And it Makes Her But it Breaks Her
It's been a while since I updated this (or it's certainly felt that way), not for any reason other than nothing has happened. It's as simple as that; I haven't heard anything on the surgery side, I haven't made any leaps in my writing, we're not planning anymore fundraisers and there's no other reason I would update this.
However, now I have a reason. If you've come here for a quick look you might want to save this for later because I don't think this will be considered easy reading, it's more explaining stuff.
Yesterday, I woke up early in the morning with the knowledge that it was that time of year again - check-up in Glasgow. I'm not going to lie, I was a bit pissed off. Purely because I hadn't slept much then as soon as I left the house (in just jeans and a hoody) it started raining - as usual - so I was walking in the pouring rain, soaked, unable to see because my glasses were covered in rain and this damn pigeon walked from one side of the pavement right over me, so that I had to stop and walk around the fucker. After huffing and puffing I kept walking, turned the corner only for another pigeon to do exactly the same. Exactly the same fucking thing. By then I was ready to walk into Tescos and start throwing people out of my way, pushing them into Krispy Kreme cabinet to get to my pasta; the pigeons took all my patience.
And then I left Tesco and walked up to the bank, in the pouring rain, only to find it shut and people standing outside, waiting for it to open. The only reason I didn't put one of them through the door to get inside was the fact that I would rather eat my pasta in front of the tele than try to get my Docs off before being shoved into a cell. So, I stormed all the way home - during which I had to move out of three people's way. I won't get enough credit for not pushing them into oncoming traffic.
Eventually I got home and couldn't justify missing the appointment. It's not the appointment I care about and I usually like the train journey but I was just so tired and pissed off. I had a funny feeling I'd come away from Glasgow having not moved any further or with any more information than when I arrived.
We got the bus down to the bridges and when we got off we noticed that only one side of the bridges - the other side to us - was wet, as if it'd only rained on one half. Anyway, we got on the train and, weirder still, on one side the sky was blue and clear and on the other a dark grey cloud covered the entire sky, seemingly meeting just over the roof of the train. Almost as if the tipping point for the Earth's mood hung on this journey. It stopped raining for the duratin and didn't start again on the way from the train station to the hospital but that wouldn't last obviously, it's Scotland.
We got to the hospital and took the lift up to the second floor, finding the outpatients department (or OPD) up there, which is different from the main OPD on the ground floor I've spoken about before (if you've read past posts). This OPD is specifically for cardiac patients and this is where my doctor's office is. It's also where you're likely to find the SACCS team, including Elaine, who you'll remember from previous posts. SACCS stands for 'Scottish Adult Congenital Cardiac Service' which I had to look up, so don't worry if you've never heard of it.
Wee reminder - a congenital heart condition is present from birth as opposed to acquired which develops after birth. You can click here for an article on the differences if you're interested.
Before I get to see the Wizard, I've got to team up with the others first (the cardiac physiologist and eletrocardiagram technician) so me and Toto (sorry, Mum) spotted Elaine in the waiting room and we talked for a few minutes. There is nothing that makes me so glad I barely watch live TV now than the daytime programmes STV were showing. Brian McFadden jumping up and down on a mini trampoline dressed as someone from Baywatch honestly made my soul leave my body, it got back to Edinburgh before me. Seriously man, you were in Westlife, don't lower yourself.
Usually I have my ECG first but this time it was my ECHO first. The woman who did it, Ruth, I think has done mine once before but I couldn't say for sure. We spoke about the weather, holiday plans, Netflix, TV shows and how busy they were that day.
And after another wee wait I had my ECG. I can never remember the guy who does it's name but in my defence he's told me it twice and not since because he recognises me to the extent that he just doesn't say it. If you've read my previous posts (and remember) this is the guy who was doing an ECG on the ward after my open heart surgery a couple of years ago and dropped something on the ground and, when I bent to pick it up he made the 'a-cha-cha!' noise and freaked out. So, he did the ECG while we talked about Batman (since it was my t-shirt), 'Gotham' and William Shatner's role in 'Boston Legal'. Apparently he played a lawyer who thought he had mad cow disease and it was really good. You learn something new, eh?
