Walter Michka – My Bypass Story
Walter Michka is a Chicago writer and comedian: national TV, local radio, and major ad campaigns; wife, four kids, house in the suburbs. In January of 2009, Walter underwent an emergency quadruple bypass after experiencing chest pains that even his doctor thought, at first, was acid reflux. Additional blogs at: www.chicagonow.com/open-heart.
It’s hard to put a finger on what got me to that operating table undergoing a quadruple bypass. I’m not one of those guys. You know the guys—beer gut, flopped on the couch, chomping on a burger. Those people you see from the neck down in B-roll on the evening news and say to yourself: “there’s a heart attack waiting to happen.” That’s not me, never was. 5'11", 180 pounds, my cholesterol was in the mid-160s. No family history, I’ve never smoked. Red meat once or twice a month. I liked fish; I ate my veggies. I worked out 3, 4 times a week. I took yoga.
There’s a thing between cardiologists, I’ve been told, when they’re consulting on a patient. One of them will ask the other one, jokingly but not jokingly: “What’s his sin?” Meaning, what’s this guy’s weakness, his vice that brought them into their office. What clogged him up; what’d he do wrong? It’s got to be something. Two packs a day. Fat, juicy steaks. Something.
So the sixth question they always asked me was: “What do you do for a living? Do you have a stressful job?” When I tell them advertising, they set their jaw and nod their heads knowingly. Mmm, yes, I see, of course.
I never thought of my job as stressful. Aggravating, maybe. Frustrating, certainly. But not terribly stressful. Okay, something got my blood pressure kind of high; it’d been creeping higher each year. Since I fell into my first agency job back in the mid-’90s. So there was probably a connection. My doctor gave me BP meds a couple of years before this heart stuff. I stopped taking them when I thought they were causing side effects but I never told him and he didn’t ask so my blood pressure went unchecked.
This thing felt like acid reflux. I knew what acid reflux felt like, I had that plenty of times before. This was sort of like that. Only different.
I had come back from a particularly tense production trip with my particularly high-strung art director partner, and I thought it was that aggravation. I’d get a pain in my chest. No numbness down the left arm, no tightness, nothing the Internet said was a sign of trouble. So for a week I watched and I waited. Walking from the train station to the office, I’d stop every other block when the pain kicked in. Prilosec seemed to help but only a little. No neck pain or shortness of breath, none of the usual signs. Only one website mentioned: “pain upon exertion” as a warning sign. That made me get in touch with my doctor’s office and they squeezed me in on a Tuesday.
“Yeah, it sounds like acid reflux to me, too,” he told me. “Double the Prilosec and see if that helps.” Then he added: “But I want to schedule you for a stress test anyway to check your heart, to rule out what it’s not.”
He got on his computer and we went back and forth, trying to find a good time, no hurry, what’s good for you?
“No, I’ve got a lot of meetings Wednesday.”
“Hm, maybe. In the afternoon.”
“Okay, good. I got you down for 1:30.”
I spent Thursday morning in a recording session directing actresses as they pretended to be glad they finally did something about their varicose veins. Then I walked the four wintry blocks to the hospital, stopping every block.
# # # # #
Backless gown. Running shoes. Sensor disks stuck everywhere. IV catheter in my arm. Ten minutes on the treadmill and the pain slowly ramped up.
“On a scale of one to ten, how bad would you say the pain is?” the med tech asked me every couple of minutes.
“Two,” I’d tell her.
When I got to nine, she stopped the treadmill, put a chair directly on the belt, and told me to sit. She hunched over the read-out paper, studying it, glancing back at me. Back at the paper, then at me again. She motioned over another tech, or maybe he was a doctor, and they both studied the readout. Look at the paper, look at me, look at the paper. Until he left and she walked over to me.
“Get your things, Mr. Michka,” she told me in her serious voice. “We’re going to have to admit you.”
They might’ve said something about blockage, they might’ve told me a lot of things, but I was only half listening. Not counting the on and off pains in my chest, this came out of nowhere for me. I called my wife, Anne from the locker room on my cell. A wave of shock and fear and denial washed over me and tears clouded my eyes. She could hear it in my voice.
“I’m driving down now,” she told me.
I gathered my stuff and walked through the underground hallways with the tech and her assistant to the hospital and the admitting desk. I had pants on, but I was still in the backless gown, still wired with sensors, the IV poking out of my arm. I kept thinking: I was the one who dodged these kinds of things. When I filled out doctors’ surveys I always checked down the “no” column. Diabetes: no. Glaucoma: no. No, no, no. I have a cyst in my lung: benign. Nodules on my thyroid: might’ve been cancer, but no. There were never any problems, never any surgery. It always turned out to be nothing. I thought, maybe, just maybe, this would be the same.
“Good luck,” the tech said as they left me there. “Let us know how it turns out.”
I went from the waiting area to the cardiac floor to my own room in less than ten minutes. The angiogram was already scheduled for the next morning, bright and early. That’s where they shove a tiny tube into a vein in your groin, snaking it through your body into your heart. There’s some kind of dye involved and they watch everything on TV.
