Chapter 1: Call 911!
It was somewhere around midnight, I guess. I didn’t see the flashing lights of the fire engine or the flashing lights of the ambulance but they were there, outside my house within a very few minutes of my wife dialing 911 and calling for help. I could swear she was still on the 911 call when I suddenly became aware of three burly firemen jammed in the doorway of the bedroom, while a fourth sat or stood by my side checking me out. It couldn’t have been more than a couple of minutes later, that they were joined by three paramedics, dressed in the familiar “Pullywooly” type jerseys, who also appeared in a flash and then assumed control of me. (They must have arrived almost simultaneously, like genies from a bottle!) I sat there on the edge of the bed not quite sure what was wrong with me, but sure nonetheless that I needed medical help.
What a wonderful credit to the City of Mississauga and the Mississauga Trillium Health Centre those first lifesavers on the scene were. My blood pressure was over 200. Just a few minutes earlier I had got into bed, tired but with no feeling of pain or discomfort that I can recall. I just didn’t feel right, and that feeling followed the exhaustion I had felt while taking a walk in the local park earlier in the day.
After my history had been taken down by the paramedics, those burly firemen loaded all 275lbs of me into a portable chair arrangement, and I sailed through the air above the stairs down to the ground floor and out into the cold night air where the paramedics transferred me into their ambulance. I was on my way to the Trillium Hospital. The paramedics were quietly efficient, but at the same time very friendly and comforting. They couldn’t have been better!
There are so many wonderful people that come into this true story that it is impossible for me to single out more than a few by name. But named or not, I would guess the number of doctors, nurses and their helpers, occupational therapists, physical therapists, social workers, family, neighbours who pitched in, and many others directly involved with my case literally totaled well over a hundred individuals, all of them putting their everything into getting me back on my feet again. I sincerely believe the richest man or woman in North America could not have received better treatment or more loving care than I did. It surpassed all reasonable expectation, and is a beautiful example of the greatness and warmth of the Canadian people and its healthcare system, a system which works quietly and efficiently behind the bustle of everyday life helping those who need medical attention and those who can’t help themselves. What a difference to life below the border, where the cost of major health treatment can result in the ruination of one’s life financially. Canada has a lot to be proud of, and my experience is a testimonial to that statement.
At the hospital, I was admitted at the ambulance entrance. It was a preliminary check, I assume, to determine whether there was an immediate threat to life. There wasn’t, and I was set up in a wheelchair in the main waiting room. While I waited for a bed in the Emergency Ward, a paramedic stood by me. He was a great comfort, and I was glad not to be just left in a hall somewhere. He came back later, before I had actually been taken into the Emergency Ward, and found me a more comfortable spot to wait. Eventually I was wheeled in, where I was asked for my date of birth umpteen times. (I realized later that it is one way the hospital staff double check to see who they are working on, or with.) It was the first step in what was to become a six-month period of operations and recovery, and I have nothing but praise for both the firemen and the paramedics; they were first on the scene, going about their business coolly, efficiently and with a genuine warmth that put one at ease.
Chapter 2: The Prelude to the 911 Call
It all started at the time of my annual medical checkup in the fall. I was concerned that the collapsed discs and arthritis in my spine were at a critical stage. While I could stand pretty well perfectly upright for a few minutes in the morning when I got out of bed, I would soon find myself bent over. I believed I was at a critical point. If I didn’t find some sort of solution soon, I would soon be bent over permanently. First, my family doctor sent me to get an up-to-date reading on my spine. The results showed no significant change in the past five years; arthritis, a lot of disc compression, and some fusing. I had mentioned to her how I managed to stand up straighter at Loblaw’s when using their grocery cart for support, and this led to the idea that a walker might help. I started to look at them on the Internet.
In the meantime, a couple of relatives put their heads together and gave me a beautiful walker for nothing. It turned out to be too low for my height but was gratefully used by my wife, who has some difficulty walking. When my sister-in-law heard the news, she immediately rented a replacement for me. She also arranged for an independent occupational therapist to have me checked out. The result was my sister-in-law “J” eventually had a brand-new rollator delivered to me. It has been a god-send, and I am still awaiting an opportunity to settle up with her for all the money she has laid out so far. It was another example of the many lifesavers I was to experience or meet during this period. Well, walking isn’t my favourite pastime, but I knew I needed to start walking. Now, I had a beautiful, functional rollator. It was delivered shortly after I came home from the hospital and there would be no more “begging off”! I would have to leave the comfort of my computer chair and hit the road. Without that rollator, I doubt I would ever have walked again.
