In January, 2007 I went to see my cardiologist for a routine visit. For the last several years, I have been ever six months so that he can monitor the degeneration of my congenital heart valve problem. My visit in January was not much different other times. As on previous occasions, he informed me that my condition was slightly worse than the last visit, but he asked me to have an ultrasound at the hospital to get a second opinion and to be able to make more precise measurements of the valve and the aorta. The hospital called me to schedule the appointment for March 15th.
Thursday, March 15th began like any other day. At noon I went in to the hospital for the ultrasound. The actual ultrasound was very normal; however, when the doctor finished, he turned to me and told me point blank that I was in pretty bad shape. The diameter of my aorta was within the risk zone. It had been stretched to the point that it was in danger of rupture. He told me that I needed surgery soon. The following morning, my heart specialist called me at home to let me know that he was going to be talking to the surgeons that morning and would try to schedule the surgery for as soon as possible. I assumed that there would be a significant amount of time between the diagnosis and the surgery, but he suggested that it would be best to have the surgery within a month's time. He sent me immediately to begin all of the tests that would be necessary before the operation and scheduled me to talk to the surgeon two weeks from that Friday. The next two weeks were very difficult weeks. We had just purchased a house in Petrer and were trying to paint so that we could move over the Easter holiday. All of the sudden, all of our planning came to a screeching halt. But until I talked to the surgeon to find out the date that he was planning on, I didn't want to tell everybody.
Finally, Friday, March 30 rolled around. I was ready to talk to my surgeon. I had downloaded and watched a live video of the operation that I would be having. I had done some reading up about the surgery and the recovery and was ready with all of my questions. What I was not ready for was the date! My doctor, complaining that he had not received the results of my CAT scans yet, turned to the nurse and asked, "How am I supposed to operate on Monday if I don't even have the CAT scans yet?" I reluctantly asked him which Monday he was talking about, and he informed me that he was talking about that Monday, in three days. He sat down with us and explained the procedure to us and all of the risks involved. A bypass, he told us, was a bit easier: the heart would be stopped for 15 to 30 minutes. A normal valve replacement would mean stopping the heart between 30 minutes and one hour. But since they had to replace the section of my aorta which had been stretched (and that involved fooling with the coronary arteries), my heart would be stopped anywhere from one hour to an hour and a half. There was always a danger that for some reason my heart would not start back up or that some of the other organs could shut down since the heart was not functioning. My only thought was that I was completely in the Lord's hands. The surgeon was very confident about his part of the surgery. The major risk was out of man's hands. And so they then scheduled me to come in on Sunday morning. I managed to get permission to sing in the Easter cantata at church on Sunday morning as long as I made it to the hospital by 1:00. So I spent my Sunday morning in church and Sunday afternoon preparing for open heart surgery. I wrote two letters to my wife, only one of which would be read. But I wanted to be prepared for the worst. And the Lord gave me a peace about what would happen the next day. I did not feel an absolute confidence that I would come through the surgery without problems. But I was ready to accept whatever the Lord had in store for me. Psalm 23:5 was a great comfort to me: I could count on God's presence, even in the valley of the shadow of death.
Nearly Perfect Surgery
Monday, April 2 began early with all the preparations for surgery. By 8:30 I was in the operating room with the anesthesiologist. My next memory was a strange sensation that I couldn't open my eyes or breath. And then I opened my eyes and saw my wife and my surgeon (and a student of mine who works in post-op). The doctor later informed me that my heart was stopped for 71 minutes while they worked on the valve and the aorta. They found that the portion of the aorta that was stretched out was above the coronaries so they were able to save some time and not have to re-implant the coronaries in the synthetic aorta. Everything had gone better than planned. Monday and Tuesday were full of discomfort and, at times, pain. The worst part was probably the severed sternum. Any movement in my upper body, including breathing, was painful. After slightly more than 24 hours, they moved me back up to a normal room to continue my recovery there. By the following day, my doctor got me out of bed for the first time, and I took my first steps. Everything was exhausting at that point. I remember feeling completely worn out after eating a bowl of soup. Sleeping was complicated by the fact that I had to lie on my back, and the plasticized mattress cover made me to sweat a lot. But every test I had seemed to indicate that I was experiencing a better-than-normal recovery. On Saturday, my surgeon offered to let me go home one day early, but I decided to stay the full week and go home after they had changed my bandages the next morning. When I arrived home on Sunday afternoon, I felt decent. It was just nice to be back home after what had seemed (at that time) like a long time in the hospital.
