Vine climbing building

Waiting for the big muscle to heal

Part 3 of a memoir of heart failure, open-heart surgery and complications

At some point in my recovery at the acute-care facility, a cardiologist tells me that the muscles in my body will not recover any faster than the big muscle, my heart, recovers.
I do not understand those words at the time, but as the days of immobility wear on, I realize that the body heals lockstep with the heart; my overall recovery hinges upon my heart’s recovery, and it is very weak—my heart function was at 10 percent or less when I entered Allegheny General’s heart failure unit in February 2021.
My first big step toward mobility, taken in early April while a patient in a Morgantown, W.Va., acute-care hospital, ended with another “cardiac event.” I fear triggering another incident by attempting to walk. I am still hooked to a feeding tube, a catheter and IV lines, so there are practical obstacles, as well. I am so tired of using the bed pan, actually just a plastic tray that cuts into my skin, and the embarrassment of that arrangement. I want to walk to the bathroom, close the door and take care of business in privacy. And I want to eat.
Being cleared for eating involves working with an ENT specialist, who must convince the rest of the medical team that I am capable of swallowing. A camera is inserted through my nose and into the labyrinth so my swallowing action can be observed on a screen. I am presented with increasingly challenging items to swallow. At the end of the session, I am cleared to start eating solid food, although the tube must remain in my stomach in the event I do not receive sufficient nutrition through eating. It is a miserable procedure, but I am motivated to get it done so I can eat. I choose oatmeal and grape juice for the meal.
It is the most disappointing meal I have ever tried to force myself to eat. The juice tastes like a cocktail prepared in a college chemistry lab; the oatmeal might as well be a sauce of plaster and kerosene.
Anesthesia, antibiotics and other drugs have altered my sense of taste; I am extremely sensitive to any trace of chemicals. Even plain water, the kind the hospitals serve up in those quart-sized jugs with the flexible plastic straw, tastes like a pesticide factory’s discharge. Although I am supposed to drink eight glasses of this stuff a day, I struggle to choke down eight ounces. The IV tubes replenish my fluids.
Three times a day, a staff member from the dietary department comes in with the menu, and three times a day I push away the trays after taking one bite from each offering. Nothing except apple sauce resonates with my palate. All the foods I once loved are repulsive. Worst is anything with a tomato base—pasta and tomato soup go from being staples to taste-bud enemies. Ice cream, pudding are tolerated, but I consume such small quantities, the treats have little impact on my nutrition. I remain on the feeding tube. My weight falls below 110 pounds.
Days are torturous and boring. The television in my room has only a handful of channels that run shopping shows and repeat the same programming day after day. I watch every episode of the few Heavy Rescue and American Pickers programs that repeat daily. Worse, there is no wireless connectivity; then again, I am too weak to hold and use a laptop. What little bit of communicating I do is done through brief text messages on my cell phone. Reading is out of the question because, I am so weak I cannot hold a book. Mostly, I sleep in a drug-induced haze. Nights are restless and insanely long, and no matter how late I stay up hoping to become sleep, it never occurs. Sleep comes shortly before 4 a.m., when the first round of oral medication and the phlebotomist arrive. From then on it is chest x-rays, respiratory therapists sucking out the gunk, doctors and interns, more blood draws and more tests and bags of drugs.
Perhaps the most encouraging event to occur during those early days in acute care is an Easter weekend visit from my son and grandson, who bring me a fleece throw with a paw-print pattern and a stuffed animal that looks like my dog, Edison. Those items bring me much comfort in the days to come, silly as it seems for a 66-year-old man to be sleeping with a stuffed animal. But that gives me hope that I will one day be strong enough to walk in the woods with him again and cuddle up with him on the couch. And it opens many discussions with the nurses, technicians and doctors who share my love for dogs.

A 66-year-old man with a stuffed animal. Ridiculous, but it gave me comfort. Acute care facility, April 2021. All photos by Ruth Feather.

