US Pharm. 2008;33(2):HS-26-HS-29.

During the fall of 2007, I was 43 years old. Happily married and the father of four, I worked in pharmacy education and, at the time of the events that follow, was exercising six days a week. I had always had slight issues with my cholesterol levels but for the past few years had been able to manage it with diet and exercise and considered myself to be in pretty good health. I was more than a little wrong.

The timeline of events from when I first experienced some issues to when I had my surgery spanned all of eight days. It all started when I experienced shortness of breath while exercising. This included chest pain with referral pain in my left arm after I exercised, which I recognized as possible signs of angina. I made an appointment with my internist and was told that I had an issue on my electrocardiogram. A referral to a cardiologist followed. It is worth noting that I do not usually voluntarily go to the doctor, and why I chose to do so this time is still a little bit of a mystery to me. I heeded the warning signs and am lucky I did!

After seeing the cardiologist, I was immediately admitted to the Memorial Division of the Charleston Area Medical Center in West Virginia. Understand that I had driven myself to work and was due to leave the following day for a three-day, out-of-town golf weekend. I was in shock! I thought something could be wrong, but was in complete disbelief when I was informed that I needed an immediate cardiac catheterization to find or fix the cause of my problems. I can remember calling my wife at her job and then my office to say I would not be back for the week and how unbelievable, and scary, this was; I felt completely out of control.

Life-Saving Intervention
No one in the cardiologist's office rushed me in any way, and my cardiologist was caring, attentive, and understanding; I credit his intervention with saving my life. I was admitted to a telemetry unit and felt very strange because I was the youngest patient in there by quite a few years, which generated a lot of strange looks as visitors walked through the unit.

The following evening I was scheduled for a cardiac catheterization. Throughout the wait I was nervous and would have been much more so if not for the support of my wife and friends. What I had prepared myself for as the resolution of my problems ended up being anything but. Instead of my issues resolving with the insertion of stents, I was informed that I had six blockages and would need open-heart surgery. I was in shock again and had the weekend to ponder my upcoming surgery.

The weekend passed slowly with a series of tests and the frequent visits and calls from friends and family. My feelings throughout that weekend were best summed up by one of the nursing staff who, when looking at my face, said, "You are waiting for someone to come in and say this was all a mistake and you are the wrong patient." How right she was! I kept looking in the mirror and wondering how this could be happening to me when I didn't feel bad. I felt scared of what was to come, of the unknown, and of not being there for my wife and kids. I also felt guilty over all of the experiences that I would miss with them.

On Monday morning, eight days after experiencing shortness of breath, I had a quintuple bypass. One blockage could not be resolved, but I was assured that I would have more than enough peripheral vascularization to compensate for that one blockage. My surgery and prognosis were very good, and I was discharged three days later in both awe and disbelief. I had the standard open-heart discharge discussion and did my best to remember everything I heard. The main points that I remembered were to be compliant with my medications and exercise regimen, not to lift over 10 lbs for three months, not to drive for one month or until released, not to return to work until released (six to12 weeks), that I could experience depression, and to expect highs and lows throughout my recovery and beyond.

My drive home from the hospital was spent in tears, as I finally felt able to release all of the emotions that had built up. I was going home and was overwhelmed because I had feared the possibility of a worse outcome or going home with a less optimistic future.

Dealing with Dependence
There was one thing, however, that I was unprepared to deal with: the transition from being a very independent individual, a husband, and father of four into a dependent person who could not fulfill his spousal and parental roles. I was the parent who roughhoused with the kids, co-coached T-ball, and played in the yard, and for the next few months I could not participate in any of these activities. As a result of my health crisis, I had gone from being a participant to being a spectator.

I know that three months of rehabilitation is but a fraction of my life, but I was certainly not prepared for this reality. I was dependent for transportation and, in the initial stages, for almost everything else. Walking through the house from room to room was exhausting, and the stairs were as daunting as Mount Everest. Walking is the best form of exercise, and my cardiac rehabilitation plan recommended walking three to five times daily for predetermined time periods. But I could not walk alone for the first several weeks, and this took a whole new perspective when I listened to my 9- and 11-year-olds debating, "Who has to take dad for his walk?" Only weeks before, I had been playing baseball and soccer in the yard, and now my kids were taking me for a walk!

The "Tag-Along" Factor

I also experienced what I refer to as the "tag-along" factor. I was the spouse who went to the pharmacy when some of my prescriptions were being filled. I was along for exercise and to get out of the house but could not get there alone and was frequently asked, "How are you feeling?" I felt, at times, uncomfortable at the frail way I looked and moved and thought it seemed somewhat surreal that just a few weeks before I had walked briskly down the same aisles.

If I can convey anything from my experience, it is that the loss of independence is scary and challenging, and that even though it is a short period of time overall, it seems like a very long time when you are going through it. Having experienced this as a patient was eye opening and gave me a very different perspective on what a patient facing open-heart surgery, or anyone who looses his or her independence, must deal with.

While this was my experience, I hope sharing it can provide a window into the patient perspective. I learned firsthand that the things most concerning to me as a patient were the things that were the least visible.

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