Jeffrey's Heart Valve Journal

July 7th: 4 Month Update -- Ummm.....Still GREAT!

July 8, 2012

Hello All:

Well, I'm beginning to sound like a broken record. I'm doing very well and life is pretty much back to normal and has been for some time. Still get a little tightness in the lower part of my scar with a lot of exertion and this still seems to be mainly triggered by trying any type of forceful manipulation, which just happens to be a large part of my occupation as a chiropractor. It is getting better though and I plan on being fully back to work probably sometime in August. I did have the lower scar injected by a dermatologist a few weeks back and that seemed to help. I go back there again soon for a follow up and maybe another injection. I can do everything else but certain things may trigger a slight pain for a day or so after in that lower right side of the scar.

I am running more now. I had this thing where I was worried about my heart rate getting too high. As soon as I would go from a walking pace with a heart rate of around 115 to a jogging pace my heart rate would go past 150 within a minute or less and so I kept stopping to bring you my heart rate back down and then trying to jog again but having the same result over and over of getting into the 150s. I thought it was getting too hig too fast. However, in speaking with other people it seems like a heart rate in the 150s is really not a big deal. I spoke again with my cardiologists office and the nurse said it was okay to continue on with the heart rate at that level as long as I'm not particularly out of breath and so forth. After that conversation, I ran 1 mile straight without stopping and the heart rate stayed in the low to mid 150s. The next time out I did a mile and a quarter. The great thing is, I used to get out of breath when I got into the 150s and now it's no big deal. Also, my heart recovers quickly, back down into the 1 teens, going back to a walking pace . So, from a conditioning point of view things are improving for sure.

Baseball season is done and I was glad to be able to play a few games at the end of the season when I wasn't even expecting to be back until the fall.

When I sit back and think, it's really hard to believe that 4 months ago I was in surgery and I would have never thought I'd be as far along as I am now. I'm thankful for my rapid healing, and definitely being in shape physically and having the right mental attitude played a big role.

Thanks to all out there reading this for your support! I am very grateful.

Jeff

3 Month Update - Still Great!

June 7, 2012

Hello All:
Just wanted to write a quick update. Today is 3 months. Hard to believe! I am doing so well that is hard to believe that 3 months ago I was on THE table. It is so amazing how much progress one can make in such short a time. I only have two issues still. 1) Heart rate seems to get up too high too fast, I think, with exercise. Still on Metoprolol. 2) I can do most everything but some of the manipulations I must do with my job as a chiropractor, still bother my chest. So, I cannot really do my work yet, though I am doing the admin work.
I am walking/jogging/sprinting about 3 times a week 2.2 miles (sometimes more) and do SuperSlow Strength training twice a week.
Until next month......

2 Month Update - One word - GREAT!

May 7, 2012

Well, it's been 2 months to the day since I had my surgery. Continuing to recover very well. Yesterday, I went out and played some baseball with my teams. I actually played a doubleheader, believe it or not. I had a 1 PM game with one team in the 6 PM game with the other team. I did notice, surprisingly, that my heart rate got up pretty high just doing basic things out there. Normally, when I walk/jog and even throw in a few sprints, on my normal exercise routine since surgery, my heart rate might get above 130 at the end of it (2.2 miles). Yesterday, doing what I consider considerably less, my heart rate was up to 136 the couple of times. I think this has more to do with the intense heat than anything else. Could also be that I forgot to take my Metoprolol yesterday morning. I'm still on half a pill, twice per day.

I took it easy though, Just batted and played a little first base. I wasn't expecting to come back and play until the fall season but really was feeling good enough to do so. If someone would've told me 2 months ago, I'd be playing baseball 2 months from surgery, I'd have thought they were crazy!

I'm still not back to work physically. I've been working for several weeks now at home doing a lot of e-mails, phone calls, administrative stuff. Physically, I'm still not able to do the full demands of my occupation. As a chiropractor, one of the adjustments I do involves having to place the patient on their side and then thrust with my arms and body in order to move the lower spinal joints/pelvic joints. This motion just involves too much force on my chest. It's kind of weird how I can do certain things physically but then something like this is totally different.

Some of the earlier issues I was having like extreme sensitivity in the skin in my upper chest and the tenderness and knot like area of my lower scar are doing much better. Anyway, that's my 2 month update. Basically, could not ask for a better recovery.

Short but Sweet Update This Time - Almost 7 weeks post op

April 22, 2012

Coming up on 7 weeks (this Wed.) post-op and doing GREAT! Great energy, exercise going great, threw a baseball today and that is ALWAYS great. All I have is a little nag at the end of my scar but that seems to be slowly getting better. SO, great, great and more great! BUT I still can't do housework! LOL

One Month Post-Op Update (Ross Procedure)

April 7, 2012

Sorry for the delay in writing but I figured I would not write a 4-week update and rather wait for one month. One month ago today, at this very time, 10PM, I was in the ICU and was just getting my breathing tube out. Hard to believe that 1) it's only been a month 2) how much has transpired since then and 3) how much progress I have made.

Here are some updates, good and bad (well, only a little bit bad). First the good: I continue to walk 2.2 miles pretty much each morning and on the days that I may not walk, I do the stairs in my house (which by the way is definitely more difficult). On my last walk, I interspersed short distances of jogging just to see how I'd feel. I was mostly concerned with how my sternum would feel from the bouncing but that felt perfectly fine. I didn't want to push my heart too much so I only jogged maybe 150 feet or 200 feet at a time. This went pretty well overall and my heart rate did not get high so I may be starting to add this with each walking routine. I'm continuing to do SuperSlow workouts with focus only on biceps, triceps, leg extension and leg curls. Again, I have lowered the weights from what I was doing prior to surgery and I'm not doing nearly the intensity that this workout normally requires. My energy levels remain good and I hardly nap, though I try to most days. At least I get to lay down for an hour or so but probably only sleep 10 minutes if I'm lucky. I started driving again this past week and that's nice. I've been able to sleep on my side probably for the last 2 weeks already. I've been doing a fair amount of work for the past couple of weeks already but this is mainly administrative work that I can do from home like e-mails and phone calls. I started some scar treatment and I'm using "ScarGuard MD", recommended by my dermatologist. In other good news, the upper back spasms and muscle pains have subsided substantially and the massage therapy has really been helpful for this. I have only gained back 4 pounds of the 10 I lost from surgery and hope to keep the rest off!