It was time for the Wizard to step out from behind the curtain. We sat down with Nikki and she explained the procedure that they were planning to do, updating us on anything that had happened or been decided since we last spoke and I'm going to try and explain it to you as best as I can.
To remind you, this whole palava is to try and replace the valve in my pulmonary artery, the one that's been causing all the fuss since day one and hasn't been replaced since I was four years old. Now, consider that this replacement valve that's been doing its job this whole time is from the early nineties and even though I couldn't tell you how much the design of these things have changed it is around twenty years old. These valves are estimated to last about ten years so it's seen better days.
If you'll remember, the first time they tried to do this a couple of years ago they attempted the less invasive key-hole method which entailed using the artery in my leg, following it into my heart and placing a stent in (which is like a tiny wire-mesh finger-tapper) to stabilise the artery and then inserting another with a valve inside it to hold it in place. They couldn't complete this procedure because there was an obstruction that stopped them and they didn't want to push. The second time they went in through the rib-cage to attempt, essentially, the same procedure with one difference (except the big great gash in my chest, obviously): the valve was different, rather than a wire-mesh device it was made from a different material (the name of which I don't know) that attaches to tissue in the heart instead of sitting in place. However, they couldn't complete that procedure either because the area was so calcified it was like china, meaning there was no tissue for the valve to attach to.
So they'd scratched their heads. They didn't want to replace the whole valve area, that wasn't a very safe option and - considering they weren't even counting it a valid option - not something they would think I'd survive.
And then yesterday, sitting in Nikki's office, she began to explain to me what she'd tried to tell me before. I say she'd tried, this wasn't a failure to make it clear on her part or a failure to understand on mine it was because they were still piecing together a plan so it was all bits of a solution and now they have the whole equation.
The answer seems simple - to solve the problem of the obstruction they couldn't pass and the lack of tissue to attach the second valve to they'd combine the two.
This means that they'll use the first valve: the one that is made of wire-mesh but they'll go in through the rib cage at the front.
This sounds like the obvious option, like it would be the solution and it is, but it's not an easy one. It's never been done this way before. Which is ironic because, on reflection of my last surgery as we walked from the train station to the hospital, I said to my mum, "I don't think they'll be a time I come here and don't hear the words 'this hasn't happened before'." Nikki was up front, she told us she'd done procedures like this before but not this procedure. While it's been done a few times in Bristol before it's never been done like this before. However, it's not like this is a new phrase to me. The last time I heard it three times in one go and, when I was a kid my procedure was the first of it's kind too. The fact that Nikki hasn't done this before doesn't concern me at all, if she'd said, "we're going to go and do it right now," I would have followed her without so much as an eyebrow raise.
The team(s) in Bristol who have done it (I don't know if it was successfully or not) used a different type of valve and Nikki phoned them up and asked if she should be using their valve and they told her no, she should use her one, so she's explored all avenues there.
To clarify, plan A is to go up to theatre and Mr McArthur, who did my past surgery through there, will open my up like for open heart surgery and prep that. Then the hole will be covered by a cover of some kind they use specifically in medicine while I'm transported down to the Cath Lab, where I had my key-hole attempt and my other exploratory procedure a few years ago. In the Cath Lab Mr McArthur while be on standby as Nikki attempts this procedure - she will insert a tube into the front of the heart, going straight into the valve area, where she will then use that to insert the valve, therefore hopefully bypassing the obstruction they faced during the key-hole attempt.
I did say that was plan A, that's because, as with everything, it might not work. one thing they are worried about is me bleeding out. How would that happen? Well, when you have a plan, any plan, there is always ways it could, not only fail, but fuck up considerably. And this is no different. With any surgery like this, heart surgery that's direly needed, there are risks of death, stroke etc. That's a given, you just have to be cool with that, which I am. But, if 'this has never happened before' is the title of my autobiography then 'you're a special case' will be the tagline. So while this procedure has never been done like this before my case is a special one on top of that for another reason.
