Breath and Control

Waking up after Mitral Valve Surgery.

Coming back into consciousness from surgery is… a curious thing. At first, it's a slow climb as you take inventory of your body. Yet, that soft floating feeling is slowly but aggressively replaced with a physical force that thrusts you back into a cold, sterile reality. As I started my ascent, I realized I couldn’t breathe through my nose. Air simply wouldn't go in and it scared me. I tried to lift my arms to investigate, but they were strapped down. Somewhere in the recesses of my mind, I remembered hearing a woman’s voice say, “I’m only tying you up because you tried to remove the tube and get out of bed.” I tried to focus on this faint memory. Unfold it, relive it, and dive into it to have a clearer understanding, but I couldn’t make more of it. I went to sleep tied up, and I awoke tied up. Anxiety forced me to pry open my eyes and take stock of my body. But instead, I saw my blessed people waiting for me and I focused on them.

I was aware of beeps and voices. Someone was gently squeezing my calves and feet, which was comforting, but I still struggled to breathe. I tried concentrating on my hands and figure out how they were bound. Although I couldn’t see my left hand, it felt as though it was bent backward in a splint. I shifted my attention to my right hand. Something kept my index finger straight, but I could move the rest of my fingers and thumb. Panic was filling my mind as I struggled to figure out what to do with the tube in my mouth.

The nurse was by my side. Her voice was too loud. I needed quiet as I adjusted to being immobile and suffocating to death. She kept telling me I was too acidic. They couldn’t remove the tube until my acidity level dropped. But I had no idea what that meant. Was I supposed to breathe through the tube or was the tube breathing for me? I didn’t want to mess anything up. She said something about the tube doing 50% of the work. I didn’t understand what she was talking about. She walked away leaving me with questions I couldn’t ask.

I looked at my people who smiled and said sweet things that I don’t remember. All were present except my son and father. My son found it too hard to see me in the state I was in, and my father was sitting with him in the waiting room. I felt like I was in an invisible coffin. I could see and hear my family, but I couldn’t talk or reach out and touch them. I was taking shallow breaths and my panic was rising. I had questions and no way of asking them. The feeling of claustrophobia started inching in.

Strapped down

I tried to mouth words around the tube, but it was impossible. I was told to be still and not move my head because of the tube. It is surreal, I desperately needed to understand what happened to me. What kind of surgery did I have - repair or replace? How long have I been out? How was everyone doing? Did they cut open my chest or stick to the incision along my pectoral muscle? My voice was gone, and my ability to speak was paused.

Anxiety wasted no time dancing its awful self into my psyche. Trying to speak while being muted and your hands tied feels like a metaphor for a woman’s life. It was a complete loss of control. I was mentally begging someone to explain what happened but no one understood what I needed. I just wanted a calm, QUIET voice to tell me how to breathe with a tube shoved down my throat. I wanted the nurse to explain why I had to stay tied up. I was calm on the outside. I wasn’t going to try to pull the tube out. In fact, I was afraid of what it would feel like coming out. I am a people pleaser and didn’t indicate I wanted to be untied. I was concerned if I pulled at the ties, they would think I was still steeped in anesthesia-laced confusion, and I would have to stay tied up longer. How does a calm woman convince others she is calm without appearing crazy?

Huh, writing that sentence felt incredibly layered.

SOMEONE BE MY VOICE!

My body’s instincts kicked in. Out of necessity, I took a deep breath through my mouth. My body has wisdom of its own. I need to trust that wisdom more often. The nurse told me I did a good job. That was when I realized acidity meant a lack of oxygen. I felt a little calmer. I looked at my people looking at me, and I realized I had no idea what they were seeing. What kept my son away?

They saw me in a way that I would never know. That felt...wrong. I remembered my writing. I wanted memories of this moment to write about. I wanted to see the me they were seeing. I know this sounds crazy, but I wanted pictures. Let me see what you see, let me have something to write about. What if I want to write another book one day? I need memories.