Now the little bit of bad: my biggest issue is the bottom part of my scar. Almost since the beginning, it has had a hard, knotty, ball of scar tissue - for lack of a better description. I had contacted the surgeon and he mentioned that this is the area where there is the most bending along the scar and that this can happen. The issue is, it's also quite tender at times and if I try to extend back or straight up fully it puts tension or stretch on this area and gives me a sharp pain. (feels like I might actually tear something) I'm just not sure if this is normal at this point or not. I'm hoping it shrinks and loosens up because it's really annoying. The worst part is the lack of flexibility in it. I don't want to be worrying about this thing giving me sharp pains forever every time I extend my torso. To be clear, this is not a bump of thick scar tissue on the surface of the skin, it's more felt underneath. In other not so good news, the last 3 days I seemed to develop a rib issue on the left side. It's an extremely sharp pain that occurs mainly on deep inspiration and limits me from taking deep breaths. The sharp pain occurs almost simultaneously in the mid back on the left side and in the front part of the rib cage on the left side. It most definitely seems to be a “rib head” that is out of place and probably also irritating an intercostal nerve. (nerve between the ribs). There seems to also be the possibility of intercostal muscle strain (strain of the muscle between the ribs). It's been very annoying the past 3 days and really had me concerned with my breathing. Just this late afternoon and evening, it seems to be getting a little better. Normally, I go see a fellow chiropractor and have it adjusted which is typically very successful with rib head subluxations. Unfortunately, I tried this but it was just too much pressure my sternum to tolerate. Lastly, I've been bothered by alternating left and right costosternal (where rib joins sternum) pain and inflammation. I expect this however as a consequence of open-heart surgery and the moving around of my anatomy (rib spreader etc.) I'm going to ramp up my use of cold laser on this area.

That's about it for my one-month update, overall things are going great with the exception of a few minor things which are pretty much to be expected after such a major surgery. Sorry for the long-winded update for those who don't like to read a lot :) - ahem...a certain lady in St. Louis who shall remain nameless.

3 Weeks Post Ross Procedure Update

March 28, 2012

3 weeks ago today I had my surgery and I was recovering in ICU! Hard to believe! I could not even get up by myself, get out of bed, etc. Walking the next day or 2 after surgery felt like learning to walk all over again. Now, I just walked 2.2 miles this morning at a very brisk pace. Things continue to go really well for me. I am grateful that I do not get any of the fatigue that others seem to get a lot of. In fact, I did not even lie down once today and it's 7 PM. Most days, I try to lay down for an hour or two midday, but I'm lucky if I sleep 10 to 15 minutes of that time. I've just never been a napper. I sleep fairly well at night, but now I'm finding that if I don't go to sleep by 10:30PM or so I'm up til about 1 or 1:30AM. (more my normal pre-surgery pattern) I do sleep decent during the night however and again, luckily, I'm not affected by fatigue or feeling of any tiredness throughout the day. I'm mostly bothered by mid to upper back pain and this seems to be in association with chest tightness. Thankfully, I have a wonderful massage therapist who has been coming to my home and this helps tremendously. It just seems that the mid back is quite persistent and took a big hit during the surgery. The chest gives me minimal pain, even when coughing, and like I said prior, I just take ibuprofen 400 mg as needed, and it's needed less and less (I only took one in the past 24 hours). So far, it's been 3 weeks and no sneeze! I've come close a few times but was able to stop it with the old “pressure against lower nose” technique. Saw my cardiologist today for the first time since the surgery and he was very impressed with the results. He listened to my heart and felt the pulse in my neck and had comments like “very nice”. He cautioned me not to push the recovery too fast as he knows I'm prone to do. It's important during the first few months to let the suture lines/soft tissue heal (and we are talking about the sutures inside the actual heart for the valve etc., not the skin). One of the main things that can affect the healing of the sutures is raising the blood pressure. Obviously, when exercising, blood pressure is increased and therefore exercising too much or too intensely too soon would not be a good thing. I was also cleared by my surgeon to do isolated strength training which I did yesterday. I just worked on biceps, triceps and leg curls and leg extensions using the SuperSlow technique that I've done for years. I reduced about 20% on all my weights and went nice and easy and did not do any high-intensity as I would normally do. From a heart point of view this is perfectly okay, it's more of a sternum issue I need to be careful with, and that is why I did only the exercises noted above, which do not put any stress on my chest or shoulders. It's so important to maintain muscle mass and strength. The heart serves the demands of the muscular system so it's really good for the heart. It's just that I need to go easy for a few months, thats all. Even though I was asymptomatic before surgery for the most part, I did notice something yesterday when doing the weights. Even though I didn't push it, and the weights were 20% lighter than my normal amounts, I could tell by the end of my set when it was getting a bit more difficult, that I felt “different” in terms of my breathing and my heart. It's a little hard to describe and as I told the cardiologist today, “the heart just seems more efficient”. And I'm sure it is! I'm also sure that as time goes by and I start doing more and more activity I will eventually come to notice many things that would lead me to the conclusion that I probably was more symptomatic that I realized. Again, I am blessed and amazingly grateful that I live in this day and age and was able to get this procedure done. I'm looking forward to a long, full and active life, with my highly efficient heart.

