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After Covering Sophisticated Surgery, He's the Patient : Veteran Correspondent Writes a Story That's Straight From the Heart

January 24, 1988|ARTHUR H. ROTSTEIN | Associated Press

TUCSON — People most associate valve jobs with cars, a way to keep the old crate running a few more miles. I've had two valve jobs. Not on my car, on my heart. Two. In four months.

I had little choice. My engine was starting to fizzle, and the solution was a valve replacement if I wanted a shot at old age.

So I went from writing about cardiac patients as a reporter to being one. A somewhat special one at that.

Among heart patients, bypass surgery has become almost commonplace in America, about 180,000 such operations a year. Valve jobs are considerably rarer. An estimated 39,500 people had them in 1986, the year of my first operation. I will also be included in the 1987 statistics when they are compiled.

Nobody keeps track of how many Americans make the valve-repair list two years in a row. Not many, of course, but I would gladly have declined the honor.

No Complications

My first operation, on Oct. 7, 1986, should have been the start and end of the story: surgery, recuperation, rehabilitation, get on with life. Indeed, there were no immediate complications.

But what started as a relatively uncomplicated trip along a straight road detoured into a tortuous journey down a twisting trail full of potholes. I seemed to hit nearly every one.

Along the way, over the next 4 1/2 months, I:

- Sprang a leak around my replaced valve, tissue tear causing premature destruction of my red blood cells;

- Underwent a second surgery to fix the tear, and to repair a second faulty valve;

- Potentially faced yet another operation because of a possible infection for which I received antibiotic treatment;

- Suffered an allergic reaction to the antibiotic and had to be rushed back to the hospital, and I developed phlebitis.

As if that weren't enough, 14 days before my second open-heart surgery, I had to put my dog Montrose to sleep. My constant friend of 11 1/2 years, part Airedale and the rest only God knows what, suddenly took ill of a previously undiagnosed cancer. I remember tearfully saying to him, as he lay at the vet's office, "We hit all the odds, buddy."

We sure did.

For half a year, I was strapped into an emotional and physical roller coaster, riding the downs and ups of surgery, rehabilitation, surgery, rehabilitation. During that time, I gained a fairly extensive insight into the life of an invalid.

I also picked up a firsthand understanding about coping with life's uncertainties. The irony for me, a reporter, was that I was my own subject. Those peaks and valleys were mine.

In the first weeks after my initial surgery there were many days when I felt worse, not better; when I was short-tempered, had no strength, no appetite, became angry if people told me how well I looked and sounded--because I certainly didn't feel that way. My chest, which had been cut and cracked open, ached. Sleep was difficult. I seemed to become a crusty ogre.

But there also were times when I definitely felt better, more frequently after I started in a rehabilitation program about a month after surgery.

That involved wearing a heart monitor, walking on a treadmill, riding a stationary bike, doing arm and stretching exercises and, after a time, lifting light weights. The regimen was satisfying and motivating.

The program also included nutritional counseling and heart-related lectures, equally valuable. Stress management training also proved most beneficial.

Longer Than Expected

Even so, my recovery took longer than I had anticipated. I had interpreted the doctors' optimism about the surgery to mean that within a month or so I would be running around as before. When four, then five, weeks passed and I still didn't feel that way, I became anxious and irritated.

One reason it took longer than expected was because of what the doctors would not discover until January.

The tissue anchoring my new mechanical aortic valve was proving to be about as strong as Kleenex. Two sutures had torn in separate portions of it. My mitral valve also was leaking.

Like any other pump, the heart has an inflow valve and an outflow valve. They control the flow of blood into and out of the left ventricle, the chamber where the blood is purified and sent back into the body. The mitral is the inflow valve, the aortic the outflow. They work in unison; when one closes, the other opens.

The leakage around the aortic valve wasn't as severe as what had necessitated my surgery, but the potential consequences were dramatic. I had just returned to work and was resuming a somewhat normal existence as a husband, father and provider, only to learn that I would be back on the table again on Feb. 16, four months and a week after my first operation.

The surgeon learned, on going back in, that my mitral leak was significant. Its severity either had been masked previously by the massive aortic leak or had developed only after the first operation.

How had all this come about?

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