Understanding the Significance

Hello everyone…in my first blog entry I shared the events of that day 8+ weeks ago that would change my life forever…or, more importantly, give me clarity to be thankful that I still have a life! To understand the significance of this it’s important to understand what has defined me as a person and what I have been through.

I started competitive sports at age 7, playing soccer for my local competitive team. It was there that I found that I thrived on pushing myself to the limits. I also met many lifelong friends on those teams. I credit my second coach with instilling that deep drive and competitiveness in me as he pushed us in ways we never thought possible. We ran and trained for hours on end to the point of exhaustion yet we kept coming back for more. I was at my happiest when I was testing just how far I could push myself.

I took this drive and discipline with me throughout my athletic career enjoying a successful soccer, softball, and later volleyball career. It was in high school that I discovered volleyball, our high school coach had seen me at a softball all-star game the summer before and suggested to my brother I try out for the team (he had coached my brother in water polo many years before). I was flattered so I thought I’d give it a try. I was hooked. I played every chance I got and started playing year round my freshman year. I made varsity as a sophomore and had an amazing time playing on both my high school and club teams, again, making many lifelong friends. I wasn’t highly recruited out of high school so I decided to continue playing for our local community college which was one of the top-ranked teams in California at the time. This is where I really feel I blossomed as a player.

Another life changing event also occurred shortly after my freshman year, the loss of my father to a ruptured cerebral aneurysm. My father had been a huge part of my athletic life, having helped coach many of my softball teams, etc. It was at that moment I was determined to never have to rely on someone else after I saw what my mom had to go through trying to pick up the pieces financially and otherwise.

Again, we were tested mentally and physically in ways I never thought possible. We endured 8-hour practice during double days, hours of being pushed and yelled at to be our best, yet we kept coming back for more. It takes a special type of athlete to handle this stress and my teammates and I thrived on it. We went on to finish as state runner-ups both years, and, although we didn’t win state championships we still proved to ourselves that we could do almost anything we set out to do! I was recruited by several schools after my two years at De Anza and chose West Texas A&M University to continue my volleyball career at.

I arrived in the grassy high plains of West Texas in early August to meet my coach and teammates. I remember driving into the Panhandle and thinking, “this certainly isn’t like California”. I was excited about the possibilities but also frightened as I’d never been away from home. Once my teammates and I stepped on the court and started to mesh as a team and as friends it was clear we had great potential. Each and every one of us set aside our individual needs to become part of something bigger, a team. We endured hours upon hours of practice, weight training, studying films, etc. But, in the end, it was all worth it as we walked away with West Texas’ first Div. II National Volleyball Championship in December of 1990.

We had an amazing run that year and the feeling of accomplishing a dream is like no other. Once the shock and awe started to wear off I think each of us understood that we had accomplished something very special and that we may never experience anything like that again.

The summer after that first year at WT brought many changes…we found out while on summer break that our beloved coach was moving on to a Div. I job and we were devastated. We arrived at campus in July to work camps but still didn’t have a new coach lined up. In fact, here we were, National Champions and we didn’t get a new coach until two weeks before the season started. Also, because our school dropped the football program for that year due to financial constraints we were forced to become independent and were not affiliiated with any league. We already had two strikes against us yet we were determined to make the most of it. We had lost our senior leadership and now there were only two seniors, myself, and another.

In many ways, I look upon that season as an even bigger accomplishment because it seems we had so many strikes against us starting out. But, again, we put in countless hours of hard work and it paid of as we went on to win a second National Championship with our new coaching staff.

After those two wonderful years at WT, I continued to fuel my competitive drive by moving back to California to attend nursing school while playing on a competitive women’s club team and trying new sports like triathlons and running. I am not a natural runner or swimmer but I enjoyed doing both sprint and Olympic triathlons for many summers during my 20s.

In 1999 I married my husband and also started graduate school for nursing. Another challenge. It was at this time that I stopped playing volleyball due to time constraints and the physical toll it was taking on my body due to chronic injuries (back, shoulder, knees). Thus, I began a decade of new and different challenges.

On October 1st, 2000, I went to work after spending the weekend moving with a “side cramp”. After working all day with progressively worsening pain my coworker and other assistant manager drove me to Kaiser where it was determined I had appendicitis. Later that night, after working a full shift at the VA I was taking to what would become my first of many surgeries over the past 10 years. My husband dubbed me a “lemon” jokingly, but, boy he had no idea at that time!

Six months later I underwent bilateral fasciotomies for compartment syndrome in both calves caused by running. This is a very rare condition but can be caused when the muscles grow beyond what the fascia can handle. Go figure, it happened to me. But, once this was fixed I was able to begin working out again and even ran a 5K 10 days post-op! I had my active life back, or so I thought.