Finally! - A Poem for Nancy Friedman.

March 21, 2012

There once was a lady named Nancy,
It was customer service that was her fancy.
She teaches companies how to be nice on the phone.
All over the world she travels, far away from home.
I saw her speak here in Orlando one day,
And she was really, really great, I have to say.
Shortly after that talk, it was her turn to go,
For that AVR procedure we all know.
Was she worried? Not a bit! And the surgery went off without a hitch,
She flew through that surgery with not even one glitch.
She is fiesty that is for sure,
Which makes us love her all the more.
I raise my glass to Nancy, who has been so great
She has supported us all, easing our wait.
Let face it, it’s not everyone who gets to rehab in the Florida keys,
Must be nice to be Nancy, basking under those glorious Palm trees.
Back to your life Nancy, a full one ahead of you,
With that new valve, there is nothing you can’t do.

2 Weeks Post Ross Procedure

March 21, 2012

Time for an update. Things are going great! Sleeping in my own bed -thankfully we have an adjustable foundation bed. And I am actually sleeping!! Sure I get up 3 times a night or so, but it beats 10-12 times like before. I am walking twice daily around my community, which is 1.1 mile. I have that down to 19 minutes now, 8 minutes less than it was just on Saturday. My pace is quite brisk. My appetite coming back but I don't want to eat too much and upset anything and also I am down 10 pounds from my PRE-surgery weight and wouldn't mind keeping that off. So, I have lost all my surgery weight (20 pounds) PLUS another 10. Crazy! My energy is still good. My pain is minimal. Just take Ibuprofen maybe once or twice a day when needed. I have no issues taking care of myself. People who see me can't believe I had major open heart surgery 2 weeks ago today. The ONLY thing is a nagging cough from reduced lung capacity. Doc said that could take a month to get back. It is really annoying, Anytime I try to take a deep breath, I cough and my lungs just feel sore. That is about it. Overall. doing great!

Home to Florida Tomorrow

March 15, 2012

Another great day today. Walked alot, went to see surgeon one last time and went around to thank the nurses who helped me so much. I still can't believe how good I am doing. Other than a fast heart beat, and my digestive system being slow to recover, I'm doing well. In fact earlier today, I almost felt like my usual self. In any case, I know I've got a ways to go and need to take it easy. I'll focus on that when I get back home. So, goodbye to NY, my original hometown. It's been very good to me and the people in NY are really so nice! (don't believe what they say about New Yorkers). Looking forward to getting back to Florida, my home, great weather and most of all my kids. :)

One Week Post Op Update

March 14, 2012

Well, it's been one week! Hard to believe a week ago I was on the operating table and now for the second day in a row I'm walking the streets of New York City and today I went by myself and walked a half a mile or more. I only take Motrin as needed and the last one I took was at 10pm last night. So no pain meds at all today!  But it gets better.  I have boundless energy and I hardly nap at all. I'm up every hour at night but I do sleep, just this waking up all night long. I know many have great fatigue but I'm not getting that and I hope not to.   All I can say is I'm astonished where I am at at one week post-surgery. I'm blessed and fortunate beyond words. 

Discharged Yesterday

March 13, 2012

I was a discharged yesterday at around 4pm. Spent the day in the hotel. Much better than at the hospital. Doing better. Had my first shower since last Wed. That was NICE! Sleeping is still an issue. Thankfully I have a power recliner at the hotel but even with that I wake up about every hour. I did sleep though, but just woke up each hour or so for a little bit. As I mentioned before pain is not bad and I just take a couple of Motrin throughout the day. Hardest thing now is getting a good cough and try to get the mucous out. The lungs take a big hit on this surgery, I think almost more than the heart. (or so it seems). Nice weather in NY today so I will get out for some good walks. Going to get a pedometer to track my distance and try to increase a little each time. My heart rate is staying high, 110-120, (this morning 103). Woke up at 10:30 last night with rapid shallow breathing and a fast heartbeat (114 even after meds), same as I had in hospital. I emailed my doc out of concern and luckily he emailed me right back and put me at ease. He also mentioned that the echo I did yesterday, before leaving the hospital, looked "perfect". So great to hear this after a lifetime of worse and worse looking echos!
So, the plan this week is to rest up, walk a lot, get some nutrition in me, get an appetite back, see doc on Thursday and fly home on Friday. Can't wait to see my beautiful kids, I miss them so much. Finally, I must say again how humbled I am by the outpouring of support. I cannot read your guestbook entries without getting emotional and choked up. Thank you ALL!!

Day 4 Report

March 11, 2012

Day 4 Report:

Well it's 7pm on day 4. Definitely getting better each day. Managing pain mostly on Motrin and nurses are surprised at how little pain meds I've asked for.  I did take a Percocet last night to help me sleep though and overall it was a much better nights sleep.  Been having lots of visitors which keeps me busy.  Walked more and faster today and the walking helps. Appetite SLOWLY coming back. I woke up today craving a NY city bagel and cream cheese and at 3/4 of it. Couldn't eat lunch so had a protein shake instead. I'll know I'm good when I want that NY pizza. Overall much better today. Plan is to discharge me tomorrow sometime and then I'll stay in the hotel here and fly back on Friday.  For those of you who didn't like my bitching, did I mention this SUCKS? :)
Thanks again to all who post in my guestbook, it's so great to read all the nice things and have your support.  Keep 'em coming!

Hi Everyone, It's Me!!