As I explained in previous posts, when there is something foreign in your body your system doesn't like it, in fact in sends it's own kind of enforcement round to knock on the door to remind it who is the boss. This varies in strength and effectiveness as is the case with real life. Sometimes they just go to the door and ask politely, sometimes the police are called, some phone a family member to do the knocking, some might even get in the army or some goons with baseball bats and knuckle dusters, and occasionally someone will press a big red button and blow everyone to shit because why not?
Well in the case of a valve in the heart your body sends calcium, absolutely no idea why it thinks this intruder might appreciate a nice glass of milk, like he's Santa Claus, but whatever works. The idea, I read, is to stop it travelling around the body, so they huddle into it and keep it trapped where it is. However, in the case of a replacement valve, by doing this, what the calcium accidentally does is help the valve stay in place by binding it to the tissue of the artery. Jokes on you, body. The younger you are the more calcium the body sends, it decreasing over time. Which sounds like a good thing - they say children are resilient but that's because the body amps up the national guard and then mellows out as you get older.
But consider this; I got my valve at four years old so my body, which was already in a pretty bad way with a previous hole in the heart and stoke which resulted in seizures, has been trying to kick this trespasser out, for twenty years it started off phoning the police constantly and as the years have gone on it's got less and less but it hasn't stopped. It doesn't just accept it's stuck and gives up, it keeps trying. Meaning that the reason that second valve had no tissue to attach itself to is a twenty year build up of calcium that has calcified the surrounding area so much its hard like china, hard enough to tap on.
So, the big worry is when Nikki gets in there, places the tiny little finger-traper soon-to-be scaffolding tube, she then has to blow it up to fit the narrowed arterial wall with a tiny balloon. Have you ever had a china vase or cup and forced something into it? It cracks, it shatters into thousands of tiny little pieces. Which is fine if you drop a teacup, the tea goes everywhere and so does all the china. But you can just mop up the tea and, if you wanted to, glue the teacup back together.
When Nikki blows that balloon, it needs to fit against the wall, it can't just sit in the air, it needs to stay there, so she needs to fit it right against the wall.
Imagine the pressure is just too much. Imagine it cracks, worse still, imagine it shatters into a hundred tiny little pieces. It won't be tea that spills out and she won't have the luxury of mopping it up at her leisure.
And that's where plan B comes in. Plan B is to put me on a bypass machine, that takes the blood out of my body, through a machine and then puts it back through the body. It might sound like it doesn't do anything but the blood will come from the brain and then go through the machine which will perform the function of the heart and lungs and then go back to the brain. This effectively bypasses (does what it says on the tin) the heart and lungs, making it easier for them to try and repair the artery if it's possible.
But that won't be possible if the artery shatters like a fallen teacup on hard flooring. She won't have the choice to slowly piece it back together. That is the nightmare scenario and that is what Plan C is for: to keep me on the bypass machine, grab Mr McArthur and just go ahead and do what they've been trying to avoid: that procedure I mentioned before that they weren't even treating as an option because they didn't think I'd survive it - to replace the whole valve area. They wouldn't have a choice, it'd be that or watch me bleed out with no other option but to watch.
But, say if they try plan A and it doesn't work so they move onto plan B and that doesn't work so they go onto plan C, say the artery shatters beyond what the tubing can do and they try to replace the artery. That might not work either. And there might be twenty-six letters in the alphabet but they only have use for three here. If they end up on plan C and it doesn't work it really is a case od all they can do is watch. That's not just a dramatic device used in hospital programs while screaming relatives demand they do something. Sometimes there's nothing you can do.
Before every procedure Nikki gives me the run down of risks and percentages, which I appreciate the honesty in, I'd rather that than sugar coat it. Except that this time this is a procedure that no one has ever done before with the added note of the 'special case' so there were a list of risks but no percentages.
