September 2, 2015

Lessons Learned from Aortic Replacement Surgery

by Eric Davis

enlarged_aortaAs mentioned in a post a few months ago, I have was born with a condition called Loeys-Dietz syndrome. One of the symptoms is aortic aneurysms which often necessitate a procedure that removes the damaged ascending aorta and replaces it with a synthetic one. In God’s good providence, I underwent this procedure about 8 weeks ago.

I found it a spiritually enriching and sanctifying experience. Many of the physical or medical lessons have direct application to life in Christ. Here are a few lessons learned:

  1. It takes very little to end our lives.

Loeys-Dietz syndrome causes your connective tissue throughout the body to stretch a bit. Subsequently, a few inches of my aorta, just off the heart, swelled a mere 10 millimeters in diameter. That’s less than half an inch. And yet it’s enough to kill instantly, should it pop. After the procedure, my surgeon said that the aortic tissue was weak, paper thin, and ready to go.

In the case of a stroke, for example, a particle hardly visible to the eye is enough to send us back to dust. A little bug/virus invisible to the naked eye can do the same. Or deprived of air for a few minutes. Or a little cut in the right place. And on and on we could go. It takes very little to send a human back to the dirt from which he came.

  1. Pre-op and cardiac operating rooms are great equalizers.
gI_127697_Double_Sided_Slipper_Socks

ww1.prweb.com/prfiles

Typically we think of death and judgment as the great equalizers. While that is true, the pre-operational and operating rooms are a close second.

The whole cardiac pre-op experience is fascinting. It’s busier than Chicago’s O’Hare airport on a Monday morning, hustling and bustling with nurses, CNA’s, anesthesiologists, surgeons, transporters. There are individuals with the title, “The Pre-Op Barbers,” who are tasked with trimming you down below the neck.

All of us in pre-op were clothed identically: those white and light blue dotted surgery “gowns,” which are little more than a fig-leaf like implement for nakedness. Then, those deep purple socks with rubber diamond-shaped grippies on both the top AND bottom (in case you forget which is the top and bottom of your foot). Outside of cardiac pre-op, you might be a rocket scientist, a stay-at-home mom, a Nobel Prize winner, professional athlete, or president of the United States. But it matters not inside pre-op. You are a fig-leaf-gown wearing, grippy-socks-sporting, son of Adam who is hastening to the dust, and nothing more.

And this fact is accentuated once you’re wheeled away to the OR. It’s a surreal experience; the possibility that death awaits as you enter the no-turning-back zone. In a moment of unintended morbid comic relief, the lead anesthesiologist casually mentioned to me as he and his team were wheeling me out of pre-op, “You know, there’s a bit of a risk with this procedure.” Heh, thanks… And off I went.

Operating Room in Hospital

surgeonabroad.com

The OR was no less extraordinary. Machines and gadgets filling a large, high-ceiled room which were the product of centuries of blood, sweat, dollars, and tears. A couple guys introducing themselves to you as “Dr. So-and-So,” while others prepared instruments, and things like the “sternum saw.” There were something like 20 people scurrying around the OR. You are asked to prop yourself up and onto the hard-rubber operating table. And then it happens. Dr. Anesthesiologist (aka the “OR Pusher”) says, casually, “I’m giving you a little something to relax you…” And 3 seconds into a very happy feeling, it’s lights out for a 12-hour nap.

Pre-op and ORs are great equalizers.

  1. God has made the human body a masterful machine.

By necessity, going through surgery involves a crash-course in anatomy and physiology. Aortic replacement surgery gave me a new appreciation for God’s masterful wisdom in designing the human body. The heart, and its functions, for example, is simply incredible.

During the average lifespan, the heart will beat 2.5 billion times and pump about a million barrels of blood. Every day, your heart moves your blood about 12,000 miles. And things get way more complex when we start talking valves and aortas.

heart

stanfordchildrens.org

During aortic replacement surgery (apologies for the remedial explanation), surgeons must stop the heart in order to cease blood flow into the ascending aorta. To keep you alive, they hook you up to an incredibly complex and expensive machine called the “heart and lung” machine (an invention which revolutionized open-heart surgery several decades ago). Stopping the heart is highly complex in itself. To do so, among other things, they bathe your heart in potassium-enriched water at about 38F. This puts the heart into a sort of hibernation. After the bad portion of the aorta is removed, and the synthetic sewed in, the heart is slowly “warmed” up, which then causes it to start beating again. All the while, the sternum is sawed completely in half, the heart valve is spared, attached to the synthetic aorta, and the patient kept alive. The fact that the body can withstand such things, and heal, testifies to God’s extraordinary wisdom.