Scars, seromas and Rich

The tracheotomy tube is removed April 15. The hole begins to heal over, although infection around the spot where the pipe rubbed against my skin still oozes from the wound. I am down to one bed sore, which is irritated by the metal bar between the mattress sections on the bed.
A false aneurysm pops up on my right arm at some point between the heart surgery and my return to Morgantown. None seems to know what it is, what caused it or what to do about it, despite doctors and interns alike stopping in to see “it.” All they can suggest is that an artery was blown out during a procedure. I name it “Rich,” in honor of the respiratory therapist who becomes my best caregiver and advocate for getting me out of acute care.
Scar tissue forms where the lines for the ECMO and surgical paraphernalia were inserted. My body looks as if the undertaker in my alternate reality had indeed applied his assortment of needles to it. Today, when I look at photos of myself hooked up to all those lines and machines, I do not recognize this very ill man; I feel intense sympathy for him and wonder how he could possibly be alive in that condition. Today, I need only touch my abdomen to confirm I am he; the seroma is his, as are the zipper scar and swollen lip, the white patches on my legs from the tape that held the multitude of lines in place for weeks and removed the top layer of skin when they were ripped off.

Tubes and IVs left many scars on my body. Allegheny General’s heart failure unit. My hands were constrained in mittens to keep me from pulling out the tubes and needles.

As my 40-day Medicare limit approaches, doctors talk about moving me to a rehab hospital that can provide the physical and occupational therapy I need for independent living. The roadblock is that no place will accept me unless I can walk for a few steps, from the bed to a wheelchair. A physical therapist visiting from another hospital and named Tim assures me that I can do it and that the trepidation that I am experiencing is normal. He gives me exercises to do, works with my atrophied legs and shows a kindness and compassion I’d not received from the acute-care physical therapist. With his strong arms to lean upon, I pull myself up and take the first steps. I get dizzy and beg to return to bed. We try it again. My legs ache. It feels as if I am trying to walk on a thousand beach balls floating in a pool. Perhaps my subconscious reverts back to some 66 years earlier, when I was first learning to walk. Back then, it was a short fall to the floor and the floor was grass or carpet; my mother was there to catch me. Here, it is a sterile, hard surface that offers only injury and even more surgery and hospitalization if I collapse.
During one such attempts, a doctor takes note of my progress as I take three or four steps. While the other physicians feel I am not ready to move on, he becomes my advocate for release to a rehab facility. And after being rejected by a couple of facilities near the hospital, I am accepted at a nursing home/rehab center in late April.
Because I had heart failure when they attempted to walk me, I must wear a “life vest” that will sense if my heart stops beating and deliver a shock to restart it. The vest is attached to a huge battery pack that I wear around my neck or off the shoulder and makes any attempt at walking all the more difficult because it throws me off balance. It adds to the discomfort of being “skin and bones,” but it is a condition of my release.

10 worst days

On April 27 I leave the acute care facility for the rehab hospital, also in Morgantown. The 10 days in that facility, aside from my alternate reality experiences, are the worst of the entire ordeal. Perhaps it is because I am much more cognizant of my surroundings than I was when drugs dulled the pain and reality, but even a drugged person would recognize this as a nursing home posing as a rehab hospital.
My first night there, I am left alone in an otherwise vacant wing sealed off from the rest of the facility. My attempt to summon a caregiver is ignored. The phone in in the hall rings and rings, but no one is there to answer it or my call button. It is as if no one knows there is a patient in that wing. Indeed, my wife finally has to call the office and tell them that I am in the wing. Five hours pass before I am even acknowledged or assessed by staff.
The facility is severely understaffed; one nurse is responsible for an entire wing. One day I witness her work three shifts straight. Because of Covid-19, I am isolated, and Ruth is not permitted to visit me in my room. An outdoor meeting is arranged behind a Plexiglass divider outside the facility; the aide who comes to take me outdoors in a wheelchair doesn’t take the time to put my feet on the footrests and they drag on the concrete. I repeatedly ask her to stop, but she tells me to lift up my feet and keeps moving. But my legs are so weak they cannot lift the feet that once carried me on great adventures and helped me earn a living. They drag and bump along the pavement as the wheelchair is pushed around the building’s perimeter in search of my wife’s car.
The best thing to come out of those 10 days is that a physical therapist gets me to the point where I can walk down the hall with a walker. But there is no occupational therapy, to speak of, aside from making sure I know how to write a check (seriously). Because there are no showers in the facility, I am limited to the sponge baths that I detest; learning how to shower and shave myself again will have to be done on my own, at home.

For three days in a row, I walk the entire length of the hall, as far as I’m allowed to go due to Covid restrictions. I even work on climbing a single step. I tell the staff and my wife that I am going home; I am checking myself out.