All she could say was this was high risk, there is a very good chance I could die. But hey, I could be hit by a car crossing the street, I could go to sleep and not wake up the next morning and I've had depression for ten years I've almost done the deed myself more than a few times. Everybody dies. Nikki would not be doing this if she didn't have to and, she said herself, if she didn't think it would work. And if it doesn't work, if I die, yeah, it's a shame and all that, but that'll go in a file somewhere, and whether it's the next month or year or ten years in the future, someone somewhere will be looking for a solution, something to help this poor person they're treating who is fading away and they'll find the file and the technology that we don't have right now they might do and my case might help, just like countless before me is the only reason I've survived until this age. It's not just the people, it's research and case studies and losing people because of a flaw in the technology that we then go onto target with research to solve that saves the next ten people. So yeah, it's a shame, but it's not for nothing.
If nothing else, that'd be my legacy.
Nikki asked me how I was feeling and usually I give my template, "I'm okay," answer and she has to drag any information out of me. Not this time. This time I told her right away I don't feel right and I know it's not my depression. Last time she asked me how I was and I said I felt like hell but I couldn't say for sure if that was a result of physical illness or mental, because I didn't want her to go ahead and do a surgery when on the other side of it I might still feel the same because it was my mental state that was the problem. This time I told her, I've had good and bad days in my head but I've felt the same, that's how I know. How bad I feel now is actually making my mental health worse, I can feeling it draining on my emotional energy. I have insomnia but it started off with me gradually sleeping every night because I'm too physically exhausted to endure it. That progressed to not being able to stay up for even a whole day anymore and now I can lie in my bed for over twelve hours not moving because I don't have the energy to do so. And now, I'm wakening up in the night with pain, and that's my heart crying out for help.
Nikki said that she didn't like my tests but if I hadn't noticed any changes she would have been happy waiting but since I'm feeling it and she knows, since I don't say these things lightly, that we can't afford to wait anymore.
After speaking about that and clearing up any doubt we had Nikki said that the date was the eighteenth of November so we all sort of nodded and talked about that. And then the good witch Glinda (or Elaine) appeared at the end, as she often does to join us and give us a run down of what she'd worked out. And Nikki informed her that she was just telling us the date for the surgery - eighteenth of November.
Elaine looked confused and just simply said, "October."
As it turned out the surgery was supposed to be in October but the surgeon, Mr McArthur, not knowing this, took the entirety of October off and they had to shift it to November while others were shifted to the New Year (that's how much I need it). But, Elaine said he was coming back for three days in October an my operation was one of those days.
We all joked that Elaine clearly has some dirt on this guy and she's not to be messed with but Nikki at first looked a bit like a rabbit in headlights at this news and then said she was happier it was October than November. She also told us this is an all day session, the operation gets started in the morning and I won't be coming out until at least getting on for past dinner time. I can see it taking longer than that though because things never go completely to plan when it's me.
So we all kind of settled that in our heads, talked some more and then, since I was there, I talked to the anaesthetist about my jaw being dislocated last time and, after seeing Jim (who works with Elaine) briefly, I got some of my pre-assessment out of the way, such as blood and MRSA tests. It was gone six by the time we took a breather in the cafeteria to check the train times, we'd been there since three.
There was talk in the appointment, with Nikki, about some work after my surgery to work on my fitness levels after the surgery. They said that because I haven't been able to do as much as everyone else my muscles will need to be retrained and we'll work on that. So this isn't a 'open you up, do the thing and then kick you out' number this is a 'do this first, but then we still have work to do' which I find funny because they think I don't do anything because I can't when they're going to find out it's actually because I'm a lazy bastard. Sit in front of the TV or go to the gym? Like, really? These poor guys are in for a shock.
As it stands, I have seventeen days until I have to go through and be checked in the day before the surgery and get all of my preparation done for the surgery that could literally make me or break me.
What is it they say, third time lucky or these things come in threes? I suppose we'll find out which one soon enough. For those of you who might ask, and I do get asked this, I'm not worried, I'm not stressed. I still see it as there is nothing I can do but go through it, getting worked up about it - however justified - is going to do me more harm than good. It's all out of my hands and even if it doesn't work it's not really in the doctors hands either because you can do everything you're supposed to do and stuff still goes wrong, that's just life.