But how in the world was I going to tell my people to take pictures of me? And, how do I make sure they know that I know how ridiculous the ask sounded? Then I remembered that I knew the American Manual Alphabet. I could sign. Again, the only fingers I could move were the three on my right hand and my thumb but it was a glimmer of hope. I wasn’t sure it would work, plus I would have to get my family to look down at my hand, but it was worth a shot. As weird as this sounds, I started signing “P-H-O-T-O” with my right hand. I had to do it a couple of times, no one was looking at my hands, just my face. Then the nurse said, “She’s drawing pictures with her hands.”

God love her.

Everyone looked at my hand. It took two seconds for my husband to get it. He said, “She’s signing.” Tears of relief brimmed. However, they quickly disappeared once I remembered that I was the only one in my family who knew the American Manual Alphabet. Damn It. But in perfect synchronicity, my husband and daughter whipped their phones out, pulled up a chart, and started their best to interpret.

God love them.

They had to work around my incapacitated index finger, but I kept signing the word until they got it. Then they gave me a crazy look. “You want us to take a photo of you?” I signed B-O-O-K. My daughter told the nurse, “She wants to write a book.” I know this sounds crazy. I know.

My daughter took the photos. I saw what they saw. It was shocking.

I signed T-I-M-E. Surgery started at 7:30 am. It was over by 11:30 am. It was now 6:00 pm. I was shocked at how much time had passed. The nurse explained that they didn’t reverse the anesthesia for this surgery. Instead, they let it wear off naturally. Why don’t they do this for all surgeries?

Now that I could communicate, I went for the harder question and started signing C-H-E-S-T. They had some trouble with this one, I couldn’t get my thumb under my index finger for the T. When my family couldn’t guess the letters, I became overly frustrated. I would frown, stop looking at them, and make a flicking motion with my hands. It was hard to stay calm. At some point, I realized that the squeezing of my feet wasn’t from a person, but by some compression thing that although comforting, meant I couldn’t move my legs either. All I could move was my eyes and four fingers. This meant that those small body parts and my husband and daughter's interpretation skills were all I had to communicate with. That was the extent of my control.

I tried it again: C-H-E-S-T, C-H-E-S-T, C-H-E-S-T. My husband finally understood “She’s saying chest.” But he didn’t understand what I meant. My mom was silent for a moment and then said in a soft voice with a slight catch in it, "She's asking what happened during surgery.”

There was a collective pause as my husband gathered his words and leaned in close. “They had to do a replacement. The valve was pretty damaged. But everything went well."

And there it was.

No one said whether they had to go through my sternum, so I figured it was still in one piece. I processed what this meant for me: medicine, dr. visits, blood checks… This all coincided with the nurse on the phone outside my ICU cubicle, "She's breathing…. Beautiful volumes…. Okay.” She hung up the phone. Coming to my bedside she said in a voice much too loud for my sensory system to tolerate, “Heather, we can remove the tube and untie you.”

She asked my family to step out, but once again, I was in a panic. HOW was she going to remove the tube? Would it hurt? What were the dangers? I looked around wildly at my sister, a nurse. She made eye contact with me. I mentally begged her to explain what would happen, but people aren’t mind readers. There was no way for her to know what I was thinking.

My people were gone, the curtain was pulled, and it was just me and the too-loud nurse. She quickly explained the process. I would breathe in, then exhale as she pulled out the tube. She told me it wouldn’t hurt but it would feel odd. She also told me I couldn’t talk for an hour after the tube was removed. Then I was breathing in and giving the best people-pleasing exhale I could while she gently pulled, taking steps backward as she did. Holy Hell. That damn tube kept coming out of me. I had a visual of a magician pulling handkerchiefs out of his mouth. She was right, it didn’t hurt, but it was the oddest sensation. She untied my hands.

I inspected my body. My left hand was bent backward in a splint because a large IV catheter was inserted in the artery in my wrist. My right index finger had an oxygen monitor taped onto it. My legs sported compression cuffs that gave gentle, loving robotic squeezes to keep blood flowing and chase off any chance of clots. I had miles of wires coming out of the artery in my neck, and an oxygen tube gently blew air into my nose. But, I had some control again, and more importantly, I had my breath back.

Understanding me was a family effort, I pointed at my sister as she said, “T”. I was spelling C-H-E-S-T.