Duane's Heart Valve Journal

Today, I turn 51. And, unlike the last several years, I am not whining, complaining or carrying on about turning a year older. Perspective. It’s good to be 51. I fully believe in Philippians 1:21, “For to me, to live is Christ and to die is gain,” but it’s still good to be alive, serving and loving God, family, friends, and fellow man.

This has been my first week back to work and, though it’s been a busy one, I’ve done quite well. It has felt good to be “back in the saddle” and feeling more valid and less invalid. I do try to sneak in an afternoon nap here and there. Sometimes, it’s involuntary. I just drop in my recliner, and I’m gone. The memorial service for Herb Jurs was on Wednesday, and it was a beautiful celebration of his life and the hope of heaven. Thank you to everyone for your expressions of sympathy, empathy, and kindness. I used my heart pillow as a prop during the message, since Herb and I shared the open heart surgery experience, and I took the angle that God wants to do open heart surgery (it’s a spiritual metaphor) on all of us. (See Ezekiel 11:19-21; 18:30-21; 36:26-29).

Medically, I had another echocardiogram and labs on Tuesday. I asked the technician if there was still any effusion or fluid in the pericardial sack around my heart (the purpose of this echo). I knew she had to be careful not to diagnose anything or tell me too much; I didn’t want to get her in trouble. But she showed me on the echo screen. There is only a little fluid remaining. That’s good news. On the echo, it’s just a fine line between the heart wall and the lining, when before it was a much larger gap. So we’re moving in the right direction on that, thank God. I was supposed to see my cardiologist today but the appointment was rescheduled for March 24.

INR-wise (my target is 2.5-3.0), I was at 2.4 on Monday and 2.2 on Thursday. So my dosage of Coumadin has been increased a bit and I go back again on Monday. Of course. I have an appointment with my hematologist in Orlando on Tuesday. Yeah, I get to drive outside of Winter Haven, all by myself!

Finally, in the end, my family doctor was concerned about my anemia and ordered a home stool test kit. I’ll not go into the dramatic retrieval story, but suffice it to say, my wife is a saint! Well, the results came back that there is some blood in my stool. With Coumadin thinning the blood, it exacerbates the problem. We have to find out the source of the gastrointestinal bleed, so I am being referred to a local gastroenterologist to have a GI evaluation, aka upper endoscopy and colonoscopy. Happy birthday to me from both ends! ;-) Being over 50 now, I knew this day was imminent. I have been dodging automated phone reminder messages from my clinic to get my colonoscopy for the last several months. But okay, I’m not the first nor the last. Everyone eventually gets it in the end. And everyone says the prep is worse than the procedure. But, oh crap! Both can be done on the same day at a local outpatient surgery center. The trick is I’ll have to stop taking Coumadin for 5 days before, which will put me at elevated risk for stroke, so the doctor mentioned lovenox. I don’t even know what that is. I’m waiting for the appointment with the GI doctor at this point. In the meantime, I’m to increase my dosage of Prilosec from once to twice per day. One door at a time.

On Sunday I plan to share the account of how we sensed God’s peace and presence throughout my ordeal. Not that I have any expectation, but if anyone has any interest, it will be posted as a podcast on our church web site: www.centerpointchurch.org/media. Keep ticking, one and all!

Yesterday was slated to be my first Sunday easing back into my teaching role as Pastor of CenterPoint Community Church. And while I did indeed teach, and I seemed to handle it well, the day began unexpectedly and sadly. Rough way to return to ministry.

Early Sunday morning we got a phone call that Herb Jurs, a member of our church who had heart surgery to replace his aortic valve plus two bypasses on Feb. 19, had been rushed to Winter Haven Hospital because he was hemorrhaging. When I arrived at the ER, things did not look good but they had him stabilized as much as they could to move him to an ICU unit. As I stroked his head, Herb said to me, “I just want to go home, Pastor. I’m ready.” In a little while, things took a sudden turn for the worse, and a doctor rushed to the family and asked us if we wanted him intubated and placed on a ventilator. No, he did not want that. Within moments, anyhow, Herb was gone from this life and entered the next, with his wife, daughter, son-in-law and myself by his side. As a minister, it is a sacred honor to be with someone when they die (not that I have any enjoyment in it). He died around 7:40 a.m. at the age of 77.