One day in January of this year, Jan 16 to be precise, I suggested to my wife we take a walk in the park. It wasn’t our first walk with the rollator in that park, but it was destined to be the last for another couple of months. Once she got over the surprise of me suggesting a walk, off we went to Rhododendron Park. It is a very small park, more a “gardens” than a park. At the top of its little hill, I had to sit down and rest. A few more yards and I had to rest again, and it went on like that until I got back to the car a few minutes later completely exhausted. After getting my breath, I drove to a local store as planned, and then we made our way home. (The total drive from park to home was no more than one mile.) I then spent an hour so at the computer after supper, finally climbing the stairs from the basement to the second floor and going to bed just before midnight. No sooner had I laid my head down, I realized something was radically wrong and shouted for my wife to call 911.
Chapter 3: From ER to the Operating Room
I guess the job of the ER is to diagnose the problem, eliminating possible causes one by one. After all sorts of checks, of my blood pressure, my heart rhythm, blood analysis etc. it finally got to where I was visited by one of the chiefs of Cardiology, Dr Platonov, the “electrician” as he playfully described himself. Apparently, the ECG’s, blood work etc. had been done, and he was handing me over to the “plumbers” who would check the blood flow etc. That resulted in an angiogram, an operation in itself performed under full anesthetic. When I “came to” I heard the doctor say, “Triple bypass”. Another doctor or nurse showed me a small diagram showing 3 of my arteries 80% blocked, and a fourth artery 90% blocked.
Hmm, I wondered how on earth I had reached this abysmal level, when each year’s annual checkup gave me no such warning. The checkups had always shown everything to fall within acceptable margins, so I had figured I was home free. It was to be three or four months before I had a clearer picture of what the root cause might have been.
After the angiogram, Dr Platonov came back to tell me that, based on the blockages they had found, I was being handed over to the surgeons now “to let them have a go at you”. Shortly after that, I was moved out of Emergency into the older section of the hospital. I shared a ward with Antonio, another young guy in his eighties. Communication between us was very limited at first because he was under quarantine, due to a respiratory problem which, in fact, was already resolved. He had been warned to keep his distance. Poor Antonio had already been in the hospital a whole month when I arrived on the scene, waiting for some novel operation procedures to arrive from Vancouver. He was still waiting when I was later carted off to the new wing for my bypass operation. Antonio is a very interesting man, and we enjoyed quite a few chats in that somewhat crowded old ward. It would be another week or so before we met again in the new cardiac wing, me having had my operation and Antonio still waiting. His wife, who seemed to be sat by his side night and day, would send me over the odd banana and Clementine, those little seedless tangerines which I learned to treasure.
Preparation for the operation had its lighter moments. While having my chest shaved, I learned that oriental men don’t have hair on their chests. I never knew that! Another light moment was when I was being wheeled into the operating room. We passed the male nurse for my room. I called out “See you later Al”. His spontaneous answer came back, “Yeah sure …maybe!” I gulped and then broke into loud laughter. I think he was meaning he may not be on duty when I came out, but in the circumstances it had other connotations. I found it funny. The other thought that went through my mind was one of peacefulness. It had occurred to me that if the operation was successful I would end up healthier, and if it failed, what better way to go! Either way, I saw it as a win-win situation. A couple of the medical staff grimaced when I mentioned that, but nobody gets off this planet without some discomfort and I was being offered a runner-up prize of getting off and never knowing what happened. It seemed like a good deal to me. And so, in I went, my mind at peace!
Dr Platonov watched me go in, saying “For a triple bypass or perhaps even a fourth!”
The Trillium Health Partners Record of Operation shows that the surgery included: Coronary bypass grafts x 4 off pump with left internal mammary anastomosis to the LAD, left radial graft to the diagonal sequential to obtuse marginal and vein graft anastomosed to the RCA. The post-operative diagnosis showed: Coronary artery Disease/Left Main Stenosis.