I'm as helpless, but not quite as hopeless, as a feather on the Clyde.
However, now I have a reason. If you've come here for a quick look you might want to save this for later because I don't think this will be considered easy reading, it's more explaining stuff.
Yesterday, I woke up early in the morning with the knowledge that it was that time of year again - check-up in Glasgow. I'm not going to lie, I was a bit pissed off. Purely because I hadn't slept much then as soon as I left the house (in just jeans and a hoody) it started raining - as usual - so I was walking in the pouring rain, soaked, unable to see because my glasses were covered in rain and this damn pigeon walked from one side of the pavement right over me, so that I had to stop and walk around the fucker. After huffing and puffing I kept walking, turned the corner only for another pigeon to do exactly the same. Exactly the same fucking thing. By then I was ready to walk into Tescos and start throwing people out of my way, pushing them into Krispy Kreme cabinet to get to my pasta; the pigeons took all my patience.
And then I left Tesco and walked up to the bank, in the pouring rain, only to find it shut and people standing outside, waiting for it to open. The only reason I didn't put one of them through the door to get inside was the fact that I would rather eat my pasta in front of the tele than try to get my Docs off before being shoved into a cell. So, I stormed all the way home - during which I had to move out of three people's way. I won't get enough credit for not pushing them into oncoming traffic.
Eventually I got home and couldn't justify missing the appointment. It's not the appointment I care about and I usually like the train journey but I was just so tired and pissed off. I had a funny feeling I'd come away from Glasgow having not moved any further or with any more information than when I arrived.
We got the bus down to the bridges and when we got off we noticed that only one side of the bridges - the other side to us - was wet, as if it'd only rained on one half. Anyway, we got on the train and, weirder still, on one side the sky was blue and clear and on the other a dark grey cloud covered the entire sky, seemingly meeting just over the roof of the train. Almost as if the tipping point for the Earth's mood hung on this journey. It stopped raining for the duratin and didn't start again on the way from the train station to the hospital but that wouldn't last obviously, it's Scotland.
We got to the hospital and took the lift up to the second floor, finding the outpatients department (or OPD) up there, which is different from the main OPD on the ground floor I've spoken about before (if you've read past posts). This OPD is specifically for cardiac patients and this is where my doctor's office is. It's also where you're likely to find the SACCS team, including Elaine, who you'll remember from previous posts. SACCS stands for 'Scottish Adult Congenital Cardiac Service' which I had to look up, so don't worry if you've never heard of it.
Wee reminder - a congenital heart condition is present from birth as opposed to acquired which develops after birth. You can click here for an article on the differences if you're interested.
Before I get to see the Wizard, I've got to team up with the others first (the cardiac physiologist and eletrocardiagram technician) so me and Toto (sorry, Mum) spotted Elaine in the waiting room and we talked for a few minutes. There is nothing that makes me so glad I barely watch live TV now than the daytime programmes STV were showing. Brian McFadden jumping up and down on a mini trampoline dressed as someone from Baywatch honestly made my soul leave my body, it got back to Edinburgh before me. Seriously man, you were in Westlife, don't lower yourself.
Usually I have my ECG first but this time it was my ECHO first. The woman who did it, Ruth, I think has done mine once before but I couldn't say for sure. We spoke about the weather, holiday plans, Netflix, TV shows and how busy they were that day.
And after another wee wait I had my ECG. I can never remember the guy who does it's name but in my defence he's told me it twice and not since because he recognises me to the extent that he just doesn't say it. If you've read my previous posts (and remember) this is the guy who was doing an ECG on the ward after my open heart surgery a couple of years ago and dropped something on the ground and, when I bent to pick it up he made the 'a-cha-cha!' noise and freaked out. So, he did the ECG while we talked about Batman (since it was my t-shirt), 'Gotham' and William Shatner's role in 'Boston Legal'. Apparently he played a lawyer who thought he had mad cow disease and it was really good. You learn something new, eh?