March 10, 2012

Hello all, it's me. 
Firstly, I want to thank my wife, Carol.  She is the most amazing and supportive wife and mother around.  I love her beyond words. Secondly, my parents, family and friends who were all here for me from early morning til the nighttime.   I am truly blessed to have them here for me and love them all.  To my staff, baseball friends and professional friends, you are all just amazing. And all my heart valve journal friends who have a special place in my newly repaired heart. THANK YOU! I got to meet Mitch Freidman and Chris Dixon which was really special.  Finally, I'd like to thank Dr. Stelzer and his team. He is an amazingly gifted surgeon and an amazing human being! I literally owe my life to him.
Now, on to surgery and recovery. I'm gonna be honest here, IT SUCKS!  Yes I did great and all that but it still sucks. It's major invasive surgery, they stop your heart and lungs and it sucks! I know, I know, but I've been so positive all along. Yes, the guided imagery and affirmations were KEY! In fact I'm doing post surgery ones now, and these are amazing.  Having my surgeon say positive statements before during and after surgery,  when I was under anesthesia and highly suggestible, I think went a long way. With all that said, it still sucks. Good news it, they say each day is better and it seems to be. I'm not even 72 hours out but I feel better this morning than yesterday and certainly more than the day before. So much to report that I can't do it all now. Appetite is very slow to come back. Lung capacity is horrible. I'm getting walks in. I can't sleep hardly at all. Not cause of interruptions as much as just my mind racing and so forth. I've been up since 4:30 this morning. But at least slept from about 11-4:30, with waking up 5 times! Better than the prior 2 nights with virtually no sleep! I'm in the recliner as I don't like the bed. OK, gotta drag myself up now, try to wash up a little and go for my walk.  Thanks again to all the amazing guestbook posts. I've read many and though there are too many to reply to, it brings tears to my eyes to see the love and support for me that was there as I went through surgery.

Walking today

March 9, 2012

Jeff began walking today. He took 3 laps around the nurses station this morning, and three times up steps. Repeated the same this afternoon and tonight. He is doing well but is very tired. He can't seem to sleep. He had a massage today thanks to fellow Chiropractor, Rob here in NYC. I'm hoping Jeff will get some better sleep tonight. If so, I'm sure he'll feel even better tomorrow.

Carol (at 11:44pm)

Out of ICU!

March 8, 2012

As of 6pm, Jeff was moved out of ICU to his own room. We were able to get him hooked up with a private room for the "king of recovery". ---Jeff made me write that last part. Jeff sends his best to everyone and thanks you all for your support. He hopes to be writing his own journal in the next day or two... Carol

It's A Good Morning and Dr's are Amazed!

March 8, 2012

Jeff is doing absolutely fantastic today. The doctors are amazed at how well he is doing. One doctor came over to ask him if he is ready to go into surgery. All his numbers including blood pressure, blood supply, oxygen, etc. are like he never had surgery. He's talking a lot, eating ice chips, had a popsicle. They are planning to move him into a regular room real soon, within the next couple of hours....Carol

Breathing Tube out and Jeff making his requests!

March 7, 2012

Jeff is doing great. He was definitely glad to get the breathing tube out, like everyone else. That came out around 10pm tonight. Then he asked me if I texted everyone and posted in the journal. Just like him:) He is having a lot of back discomfort, but that's normal of course. He had the nurses change his position in the bed, requested his ear plugs, headphones and ipod, his watch to tell time and chapstick for his lips. He was also asking for ice chips which they were going to give him soon. I'll post again in the morning. Goodnight.....Carol

Out of Surgery in ICU!!!

March 7, 2012

All went perfectly according to Dr. Stelzer. Dr. Stelzer told us that he repeated many positive messages to Jeff throughout the surgery. Just what Jeff wanted. He will be happy. We are waiting to see him any minute. Thanks for the wonderful prayers. Prayers are obviously still welcome until he is out of ICU. Hopefully he will be out of ICU sometime tomorrow.

Carol

Surgery Started

March 7, 2012

Hi all, This is Carol, Jeff's wife. He went into surgery around 9:30am this morning. We will hear from the doctor between 3-4pm. I hope to update shortly after speaking to him. Prayers are welcome all day!!!!

Last post Pre-surgery. First Post-surgery post coming soon:)

March 6, 2012

Hi All:
Many of you don't know something about me. I like to write poems. I guess I learned this from my grandfather, who used to write us letters as kids, but always in a poem form. I'm not sure why he did this, but it was always a nice touch. My staff knows all too well about my poems. It's how I honor them each year at Christmas time. Only their poems mix in some funny stuff too.

I literally just threw this together in the past 30 minutes. So, without further ado, my final post PRE-surgery:

My surgery is tomorrow,
But I go in without any sorrow.
Instead, I look forward to a great fix,
Playing ball, doing even more sports and being right back in the mix.
For all those praying for me, I say thank you very much,
So many of you are there for me and that adds a special touch.
Tomorrow, I will have my "magical band of angels" with me in the O.R.,
Watching over me and protecting me from both near and afar.
For those who don't know who these angels might be,
It's MY "imagined angels", each with a face that is one of YOU, you see.
Family, friends and loved ones watching over all the way through,
And then accompanying me right into the ICU.
They are with me without ever losing sight,
And make sure everything goes just right.
With these angels and some other positive mental attitude stuff,
They keep me focused, goal oriented, and tough.
Sooo, I know I'm in the best of hands and all will be well,
And when I'm done, I'll have one heckuva story to tell.
Thanks to everyone, I'm ready now to do this,
Gonna do great, I leave you all with hugs and a kiss - XOXO

Jeff
Ross Procedure and Ascending Aorta Repair 3-7-12

P.S. Surgery is 9:30am tomorrow. Wil be about 5 1/2 - 6 hours. My wife Carol will post updates as they are available.

P.P.S.: It's gonna be a bright, bright, bright, bright, sunshiny day!!! (that's my surgery theme song/mantra)

Last Weekend Home...for a little while!!

