Asheviller: Ron and Valerie Move to Asheville…

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Sat
31
Dec '11

Western North Carolina Report – Our Yearly Christmas Letter

 

Signed, Sealed, Delivered

March 8, 2011 was a very good day. That afternoon, with the aroma of fresh landscape bark and drying paint wafting through the air, the moving vans arrived at our newly completed home and after a long, arduous, twenty-six months, our relocation from Seattle was complete. Okay, okay, it wasn’t quite complete (more on that, below) but it was close enough to declare victory. We were officially moved in!

The whole construction process went very well. There were a few gotcha’s and a few coulda-shoulda-woulda’s and we ended up taking eleven months instead of the planned ten, but all-in-all everything turned out great. Valerie still calls it “Ron’s house” but she kinda likes her mega-sized pantry, great kitchen, and outdoor pizza oven. We both especially love the screened porch and spent nearly every summer evening out there reading, watching TV, and listening to the cicadas.

Camp Bell – We Hardly Knew Ya

Although March 8 was a milestone for moving into our new home, we did have the little matter of selling good ol’ Camp Bell, our temporary fixer-upper house on the other side of town. Although Camp Bell had good bones, it was vintage 1975 and was fairly rough around the edges. We spent a year-plus in remodel hell (there, I said it) painting, grouting, spackling, flooring, fixing, wiring, plumbing, landscaping, etc. Our goal was to make Camp Bell spotless and move-in-ready so it would stand out from the many other comparable houses for sale in the area.

Over the year we watched the real estate sales numbers decline and cringed at our prospects. The move didn’t kill us, the construction didn’t kill us, the remodel of Camp Bell didn’t kill us, but sitting on an unsold Camp Bell in a tanking market for who-knows-how-long might do us in.

Well…Camp Bell went on the market on Monday, April 11. There was a showing on Saturday, April 16. We had an offer on Sunday, April 17. And, we closed the deal on Tuesday, May 17, five weeks after Camp Bell went up for sale. With the right house in perfect condition in the right neighborhood at the right price being marketed by a super real estate agent it is possible to sell a house in today’s tough market!

Unfinished Business

We’re not sure what took longer, packing 369 boxes or unpacking them. Needless to say, you know what we’ve been doing since we moved in. The phrase “Hey, do you remember this thing!?” has been said too many times to count. As of last week there was still one unopened box under the living room bench seat. It has a label on it so we could look up what’s inside, but, as they say, if we haven’t needed it by now…

One thing that contributed to our long unpacking process was that we chose not to finish the workshop when we finished the house. Ron had planned to work on it, himself, but March became July became September and he finally (with Valerie’s prodding) decided to just let Steve, our builder, finish it. Wow! That was a great decision. Steve does awesome finish work and the shop came out way better than we expected! We’ve spent the last few weeks unpacking those boxes, putting away long lost tools, and getting ready to be crafty, again.

Our Local Fauna – Bear and Delinquents

Although our house is just one mile from downtown Asheville we live in the woods. Lots are large and homes are sparse and the further you go up Town Mountain towards the Blue Ridge Parkway the fewer people and the more wildlife you see. Turkey, fox, coyote, bobcat, and black bear are common sights. In the late summer and fall as the bear search for food they become a bit too common. We had bear within peach-throwing distance of our house or along Serena’s walk nearly every day. Ron had to shoo one away that was sitting in our front yard eating berries off a bush, and Serena, on two occasions, chased one down the street. They are skittish and will respond to yelling and hand waving but it is a bit unnerving to walk out the door or round a bend in the road and happen upon a 250lb bear sitting there staring at you.

While the bear come from the woods, our other local fauna, delinquents, comes from downtown. We live in the only house on a dead-end street about 500’ from the end. The dead-end was created in 1977 when Interstate 240 was cut through the mountain and split Vance Gap Road. Our neighbors tell us that since then our street has been a magnet for mischief-makers. Luckily, we only had one incident during construction when someone stole the American flag from our front porch.

Wait, what? Someone stole your flag? Yep. It was a she, last January, in the dark of night. She ripped it from the flagpole and ran back to her car. We caught the whole thing with our security cameras. Ron reported it to channel 13 and sent them the video. Next thing we know the news crew is out front and Ron is being interviewed on TV to tell the sordid tale. They ran the story, “Our Top Story, Tonight”, for several days. The thief was never caught, but hopefully, with her picture splattered all over the TV, she and her family were thoroughly embarrassed.

Won’t You Be My Neighbor

Our neighborhood is not all bear and delinquents. The people who live here are fantastic and are a good match for us. Everyone’s laid back, friendly and inviting. Being on a quiet street, we have dog walkers going by the house throughout the day – Serena likes that. Wayne and Sally hold fantastic, over-the-top, dinner parties. We held a tamalada (a tamale making party) and have had neighbors over for ribs and pizza. Ron’s found a couple BBQ buddies and Valerie will be looking at starting a Town Mountain Book Club.

A Walk in the Woods

With our relocation fun behind us and our hiking boots unpacked we were able to get out and explore the area this summer. Every Friday the Blue Ridge Parkway rangers hold guided hikes on trails along the parkway and we made it out for at least a half dozen. The rangers talk about the history of the area, the geology of the region, and the plants and animals we might see. This was a great way for us to learn about the mountains of North Carolina and to get some exercise as well. We also went hiking several times on our own. One of our favorite hikes was on the Laurel River Trail, and old abandoned railroad bed, near the North Carolina/Tennessee line. On that hike we got to check something unique off our bucket list: “Saw a live rattlesnake in the wild!”

Other fun things we did…Asheville Tourist Baseball, Brewgrass Beer Festival, Texas Instruments/Siemens reunion, Ribfest, Asheville Food and Wine Festival, Western North Carolina Chef’s Challenge, Biltmore House, Grove Park Inn Gingerbread Festival, Belle Chere Summer Festival, Southern Highlands Craft Guild Show, Big Crafty, numerous plays and shows at the Diane Wortham Theatre, and last but not least…Discount Shoes! Hey, even Ron has been seen shopping there!

Miles and Smiles

It had been a long long time since we had been on a vacation so we made it a point to get away this year. Our first trip was to visit Cara and Mike in Phoenix. We had a great time doing the educational-tourist thing visiting Meteor Crater and the Titan Missile Museum (two must see sights). We got our vortex spiritual fulfillment walking around Sedona and, Cara and Mike, being fellow foodies, took us to several great restaurants for hot and spicy Southwest food.

In November we returned to St. John, USVI, for ten days. It was our fourth visit! We love the place for the views, beaches, snorkeling, food, and relaxation. It’s so much easier to get to now that we’re on the east coast. We rented One Particular Harbour, a house that we stayed at in 2004, high on the hill overlooking Coral Bay. On this visit we found a couple new bays to snorkel (glad we had a Jeep) and we sampled true local food at two hole-in-the-wall restaurants – Clean Plates (love that name) and Vie’s Snack Shack. We had a surprise, but very welcome, guest this time. Valerie’s sister, Pat, called the day we arrived and said she was coming, too. To quote Southwest Airlines: “Gotta Get Away!”