On Monday afternoon we learned that Vicente, a dear man from our congregation, had gone home to be with the Lord that morning. Maribel and I ended up going to the funeral home that afternoon and plans were made for the funeral the following morning. And so, on Tuesday, a week and a day after my surgery, I stood up before a group of mostly unsaved family and friends and preached a funeral message. But for as much as people told me that I looked great, I did not feel great. Every night that week I woke up in a cold sweat. And my temperature was almost constantly slightly higher than normal. However, my doctor had told me that a low fever was normal, especially in younger patients. He had told me not to worry about it as long as it was not a high fever. Finally, after nine days at home, my temperature started to rise, so we returned to the hospital for what I assumed would be a little bit of blood work.
I realized how wrong I was when the nurse brought me my pajamas, the uniform I would wear every day for the next 51 days! A new doctor explained to me how serious my situation was. The fact that there was no apparent reason for the fever which I had been experiencing over the last week and a half led them to assume that I had an infection in my blood stream which was attacking the new heart valve, and since the valve was made of non-organic material, the body was not defending it. I began an aggressive antibiotic treatment immediately, and over the next few days the doctors began to eliminate other possible causes for my fever. During one of the tests, the same doctor who had seen me just a month earlier when all of this began examined my new valve with an ultrasound, and then asked me a question which really surprised me. "Did they tell you that your valve has a slight leak?" Of course they hadn't told me anything like that. When I went home everything was in perfect shape. "Well," he continued, "you've got a leak now, and there appear to be small nodules on the valve's outer ring." My surgeon came to visit me immediately when he received the results. It was the worst possible news. The nodules appeared to be the encrustation of the infection, and the leak meant that something had already destroyed enough of the valve that there was a slight flow of blood around the valve instead of through it. Everything was still pretty sketchy, but they had the first solid evidence for a plausible cause for my fever. At that point I was still upset about the thought of having to spend more time in the hospital, and I feared that this might mean I would have to spend all six weeks that the antibiotic treatment would take. The surgeon, however, informed me that there was little to no hope that the antibiotics would do anything to kill the infection that was already attacking the valve. Since it had already encrusted itself on the valve, the antibiotics would not be effective. The only solution was to repeat the operation. The following day, another doctor discovered an abnormality in my right eye. The diagnosis was that microscopic pieces from the valve had flowed through the blood stream and formed a clot in the tiny blood vessels in the back of the eye. When my doctor came to see me on Wednesday, he was no longer tentative. I had an endocarditis, and the only solution was to operate. He had already cleared a slot for me the following Thursday in the operating room and was ready to perform the surgery again. I asked him if there was not another option, but he told me that it was the only way. What was more, he informed me that this operation was much more complicated and dangerous than the first. In that operation, they had been dealing with a strong heart with a valve problem. Now, however, they would be operating on a heart that had just been through major trauma, with the added complication that the area around the valve had been under attack by a virus. The risk factor was now six times higher. And if we waited any longer it could jump to double that.
That was a very low moment for us. It was very hard to understand why God had allowed me to come through the first surgery just to go through it all again. At that moment, some 25 days after open heart surgery, I felt that I did not have the strength to go through it again. I was sure that if I had to go back into the operating room, I would not come out alive. I told a friend that night, that I saw only two options for myself: I could get bitter at God for allowing me to go through a situation that was really unfair, or I could accept this too as part of his "good and perfect" plan for my life (James 1:17). I knew the second was the only option that could really help me, but it was strangely difficult to accept. I also had to realize that when I gave my life to the Lord years ago, submitting myself to His will, it was not just for that which I approved of. My surrender was for whatever God wanted to do with my life. And now, if He had a purpose in taking me to heaven "early", even though it seemed that it would have been easier in the first operation, I had to accept that as part of His plan. Maribel and I cried and claimed the victory. We knew once again that we were in the Lord's hands.
