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“Outside the pull of gravity, beyond the spectral veil, within our careful reasoning we search to no avail - for the constant in the chaos, for the fulcrum in the void - following a destiny our steps cannot avoid…” – Dan Fogelberg (“Nexus”)

Imagine waking up and not knowing where you are. Then, as soon as you start thinking about it, you find that you are unable to move more than just your legs and arms.

I awoke in the CICU on Sunday afternoon, September 29 th. I do recall waking up. The first thing I noticed was the sound of the machines and the warmth of the air. I felt so cold in my coma, that the heat in my room was very comforting. Within a minute or two, I tried to call the nurse, however, my mouth was very dry and I could barely get a sound out. I don’t know how long it took for the doctor, or nurse, to come into my room. What I do recall is someone asking me if I knew where I was and if I knew how I got here. I remember thinking that this was weird question. I tried to clear my head, but I was very woozy and disoriented. I couldn’t talk and I could not focus on what he was saying. My arms and legs felt very tired and I had no desire to move them.

What I do remember was a doctor telling me I was in Montefiore Hospital in the Bronx. I had no idea how I ended up there. The only I knew about the Bronx was Fort Apache, and that I drove through it on the way to Connecticut. They informed me why I was there, but they had to repeat it over and over again.

A few weeks later, Renee told me that I had actually woken up once before, during the coma. At that point I remembered that I saw my brothers, Mike and Bruce. I recalled Mike asking me how I was doing and Bruce waving to me. I seem to recall that I had something in my mouth, perhaps a tube, but I felt very tired and wanted to sleep. It seemed afterward to be so surreal, knowing that something happened, but having no understanding of why.

Because it was a Jewish holiday of Simchas Torah, Renee stayed in Brooklyn with a dear family we knew. She had informed the doctors that if anything changed, they were to call and leave a message on the answering machine, since using a telephone is forbidden on the holiday (unless it is an emergency). However, no one bothered to tell Renee that I had woken up until she called them after sunset, when the holiday ended. Because of the late hour and the fact that I was sleeping (which I wasn’t, but I’ll get to that later), they advised her to come in the morning.

The CICU room was pretty large. It was bright and noisy. My IV machine was constantly beeping, because I kept moving my arm and cutting off the medicine drip. It was very annoying. To my left was a large window. It took up the entire upper half of the wall. It had blinds that didn’t quite close right and also annoyed the daylights out of me. To my left was a small TV that was on a moving arm and did not reach long enough to be right in front of me. However, I didn’t really care. I had no desire to watch anything and my neck hurt too much to keep it turned towards the TV. In front of me, there was a window covered by a curtain. I assumed that it was an area where the doctor’s watched me, but I was probably mistaken. Also on the wall was a generic clock.

It was while watching this clock that I realized what I thought was a big problem. I couldn’t see. I don’t mean I became blind, I mean I couldn’t make out anything beyond shapes. It occurred to me that I wore glasses and didn’t have them.

Renee came to see me the next day. I don’t think I ever saw her so beautiful. I remember the first thing I said to her was how great she looked. Renee didn’t think she looked so special and perhaps I felt that way because hers was the first face I recognized. But I just thought she looked wonderful. She came in while I was trying to each lunch. I say “trying”, because I was not doing a very good job of it. I had terrible tremors and was having trouble handling my fork. On top of that, I had absolutely no appetite.

Renee sat next me and I couldn’t stop shaking. My left leg was uncontrollable. Dr. Garcia came in briefly and told me that I was experiencing withdrawal from all the medications and that it would improve. Renee and the doctor tried to explain again what had happened to me, but I still had a hard time understanding it. Additionally, Renee confessed that she had no idea what happened to my glasses. This was a cause of great anxiety for me. I started to feel like I was, once again, in a nightmare. I realized I was awake, but was very confused. I couldn’t understand anything. It seemed I had lost the ability to think straight. But everyone was smiling and telling me that I had survived the worst and all would only get better. I had no idea what that meant. I simply surrendered myself to them. I was not strong enough to do anything about it and I trusted Renee. I knew that would take care of everything. I knew that I had to trust her, knowing that she loved me.

On the fourth day A.C. (after coma), a doctor I recognized, but couldn’t name, came in and told me that he needed to insert a new line into the artery in my neck. He warned me that it would not be comfortable, but he would inject Lidocaine © to numb the area first.

It was torture. It hurt so extremely that it brought tears to my eyes. Once again, my thoughts were focused on this being some kind of nightmare. I remember just closing my eyes and just accepting it. It wasn’t as though I had any choice. I still couldn’t even get up to go to the bathroom. I was still attached to a catheter, so I had no reason to get out of bed much.