Ruth tells me I’ll have to come home in an ambulance, she can’t handle me in the car, and there are two stone steps leading to our front door, steps I cannot navigate. Further, there is no hand railing to assist my climb. My options are stay in the rehab hospital until I, hopefully, gain the strength to walk up steps and get in a car, or go home in the ambulance.
The morning I am released, I fall while trying to get myself into the wheelchair after using the restroom. The racket attracts more staff than I’ve seen the entire time I’ve been in the place. The nurse attending me is certain that I’ll be back. I need more time there, more therapy, they tell me as the ambulance arrives to haul me home.

Coming home, May 7, 2021
Coming home to 6 Seaford, May 7, 2021

Going home

The ambulance ride is frightening. My mind struggles to separate the new reality from the alternate in which my mind has been living. I fully expect the ambulance driver to disregard the home address and deliver me to an abandoned building in Sheffield Township, Ohio, where burly men strangle me with wire, drain a gallon of blood through this hole in my neck and laugh at my misery. I have known fear before, but never like the fear born of those hallucinations. I fully expect to wake up from this “reality” and find myself back in that dungeon.
I count off the minutes on Interstate 68 once I feel the acceleration of the ambulance tell me we are on the four-lane. From the gurney, I can see nothing. There is relief when the ambulance slows after 15 minutes and makes a left turn onto what I hope is Route 26. Further relief when I feel the ambulance rock to the right a minute or two later. We are on the Brandonville Pike, and I am going home.

It has been 94 days since I’ve been there. My vision of it comes not from the three months we lived there, but the nights I were chained in its nursing-home basement to an iron bed. I expect to see a security fence around it and extensive remodeling.

Instead, it looks just like I left it.

I am carried into our house on a gurney and assisted onto the air mattress bed that my wife prepared for me downstairs. It is the evening of Friday, May 7, and I am finally home.
The bed feels amazing. Although my body aches, I have no appetite, my digestion is seriously messed up and I look horrible, I am so grateful to be home.
I sleep better that first night at home than I had in years. Prior to the heart surgery, I woke up dozens of times each night. In the hospitals, it was impossible to sleep with all the intrusions and noise. This night, however, I sleep and sleep. I wake up before my wife and study the ugly peach-colored ceiling and tan walls that remind me of those in the hospital rooms. For a minute, I find myself believing I am back in acute care. My eyes scan the printer’s box on the wall and all the mementos of my life stashed in their cubicles. My cat jumps on the bed and curls up next to me. The log trucks roll down the pike in front of our house, I hear Ruth stirring upstairs. It all seems so strange to me, yet vaguely familiar. I could get used to this.

I thank God that I am alive, home and in the loving care of my wife. I thank God for all he has brought me through. The doctors can’t explain it, and the only way I and Ruth can is prayer, lots and lots of prayer.
As the drugs flush out of my body, I improve my intake of fluids and food and learn to do everything all over again. One of the great moments of those early days is when I garner enough strength to push myself up from the edge of the bed and get into the wheelchair without a “boost” from my wife. But the day she helps me get out of the wheelchair and onto a seat in the bathtub is the greatest. Feeling the warm water on my head and back is both physically and emotionally refreshing. It takes 30 minutes to get me in there, showered, dried off and dressed, then another 30 minutes for me to shave myself while sitting at the kitchen table. A few days into my return home, Ruth gives me a haircut, the first since January.
Life is far from perfect, but it is good. I am grateful for each little comfort of home, act of self-care and the loving attention of my wife. Only one thing is missing: Edison.

Continued February 25

old-time music string players

And the jam goes on

Nearly four years ago, Ruth and I attended the old-time music jam at the Morgantown Brewery on a Wednesday evening in October. It was 2018 and the world was a wonderful place. People didn’t wear masks unless they had a medical condition, gasoline was affordable, and a trip to the grocery store didn’t involve a second mortgage.

The jam had been going on for nearly 20 years when I visited it for a Goldenseal story. But the story didn’t make it into the magazine before Covid-19 struck. During the pandemic, the brewery changed owners, and the jam moved up the hill to 268 High Street and the Art Bar.

