Randy Fritz: Trusting Your Medical Team Makes All the Difference
Randy shares the most valuable lesson he learned through his journey from initial diagnosis to fix a leaky mitral valve to his recovery from open-heart surgery.
When my family doctor told me I had a heart murmur at the end of a routine annual physical, I was a 61-year-old man who exercised vigorously four or five times a week. Since I had no symptoms, I was flabbergasted when my new cardiologist told me I would need open-heart surgery to fix the leaky mitral valve responsible for my sloshy heartbeat.
Being flabbergasted didn’t equate with fear or anxiety because my condition didn’t require immediate action. At first semi-annually, and then quarterly, I dutifully reported to his office to discuss the results of my most recent echocardiogram. He encouraged me to schedule the surgery while I was healthy, and I said I would—but not yet.
Three years passed and I rarely thought about what it would be like to expose my heart to a surgeon’s knife to prevent rather than treat the symptoms that would eventually degrade my life and possibly shorten it. I had my next echocardiogram while watching Joe Biden take the oath of office and hearing Lady Gaga sing the National Anthem. A day later, while strolling through my Central Texas garden on a bright winter day, my phone vibrated and my cardiologist—with a tone that had abruptly switched from suggestive to emphatic—warned me that if I did not schedule my surgery soon, my post-operative prospects would no longer be optimal.
After consulting with the surgeon he recommended, I faced a choice: accept their joint clinical recommendation and submit to a procedure I had a hard time imagining or disregard it and wait until my lungs and stamina proved my mitral valve was defective. After scheduling the surgery, I did what any 21st-century man would do: dive into the online world.
My questions were harvested from a bramble of dread. How would my breastbone be cut open and then securely reattached? Can the heart-lung machine fail and, if it does, how long before my brain abandons my lower extremities? How can I be sure they can get my heart going again after messing with it? What is my chest going to feel like after the bone and muscle and flesh are subjected to unnatural acts? What are the odds of dying on the operating table?
Besides these online searches motivated by fear and ignorance, I also wanted to know what would happen in the hospital after my surgery and the first few weeks at home, assuming I survived that long. How much control over my daily life was I surrendering? And how long I would have to wait for it to return?
As I squandered hours online many evenings before my operation, I wasn’t sure whether I was trying to find or avoid anything that would weaken my resolve or tempt me to postpone or cancel the surgery.
I am now more than three months past my surgery and my life has largely returned to normal. I am playing tennis and riding my bike again and I have no post-operative discomfort. I also have a much clearer idea of what I needed to know before the operation and what questions were counter-productive or worse.
While each person’s experience will be different, I hope that what I learned and experienced will be useful and reassuring to any asymptomatic candidate for open-heart surgery.
The most basic thing I learned is that successful recovery from open heart surgery begins with trust: in the medical professionals who will care for you and in yourself for making the commitment to repairing your heart when your body isn’t forcing you to do it.
If you trust your cardiologist, surgeon and the nurses and medical assistants who support them, you don’t need to know the mechanics of the surgery or the statistical odds of success. Being wheeled to the operating room is like sitting in an airplane as it taxis to the runway. If you don’t have a fear of flying, you trust that something big and heavy can safely go airborne. So it is that the men and women to whom you have trusted your life will be able to work together to make the necessary repairs to your heart without you understanding how it’s done.
When you find yourself in the intensive care unit after your anesthesia wears off, you will have to confront the inevitable rigors of a major operation, some of which will be universal and some specific to your body and mind. Among the universal rigors will be exhaustion and an inability to do basic things with the efficiency and speed to which you are accustomed.
Among the specific rigors will be those related to your lungs, your chest, and your mind. I was lucky to have almost no pain in my surgical area while others I heard about had severe pain. But I was unlucky to have a persistent cough that was perhaps a remnant of my childhood asthma or simply the consequence of having my lungs deflated like a balloon with no air in it. I would cough unceasingly for hours, almost tearful with gratitude for the brief moments when I was able to cough up enough phlegm to momentarily disarm the gurgling war being waged in my alveoli.
The cough was initially so miserable that it provoked a significant risk to my recovery: an impulse to second-guess my decision to have the surgery and revile those responsible for it. I was able to face down this challenge with the help of my surgeon and his physician’s assistant. I was honest with them about my feelings—a mixture of resentment and anger at what I had allowed them to put me through. And they helped me come to accept my decision with empathy and understanding, even as I regretted my situation and their role in it.
For anyone with little or no experience with inpatient hospital care, the days following open- heart surgery will be an unfamiliar mixture of routine medical activities, boredom, sleeplessness, loss of appetite, and difficulty performing routine tasks like walking or getting into and out of bed. Having reading material will help and empathetic visitors will be a godsend, although probably not for longer than several hours at a time.
By the time I was discharged from the hospital, my gratitude for the care I had received had overtaken my negative emotions, and I was in the proper frame of mind to follow the many instructions I received for my post-operative care. I was relieved to discover that the many initial limitations on my daily activities—getting in and out of bed, taking a shower, walking up and down stairs, and being careful about how I used my arms and upper-body—were easily achievable and only mildly inconvenient.
Just over four months passed between deciding to have my surgery and the 12-week milestone of my recovery—the point at which all the limitations on my physical activities ended and my cardiac rehab activities neared their completion. I put my trust in my cardiologist, surgeon, and all of the medical professionals who helped me along the way, including the attentive physiotherapists in cardiac rehab. And my trust was rewarded with a return to all of my prior activities and a heart that will support them for a far longer period of time than what would have been possible before the medical wonder of open-heart surgery.