Surviving Heart Surgery—From an Endovascular Surgeon’s to a Patient’s Perspective

By James B. Williams, M.D.

As many of you know, due to postponed peripheral vascular interventions and visits in our office-based vascular interventional center, I have recently transitioned from interventional surgeon to patient. I want you all to know I GET IT!  How one’s perspective changes…

Trained initially as a heart surgeon, for years I have explained to patients—from a surgeon’s perspective—that heart surgery can be transformative, and lifesaving. You, the patient, will live longer, feel better, recovery will be fairly quick (as compared to other chest and abdominal surgeries) and the journey through and after the operation will pass before you know it.

The devil, of course, is in the details!
Leaving the comfort of being surrounded by family, and with the wishes of literally hundreds of people for a swift and successful outcome, entering the operating room on a gurney, with nothing but a hospital gown and blanket between me and the frigid environment, encircled by masked staff and physicians, I have never been so frightened. This, of course, did not last long, thanks to the anesthesia team.

My next memory, and perhaps the clearest, persistent, and most uncomfortable moment, came as I was awakened. I had to demonstrate I could breathe on my own, and the tube down my throat into my trachea was suctioned and the tube was removed quickly. This was terrible pain, causing the worst cough and I felt the tube being removed. I was briefly fully awake for this and it was terrible!  (The worst dry, deep cough imaginable!)

From this point on, recovery was progressive and every hour, every day became easier. Never was I more aware of the value and comfort of the nursing staff, excellent one and all, whose job was to propel me back to the land of the aware and living.

I was afflicted with overpowering nausea for 3–4 days. Narcotics were stopped; any movement, talking, or changing position could provoke terrible nausea, at times relieved only by retching (with a fresh chest wound).

Simple tasks such as eating, sitting, bathing, and bathroom “duties” required multiple people to help me. I learned that modesty has no place in the postoperative period.

Family, nurses, and friends helped me to reorient to person, place, and time. My wife and children were unbelievable—always there, kind, loving, and so supportive. I read their faces like a book.

Tubes and external connections had to be removed. Another example of 1–2 seconds of terrible pain followed by relief!

After all the tubes are out, the speed of your recovery is up to you. Listen to your caregivers who have nothing but your interest at heart.

Just a few rules:

1. You must do the rehab—people our age lose their strength (called “deconditioning”) at a very rapid rate. Walk!
2. You must eat. Your body needs the calories, (fat and protein) to heal.
3. Cough and deep breathe—to prevent pneumonia. This hurts!
4. Stay out of bed except to sleep—up in the chair, walking, or rehab during the day.
5. Probably this is the most essential—reach out to your family, friends, loved ones, and professionals. This is extremely important to the human body and brain to heal and recover, physically and mentally.
6. When you are able, text or write to those who have been there for you, to let them know you are recovering. It helps you, and them.

This experience is something that I intend to use to improve the care delivered to our patients in our peripheral vascular interventional center, which was created to favorably influence the patient experience in those requiring intervention.

What makes our interventional center different from the standard approach to peripheral vascular disease?

We approach limbs that are in need of more blood supply from the foot, instead of from the groin. There are several advantages:

1. Local anesthesia, with mild sedation, is much more effective for pain control during the procedure.
2. We are able to use almost no contrast (dye) because of the ability to image obstructions with intravascular ultrasound. This is far easier for the heart and kidneys.
3. This “straight line” approach allows a more complete opening of the affected vessels above and below the knee.
4. Blood loss is minimal. In over 2000 cases, we have had to give no blood to our patients.
5. The procedure is safe. We have lost no limbs as a complication of the procedure, and no patient has died.

This has become my preferred approach, instead of from the groin. Of course, an ounce of prevention is worth several pounds of a cure:

• Don’t smoke—at all
• Exercise (walking or swimming) two or three times a week
• Eat healthy foods

It is best to avoid the need for intervention.

For more information, contact Cardiac Thoracic & Endovascular Therapies, S.C., 2420 West Nebraska Avenue, Peoria; or call us at (309) 680-8666. Email: info@cvendo.com