Dr. Griffin answered
every
question we had.
Even more remarkable was his ability to go to his computer and look at the tests I had taken
earlier that morning
and go over the results until both Karla and I understood the intricacies to every detail. He was a warm, kind man. The person anyone would want as their uncle. (Does that make sense? It will after I ask him to be my uncle.)
That morning I had an angiogram/echocardiogram—and every single nurse, every doctor, every tech person that I came to respect told me:
You don’t want a 5th open heart surgery Robby...
I thought, why not? I’m an old pro. I know what to expect. What I never really took into account was that my heart, not my mind, was going through these surgeries. They all told me that if Dr. Gosta Petterssen was my surgeon, I probably would never need a fifth surgery. The consensus seemed clear; to avoid a fifth surgery, I would need a mechanical valve, and with that came rat poison—err, Coumadin. (The chemical is used in rat poison, causing death by internal bleeding.)
I loved all veggies and salads, even sometimes juicing green drinks. How would that work with Coumadin? Karla realized if I was going to be on Coumadin for the rest of my life we were going to need some great nutritional advice. Did the Cleveland Clinic have an expert? The chief wellness officer and chair of the Wellness Institute of the Cleveland Clinic is
New York Times
#1 best-selling author Dr. Michael F. Roizen. Karla had read several of his wildly successful “YOU” books, co-written with Dr. Oz.
We made an appointment and brought a concise list of questions so we wouldn’t forget anything. I brought a tape recorder and said I wanted to ask him some questions. Would he mind?
“Sure. Go ahead. I’ll do the best I can.”
Many of our questions had to do with the use of Coumadin because my life was going to change radically if I were to have a mechanical valve—and with a mechanical valve in the aortic position, I needed a blood thinner so I didn’t ‘throw off a clot’ and that meant rat poison—err, Coumadin—every day. (I make jokes about it, but in certain heart patients Coumadin’s blood-thinning ability saves lives.)
Dr. Roizen:
“Coumadin is what we call a ‘blood thinner’. What it really does is stop some of the coagulation pathway by depleting certain factors. Consequently, you can oppose it with certain factors such as green leafy vegetables. Many of these green leafy vegetables are rich in vitamin K. You can boost your Vitamin K factor with certain green leafy vegetables and deplete your system of coagulation with Coumadin. If, God forbid you were to hit your arm while on Coumadin you would bleed more. So it is a very dangerous thing for people who do extreme sports. It’s a dangerous drug for bike riders who don’t wear helmets.”
“I know you are a big proponent of Omega 3. Is it permissible to take Omega 3 while on Coumadin?”
“Yes—as long as you use DHA rather than fish oil. DHA is the active component of fish oil for the heart, it is the EPA component of fish oil that is the anticoagulant in fish oil—but DHA gives you all of the benefits for the head, all the benefits for the eyes and most of the benefits for the heart doesn’t interfere with anticoagulants. It has 15 calories in 600 milligrams. Coumadin, because of its very potent anticoagulant effect has a lot of impact on other parts of the body. Heparin not only has the anticoagulant effect but it can often have an allergy to platelets. It can attack your own platelets. Some medicines have a short-term effect like Coumadin and other medicines may have a long-term effect like Heparin.”
“Let’s say I eat a little bit of broccoli every day and I stay consistent and we’re able to balance the Coumadin. Is it okay to eat this leafy vegetable as long as I’m consistent?”
“You’ve brought up the key point. Do not avoid leafy green vegetables and vegetables and foods that are good for you and all of your organs, but—it is important
to stay consistent
. Eat the foods every day at the same time so your physician or Coumadin Clinic staff can get an appropriate reading to keep your Coumadin levels stabile. Lutein, very important for eyes and joints and the brain, has nutrients that you need—you want to get that in your diet. Broccoli and all of the cruciferous vegetables, watercress or arugula have one of the compounds that have an anti-breast and anti-colon and anti-prostate effect for cancer. You want the good foods—and work with your physicians so you get the proper balance of all of the good nutrients that wonderful and healthy foods give you without negating the effects that Coumadin gives you; that you need for your mechanical valve. You must be consistent. If you are consistent you can eat the good foods that will keep your body strong with the nutrients that come with those foods. One of the key components is working with your physician and the team you have to get a stable level. Don’t eat all of your leafy vegetables on one day of the week and then not for the rest of the week; eat your salad, let’s say, everyday at lunch. That way your physician will get stable and proper reading, the therapeutic range—the right range for you—this is very important—for
you
—because everyone is different—but you can still get the proper nutrients that good foods can give your body. There are new medications that are being developed that will help people who do not have the opportunity to work with a lab and a Coumadin team or live near a hospital where they can get their Coumadin monitored, so they will someday soon be able to take this new medicine that is being developed and there will be a lot more freedom to the way they live their lives when it comes to the foods they eat. We’re working on this. Hopefully… hopefully it will be available soon.”
