Open Heart Surgery by Alan Weinstein

As Frank Sinatra once sang……. “Ya Gotta  Have Heart”

And, sometimes, Ya Gotta have heart…surgery.

My time came last Fall when the mitral valve in my heart was failing. It came on rather suddenly (About 3 months) and shook up my family. More than me, even.

The first group of Drs, were divided on how to treat it. One side, led by an “Interventionalist”, suggested a treatment called…..”MitraClip.” I suspect none of you have ever heard of this.  I, surely never did.

It is a relatively simple treatment compared to open heart surgery.  It is a new treatment whose duration was unknown but thought to be only 5 years or so. It is usually suggested for “older” patients, who had other conditions that might make full open heart surgery, dangerous.  In my case, my 80 years put me on the cusp of “older.” 

The surgeon, of course, recommended straight Open Heart surgery.  This hospital puts it up to a committee to take both recommendations and suggest a solution. Their suggestion was the MitraClip. But, I was really worried about having to face this again in 5 years. I was (still am, in fact) hoping to see my 90th birthday.

So, I went for a second opinion.  The same result.  Based largely on one blood test that suggested that my kidneys would not stand up well to open heart surgery. So, at the last minute before scheduling the MitraClip procedure, I decided to do the kidney blood test done again.

I can still remember the scene of this decision for another test. I was emerging from a final consult with the Surgeon.   As I waited for my wife to return from the bathroom, I toured to the Surgeon’s Assistant and said, “How about another blood test for my kidneys, just to be sure they are really that bad.”

She said. “Hmm OK…Good idea.”  She prepared the paperwork and led us across the hospital to the blood testing facility. A long and winding path that I would never know how to navigate without her.   Along the way, lots of people greeted her.  A very popular woman, I thought.  I must be in good hands.

They took my blood. And she asked for a quick result.  It came back in just 20 minutes.  A Long 20 minutes. And this time the number came back showing that my kidneys were in much better shape.  Imagine, a spur of the moment decision too have a second blood test, changed everything. But, to be honest, I think I really wanted the longer lasting procedure after all. Despite the higher risk.  I wondered if my mind had influenced the kidney number outcome. 

Faced with that test result, the second hospital’s Committee recommended Open Heart Surgery.

A recommendation that I liked better.  Although riskier, it would outlast me.

All of this took a couple of weeks to sort out. It was a most stressful two weeks. But, in the end I decided to go ahead with the open heart surgery. By a surgeon who had performed a similar surgery on my wife, very successfully, a dozen years ago.

It took another couple of weeks or so to make all the preparations. By this time, it was approaching Christmas holiday time.  Not a good time to be having a serious operation. But, I did go ahead with a schedule of 17 December,  Based upon two reasons. One, that I sorely wanted to go back to Naples for the winter, rather than ride this winter out in cold DC.  Besides, I had already paid for the 3 month rental.  Always the calculating kind off guy. Two, that I could not stand another month wait for the Christmas vacation period to pass and the regular staff got back.

Now, how to prepare. First step was too update my Will and related paperwork. A couple of weeks of back and forth deliberation with my Estate Lawyer. More stress as I had to be sure that all of my heirs understood all of my decisions—my daughters, my wife, my sister. All of this was only completed the day before the scheduled surgery.

Through all of this, I must admit that it was more troubling for my wife, my sister and maybe my kids, than me. I continually asked the Drs what the odds of some catastrophic on the operations table might be. They gave me vague answers but always on the very low side….1-3 percent. 

While I would have preferred just a few tenths of a percent, I could live with 3 if need be.   Still a 97 percent or so chance of total success.  I liked those odds. My wife did not.  She worried more about the 3 percent. 

Ok, so the day of the surgery approached. Both of my daughters came to DC to be with me and my wife.  I was touched by that devotion.  Truly touched. 

So, here I am.  On the table being sedated for the surgery. It was only then that I did get some butterflies in my stomach.  Not that I feared actual death on the table.  But, what about a life compromising stroke. I kissed my wife and children goodbye as they wheeled me off. 

Once in the operating room, the anesthesiologist  explained her job and gave me some forms to sign.  Does anybody going into surgery ever really read those forms?  Do we really have a choice?  Sign the forms our call off the surgery.  So…….I signed.

I still remember the scene. The anesthesiologist to my left.  One nurse in front of me. Another behind and the surgeon on my right.  Some kind of big structure directly above me and beeping sounds all around.  I do not want to be melodramatic about this.  But, the thought did pass my mind that this might be my last sight. 

The next thing I knew the friendly nurse whose face I seemed to have just seen a moment ago, wished me good morning. She informed me that everything went well and did I want some water to drink.

Water was the last thing on my mind.  The first thing was to assure myself that I could feel all of my limbs.   That I could move all of them.  That I could see around me. In other words…that I was not only alive, but fully functioning. Well, I did not exactly jump off the bed, but, I did feel confident that I was fine.

I accepted the water and waited for my wife to come greet me. Which she did with a warm hand and a kiss. Next came my daughters with the same greetings. 

The Surgeon assured me that all went well.  He even smiled approvingly at the long scar on my chest.  He explained to me that for this surgery, they cut into my chest and separate my sternum with a surgical circular saw to open my sternum to get at my heart.  All of this would take time to heal. So, I was not going to jump of the gurney and go home. Nope, First was intensive care for a few days, then Rehab and then, finally……. home. And, then off to Naples for longer range rehab. My wife took copious notes and I just listened.   To be honest, I was suddenly quite tired but happy to be alive.

I never really feared dying.  I always thought the odds were strongly in my favor.  And, besides, if I did actually die, that would be the end.  No suffering, no burden on anybody.  Doesn’t everybody hope the end would come that quickly? Of course, a disabling stroke did worry me.  But, the odds of that happening were also very low. 

So, here I am now.  About 9 months out from the surgery.  Fully recovered.  To be honest, I do not feel as strong as I did before the whole thing.  Some better days, some worse ones. Ever thankful that I pushed ahead with the surgery in December. Imagine if I had decided to eat until after the holidays.

And then the virus hit.  Who knows how long I would have had to wait. 

Not a nice thought……..


Alan Weinstein is a product of New York City schools and City College of New York. He received a Ph.D from Penn State University in Meteorology. After a 40-year career as a meteorologist he retired from SES at the Navy’s Office of Naval Research. Alan now is a tour guide in Washington, D.C. and winters in Naples.