Owners Stephen Wilson and Robert Abel welcomed the musicians to their new venue, which opened in September 2021. With Goldenseal planning a music-focus for its Summer 2022 issue, I was asked to update my original story with the jam’s new location, which is just down the interstate from our home in Bruceton Mills.

The Art Bar is a brilliant concept, although “bar” is a bit misleading at this point because alcohol options are limited to wine and hard cider (adding beer is in the process). Food is available throughout the day and evening, and there are options for adults and children, alike.

The owners recognize the value of art in everyday experiences, and to that end provide white sheets of paper on each table for doodling and coloring. Markers and crayons are available, as are coloring books for any age. For a few dollars, you can add a craft project to your burger and tots. The walls are adorned with the work of regional artists, and the bar offers workshops for adults and children in a variety of media. It’s refreshing to see this kind of creative thinking and re-defining of what a restaurant or bar should be. The owners clearly understand that not all bar visitors want to be bombarded with sports and FOX news blaring on 16 monitors.

The old-time music jam is held Wednesday evenings. Not every Wednesday evening, but many of them. Check the Art Bar’s Facebook Page to get the dates.

Playing begins between 6:30 and 7 p.m. and has been known to go until 10 p.m. The emphasis is on string instruments and old-time music. Guitars, fiddles, banjos, mandolins and a bass the mainstays of this gathering. The evening I attended, a harmonica player from Pittsburgh, Chris Hollingshead, joined the group, as well.

Jim Wilson, a bass player, told me, “If you come next week, it may not be the same. It is always changing.”

The entertainment is free, as is participation in the group, which includes many seasoned players eager to perpetuate the old-time music. They do this by recruiting whoever shows up with a stringed instrument. Lily Farabaugh, a WVU senior, came to a jam with friends back in December 2021. She had her guitar with her, and noticing her clapping and instrument, banjo player Sue Gimbal invited her to play. Two days later, Lily bought a mandolin and has been sitting in the players’ circle ever since.

Players in the old-time jam at the Art Bar sit or stand in a circle on the bar’s front-window stage. From left are Larry Spisak, Jeanne Sutton, Gabriel Bass, Lily Farabaugh and Scott Radabaugh (foreground). Bar guests can listen to the music while they enjoy their food and beverage at the bar or tables. There is no admission fee for the players or audience.

If you enjoy being around a group of friendly people who are passionate about keeping old-time music alive, this jam is for you. Bring your instrument and join them. If you are musical klutz like me, come out for the experience, food an Appalachian-made hard cider and camaraderie.

Just remember to wear a mask.

Morgantown Art Bar is located on 268 High Street, Morgantown. There is plenty of parking on the street but bring a pocket full of quarters. You don’t get a lot of meter time for a buck, and the meters are checked “after hours.”

Blazing sunset over mountains

Are you ready to die, Carl Feather?

A memoir of heart failure, open-heart surgery and complications

I have chased sunsets most of my life, although of late I’ve not had no passion for such pursuits. Nevertheless, on that evening in February 2021 was before me the most stunning example of a fading Helios I’d ever witnessed.

The afterglow across the Amish hamlet in North Central West Virginia has more orange than a pumpkin field and red than a blood bank. It glows brighter than a searchlight. Bare, blacker-than-eternity hardwood forms stand gaunt against this sunset of sunsets.
I stand in the side yard of a brick church and gulp the blazingly cold air into my lungs; my body shudders and begs for more air as my legs tremble.
The day star and I are one in this moment, both fading, both dying.

A preacher comes alongside me. “Are you ready to die, Carl Feather? Before this day is over, you will be dead.

February 5, 2021

For weeks I have been working 16 hours a day on the house at 6 Seaford Lane, Bruceton Mills, West Virginia, into which my wife Ruth, my father Carl J. and I moved into in mid-November 2020. The joy of buying a retirement home and relocating to our favorite state has quickly turned into a nightmare of undisclosed, serious issues with the house requiring far more energy and money that remained after remodeling and selling our home in Ohio, then making the move of 240 miles.
I am exhausted. For days, I have been unable to work on the house. My nights are sleepless with worry and coughing; day and night I struggle to draw in enough air to gasp for the next breath. I and my wife suspect Covid, but I won’t know for four days if the test that I took the day before is positive. I need air!

