My Broken Heart

This is a story about the most challenging ordeal that I have ever had to endure. Last spring I had bypass surgery to replace blocked arteries in my heart. The operation was complicated and according to the post-surgery report, my heart went into v-fib arrest and I had to be shocked back to life. 

To my own generation, I write this story as a shared experience. After a long recovery, my chest pains and shortness of breath went away. I can go for long walks and hikes without getting tired. To those who are younger, please consider this piece a cautionary tale, a lesson on how to live a healthier lifestyle, consume less and exercise more. 

PART I – BAD HABITS

I should have known better … When I was 10 years old, my parents went on vacation and left me with my grandparents. My grandmother enlisted my help in making varenikis, a dumpling consisting of mashed potatoes with fried onions enclosed in a thick shell of soft dough. The potato mixture had a magical ingredient known as schmaltz, rendered chicken fat used in almost all my grandmother’s recipes. My grandmother would roll out the dough and use a glass to make a perfect circle. My job was to scoop the right amount of potatoes into the center of the dough. My grandmother would close the circle around the potatoes and gently drop the dumpling into a pot of boiling water. My grandmother would use a flat ladle with holes, to scoop up each delicious vareniki. Varenikis could be served in different ways, either as a side-dish to a meat meal, or on their own with dollops of high fat sour cream. Oh how I loved those varenikis! I could never get enough. With each vareniki consumed, my cholesterol score worsened and my weight increased. It was the beginning of incredibly bad eating and lifestyle habits that have resulted in my obesity, arteriosclerosis and depression.

I should have known better … On Saturday mornings, my dad would take me with him to his workplace. Before going to the office, we would stop for breakfast at Le Roi du Smoked Meat (The King of Smoked Meat), a diner-style restaurant that still exists to this day. A lard-coated griddle was the birth place for almost every breakfast platter; eggs served with bacon, ham or smoked meat. A toasted bagel completed the order, and while my father enjoyed his coffee, I preferred a glass of cold chocolate milk. My father had his first heart attack at the age of 53 and was plagued with angina until his untimely death at age 66 from cancer. 

I should have known better … Growing up in Montréal with its incredible selection of wonderful restaurants was both a blessing and a curse to this stout little man with a Gold American Express Card. At the Yangtze almost every Sunday night, they served up crispy eggrolls, won ton soup and incredible spare ribs. For classier Chinese fare along with the best roast beef in town, Ruby Foo’s was the place. In the mood for Italian, a short trip to Piazzo Tomasso for your choice of pasta or Veal Parmigiana.  For the best barbecued chicken, you could choose between Chalet Bar-B-Q and the more upscale Laurier Bar-B-Q. Are you in the mood for dessert? You could enjoy a piece of Moka cake at the Pam-Pam or a South American Ice Cream Sundae at Pumpernick’s. 

And the delicatessens … cornucopias of Jewish-style cuisine with the focus on fat, juicy smoked meat sandwiches on rye bread. These heart-stopping delights along with sides of pickles, coleslaw and the greasiest French fries were available on almost every corner. All the while, the calories, the sodium, the fat and the nitrates were enjoying their own little party in my gut.

I should have known better … By the 1970s, discos were the “in” spot. The music was loud, the bars were crowded and smoky and the only way to get a girls attention was to buy her a drink. And so I took to drinking; Bloody Marys, Black Russians, or just straight up scotch. The bartenders were my “friends” making sure that my glass was always full. 

Lucky for me, my addictions only involved food and drink. Smoking always seemed like a disgusting habit, but the fact that I never smoked is probably inconsequential. From the 1950s to the 1990s the whole world was a giant ashtray. Everyone smoked including my parents, my sister, my girlfriends, the bank tellers, the grocery store cashiers and the waitress at the deli. You couldn’t escape the haze of second-hand smoke that was certainly a factor in heart health.

My food and drink addictions continued until my wedding day. My wife moved in and threw out my salamis, my boxes of Kraft macaroni dinner, the Bar-B-Q chips and my Whippet cookies. It was time to start living a healthy lifestyle. My partner was very strict concerning the food inventory. There were always a lot of fruits and vegetables, low fat yogurt and whole grain cereals. For snacks, we had dry fruit and my mother-in-law’s homemade galettes.

