On July 17, 2014...

Bob Stoltz--pcstoltz@yahoo.com posted a note for Susan that says:

My name is Robert Stoltz, and I would like to share with you my recent experience with Open Heart Surgery. I will be 82 years old this June. Thanks to my recent surgery, I can look forward to this birthday, and perhaps many more. My Aortic valve was replaced with 23 mm Edwards magna ease aortic valve prosthesis, My tricuspid valve was repaired with a 36mm ring and my left atria appendage ligation with a 35mm atria clip and three coronary by-passes. This was done on Oct. 19, 2013 at Greenville hospital in Greenville SC.

I am thankful to God that I have never been sick to any degree in my life. I have lived a wonderful life and am happy with the pleasant peace of mind that comes with the aging process.

I was diagnosed with Aortic Stenosis in 2002, but I was told by my doctor not to worry unless I developed symptoms. I had no symptoms I never had any pain so I worked out in the gym daily, jogging, bicycling, lifting weights etc. I kept track of the stenosis with echocardigrams. My aortic opening area had gone from 1cm opening in 2002 to .6cm opening in 2011. It stabilized and did not change from here, and I was very happy about this.

I took my annual physical in July of 2013; all of my tests were great for a man of my age. My doctor said whatever I was doing to keep on doing it!! He cautioned me to be aware of any symptoms that the Aortic Stenosis might cause and to notify him if I noticed any. The symptoms I was looking for were, dizziness, fainting, chest pains, shortness of breath, fatigue etc. I never developed any of these!!

On the night of August 15 2013 (Three weeks from my physical in July), I could not go to sleep. I told my wife I would like to take a sleeping pill (Ambiem) She said: �No don�t take it,� but I did anyway. I got worse, severe anxiety developed; when I started to walk I became very tired. My wife said,� � I am going to take you to the emergency room�. I refused to go. Things got worse, and I relented and finally said, �let�s go�. We drove 100 miles to Asheville NC, to the VA Emergency Room. After many tests and much anxiety they told me my Aortic valve had failed, and that ejection fraction (Measurement of blood flow force from the aortic valve) was down from my last reading of 60% to 20%!! I explained that I hadn�t experienced any symptoms prior to this. They informed me that one of the symptoms of a complete aortic failure is SUDDEN DEATH!! That got my attention right away.

We returned to our home and I started to check on the Internet for Surgeons who had an excellent record in this field. The name of Dr. Barry Davis surfaced to the top of my list. He was located in Greenville SC, about 140 miles from our home. I called him and was told to get all of my records, echo�s etc together and mail them to him. He said he would set up a consultation meeting with me when they arrived. I decided to get another surgeon also, just in case Dr. Davis could not do the operation. I contacted a surgeon at the Sanger Hospital in Charlotte NC. He told me the same thing, get records together and send them to him.

It took me four miserable weeks to get all of this together and send the information to both places. Dr. Davis notified me he had scheduled a consultation meeting with me on Sept. 15th 2013. At this meeting he reviewed the different procedures available for an aortic valve replacement. The catheter method (Minimum invasive procedure) and the open-heart procedure. He mentioned drug programs etc. also. This was my decision, so I decided on the time proven procedure of open heart, although the thoughts of it frightened me. Catheterization and pre- op was scheduled for Sept. 28, 2013. The catheterization and an was echo done through my stomach revealed that the Aortic valve had to be replaced, the tricuspid and the mitral valve needed to be. Three of the coronary arteries needed repaired with by-pass procedures also. I asked if this all could be done at the same time, and he assured me it could. The operation was set up for Oct. 9, 2013. I remember seeing my wife and all of my friends at my bedside, as I was put on the gurney and moved to the operation room. I had a very strong feeling that I would never see any of them again on this earth. I remember seeing the bright lights over my head in the operation room, and a lot of people in white clothes and masks. I felt like I was moving into a strange new world, where everything was white, I was walking along side of a river that was partly frozen over, and I looked down at my feet and I could see the slushy snow coming up between my toes. I looked out at the frozen river and I saw an old man wearing a white coat and motioning for me to come over and get on his ice-boat. The last thing I remember was giving him the bird (sticking up my middle finger) I wasn�t about to get in that boat!
The realty was that the surgeon had completed all of the surgery at this time and I was sent stabilized to Intensive Care on Oct 9, 2013. At 2:00PM. Dr. Davis reported to everyone that everything went Great! The operation was complete, everything done as planned. Susan, Don, Billy Raye, Jane, Charity and Peggy left the ICU around 6:00 PM.

The next thing I remember, I could hear a humming sound, and everything was pitch black. I had a feeling that someone was there, but I couldn�t see anything, a feeling of PRESENCE flooded my body, someone was with me I knew, but I couldn�t see. My wife and friends told me later that they were there at this time Oct. 10, 2013, and I was in Intensive Care. I was intubated and stabilized, but I did suffer from low blood oxygen and was ventilator dependant due to respiratory failure. I then experienced cardiogenic shock (Cardiogenic shock is when the heart has been damaged so much that it is unable to supply enough blood to the organs of the body) I was told that 5 years ago everyone who experienced cardiogenic shock died but with new procedures developed since, I had a 50% chance of survival. A New procedure was used to maintain my blood pressure called pressor support (This is a method of using adrenaline like drugs to maintain my blood pressure). They managed to wean me from pressor support, and. I was extubated (tube removed from trachea) on October 10, 2013. I talked to Peggy and friends in Intensive Care, and we all felt good that things were OK. They all left me, feeling well that I had made it!
My chest was sore, my throat was sore and my eyes ewere dry but I felt OK. I was able to joke around with everyone before they left.