I woke from a rare nap one day to find an older man (maybe 50-55 years old) in the room. He introduced himself, but he did not speak English (I believe he was Mexican). I had no idea why he was there, but he kept trying to assist me in getting up, making sure I was comfortable and helping me cut my food. It was unnerving me. When he left a few hours later, he announced that he would see me tomorrow. I figured he must have been a volunteer who did this. Later, I found out he was hired as an aid by the hospital. We’ll talk more about the aids the hospital supplied me with in Chapter 5.

After about 3 days in the CICU, I was introduced to a physical therapist and an occupational therapist. Both were young, seemingly just out of college and horribly cheerful, women. I liked them and they did a good job, but I had no patience for cheerfulness. I wish I could remember their names. I would send them both a letter of thanks for putting up with me and forcing me to heal, when I least wanted to. They started working with me right away and it gave me a break from my daily routine. This was good thing. My days were very long and boring. I still could not watch television, still couldn’t read, still couldn’t dial a telephone and still couldn’t see well. My eyes had been dilated, so even if I had my glasses, I still would not have been able to see.

One of the biggest issues Renee had with me over the years was my anxiety. Especially when it concerned her. I would always get nervous if she were late and often, I would track her down. I didn’t do this to try to control her, but out of fear. I remember, right after we were married, her being stuck on the F train in Brooklyn, late one evening, returning from work. I freaked out. I saw train after train after train pull up to the station by our home and leave without her. I could not understand where she could be and I got very frightened. It turned out her train broke down in the city, and all the other trains were re-routed around. It was a simple, obvious delay, but I just panicked. This is just an example of my mindset, before I had the heart attack. I would have Renee call me to tell me when she was going to be home and would pace, if she were more than a few minutes late.

Suddenly, I had absolutely no way to do this. I still worried, but because I couldn’t dial the phone, I had to trust that she and the kids were okay. I refused to allow my mind to believe the worst. I put Renee and the kids out of my mind as much as possible, so I would not fret so much. It was a defense mechanism and it forced me to live somewhat in denial. However, I am much better today because of it. One of the doctor’s biggest complaints about me was my inability to relax. I had become very, very anxious. Although, with good reason. I had to learn to trust people I hardly knew and was powerless to do anything. In addition, my brain had been so totally scrambled by the stroke, that I had a hard time voicing my concerns. I would ask them over and over again about what the doctors said, what they meant, why they were doing whatever it was they were doing and anything else that popped up.

On the 10 th day A.C., I was finally moved to a regular room. They decided I would be better served outside of the CICU. I, of course, panicked. I wasn’t happy being in the CICU, but at least I wasn’t alone. The nurses may have pretty much ignored me, but at least they were in sight. Now, going to the cardiac ward meant I would be even more alone than I already was.

The room was smaller than the room in the CICU. However, it was clearly nicer. It had a fresh coat of paint and a more “homey” feel. Plus, it had a large color TV with excellent reception, as opposed to the CICU, which had a 7 inch b/w screen and sometimes picked up local channels (not that I really cared anyway). I still had no desire to watch. My mind wandered too much for me to concentrate. I felt very lonely and bored. Renee was able to stay longer and I was allowed visitors, although, I really didn’t want any. It’s not that I didn’t want to see anyone, it was more that I was embarrassed by what I had become and I was so tired and depressed.

During the next week, I started to notice improvements in my mobility. I was able to walk, with a walker, about 30 feet and started to remember small details of things I used to care about. I began to grill Renee about what happened to me and started becoming a little optimistic. Since my heart attack, a number of friends came to visit me. Some were there while I was at Maimonides, others while I was in a coma and then during the first weeks after I woke up. Many of my close friends kept in contact with Renee as well.

While she didn’t mention it in her story (I asked her to wait until this time), Renee felt enormous gratitude to a number of people who called her regularly and visited with her in the waiting room. Larry Fruend called all the time and was Renee’s guide (by phone) when she’d get lost in Manhattan. My oldest friend (and best man at my wedding), Nachie Siebzener – I think I’m still the only one he knows who can spell his name correctly – and Joey Goldberg called a lot as well. There were a number of others who called Renee as well, but she was so occupied, she wasn’t able to return their calls.

Renee informed me of the wonderful things our friends did for her. Ben Meltzer, who I had not seen for many years, came in two or three times from Silver Spring, Maryland, and spent hours visiting with her and kept her from being bored. One night, Renee tripped down a few steps and Ben spent a long time with her in the ER, awaiting x-rays on her ankle and knee (they were not broken, but badly sprained).