But that is when things started to change! Friday I suffered through another ultrasound, this time from inside the esophagus (yes, swallowing that wand was not comfortable). The same doctor who had done my other two ultrasounds spent 15 minutes examining the valve from every possible angle (even from within the stomach looking back up toward the heart) and finally gave the verdict: no infection. I almost skipped back to my room (even though I was far from being able to skip, physically speaking!). And then came my surgeon with the best news: no operation! God had answered our prayers. Just two days before, my surgeon had assured me that surgery was the only option; the same man was now standing in front of me, telling me that I no longer needed the operation. The slight leak was still there, but it was not a problem as long as the infection was not continuing to eat away at the valve.
The only bad news was that I would have to finish out the six week antibiotic treatment that I had already started. But compared to going through the surgery again, six weeks in the hospital was nothing. In fact, there was even the possibility that I could go home and finish my antibiotics at home. As the weeks dragged on, however, and I could not go home because of a conflict between the antibiotics and the anticoagulant, it became harder and harder for me to stay in the hospital. One of the most difficult things was when the kids came to visit and I began to realize that after spending so much time away from them, I was no longer the same part of their lives that I had always been. I felt like I was just a person they visited, but I was no longer their daddy. But the hospital was full of other opportunities for me. I was able to read quite a bit, and the Lord gave me many opportunities to be a witness and a testimony for Him.
Coming Down the Final Stretch
Finally, Wednesday May 30th came when I received my last antibiotic treatment through the i.v. All that was left at that point was for the oral anticoagulant I had been taking for weeks (the one that was canceled out by the antibiotics) to start taking effect so that they could unplug me from the anticoagulant i.v. My doctor promised me that I would be home by the weekend. But it did not happen. On Sunday, however, my levels were slightly better so they disconnected me for two hours and let me leave the hospital with Maribel and the kids. But after two hours I was back and hooked up again. But that time was so special. I cannot describe the emotions I felt to wear something other than pajamas, feel the sun on my skin again, and best of all, spend time with my family outside of the hospital! Back in the hospital though time kept dragging on. And then came the big scare again. On Wednesday night I felt my temperature rising. It was the first time I had had a fever since late April when the antibiotics had kicked in and controlled the fever that had returned me to the hospital. That night I lay in my bed shivering and thinking about what this would mean. Many days when my doctor had come to see me, she had asked me if I had had a fever. That could be the sign that the infection had hidden somewhere in my body, and now it was back. That night I cried again as I prayed to the Lord. Could it be that I would still have to face that surgery? When my doctor came to see me in the morning, I asked if this meant more time in the hospital and more antibiotics. "No," she told me. "If the antibiotics didn't kill it before, they won't work now." But the Lord did not leave me in that valley for long. As it turned out, it seemed to be an infection of the i.v. They moved the i.v. to the other arm, and the fever never returned. In fact, on Thursday June 7th, my anticoagulant levels came into range and they sent me home.
"Why did all this happen to you?" is a question that some have asked (and perhaps many have thought). And to be truthful, I asked it as well. All I can say is that God is much greater than we are. We tend to think in terms of a single purpose, but of course God can control a much greater area than we can imagine. I suspect that God did not have one single purpose in this whole situation. Rather, God was doing multiple things in many lives. I know in my own life He did many things. There is nothing like having to face death to remind us how to live. There were also lessons of faith and surrender. I was reminded like never before that my life was not my own. And I was tested, as I had not been in years, about whether or not I would accept God's will no matter what. God gave me the opportunity to witness to many people through this situation. I even had many special opportunities with believers. Several church people opened up to me about problems, and I was able to give Biblical counsel from my hospital bed. But I know that God has done and is doing things that are beyond what I can even imagine. All I can say is that God is truly good, and I praise Him for His infinite love that never abandoned me.
David Bell, Petrer, Spain 2007