March 2, 2012

Well, its my last weekend home before the surgery. Spending the weekend with family. Tomorrow my 7 year old son Jason has his baseball opening day carnival - games, food, rides etc. I will hang there with him and have some fun. Forecast here in Orlando is unseasonably warm - 90 degrees. Tomorrow night we have an Orlando Magic game to go to. Great father and son time. My girls, Brooke (15) and Erica (11), well, they are hard to pin down - teen and pre-teen ya know! Got to have a nice dinner with the two of them last night. Sunday, my gracious sister and brother in law are hosting a get together for family at their house. Sort of a send off for me. Will be nice to gather with all the family before I leave on Monday morning. I am back in a better frame of mind now. Had the priest say a blessing for me today (yes I am Jewish but my wife is catholic and we went to meet the priest at her church), I have Rabbi's across the country saying prayers for me, my "Ross" brother Chris Dixon is doing so much better, the mental imagery CD's are working well for me, and I continue to realize I have everything going for me going into this - age, heart function and size are good, coronaries are clear, weight is good, muscle mass is good, no other health or organ issues. Hell, I don't think there is a better candidate than me for this :) OH, and did I mention one of the best surgeons around and THE best and MOST experienced with THIS procedure. I got it goin' on!!! And of course, there is god in the room with me and my "Band of Angels" watching over me. Who are the Band of Angels, you ask? Well, that is all of YOU. Family, friends etc. Angels that I visualize when I do my mental imagery. And these Angels, with YOUR faces on them, are there in the operating room with me, and in recovery, watching over me. Can't beat that now can you?!

So, I plan or relaxing this weekend, clearing my mind, showing love to my family and jumping on that plane Monday morning, ready to go and seal this deal.

ONE WEEK 'TIL "V" Day!

February 28, 2012

One week to go. Reality is finally setting in. I am still doing OK, but after what happened with my good friend Chris Dixon last night, it hit me. It was just too close to home. (same surgeon, same procedure, etc, etc) And Chris and I have have gotten real close through all of this. Well, thanks to Chris, I DID have the big cry last night. A couple of times. It's the cry that everyone seems to talk about. I thought I'd get by without that. It wasn't SO BIG of a cry, so let's get that straight. (I'm no "girly man") I think it just all hit me. I was feeling so bad for Chris and Niki and at the same time, I thought WOW, this IS really a BIG surgery and some complication can happen with any of us. We see so many here doing so well and breezing through this that we tend to lull ourselves into a sense of security that it is "routine", "these guys do this all the time", etc etc. It iS true and comforting to know that the mortality rate is like 1.5%. Our doc (mine and Chris') is under 1% and that is for a more complex procedure too. Still, there is always someone who IS that 1% or so that does not make it. So, we don't like to think about it or face it but it CAN happen. Anyway, it's just all so real now and as I move into my last week "on this side", it sure does get more nerve racking. I am good though. I can and will do this..and do it well! I am probably the most persistent person around and I will push thru this and come thru great. I am hitting my CD's hard to get relaxed and keep positive. Sometimes though you have to face the reality of it all. (like going to safe deposit box today and getting my living will out and power of attorney out - that's REALITY). To end on a positive note, Chris Dixon is doing much better. His complication had nothing to do with the procedure and it can happen to anyone getting OHS. Balloon pump out, ventilator out! He had made some great progress today and our prayers for Chris seems to be working. . He is in a lot of pain though from the chest muscles (apparently these muscle guys get more pain - better off being flabby for this operation I guess). On another positive note -- "I GOT THIS"!

10 Days to Go.....and YES I am GOOD

February 25, 2012

10 days to go and I am still feeling good mentally/emotionally. Of course, sometimes I think of the "bigness" of this surgery and I well up with tears. I have not yet had the major "cry" like some have. I suppose that can happen at any time, if it happens. The other day, 2 of my great patients, husband and wife, asked me if they can say a prayer for me after I treated them. They each got on one side of me, held a hand on my shoulders and said a nice prayer. Well, that was touching to say the least and they got to see their doctor cry a little. It really did choke me up so to speak. Human I guess. Heading up to NY a week from Monday with the surgery scheduled for that Wednesday. Luckily, I feel well physically and I am playing in, not one, but two baseball games tomorrow and looking forward to my last day with the guys (until the fall season that is when I come back better than ever!). Thanks again to all my HVJ friends, both the ones I am close to and the occasional ones. You are ALL amazing people and we have something so special in common that it is hard to explain to others not going through this. I also must add that the positive imagery/relaxation CD's really do help. In fact, off to listen and imagine again before I go to sleep.......zzzzzz

Two Weeks 'til "V" day

February 21, 2012

Two weeks from tomorrow. Hard to believe. I am getting ready with reading 3 different books, doing a relaxation and guided imagery CD, compiling my surgery song playlist, writing a surgery affirmation, writing my pre and post surgery "healing statements" that the surgeon or anesthesiologist will read to me, and so much more. I WILL be ready when the day comes. Well, ready as I can be for something so huge as this......

Heart Valve Journal "UNION"???

February 20, 2012

When we are all past our surgeries, or are fully recovered from our surgeries, I would really love to see a Heart Valve Journal "union" (can't say reunion since most here have never met prior). Orlando would be a great place for that. Not just because I live here but its Florida and people like to come here. Can make a family trip of it and outside of the big "union" people can go to the parks with the kiddies, etc. Just a thought. What a great way for all of us to meet in person. I feel such a connection with so many and we have never even met. I know others feel the same way. Would be great if we could all meet up IN PERSON. Just curious what some of you think about this idea. I could help organize this. Nice dinner banquet type of thing. Maybe November or something like that. Let me know your thoughts.