In June we attended a mini-reunion of a bunch of the people we worked with at TI and Siemens. My how we’ve grown up. We were just kids back then. It was great fun reminiscing old times and hearing what everyone has been doing for the last twenty years. The common theme seems to be that they’re all very ready to become empty-nesters.

Living closer to family we had lots of visitors this year: Mom and Dad Patton (twice); Linda, Steve and Sarah; Pat and Jack; Cindy and Jeremy; Aunt Edith and Cousin Denny. We also made some family visits: Ron to San Antonio and Pittsburgh and Valerie to Indiana.

Next Year

What’s in store for next year? Hmmm…Making a trip to Seattle. Crafting in our new shop. Celebrating Ron’s big Five-Oh birthday. Volunteering. Taking classes at Blue Ridge Food Ventures. Chasing Bear. Europe? Ron might even look at finding a paying gig…

Merry Christmas and Happy New Year

Ron and Valerie

Fri
24
Sep '10

I Used My “Be Stupid One Time” Card

It’s Friday morning and I’m still here at Mission Hospital. Overnight has turned into three days! My cardiologist really thought it was just a dehydration episode but he referred me to an electrophysiologist cardiologist (expert in the heart’s electrical signals) just to be sure. He’s ordered a battery (pun intended) of tests and, unfortunately, with the time it takes to get scheduled for one test followed by the time it takes for a doctor to look at the results…well, that’s why I’m still here. Sort-of.

Actually, I passed my regular echocardiogram and my stress echo (13.7 minutes jogging on the treadmill with 75% ejection fraction thank you very much) and my carotid artery test, but they found a little blip on my 15-lead EKG. It’s called an inverted T-Wave and having one usually means that you’ve had some sort of catastrophic event occur to your heart. (Hey, doc, I had open heart surgery a year ago to repair a bad valve–that might be the reason.) Unfortunately, that message fell on deaf ears and I became an episode of TV’s Houseobscure medical condition relentlessly investigated by genius doctor. So, 2½ days later, here I sit, after a battery of Microsoft Alumni insurance busting tests, waiting to see if I need just one more test to discover why my T waves are upside down…more to come…

At 11:30 this morning (Friday) last night’s cardiac MRI came back negative for a rare, but dangerous, heart condition. At noon, today, I was given an all-clear, no limitations, discharge notice. I was also given a copy of my EKG to show to any future emergency doctors. Valerie will be giving me bottles of water to drink and I’ve been told that I’ve used up my only “Be stupid one time post heart surgery” card. On a positive note, at least I know, without any question, that my heart is A-OK.

Back to wiring, tomorrow!

Wed
22
Sep '10

Wiring Problem (?)

Ah, nothing is ever simple. On Saturday, Dad flew down to help me do the low voltage wiring on our house. It’s no small task with me trying to “future-proof” by running wires for cable TV, satellite, network, telephone, alarm, security camera, whole-house-audio, doorbell, even a weather station. We worked all day Sunday, Monday, and Tuesday pulling bundles of wire from the mechanical room to each room in the house. Dad mostly worked at the spools of wire, feeding wire to me as I routed it across the ceilings and through holes I drilled in the walls. It was hot (mid 80′s) both days and I was soaked with sweat from all the trips up and down the ladders and back and forth to the subs answering questions. We made good progress and called it a day about 5pm on Tuesday.

We returned to Camp Bell, got cleaned up, and Valerie, Dad, and I went to Marco’s for dinner on their outside patio. Dinner was good, I had a hot Italian sandwich with potatoes and a Wedge IPA beer. Dad paid the bill and we sat around for a few minutes planning our work for the next day.

I began to feel light-headed and started to get tunnel vision. I put my finger to my neck to feel my pulse, leaned over to Valerie and said, “I’m not feeling well,” and passed out. I awoke on the ground staring up at people leaning over me (Valerie apparently caught me and guided me slowly to the ground). A short time later, out I went, again. The next time I woke I was covered in vomit and heard sirens. The EMT’s arrived and started checking me. I was woozy but was able to answer their questions and passed their stroke tests. Then, I remember saying, “I’m going out again,” and out I went. I awoke the third time covered in more vomit and hearing talk of loading me up in the ambulance. A few minutes later I was wisked away to Mission Hospital.

I was awake for the entire trip and was starting to feel “better.” They were in the process of moving me from the EMTs gurney to the ER bed when I said, “I’m going again” and bam, lights out. I awoke covered in even more vomit (it was a big dinner) and a flurry of ER activity. But, I could tell that, this time, I was awake and feeling better. No more passing out.

After lots of poking and prodding, answering questions, and some quick tests the doctors declared, “We don’t know.” The thinking was that I overworked myself, didn’t drink enough liquids and became dehydrated, took my heart pills on an empty stomach before dinner, and had a beer (mission failure is never caused by just one thing). My heart rate and blood pressure dropped and out I went…and again and again and again. But, because of my heart history—once a heart patient, always a heart patient—they had to admit me for evaluation.

To be continued…

Sun
11
Apr '10

It’s not 50% Because It Can’t Be 50%

Tuesday, March 30, was the 6-month anniversary of my heart valve surgery! I saw Dr. Usedom, my cardiologist, that day and had an echocardiogram on Thursday. This time he scheduled me for a 3D echocardiogram to more accurately measure my heart function because my high activity level and general health don’t mesh with the “supposed” low ejection fraction measured since my surgery. I should have problems climbing stairs. Hiking 7+ miles and rebuilding a 9′ high deck should be impossible.

During the test I carefully watched the monitor. 3D echo’s are way-cool technology. You’ve probably seen pictures of fetus 3D ultrasounds, the ones where you can make out the baby’s features. It’s the same technology for the heart. The details are amazing and it can measure the heart’s function perfectly. For all you geeks, or budding geeks (nieces and nephews – listen up!) it uses calculus, specifically Simpson’s Rule, to calculate the volume of the heart’s left ventricle just before the contraction and at the end of the contraction. The difference between the two is the amount of blood that was pushed out and gives you the ejection fraction number. A 2D ultrasound can only use Simpson’s rule in 2 dimensions and makes an assumption about the size and shape of the ventricle. A 3D ultrasound takes infinite 2D slices all the way across the ventricle and more accurately computes the volume. It also looks at 16 different segments of the heart and tracks their motion to identify any that might not be contracting like they should.

What I saw on the monitor was EF=51% and that all the segments were contracting and relaxing together! Normal EF is 50%-60%.

Fast forward to yesterday. Dr. Usedom called with the results. He said that one reason it took so long to get back to me was that he wanted to personally look at the pictures. The radiologist who read them came up with 50% and put that number in the report. Dr. Usedom couldn’t believe that 50% was correct because he didn’t think it was possible to get there from where I was last fall—in the danger zone of 25%-28%. That level of improvement just doesn’t happen. So he looked at the pictures, himself, and applied a little bit of “art” to the “science”. He feels that the one area of my heart that post-surgery wasn’t contracting at all is now contracting, but not as much as he would like, so he’s knocking 5% off of the radiologist’s number and calling it EF=45%. Spoil sport! He says my valve repair looks good with only “trace” leakage and that overall my heart is in good shape. Yah! That explains why I feel great. Smack me on the forehead, I’m healed!

