Surgery Update -- Heart Valve Surgery 101, Recovery day 3

My surgery was Monday, and I’m pleased to report that the surgeon was able to repair the mitral valve rather than replace it. I’ve been in intensive care since then because the medical people are continuing to watch my vital signs. I’m doing my best to keep having vital signs for them to continue monitoring.


I know that some readers are curious to know exactly what is involved with heart valve surgery, so this posting will cover the details. If you are at all squeamish, I recommend you close your browser and wait for the next posting, or at least take a mild sedative before proceeding.

The heart valve job involves four separate steps. Step One is going to sleep. Medical people always like to start with something easy, and I’ve had a lot of practice with this step, starting when I was a child. I sometimes still practice during the afternoon at my office with a law book resting on my lap. This revelation may alarm some clients who pay me by the hour, but I assure you that I bill such time at only half my standard rate. You are not allowed to proceed to Step Two until you have successfully completed Step One.

Step Two is waking up. This step is very important because otherwise the medical people may think you are dead. Now, those of you who are not as well-versed in medical procedures as I am may think this second step is easy. “After all,” you might think, “Ken has also been practicing waking up since he was a child.” But that’s where you miss the point. When I was a child, I always awoke to sunlight streaming through my bedroom window and birds merrily singing outside. It was the start of a whole new day, with exciting things to explore and new discoveries to be made. Now that I’m over 60, it‘s always dark when I awake, and the most exciting discovery is that I had not wet the bed, no matter how full my bladder feels.

When you try to awake from a valve job, the first thing you notice is that tubes are protruding from every bodily orifice except your ears. “How many tubes?” you might ask. Thousands. “How can that be?” you ask, while wryly counting the number of your own bodily orifices and subtracting two. Once again you show your naivety, because you have forgotten that the first thing medical people learn in school is how to create new bodily orifices for the sole purpose of attaching tubes.

While you, the patient, are trying as hard as possible to complete Step Two so as not to be mistaken for the departed, your mind is distracted by the tubes protruding from all your old and new bodily orifices, and like any reasonable person you start to count them. You might as well be counting sheep. Except that sheep are easier to count.

The reason you can’t actually count the tubes is that, while you were engaged in Step One, the tubes became entangled. To avoid counting a tube twice, you’ve got to trace each tube from its source to its destination through a Gordian knot of tubes.

At this point, I must digress. When I was in the army, I flunked knot tying. Back then, we needed to learn how to tie knots so, among other things, we could string telephone wire between headquarters and outposts. I was so inept at stringing wire that I was the sole cause of the U.S. Army abandoning the landline telephone system and moving to satellite communications.

When I started climbing mountains, my good friend and mountain guide extraordinaire, George Dunn, co-owner of International Mountain Guides, spent untold hours trying to teach me rope management. That is the only thing George ever failed at, because whenever I get within arm’s length of a rope, it coils itself into an unrecognizable mass of spaghetti. This wad of rope has become known in the mountaineering community as the Ken Klug Coil.

Mountaineers have attempted to alleviate the difficulties resulting from the Ken Klug Coil by using different color ropes. I know that many of you always thought that mountaineers were just trying to be fashionable with all their pinks, purples and yellows, but in reality different color ropes were invented because mountaineers couldn’t rely on the Army’s satellite system to protect themselves from falls.

The medical community isn’t as creative as the mountaineering community, because all of their tubes are the same clear non-color. Perhaps medical people are able to trace each tube to its end by visually identifying the bodily fluid within each, but for us patients, that’s a disgusting task. So, with all the tubes hopelessly entangled in a Ken Klug Coil, repeated attempts to count them are in vain, and the patient will unavoidably nod off, even without a law book in his lap. Unfortunately, at this point the medical people don’t charge half rate.

The patient’s vain attempts to untangle the tubes himself are inevitably met with further entanglements until the patient becomes more restrained than Houdini. Eventually, the medical people mercifully conclude that they have had enough fun and remove some of the tubes, slowly freeing the patient so he can actually write the check to pay the bill. With the tubes removed, the patient is now fully awake, and ready to move to Step Three.

Step Three is walking. Medical people require that you walk right after surgery because it’s the only way for them to confirm that all of your body parts have been put back. “Aha,” you think, “Ken should be good at this one. After all, Ken has also been walking since childhood, and he’s got us all convinced that he actually may attempt the End to End Walk someday.” But once again you miss the point. The point is: hospital gowns that give new meaning to "Mind the gap."

No self-respecting walker would moon everyone he passes. Well, if truth be told, there was a LEJOG walker a few years ago who not only mooned everyone, but gave the Full Monty. That worked exceptionally well in liberal England, where he was given a meal and a bed each night courtesy of the local magistrate, and was then sent on his way the following morning. But upon reaching more conservative Scotland, he was given a bed for six months, thus delaying his walk. I’m not sure how liberal or conservative things are in hospital hallways, but I don’t want to risk being sentenced to a six months stay.

With a sufficient quantity of safety pins and adhesive tape, I am now braving the hallways. As you know, I had originally intended to walk 1200 miles this summer. Right now I’m happy to walk 1200 inches. It’s surprising how difficult it is, what with dragging those tubes and all. I’m told that each day I will get stronger and stronger, and that the hospital staff will push me to walk farther and farther, until eventually I can reach their collections office and pay the bill. That’s Step Four.

© 2010 Ken Klug