After checking those medical terms on Google, I came to the conclusion that I was a bit like a worn old suit that had been made over by a cut and tuck here and there. Nothing I couldn’t do myself with a bit of practice, right? What went on inside the operating room – and inside me – is beyond my recollection of course, which is just as well. The surgeon, Dr Ahmed, and his team seemed satisfied with their efforts, and eventually I was transferred to an intensive care unit.
I remember later, as I was being wheeled out of the intensive care area, making a point of giving my profound thanks to those pushing the bed for the excellent work they had done. However a voice of someone in authority, standing off to my right as I passed by, chastised me a little by reminding me there were quite a few other people involved in my well-being. She was, of course, quite right, although I had meant it as a blanket thank you. To set the record straight, there were more people involved than I could possibly imagine. Still, at least I can now say thank you to the operating team because their names are recorded on the Record of Operation. First, a great big thank you to Dr Ahmed, the surgeon. He is the most unassuming surgeon I have ever met, with a wonderful bedside manner. He looked so young and easy-going that it was difficult to imagine how he had learned so much so fast. But let me also thank his team: Dr Cutrara, David Melmer, Ruth Singh and Dr Hultzer who were there to help make it all happen.
Trillium Health Partners serves South West Toronto and Mississauga, and is composed of two hospitals and one health team. It is a large reservoir of expert talent and beautiful women, and I felt so lucky to be in their hands. Everyone I came in contact was very professional and so helpful.
Whilst in the Intensive Care Unit I had a couple of new experiences: non-invasive blood-tests and x-rays done by a portable machine that photographed me where I lay. But before I leave the intensive ward area completely, let me tell you about my hallucinations! Due to the surgery in and on my chest, I was obliged to lay on my back in the hospital bed with my arms close to my sides. (Those hospital beds are quite narrow!) In my darkened room, the world beyond the bed was a mystery. I couldn’t turn to see behind me, and in front and to the side was a very shadowy area. At one time during the night (or was it day?), I noticed a beautiful blond woman standing beyond the end of my bed and off to the right of it in the corner. Her hair was very striking, and I gazed at her with longing. Just behind my line of vision and to my left stood a tall man with a matchstick-like body and a very square face. After gazing at, well perhaps ogling, the beautiful blond-haired girl, I turned my head towards the stick man because I thought I had heard him clucking; and there he was shaking his head at me as if to say the blond was a “no-no”!
A day or so went by before I realized that the blond lady was actually a file cabinet over in the corner to the right that had been painted diagonally a yellow/brown. Hmmm, and another look at the stick-man showed him to be a tall metal stand on my left, atop which was a square screen that showed the patient’s vital signs; well, my ogling of the blond could be considered a vital sign, I guess. So much for hallucinating! At least I had made it through the operation, which meant I might even see Al again!
Chapter 4: The Trauma I Left Behind
While I lay in the Emergency Ward feeling pretty good about my decision to call 911 and having heard “You got here just in time!”, there was a stressful situation building at home. The fire truck and ambulance were gone. All of a sudden, from a house bustling with firemen and ambulance workers and the sight of her husband be bundled off to hospital around midnight, my wife found herself completely alone. She locked the doors and got ready for bed. It had been a hectic few hours and she was tired, but sleep didn’t come too easily as she wondered what was happening with me. Would I be okay, or would she awaken to bad news in the morning. It had all seemed to happen so fast after she made the 911 call. But now everyone was gone, and the house was quiet. She shuddered to think of tomorrow, and prayed the sleeping pill would work.
Next morning, having had little sleep, she found it difficult to get going. The seriousness of her own situation now made itself felt as she realized that she was alone, so very alone. How would she cope on her own? Already in her late eighties, coping was not easy even with a husband around to help, but who should she call to say I was in hospital? How was she going to get to the store for food etc.? The family car was in the garage, but it was a year or more since she had driven. All of a sudden, she felt terribly lonely. To top it all off the TV connection was lost, along with her favourite channels, and she didn’t know how to fix it. She decided to call her daughter in Virginia for moral support, and to call my daughter Hazel in Toronto to inform her of what had happened to me.
Her daughter flew up and stayed for a few days, which helped settle her down. She is a senior flight attendant with Air Canada, who now lives in Virginia. Tracy spent as much time as she could supporting her in those early days, before she was off flying again. Peter, our next door neighbor, and his wife gave Rosemary tremendous support every day. Without Peter, things would have been rough after her daughter left. Ken, who lives on the other side of us, took on the job of keeping my large bird feeder filled, a job beyond the strength of Rosemary, and Bruce came over and got her TV going again!