He wants me back for an office visit in three months and may at that time drop my digoxin. There’s controversy as to whether it’s actually beneficial so we might try cutting it out. He also said that we might eventually consider dropping the carvedilol and the lisinopril. It all depends if my heart has actually healed or if the drugs are just making it easier for my damaged heart to pump. I expected to be on meds for life so I won’t be disappointed if that’s the case, but it sure would be nice to be off them. All-in-all I got very positive news. He’s happy. I’m happy. It’s time to visit our new Cook-Out restaurant for a footlong Cookout-Style hot dog (chili, slaw, mustard, and onions)!

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Tue
29
Dec '09

I Got 41% On My Pop Quiz!

This morning I had an appointment with my new Asheville cardiologist, Dr. Usedom (pronounced You’s-dom, like you’re from New Jersey and asking “Where you’s goin’?). We had an in-depth 45min conversation about my heart and I was happy to receive a third opinion that seemed to be more optimistic than the ones I’d received from my Seattle cardiologist and surgeon. Dr. Usedom wants to up my dosage of carvedilol to see if I can tolerate it. Right now I can get dizzy and see black if I quickly stand up (orthostatic hypotension) and that could get worse with an increased dosage, but carvedilol is the medicine for rebuilding the heart and more is better. We’ll try it and see. I won’t use the chain saw (like I did yesterday) for a while until I know how it affects me.

My heart rate has been steadily dropping since my surgery. It was in the 90′s in October, high 80′s in November, low 80′s in December, and this morning was 79 at home and 70 in his office. That could be a sign that my heart is pumping more efficiently. More blood pushed per beat means that my heart doesn’t need to beat as often to push the same amount of blood out to my body. One way to check that is to have an echocardiogram. I figured that I’d need to schedule one for late January, after we returned to Asheville, but they had some cancellations and were able to fit me in, today, right after my appointment.

As we all know, the technician is not allowed to tell you what they see. But, I’ve had enough echo’s done over the last couple years that I know what they’re doing and what’s on the screen. When she was measuring the SV (stroke volume) and EDV (end-diastolic volume) I looked up and saw EF=41% on the screen! Hooraw! Seven weeks ago my EF (ejection fraction) was 25-28% and my cardiologist was talking about a pacemaker. Heart-failure territory is anything under 35%. Normal is 50%-65%. I ain’t normal, but I ain’t diein’ either. Now, Dr. Usedom still has to review the test results and make his own measurements and conclusion, but for now, I have my hopes up that my heart is mending and that 41% is a good number for a pop quiz that I didn’t even study for.

P.S. When I took off my shirt and laid back for Dr. Usedom to listen to my chest, he asked, “Where’s your incision?” He knew I had my surgery done robotically but probably sees so many 10″ sternotomy scars that he didn’t expect to see nothing but a few little scars on the right side of my chest. Thank you Dr. Siwek!

Thu
3
Dec '09

You Know You’re an Asheviller If…

We bought our annual passes to the Biltmore, today. I also stopped in at Asheville Cardiology, filled out the new patient forms and scheduled an appointment with my new cardiologist for December 29.  We had our heating oil tank filled, subscribed to the daily paper, and have been busy working on Camp Bell. I think that makes us Ashevillers.

Oh, Asheville Cardiology is IMPRESSIVE! It encompasses an entire building. There are 29 cardiologists and they do everything heart related including stents, nuclear imaging, and pacemakers. They even have an ambulance entrance. It’s one-stop shopping for heart care. There were at least 40 people in the waiting room (as is typical, I was the youngest and most in-shape looking). Their location is now programmed into our Jeep’s GPS.

Thu
12
Nov '09

Spokane to Bozeman

My surgeon said that my ejection fraction is nothing to worry about…yet. It’s low, but he said to give it 3-6 months, have another echo, then we’ll know if my heart is recovering or not. He isn’t convinced that the numbers we have now are worth acting on as they were taken just three weeks after surgery (American Heart Association guidelines). He was happy that my heart had already shrunk so much so quickly and said that doing so was a good sign my heart might get better. But, he couldn’t guarantee an outcome. Basically, he said, give it time, don’t worry, be happy. So, we turned the Jeep eastbound at 11:00am!

We pulled in to Bozeman at 7:00pm after multiple stretch and pee stops, a gas up, an unsuccessful search for a dog park in Missoula, and a late lunch. Here’s the current Bozeman weather report:

A Winter Storm Warning remains in effect until midnight
MST tonight for Madison and Gallatin counties.
Moderate to heavy snowfall will continue across much of
Gallatin and Madison counties into the early evening hours.
Snowfall rates up to one inch per hour can be expected
through 6 PM today... then snowfall rates will slowly begin
to diminish in intensity through the evening hours. By late
this evening... expect storm total snowfall amounts to
range from 18 to 24 inches at lower elevations... including
in the cities of Bozeman and Ennis... to around 30 inches
in the mountains. Additionally... expect visibilities to be
reduced to less than one quarter of a mile at times.

Merry Christmas! It’s a winter wonderland! We’ll take some pictures and post them tomorrow. Hopefully I-90 will be cleared by late morning. The plans are to take Serena to a dog park to play in the snow and wear herself out then get back on the road, weather permitting. Worst case, we spend an extra day in Bozeman.

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Fri
6
Nov '09

Eastward Ho!

Wednesday after lunch we are handing the house keys to our realtors and heading east. At least that’s the plan. We’ve tried this before and, well, you can read what happened between the end of August and now. We’re tired and frustrated of not being able to live in our house—keeping it spotless and showing it at a moment’s notice. Five months of “For Sale” and we are at our breaking point. We need to get outa here!

Tomorrow (Saturday) we have FOUR! showings starting at 10:00am. Don’t know what that’s all about, but hey, people are looking and that’s a good thing. Sunday from 1:00-4:00 is an open house so we need to find something to do both days this weekend. Molbak’s Poinsettia Festival begins Saturday and we’ll be there. We may then say “No Showings” until we leave on Wednesday to give us time to pack and to clean the house one last time. You watch, we’ll get ready to leave and someone will make an offer on the house and we’ll have to cancel our trip. At this point, I’d believe anything.

We’ll leave Wednesday afternoon and the first stop is Spokane. I have an appointment with my surgeon Thursday morning. After that we’ll continue heading east with the route and stops determined by the weather. Around the 16th or 17th we’ll arrive in Indiana. We’ll spend a week or so through Thanksgiving with Valerie’s family then after turkey day we’ll drive down to Asheville. Our return date is unknown but we’ll be there at least a couple months. We have tons of work to do on Camp Bell but we plan to enjoy the holidays in Asheville, too. There’s lots new to explore and experience. Can’t wait to see the National Gingerbread House Competition at the Grove Park Inn and Christmas at the Biltmore. Somewhere in there I’ll figure out how to get an out-of-town echocardiogram and maybe our house will sell and we can start building and moving. After the last several months I’ve given up trying to plan things. It’s time for an unplanned, unexpected, positive adventure!

