Jane’s Story- “Surviving Hodgkin’s AND open heart surgery” by Jane Isaacson
When my cardiologist told me I was facing a coronary bypass operation, I have to be honest: I flew into one hell of a crazy panic. I was well aware of the possible late effects arising from my treatment for Hodgkin’s Lymphoma in 1978, had already experienced quite a few and had always made sure I stayed right on top of the annual checkups needing to be organized. My sister-in-law, Anita, who suffered from Hodgkins Lymphoma in the same year as I did, had recently passed away due to coronary artery complications and I decided that as a precaution I should ask my cardiologist to organize some additional tests of my coronary arteries. I’d been having annual hölter and echo stress tests for a few years and apart from some breathlessness when walking up steps and hills my symptoms had been zero. The CT scan he subsequently ordered (whilst protesting that it wasn’t necessary and I was over-reacting) showed my arteries to be severely narrowed and clogged. The angiogram which followed a few weeks later revealed my right coronary artery to be 99% occluded. Thankfully for me this was able to be stented during the same procedure.
I was now taking extra strong statins to limit the radiation-induced atheroscelorosis. Unfortunately, by the end of 2018 (two years later) the stent had completely closed over and my left coronary (LAD) was also suffering from a 70% plus blockage. I was told by various cardiologists that this was most definitely too risky to leave and further stenting was too risky and therefore out of the question. The overwhelming advice was to undergo a coronary bypass operation or CABG (Coronary Artery Bypass Graft). I just couldn’t get my head around this turn in events. Even though I had suffered from my share of late effects, this seemed in another realm. Had I known at the time how truly routine such a bypass operation has now become, perhaps I would not have been so traumatized by it. The build-up of fear prior to the operation was truly intense and I couldn´t dispel it despite the many wonderful people on the Hodgkins Lymphoma/Disease Survival & Late Effects 1960-early 2000s Facebook page who gave reassurance, support, and much-valued advice, including the comment that the operation, although a big one, was oh so routine. I just didn’t believe them!
I went into hospital on the same day that the operation took place. As I live in Spain, I had chosen a surgeon in Malaga, near to our home in Granada, who came recommended by Spanish friends and who had had many years of experience with open heart surgery. I felt this was particulary important since radiated tissue reacts differently to a normal person’s and there can be added complications. He told me not to fear the operation but to look on it as a solution to be embraced. He told me he was accustomed to dealing with fibrosis in irradiated patients and that in a worst case scenario it might mean a longer operation in which they might not be able to use the internal mammary artery (significantly more durable over time than other veins commonly grafted).
Before I knew it, I was being wheeled into the operating theatre and the anaesthetist was asking me if he could use an epidural anaesthetic in conjunction with the standard general. He said the pain was far better controlled this way and although I wasn’t particulary convinced, having had several epidurals in the past and not reacting well to them, I gave my consent. He then told me he was putting me to sleep and I was thankfully oblivious to the rest.
I awoke in the ICU, drowsy but not unduly uncomfortable. The inevitable sound of beeping machines was all around me and I saw flashing coloured lights emanating from the bulky machinery to each side of the bed. I felt surprisingly pain-free but overwhelmingly tired. The worst part was over and it turns out I was fortunate. They had been able to use my mammary artery and there had not been too much intensive bleeding at all. In fact, things had gone incredibly smoothly really and now I needed to concentrate on getting better.
The day after the operation the nurses were already offering me food which provoked strong feelings of nausea (I wasn’t ready), two days afterwards they had me sitting up in a chair by my bed and three days afterwards I was told I had to make my way to the bathroom to wash myself. I was truly amazed at how quick things were moving. On the fourth day they moved me up to the normal ward and the very next day I was discharged and told I could go home to recuperate. My hospital stay had gone by in a whirl and I was onto the next stage in the “adventure”.
I won’t lie, the operation was “no walk in the park” and recovery has been mighty slow. Slow but nonetheless steady and relatively pain-free. I developed some fluid on my lungs due to operational trauma which only shifted about a month after the procedure with the help of diuretics. This is pretty common after operations such as these. It made me breathless, unhappy when exerting myself and uncomfortable when lying horizontal. It was far better to sleep bolstered by many pillows and of course I am still unable to lie on my front and only recently managed the right side (two months out).
I am proud of my two scars which are shaping up nicely. The one down my front now joins with the other marking the removal of my speen when the Hodgkins Lymphoma was discovered. That was the mother of all scars! The other one on my leg where they took my saphenous vein is long and zipper-like but I can live with it, no problem. I am looking forward to my cardiac rehabilitation programme which starts soon at the hospital and to getting back to grips with my life again. I am fortunate to be here and am trying to be as positive as I can about my future. After all, I am still here and have no intention of giving up without a fight!