Another Kind of Broken Heart

My daddy’s mother always considered herself sick nigh unto death–even though she probably accomplished more than most women–and a lot of men. Daddy remembers when he was young and she was probably on in her twenties that she would tell them, “Boys, this may be my last Christmas.” She lived into her late eighties.

Mama Coats had problems with blood clots. Part of the problem might have been all those years she spent on her feet, working as one of the “cafeteria ladies” at Wilson School. I don’t know how many years she worked there, but somehow I never even thought to consider her a working woman, even though work is almost all she ever did.

She loved the kids at school, telling us such funny stories about them. Since she worked before school cafeterias adopted the “serve them what they’ll eat” mentality (the last major movement before the current shift), they served up real food–local vegetables, meat other than chicken fingers and ultra-thin hamburger patties. Back then, in fact, chickens didn’t even have fingers. She told us once they when they had served stewed okra, a food I love but which I realize most kids don’t, one student told her he had to cross his legs when he ate slimy stewed okra so it wouldn’t slide right through him.  She passed that along to us, enjoying its innocent naughtiness.

Perhaps part of the reason she had clots and eventual heart problems could be traced to her cooking. I’m sure she used more lard and shortening than Canola oil! She ended up having a pacemaker, after which she was cautious about her activities, fearing that reaching across the frame when quilting might pull something loose. Somehow it didn’t stop her from beating a gopher to death when she caught him trying to eat her garden crops.

To counteract the clotting problem, evident in her black mottled legs, the doctors prescribed blood thinners. The slightest injury could result in heavy bleeding.  Trying to get from her hospital bed to the bathroom by herself once, she accidentally pulled loose an i.v. and the nurses found her amid a puddle of blood.

With those memories firmly implanted, I had to help my husband make a decision when his doctor decided he needed aortic valve replacement.  The diagnosis was not big surprise. His father had the surgery at eighty-five and lived until he was ninety-nine. His brother had three such surgeries, and many of his cousins and uncles as well. He had always suspected it was more a case of when than if. The decision, then, was whether to go with a tissue valve (bovine or porcine) expected to last an average of ten years or a mechanical valve that, with luck, could outlast its owner.  The decision to go with the mechanical valve might have been an easy one. After all, he’d seen his brother outlive one pig valve, eventually having his own mechanical one. The prospect of having to go back in for heart surgery in his seventies wasn’t a pleasant one.

The only drawback was that patients with a mechanical valve must take blood thinners (Warfarin) for the rest of their lives, going in regularly to the doctor’s office to have the INR level monitored. Individuals on this medication must also be consistent in their intake of green vegetables–the ones we’re encouraged all our lives to eat–since they promote clotting, affecting the work of the blood thinners.

Even after healing properly, he found that his heart and his medication would affect everything. He needed some oral surgery before the dentist put in a permanent crown, but that meant coming off the medicine and taking shots (given by yours truly) twice a day.  He went back to the dentist for other options.

Not so lucky with the every-so-many-years colonoscopy.  Because of his medical history, they gastro doctor required him to visit a cardiologist for an okay.  This took two office visits and an echo-cardiogram (a thousand dollars thrown to the wind). He had to stop the pills, and I had to give the shots–for a week before and two weeks afterwards. He developed a Pavlovian instinct, cringing whenever I neared him with the hypodermic needle. He wore the ugly bruises on his belly, which faded gradually for days afterwards. Even the procedure itself had to be done in the hospital “just in case” instead of the office, where we had always gone before.

Finally, we’ve gotten back to normal. He takes the handful of meds I put in am/pm slots for every day, and after a couple of doctor visits, his numbers are right in the target range.  We hardly think of his health conditions most of the time–unless I decide to put turnip greens on the menu.

The most obvious reminder of all he’s been through comes at night, when we quieten down to sleep. Above the croaking of the frogs in the neighbors’ pool, I hear the tick-tick-tick of his valve doing its job. Surprisingly, though, it doesn’t bother me the way the crocodile’s clock haunted Captain Hook.  Instead, I sleep like a new puppy put to bed with an alarm clock, the ticking reminding me that everything is working just as it should.