Thu
5
Nov '09

Fox Glove and Pit Vipers

In the last two days, I’ve had 90 minutes of consultations to get more information on my condition. Yesterday I spent 60 minutes with Dr. Maidan’s cardio nurse and today I had 30 minutes with Dr. Maidan. Bottom line: they’re not concerned. This happens, sometimes, after valve surgery. The heart simply doesn’t squeeze like it should. Yes, I’m technically in heart failure (ejection fraction <35%) but Dr. Maidan said that I’m not the typical heart failure patient. I’m not overweight, my arteries aren’t clogged, I didn’t have a heart attack, I don’t smoke, my physical recovery and activity are fine, etc. etc. He can’t guarantee that my heart will get better, but he feels that no matter what happens that it can be maintained with drugs and, if necessary, a biventricular pacemaker. He thinks we’ll know in three months or so, after another echocardiogram, what the prognosis will be.

foxgloveIn the last six weeks I’ve gone from only taking a daily baby aspirin and a multivitamin to being the proud owner of two, AM and PM, 7-day pill organizer boxes. Yes, I know, most of you are saying “been there, done that” but it’s all new to me. Bah humbug. Interestingly, two of the three drugs I’m on were discovered and derived from natural poisons. Digoxin, used to slow and strengthen the heart beat, comes from the foxglove plant (Dead Man’s Bells, and Witches’ Gloves). And, Lisinopril, a blood pressure medication, comes from the jaraca, a venemous pit viper found in South America. Both of these drugs, plus carvedilol (AKA Coreg), are used to treat heart failure. In trio, they make the heart beat stronger and make it easier for the blood to move around the body. Plus, Valerie has me on fish oil pills, CoQ10, and magnesium—all good for the heart. Better health through pharmaceuticals, eh?

The bottom line is my cardiologist is comfortable with my condition. He thinks it’s manageable and that it might improve but he can’t guarantee anything. I should continue taking my pills and come back for another echocardiogram in a couple months. Oh, and see my surgeon in Spokane for my post-surgery follow-up next week—more on that in tomorrow’s post. Que Sera Sera.

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Fri
30
Oct '09

Angiogram Take 2

Yesterday’s angiogram was uneventful. I checked in at 7:45am, was on the table at 10:30am, the actual procedure was over in less than 10 minutes, and I was discharged by 3:30pm. The news (I’m done labeling my heart test result news good or bad) is that my heart arteries are still clear. There was no damage done to them during my surgery. But, the other news is that my ejection fraction is only 28% when it should be greater than 50%, which it was prior to the surgery. Anything less than 35% signifies heart failure and has lots of risk associated with it. My heart (specifically the left ventricle) is simply not pumping out the volume of blood that it should. This can be due to lots of things — one possibility suggested by Dr. Maidan, my cardiologist, is that my heart was damaged during surgery because it was on bypass for so long or because the bypass was stopped and then restarted. But that’s just speculation. I’ve been reading everything I can find on the subject and found a couple studies that did show in some people a drop in ejection fraction after mitral valve surgery. That doesn’t mean that its okay, just that it’s a known possible issue. Valerie asked Dr. Maidan whether exercise would help, and he said, no, though it wouldn’t hurt as long as I could tolerate it. He also didn’t give any indication that the number was misleading and due to the test being done only three weeks after surgery or that the numbers would improve.  However, several of the nurses who cared for me during my angiogram dismissed the problem and said, “just give it time.”

This is serious enough that I need to get second opinion so this morning I called Dr. Hill’s office to see if I could get him to review my test results and offer me some education and advice. Dr. Hill is the cardiologist who saw me while I was in the hospital for surgery. He’s a really nice guy, down to earth, and I think more experienced with valve repair patients than my doctor and other cardiologists here in the Seattle area — just because they do more of them in Spokane. I left a message and his nurse is to call me back. I don’t know if I can just have my records sent and have a phone consult with him or if I’ll need to go to Spokane for an office visit. Doesn’t matter. I need to talk with him. More information is always good. For now I’ll just keep walking and exercising and taking vitamins and supplements to improve my heart health. Gotta keep my spirits up, too, which right now is difficult. Too many kicks to the gut recently.

So as not to make this post so negative I will say that having robotic surgery out of town and then going to a local hospital where it’s not performed, really makes you the “celebrity” patient. Every nurse and tech quizzed me about the surgery and my quick recovery. Some wanted to see my incisions. They were really impressed with my heart-lung bypass scar in my groin with one saying he didn’t know it could be done “down there.” The funny moment came when my nurse, Kevin, was filling out the admission paperwork and was asking about my surgery. He asked when I had it done and I said, “September 30.” His next, totally straight-faced, question was, “what year?” Guess I don’t look and act like someone who had valve surgery just four weeks ago.

Wed
28
Oct '09

#%^*&)!;”[\}]@*&%^ #@+|?>;%@# !!!!!

The good news is that my valve is fixed and my heart has already reduced in size, a lot, back towards normal.

The bad news is that my heart function (the actual pumping of blood) is now less than it was before the surgery. My heart muscle isn’t doing the job that it should. This could be due to an artery being damaged during the surgery, the heart being stressed/damaged from being on bypass for 4 hours, or who knows what?

So, tomorrow at 7:45, I go back in for another angiogram to see if there is some sort of blockage. If there is blockage, doctor Maidan says that he can open it back up and that should restore the heart function.

If there is no blockage and it’s just that my heart muscle was damaged from the long surgery then I need to monitor it closely – maybe an echocardiogram  every month or so to see if it’s getting better or worse. If it gets better, great, if it doesn’t or gets worse then I will need to get a permanent pacemaker to make my heart squeeze harder.

 It ain’t over yet…

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Tue
27
Oct '09

Recovered?

Tomorrow is three weeks post op. In the last 48 hours I have: Helped Valerie (just a little) dig a 6′x6′x1′ deep hole at the back corner of the house; carried five 40lb bags of rocks from the driveway down to the hole; installed the plumbing for a yard drain in the hole; cut out, removed, and replaced a rotted out sill plate; removed, replaced, and painted 24′ of siding; made numerous trips to Home Depot and Cedar King. Oh, and I vacuumed the house and swept the deck for this morning’s showing. Needless to say, I have slept really really well. Valerie says I should have milked the recovery more. Now the gig is up — no more babying.

I see Dr. Maidan, my cardiologist, tomorrow at 3:00. He’ll tell me how I’m doing and hopefully give us the okay to drive to Asheville and spend a couple months. My only real concern is my heart rate which is still in the 80′s and low 90′s. Maybe that’s okay or expected but it’s something to discuss. My BP is low, sometimes less than 100/70, but that is due to the medication I’m on to keep my heart from working too hard during recovery. I have to be careful when I stand up quickly because everything goes black for a few seconds. All in all, I can’t complain being just three weeks out.