My angiogram showed 80% to 90% blockage in three major arteries, including the left anterior descending coronary artery, affectionately nicknamed The Widow Maker. They were too blocked for stents.
“This is very serious, Mr. Michka,” a doctor told me back in my room. I got told that a lot.
It didn’t seem like he was talking to me, somehow. He must have the wrong guy, I thought. They got the wrong chart, some poor slob named Mitchell. It had to be. That kind of thing happens a lot in hospitals, right? I mean, “bypass” and “me” aren’t two things that make any sense put together in the same sentence. Bypasses are for old guys; I’m not an old guy. At least, I didn’t feel like an old guy. My driver’s license might’ve said otherwise but I’m not what you’d call old. Besides, my doctor said I was without sin.
# # # # #
I spent the weekend prepping for my surgery on Monday but there was nothing to prep. There was just waiting, hanging out for two days in a backless gown. They scanned me, drew blood, took x-rays. Nurses or med techs stopped by to poke me with needles or wheel me somewhere on a gurney. I watched movies on cable. I ate the hospital food, which, oddly, wasn’t that bad.
The whole time I was trying not to think about dying.
The heart surgeon came in Sunday. To say hi, I guess. I didn’t pick this guy. I hadn’t met him until right then. There was no audition, no vetting process. He was just assigned, an eeny meeny miny kind of thing. He was suddenly my surgeon. He was a young guy: I mean, 30s; he said he had kids. He started in on his explanation of how he’d break open my chest, strip veins from my legs, when I stopped him. Knowing the gory details of medical procedures made my brain spin out of control with weird thoughts. If he got specific about what he was going to do with a body part, I’d feel him doing it to that body part inside me and I’d start to freak. I told him to stick to the highlights.
I thought about getting a second opinion, for a minute. But everyone was so concerned with having this done quickly, like I was one flight of stairs away from a massive heart attack. They wouldn’t let me go home for two days for fear of me dropping dead. I couldn’t imagine they’d let me wait a week while I made doctor appointments. So I settled in and crossed my fingers.
Monday morning eventually came. Around 6am, Anne and I hugged for a long time and they wheeled me away—up or down, I don’t know, just away. They took me to an area surrounded by white: curtains, walls, lab coats. If they were going for that Heaven look, they did a good job. Techs, attendants, I didn’t know who was what; they scurried around me. “But you look so young,” they said again and again. I could only see the top half of them, of course, because I was flat on my back. They were blurry, too, because I wasn’t wearing my glasses.
I tried not to think about the bad things that might happen, forcing them to stay out of my head. I let go of control right then, to a bunch of people I didn’t know. I was helpless, but trusting. I gave myself to the inevitable, good or bad, fate. It was like jumping out of an emotional airplane, freefall. And hoping my chute opened.
A woman in green scrubs came up to me at my side. She said she was the anesthesiologist or his assistant or something; I wasn’t paying full attention. She pulled a syringe from behind her back and showed it to me like a magic trick. Abracadabra, she stuck it into the IV tube that had been in my arm since my stress test four days earlier.
“Okay,” she said, referring to the sleight-of-hand needle. “This is going to feel like a couple of cocktails.”
And that’s the last thing I remember until my eyes blinked open in the ICU/recovery room nine hours later. NINE… HOURS... There’s now a nine-hour blank spot in my life. A team of doctors, however, put in a full day’s work like a shift in a factory, with OT.
I have no idea what exactly they did for nine hours. But my active imagination fills in the gaps if I let it. It helps me picture myself flat on a table under harsh, glaring lights. I’m laid out like a frog in biology class, naked but covered in green, sterile sheets. They shave me, mess around with my genitals to put in a catheter. People I don’t know, people I’ve never met. I picture them cutting into me, slicing my skin, sawing my bones, prying me apart. They reach in and dig around inside. I used to be factory sealed, mint condition, but that seal was broken. They gut me for parts, pull veins from different places, chop them into pieces, then sew them onto my heart—turning it into a contraption of some kind.
They stopped my heart, I’m told. I was there but not there. Cooled it down, I guess, until it stopped beating. (Doesn’t that make you dead?) I was on a heart/lung machine for an hour or so; it kept me alive-ish while they monkeyed around in my body. Then they jump-started me back to life.
But I don’t remember any of it.
That’s a good thing.
# # # # #
When my eyes blinked open in recovery, a large plastic tube blocked my view at the bottom. It poked out of my mouth. It’s that tube they always stick down people’s throats on TV medical shows. Something else stretched across my forehead, across the top, blocking that view, too. I could turn my head enough to see Anne sitting at my side. She stood, and came over when I tried to speak. I made a sound but nothing came out.
I couldn’t move.
There was a nurse that I mostly couldn’t see buzzing around—checking stuff, changing things. When she saw me looking around, she peeled the tape from my face and ready 1, 2, 3 slid the intubation hose from my throat. The next hour or so were flashes, pieces of moments. The tubes taped across my forehead ended in my neck somewhere and the nurse laid those on my belly.