The call to Hazel brought Rehab Results Inc. of Toronto into play. Although I didn’t realize it at the time, Hazel immediately started to make the moves that would help both my wife and myself in the weeks ahead. Most importantly, Hazel helped my wife realize that she would not be alone; that there would be help forthcoming. One major concern of my wife’s was how she could manage to look after me when I returned home. She didn’t have the strength to help me if I fell, and she had no idea how she was supposed to help me upstairs to bed. At 260 – 270 lbs., I was far beyond my wife’s weightlifting capability, but Hazel assured her that I would be able to manage the stairs as soon I arrived home. She was right, of course; the hospital would eventually train me to walk up and down a flight of stairs without help.
Hazel, an occupational therapist in her own right, together with her husband Dan, brought to bear all her love and support, taking a leading role in helping Rosemary cope and scoping out the house for changes that would be needed if and when I returned. She did a masterful job of that, plus she proved to be a real gem when it came to dealing with the various medical authorities, including doctors, physiotherapists, occupation therapists, family members and a hospital official anxious to free up a bed as soon as possible. Hazel was always there, readily available because she was linked in with her portable phone. (She did her very best to be bring me into line by supplying me with a cell phone. However it is a difficult task teaching an old dog new tricks, as they say, but she hasn’t given up yet!)
Although it was originally felt that a bed would be necessary downstairs in the living room for me, it was Rehab Results, of which Hazel is the president, that persuaded all concerned that a downstairs’ bed would be unnecessary, given that I would be able to use the stairs. Instead, a reclining chair with lift assist was recommended and proved to be the perfect answer when I did arrive home. Rehab Results made the necessary arrangements to have one delivered to the house, and it was there waiting when I arrived home. It proved to be a godsend in the following days.
Luckily, the two-flight staircase already had ample handrails, but changes to one of the toilets was necessary. The toilet on the upper floor was standard height with a hand rail close by, but the toilet on the main floor was one of those quieter but lower toilets. Rehab Results made the arrangements to have a commode delivered to the house, which was to prove ideal given my difficulty sitting and standing.
They also arranged for a taller rollator to be delivered to the house so that I could get around. I don’t know how I would have managed without that! As a final addition, in terms of equipment, Rehab Results arranged for and set up a cell phone that I could wear around my neck, which would put me in touch with its staff plus all the other wonderful people involved in my operation and recovery. As a result, my wife’s fears and apprehensions were steadily addressed one by one, and she bravely awaited my return home.
Chapter 5: In the Hospital after Surgery
All of this was arranged while I languished in the hospital, learning how to walk again and how to take care of my bodily needs.
The reader may be interested to know that, following the operation, patients were warned not to apply more than five pounds pressure to either arm; no lifting, no pushing, and no pulling beyond that limit. Well, try to raise yourself from the lying position in bed and sit up, given those limitations! It was very difficult. Once in a sitting position on the edge of the bed, the next problem was how to get onto ones feet. Remember, the same maximum limitations of five pounds per arm still applied! The only way to do it, and the recommended way, was to lean forward getting your body weight positioned over the knees, and then gently rock backwards and forwards until you could get your balance and stand up using the leg muscles! But always present was the overriding fear of falling forwards and landing on ones face on the floor. It took a long time to master getting out of bed alone without help. A fall seemed to be the hospital’s overriding concern, but it was mine too! They took great pains to ensure that we didn’t fall, but more on that later when I describe a patient who did fall.
I was moved to a beautiful room in the new sector, overlooking Queen Street; one really couldn’t ask for anything better. But I was still out of it. I lay there, arms to my side, unable to turn to my right side or left as the chest bone started to heal. Even after the first six weeks, my chest was super-sensitive and I couldn’t bear it to be touched. The feeling was one of static electricity or a tender sunburn. (I fended off all advances as bravely as I could!)