Mon
19
Oct '09

I Feel (Almost) Normal

I walked Serena last night for 45 minutes—alone. Valerie was comfortable (not really) letting me go myself as long as I stayed on the streets. At 5:30 our neighborhoods are pretty busy with people coming home from work, walking their dogs, etc so if I passed out I’d be quickly found. But, I felt fine. I wasn’t winded. I wasn’t light headed. I felt (almost) like I did 3 weeks ago. The only indication of my surgery is when the incisions rub against my shirt. Now, I doubt that I could break into a sprint, but I had a good pace going and was sweating a bit. Gotta do more and more every day.

My pulse rate has dropped slightly but it’s still in the low 80′s most of the time. It doesn’t go up much when I walk. Maybe that’s what my “Coreg” is supposed to do…regulate/moderate my heart rate. I’ll find out more, maybe, on Wednesday when I go for my echocardiogram.

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Tue
13
Oct '09

So Far, So Good

I had an appointment today with my cardiologist’s nurse. Everything looks good: EKG, blood pressure, incisions, heart and lung sounds. The only thing out of the ordinary is my heart rate. It was 91 in the office and the lowest it’s been at home since I was discharged is 83. It’s probably that my heart is just irritated from the surgery but they would like it lower so that my heart isn’t working so hard. The medications I’m on should be doing that but my dosages are very low and can’t be increased because they also reduce my blood pressure which is around 110/75. So, for now, she just wants me to monitor my heart rate and also make sure that when exercising that I don’t get it above 120. If it doesn’t drop over the next couple weeks then I may get switched to another drug that has less impact on blood pressure. So far, fingers crossed, I haven’t had A-Fib. I have a 3-month risk window where it could occur. If it does, I need to get to the hospital and get “converted” back to a normal rhythm so blood clots don’t form. That’ll hurt.

But, I’m walking at a normal pace for an hour each morning. Sometimes I add in another 30 minutes in the evening. If I’m not moving I have zero pain but once those arms start going and my right arm rubs against the incisions…ouch. I also pop a Vicodin when I go to bed and take another in the middle of the night. That helps me sleep through the pain of rolling around but man, oh, man, those Vicodin dreams are long, crazy, multi-chapter, 3-D, picture shows.

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Sat
10
Oct '09

Healing and Heeling

On Wednesday, Thursday, and Friday I walked for an hour at Marymoor Park with Valerie and Serena. Friday’s walk was with no bench breaks! I was walking or standing the entire time. Of course I’m still at a leisurely stroll but I’m happy to be able to walk for that duration. Today we’re back for another morning Marymoor walk and I’m going to add in an evening neighborhood walk, too. We have a house showing from 6:00-7:00pm so that’ll work out well.

Mornings are still painful because I (apparently) keep trying to roll onto my right side while I sleep. That’s where all the incisions are and by morning they are most irritated. Maybe I’ll try setting the alarm for 5:00am, taking two Vicodin, and seeing if that will lessen the pain when I wake up a couple hours later.

I am HUGELY aware of any transient pain in my chest. I got zero indications from the surgeon, cardiologist, or discharge nurses that I have anything to worry about but man it’s scary when I get a chest pain for a few seconds. It’s probably just healing pains from being internally manhandled for several hours but I feel like grabbing the phone and dialing “9-1″ and hoping I fall on the last “1″ key if I pass out.

I have an appointment with my cardiologist’s nurse on Tuesday. I also have an appointment with my primary doctor on Wednesday but I think I’ll cancel that since I’ll get into the cardio office before him. I have an echocardiogram on the 21st and an appointment with my cardiologist on the 28th — my 1-month anniversary. I’m hoping that he clears me to drive to Asheville in early November. Gotta get this Asheviller show on the road!

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Thu
8
Oct '09

It’s the Simple Things

Over the last couple days I’ve been making a list of the simple things (quotations, observations, bits of wisdom, etc) that I witnessed while in the hospital. Some are funny, some serious, but they are all definitely things I want to remember. Check back occasionally as I’ll add to the list as I recall more. Here goes, in no particular order:

•  On Thursday, the day after surgery, I kept getting the hiccups. Needless to say, that was painful. Valerie found this solution that, thankfully, worked every time. The 30-Second Hiccup Cure… Eventually, they stopped completely. Whew.

MrT• Prior to surgery I received an armpit to toe body shave. That’s done so they can sterilize your skin all over with a betadine bath in case the surgery needs to change and they have to cut or puncture you someplace other than planned. However, armpit to toe is not exactly correct. They only did my right armpit (where one robot arm went in). The body barber explained that after surgery I could choose which way I wanted to go. And, she didn’t shave my privates, entirely. I got what they call a “Mohawk”. Think Mr. T, but “down there” instead. Guess I get to choose if I want to keep that or not, too.

• You know how nursing homes are filled with elderly woman and maybe one or two elderly men? Well, cardiac care floors in hospitals are filled with elderly men and maybe one or two elderly woman. Hmmm.Roncutus of Borg

• I know that my family traveled at large expense and time to be with me and I REALLY appreciate that. If you feel that you were “slighted” and didn’t get to spend enough time with me after surgery, I apologize. I didn’t limit visits because I don’t love you, I limited visits because I was recovering from surgery in the cardiac care ward and needed privacy and lots of rest. It was stressful for me to wake up from my frequent naps to see everyone sitting in chairs staring at me. I knew that you were there with me whether you were in the hall, in the lobby, in the cafeteria, or wherever. I can’t thank you enough for putting your lives on hold to support me and Valerie through this difficult time.

• Valerie was my rock. She held my hand, fed me ice chips, and kept a cold cloth on my head the first night in ICU. She also sneaked me some ice water but got caught by the nurse.

• The nurses in ICU and CICU were the best. Besides all the medical stuff, they even took the time to microwave my orange sherbet for a few seconds so that I could more easily eat it to soothe my raw throat caused by the breathing tube.

Locutus of Borg• “I am Locutos of Borg” (I was told that I said this while coming out of anesthesia in ICU).

• The last words I remember were by the anesthesiologist just after 7:00am, “Okay, we’re ready…”  My next cogent thought was seeing the clock on the wall in front of me at 6:30. My brain struggled with that since I expected to be awake shortly after noon. I remember thinking, “Is that pm?” “How could that be?” “Is that clock right?” “What day is it?” Then I was out again.

• My other recovery thought, though I don’t know if it occurred before or after 6:30pm, was Valerie smiling and giving me the thumbs up—our preplanned, unspoken, signal that my valve was fixed rather than replaced.

• Thursday morning, the day after surgery, the nurse removed my urinary catheter (all you guys can cringe now). A few hours later I hadn’t been to the bathroom, yet. The nurse told me that if I didn’t pee on my own, soon, that she was going to have to put the catheter back in (all you guys can really cringe now). I grabbed my bottle, went to the bathroom, and thought of all things liquid. I stopped short of running warm water over my hands. In a few minutes I managed to produce about 1/2″ of highly concentrated pee and proudly handed it to the nurse, telling her that she scared the piss out of me. It was probably a very old joke for her, but I thought it was funny.

• “That’s not a cough, that’s a throat clearing!” is what one ICU nurse told me when she was trying to get me to cough up the mucus in my lungs.The Christmas Tree Painful is an understatement.