Shortly after noon that Friday, I struggle to the front door, throw it open and stick my head into the frigid mountain air. I inhale like a diver who has just broke the surface after having his oxygen tank spring a leak. But I get no relief; dizzy and weak, I struggle back to the sofa and resume staring at the disaster.
“Dad, I have to go to the emergency room.”

The ER physician at the Mon Health System hospital in Kingwood listens to my heart and orders blood work. The extremely elevated level of the enzyme troponin indicates that I am either in the midst of a cardiac event or coming out of one. I have congestive heart failure, as well.
Within two hours of my wife delivering me to emergency room and convincing the intake person that it was indeed an emergency and my Covid test results were not available, I am in the back of a KAMP ambulance, prostate and under the care of a muscular, middle-aged male EMT who makes small talk about his open-heart surgery. As the ambulance traces the winding concrete ribbon of Route 7 from Kingwood to Morgantown, he assures it will all turn out well. He pulls open his shirt to reveal the zipper scar on his chest as proof, but he warns me not to have it done locally.
“Go to the Cleveland Clinic, that’s who did mine,” he says.
“Great,” I think. “I lived 50 miles from Cleveland for 66 years and never once required medical care from the facilities there. I move away and three months later, I have to go back for open heart surgery.”
That unpleasant prospect aside, as the ambulance snakes its way through the Appalachian night my thoughts are not so much on myself or the likely surgery and painful recovery as they are on my third great-grandfather Jacob Vatter. He and his wife Mary settled in Preston County circa 1810 and lived out their lives on a farm in Crab Orchard, five miles from our new residence. I thought of how frightful the event I was undergoing would have been for him and his family, living without benefit of blood tests, a physician, ambulance service or choice of cardiology departments, let alone a hospital 275 miles to the north.

Among the reasons for wanting to live out my years in West Virginia was to experience firsthand the land of my fathers and eventually be buried among them in that soil.

It appeared the second part of that objective was about to be fulfilled much earlier than I had anticipated.

February 7, 2021

The EKG, echocardiogram and heart catheterization confirm what the ER physician had suspected. My aortic valve is failing, and my heart drowning in fluid. There was no going home to get stronger or anticipate the surgery; the event is scheduled for February 12, a Friday.
The surgeon is optimistic that the valve and single bypass will take care of the issues. I should be fit to go home a week or so after the surgery.
This is one of those events that I expect to happen to others but omitted from my map. My journey thus halted, the washed-out bridge before me, I have but one option: jump into the raging river and trust the surgeon to have a good lifesaver and rescue team waiting for me downstream.
I put it all into God’s hands as they wheel me into the operating room that morning. I expect the worst, hope for the best. My mind races with all the unfinished projects at the house, unfinished manuscripts and unaccomplished dreams. They will have to await the outcome of the surgery. My heart has run out of time, this is my only shot at life.
As the drugs are injected and the bright lights over my eyes grow dim, I determine that if I meet God along this journey, there is one question I want to ask him.

What is truth?

I am an electron. In the alternate reality of anesthesia and whatever drugs are pumped into the body of a man whose chest has been opened and heart repaired, and while he recovers in intensive care, I am reduced to an electron trying to escape the maze of logic gates in a computing device.
For the next several days, I travel this circuit in a Fed Ex box destined for a boutique in Pittsburgh. In this reality, Fed Ex has developed smart shipping boxes with circuitry between the layers of cardboard. At my departure point in Japan, I am injected into this maze of diodes and logic gates, resistors and a trillion possible paths.
It is maddening, and I just want to escape the circuit, take on the body of a human and go home. And it continues for days: it is the only reality my mind knows during and after the surgery.

The early morning of February 21, my wife receives a text message from the hospital. During the night, I suffer another cardiac event. My heart fails while undergoing another catherization. I am placed on an external pump; my only hope for survival is an advanced heart failure unit. The nearest such facility is at Allegheny in Pittsburgh.
I recall nothing of this, not even the $32,000 helicopter ride. In my alternate reality, I gyrate between imprisonment in an electronic maze and hospice care at home.

Visitors over my body as I lie on a table in my office. I speak faintly to the former neighbors, coworkers, pastors and friends who travel from Ohio to say their goodbyes and extract mementos.
The pastor who told me I was going to die talks to me about Jesus and the afterlife. He did not hear my mother’s voice and is certain of my fate.
At some point, I get to pose my question, although I cannot say to who
. The answer is simple and complex.

