Strange Perils of Surgery

It’s happening again. The right side of my chest is swelling up. My right armpit feels bloated too, like I suddenly gained a pound of fat and it all went there. The whole area is sensitive, tender to the touch. I’ve been sleeping on my left side for a week now.

The last time this happened, I wound up looking like an Amazon. A massive, bulging bruise formed on my chest, shifting gradually from purple to black to yellow. Once that was gone, the swelling subsided over a period of weeks. It took forever just to figure out what the Hell was going on. I underwent a wide range of tests. Blood work. Echocardiogram. (Very painful on sensitive skin.) Even, humiliatingly, a mammogram. But it was a plain old X-ray that finally revealed the cause.

Open heart surgery requires that the sternum, that central meeting place of the ribs, be cracked in two. Clearly, this is not a state it should be left in, so before the patient is sewn up the two halves of the sternum are wired together. On my X-rays, the two loops look just like twist ties from the grocery store. Or at least they usually did. One of these loops––no doubt overstressed by tai chi, marital sex, and regular visits to the chiropractor––had snapped. One of the loose ends had sliced it’s way into the muscles of my chest, causing a small amount of internal bleeding. With nowhere to go, this blood lingered in my body, gradually pulled toward the skin by gravity. Slowly and painfully, it went the way of all bodily waste.

The scary thing is, once I knew the cause, I could remember the exact moment it had happened. I had woken up late one Saturday morning. As I yawned and stretched my shoulders, I felt a small pop near the middle of my chest. Wondering vaguely what it was, I had gotten up and gone about my day.

This time I didn’t notice when it happened, though I suspect all the coughing from my recent cold may be to blame. I’m not freaking out this time. I’m just wondering how swollen I’ll get and how long it will take to go away. Mostly I feel annoyed. I’ve seen exactly one doctor, my general practitioner, for antibiotics and an X-ray.

On the whole, I consider this a small price to pay for not being dead. I’m nothing less than grateful to the men and women who crack my sternum open from time to time in order to keep this show on the road. Still, it has to be said, I wish they’d mentioned this in the sales pitch.

What happens to the wire? That stays put until my next round of surgery. It’s not going anywhere, and the grief involved in digging it out would be absurd. I expect it’ll come out in about five years, when my pacemaker leads need replacing.

I’d like to close with a little story my G.P. told me during my visit. This happened during his residency days. His supervising doctor had asked him to remove a drainage tube from a post-op patient. He gripped the tube and pulled with what seemed to him to be the necessary amount of force. Nothing happened. The tube refused to budge. He pulled ever so slightly harder, and still the tube stayed put. Resisting the urge to give the tube a violent tug, he summoned his supervisor and confessed that it seemed to be stuck. To make a long story short, an X-ray eventually revealed that one of the wires holding the man’s sternum together had snapped. One end had punched clean through the drainage tube, pinning it in place. If my G.P. had pulled any harder, he would literally have torn the patient’s chest open. I’m not normally squeamish, but I had to shudder when I heard this, as I vividly remember one surgeon who braced a foot against my bed, gripped one of my drainage tubes with both hands, and yanked.

David Hurwitz