• The super IV attached via two punctures into my jugular and stitched into place so it wouldn’t pull out was named by my family “The Christmas Tree.” I guess, maybe from the right angle, it sort of looks like a triangular pine tree with lots of pretty colors on it.

• “I underappreciated the severity of his valve problem.” Surgeon Dr. Siwek to my family after the surgery.

• I was supposed to have four incisions; one 2″ in the goin for the bypass, one 1″ in the right chest for the camera, and two ½” in the right chest for the robot. But, because Dr. Siwek wasn’t happy with his initial fix (and they had to remove everything in order to do the echocardiogram to determine that) I was essentially operated on twice and have seven incisions; three extra in the right chest.  I’ll take that over sawing through my sternum any day!

• While I was in the ICU, I was directly connected to a heart monitor, a fancy 19″ LCD screen that displayed all my vitals. The morning after surgery I was sitting up and feeling fine when all of a sudden the monitor started flashing red, beeping wildy and spitting out a paper EKG. I’m like “Holy shit, that’s me!” The nurse came running over and looked at the printout. She showed it to the other nurse and they shrugged their shoulders and said, “It’s okay, just a rapid beat for a few seconds. Not unexpected.” For a moment I thought that was all she wrote.

• I’ll apologize now to all the members of the Microsoft Alumni Network for causing their health insurance rates to go up next year.

Wed
7
Oct '09

Just a Walk in the (Dog) Park

I just wanted to drop a quick note to say that I’m back and feeling good and to THANK YOU for all your wonderful thoughts, prayers, and support for Valerie and me. We couldn’t have gotten through this without you. I’m writing this 7 days and 2 hours from when I awoke after 6½ hours of surgery and 4 hours of heart-lung by-pass. Today I walked (slowly) for a little over an hour at Marymoor Park. It was flat and I was no speedwalker, but I was thrilled to be this mobile so soon after surgery. I have very little pain throughout the day but mornings are a bit rough – that’s what the Vicodin is for. Hopefully in a few weeks I’ll be better than I was before the surgery.

If you know anyone who might have heart surgery in their future I can’t recommend enough Dr. Leland Siwek and the Heart and Vascular Institute at Providence Sacred Heart in Spokane. They are truly first class.

Again, thank you for all your support!

Remember, the answer to the question, “Would you like more morphine?” is always “Yes!”

Ron and Valerie

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Mon
5
Oct '09

Home Again

We are leaving Spokane today; we may not make it the entire way home. It is noramally a 4.5 hour  drive, but we need to stop every 45-60 minutes for Ron to move and walk. 
All is well.

6 pm – we made it home!

Today’s blog by Valerie

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Sun
4
Oct '09

Recovery

Update on the hole count: 8 incisions and 8 major punctures (and countless stabs for blood draws, glucose tests, stitches…).

Ron’s plans for today (of course he has plans): Walk (still a shuffle), Sleep, Eat; repeat. 

Today’s blog by Valerie

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Sat
3
Oct '09

Ron Has Left the Building

At 12:30pm Ron was released and shuffled out of the hospital.  He is still required to stay at the hotel across the street until Monday; but now he can finally sleep.

Todays post by Valerie

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Fri
2
Oct '09

Ron’s Walk-About

Ron is recovering quickly; by 3:30 pm he has completed his 3 required walks (shuffles) of the day.

Ron will probably be released from hospital care on Monday. I will be staying here until I’m sure that he’ll be fine on the drive back; Ron may have other plans, but he’s at my mercy. I love it.

Ron’s Post-Surgery Wisdom:
Keep your body healthy. It seems counter-intuitive, but the poorer your health, the fewer surgical choices you may have, and those choices are likely the most invasive with longer recoveries. Because he was in good health with clear arteries, he was a candidate for less-invasive robotic surgery. 

Today’s blog by Valerie

Thu
1
Oct '09

Ron Unplugged

2 am Ron had an x-ray while in the bed. To protect the patients below, the bed has a lead pad.
4:11 am I woke and called the nursing station to see how he was doing. They tell me he is sleeping well; latter Ron said it wasn’t possible to sleep.
The monitor started flashing red, the nurses showed up; checked it. “It’s okay, just a rapid beat for a few seconds. Not unexpected.”
Ron’s day nurse is Jane; CICU nurses are on 12 hour shifts and have 1 patient.
Ron does his breathing exercises or incentive spirometer every ½ hour.
7:30 am Ron is sitting up having “finger foods”: blue GoGurt , mozzarella stick… .
I put more cold washcloths on his head and get him some ice chips.
8:15 am Dr. Siwek visits on rounds, mentioned that he told family that you may not bounce back as quickly, doing well.
8:30 am Ron’s family visits.
10:30 Ron’s family goes to the lobby and gift shop; I stay while Ron has procedures: listens to chest (he has a rub in his cardiac sack – it’s causing breathing pain), sitting up, chest tube used to take blood. Ron is on Lasix to get rid of tissue fluids; as Jane said “he’s peeing like a horse” when she checks his bag.
I ask about the clock on the wall, Luis had wanted to know what it was. Jane says it’s a code clock and tries it out. They don’t use it anymore.
11:00 Jane removes Ron’s neck IV. There are only 2 holes that go into the same vein a few inches apart. The IVs are plastic tubes that are taped and stitched in. Jane complains that the doctors put the knots close to the skin; she couldn’t cut them with scissors, she used a tiny scalpel.
1:00 pm Ron got in the chair and back into bed by himself.
Ron has lunch.
Ron had me check the neck IV holes and chest tube hole. There was blood on the pillow; Jane said it was okay… it was old blood.
Ron gets insulin shot; before it was given in a drip, but he is disconnected now.
Ron’s chest tube (on right side) and catheter removed. UNPLUGGED
2:30 pm Ron has a bit of a headache.
4:00 pm Dr. Hill, cardiologist, discusses cardio plans:
Ron will be on meds to restructure and reduce his heart size.
Will check his heart size in 18 months.
Waiting to have surgery until the technology develops is acceptable.
Insulin levels are watched to keep the sugar levels low and improve healing.
5:00 pm Jane calls for transport to take Ron to the 6th floor.
6:00 pm Jane got tired of waiting for transport; she found an old wheelchair and took Ron to the 6th floor.
Pain level is 0; 1-2 when he breaths in.
Ron walked look for first time.
After dinner blood sugar was high (the cardiac menu had a huge chocolate chip cookie) – 186 had second insulin shot when sugar stayed high.
9:00 pm The nurse gives Ron his evening pills: lycenopril, lasix, asprin, co-reg, senna, ibuprofen, and a giant, awful tasting potassium pill.
She tells Ron he still needs to pee after catheter removal.
Ron drinks lots of water and pees a little (dark).
Ron walked the loop; his second walk.
He needs the pain pill after the walk.
11:00 pm Ron goes to sleep.

Today’s blog by Valerie.