Saw Another Surgeon Yesterday

February 18, 2012

Well, I had another visit with a local surgeon here in Orlando who is actually also featured on Adam's website, Dr. Accola. The visit went well and he was a very nice doctor and it went as expected. My choices with him are tissue or mechanical obviously. Since I do not want Coumadin it would be tissue and his personal choice is bovine. Apparently, the bovines may last longer than porcine and with the newer heat preservation methods, longer still. He quoted a statistic of a 30-40% reoperation rate at 18-20 years. Said another way, a 60-70% chance of no reoperation in 18-20 years. And this is apparently with the older bovine valves that were preserved with glutaraldehyde. He's only been doing the heat preservation ones for 9 years, but the predicted durability would apparently be better than stated above which is based on the prior generation of glutaraldehyde preserved. Has anyone out there reading this had a bovine valve put in at 45 years of age with a fairly high activity level and have it last 18-20 years a more? Certainly, these numbers are somewhat encouraging but personally I think, from what I've read and researched, quite optimistic. I've seen and heard from other sources that at my age the predicted lifespan is 8-10 years for a tissue valve, however it could even go 15. I'm not sure which tissue valve that refers to exactly, bovine the porcine. In any case, there were no surprises for the most part with the visit yesterday other than maybe this statistic. I mentioned the Ross Procedure and of course Dr. Accola doesn't do that. I got the usual "you are making a 1 valve operation into a 2 valve operation” answer". I realize this is the primary objection to doing this procedure and I wrestle with it all the time. Dr. Accola further added that he has a personal (I think he said ethical) issue with doing this.

He did say it could be a very good operation and on at least 3 or 4 occasions mentioned that Dr. Stelzer is an excellent surgeon and does a lot of these. Dr. Accola never bashed the procedure or Dr. Stelzer, but like I said, commented on both being very good. We agreed the operation is more complex and more "unforgiving" if the surgeon doesn't follow the steps and pay attention to detail. We also agreed that experience in this surgery is the key. That being said, Dr. Accola just doesn't do this surgery and won't do it for the reasons he stated above and I respect that.

Needless to say, the visit with Dr. Accola got me thinking again and going through all the pros and cons of the different procedures. I went ahead today and watched this video again with Dr. Magdi Yacoub and it certainly helped my confidence in the Ross procedure http://www.ctsnet.org/innovation/ross/YacoubMagdi_CryoLife_2011.html If you have an extra 36 minutes or so, you might like to watch this interview with him from the Ross 2010 Summit. For those who don't know, Dr. Yacoub is one of, if not the, most respected cardiothoracic surgeons in the world. He has done more heart transplants than anyone else in the world. Here is some info on him from Wikipedia: http://en.wikipedia.org/wiki/Magdi_Yacoub I asked Dr. Accola if he knew about Dr. Yacoub and his eyes lit up and he acknowledged this great man and surgeon. He acknowledged what a pioneer he is in the field of cardiothoracic surgery and he acknowledged that he has done more heart transplants than anyone else. I then asked if he can explain why Dr. Yacoub is so fond of and highly recommends the Ross operation, while many surgeons do not. I don't recall getting any kind of explanation other than him repeating that he personally would not do it due to messing with the good pulmonic valve. In the end, Dr. Accola gave me the very same advice that I have heard over and over again on this site and other places. He said: “Whatever you choose will be the right procedure for you. Go with your gut feeling". That sentence alone, gives me a whole lot of respect for Dr. Accola. He was neither pushy about going with him nor negative on any of the choices. Just factual and up front.

I you want to see the interview with Drs Brown and Stelzer at the 2010 Ross Summit, click this link here. This one is like an hour and 16 min but filled with great info. http://content.bitsontherun.com/previews/o102Z1Hd-NaTo09VE

I have researched this to death, I have wrestled with it time and again, and what I have found is this: regarding the Ross procedure, it is definitely a controversial issue within the profession. That being said, and as you'll see in the interview link I placed above, experience is what counts with this surgery. I know that sounds silly as it counts in ANY surgery, but when it comes to this particular surgery, it really is a major factor. I'm lucky to benefit from the improvements in this procedure that have occurred over the years. Dr. Stelzer has basically dedicated his career to this operation. (Yes, he's done thousands of standard valve operations too). When it comes to the Ross procedure he's basically THE most experienced in the world. He has developed modifications to help minimize or avoid some of the reasons why this operation may fail, early or late failure. It is being shown more and more (and Dr. Yacoub's recent randomized trial study showed this), that this operation can give the best quality of life and also returns patients to a lifespan that is normal and equal to that of the regular population (at least in Britain where the study was done)

My date is set for March 7th for the Ross procedure with Dr. Paul Stelzer at Mount Sinai in New York City. I'm now about 2 and half weeks away and it is certainly on my mind A LOT. I'm preparing mentally with some great resources including a wonderful book and CD called: "Prepare for Surgery, Heal Faster - a Guide of Mind-Body Techniques”, by Peggy Huddleston. I HIGHLY recommend this. I'm going to write my surgery affirmation this weekend. And I'm compiling my surgery song playlist, of basically songs that I have found very inspirational to me over the years. I'm going at this with all the positivity I can muster! And I plan on being back to my old self fast.

Like my newfound heart valve brother Chris Dixon (and fellow "Ross'er", Feb 27) said so eloquently in the close of his last Journal: Homework Done!

A special thank you here to Chris Dixon. Together, we have done an amazing amount of research and communication to reach our decisions. Our surgeries will overlap somewhat in New York City and will get to meet. I feel like I've known Chris my whole life and it's been maybe a month or 6 weeks. The bond that is created by going through something like this is pretty special, especially since we are undergoing the same procedure.

I will also get to meet Mitch Friedman in NYC on March 5th, prior to my surgery. Mitch has also become great friend. Special thanks to Mitch too for all his support and advice. Glad to hear you are recovering great bro!