I’ve known Herb for about a year. He has had many health issues—heart disease, diabetes—including two hospitalizations I recall this past year during which they could not determine the source of his hemorrhaging. In recent months, he grew progressively weaker and had increasing issues of dizziness and passing out. He had been told he needed heart surgery but was too high a risk; he had a quadruple bypass surgery 28 years ago. When I first announced my mitral valve issue last fall, Herb told me he had a leaky valve. Herb and I (a somewhat unlikely duo) have been joined at the hip and on parallel journeys ever since. On Jan. 6, Herb had a heart catheterization that revealed severe aortic stenosis. Local doctors viewed him as too high risk for surgery, but referred him to a transcatheter aortic valve replacement clinical trial at the University of Miami. I helped them do some research, with all the resources available through this site, and he had his wife went to Miami to begin the process. Lots of hoops and delays and uncertainties he would even be accepted into the program.

On Jan. 28, though he was in no condition to do so, Herb and his wife insisted on sitting with my family through my surgery at Florida Hospital Orlando. He was impressed by my surgeon, the CVICU tour, and everything he saw and scheduled on appointment with Dr. Accola. His initial appointment and my surgical follow-up appointment were on the same day, Feb. 15, and we sat in the lobby together. Dr. Accola felt confident he could get Herb through this second open heart surgery but did express some concerns about the recovery. Herb decided to go for it, and had his aortic valve replaced (cow tissue) and two bypasses on Feb. 19. I was bummed that I was unable to sit with his family through the surgery (as he did mine), but my parents went in my stead. Peggy did drive me over to Orlando the following Sunday afternoon for a brief visit with him in the CVICU. He did very well through the surgery and went home in a few days (much faster than I did). After a few days at home, he developed some alarming symptoms, went back to Florida Hospital, and had a blot clot in his lungs. One of the ways they addressed the clot was Coumadin. After a few days, he was doing well again and came home this past Thursday. Friday and Saturday were good days. And then he began hemorrhaging Sunday morning. His INR was 7!! Medically, he was a catch 22—his blood needed to be thinned because of the clot, but he had a history of bleeding. Bad combination. Moral of the story for all heart valve patients on Coumadin: keeping our INR in the right range is critically important!

It was a really gut-wrenching morning, but I was happy for Herb that he went home to heaven, like he wanted to. He had just really had enough. At that point some of what I was planning to share in my teaching Sunday morning (about my own story) just didn’t seem to fit, so I made some adjustments, and was able to teach about the supernatural peace of God that passes all understanding. (I’ll share my story next Sunday.) I did okay. I sat some on a stool. But I really felt fine. In the afternoon, I took a good nap, and then in the evening we gathered with the family to plan the memorial service (Wed. @ 1:00).

A really hard first day back in the saddle, but all I can say is God gave me the strength and energy I needed. The post I had planned today to mark my 4 weeks home by reflecting on some hilarious moments of hospital life, I will post later. I do have a Coumadin Clinic appointment today, and I’m definitely going.

Today’s title is for all the Baby Boomers out there, of which I am one. (For the uninitiated, “Getting Better” was from the Beatles’ 1967 album “Sgt. Pepper’s Lonely Hearts Club Band”). As my recovery period nears the end, I have completed listening to the entire Beatles remasters box set. Awesome sound. I am still amazed at the music of the Beatles! Always makes me feel better!

The past three days have definitely been much better. Thank you, everyone, for your messages of concern and encouragement during my rougher patch. I have felt much better and am feeling much closer to the “old Duane” (I just hate that phrase!). My fever is gone, my chest pain reduced. I am no longer needing even the extra strength Tylenol. Back to walking 3 miles (our weather has been sunny and beautiful, if a bit cool). Yesterday my INR was at 4.5, so I took no warfarin/Coumadin last night, ate a bunch of greens, and went back to the Anticoagulation Clinic today. Back down to 3.1. Come back and see us on Monday! They just can’t get enough of me!

