My husband’s heart Part 3: Cardiac rehabilitation

Over two weeks have gone by since Brian had his open heart surgery, and it is one week since he was discharged from inpatient care.

We are both very happy that he is back home, though there continue to be ups and downs in his condition. During good periods he is able to walk short distances both inside and outside the house, and to eat reasonably well. However he has relapsed into atrial fibrillation on several occasions, and a recent blood test showed him to be anaemic. At times he feels weak and breathless and is unable to get warm. Formerly an avid reader, he has no interest in books at present, though he does follow the news on his computer.

We were advised that recovery from such a huge operation takes about three months, so perhaps cannot expect too much too soon. His medication – currently including amiodarone, warfarin, aspirin, an occasional beta blocker – will be reviewed by the cardiologist next week.

After the previous month of acute anxiety combined with frantic activity – travelling to and from the hospitals to visit Brian every day while managing practical, legal and financial affairs at home and dealing with medical appointments for myself – my own life has entered a quieter domestic phase. My role as nurse-housekeeper is not unduly arduous, so I am catching up on lost rest and sleep. Brian and I have time to spend together in a relaxed way talking, listening to music, or watching the four cats in the garden.

Daisy with flowersLeo on gatepostMagic on plum tree best photohomer at feijoa tree

All the regular engagements which once provided structure to my weeks – singing with St Patrick’s choir, volunteering at Auckland SPCA, attending Auckland Film Society, dog walking on Takapuna beach, coffee dates with friends in the city, yoga class – have been cancelled for the time being. The activity which means the most to me, creative writing, is also on hold. Apart from this blog and emails to friends I have written nothing for six weeks, but look forward to getting back to editing my new novel soon.

My husband’s heart Part 1: North Shore Hospital

It is over thirty years since my husband Brian started feeling breathless after walking up long flights of stairs. He was found to have aortic stenosis and an aneurysm of the ascending aorta. As time went by, occasional repeat investigations showed this pathology gradually getting worse, and several specialists advised cardiac surgery to prevent the risks – including sudden death – associated with his condition. He declined, on the grounds that his symptoms were not too severe and that the operation itself could be fatal or cause some intellectual impairment. His diagnosis was one factor in our joint decision to leave our medical careers in the UK and go to live in Auckland, New Zealand, where Brian had been born and brought up. That was fifteen years ago and over most of this time Brian has continued in good shape – even walking the Milford Track.

on milford track

He continued adamant that he did not want surgery. He asked me and our family doctor not to send him to hospital if the aneurysm burst, but to give him morphine and let him die at home.

In July this year, soon after his 82nd birthday, Brian had a bad attack of flu and we attributed his continued lethargy and reduced exercise tolerance to the aftermath of that. He did seem to be getting better. Then on 4th September, on the way back from an enjoyable evening at the ballet, he said he did not feel well. He refused to let me call for help. Somehow I managed to support him on the walk home, but as soon as I opened our front door he collapsed in the hall. At that point I went against his wishes and rang 111. Time will tell whether I did the right thing.

A skilled ambulance crew arrived promptly, and did an ECG which showed atrial fibrillation with a pulse rate of 160-170 per minute. They started intravenous amiodarone and advised that Brian was likely to die unless he went to hospital. With a little persuasion he agreed to go. After many hours of investigation and treatment in the resuscitation unit of North Shore Hospital he was admitted to a ward and at 4 a.m. I took a taxi home.

The immediate cause of the collapse was not a ruptured aortic aneurysm, but a 70% blockage of the main stem of the left coronary artery. With excellent medical treatment and nursing care, Brian’s condition improved greatly over the next few days, but he was presented with a stark choice – go back home with probably just a few months to live, or undergo surgery which carried a 20% operative mortality but if successful could give him many more years of good quality life. Brian decided to “cooperate with the inevitable” and accept the operation that he had been refusing for so long.

He stayed three weeks attached to monitors in the cardiology centre, not allowed to leave the ward although he was feeling fairly well. Every day we anxiously awaited the news that a place had become available on the surgical unit at Auckland Hospital. On several occasions the proposed transfer nearly happened but was then cancelled – later we would come to understand all too clearly the reasons for this. Brian appeared to benefit from the long rest, and remained in good spirits. He spent much of his time exercising in the corridor, or with his laptop computer composing a self-written obituary for Munk’s Roll.

There is much more to the story, but to avoid making this post too long I will continue next time. Please sign up in the box if you would like to receive future episodes by email. I should add that I am publishing this with Brian’s full knowledge and consent.