On Oct. 11, 2013, after trying to swallow some applesauce, I choked and couldn�t breathe. I experienced respiratory failure again and had to be reintubated , my kidneys started to fail at this time also. They tried to unload the pressure on the right side of my heart to improve my blood pressure. I was started on broad-spectrum antibiotics. My kidney function stabilized, but I was kept on antibiotics for pneumonia. I was extubated on Oct 12, 2013, and was kept in Intensive Care. On Oct. 13, 2013 I was taken off the antibiotics (vancomycin) and put on a vibrating bed for secretion clearance. I was sent to a private room. I had a re-bronchoscospy and found to have trachobronchitis and pneumonia. I was unable to swallow or eat or drink. On Oct 14, 2014 It was decided to have a percutaneous endoscopic gastronomy tube placed.(This is when I started to get nourishment from an IV looking bottle which metered the correct amount into my stomach as scheduled). On Oct. 15th 2013 they discontinued the antibiotics Zosyn and Cipro, I could not swallow, so Language pathology was brought in and I was given tests that confirmed that I had severe dysphasia (Unable to swallow due to absent epiglottis deflection.) On Oct. 16 2013 Nephrology was called in for my acute kidney failure. At this time I experienced a very painful aspiration whereby I lost consciousness. On Oct 17 2013 my kidneys stabilized, creatine come down from 2.0 to1.4. On Oct 18 2013 my foley (catheter) was removed and I was prepared to go to floor 4D for cardiac rehab. I had postoperative anemia and postoperative delirium. I suffered this delirium Oct 18th and 19th. I was crazy, living in a twilight world, where everything was real and strange. I could see buildings with mortar seeping from the bricks, I felt like I was on a large boat moving through a strange city. This was not like a dream because it seemed like I was actually living everything in some kind of reality. My hallucinations were very real and sounds, colors and smells were intertwined in them. Peggy said I was talking �Crazy� at this time. I said mean things to her that I do not remember saying, so I must have been crazy. Neighbors, Don and Susan picked up my spirits by talking about things I was familiar with.

On Oct. 20 2013my heart was found to be in junctional-atri fibrillation rhythm. Carolina Cardiology was called to determine if I would need a pacemaker. Small wires were imbedded into my heart for this, if needed. It was determined that I did have chronic afib. Cardiology decided not to proceed with any intervention at this time.

On Oct. 21 2013 I was given a barium swallow test and it was determined I had severe dysphasia with silent aspiration. My tube feeding was to continue and I was to have NOTHING BY MOUTH until further notice. Gosh, this was disheartening to me.

On Oct 22, I was notified that the bronchial washings they had submitted for analysis returned POSITIVE FOR TB! Wow, I couldn�t eat I couldn�t walk, and now I had to wear a mask for my breathing. I was put in a pressurized room and all visitors were restricted. To make matters worse, I hadn�t been out of bed since I was admitted to the hospital, I couldn�t stand up-, my legs looked like tooth picks, It was at this time I learned what depression was, but there was more to come.

On Oct 24 2013 I was thought to have Thrombocyclopenia (TCP) as my platelet count was low. I had many tests, x-rays etc. Chest x-ray was done Oct. 29th, 2013 revealed minor pulmonary problems, Cardiac telemetry exhibited atrial fibrillation at the rate 60-s 70-s

On Nov 4 2013 all tests etc were done, and the TB tests were found to be false positive readings. Finally I could be released to REHAB. I was carried to a wheel chair, and put in a waiting bus van. I was taken to rehab 90 miles away. I couldn�t eat, I couldn�t drink, I couldn�t walk and I could barely talk, but I was HAPPY! I was going to get to stand up- and walk, Wow!! Maybe I could be able to eat again. I was actually excited that I was leaving the hospital.

The professionals at Rehab were wonderful. The doctor told me he would have me eating if I followed his instructions. I had to do exercises to strengthen my swallowing muscles; he showed me how to do it. He also stimulated the muscles with some electrical current.

The doctor had me eating in a week. He started out with one drop of food and water on my tongue at a time and I ended up eating McDonalds Big Mac�s in a week. Life was wonderful again.
The trainers started by making me take one short step at a time and I was walking one half a mile in a week. I was released to go home from Re-hab after two weeks.

I am now back to my old self as my wife calls it, doing all of the things old people do Walk around the foothills of the mountains, go to the gym and work out, eat at nice restaurants with our friends. Once again we can sit on our deck together in the morning and watch the sun come up as we drink our coffee, admire the blue Cyprus trees, and look at the mountains shaded in the early morning fog. My wife is so glad I am home again, our dog Scruffy, just can�t get enough of me, and she follows me everywhere. To make a long story short --I AM VERY HAPPY!

I am also thankful that I had full support of our neighbors and friends. Billy Raye, Kenny Schulte. Susan Todd, who took time off from her job as a schoolteacher to be with my wife and me during the operation, and her husband Donald brought my wife to visit with me every day for almost a month. (A 100-mile trip) Mr. Nathan Fulton and his family (Father Wylie and Mother Lou) visited me and brightened my sprits. Jane Fulton (Nathan�s wife) helped my wife by driving her to the hospital, cooking meals etc. during these difficult times. Mr. Jim Bennett kept our property clean by mowing the lawn and blowing debris from our yard. He and his wife Debbie visited me and brought good reading material to help pass the time. All of our neighbors, Ray and Donna Green, Bob and Robin Street, Mrs. Fred Street, Peggy and Tim Brackett and others too numerous to mention visited and gave their support. These friends gave me a good reason to get well so I could be part of their lives once again. I am so grateful to all of them.

Bob Stoltz