01.28.23 unanticipated fear

Before I move to other topics beyond my recent open-heart surgery, I want to record thoughts and fears that have frequented my consciousness since coming out of sedation on November 30, 2023. I’ll likely not remember these as acutely in the future. Perhaps, like other traumas, they will take up residency in my subconscious, sneakily affecting motivations and decisions from a safe hiding place.

Memories of recovery in the ICU are already blurry, more recollections of a fever dream rather than defined memories. That fuzziness was influenced from the cocktail of anesthetic, fentanyl and Oxycotin in my blood, ICU psychosis I experienced (a real thing), and my psyche dealing with the body trauma of having my sternum cracked open, lungs deflated and heart exposed to the outside world.

One of the biggest challenges following my open-heart surgery was getting my lungs to work again (during surgery, an able-bodied machine did my breathing). I was asked to do a series of simple breathing exercises every hour, painful at first. Coughing, which is common following heart surgery, was excruciating. The nursing staff gave me a heart-shaped pillow to use as a splint to reduce the pain. I’d clutch the pillow tightly against my sternum when I coughed, but it was still quite painful.

The pain, however, wasn’t the main issue. Instead, my issue was coping with a fear and feeling of suffocating, a dread that my lungs weren’t getting air. Part of this was caused by adema in the actual lung tissues, like having a wet sponge in my chest. Part of it was a free-floating dread enhanced by the bad trip of pain meds which didn’t agree with my mental state. Part of it may be other factors I don’t know. The dread, however, was real and at type bordered on inner hysteria.

I spent most of my recovery alone without distraction (for some reason the sound of the television bothered me), so my mind had gone into unexplored and dark areas. One night, during a particularly terrifying bout of lung issues, I attempted to logic my way through my panic, telling myself much of it was mental.

In as calm a voice as I could muster, one bad evening I asked the night nurse, a quirky guy, if anyone actually died following heart surgery from suffocating. He stopped, thought, and in a wistful way said, “Hmm. I don’t think anyone ever did when I was working. No, I don’t remember anyone dying.”

I don’t think his answer was delivered for comedic effect, but even in my panic, I realized that answer was hilarious. I was on my own on this one to talk myself down.

Fear about my lungs failing continued for a month, even after coming home, but that fear also spread to the worry that my heart wouldn’t work. After all, it had a completely foreign valve installed. I fought the paranoia that my body would simply stop working, even sleeping with the light on like a child, afraid of dying in the dark while I slept.

Later, during follow-up visits with nurses and doctors, I learned that fear was not uncommon. A friend of mine recently told me he knew of multiple men, tough, bad-ass working class dudes, who after heart attacks became fearful of exertion for fear their hearts wouldn’t hold up. I hadn’t had a heart attack and my heart itself was strong, but the fear was the same.

A doctor I know told me about a patient, a young martial artist, who experienced a rare condition that caused a lung to completely deflate. His life was saved, but the trauma left a nearly crippling doubt. For years he was afraid to sleep, convinced lungs would quit. Like me, he revealed he left the lights on in the night, and his experience left him fearful to return to the hyper-active life he had once left. His mental recovery took years.

I wanted to put this, at least in short-form, in writing, because from a purely removed basis, I found it fascinating. With zero doubt I can say the most challenging part of recovery has been mental/emotional, not only about irrational (and sometimes rational) fears, but other more existential thoughts such as what does my life mean, why did I live when others have died (my father-in-law died of a sudden heart attack in his home the night I was going over discharge papers in the hospital), and how do I reconcile my simultaneous fear of death with a fear of life? How could I be both tired of life and yet fearful of losing it at the same time?

I didn’t feel comfortable speaking with anyone about these thoughts. I was grateful for the miracles of medicine that had saved my life and didn’t want to appear that I took for granted the second chance I had been given. Additionally, I didn’t even fully understand my fears and doubts.

I had been laid off on Friday the 13th in May of the same and year, and while devastating to my finances and self esteem, my layoff ultimately saved my life because the health insurance I had previously had wouldn’t have covered the expenses. After months without insurance, I was able to get Medicaid way before I had any idea my heart was failing, and it likely saved my life, but should my life even have been saved? How had everything fit together, and was their meaning or mere coincidence?

My brain was a shitstorm of doubt and confusion, and this journal entry only begins to scratch the surface of the contradictions and worries I had following surgery. I’m approaching two months out, and everyday I continue to work through mental issues relating to all that has happened.

Pre-surgery, I expected that I would emerge with a renewed vigor for life after dodging such a near miss with death, a story like so many of those feel-good ones I’d seen on the Internet or television. When I didn’t feel that way and in fact oppositely struggled with depression, I felt … wrong. Ungrateful, spoiled, dissapointed in myself. I understood gratefulness on a mental, but not an emotional plane. Even writing this, though, implies duality, as if things were one thing and not the other, but that’s not accurate. Instead, I had conflicting feelings coexisting in me at the same time, a soup of emotions more complex than the monk’s recipe of herbs for Bénédictine. Recovery from open-heart was, and continues to be, a mental game for me.

While the nature of a journal entry means a beginning, middle and end, that doesn’t capture the experience. Should this potentially reach someone who needs to read it, however, I will say one of the main coping mechanisms I have with all of my doubts has been to listen and simply be nice. During visits with nurses, I work to be humble, patient and friendly, and to ask them questions.

In the two months since my surgery, I’ve talked to nurses about their own experiences with cancer, divorce, careers and dreams, not in prying, but in natural, human connection ways. Just listening and shifting the focus from my own self has been critical to my healing, because when wounded, both physically and psychically, it’s easy to draw inward and maintain only a dialogue with oneself, at least it is for me. I can’t speak for all of humankind.

My point is I’ve made an effort to find the humanity in others, and in doing so reinforce my understanding that we’re all struggling and searching for meaning. My mental struggles resulting from my surgery and related issues has also helped me to better reconnect with others. I have experienced legitimate moments of joy in talking to nurses, if not for anything but to feel for a fleeting moment of a connection to another human, a realization I’m not so fucking insignificant and alone. We all are and at the same time completely are not. It’s all contradiction, but my bliss has come when I step away from my own fears and just listen, maybe smile, and know that I’m part of something so much bigger than myself, my lungs, and my heart with a pig valve.


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