Time to get back in the saddle. The past weeks, I have been low key taking care of church business since I have a home office (don’t ask me how I was dressed—good thing there’s no video phone). I have manned the phone, caught up all mail, business and correspondence, and handled many emails. But this weekend I am gearing up to return to teaching this Sunday. I will definitely be “Duane Light,” much calmer and lower key than my normal hyper self, and I will have a stool nearby, but this is a day we’ve been waiting for. I’m sure my feelings will be all over the map. Will I cry? (Maybe…probably!) But I plan to tell my story, how God has seen us through, and what He is teaching me. I’m praying for the energy I need, and I’m feeling up for it. Next week, I have added some appointments to my schedule, so it’s time to dive back in the water, even if I paddle more slowly, and I will.

Coming Attractions. Monday marks 4 weeks home from the hospital for me, and I hope to post some hilarious recollections, and some not so hilarious, from our 13 days of hospital life. Also, all my bills and insurance claims are coming in. I’ve had 89 separate claims so far this year. And ain’t it fun to sift through all that?! Anyhow, I plan to organize some totals so other heart valve patients can have a point of reference for what my procedures cost—billed amounts, insurance paid amounts, etc. Hold on for these exciting upcoming entries!

Since my last post last Wednesday, I had some really good days and some not so good days. Peggy and I have continued our 3-mile walking loops around the neighborhood (except for today). It is so wonderful to be outdoors with my sweetheart; why haven’t we been doing this consistently already? I have been driving but just around Winter Haven. We went out to eat for the first time at Chili’s on Friday night. I attended church again on Sunday morning, but after singing the worship songs and leading a prayer time, I thought I was going to pass out. Thankfully I didn’t. Enough drama already!

Since Sunday I have felt really dragging, tired, just exhausted. No energy at all, it seems. I went into atrial fibrillation Sunday night, which is always unpleasant and tiring. Thankfully, I was out of it Monday morning when I awoke. But I have had a renewed discomfort/pain in my chest in a new area (are there still any new territories remaining?)—it’s a new pain with deep breathing behind the rib cage slightly left and up to my left shoulder, plus the incision and sternum feel more uncomfortable. I have resumed taking 2 extra strength Tylenol (okay Equate) with some regularity; I haven’t needed anything for pain for a couple weeks. I have also run a low grade fever up to 99.5. Since the hospital instructed me to call the doctor if my temperature went above 100, and it was so close, I did call my family doctor, who wanted to see me today. I’ve been fearing the increased chest pressure could indicate an increase in the pericardial effusion. My doctor feels everything looks and sounds okay, but he did send me to the lab. My iron is very low, so now I’m adding an iron supplement to this walking pharmacy. And he also is sending me a stool kit to check for bleeding. Oh crap!

On the INR front, my level was 2.7 on Friday and 3.1 today. I will take a full 2.5 mg tablet of warfarin/Coumadin today and a half pill tomorrow. Recheck with the Anti-Coagulation Clinic on Thursday. Next week, I have another echocardiogram on 3/10 to check the effusion (fluid) and an appointment with my cardiologist on 3/12 (my 51st birthday). Fun, fun, fun!

On a positive front, we got to see our youngest granddaughter Daisy (4 months) when her dad and mom spent Sunday night with us. Unfortunately, they were in town because our daughter-in-law’s grandfather passed away. But it was wonderful for us to see them, and how great to hold Daisy. She’s so beautiful!

I posted a pic to show my incision at 4-weeks, for those who are interested. I had a couple more subcutaneous sutures surface at the bottom of the incision, but they are gone now after showering. As of now, I am scheduled to teach this coming Sunday, March 7. I am a little apprehensive about it, but am praying my energy is up between now and then. God is teaching me so much, so I have a lot to share.