And to my valve journal hotties, Nancy, Linda and Janis, thanks a ton! :)

Fatigue Follow Up Post

February 17, 2012

Took this from Dr. Wilson's site. Notice below the part about "major surgery"

What causes adrenal fatigue?
Adrenal fatigue is produced when your adrenal glands cannot adequately meet the demands of stress.* The adrenal glands mobilize your body's responses to every kind of stress (whether it's physical, emotional, or psychological) through hormones that regulate energy production and storage, immune function, heart rate, muscle tone, and other processes that enable you to cope with the stress. Whether you have an emotional crisis such as the death of a loved one, a physical crisis such as major surgery, or any type of severe, repeated or constant stress in your life, your adrenals have to respond to the stress and maintain homeostasis. If their response is inadequate, you are likely to experience some degree of adrenal fatigue.*

During adrenal fatigue your adrenal glands function, but not well enough to maintain optimal homeostasis because their output of regulatory hormones has been diminished - usually by over-stimulation.* Over-stimulation of your adrenals can be caused either by a very intense single stress, or by chronic or repeated stresses that have a cumulative effect.*

http://www.adrenalfatigue.org/what-is-adrenal-fatigue

Fatigue and Scar Advice - Hope this helps

February 17, 2012

It seems like I keep seeing some of the same things across peoples journals. A lot of issues with scar pain, bumps etc and a lot of fatigue. Both are "normal" but I wanted to address them a little and offer my advice. As for the scar tissue, there is a non-invasive, safe and very effective therapy out there that is growing in popularity. It is called "cold laser" or "low level laser" therapy. It uses a low powered laser (non-heat producing) to penetrate the tissue and speed healing in tissues. I have had amazing results with my patients with this therapy. Here is a link to the website for the ML830 laser (the one I use in my offices). http://www.microlightcorp.com/technology/videos/

As for fatigue, obviously having a major surgery is a major stress to the body. BUT that is as far as most people think about it. But HOW is it a major stress to the body? What system deals with "stress". Well, its your adrenal glands. And besides all the mental stress we have, these glands deal with physical stress too. A major surgery can "tax" your adrenals in major way and can lead to "adrenal fatigue". That would be basically that the surgery was such a major stress on the body that the adrenals cannot compensate well with raising the cortisol levels. Too much to get into here, but the adrenals respond to stress and help you deal with it by raising cortisol levels, not good long term but good short term. This helps give you energy. It is likely your cortisol levels had been high for a prolonged time leading up to the surgery, especially if you were REALLY worried and anxious, as most of us are. Add to this the stress of family, marriage, work and you get a recipe for chronically high cortisol levels. NOW, add in a major surgery, stopping the heart, drugs, pain, emotional stress and so on and you have the setting for adrenal burnout. Once the cortisol cannot be produced in sufficient amounts, big time fatigue sets in....and a host of other possible symptoms. Sooo, what can we do? For one, take an adrenal support formula. I am taking one by the foremost authority on this, Dr. Wilson. I will leave his website link at the end. Another thing is to SLEEP...ALOT. Get as much as you can. Take the daytime naps, especially at around 2-4 pm when cortisol levels start to fall anyway. Reduce stress as much as you can. Use relaxation CD's. Meditate. Laugh. Watch a funny video or movie etc (be careful of the chest pain though when laughing). Use bio-feedback. Cut out sugar and caffeine, major false energy and strain the adrenals. Anyway, I could go on and on. Here is Dr. Wilsons website: http://www.adrenalfatigue.org/
Hope this info helps.
Jeff

Just Pitched 7 Innings!

February 12, 2012

Damn this sucks! I am going for major OHS in 24 days. I have no symptoms. I worked in my super busy chiropractic office all week, adjusting many, many patients, which is a physical job. I worked out this week with my usual high-intensity strength training "SuperSlow" (though not to the max). This morning I pitched 7 strong innings in my baseball game (yes baseball not softball! - let's be clear on this - LOL). Not to mention getting on base 5 times and running the bases. I go all day long in my busy life and I never get tired or fatigued. I feel GREAT! I am SO HEALTHY! This is the hardest part to get my head around. WHY THE HELL AM I GOING FOR OPEN HEART SURGERY??!! I know the answer.....unfortunately!

Focus!! - On What??

February 9, 2012

Well, it seems like all I do these days is focus on heart valve choices; pros and cons and research, research, research. I feel like I know so much I could practically do the surgery myself...NOT! It's weird how this can consume your life. Not sure why that would be. I mean, it's just a small little procedure...NOT! People keep asking how I am feeling. I think they mean mentally usually. Physically I feel really good. In fact, I was driving to work yesterday thinking about who good I feel and how healthy I am everywhere else. I was like, do I really need this? Mentally, I am doing well. A few moments here and there where it hits me and I get a little teary-eyed, but doing well over all. A month from today it will all be over and I will be day 2 post-op. Anyway, guess I have to get back to work now.....and try to FOCUS on that!

Donation $$$

February 7, 2012

Hello Fellow "Valvers":
Just wanted to put it out there on behalf of Adam Pick. The guy has done an AMAZING job with this website. I have made friends here that I feel like I have known my whole life. It is all so strange and surreal. I guess when people with the same issues face something like this and support one another, bonds are made quickly. And what a resource to be updated in real time, how our loved ones and friends are doing. In any case, I recently made a doantion to this site. While Adam does get doantions from the Heart Centers and doctors, it would be nice for all of us, the patients who benefit most from this site, to make a donation too. Anything would help. Please note that Adam did not ask me to do this. It would be great if each and every one of us went ahead and made a contribution, in any amount you feel comfortable doing. I think Adam would be overjoyed. Thanks.
Jeff

Second Opinion

February 6, 2012

I am going to see a local and highly respected surgeon next Friday, Dr. Kevin Accola. You may ask: Why Jeff, you aleady scheduled surgery for March 7 in NY? Well, with a decision as big as this one, you are never completely sure. I just felt I owed it to myself to have at least one other opinion. Just want to get this doctors views and input. At this point, I am extremely knowledgeable on my choices, the pros and cons of each, the risks involved, the outcomes and so forth. I've done my research, spoken with other patients etc. I know what I "feel" is best for me. I am hoping Dr. Accola is in agreement with my choice. Even if he is not, it is unlikely to sway me from my informed decision. All this being said, my conscience would feel better, having spoken with another surgeon.