But … I should have known better. Even though my wife prepared delicious, healthy dinners, I still spent many lunch hours at the deli or the Chinese restaurants. The worst part was that I cheated on my wife. Most days on the way home from work, I would stop at the store and pickup my mistress – a large bag of Miss Vickie’s potato chips. Miss Vickie would sit in the passenger seat, while I munched on her incredible chips during my drive home. It was the only time that I wished for heavier traffic so that I could consume more chips. 

I had secret stashes, in the garage, office and kitchen cupboards. Inevitably my wife would discover these treasures and they would end up in the trash. I went to doctors, dieticians, psychiatrists, weight loss support groups and hypnotists. They offered excellent solutions to control my intake, modify my food choices and exercise more. The counselling and coaching worked well in the short term, but I would always revert back to my old bad habits. 

PART II – RETIREMENT AT LAST

I retired at age 66. I was fed up with the stress that came with my job. The constant fear of computer viruses, ransomware attacks and software bugs was always on my mind, even while on vacation. Now I was finally free. That first Monday morning that I was able to take my coffee on my back deck and listen to the chirping birds was one of the happiest days of my life. I started going for long walks and joined the “Y.” One day last spring while I was on a walk, I started to get chest pains. The pains were intense and I had to sit down for a few minutes until they passed. I consulted my family physician who sent me to see a cardiologist. The doctor put me through a battery of tests; electrocardiogram, ultrasound, treadmill and blood tests. All the results came back negative. I was given pills to lower my cholesterol and control my high blood pressure. 

Bad dietary habits and a passive lifestyle were only part of the problem. Many cardiac conditions, including those that can lead to heart attacks, are inherited. This means that if you have a close family member with heart disease, your risk of developing it is higher. Genetic variations are passed from parents to children. 

My grandfather came home from work at his shoe repair shop one day. He greeted his wife and children, then keeled over and died of a heart attack at the age of 36. My other grandfather had a near fatal heart attack in his 60s. My own father had his at 53 years old and my mother died of heart failure at 83 years old after two bypass surgeries. With genes like that, my risk of having heart failure was higher than normal.

PART III – THE DIAGNOSIS

The chest pains persisted and I was walking less, so I went back to the cardiologist. He couldn’t figure it out. Previous test results were good and I was dutifully taking my meds, so why were the chest pains continuing? Time for an angiogram – a radioactive dye is injected into your veins and x-ray photography is used to trace the path of the chemical as it circulates through the heart. The results weren’t good. In fact the cardiologist was so surprised to see the outcome that he called me the very same evening to come to his office the next day. He screened the angiogram on his computer and showed me, with great detail, the blocked arteries. There were seven blockages that were clearly visible and the doctor highlighted the areas that were most heavily constricted. There were few options available, too many blockages for angioplasty; the only viable choice was open heart surgery to bypass the obstructions.

The cardiologist would advise the surgical team and I would be called in for a consult. The doctor advised me to avoid stress, stay away from fatty foods and not to travel. A few weeks later, I had my appointment with the surgeon. The doctor explained all the steps that must be followed to ensure a successful outcome before and after the surgery. A week in the hospital for recovery was the norm, three days in the Intensive Care Unit (ICU) followed by four days in the Cardiac Care Unit. Physiotherapy would be required after the operation as well as participation in a cardio rehabilitation program. 

PART IV – THE SURGERY

To prepare for the day, I ordered a new pair of pajamas and slippers on Amazon. I added a couple of novels to my e-book reader. I visited my children and grandchildren. I showed up early in the morning at the designated department. My chest, legs, and groin area were shaved and I was given the standard hospital gown. Forget anything about dignity. The gown barely covers your privates and you are pretty much “out there.”