I had absolutely no appetite, but craved ice-water to stop my coughing, which felt as though it would tear me open. I couldn’t stand a bulky pillow under my head, but did want a pillow each side of my head as a sort of shield from the world beyond. It must have been a week or more before I ever saw the rest of the room behind or to the right of me. I had ordered a phone, but had tremendous difficulty answering it because it was on a chest of drawers to my right. I neither saw nor heard it most of the time. I tried putting it in the bed but gave that up after sleeping on it one night; it was deeply embedded in my back, but I hadn’t noticed. That’s when Hazel very generously bought me a cell phone of my own, which I am still learning how to use.
Even the bathroom was beyond my ken for a while. I had a catheter in me, and because I was eating nothing I didn’t need the bathroom at all at first. I guess I was sponge-bathed for a while during a period when all I wanted to do was sleep. I asked to have the room as dark as possible all the time and usually succeeded in getting my way, except when the nurse came in every morning at about 6am to take blood. Some nurses left the full light off, but a few insisted on as much brightness as they could get, “because I need it to see what I am doing!” I would grumble and fuss, but with the “bright girls” it didn’t work. No more needle-less sample-taking either, I was back to the needle punctures up and down my arm and in my hand every morning; but the nurses were good, and I rarely felt a thing. Pill taking was three times a day as I recall, the last being around ten o’clock at night. With a urine bag draped over the side of the bed, a bunch of wires stuck to every part of me and attached to the “stickman”, an IV in my arm and a catheter attached below, it was more than I could do to turn in bed. Any attempt invariably resulted in the visit of a nurse or her assistant, telling me I had pulled off one of the wires. Still, all in all, I was spoiled in there. Everyone did their best to make me comfortable, and put up with my idiosyncrasies.
During this period, I was lucky to have visits from Rosemary and Tracy, from Hazel and Dan, and from my son Peter and his fiancee plus visits from my neighbours Peter and Ken. I also received phone calls of best wishes from my out-of-town daughter Juanita and son David. And, via Hazel, came best wishes from Rhonda. How could anyone ask for more? I was certainly not alone.
The hospital staff was very patient and I have nothing but the greatest praise for their help and dedication to getting me through the difficult after-surgery period when one is initially as helpless as a baby. In my case progress was lamentably slow, but Hazel’s careful monitoring of everything that was going on at home and at the hospital, plus visits and phone calls from family, friends and neighbours were excellent therapy. However, at the hospital, I was taking longer to recover than expected. One important reason was, I wasn’t eating enough to regain my strength. Initially, I refused any food except iced water.
Hospital food? Ah, that deserves a comment at this point. In all fairness I did think the food offered was of the best quality, and was nicely prepared. A lady came to the room each day and took your order for the day after next, and there were a half dozen dishes to choose from. I was on a reduced salt diet which, of course, was bland so I hate to complain because I could see that a lot of effort went into providing good meals. In the final analysis, I ate very little of it for these reasons: hard-boiled eggs came in a plastic container that contained a little condensation – I couldn’t handle that aroma when the plastic was opened. I also couldn’t handle coffee with 1% milk, and I couldn’t handle their coffee black. The daily protein drink was probably very good for you, but I couldn’t overcome the after-taste.
One memorable day was when Hazel and Dan arrived with two Japanese dishes: sashimi and sushi! I thoroughly enjoyed those dishes, and they set me back on the path of eating. It was the first time since the operation that I had enjoyed ANY meal, and it was to prove a turning point. Thereafter, I started to eat hospital food again, but I gradually I cut that back to a minimum. However, I was more or less warned that I’d never get out of there if I didn’t eat; I needed to keep my strength up. So I resorted to eating my dinner meal around midnight when it was cold and the warm nauseating smells were gone. That helped. I inched forward.
In the meantime the hospital was anxious to get me up and walking because they needed the bed. You could say, I was beginning to overstay my welcome. I was now being continuously asked by the nurses etc. whether I wanted to go home. Well, of course I wanted to go home, and told them so. Meanwhile, Hazel could see I was not ready and knew that my wife couldn’t possibly handle looking after me. The hospital would say, “He wants to go home!” and those on the other side of the fence were saying but there is no-one to care for him at home in that condition. Just about then, the catheter was removed and I started toilet training!