Another long lost good friend, Gregg Goldenberg, who I didn’t recognize when I saw him, used to bring her food from the Einstein cafeteria, which he was in charge of. He was the first friend to visit after I arrived at Montefiore and the first one I saw after I woke up. However, it was a former NCSYer of mine, Geoff Dworkin, who spent the most time with her. Geoff and I were close when I was the Regional Coordinator for NCSY in Detroit. We kept in touch over the last few years and he was really affected by what happened to me. He stayed with Renee in the waiting room many evenings, and when I woke up, he was constantly on the phone or visiting me. Geoff was remarkable and I will discuss more about the wonderful mitzvah he did for me in the next chapter.

Just like Geoff, Ethan Miner, one of our oldest friends, who I’ve known for 25 years, visited after work on many occasions. He offered Renee emotional support and visited with me many times as well. Geoff and Ethan were remarkable and I will discuss more about the wonderful mitzvos (good deeds) they did for me in the next chapter.

There were others as well, including David Jarcaig and Neil Kleid, who I will discuss in more detail in the following chapters.

I trusted the doctors and really liked one nurse who seemed to be the only one who liked her job. Once this happened, Sherman (Casanova – the transplant coordinator) took me across the street to the ophthalmologist. It was the first time since my heart attack that I saw the streets outside. Although I never left the building (we went through a tunnel underground), I was amazed that the leaves had turned and it seemed winter was coming. I really had lost track of time being holed up in the hospital.

On Sunday, October 13 th, Ethan came over to watch some football games. I still didn’t have much desire to watch, which was pretty amazing, considering I have been a die-hard Dallas Cowboys fan since the age of 6. I can not remember a game I didn’t watch, listen to or at least read about the next day. But I had no real desire to watch or even follow along. I was concerned by this, but figured It would either get better or it wouldn’t. I didn’t really care. I was starting to get tired of feeling like this. I was just so frustrated. One thing I also noticed was that my back was hurting badly. It’s amazing that I didn’t remember the fact I had back surgery two years before. I told Sherman that my back was sore and didn’t know why. After consulting his records, he realized that I had back problems for 20 years and put me on the proper medication.

I believe the hardest problem I dealt with was the fact I wasn’t able to sleep. They finally gave me 5mg of Ambien© to help me rest, but it barely had any effect. They raised it to 10mg, and it helped a little. I was still so anxious and scared. My best sleep was usually between 2 and 5am. The nurse usually came in around 5 to weigh me and to take my blood. I didn’t mind it so much because I was too tired to notice. As my condition improved, I began to fall asleep after the morning ritual.

One morning, after a very restless night, which annoyed the daylights out of my aid, he decided I needed to “learn my lesson” and he bathed me (sponge bath) with cold water. I can still remember his voice. It was of revenge. I recall him threatening me that if I kept him awake again that night, I would be very, very sorry. I was very frightened. I had no ability to defend myself and still had a hard time with my words. When I told Renee this, she was furious and demanded that the aid be replaced immediately. That night, the same aid returned. Although scared at first, he apologized and treated me as if it never happened. After the next day, he was gone.

Two days later, October 15 th, was my 40 th birthday. Renee brought me a cake and balloons and cards from the children. She also brought me two black and white, framed pictures of my twins, taken by my niece, Shayna Chinskey. It was very surreal, celebrating what should be a very happy milestone (for some) while fighting for my life. Although I was no longer in the CICU, my condition was still considered critical. But the day turned out to be pretty good. Before she arrived, I was able to walk the length of the corridor (about 100 feet) and felt better than I had in a long time. The transplant team started to teach me how to connect a mobile LVAD machine, in preparation for when I go home (assuming I leave without a new heart). Then to top it off, the “nice” nurse brought me a birthday cake and a card. It was very sweet and it made me feel a whole lot better.

One thing I did not like was when they posted an NPO notice on my door. It meant that I was not allowed any food or drink after midnight. These notices were posted in my room whenever a procedure, such as a biopsy, was scheduled for the next day. There were two big problems with this. Although I had no appetite for food, I was exceptionally thirsty. Never more so than when I was not allowed to drink. Secondly, this usually happened when I had a biopsy or angioplasty. Usually, the procedures were scheduled in the earlier part of the morning. However, on two separate occasions, due to emergencies, mine was delayed. One time the delay was until 4:00pm. Another time, after fasting since midnight (except for my medications), my procedure was postponed until the next day. I wasn’t informed of the delay until around 6 in the evening. I was dying of thirst. Apparently, they had been giving me Lasix©, due to some swelling in my legs. One of the prominent side effects of Lasix is dry mouth and excessive thirst. They allowed me to have ice chips, but only a few. I later found out that the procedures I went through didn’t really require fasting, but they said that they had to follow their archaic guidelines nonetheless.

