One Week: the Backstory

Nineteen Ninety-One

The first time I found out that not everything was perfect in my heart was in late 1990, in late December. I had just returned from a vacation with my girlfriend to the Caribbean island of Aruba. I don’t know what it was but I wasn’t feeling well; there was a buzzing in my ear and a funny turning in my stomach.

During the night, I jumped up with a low blood-curdling moan from having just passed out in the bed, my blood pressure very low (I know that awful feeling now) and very nauseous. Arlene called for an ambulance.

My heart had gone into an irregular beat (atrial fibrillation). You have a funny tickly feeling in the heart area. Feel the pulse and there it is, not the regular thump, thump of a normal heartbeat but a pulse followed by a moment when there should be a beat.

I’m a Taurus. We love continuity. To suddenly have a heart beating in an irregular beat was very discomforting, to put it mildly.

I stayed at the hospital into the New Year, 1991. While I might be inspired to write about this past week at the Montreal Heart Institute, I have no desire to relive my stay at the Jewish General Hospital where the atrial fibrillation stubbornly continued. In fact, they released me with a blood-thinner prescription with the beat still out of whack. You can imagine the joy I felt that day in January when put my fingers at my pulse and there it was – a normal beat!

It was at the hospital that I learned that I had a congenital problem with my heart – the mitral prolapse already mentioned in yesterday’s blog. Dr. Langleben, the cardiologist at the Jewish, told me about the leaflets in the valve of my heart, the ones that flip this way and that with each beat, to allow the refreshed blood from the lungs to pass from the left ventricle to the left atrium. Nope, I just checked. It’s the flappy valve connecting the left atrium to the left ventricle.

Excuse me, I’m getting a bit Verklempt (it’s happening a lot lately, please pass me a Kleenex). The reason I’m feeling emotional is just thinking about the miracle of the heart, the structures built into this impressively powerful pump that make it work. The things that we take for granted! But just look at all the inner organs, how they work, etc. What a freaking miracle!

OK, I’m glad that’s over with.

Anyway, my flaps or leaflets did not close perfectly. One, I believe, was too flappy or too small; not all the blood was being pumped out. I am happy to refer to Wikipedia at this point:

Mitral regurgitation (MR), mitral insufficiency or mitral incompetence is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle, through the mitral valve, and into the left atrium, when the left ventricle contracts, i.e. there isregurgitation of blood back into the left atrium.[1] MR is the most common form of valvular heart disease.[2]

I know, I know: you only start to learn a little about the body when something specific happens to you. So it has been with me.

But at the time, January 1991, Dr. Langleben looked at me and said, “There’s nothing you can do, Mr. Silverman. Exercise a lot and you should live a long life.”

In the intervening years, 23 to be exact, I went for a couple of echograms. I never took any medication.

I did experience, from time to time, for only one beat at a time, an irregular heartbeat. Out of nowhere, there would be this tickle, this jump inside. Oh, I would think, yuck.

But these had diminished in the last three or four years. I don’t think that I had one irregular beat in all of 2013.

When I passed out again, New Year’s Eve 2013, the process began that would lead to being admitted to the Montreal Heart Institute last week.

My doctor recommended another echogram; my last one had been in 2007. That day in July 2013, following an interminable test at the hospital in Cowansville, Quebec, Dr. Nguyen spoke to me and said that my heart had dilated to a severe 4 out of 4. I could barely keep standing I was so much in shock.

This is the backstory to my operation. Echogram led to another test where they put the little camera down through my trachea in order to get a better picture of my heart, followed in early December to the angiogram that proved that I didn’t have any blocked arteries, finally the operation. If I hadn’t passed out 12 months or so earlier, I would today be way behind in the whole timing of the tests and operation.


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