But a visit by my son Peter and his fiancée picked up on another problem. His fiancée, a nurse herself, recognized I was running a temperature and after a couple of questions realized I had an urinary tract infection. Well, that set things back for another little while, until the infection was brought under control. When I mentioned that I heard cranberries were beneficial in cases of urinary tract infection, Hazel and Dan arrived at my hospital bedside with jars of cranberry juice and cranberries in cans – not just one of each, but an armful. During my hospital stay they brought me cappuccino coffee, sashimi and sushi and now cranberries. Without those Japanese treats in particular, I might still be in there! (The urinary tract infection actually broke out again twice after I got home. It was finally clobbered with a ten-day antibiotic treatment by my family doctor, Dr Chrizette Ang.)
Then came the physiotherapists… Pat was the head one and, recognizing me as a probable trouble-maker, took care of my walking personally, especially on the stairs. I eventually took my first few steps and then gradually a few more, working my way up to a monumental walk of about 60 yds. round the cardiac floor. I also learned how to walk up and down a flight of stairs. It is hard to imagine the trepidation with which I approached that first attempt at the stairs. I exerted my independence of course, but I had met my match. Pat, with the greatest of professionalism and patient patience, let me know who was running this show and stuck with me until I could manage those stairs. Although I tried many times to regain control, it never happened. Slowly but surely she got me back on my feet and I learned to respect her, although secretly I was afraid of her. If she as much as hinted I was wobbly on the stairs, I felt I would be held for further treatment, and I couldn’t risk that.
The physiotherapist team was very supportive but also very persistent, cajoling and urging me on when all I wanted to do was get back into bed. I resisted but they persisted, and soon I was able to go up or down without a fall. Those first flights of stairs were exhausting, but once conquered they were the signal that I should be going home soon.
My release was on again, off again for a while but finally there was a meeting of the minds as to my fitness to return home and I left the hospital in late February, about one month after the operation. Antonio meanwhile beat me by a day or two, but then came back a few days later with complications. He still managed to get out again before me, but that was only fair – he had been in there for about two months by then. Still, none of it beat the story I heard at the Rehab Centre a couple of months later from a former patient. He went in for some heart valve work and, what with one personal complication after another, he was in there for five months! I was not about to complain.
It is to the eternal credit of Rehab Results that they resisted attempts to send me home too early. Even as they were working on that, additional complications arose when my catheter was removed and I contracted the urinary tract infection. In addition, there was a massive swelling on my inner thigh where a vein had been removed, my pulse had shot up to over a hundred soon after I started walking, and my heart rhythm was fluctuating. But Rehab Results persisted in their efforts, and I was not released until the pulse rate and rhythm were brought under control, and the urinary tract infection had been cleared up. I shudder to think how my wife would have coped if I had been sent home any earlier. I don’t know what Rosemary and I would have done without her. Hazel knows of, and works with, medical agencies that I didn’t even know existed, and I could see that those she dealt with appreciated the fact that she spoke their language. From being a Controller, I had become the controlled one. For me, life would never be the same again!
Chapter 6: Recovery at Home
When I did finally arrive back home on Feb 22nd, just over one month after arriving at Emergency on January 16, I was amazed at how well everything had been organized for my return. My wife was still worrying about whether I would be able to negotiate the stairs, but within minutes I showed her it would be no problem; the hospital’s physiotherapy staff had done a good job in showing me how to do it, walking up and down stairs like a crab.
As I settled in, I was amazed at the help extended to me by the Community Care Access Centre, another great assist in which Rehab Results acted as a go-between for me. Apparently, the Community Care Access Centre couldn’t commit to services until an assessment had been made, but the assessment couldn’t be scheduled until the day of discharge or after discharge. That meant that Rehab Results needed to plan in the event that they provided no services.
To this day I still not sure of all the departments or companies under contract that were taking care of me, but I knew I was getting the very best help in every way; a daily shower to keep me clean when a fall in the bathroom alone could have been disastrous, a nurse who came to the house daily to change the dressing on my inner thigh, occupational therapists and physiotherapists who monitored and managed me while I was still finding my feet. I believe Rehab Results also arranged the blister packs etc. for the nurse, because a large package arrived at the house addressed to the nurse just in time for her first visit. After about a month, once the vein area no longer seeped, the wonderful nurse, who is employed by Spectrum Health Care, ended her visits. The showers by Care Partners were eventually reduced to one shower per week. Several different social workers were involved over that period, all of whom were very helpful, but I only thought to get the name of the last one Cherise Pollard, who was excellent. All the rental equipment was finally returned and by late April I was feeling pretty much my old self.