It was time for the Wizard to step out from behind the curtain. We sat down with Nikki and she explained the procedure that they were planning to do, updating us on anything that had happened or been decided since we last spoke and I'm going to try and explain it to you as best as I can.
To remind you, this whole palava is to try and replace the valve in my pulmonary artery, the one that's been causing all the fuss since day one and hasn't been replaced since I was four years old. Now, consider that this replacement valve that's been doing its job this whole time is from the early nineties and even though I couldn't tell you how much the design of these things have changed it is around twenty years old. These valves are estimated to last about ten years so it's seen better days.
If you'll remember, the first time they tried to do this a couple of years ago they attempted the less invasive key-hole method which entailed using the artery in my leg, following it into my heart and placing a stent in (which is like a tiny wire-mesh finger-tapper) to stabilise the artery and then inserting another with a valve inside it to hold it in place. They couldn't complete this procedure because there was an obstruction that stopped them and they didn't want to push. The second time they went in through the rib-cage to attempt, essentially, the same procedure with one difference (except the big great gash in my chest, obviously): the valve was different, rather than a wire-mesh device it was made from a different material (the name of which I don't know) that attaches to tissue in the heart instead of sitting in place. However, they couldn't complete that procedure either because the area was so calcified it was like china, meaning there was no tissue for the valve to attach to.
So they'd scratched their heads. They didn't want to replace the whole valve area, that wasn't a very safe option and - considering they weren't even counting it a valid option - not something they would think I'd survive.
And then yesterday, sitting in Nikki's office, she began to explain to me what she'd tried to tell me before. I say she'd tried, this wasn't a failure to make it clear on her part or a failure to understand on mine it was because they were still piecing together a plan so it was all bits of a solution and now they have the whole equation.
The answer seems simple - to solve the problem of the obstruction they couldn't pass and the lack of tissue to attach the second valve to they'd combine the two.
This means that they'll use the first valve: the one that is made of wire-mesh but they'll go in through the rib cage at the front.
This sounds like the obvious option, like it would be the solution and it is, but it's not an easy one. It's never been done this way before. Which is ironic because, on reflection of my last surgery as we walked from the train station to the hospital, I said to my mum, "I don't think they'll be a time I come here and don't hear the words 'this hasn't happened before'." Nikki was up front, she told us she'd done procedures like this before but not this procedure. While it's been done a few times in Bristol before it's never been done like this before. However, it's not like this is a new phrase to me. The last time I heard it three times in one go and, when I was a kid my procedure was the first of it's kind too. The fact that Nikki hasn't done this before doesn't concern me at all, if she'd said, "we're going to go and do it right now," I would have followed her without so much as an eyebrow raise.
The team(s) in Bristol who have done it (I don't know if it was successfully or not) used a different type of valve and Nikki phoned them up and asked if she should be using their valve and they told her no, she should use her one, so she's explored all avenues there.
To clarify, plan A is to go up to theatre and Mr McArthur, who did my past surgery through there, will open my up like for open heart surgery and prep that. Then the hole will be covered by a cover of some kind they use specifically in medicine while I'm transported down to the Cath Lab, where I had my key-hole attempt and my other exploratory procedure a few years ago. In the Cath Lab Mr McArthur while be on standby as Nikki attempts this procedure - she will insert a tube into the front of the heart, going straight into the valve area, where she will then use that to insert the valve, therefore hopefully bypassing the obstruction they faced during the key-hole attempt.
I did say that was plan A, that's because, as with everything, it might not work. one thing they are worried about is me bleeding out. How would that happen? Well, when you have a plan, any plan, there is always ways it could, not only fail, but fuck up considerably. And this is no different. With any surgery like this, heart surgery that's direly needed, there are risks of death, stroke etc. That's a given, you just have to be cool with that, which I am. But, if 'this has never happened before' is the title of my autobiography then 'you're a special case' will be the tagline. So while this procedure has never been done like this before my case is a special one on top of that for another reason.
