, 2017 at 7:45 pm Reply

    Reading your account of the post-op period and your trying to read the note, I had a vivid vision of Harry and Franc trying to make sense of it and suddenly shouting WATER, he wants Water! That must have been the happiest moment of your life. I am so happy for you Peggy.

    Bill Starling

    • Peggy Payne
      February 3, 2017 at 10:26 pm Reply

      They helped me so much, Bill. And in retrospect I can only imagine Bob’s frustration/anger when I tossed his note — awful!

  • Jane Albright
    February 3, 2017 at 11:15 pm Reply

    While this story has a happy ending, I feel it’s continuing. I look forward to the next chapter. Bob was smart to know something was wrong; too many people ignore the pain thinking it will go away. Glad all is well now.

    • Peggy Payne
      February 4, 2017 at 12:32 am Reply

      Thanks, Jane. And, continuing how?!

  • February 3, 2017 at 11:40 pm Reply

    […] Bob is recovering now and much better. To read Payne’s account of her travails, click here. […]

    • Peggy Payne
      February 4, 2017 at 12:31 am Reply

      Thanks for sharing this!

  • Gail Waters
    February 4, 2017 at 1:08 am Reply

    Pls give Bob my best wishes. Was our group therapist for the social workers at Holly Hill Hospital and I still remember so many of his sage wisdoms gifted to us…like learning how to grieve so that when we reach the Big Goidbye we are ready. So empathic to your experience. Had to medevac my husband Bruce from St Lucia after suffering “the widow maker” and the beautiful people at Duke saved his life. That was 2010. He will be 90 this year. Blessings for return to health. Such a gifted man.
    Gail Waters

    • Peggy Payne
      February 4, 2017 at 1:13 am Reply

      He appreciate your good wishes, Gail, and comments “She was good at her job.” I’m glad Bruce survived his adventure!

    • February 4, 2017 at 10:18 pm Reply

      So nice to hear from you after all these years. Gail. And I’m sure glad your husband has done So well !

  • February 4, 2017 at 10:00 am Reply

    Such a reminder to pay attention to our bodies! And our partners. I’m glad Bob knew he needed help. And that you have shared this with us in great detail so we can hug our loved ones closer. Every day above ground is a gift. I forget that when fighting traffic or waiting for late taxis or a host of other things that make up living.

    • Peggy Payne
      February 4, 2017 at 5:17 pm Reply

      Good to hear from you again, Mohana!! And thanks for your nice summation of what to pay attention to. That host of other things can easily get in the way for years.

  • […] to therapist)    Nicholas — So many surprises for me since Bob woke up from his near-death crisis in heart surgery. The cardiac medical emergency itself was the first and largest surprise, of […]

  • […] trying to put my regular self/life back together after the six weeks at home and hospital during Bob’s medical adventure.  I do know this is very little shake-up compared to that of Syrian refugees and people who lose […]

  • March 1, 2017 at 2:37 pm Reply

    Peggy is a great writer and human being and I am happy she is sharing this blog. What about a blog about logs?

    • Peggy Payne
      March 3, 2017 at 5:14 am Reply

      Thanks very much, Randy. A blog about blogs?

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  • December 13, 2017 at 3:27 pm Reply

    […] Nicholas, Tomorrow at about 3 p.m. is the one-year anniversary of the moment when a Duke aorta surgeon came out to the waiting room and told me that Bob was alive but he […]

  • […] from the impact of something large, like a meteorite. I felt some sort of turning beginning before my personal meteorite hit–a cascade of serious family medical problems beginning with husband Bob’s very […]

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  • […] not a high-risk surgery. No need to be freaked out about it. But there’s some of history of seriously scary moments in the medical care of Bob’s heart. I think the effect is never entirely […]

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