Soon, we would meet with our surgeon.
(I always say ‘our’ because he might as well be operating on Karla. We are a team, period—and always will be.)
One of the ironies of our lives is that I did voice over commercials for GE (“Imagination at work”) for about two years, and every time I was going to have heart surgery, a GE machine was used to help save my life. I could honestly say, “I believe in this product!” This is a state-of-the-art ultrasound echo machine.
When your life is hanging in the balance, you realize that companies like GE are literally helping to save your life—all jokes and
cynicism
go flying out the window. I usually just close my eyes and dream…
Before we met with the surgeon, Dr. Gosta Pettersson, we were told ‘he is one of the best heart surgeons in the world.’ Dr. Hillel Laks at UCLA was on that list. These surgeons
touch our hearts…
We use the phrase in poetry, sometimes in our daily lives, but these surgeons touch our hearts in the most literal way. Someday there will be a way to quantify the tenderness, the expertise, the quality that comes from gifted surgeons who do this delicate operation and what impact their work has on the psyche and future of the patient, far beyond the physical.
Dr. Pettersson is tall, thin, pale and has a smile that reminds me of life, death; experience, an attempt at happiness, profound sadness and… humility and knowledge. All in one smile.
As a director, I wanted to bottle that smile and show it to actors—study its every wrinkle, crinkle, and how every director must follow the creases at the end of the smile, and use the cheeks as a map on the way up to the source of the smile—the origin of expression—
the eyes
.
Karla did most of the talking at first, asking questions that we’ve discussed as a couple so many times: ‘From the results of the tests, what were his surgical intentions? How would he deal with the aortic valve? Would he really try the Reverse Ross Procedure and take my original pulmonary valve off of the aortic position and put it back to its original home, in the pulmonary position? Is that possible?’
I just stared and listened to the man with the elegant Swedish accent who would soon have his hands in my chest. Everyone had told us that we would like Dr. Pettersson as a person as well as a miraculous surgeon. The phrase that seemed to follow every description of this surgeon was ‘down to earth.’
Yes. He was. Down to Earth—and brilliant.
He spoke to us as if we were out on a park bench, and he was quietly, seriously, but with an honest amity, explaining the fate of my heart. Dr. Pettersson did so with a gentle devotion, ardor and commitment that had both Karla and me listening to his every inhalation, swallow, consonant—becoming more and more impressed with his detailed descriptions so that nothing would come as a surprise to either of us. We felt calm, yet he was discussing the stuff of horror films. Blood, incisions, and even cooling my body by putting me on ice and stopping the blood flow to the heart and the brain for 21 minutes—completely off the heart-lung machine. We were captivated.
When he finished I wanted to jump up like a Studio Executive and say, “I’ll buy that script! I want to make that movie!” Then I remembered, this was my movie—and I had already ‘bought it’…
We left Dr. Pettersson’s office with every question answered to our satisfaction and not one false moment. Even the needle on my show business B.S.-meter never moved.
Everything was honest
. It was quite daring, audacious—bold, to try the ‘Reverse-Ross,’ but I honestly believed he was trying to give me the best future-life possible. He made a point that this had absolutely nothing to do with him and his reputation as a surgeon. Everything had to do with me.
The patient
. Making me
better
. And my family. Giving Karla and me more time to be together in this lifetime.
Karla and I waited in the hotel room for an opening in his schedule because he was in such demand and my operation was so complicated that he wanted to make sure everything was perfect.
At the hotel, we had a surprise visitor. Lyric came to stay with us. She not only made us both feel better and was always cheerful, Lyric filled the room with light.
I tried to walk on the treadmill down in the hotel gym but it was really pathetic. I don’t know if I was doing it for exercise or if I was walking to prove to myself that I was a machine and this surgery was basically a ‘valve’ job—a lube job. There was nothing
really
wrong with me, I thought. Then I’d see an 80 year-old man next to me running and I looked into the gym mirror—overweight because I couldn’t exercise; bloated from certain medications, and walking at a pace that was slower than Dick Cheney on a bad day. Crap! Crap! Crap! I was so angry. Why can’t I beat this? Why doesn’t my heart work? I had finally come to the ‘Why me?’ moment and I would not allow it to linger. I got off the treadmill and went to the stationary bike. I rode for 30 minutes. At the setting of “1”—but I still rode for 30 minutes. I
tried
. I stopped complaining and I tried.