As I explained in previous posts, when there is something foreign in your body your system doesn't like it, in fact in sends it's own kind of enforcement round to knock on the door to remind it who is the boss. This varies in strength and effectiveness as is the case with real life. Sometimes they just go to the door and ask politely, sometimes the police are called, some phone a family member to do the knocking, some might even get in the army or some goons with baseball bats and knuckle dusters, and occasionally someone will press a big red button and blow everyone to shit because why not?
Well in the case of a valve in the heart your body sends calcium, absolutely no idea why it thinks this intruder might appreciate a nice glass of milk, like he's Santa Claus, but whatever works. The idea, I read, is to stop it travelling around the body, so they huddle into it and keep it trapped where it is. However, in the case of a replacement valve, by doing this, what the calcium accidentally does is help the valve stay in place by binding it to the tissue of the artery. Jokes on you, body. The younger you are the more calcium the body sends, it decreasing over time. Which sounds like a good thing - they say children are resilient but that's because the body amps up the national guard and then mellows out as you get older.
But consider this; I got my valve at four years old so my body, which was already in a pretty bad way with a previous hole in the heart and stoke which resulted in seizures, has been trying to kick this trespasser out, for twenty years it started off phoning the police constantly and as the years have gone on it's got less and less but it hasn't stopped. It doesn't just accept it's stuck and gives up, it keeps trying. Meaning that the reason that second valve had no tissue to attach itself to is a twenty year build up of calcium that has calcified the surrounding area so much its hard like china, hard enough to tap on.
So, the big worry is when Nikki gets in there, places the tiny little finger-traper soon-to-be scaffolding tube, she then has to blow it up to fit the narrowed arterial wall with a tiny balloon. Have you ever had a china vase or cup and forced something into it? It cracks, it shatters into thousands of tiny little pieces. Which is fine if you drop a teacup, the tea goes everywhere and so does all the china. But you can just mop up the tea and, if you wanted to, glue the teacup back together.
When Nikki blows that balloon, it needs to fit against the wall, it can't just sit in the air, it needs to stay there, so she needs to fit it right against the wall.
Imagine the pressure is just too much. Imagine it cracks, worse still, imagine it shatters into a hundred tiny little pieces. It won't be tea that spills out and she won't have the luxury of mopping it up at her leisure.
And that's where plan B comes in. Plan B is to put me on a bypass machine, that takes the blood out of my body, through a machine and then puts it back through the body. It might sound like it doesn't do anything but the blood will come from the brain and then go through the machine which will perform the function of the heart and lungs and then go back to the brain. This effectively bypasses (does what it says on the tin) the heart and lungs, making it easier for them to try and repair the artery if it's possible.
But that won't be possible if the artery shatters like a fallen teacup on hard flooring. She won't have the choice to slowly piece it back together. That is the nightmare scenario and that is what Plan C is for: to keep me on the bypass machine, grab Mr McArthur and just go ahead and do what they've been trying to avoid: that procedure I mentioned before that they weren't even treating as an option because they didn't think I'd survive it - to replace the whole valve area. They wouldn't have a choice, it'd be that or watch me bleed out with no other option but to watch.
But, say if they try plan A and it doesn't work so they move onto plan B and that doesn't work so they go onto plan C, say the artery shatters beyond what the tubing can do and they try to replace the artery. That might not work either. And there might be twenty-six letters in the alphabet but they only have use for three here. If they end up on plan C and it doesn't work it really is a case od all they can do is watch. That's not just a dramatic device used in hospital programs while screaming relatives demand they do something. Sometimes there's nothing you can do.
Before every procedure Nikki gives me the run down of risks and percentages, which I appreciate the honesty in, I'd rather that than sugar coat it. Except that this time this is a procedure that no one has ever done before with the added note of the 'special case' so there were a list of risks but no percentages.