On Wednesday, I met with Dr. Garcia and he told me I was doing well, but was still not healthy enough to go home. His best guess would be about 2-3 weeks at the earliest. As much as I wanted to get out of there, I felt he was being too optimistic. He told me that because of my blood type and age, I was a good candidate to receive a new heart rather quickly. Unfortunately, I was not well enough yet to receive it.

I had a new pair of glasses shipped to me by Mike (my brother), but I had a serious hole in my sight. I still could not focus. The Neurologist concurred that I indeed had had a stroke and ordered a battery of neurological tests to be administered. I walked around up and down the corridors and did my leg exercises. One big problem I had (and it would bother me from then on) was that while in the coma, I had developed a bed sore on my left foot, by the heel. Apparently, while I was out of it, no one watched to see if my skin was developing lesions. This is a no-brainer for most hospitals and nursing homes. But not for my doctors. I began to feel that although the were incredible with the way they took care of my cardiac needs, they completely ignored everything else. I have to admit, I don’t believe it was deliberate. They are very, very good doctors, when it came to the matter of my heart, but they were weak in other areas. Of course, I’m not trying to be critical. I am truly indebted to them for saving my life.

The problem with my heal was that it had a large black wound that hurt when I stepped on it. It made for difficult walking. It, more than anything else, discouraged my strengthening plan. I had to keep it elevated and completely off the bed. The hospital gave me a donut-shaped brace to keep around both feet, in order to allow space between them and my bed. It was very uncomfortable and still is not fully healed (more on that later).

That night, I received a call from Rabbi Howard Wolk, the Rabbi at the Young Israel Synagogue, in Hartford, Connecticut. Rabbi Wolk had been in Dallas for many years and was the Rabbi of my synagogue when we recently lived there. He called to tell me he was coming to see me in the morning. I believe he had been to see me a couple of times since I got here, but I’m not sure exactly when. I was very excited about the company. Plus, I was quite honored. It wasn’t everyday that a Rabbi, who left a community, would travel that far to visit a congregant, who also left. I was deeply touched.

However, my mood quickly darkened when I saw those fateful letters, NPO.

I asked a nurse why and she told me that Dr. Garcia had ordered it. The doctor mentioned a few days earlier about taking a CAT scan, but I didn’t think I would need to be NPO. Since I couldn’t get a straight answer from the nurse, I had her call Renee (no ability to dial a phone yet). She told me not to fret and that she was sure Dr. Garcia would explain it in the morning.

I woke up Thursday, October 17 th, at around 5:30am. The nurse said she had to weigh me earlier and get me cleaned up. It was very early and I could not understand why I was being woken up early. In fact, I resented it. Although they broke this rule many times, this was the first time they did more than just wake me. I asked the nurse what was going on and she said they were preparing me for surgery. My heart raced. Surgery? The only surgery I could imagine having now would be a transplant, but Dr. Garcia told me a coupe of days before that I wasn’t ready.

At around 7:00am, Desiree Flick, the transplant nurse practitioner, who saw me on an everyday basis, came in and confirmed that I was indeed being prepared for a transplant. I was stunned. I knew that there was a long waiting list for hearts and even though I was considered an excellent candidate, I assumed the process would take a whole lot longer.

Apparently, a young man (about 21 years old), from somewhere in the Midwest, had died. His family had wanted to donate his heart, so Dr. Garcia flew, with Sherman, by private jet, to receive it. There is a very small window of opportunity, about four hours long, in which the heart can survive outside the body. Doctor Garcia met the surgical team at the airport and flew the heart, which was on ice, back to New York. Everything had to be perfect. If there were any delay, the heart would be useless. As soon as it arrived in New York, they were to bring me downstairs to the operating room.

About 10 minutes before I was to go down, a young orthodox Jewish man came in and asked me if I wanted to put on a pair of tefillin (two small black boxes, carrying a prayer, with black straps attached to them). It’s required of Jewish men above the age of 13. I hadn’t even thought of these since I had become ill. For some reason, this young man came to see me on the very day I was to have my transplant. I took it as a strong sign from above. Although it generally takes a little bit of time and the nurses were getting anxious, I refused to go until we finished. Just then, Rabbi Wolk arrived and accompanied me to the OR.

The transplant team immediately called Renee when they got back in New York. However, since it was close to rush hour, when the trip can take up to two hours, she arrived after they wheeled me in. I felt very fortunate that it was all happening so quickly. I had hoped I’d receive a new heart while I was in the hospital and not have to worry about the LVAD. I had no time to be scared. The doctors did an excellent job of reassuring me and I felt somewhat confident. I seemed to have managed to put my last experience (the bypass) out of my mind.

I remember feeling very sleepy and hoping Renee would be there when I woke up.