  1. We need to be ready to die.

Though the risk of death was low for this surgery, I still needed to ask myself, “Is the way I’m living today before God appropriate as if it was my final week or month?” For the most part, we should be living like we would want to if it was. It only makes sense since we cannot boast about tomorrow (Prov. 27:1).

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Following the mantra of Jonathan Edwards, we ought to live according to his seventh resolution: “Resolved, never to do anything, which I should be afraid to do, if it were the last hour of my life.”

  1. Near-death experiences are good for the soul.

I’m not referring to foolish experiences to taunt and tease death, but those which are the product of life’s battles and fallenness.

All of life, really, is a near-death experience. Being mere human, death is always near.

But there is unique benefit to those particular moments when our toes are hanging over death’s edge. There is a new sobriety in life. There is a new healthy fright at the power of God and frailty of self. There is a new preparedness to enter eternity. Life in Christ and love for Scripture becomes sharper.

  1. Developing leaders and mentoring others is essential to promote advancement and excellence in any field.

During my recovery, whenever I visited, or was visited by medical professionals, they never came alone. There was always a team of individuals. And when the head surgeon or physician spoke with me, he or she always had at least one disciple shadowing them. The disciple’s eyes were intently focused on their mentor, as they took notes. During my surgery, three generations of surgeons were present: the seasoned guy who pioneered the procedure, his accomplished disciple, and that disciple’s younger disciple, called a “fellow.” Because of the complexity of the procedure, the seasoned surgeon and his disciple perform it together. However, the fellow is also allowed to perform a few moves as his mentor observes and coaches.

discipleship

medicine.stanford.edu

So it should be in the church: “[W]hat you have heard from me in the presence of many witnesses entrust to faithful men who will be able to teach others also” (2 Tim. 2:2; cf. Titus 2:3-5). In this verse are four generations of discipleship: Paul, Timothy, those Timothy would disciple, and those disciples’ disciples. It’s a brilliant design. And should be highly normal in our churches.

I wonder how much more godliness and biblical productivity we might experience in our churches if we were more diligent to take up this model. Despite what is often propagated in American churches, normal Christianity is not about a few pastors and zealous Christians on the field making disciples while the other 97% of us kick back in the grandstands, vicariously living through those on the field. Rather, it’s about local church leadership training and nudging every single one of the 97% to be on the field, getting equipped to joyfully make disciples who make disciples. This is the model of medical professionals, and their excellence is a product of that. Local churches ought to be doing the same.

  1. A competent wife is a priceless asset.

God knew what he was doing when he designed this individual of whom he said, “…a helper suitable” (Gen. 2:18). The scope of that statements is incalculable. Most of us guys really need a competent wife.

By God’s grace, my wife has shown herself heroic every day over the past 8 weeks of my recovery. She slept on hard chairs in the ICU next to other moaning patients, endured my complaining, confronted my sin, pointed me to Scripture, helped me in the most humbling of ways which would not be appropriate to describe here, not to mention figuring out medical bills and insurance and scheduling and on the phone with hospitals, etc., etc.

The saying is true: “He who finds a wife finds a good thing and obtains favor from the Lord” (Prov. 18:22).

  1. procedure

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    God has given incredible skill to mere men.

The knowledge and skill to pull off a surgery like this is mind-boggling. In a journal article on this procedure, one of the pioneers said, “Patients should seek out a cardiac surgeon who has considerable personal experience with valve-sparing aortic root replacement, as the learning curve can be steep. This procedure is unforgiving in terms of small technical errors, and truly is based more on 3D geometric thinking and ‘art’ than it is on science.”

God has shown his common grace in the form of giving sinners amazing skill. My main surgeon, though fairly young, has two doctorates, has received many awards, teaches surgery to medical students, and spends four days/week fixing aortas and hearts. Patients are regularly sent to him because few care to deal with aortic disorders and he has the lowest operating-room fatality rate around.

  1. Exerting effort to progress is considered a sign of health and life.

imageImmediately after surgery, doctors and nurses expected me to push myself in the healing process. The morning after surgery, cardiac therapists showed up at my bedside in the ICU, commanding me to sit up on the bed, get up, and take a few steps (with a walker). And, despite chest tubes and pacer wires hanging out, they expected us to practice coughing to avoid pneumonia. Once moved to the non-ICU cardiac recovery, the expectation increases. Every day therapists came in with respiratory gadgets to exercise the lungs. Regardless of nausea, pain, and weakness, nurses expected us to get up and start walking around the floor. They said that for every day we did not get out of bed, we add a few days to recovery. The saying in cardiac rehab is, “Pushing yourself to get up and walk around is the best medicine.”