March and April passed, lazily at first as I started to eat properly and regain my strength, but I steadily progressed. Crab-like walks up and down stairs gave way to normal forward, but careful, steps. Then came the first steps outside the house, initially onto the deck at the back of the house, then to the bird-feeder; finally, down those tricky steps at the front door and thence to the garage. My world was expanding every day and my confidence improved bit by bit until one day I opened the door of the family car, climbed in and backed it out of the garage! So far, so good. It wasn’t long before I had it out on the road, cautiously at first and for just very short distances, but eventually far enough to get to the local grocery store. Driving was so much easier than walking, not just because of the open-heart surgery but also because of chronic back pain that had bothered me for years. I was mobile again, and figured that was it, free at last. Free at last? Well almost…but not quite.
There were exit appointments with the surgeon and the cardiologist still to come. There was also Rehab! Not Rehab Results this time, nor the physiotherapists on the wards but Rehab run by the Cardiac Wellness and Rehabilitation Centre of Trillium Health Partners. It would be another three months before I finished the Rehab Course on July 20th.
Chapter 7: Rehab at the U of T at Mississauga with Trillium Partners
On Mar 03, 2016, the Trillium Health Centre at Queensway wrote me saying that Dr. Ahmed had referred me to the Cardiac Wellness and Rehabilitation Program at Trillium Health Centre. Patients eligible for entry into the program had to have had one or more of the following:
• Coronary artery disease, angina, heart attack angioplasty, bypass surgery, heart valve surgery or heart failure. I qualified!
The program would be approximately 3 months in duration and consist of the following: medical evaluation by a physician, supervised on-site exercise classes with heart monitoring by Cardiac Rehab Therapists, nutritional assessment and education by a registered Dietician, cardiac risk factor assessment and education, and a series of patient and family education classes. The cost would be covered by OHIP, except for a giant 3-ring manual plus a beautiful stopwatch all for the price of $60.
OHIP also didn’t cover the cost of parking at the University of Toronto, Mississauga Campus. Well, the parking cost (at half rate!) of $7.00 per visit made me choke, and I asked Dr Ang if it was worth my while going. That was a mistake! She looked at me as though I was a real cheapskate and said, “That’s just the cost of a cup of Starbucks coffee!” Hmmm, I’d never paid that for a coffee but I got the point. Go Gerry, it will do you good! So I went… And from the very start, or at least one week later after I started getting the 50% parking rate, I realized Dr Ang was right. The program was good for me!
After being given an initial stress test at the Trillium Health Partners – Queensway Health Centre on Wednesday April 20th, I was sent for an intake appointment at UofT at their Mississauga site on Friday April 29th. The intake appointment was a real exercise session and took approximately 3 hours. I survived those tests, and the exercise classes started in earnest on Wednesday May 4th at 8 am. Thereafter it was every Wednesday at the same ungodly hour, which meant I had to get up at 6am in order to be there on time.
Each exercise class consisted of a half hour lecture on one topic in that gigantic 3-ring binder, and covered a wide range of subjects best summed up in the Table of Contents: Angina Management, Heart Healthy Targets, Resistance Training, Blood Pressure, Weight Management, Eating Outside the Home, Benefits of Exercise, Coping with Stress, Medications, Fat, Exercise and Weather, Label Reading, Online Educational Handouts, Exercise Tools, and their Alumni Program.
The following half hour was devoted to aerobic exercises and resistance exercises. After that, we all went to the second floor which had a walking/running track where nine laps equaled one mile. From that, I guess one lap is approximately 200 yds. Each individual was given their own initial target. Mine was 1 mile in 30 minutes with a pulse rate of between 78 and 83 beats per minute, or between 13 and 14 beats in seconds which became the preferred way to refer your pulse rate because we were taught to take our own pulse rate over the space of ten seconds with two fingers. We always found our initial pulse rate at the end of the first hour lecture period, and we always checked it during our walk on the second floor, and again after a cooling down period.
