Operation: Catheter Ablation
The time has come. After six weeks of palpitations, an overnight hospital stay and diagnosis, and two separate near-death experiences at the hands of adenosine - I am finally on the home stretch of this little speed bump
For those after a TL;DR - I survived a heart procedure, and I'm typing this 8 hours after a doctor fiddled with my ticker through my GROIN.
Take a pew, troops, here's how this battle played out. 0600 I take a pre-booked Uber to the Epworth Richmond, where at 0630 I begin my admission. By 0700, I'm told to get into some tighty whitey hospital gowns that make me feel like an oversized condom, and by 0730, the admission nurses have failed on three occasions to insert an IV. Seriously, c' mon ... My veins stick out like a KKK mask at a gay rights parade ... Anyways, 0745 rolls around and I'm in finally in what's called the Catheter Lab, or Cath Lab, for short. Original, huh?
So I was pre-warned what the procedure was going to be like, and did enough research to understand it, but nothing quite prepares you for it. I'm going to continue this story with the assumption that you have no idea what a Catheter Ablation is. This is an experience that made everything else in my life seem like a pre-school play date.
I'm wheeled into the Cath Lab and instantly feel the shock of cold that rushes out of the room. The theatre is cooled to 5 degrees Celsius to keep the equipment happy and chilled, and I'm distinctly reminded of Dante's Inferno - Lucifer burns cold in the Ninth Ring of Hell ...
Measurements are approx 6m by 8m, the size of a decent double garage. The entrance is via one of the 8m lengths, the operating throne/table sits in the middle. Along the other 8m length is a whole rack of servers buzzing away. On one side of the 6m runs stands the anaesthetist and her bundles of joy and happiness. Residing on the opposite side is a full glass window - with some reps from the medical engineering company who are getting a demonstration of how quick an ablation can be done.
In the room are the aforementioned injector of joy and happiness, my cardiologist, and five or six nurses. I barely remember names or faces, but one of the girls had a charming French accent. The nurses get to work hooking me up to two different types of ECGs, slapping all these thermal pads to help the equipment pick up my heartbeat, and I'm finally instructed to slide from the admissions stretcher onto the operating bed.
Now, this is no easy task. I've got 20+ wires attached to me, and HOLY SHIT WHY IS IT MADE OF LEAD AND WHY IS MY ASS FREEZING WHAT THE HELL IS THIS GOD DAMN!?!!? The nurses get a little bit of enjoyment out of my outburst, and that's not the first time they'll be getting a good laugh out of me today. The operating bed has a huge circular drum around it, which allows them to X-ray my heart and monitor what they're doing. From my unique vantage point, I can see the 8 different monitors the cardiologist will use to check for the misfiring signals in my faulty blood pumper.
The anaesthetist realises I don't have an IV, and in a moment of pure skill and technique, she slaps one in three seconds. I wish she would teach the admissions nurses how to do that ... The cardiologist instructs they're ready to begin, and they get the sleepy juices flowing into my veins.
"You're going to start feeling very heavy soon, just go with it" she informs me. A few minutes pass when, unexpectedly, I feel the rush of mixed happy/sleepy hit my head. "Ahhhh, there it is ..." I sigh, and the cute French nurse echoes "don't fight it." Oh, I won't.
Did I mention that you're awake and conscious for this procedure? No? Ok, well this is where the fun begins. I'm told they're going to inject the local into my groin, and I feel someone rip my hospital issue paper underwear to access the area. In my drug-induced daze, I lifted my head, stared right at the cardiologist, and whispered: "Hey Doc, normally people have to buy me drinks before they get to touch me like that."
After a pause for laughter (thanks, I'm here Tuesday and Fridays), I feel the jab of the needle multiple times. Right now I'm subjected to various levels of anaesthetics and time dilates, as if someone has Inceptioned the hell out of me. I remember feeling a warm liquid pooling around my ass cheeks, which I later realised was from the entry of the catheters into my femoral vein. For those who don't know, that's the central vein that runs from the toes all the way up to the heart. If this vein bleeds uncontrollably, it's lights out, goodbye Tony for good, within two minutes. I continue to feel the pressure of these heavenly devils inserting medical devices through my hip. They are now running four thin cables up the vein into my heart.