All she could say was this was high risk, there is a very good chance I could die. But hey, I could be hit by a car crossing the street, I could go to sleep and not wake up the next morning and I've had depression for ten years I've almost done the deed myself more than a few times. Everybody dies. Nikki would not be doing this if she didn't have to and, she said herself, if she didn't think it would work. And if it doesn't work, if I die, yeah, it's a shame and all that, but that'll go in a file somewhere, and whether it's the next month or year or ten years in the future, someone somewhere will be looking for a solution, something to help this poor person they're treating who is fading away and they'll find the file and the technology that we don't have right now they might do and my case might help, just like countless before me is the only reason I've survived until this age. It's not just the people, it's research and case studies and losing people because of a flaw in the technology that we then go onto target with research to solve that saves the next ten people. So yeah, it's a shame, but it's not for nothing.
If nothing else, that'd be my legacy.
Nikki asked me how I was feeling and usually I give my template, "I'm okay," answer and she has to drag any information out of me. Not this time. This time I told her right away I don't feel right and I know it's not my depression. Last time she asked me how I was and I said I felt like hell but I couldn't say for sure if that was a result of physical illness or mental, because I didn't want her to go ahead and do a surgery when on the other side of it I might still feel the same because it was my mental state that was the problem. This time I told her, I've had good and bad days in my head but I've felt the same, that's how I know. How bad I feel now is actually making my mental health worse, I can feeling it draining on my emotional energy. I have insomnia but it started off with me gradually sleeping every night because I'm too physically exhausted to endure it. That progressed to not being able to stay up for even a whole day anymore and now I can lie in my bed for over twelve hours not moving because I don't have the energy to do so. And now, I'm wakening up in the night with pain, and that's my heart crying out for help.
Nikki said that she didn't like my tests but if I hadn't noticed any changes she would have been happy waiting but since I'm feeling it and she knows, since I don't say these things lightly, that we can't afford to wait anymore.
After speaking about that and clearing up any doubt we had Nikki said that the date was the eighteenth of November so we all sort of nodded and talked about that. And then the good witch Glinda (or Elaine) appeared at the end, as she often does to join us and give us a run down of what she'd worked out. And Nikki informed her that she was just telling us the date for the surgery - eighteenth of November.
Elaine looked confused and just simply said, "October."
As it turned out the surgery was supposed to be in October but the surgeon, Mr McArthur, not knowing this, took the entirety of October off and they had to shift it to November while others were shifted to the New Year (that's how much I need it). But, Elaine said he was coming back for three days in October an my operation was one of those days.
We all joked that Elaine clearly has some dirt on this guy and she's not to be messed with but Nikki at first looked a bit like a rabbit in headlights at this news and then said she was happier it was October than November. She also told us this is an all day session, the operation gets started in the morning and I won't be coming out until at least getting on for past dinner time. I can see it taking longer than that though because things never go completely to plan when it's me.
So we all kind of settled that in our heads, talked some more and then, since I was there, I talked to the anaesthetist about my jaw being dislocated last time and, after seeing Jim (who works with Elaine) briefly, I got some of my pre-assessment out of the way, such as blood and MRSA tests. It was gone six by the time we took a breather in the cafeteria to check the train times, we'd been there since three.
There was talk in the appointment, with Nikki, about some work after my surgery to work on my fitness levels after the surgery. They said that because I haven't been able to do as much as everyone else my muscles will need to be retrained and we'll work on that. So this isn't a 'open you up, do the thing and then kick you out' number this is a 'do this first, but then we still have work to do' which I find funny because they think I don't do anything because I can't when they're going to find out it's actually because I'm a lazy bastard. Sit in front of the TV or go to the gym? Like, really? These poor guys are in for a shock.
As it stands, I have seventeen days until I have to go through and be checked in the day before the surgery and get all of my preparation done for the surgery that could literally make me or break me.
What is it they say, third time lucky or these things come in threes? I suppose we'll find out which one soon enough. For those of you who might ask, and I do get asked this, I'm not worried, I'm not stressed. I still see it as there is nothing I can do but go through it, getting worked up about it - however justified - is going to do me more harm than good. It's all out of my hands and even if it doesn't work it's not really in the doctors hands either because you can do everything you're supposed to do and stuff still goes wrong, that's just life.
I'm as helpless, but not quite as hopeless, as a feather on the Clyde.
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