And regardless of your age, if you are not trying hard to recover and progress in cardiac rehab, then medical professionals conclude that something is wrong.

sanctification

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So it is when it comes to sanctification for the Christian. We are to discipline ourselves for godliness (1 Tim. 4:7) and work out our salvation by faith in God’s power (Phil. 2:12-13), so as to bear increasing fruit by Christ’s grace (John 15:4-5). And if we are not exerting effort to grow in godliness, then something is wrong (John 15:6). Increasing fruit-bearing is as normal to the regenerate as apples are to a living apple tree.

  1. All the pain, sickness, and surgery here serve as arrows to heaven.

It’s hard to envision what that doctor-less and surgeon-less utopia will be like. When I told my hospital roommate about a painless heaven, he said, “That’s hard to imagine.” But we can be sure of this: pain, surgery, sickness, sin, and death will become mere shadows, all by faith in the Person and finished work of Jesus Christ (Rev. 21:4).

And until that great day, we press forward, striving together according to the grace and power of Christ.

Eric Davis

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Eric is the pastor of Cornerstone Church in Jackson Hole, WY. He and his team planted the church in 2008. Leslie is his wife of 14 years and mother of their 3 children.
  • Ira Pistos

    Amen Eric!

    • Eric Davis

      Thanks Ira. You have a great name, by the way.

  • Johnny

    A good and humbling message

    • Eric Davis

      Glad it was helpful.

  • fundamentals

    God be praised!…..what wonderful words you have shared. Thanks for them, and thanks to God for your recovery!

    • Eric Davis

      Amen!

  • Adam James Howard

    Good stuff brother. Glad to have you back with us by God’s grace, and I’m excited to strive alongside you for the Gospel once again.

    • Eric Davis

      Thanks Adam. Grateful for you.

  • pearlbaker

    Praise the Almighty and Wonderful Great Physician, for the healing of both your heart problems, the spiritual and the physical, so you can go on to minister to many other hearts! So grateful you are still with us for as long as the Lord has ordained. Much love to you dear brother.

    • Eric Davis

      Thank you for your care, Pearl.

  • Wisdom and humility imparted through trial, Glory to God.

    These are excellent and diverse “lessons”, Eric, well lived-out and written here, thank you for this! And what a lovely tribute to your wife, God sure is good 🙂

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  • cowborg

    Great article. I too had aortic valve replacement surgery 8 yrs ago. My “cow valve” is still working okay today.
    You mentioned the surgery prep; mine was amazing. Talk about God putting you in unique situations. On numerous occasions in the process of explaining what could go wrong, I affirmed that I’d wake up and either see my brother ( a good thing), OR, I’d wake up and see Jesus ( a better thing). Twice I was asked by prep staff about my hope in Jesus. I trust God is “dealing” with those who inquired.
    By preparing for the stark possibility of death, I didn’t foresee the twinge of disappointment in waking up and NOT seeing Jesus. I was ecstatic to survive the surgery and live another day, but, there was indeed this touch of sadness.
    Again thanks for the post

    • Eric Davis

      Cowborg-Sounds like you’ve really been throw some sanctifying times. Glad your cow valve is still doing what it should. By God’s grace, I was actually able to keep my own valve. Now, before surgery, I was asked if I wanted a mechanical or animal valve should mine no longer work. But thankfully, they were able to spare my valve and attach it into my new dacron aorta. We’ll see how long it lasts… And praise God for those who asked about the hope within you during your trial.

  • Az1seeit

    Worth reading for point 9 alone. Thanks Eric.

  • Bettina

    Thank you so much for sharing these great lessons!

  • Barbara

    Oh Eric, Thank you for this post. I don’t know if I will be facing heart surgery in my future , but living with a congenital heart defect has made my life interesting! Your post is perfect for me, point nine really hit me, but altogether this is getting printed out, so if I have to face that day, I’ll remember your words. A final thought, my husband is, well, the BEST. He married me 25 yrs ago knowing everything about my health. He says I’m his rock, he has no clue all the helpful things he does for me daily, let alone when I’m sick, are daily reminders of God’s good gifts! So, a good husband is a wonderful thing too!
    I am so,so happy things went well, I imagine your condition will affect your whole life, so these lessons will go with you. I think about heaven more often these days, and learning to trust mightily in God’s goodness to those I may leave behind. God Bless you Eric

    • Eric Davis

      Thanks for sharing that, Barbara. Amen.

  • Sallyann

    Thanks for the article! I went through the same surgery only I have Marfan Syndrome. I relate to everything you wrote except #7. In my case #7 would describe a wonderful husband! All so true. Glad you are here to talk about it because the lessons are applicable for all!

    • Eric Davis

      Wow, Sally! Glad you had a successful surgery. Doctors thought I had Marfans at first, but I came up negative on the genetic test. After that, they discovered it was LD.

  • Lars B

    I enjoyed reading this very much. “To the spiritual man, all things are spiritual.”