Saturday, August 25, 2007

Fix you (bypass heart surgery)

If Dr Vaughn Starnes hands be crafted by God, work on! He works with the grace of a ballerina, his pinkie fingers balancing his hands as they maneouver the remaining fingers into Reuben's heart.

By cardiopulminary bypass, Dr Starnes surgically repaired the hypoplastic arch (coartation), closed the ventricular septal defect (VSD, hole, murmur), resected the subaortic membrane, closed the patent foramen ovale (ASD), ligated the patent ductus arteriosus (PDA) and dilated the stenotic pulmonary valve. The operative report reads things like “We then noted the fairly large subpulmonic VSD. We patched the VSD”. It’s startlingly matter of fact. In layman’s terms, the outer shell of Reuben’s heart has been sewn in paches to fill in the holes, narrowed valves to the lungs and body have been dilated and the breastbone (sternum) that was cut open was closed with stainless steel. That’s the gruesome part.

The surgery itself took 2.5 hrs, 48 minutes of which Reuben was on cardiopulminary bypass which meant he was blue and cooled to the level of hyperthermia.


The senior charge nurse invites me to prep Reuben for surgery. We scrub Reuben’s body until he’s cleaner than he’s ever been before. It is an emotional ritual, my tiny participation in what is to come. The anesthesiologist arrives to take Reuben to the operating room and asks us to kiss him goodnight. My stomach rolls over with panic and tremendous anxiety as Cassandra and Lisa hug Jason and I. I need to sit down very badly and nurse Susan takes us to the kitchen in the parent’s lounge where we will wait out the surgery. We had an all night vigil by Reuben's bedside, photographing him with gusto as if each take were the last, singing to him, stroking his hair, taking turns holding him in our laps.

I awake with a startle, my head on the table, as the cleaner comes into the kitchen. So we’re prompted to move to another room to sit out the surgery. Collecting our things, Jason lags behind. I turn the corner and Dr Starnes, neutrally expressive, stares back down the corridor at me. A flash of recognition. Dr Starnes is 90 minutes too early back from surgery. A lifetime of emotion squeezed into seconds. My mind floods with feelings, at once trying to analyse his expression for some sign of falling into the 88-90% success bracket, beyond the statistics for morbidity and mortality, and yet, in that split second, I can read nothing. The short walk is empty save Dr Starnes at one end and me, the other and as the distance between diminishes, a terrifying sense of dread overwhelms me. I shout for Jason just in time to join Dr Starnes in saving me from fainting as my legs give way.

I recall the scene in the Terminator when Linda Hamilton breaks out of the sanitarium and, turning the last corner towards the elevator, is greeted by Arnie staring down at her at the end of the corridor. Linda’s momentum is brought to a rapid halt as she spins on her heels, running back down the corridor. I wouldn’t have made it as Linda Hamilton.

Dr Starnes visits us later and gives a passing glance to Reuben. "I was more worried about you than Reuben" he says.

It's as if we'd been asked to jump across the Grand Canyon whilst standing on the North Rim. We now find ourselves on terra firma, the South Rim and I can't believe we're here. The months ahead we'd dreaded, desperately waiting for him to grow to 6kg whilst watching him suffer to breath, each and every calorie being used to sustain his life with no reserves left to grow. All this condensed into days. The surgery at a weight unable to hover beyond 4kg.

I wipe the blood that has dripped into the crevasse of Reuben’s sweet neck. I kiss him goodnight.
The strange irony is that Dr Starnes also fixed Arnie’s heart.


yp said...

Oh Catherine - wonderful congratulations and thank you for your beautifully written post. I feel pulled through the moments with you and I am grateful for the experience. So much love to you, Reuben and Jason. Moments like these which strech our hearts beyond any imagination become the vessels of joy which deepen our every moment. Bittersweet at times - always beautiful. oxo, y

Nana and Grandad said...

God has blessed our little grandson Reuben. We feel that all the prayers said for him, to paraphrase a song, have been "the wind beneath his wings" and carried him safely through his latest hurdle. Reuben, the future is bright and full of promise. We love you dearly.

Ericap said...

Echoing Yuka's words, your writing zooms us right in there, as much as we are able. We are thrilled for you all and whilst Reubens' recovery may be routinely long, he will be going in the right direction and all the sweeter for his homecoming.
Much love

MK said...

The phrase "a beautiful letdown" comes to my mind as im reading your amazing post today. Just know continually that blake and i through much love and prayer are holding up your arms for you when you feel there nothing to hang on to. And thank goodness for the great report. Your so gifted in writng catherine truly a book about all of this from you would be a bestseller. Im thinking of writing one, mk

Polly said...

Catherine - Your description is incredible, made me feel both fearful as the doctor approached you and tearful with the good news! What experiences you guys are having... am sure that you'll look back one day and wonder how you got through it all, but you are obviously finding the necessary strength and so is Reuben - which is fantastic. Hope his recovery goes smoothly... will look forward to your next post (I find myself checking your blog almost more regularly than my emails at the moment!). Love, Polly

Eva Nichole said...

Wow you really know how to paint a picture for people my heart is full of all the feelings you have felt.
Being the mother of a CHARGEr and having waiting that long wait of the heart surgery I know all the feelings you went threw and my heart and prayers continue to go out to your family.
God has been blssing you all,
Crystal and Eva

mighty max and mommy amy said...

Thank you, thank you, thank you for the update. I am thrilled the surgery and recovery is going great. THat is so special that they invited you to help with prepping him, etc...what a very unique moment to share.

Much love and peace, Amy and Max

P.S. You are a gifted writer my friend!

ellen charge said...


Adam said...

Hey Catherine,

FYI, Dr. Vaughn Starnes did my aortic and pulmonary valve replacements in 2005.

Needless to say, Dr. Starnes is the 'Michael Jordan' of heart valve surgery.

If anyone is interested to know more, click here to learn more:

Vaughn Starnes - USC Heart Surgeon

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