Chapter 8. Checking in the Pre-Ops room and the performed rituals

Waiting for almost a month until the surgery day arrived could feel fast either slow, depending on what perspective we looked. It felt fast because there are a lot of preparations that needed to be done in less than a month, with most of the time were used to seek the information from the internet via Google and YouTube. Google was used to search for textual information, and YouTube was used to find the videos of Bentall procedure surgery.

My sister – whose house I stayed in before the heart surgery – liked to ask me about this and that. Luckily, I could reply steadily, thanks for a long Googling. Fortunately, I also had a “photographic memory” which was an ability to remember a lot of things or details completely. So by hearing my explanation, my sister seemed quite satisfied.

Well, both of the textual information via Googling and seeing the videos on YouTube, I didn’t copy + paste them, but I just “bookmarked” them so that if someday I needed the information I could just click on it.

From the videos on YouTube I saw, if there were the videos that were very relevant to the Bentall operation procedure, I often posted the link on my Facebook’s wall; so many Facebook friends could see it. But I thought there were more friends that didn’t want to see or couldn’t stand to see them. For example, there were many of my office colleagues who were more likely to reject than to accept my invitation to see the videos that had been succeeded I linked to my Facebook.

Ah I don’t have the guts. Too much blood,” they excused.

However, looking at many links that I posted at my Facebook wall, there was an office colleague who dared to ask, “Mr. Tri, by looking at those surgery videos, are you getting scared or stable to undergo the surgery?” Which of course I replied, “Yes, certainly I’m getting stable, Sir, because I came to know what is exactly will be done with my heart. If I don’t see the video, I’ve probably scared to death.

As I’ve mentioned earlier, the Bentall procedure surgery on my diseased heart would be held on Thursday, February 10, 2011. Since I wasn’t told in advance when to begin checking in the hospital, then on Tuesday, February 8, 2011 I’d been administering the papers in the Harapan Kita Heart Hospital, with the expectation that the very day I could enter the treatment room so that physically and mentally I was ready for the cardiac surgery to be encountered.

Apparently I was wrong estimating, after I submitted the required papers to the Inpatient Register staff who was on call, I hoped a few hours later I was invited to enter the treatment room. I had been waiting for nearly 3 and half hours but the staff didn’t give me any words. After I entered the room and asked for it, the staff calmly said, “You live in the city, don’t you Sir ? You’d better go home first now and sleep soundly Sir, and until tomorrow or the day before the surgery you report here, we’ll absolutely accept you Sir. As there is no available treatment room for today.

I then nodded wordlessly and directly went to the car to go back to my sister’s home.

The next morning, on Wednesday, February 9, 2011 I reported again to the Inpatient Register staff. All the papers were processed, and promptly at 10 in the noon I was escorted by the staff to go to the Pre Ops room or IWS (Intermediate Ward – Surgical) room.

I got a bed near the window, “So you could enjoy the green foliage out there, Sir,” said the staff who escorted me just now. I was brought a baby blue patient suit by the Pre Ops nurse, “Sir, please change your clothes to this patient suit so we could recognize which are the patients and which are not, including if there are patients who run away, we would know.” The reason that the nurse made me smile, and I then headed to the bathroom to change clothes.

Apparently at that day, my Medical Record (MR) was available at the Pre Ops desk, then I submitted the copy of MSCT scan to complete my MR. Apparently, a physician had been assigned to insert the patients’ data and other data to a computer to ease the heart surgery the next day. It went without saying that all patients’ data would be inserted to the computer, including the lab result, X-ray results, and so forth.

The physician who was assigned to note the MR came to me and asked, “Sir, in the Bentall procedure surgery tomorrow, do you want your aortic valve replaces with a biological valve or mechanical one, Sir?” it was the question that I had been waiting for so I then replied quickly, “Mechanical valve, Doc, the stainless steel one, please, Doc.

Because of Googling I know the strengths and the weaknesses of both the biological valve and mechanical one. The biological valves which were usually derived from pig, cow valves, or donor valve (cadaver) had a similar nature as the initial valve so they didn’t require blood-thinning pills for the surgery, but the drawback was the durability that purportedly brief, which would last between 4-5 years and after that, it needed to be replaced again through cardiac surgery. While the mechanical valves could last for a lifetime, but the patient must take blood-thinning pills for the rest of his life – one of the blood-thinning medicine was Simarc or Warfarin which was a quite dangerous medicine for my body … I’d tell you about this issue later…

After the physician who asked what valve would be applied on my body was gone, I then tried to take a nap. Apparently being hospitalized was similar to flying by a long haul aircraft, which it would be better if we slept as much as possible so as not to be tired.

Not long after that, in that afternoon, another doctor came to my bed. Actually he wasn’t look like a doctor because he didn’t wear the doctor suit which was a white coat, but wearing an ordinary brown safari shirt. Starting with a handshaking and the greeting, “How are you, Sir?” And then I replied, “Fine, Doc …,” We then soon got involved in an intimate conversation.