Time passes at a different rate for me now. I'm lying on this bed, humming some tunes to calm myself down, and wondering how much longer it was going to take until these metal sheathes entered my heart. What felt like seconds had actually been fifteen minutes, and the cardiologist happily announces "and that's the His" - referencing the Bundle of His, meaning they had entered my heart. I look at one of the monitors and see my beating heart on a live X-ray with these four black cables branching out like a spiders legs. I had become entirely disassociated from myself now. I was looking at these claws of electricity in my heart, and this overwhelming sense of curiosity overcame me.
That passed in seconds, though, when they electrified the catheters and started poking around in my heart. Holy, fucking, shitballs. Long story short, they were placing electrical rods in my heart and creating a map to identify where the short-circuit was in my heart. They're poking, prodding, zapping, and moving into different parts of my heart. All the while, I'm watching the various monitors and continuing to hum in my head.
"All right Tony, we haven't found the problem yet, so what we're going to do is pace your heart for the next 20-minutes or so. You're doing great, keep it up" the cardiologist informs me. "Nurse, let's start with <something medical about injecting me with more juice> and up it every five minutes."
It's at this point, this operation became lower than the Ninth Ring of Hell. My resting heart rate sits around 55bpm, and by the time they'd injected me with the last of the speedy juice, my resting heart rate was 180bpm. And while at 180bpm, they're still poking and zapping my heart. I had to call it here and inform the team that, you know, I'd be ok if they knocked me out now. Thankfully, they'd identified the short circuit and could now proceed to the ablation. The time is now 0830.
WHAT!? All this and there was still MORE? I would later find out this first part was simply called an EP Study, or Electrophysiology Study. Now comes the fun part. We've found the damaged cells, and we're going to use RF energy to burn the pathways that will stop my palpitations by creating scar tissue that won't permit electrical transmittance. Fun times.
I don't remember much of the next part, but I remember feeling an extremely severe case of indigestion. The kind you get after slamming down a kebab at 3am after Lucky Coq closes and you've been drinking cheap vodka all night. It was pretty painful, but with the amount of happy juice in me, they could have severed my penis, and I wouldn't have known any better.
I'm continuing to watch the monitors when I see the black wires in my heart start combining together and start withdrawing from whence they came. That was it. The operation is done.
My groin gets glued shut, and a pressure pad applied. The anaesthetist swaps the sleepy juice for some go-go juice, and all the cables are popped off me. It's reminiscent of Neo waking up from the Matrix for the first time. I slide across to the admissions stretcher again, and I'm wheeled out. The time is 0930. My cardiologist comes out five mins later to say it's all done, they ablated what they could, and that should be the end of it. I'll be sent to the recovery ward for six-hours while the femoral vein heals, and then I'll be right to go home.
The only stipulation is that I'm not allowed to do any hip-thrusting exercise for fourteen-days, and the cardiologist is being extra insistent that that includes sex. C'mon mate, I just had my heart fixed. How can you deliver me such bad news?
Regardless, the recovery ward is dreary, so I'll skip over it. I sleep the six hours off, a nurse comes to show me how to self-inject some anti-clotting agents, and I'm sent on my way. The coolest Chief of People from work picks me up and drops me at home.
And, hopefully, that's the end of my heart saga. I'm grateful I went through this at 30 instead of 60, and now I can get back to being a total badass.
On that note, I have a new appreciation for both the preciousness of health, but also the resilience of the human body. I have total admiration for the health system, and just how lucky I am to be born in Australia. This whole experience has given me an extreme dose of gratitude that's I can only liken to the explosion at Chernobyl.
This is definitely not how I planned to start my 30's, with heart failure and a pretty epic break up. But life happens for us, not to us, and I look forward to fighting the next worthy opponent if and when it reveals itself.
Now if you'll excuse me, I have to download Tinder and get swiping.