“Truth is in the moment.”

I repeat it over and over. I don’t want to forget it, in the event I emerge from this alternate reality and have the opportunity to finish the unfinished life.

I wander into that brick Brethren church on a Sunday night and assist a young woman and her band with the engineering of a recording of her lovely Christian song. It is the most beautiful song I’ve ever heard. She snaps a picture of me with my dog for the CD jacket and delivers copies of the recording to our home. Indeed, I discover she is our neighbor and lives across the deep gully where the old Kingwood Railroad tunnel was built. Carved into the rock of the tunnel’s entrance is an elephant; the carving is being extricated by the young woman for $100, and she is incorporating it into the mantle of the massive fireplace being built in our living room.

Specialists in Pittsburgh offer Ruth little hope for my survival without a transplant. In the interim, an extra-corporeal life support (ECMO), takes over my heart function and a ventilator performs my lungs’ work. Counselors prepare her for the inevitability of being married to an invalid whose very existence will depend upon this machinery.
Daily she drives from our home in the mountains to Pittsburgh’s nest of interstates and side streets to be by my side and make crucial decisions about my care and our future. She takes off time from her job, which she started just two months earlier, to attend to these tasks. My father holds down the homestead and takes care of the pets in her absence. My son drives from Ohio to visit and help out in myriad practical ways; my step-daughter-in-law, Kristine Evans, comes from Wilkes-Barre, Pa., to encourage and support Ruth.
My father, Ruth and our friends from Ohio turn to God and call upon believers in their circles to do the same. Entire church congregations pray for me.
Each day brings a new complication and, oftentimes, a new procedure that involves going under anesthesia again, blood transfusions, more tubes and more equipment. I am told that at one point during my stay in Pittsburgh, four stands were required to hold the 16 bags of drugs, blood and fluids trickling into my body.
I kick off whatever coverings they place over my body and grab at the mass of tubes and needles penetrating and protruding from skin. I am restrained; my hands are placed inside boxing-glove-like mittens that leave my fingers numb. My upper lip is pressed between my teeth and the ventilator tube, resulting in a deep, painful cut.

Concurrently, my mind is dealing with its own reality.

I am back in Ohio with my father. The nation is in turmoil as youth have risen up against our generation, demanding relief from the onerous burden of student debt and increased taxes required to keep the older generation alive. Hunting down and killing the elderly has become a sanctioned pastime in my alternate reality, the only one my mind knows.
I witness the shooting of my father and desecration of his body. The undertaker publishes a full-page ad in the newspaper announcing that I will give the eulogy for my father. I am wheeled before hundreds of people at an outdoor gathering, but I cannot speak. For six hours, I sit before this restless crowd, speechless, motionless.
Punishment ensues. I and my wife are arrested for allegedly stealing the metal frame for an underground structure we are building onto our house to accommodate the nursing home and restaurant businesses that Ruth had to start in order to pay for my care. She develops a fashion line and makes commercials on the beach in California, propping me up in the background as a pathetic onlooker. She goes to work each day in a helicopter.
As we are booked on the theft charges, our accusers take turns abusing me. A malfunctioning CT scanner is used for my mug shot, and the sheriff repeatedly passes me back and forth through the radiation field, assuring me that the dose will be sufficient to induce brain tumors. A government official comes to my side and tells me his hobby is playing with needles. Dressed in a 19th-century undertaker’s outfit, he pulls out his collection and samples each artifact’s effectiveness and range of penetration on my body.
It is during this procedure that I notice my accusers are caring white notebooks. Someone whispers to me that if they have white notebooks, it is just a nightmare. I am given the mental tool by which to escape the nightmare, only to return to the alternate reality of an electron seeking an outle

Nightmares are nested within hallucinations.

I remain in the heart failure unit throughout the remainder of February and most of March, using up the 30-day Medicare limit. Each day brings a new challenge. As I gradually defy the odds, there is one fewer tube, one fewer IV bag. I recall nothing of it. My body is there, but my mind is trapped in these alternate realities. If I display any awareness of my surroundings and the gravity of the situation, I beg to go home.
It is out of the question.

My wife thought I was sleeping during most of my days in Allegheny’s heart failure unit. Rather, my mind was experiencing hallucination after hallucination, horror after horro.

Continued February 12, 2022