That’s because that doctor, dr. Dwito, Sp.An, asked me, “How do you feel towards tomorrow surgery?” And I replied, “Happy, Doc … I’m happy that tomorrow is my surgery day, because by reading a lot articles on the Internet I came to know that the Bentall procedure surgery is the only way I could come back healthy as before…” I said which I was oddly quite fluent to give arguments like that.

dr. Dwito who was actually Mr. Harahap’s nephew – one of the pioneer of BPPT (Badan Pengkajian dan Penerapan Teknologi or Agency for the Assessment and Application of Technology) who then worked at PT. PAL Surabaya (the marine vessel company) and a graduate of Germany – and he was also a student of dr. Herdy, Sp.An – my friend’s brother, Hermawan Sulistyo, who taught Anesthecia specialization at the Doctorate Faculty of Unair (Airlangga University) – and said, “Wow … I very rarely find a patient like you that says tone of optimism, usually most patients even hesitant to inoperable although the tomorrow morning they will be operated….” Apparently dr. Dwito was the anesthetist who was on duty to ask my age, weight, and height, with a purpose to seek for a right “dose of anesthesia” for my heart surgery tomorrow morning…

After dr. Dwito passed, once again I tried to squint my eyes for a minute and tried to have a “qualified” sleep. Prof. Andi Hakim Nasoetion – my lecturer at IPB – said in one of the collections of his essays that “The duration of sleep doesn’t affect the quality of one’s sleep” and that “For students, it is advisable to have a short sleep for about 10-15 minutes, but highly qualified.” So, I also tried to take a nap…

After waking up from “a while but qualified” sleep, I then tried to look at the trees outside from the IWS treatment room. I could see some angsana trees waving their green leaves. Blessed you who live in Indonesia that every tree could be said to be “ever green” and would never been withered like the ones in the four season countries. The swaying of the angsana was also my consideration whether it was a goodbye wave or a congratulation of my tomorrow surgery wave.

Soon there came an employee of the Harapan Kita Heart Hospital to my bed. From his brown-colored clothes and a black cap he wore, I knew that he was a cleric, but unfortunately I forgot his name because I was too excited looking forward for what he would say. Soon he shook my hand while mentioning his name and the he explained his arrival’s objective, “Sir … I am here to motivate in islamic way you. I heard that tomorrow you will undergo a heart surgery …” Waw .. it meant that there were Moslem cleric, pastors, pedanda, and monk as well in the Harapan Kita Heart Hospital –  I said in my heart. And then the cleric gave some intro as follows:

Sir … by any chance, my mother is a Cirebonese while my father is a Bantenese. You know, in these two regions, the level of Islam’s knowledge is strong. I’ve wandered from Cirebon to Banten, and the conclusion is that no Kiai (Moslem cleric) in both Cirebon and Banten that can cure your heart disease. Is it right, Sir?” I then nodded silently…

The cleric then continued, “Therefore, Sir, you are already lucky to have come to this quiet good hospital to ask for help to the doctors here to heal your heart disease that you are suffered. Is it right, Sir?” I then nodded slowly.

The conversation with the cleric at that afternoon on the D-1 ahead of my surgery day was finally ended. I then headed to the bathroom to shower. After recovering from the first breathe failure of my heart disease, my health was gradually improved, and I could also take a shower by myself. Why should I take a shower? Because the nurse of the Harapan Kita Heart Hospital didn’t like it when the patients didn’t take a shower, because usually after a shower, in the evening the patients would be served a dinner which was usually followed by taking the afternoon medicine – in addition to receive the guests for the evening visiting hour from 5 to 6 o’clock – and around 8 o’clock, the patients were given the evening medicine.

At 7.30 o’clock the night before surgery, I was brought into the briefing room on the second floor across from the ER. From my family party, I strung along my wife Susi and my big sister Enny – who were busy writing on their notebook about what were explained by the nurse about the open heart surgery that I would undergo tomorrow. That night, there were 4 patients who participated in the briefing – but there should 6 patients regarding that in one day there would be 6 heart surgeries for adult patients in the Harapan Kita Heart Hospital (I didn’t know how many child and teenager patient who would be operated), who of course, were accompanied by their own family. The nurse who gave the briefing spoke in Batak accent and spoke very clearly – the other words of too slowly –so that many attendees raised their hands to ask for something since the beginning of the briefing. However, the nurse who was giving the briefing could answer the questions clearly (I later realized that there was no question about the risk of bleeding experienced by the cardiac surgical patients). Promptly at 8:45 o’clock the briefing was ended after all the questions from the audience who joined the briefing could be answered clearly by the nurse who gave the briefing.

It was a quiet tiring day, but it was also a day full of hope for my heart disease healing, even though tomorrow I would undergo the open heart surgery. Remembering it all, I eventually fell asleep.

Promptly at 12 am I was awakened by the kitchen staff who dressed in brown, which brought a small dish containing strawberry pies, and a cup of hot tea. “It’s the last meal before the surgery tomorrow morning, Sir,” said the kitchen staff.

In the IWS room, all patients who would be operated on the next day would be given the same meal, especially the patients who would enter the operating room at 07.30. As for patients who would enter the operating room at 1:30 in the afternoon, sweets and hot tea would be given at 06.00 in the morning.

Before I went back to bed, I glanced at my watch…. evidently, It was entered Thursday, February 10, 2011 … the day of my surgery…. ( To be continued )

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