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Wed
30
Sep '09

Achy, Breaky Heart

Hole Count2 (as of 7:15am): 1 small pain killer injection for 1 HUGE IV needle.
ID Bracelet Count: 3 wrist, 1 ankle

10:55 -  Ron wants to sleep; the nurse turned down the lights. I returned to the hotel.
10:50 – Ron uses the spirometer again; the double dose of morphene makes it easier.
9:00 – Ron’s big outing:  sits up, moves to a chair next to the bed and then back into bed (with assistance).
8:30 – Ron’s entourage leaves the building.
7:00 – Ron is talking to everyone now.; he’s looking much better. Luis give Ron the highlights of his procedur; the 4 hours on heart-lung by-pass shocks him.
6:30 – Ron feels awake now. He is surprised that it is 6:30 pm, expecting it to be about 2 pm. 
6:15 – Luis convinces me to take pictures of Ron. Mine are blurry, so he takes them. I won’t post them unless Ron agrees.
6:00 – Checked Ron again. He is off the ventilator and breathing on his own through the breathing tube.
5:20 – Held Ron’s hand; actually just his fingertips (too many tubes). Told him thumbs-up twice (our signal for valve was repaired). The nurse will take him off the respirator soon to see if he can breathe on his own. After 20 minutes of breathing on his own, she will check his blood O2 to make sure he does need to be hooked back up.
5:00 – Checking on Ron, no change. I can’t stay in the room with him.
4:15 – Ron is covered head-to-toe in yellow betadine. He is still sleeping and has tubes everywhere. He’s been assimilated; he’s a Borg.
3:50 – Ron’s family is visiting Ron.
3:25 – Checked with the CICU info to see if we could see Ron. We were told to come back at 4:00; since there was no room in the waiting room Jolie, Luis and I went downstairs to wait until 4:00.
3:00 – The surgeon discussed Ron’s surgery with us. Ron had more extensive repairs that he anticipated. Ron’s heart was stopped and restarted twice to do the two valve repairs. He was on the heart -lung by-pass for a total of 4 hours (he likes to keep it under 2 hours). He also repaired Ron’s mitral valve strands with reinforcing fibers (usually only the valve or the valve strands are fixed, not both). To further support the valve the surgeon replaced the valve ring with a smaller one. Ron will be moved to CICU (Cardiac ICU). He will be on meds to try to reduce his heart and wo’nt be bouncing back as quickly.
1:41 – Update: Ron is off the heart-lung by-pass; his heart is beating. I should be able to see him and the surgeon in about an hour. This was tense a 2 hours of waiting, knowing that they were doing additional valve repairs. (6 1/2 hours so far)
11:51 – Update: the surgeon tested the valve repair, but was not happy with it. He is now doing  more valve repair; adding another hour to Ron’s surgery. Jolie said Ron is not going to like being off schedule.
10:46 – Update: the surgeon is repairing the heart valve; it looks good.
10:46 – Update: Ron’s mitral valve repair has started.
9:36 - A surgery nurse called with an update: Dr. Siwek is in and will enter the heart soon. Ron’s heart is stopped and on heart-lung by-pass.
8:10 – Ron’s entourage goes to the waiting room.
7:25 – My sister Pat and niece Abby pray for Ron and light a candle at the Basilica in Washington DC; they are on Abby’s class trip to DC and conveniently arrive as Ron surgery is about to start.
7:15 – Ron goes to surgery.  Ron’s entourage (Luis, Jolie, Walter, Eleanore, Walter, Saundra, Cassidy, and Valerie) gathers in the cafeteria.

A gown and plastic ID.TMI:
7:00 – Kathryn informs us it’s time for good-byes.  She walks us to the Skybridge waiting room and lets us know we have until 8:00 am to visit the cafeteria. Ron declines a epidural (much higher that the epidural for labor).
6:56 – The anesthesiologist arrives.
6:55 – The surgeon leaves; Ron’s bp is 109.
6:54 – The surgeon arrives. Ron’s BP is 121. Ron asks about the appendage repair; the surgeon explains that it is closed with internal stitches.
6:45 – Heart rate 102, O2 96.
6:35 – Ron’s parents arrive.
6:30 – The shave is complete – 45 minutes. We had to ask: Lisa’s longest shave took 1 hour and 45 minutes.
6:05 – OR nurse, Kyle, arrives to meet Ron. Lisa is still shaving; he gets Mohawked – not on his head.
5:49 – Kathryn starts Ron’s IV (a huge needle, that is replaced with a plastic tube). Lisa is still shaving.
5:45 – Lisa, the body barber, starts shaving the ‘robotic’ (Ron); a full body shave, neck to toes.
5:30 – The prep nurse, Kathryn, checks Ron’s bloodsugar (101 – perfect), blood pressure (136/85) and takes his history.
5:21 – Ron is clothed only in a gown and 1 plastic ankle ID. The nurse explains the surgery prep process.
5:15 – Ron and I go to Surgery Prep while Ron’s parents wait.
5:11 – Next we go to Surgery Admitting.
5:00am – Surgery Procedure Check-in.
4:45am – Ron, his parents and I walked to the hospital (Ron’s last outdoor walk for a while).

Today’s blog by Valerie.

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Tue
29
Sep '09

Here We Go…

I had a wonderful day today. It wasn’t anything grand. Pretty simple actually, but that’s what was special about it. It was sunny and cool. I had a Belgian waffle with fresh local peaches for breakfast. All eight of us sat at the counter at Frank’s. I held Valerie’s hand. Smiled when I thought of Serena. Hugged my parents and my sister. Laughed out loud with Cassidy. She and Luis are having a grand time – with Jolie keeping him in check. Checked in the hospital and had my blood draws, peeded in a cup, had an EKG and a chest x-ray. I now have two wristband IDs that the nurse defied me to remove. We all had cheeseburgers of various makes and models at the Sawtooth Grill for dinner. I skipped having beer but substituted a huckleberry shake. It seemed like the right thing to do being less than 14 hours from surgery. Afterwards we all sat around the hotel lobby, talking and laughing. That’s what I’ll remember when the lights go out tomorrow morning at 7:15. Here’s to the lights coming back on around noon.

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Mon
28
Sep '09

It’s Like Trying to Herd Cats

Herding CatsAs I write this, my parents, sister and niece, and Luis and Jolie are on their way to Spokane — but we aren’t…yet. My parents are on their way to Las Vegas for a long layover and then should arrive in Spokane at approximately 10pm. Luis and Jolie are driving and will pick up my parents at the airport and take them to the hotel. Saundra and Cassidy are flying non-rev on American (Saundra used to work for them) which means they can only fly if there are empty seats. They left San Antonio very early this morning around 5am (3am our time). They got to Dallas no problem but were bumped off every flight to Seattle. They finally made it on a 4:30pm flight that’s scheduled to arrive in Seattle at 6:30pm. If they had gotten bumped off that flight we were going to leave without them and they would have gotten a hotel room in SeaTac (when they eventually arrived) and driven a rental car over tomorrow. As it stands, we’ll pick them up around 7pm and head east, racing the rain that’s due any time. With a little luck we’ll make it by midnight. I’m curious to see what a mom and 3-year-old are like after travelling for 23 hours…or maybe I’m not.

Tomorrow will be a late breakfast, maybe at Frank’s Diner, pre-op tests at 2:00pm, then a friends and family dinner at the Sawtooth Grill. I can eat until midnight but won’t have anything heavy or spicy since it’ll be hanging around in me for a couple days. TMI.