Eventually, she decided my care didn’t need to be so intensive anymore and it was time to take me to the cardiac floor: room after room of people just like me— except older. My new place was a corner room on the 20th floor with views of the city on two sides. The patient next door was a Russian lady who moaned or yelled at nurses or complained in Russian.
When they lifted me from the gurney to the bed I noticed more tubes sticking out of me: three trailing from my rib cage that ended in bulbs filled with bloody liquid. I had two wires coming out of me, too, actual electric wires, like I was a lamp. I also had a tube stuck in at the incision that led to a blue box with a button on it. That was for local pain meds, they told me. I could push it when I wanted more drugs.
I felt like a thing, a thing anybody could come in and poke stuff into.
They measured the fluids that came out of me—pee from the catheter bag, that red stuff that leaked out of my lungs. They seemed very interested in whatever drained out. They even asked me to tell them when I pooped.
I’ve never been hit by a car but I imagine it feels a lot like this felt. It was an out-of-body experience. My chest was numb. “Oh, that’s natural,” they told me. “You’ll have some numbness for six months, a year, maybe the rest of your life.” It felt like a big plate or a shield. I could move my arms and legs but I didn’t much for fear of flexing my abs. I took small, shallow breaths even though they constantly told me to take big, deep ones. Taking deep breaths was only going to pop something, I figured.
Coughing, sneezing, clearing my throat—all hurt. They told me I could those things as long as I’d “splint” myself by squeezing a pillow against the incision. But I was sure they were wrong. I was sure I’d rip something so I taught myself to stop a sneeze in mid- aah, aah, aah—
I did everything in slo-mo… preplanned, deliberate movements, easy. Everything tentative. I felt like I was going to break or something inside me was going to disconnect and start spurting like those lawn toys kids run through during summer. I couldn’t imagine what they did inside me. It was a weird, sci-fi movie when I tried. They told me that they wired my breastbone together with titanium so it could heal and that the titanium would stay in me for good. I didn’t know how much stress it could take. And I didn’t want to test it.
The next five days were a blur. Injections and pills and scans. A steady stream of medical people, strangers I saw on and off during their shift that I’d never see again.
“Excuse me, nurse,” I’d say. Everyone was a nurse to me.
“Oh, I’m not a nurse,” I’d get back from the woman in the maroon scrubs. She’d point to her ID badge. “I’m an assistant physical therapy whatever.”
“Um, okay. Could I get some apple juice?”
I didn’t fight them. I didn’t yell at them in Russian. I did what they told me. If they needed a blood oxygen test in the middle of the night or for me to eat some nasty potassium powder, I figured they knew what they were doing and I went along.
They kept me pumped full of painkillers, morphine that made me see things crawling on the walls and gave me weird dreams. The surgeon dropped by one day to check his handiwork, I guess, check if I pulled through. When he asked how I was, I told him my back hurt. He said that was understandable, considering what he did to me.
“We cracked you open like this,” he said, making a double-claw shape with his cupped hands, like opening a bear trap. “That can hurt the muscles in your back.”
The nurses insisted I get out of bed so I could eat breakfast, lunch, and dinner sitting in a chair one the other side of the room. They also insisted I take a walk around the cardiac floor three times a day. With help, I’d gingerly circle the nurses’ station, one, two, three laps, then back. 10 or 20 nurses, techs, almost exclusively women, buzzed around, like a bunch of moms ready to help me if I asked.
Anne visited every day. She’d get the kids off to school, then drive downtown to sit on the side bench along the windows. Sometimes we talked, when I wasn’t sleeping. Little by little, day by day, they pulled stuff out of me. The catheter one day. A drainage tube the next. The wires they told me were stuck through my chest right into my heart in case they had to jumpstart me. It was unnerving to feel the lung tubes snake out of my body as they pulled on them.
Friday came around and they decided that was the day. A nurse yanked the last two tubes from my chest—ready? On three… I could feel them pull through my lungs like a ripcord. First one—zip, then the other. It didn’t hurt exactly after what I’d been through; it was disturbing. One more reminder that I was an object, a Thanksgiving turkey. They pulled the catheter out of my arm and the sticky, EKG patches off my skin.
Anne helped me get dressed. It was the first time I’d worn clothes in a week. I hadn’t showered since the morning I left for my recording session. I was pretty gamey; I left a brown patch on the pillow where my head used to be. There was nothing stuck in me anymore, no reminder of what they had done. They gave me a red, heart-shaped pillow to take home. It was a cute way to “splint” myself if I ever sneezed again.
A smiley Jamaican gentleman in a powder-blue smock wheeled me off the cardiac floor and downstairs to the front door. I could stand pretty well by then and I slowly took the ten steps from the wheelchair, through the blast of cold January air, to the car. I sat gingerly in the middle of the back seat and Anne drove us home.