Forced to Gamble

In 1977, I was the first pregnant patient with a Medtronic pacemaker, making me a case study or a pregnant guinea pig.  Everyone, except me, was concerned. The delivery entailed a full house, a cardiologist-approved obstetrician, a heart surgeon, Medtronic representative, and students from IU’s medical school.  All went smoothly, so from that point on my doctors and family relaxed.  I had two daughters.  The second daughter was of no concern.  The only doctor available ignored me as he ran from room to room delivering babies. When I screamed that I was going to push the baby out, the doctor ran in and caught her.  I rarely told friends I had a pacemaker.  My pacemaker peers were 60+ years old.

Over the years, pacers improved, but in the beginning, there were recalls, infections, one even erupted through my skin. Didn’t faze me. I was young.  I was immortal.

In 2015, forty-three years after my initial implant, my cardiologist said my surgeries were becoming complicated.  He referred me to “the best” electrophysiologist, Dr. Keating, who questioned me when I told him not to move the pacemaker location, “Leave it buried. I don’t want a bump on my chest.”  He looked surprised and asked if I still cared. 

“Of course, I care.  My chest is the only good part of my body.  I don’t want a bump showing!”

This young surgeon didn’t care if I had a chest-bump. Normal pacemaker placement is safer with easier access.  We scheduled surgery. I was glad he was skilled, but I wasn’t too happy with his attitude.

Following surgery, he came to the waiting room dripping sweat, still in his scrubs, “Tell your mom I did what she wanted.” He also replaced some leads and worked around lots of scar tissue.  He told them the next surgery would be major. I don’t remember if they told me.   I liked my new surgeon.

Six years later, on Labor Day 2021 Dr. Keating left me a very long rambling voicemail concerning my upcoming surgery. What?  Was he bored?  Was he going through a divorced? What doctor does that? My cardiologist told me not to worry, “He is very thorough and cares about his patients.”

In November, my daughters and I met with Dr. Keating concerning my next surgery. I had an old lead that needed to be replaced.  It was dangerous due to extensive scar tissue and debris.  My insides were a mess because of 40+ years of surgeries.  I needed a six-hour pre-op a week before surgery.  In the operating room there would be a heart surgeon and blood for a transfusion.  There was a possibility Dr. Keating could nick the artery trying to remove the lead, which would cause immediate drastic blood loss.  At that point I’d receive donated blood and the heart surgeon would perform open heart surgery to stop the bleeding.  The surgery could go one of three ways.  Most likely he’d remove and replace the lead, clean up scar tissue and move the location of the pacer. The second possibility was open heart surgery and the third, but highly unlikely, was death.

The surgery would be scheduled for January.  I didn’t remember much after he said “death.” The odds were good, but I don’t gamble if I can’t afford to lose.

Shortly after the appointment the doctor’s office called to see if I could do the surgery on December 8.  I told them, NO.  Who would choose to die right before Christmas?  I called my daughters.  They wanted it done ASAP.  I called the office back and we set up the pre-op, the surgery, and post-surgery appointments.  December 8,2021 could be my expiration date.

I had about three weeks to prepare. 

Surgery Prep

Prepare for the worse and hope for the best. If I died, I wanted the least amount of damage.  What scared me most about a December death was the timing. It would ruin Christmas.  I’ve pulled some doozies, but it’s always been funny after time passes.  This might never be funny. My mind raced.

I looked at my options. Option One was best, but what about the other two?  Which would be best?  With the second, I could end up needing too much care.  What if it led to dependency?  What if the kids, filled with guilt, reached their limits caring for me?  I think they would have chosen Option Two over Option Three, but I chose Three. If I died, I wouldn’t know it.  I’m pretty sure I’d make it to heaven, eventually.  Until then I’d probably sleep without dreams.  Not too bad.   

My girls and siblings lied. They told me I’d be fine. They weren’t worried.  My good friends threatened me. I was not allowed to die.

I discussed death only with Jan because she was brave enough to question me.  I told her that all mothers want their children happy.  If I died, I’d be fine. They were allowed to mourn, wail and become despondent for about a month, then move on!  She promised she would.  I was worried about Jill and Dee. Jan promised to take care of them.  Again, Jan told me the surgery would be successful.  She was not worried at all.  This from the kid who previously said she worried about me dying many times.

It’s unsettling to have a death date. I told very few people.  I knew there’d be lots of phone calls, advice, and false assurances. Even worse, if I didn’t die, I’d look like I wanted attention.  I needed to be alone.

I cleaned my house so when emptied it’d not be disgusting.  I paid two months of utilities.  I wrote long love letters to each child and grandchild. I sent a text to a priest friend telling him my kids might need him December 8.   I wondered if preparing my Last Will and Testament a few months prior was an omen or a coincidence. I’d put it on my dresser before leaving for surgery. Each night when I went to bed, I thought about my December death.  I talked to God, a lot.  How would I feel being dead?  Would I be able to see my body as I left it?  Would I have a choice to come back, but choose not to?  Who would go to my funeral?  If a memorial DVD was made, would the pictures be flattering?  Who would do the eulogy? Should I write my own? I didn’t have a church because I’m a floater. I had no funeral arrangements.  Poor kids.  Too late now. 

You can only do so much in three weeks.

The Surgery

When we arrived at the hospital at 5:30 AM, my brother Joe was waiting. Even though the hospital ruled only two people could be in the waiting room, my family ignores rules. Jill, Jan, Dee, Diane and Joe waited for over seven hours while Diane nervous rambled only to occasionally break down and say she couldn’t lose me because we were Thelma and Louise. We were supposed to die together. I wasn’t there, but I imagine all these confident people were anxious and very happy when Dr. Keating declared surgery a success. God chose Option One. 

Option-One Recovery

When I woke up, I did not realize this recovery would be much different than others.  My blood pressure hovered at 40/30 due to blood loss. I was weak and disoriented. Hospital discharge was delayed, but I was able to leave on day three with instructions on how to handle wounds and do medications to help blood pressure.  My girls spent the nights with me in the hospital and then they brought me home. They stayed around the clock. They charted, handled meds, fed me, and dressed me.  They took care of my dog, did laundry, and answered phone calls. They assumed nurse roles taking me back to hospital where a blood clot was detected.

My sister, Elaine came to relieve them on the 4^th day.  Both girls were so excited that Aunt Elaine was coming, that they stayed.  Diane and Joe also came.  I witnessed a deep love and an intense fear of missing out.  Joe suggested a slumber party, which we planned for the following day.  I was still on pain meds when Joe arrived with hard coffee and good beer.  “Only for big surgeries, do we plan slumber parties,” he said as he entered my home.

Elaine stayed with me four additional nights, until I was able to spend the night alone. Alice sent such a wonderful treat basket that I almost reordered, but it was $75.  Neighbors left gifts on the porch. Diane brought snacks, food, meds, a blood pressure machine, and probably spent hundreds of dollars.  Pay her back? She’d refuse.

Jan and I went for a follow up appointment a few weeks ago.  My red blood cell count is very low, but not low enough for a transfusion.  It may be three or four months to get the count back up.  This makes me tired, but otherwise, I’m great.

I knew my family loved me, but I overwhelmingly felt it after surgery.  I could not be a more grateful or lucky person. I could not have come home without help and never did I worry.  I’ve got three siblings and two daughters who put everything on hold, even their own families, during the holidays to take care of me.

I’m so fortunate I got Option One.  I witnessed the girls sacrifice over and over to help me.  I’m one-month post-op and they are still checking on me every day, offering to help, and taking care of my baby Maltese, Ted.   Lucky for them I know how to set them free.

Thank you.  I love you.   I’m good.