The operating room had been rebuilt only a few years ago and it featured state-of-the-art lighting, monitoring equipment and ventilation. As the team started their preparations, I was again briefed on the procedure. A few more questions to confirm my identity and then I was off to dreamland. I was told to count backwards but I didn’t get very far. Before I knew it, total blackness overtook me and when I woke up I was connected to an array of monitors and hoses. During the seven-hour surgery, five clogged arteries in my heart were “bypassed” using veins that were harvested from my leg. My memory was a little fuzzy when I came to. I was groggy, disoriented and quite uncomfortable but I could feel no pain. A lovely “angel” hovered over my bed checking the various wires, tubes and sensors connected almost everywhere on my body. All I wanted to do was return to that blissful sleep, but the effects of the antiesthetic slowly started to wear off and I realized that I was in for a challenging recovery period. 

PART V – RECOVERY

At first, I had major problems sleeping. There was a digital clock on the wall in front of my bed with bright red numbers. I kept thinking of those medical TV shows where the doctor calls out “Time of death – 3:47.” There seemed to be something wrong with the clock. The numbers changed way too slowly. When I finally managed to fall asleep, I was plagued by nightmares. The walls turned to stone, like an ancient castle, with living gargoyles sitting at the top. It seemed that the walls were closing in on me while the gargoyles swooped down the sides laughing wickedly and the big red clock flew around the room. I had no appetite and I longed for just a few hours of uninterrupted sleep. It got to a point in my recovery process that I begged for a psychiatry consult. 

I was visited by the psychiatry team. We talked about my lack of sleep and my loss of appetite. New medication was temporarily added to my nightly cocktail of drugs, and the nightmares went away. I was also visited by a hospital dietician. She agreed that the default meals could be a little hard to swallow and together we came up with a better plan.

Bodily functions were another challenge. Urinating was easy. I was given a pitcher that I could hang from a bedrail. Bowel movements were another matter. A chair called a “commode” was positioned next to the bed. When you start to get the feeling that something is about to transact, you must move quickly from the bed to the commode, all the while making sure that every wire and tube stays connected and doesn’t get tangled. Several very embarrassing accidents occurred and I have only admiration and gratitude for the brave orderlies who had to clean up the mess. 

After a few days, I was moved to a beautiful room in the CCU and most of the monitors were disconnected. I was advised to walk the halls as much as possible. I was visited by a physiotherapist who tested my breathing and my ability to walk. 

PART VI – HOME AT LAST

On Saturday, March 29, 10 days after the surgery, I was sent home. After the surgeon signed off on all the paperwork, my wife and sons helped me into the seat of the car and although I felt every bump and pothole, I was overjoyed to be going to my house and taking my first shower in over two weeks. Stairs were still a challenge. For the first days at home I had to do everything in “slow motion.” The weather was still inclement and I had to do most of my walking around the house. 

Soon after coming home, I started the cardiac rehab program. It included access to a gym with a kinesiologist for 12 weeks, meetings with a support group that involved discussions with other patients who had experienced cardio surgery and sessions with a social worker, a dietician and a physiotherapist. I was given an initial appointment for a stress test and blood tests. This would determine a baseline that would be used to compare my condition at the end of the program. 

The cardio rehab program was an excellent experience. The knowledgeable and caring staff went beyond their responsibilities to ensure a positive outcome for the participants. The gym is well equipped with modern exercise machinery and weights and other accessories. The opportunity to discuss issues concerning rehabilitation, recovery and lifestyle topics with the professionals as well as with other heart patients was a tremendous asset in making a full recovery. 

It has been almost eight months since the surgery. I go for long walks and I experience zero chest pains. I am back to my volunteer work; I wash the car, vacuum and do the laundry. I take medication to control my blood pressure and cholesterol. I have been on a strict diet, trying very hard to lose weight, although I still enjoy the occasional bagel, smoked meat sandwich and ice cream. 

Heart surgery is still risky and in some cases, fatal. The best plan is prevention. I have learned to be more selective in the foods I eat, exercise more and try to avoid stressful situations. It took me over 72 years, but I finally know better. 

Paul J. Starr is a recently retired systems analyst who has lived his entire life in Montréal, Canada. On Sunday mornings he is “living the dream,” hosting a two-hour Internet radio show featuring music from the 50s and 60s called “Judy’s Diner.”