A year later, as I was walking up the stairs to work, I felt a pop in my knee and it gave out. Another injury. This was the knee that I had torn my posterior cruciate ligament in during my volleyball days at De Anza. A few months of limping around with a brace and I was back in for arthroscopic knee surgery. Three years, three surgeries…this decade wasn’t looking too good!

I was finally back on track and even did a triathlon in the summer of ’04, although, I had a poor performance. I chalked it up to inadequate training, although in hindsight there were other factors.

I became a mother in 2005, a life changing moment that I am so thankful for. On Sept. 15, 2005 my husband and I welcomed our son into this world. He has been our joy ever since. I endured a very difficult pregnancy and birth and after seeing just how difficult it is to raise a child we both decided one was enough.

During my pregnancy I had several episodes of severe chest pain and mid-scapular pain. My doctor and NP chalked it up to GERD and possibly gall bladder disease. I was told to re-evaluate it after my son was born if it returned. We were on vacation at our condo in Palm Springs when my son was 8 months old when it returned with a vengeance. We had eaten at one of our favorite BBQ restaurants there and about 4 hours after dinner the pain and vomiting started. Luckily my mom was with us and she drove me to the hospital in the middle of the night. They worked up my heart but everything was negative so they sent me on my way.

Two days later, when we were home, I had another episode and this time drove myself to Kaiser in the middle of the night. They did an ultrasound and found that I had an inflamed gallbladder. I was scheduled for surgery six weeks later (they wanted to give it time to calm down). Now I really was looking like a lemon…in six years I was on my fourth surgery!

The next four years went by with various challenges of balancing work, raising a child, as well as some weird health symptoms (“heartburn”, frequent sinus infections, etc.). It seemed I could never get fit and no matter how hard I tried working out was always difficult. I chalked it up to being overweight, out of shape, whatever. Little did I know it was probably my heart all along. As you read my first entry, on March 24, 2010, it became glaringly clear it was my heart. And, as you can see from my past athletic history it is truly a miracle I am still alive. My type of anomaly (anomalous right coronary artery) often causes sudden death among athletes…but, for some reason I’m still here. And, boy, am I thankful!

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How’d this happen to me?

Hello,
I’m writing this blog to share my experiences of the last couple of months. During this time, my life has drastically changed as I’ve undergone emergency open heart surgery in the unit where I work. Never in a million years did I think this could happen to me, yet it did. Here’s a look back on that day and how I started my full circle journey. I am the assistant nurse manager in a very busy ICU at a large VA Hospital.

The date was Wednesday, March 24, 2010…it started out as any other workday early in the morning. I remember waking up, showering, but feeling completely wiped out, absolutely exhausted. I’d just turned 40 12 days prior and was chalking the exhaustion up to a busy schedule. What else could it be? Aren’t all moms who work full-time exhausted? More on that later. I had even posted on my Facebook page that I felt like a zombie. As fate would have it, it’s a good thing I went into work.

It was another busy day in the ICU when I arrived at work at 0720, we had a full house and were expecting one open heart surgery patient at around noon. Odd in that we don’t usually have heart’s scheduled on Wednesdays so that means this case was fairly urgent. After report, I started on my usual charge nurse paperwork and the unit was running smoothly. As the assistant nurse manager, it’s usually my role to be in charge and I also have admin time each week to complete other responsibilities such as scheduling, meetings, audits, etc. It makes for a busy job but at least I don’t get bored!

Each morning we have a bed meeting at 0900 with all the charge nurses and the bed control nurse to ensure the patients flow through the hospital smoothly. This is our time to let everyone know how many patients can transfer out of our unit and how many beds we have available. On this particular morning we started off with only a code bed but had several patients ready for transfer. This is pretty typical for us. After the meeting I started having chest pain, or “heartburn” as I thought it was. I told my manager I was having heartburn and had my morning snack, figuring it would help if I had some food in my stomach. It didn’t.

I went back to the unit and continued to work for the next hour and a half, progressively feeling worse. I don’t know how to describe it except I was wiped out and had chest pain. I finally told one of my coworkers and she checked my pulse and immediately told me to go lay down in our empty room, the code bed. She’s a very experienced nurse so I figured I better listen to her. She told me my HR was irregular and the next thing I know is I’m being hooked up to an EKG and our ICU Attending is in the room with me, along with a couple of nurses. I was feeling progressively worse, sweating, nauseated, and the pain was getting worse so they gave me a nitro tablet for under my tongue. Woo wee what a feeling that was, I got very lightheaded and had a bad headache…but…it helped the chest pain so I knew this was real. At first we were talking about me driving to Kaiser (where my insurance is), but I knew at that point it wasn’t safe to be in a car. Our doctor started an IV on me and got our cardiologist in to see me. She took one look at the EKG and told me this was real and I was not going to Kaiser but that I needed to get a cardiac cath ASAP.