Each of us was assigned to a staff member, who counselled us and assisted us throughout the whole program. My leader was Joanne Berardi, B.Kin(H) ACSM CES. She was very patient with me, and taught me to progress by small steps, no heroics, to compete against myself and not against others in the course who may well have different backgrounds even if we seem close in age. Her guidance, and the Cardiac Rehab – Exercise Log wherein I recorded my “at home” exercising in between classes, were the main “take aways” for me. The lectures really augmented material that was already in that 3 ring binder, which was just as well because I could hear practically nothing due to my terrible hearing ability and the poor acoustics of the room. Craig Rush, BSc HK R.kin ACSM RCEP also helped me tremendously getting through exercising etc., given my back problems. There was also another lady who helped me when I first arrived, but I didn’t catch her name. All in all, they are a wonderful, supportive team. If you don’t improve while on that Rehab course, it’s no fault of theirs!
Keeping in mind Joanne’s advice to take it one step at a time and don’t try to do too much, I steadily extended my walking, using the rollator of course, from one block at the outset to a distance of two miles per day. My weight dropped by about eight pounds, my blood results improved and I felt generally stronger and in better health. Dr Ang was right, it was decidedly worth a lot more than a cup of Starbucks coffee!
Chapter 8: Epilogue
Although I don’t have to get up at 6 am each Wednesday anymore now that the Rehab course is over, for me at least, I am making every effort to keep up the daily walking; and that brings me to the self-questioning of how I found myself in this situation way back in January. As I mentioned earlier, my blood tests always came back showing me passing on the items being checked. Once in a while, my prostate readings were a little high, but even an urologist felt there was no cause for concern. My eating habits were pretty good: I had porridge for breakfast every morning, didn’t like fried foods, drank very little alcohol and ate no meat. True, I ate too many cookies but cholesterol and diabetes were not my basic problem. Still, on Jan 16, 2016, I ended up in Emergency “just in time” with 3 arteries blocked 80% and one artery blocked 90%!
I think the main reason in my case was lack of exercise! I spent many, many hours at the computer and the problem didn’t really surface until I started some real exercise. The quest for a solution to my back problems had led me to realize I should start walking more. But I couldn’t do that without a rollator. So I got a rollator, and started up that little hill at the Rhododendron Park. It wasn’t much of a hill, but it was more than those blocked arteries could handle and the strain brought on a tremendous feeling of exhaustion. There was no pain in the chest that I recall, just a feeling that something was drastically wrong without really knowing what it was. Of course, I did suspect it was a heart problem in some way and that I needed it looked at immediately, but not for a minute did I expect open-heart surgery.
Being overweight was ever a problem, but I had lost over 60 pounds in 2012 or 2103 without too much trouble, and could do it again just by modifying what and how much I ate. I knew I could do it, and I knew I could do it without exercising. Hazel had always insisted I needed exercise, but I argued that I could lose weight by just controlling my food intake. I was right about that, I could lose weight without exercising, but she was right that exercise was essential.
So, in January I learned that you just can’t get away with plugged-up plumbing. Exercise is the “liquid plumber” that we all need, and merely losing weight may not be enough in itself. I just hope I don’t slack off after Rehab and get into this bind again. That day in January when Dr Ahmed and his team gave me a by-pass operation was the day they gave me a new lease on life. In two months I will be 84 years old, and now I think I’m good for another 20 or 30 years. We’ll see! If I don’t at least reach 100 it will not be the fault of Trillium Health Partners, its surgeons, its many specialist doctor, its nurses, its paramedics, its technicians, its social workers, and its maintenance staff. (Furthermore, some of the most beautiful women in the world must work at Trillium, or am I hallucinating again?) It will also not be the fault of Rehab Results or the Community Care Access Center and its contractors, Spectrum Health Care and Care Partners.
Without them all working as a team, I wouldn’t be where I am today; a man with an extension to his life-lease. I thank them all for a wonderful job done for an old man who doesn’t deserve to be so lucky. And I thank each member of my family for their loving help, and each of the neighbours who pitched in and helped both Rosemary and myself make that home run. Rehab finished on Wednesday Jul 20, 2016, but the staff left me with homework to last the rest of my life.
And just to be sure I don’t slack off Dr Platonov said, “I’ll see you again in November. It would be nice if you were down to 240lbs by then. We’ll call you to make an appointment.” I’m afraid I won’t be down to 240 by then, so what do you think? Should I worry, or just hope he by-passes me again?
Gerry Wood, Jul 27, 2016