Fri
25
Sep '09

T-Minus

Cue up the music…[fergcorp_cdt].

Thu
24
Sep '09

The Friends and Family Plan

I am going to have quite the entourage here to support me through this “little procedure.” My parents are flying from Pittsburgh to Spokane on Monday evening. My sister and 3-year-old niece are flying from San Antonio to Seattle on Monday and then riding with us to Spokane. Good friends, Luis and Jolie, are driving to Spokane on Monday as well. I’m glad they’re coming and am truly grateful for their support. I’m also getting good vibes from all my friends and family around the country. Thank you for your calls, emails, and prayers. Knowing that you care will really help me, and Valerie, get through this.

P.S. Please don’t send flowers (a card is okay). For what flowers cost, I’d rather the money went as a donation to the Sacred Heart Medical Center and Children’s Foundation or the American Heart Association.

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Tue
22
Sep '09

Coulda Shoulda Woulda

I had my meeting with Dr. Siwek today. I don’t have much experience with surgeons so I can’t compare him with others, but he comes across as a very confident, serious, quiet guy. I got the impression that while other top-notch surgeons might be out there promoting themselves for fame and notoriety, he’s happy letting his statistics talk for themselves. More on that later.

The first ten minutes of our conversation were a bit disconcerting. He wanted to know my history and why I waited until now to have my valve repaired. He felt that my heart was enlarged enough last year that he would have recommended surgery then. He also felt that with my marginal high blood pressure over the years that some doctor should have correlated the bad valve with the high blood pressure and recommended that something be done. Ultimately, I think the problem was that I was “externally” symptomless. If I was short of breath or had dizzy spells that would have been a sign that something was seriously wrong. But, since I was walking, talking, example of good health and my blood pressure was only borderline 140/90 my doctors took a wait-and-see approach. It wasn’t until this August’s exam that my heart changed enough in size to warrant surgery – in the opinion of my cardiologist.

It’s easy to Monday-morning-quarterback but if I would have had surgery 20 years ago they would have replaced, not repaired, my valve using dark-ages surgery techniques/technology and I would have been on blood thinners for the rest of my life. Even 10 or 5 years ago I doubt they would have been able to fix my valve. Should I have had it done last year? In retrospect, maybe, but my heart didn’t change from 2007 to 2008 so my cardiologist thought it was stable. I did, too. And, I felt fine. The big change from last year to now means that it’s time. Better late than never, right?

Here’s the scoop from our discussion:

Dr. Siwek currently has a 99%+ fix rate (that compares to a 60% fix rate for surgeons who open your chest and don’t do it robotically). The valves that he can’t fix are ones that were damaged from rheumatic fever and he usually knows that going in. He doesn’t see anything in my echo or angio that makes him think he can’t repair it – but nothing’s guaranteed. If he can’t fix it he will install (is that the right word?) a St. Jude mechanical valve. That means taking Coumadin (a blood thinner) for the rest of my life but he reiterated that he believes, and his stats back up, that he can fix my valve and I don’t need to worry about that.

While he’s “under the hood” I have two additional problems that need fixed. My enlarged heart has stretched out the electrical connections and that is causing my occasional bouts of atrial fibrillation (A-Fib). Even with my valve repaired it’s unlikely that my heart will shrink back to normal size, though it will hopefully shrink back some. It’s likely that my A-Fib will become more frequent and it may stop self correcting. Having A-Fib is dangerous because it can cause blood clots and strokes. In an attempt to prevent these problems he’s going to perform a Maze procedure on the left side of my heart. It’s basically a series of carefully placed scar lines that look like a maze (hence the name) that disrupts the errant electrical signals and keeps them from getting stuck in an infinite loop. He’ll do this by freezing the heart tissue, called an ablation, which will then form scar lines when it heals. He feels there’s little to no risk in doing this and if it helps prevent future bouts of A-Fib it should be done.

And finally, because of the regurgitation and pressure buildup into my left atrium caused by my bad mitral valve, my left atrial appendage is “extremely large and dilated” (to quote my angiogram report). I had never heard of a left atrial appendage, but sure enough, there is such a thing protruding from everyone’s left atrium. Your heart uses it as a reservoir for your left atrium but it’s apparently unnecessary, sort of like your appendix. When it’s enlarged it can collect blood clots so Dr. Siwek is going to “address it, too.” I didn’t ask what that involves but I read some studies that suggest closing it off completely is beneficial. I need to add that to my follow-up question list.

So, what does all this translate to for next Wednesday?

- Four to five hours of surgery starting at 7:15am
- A puncture in my neck into my carotid artery for the anesthesiologist
- A 2” cut (the largest of all of them) in my groin for access to my femoral vein and artery for the cardiopulmonary bypass
- Two dime-sized holes in my right side between my ribs for the robot
- A 1” cut in my right side for the camera and for passing in contraband devices, stitches, etc

If all goes perfectly well Dr. Siwek would expect me to be discharged on Friday (WOW!) and then stay in the next-door hospital hotel until Monday or Tuesday. However, he feels that with my history of A-Fib he wouldn’t be surprised if I go into A-Fib while I’m in the hospital (even after the Maze procedure) because of the irritation/healing of my heart. They, obviously, won’t release me with an unstable heart rhythm so he said not to be surprised if I need to stay in the hospital an extra day or two until my heart is beating properly.

Happy Happy Joy Joy

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Fri
18
Sep '09

Me and My Robot

robot

Dr. Siwek’s (pronounced “SEEweck”) office called this morning to say that he has more thoroughly reviewed my echocardiogram and angiogram films and decided that I am a good candidate for robotic mitral valve repair. Yah!

The questions ”Can it be repaired (vs. replaced)?” and “Can it be done with the da Vinci robot?” will continue to be there until the surgery is actually over. But, I’ve passed the first decision point! Dr. Siwek wrote on my chart, “Should be done sooner than later” and was then happy to hear that we were already scheduled for the 30th. They confirmed my Tuesday appointment to discuss the surgery and my Wednesday, September 30th, date with the robot.

UPDATE:  Just got confirmation that surgery is scheduled for 7:15am on Wednesday, September 30. Check-in is at 5:00am. Surgical pre-screening is at 2:00pm on Tuesday, September 29.

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Thu
17
Sep '09

Jane Robelot’s (CBS Early Show) Mitral Valve Surgery

Here’s a great video about Jane Robelot from the CBS Early Show and her March 2006 mitral valve surgery that was done using the da Vinci robot in Atlanta. It chokes me up to watch because it’s eerily similar to my story.

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Wed
16
Sep '09

Two Weeks From Today…Surgery September 30

I just got off the phone with Aubrey in Dr. Siwek’s office. My surgery is scheduled for Wednesday, September 30. I have an appointment with him next Tuesday to meet, discuss the surgery, and ask questions. For the surgery, we’ll probably drive to Spokane on Monday, Sept 28th, since Tuesday will likely be busy with tests and pre-surgery prep. FYI, the hospital is Providence Sacred Heart Medical Center.

I don’t know if I feel better or worse now that I have a date.