Holy Shit! A cardiac cath? A zillion thoughts were going through my mind…I’m 40 years old with a 4 year old at home, this can’t be happening! I was terrified and started to cry. By now there were three of our doctors in with me all working on stabilizing me, along with my own nurses. “Ok” I said, let’s do it. I then figured I better go pee because I was going to have to be flat on my back for several hours and God forbid I use a bedpan! As it turns out, that was the least of my worries, but more on that later!

I got up to pee and at this point I didn’t even care who saw me or that there was a camera watching my every move. On the way back to bed I started feeling even worse and started vomiting. My staff were preparing me for transport to the cath lab while I was puking my brains out. Once I got to the cath lab I was given Compazine for the vomiting, Fentanyl, and Versed to calm down. I’d also had several nitro tabs by now. I was happy to see two of my friends as my cath lab nurses and I know the doctor is one of the best. I think I slept through most of my cath and woke up to find my husband and the cardiologist showing me the video and explaining how I had an extremely rare coronary artery anomaly. My right coronary artery was just a branch of my left anterior descending artery and was kinked and stenosed. At first the cardiologist thought it was something that could be treated with medications, but the next thing I knew is our cardiac surgeon was in the room telling me I needed coronary artery bypass surgery and quickly! What???? Holy Shit! I told him, “you are bullshitting me”. But, he clearly wasn’t. He looked very stressed and had me sign the consent right on the cath table. He explained that it wasn’t safe for me to go by ambulance and asked if I minded if he did the surgery. Minded? Of course not! I know he is one of the best and I couldn’t think of a better place to be with familiar faces everywhere.

After that they decided to do a 3D CT scan of my heart to verify that the coronary artery was, indeed, running under the aorta and pulmonary artery (essentially causing mechanical obstruction). I had received a lot of medications by this time and I don’t know how long we had to wait for the CT scanner but it was a while. They also gave me several doses of beta blockers to try and slow my HR down as it was too fast to get a good scan.

Finally, the CT scan was completed and I was wheeled up to the Intermediate ICU where my husband works (he’s a nurse also). I remember seeing my son in the elevator and daddy holding him and he looked very frightened. They checked me into my room and the cath lab nurse who had stayed by my side all day took out my sheath. She had to apply pressure on my groin for quite some time but I’m not sure how long.

That night in the IICU was pretty much a fog…I didn’t sleep much but I also don’t remember much until my husband came back at 0600 to visit. He hadn’t slept much either in anticipation of my surgery. I do remember borrowing a laptop computer and posting on Facebook that I was taking my last sip of Gatorade before being NPO after midnight.

My surgery was scheduled for around 10:30-11 am, they had to do a case before me and then the OR would be ready. Our wonderful anesthesiologist came in to see me and told me he was assigned to the case and would I mind? Of course not, he is awesome and very experienced. Another anesthesiologist friend was also going to stay in the room and help. Wow, who gets two Attending anesthesiologists? I knew I was in good hands with people I trusted and that are like family.

The cardiac fellow also came to see me and asked how I was doing. “Nervous” I replied while trying to keep a brave face. He laughed and said he was probably more nervous because there were 50+ nurses upstairs that would kill him if anything happened to me! Ha! Two more of my best friends and coworkers stopped by right before their shift started and they were clearly upset but were trying to be brave. By this point I was mentally prepared for what needed to be done.

A few more hours went by and the OR staff showed up to wheel me to the OR…haven’t I seen this with patients a hundred times? Now it was me! I kissed my husband good bye and into the OR holding area I went. More familiar faces, my friend, a CRNA was starting an IV across the room and the OR nurse checking me in is an old friend as well. My anesthesiologist came to see me and that’s all I really remember until later that night!

I was in surgery for about four hours and had a one vessel bypass. Of course I don’t remember anything but I do remember waking up to people cheering for me and encouraging me to “open my eyes”. All I remember thinking is…”leave me alone, can’t you see I’m sleeping?”. When I finally did open my eyes I saw a large group of our nursing staff standing around me and they were about to extubate me. The RT told me to take a deep breath and the next thing I know the tube is out. No pain, no discomfort, not what I had imagined at all after seeing it hundreds of times! Phew! I also remember thinking, “gee, my chest doesn’t hurt too bad”…well, that thought was short lived once the anesthetic and pain meds wore off!

More on my journey to follow…

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