Mitch Friedman - On My Journal?

February 5, 2012

Just spoke to Mitch. From the ICU!!!! I thought really sick people are in the ICU. Well, Mitch is talking on the phone, emailing, making journal posts. Funny thing is, this was the first time I have actually spoken to him. We email and post journals but never spoke. Until now...when he's in the ICU. Anyway, he sounds great and is still in ICU due to low blood pressure. He said, as most have, it's really not that bad and it's much worse in your head before going in than it is on the "other side". Best wishes to Mitch. The damn guy even makes headlines on MY journal. - LOL

Decision Made - Date Set

February 4, 2012

Well, it looks like my decision is made. Tonight, I just spoke with 2 Ross patients. One at 17 years and one at 22 years post surgery. The one at 22 years is a patient of Dr. Stelzers. He has quite an interesting story. He had two failed porcine valves by the age of 22. When the second one failed, he was dying, lost weight down to 150 pounds (at 6’2”), short of breath, headaches, etc. He went up and down the east coast meeting with surgeons trying to find help, some solution. He eventually got referred to Dr. Stelzer and has the Ross done. That was 22 years ago and he is still doing great. He does everything athletic wise and has no restrictions, and has not had to be on Coumadin for the past 22 years. He just had an echo done and it looks at though he never even had surgery (except for the scar on his chest) He tells an amazing story about the beloved Dr. Stelzer, as other patients of his have. For me, the Ross is the right one. While all the valve choices have pros and cons, the Ross seems to me to make the most sense and offers the best quality of life and has recently been shown to offer a return to normal life expectancy ( I don’t think any of the other valves can say that as far as I know). If I am fortunate to have an amazing outcome I could be looking at: a valve that is durable and has longevity, no change in lifestyle, better hemodynamics, no blood thinning medications, no special diet, no activity restrictions. My date is tentatively set for March 7th. For those interested, Sir Magdi Yacoub, MD is one of the most respected surgeons in the world. He has done more heart transplants than anyone else in the world. He also has done a lot of Ross Procedures and has done studies documenting the Ross Procedure. Here is a great 2010 interview with this legend in the field. (36 minutes) http://www.ctsnet.org/innovation/ross/YacoubMagdi_CryoLife_2011.html

My Surgeon Visit in New York

February 3, 2012

Just got back from visiting Dr. Paul Stelzer in NY. Very nice man and spent 3 full hours with my wife and I. He reviewed all my tests and then answered all our questions. I tentatively set a surgery date for March 7. I say tentative because I still have some final decision making to do. Choosing a surgeon is one thing. Choosing a valve is entirely another decision. All valve choices come with certain draw backs. My reason for visiting Dr. Stelzer in NY was because I am considering the Ross procedure and he is the most experienced at it in the U.S. Tough, very difficult decisions........

Photos FINALLY!

January 31, 2012

I finally got my photos compressed below 1MB and got them uploaded. WITHOUT Nancy Friedman's help. I asked her how and she said "I don't know" - LOL - Inside Joke

Ross Procedure

January 31, 2012

Spoke with a man named Ralph today from Maryland. He had the Ross procedure 4 years ago and is doing GREAT! He had it done by Dr. Stelzer and said he was an amazing surgeon and person. Sooo, that helps me a lot. That is 3 people I have spoken with now, who all said the same thing about Dr. Stelzer. I am meeting him on Thursday...and then dinner and a broadway show (Rock of Ages) with my wife -- hey might as well have fun while I'm there!

Question: Traveling for Surgery. Need Help

January 29, 2012

Hello All:
Maybe someone can help me with a question/concern I have. I live in Orlando but will likely be traveling to NY for my surgery (Ross procedure). I know that the average hospital stay is around 5.9 days in general. Once released to go home, do most people go back the following week or so to see the surgeon for another check? If you have traveled for surgery, do you go straight home after being discharged from the hospital? Or do you stay an extra week in a hotel etc to make sure things are OK before you fly home? And can you fly home 5 days after surgery? Is that allowed? My real concern is follow up after discharge from the hospital. I realize I will see my own cardiologist back home, but what about any issues related to surgery? I hope to have none of course. Who handles the chest check ups - the stitches etc. I assume my cardiologist? Do I need to establish myself with a surgeon here for follow ups just in case? Or are all follow ups sone through my cardiologist? My real concern overall is traveling 1000 miles back home only 5 days after major cardiac surgery. If something weird happens my surgeon is 1000 miles away.

Vacation

January 29, 2012

Just got back from a relaxing vacation at our condo in Turks & Caicos. So beautiful there. That looks to be the calm before the storm so to speak. Last vacation before I go and "get the job done".

CTA Results - ALL CLEAR!

January 24, 2012

Had my CTA today and spoke to the radiologist this evening. Said my coronary arteries look "GREAT" and I have 'ZERO" calcification. So, one less thing to worry about! Just wanted you all to know :)

CTA Tomorrow

January 23, 2012

Going for me CTA tomorrow. One more step toward the big day!

Addiction - in a good way!

January 23, 2012

This Heart Valve website is like a FaceBook for valve people. It's crazy addictive! In a good way. Making great friends here and I love the camaraderie. Thanks to all those who write. What a great thing Adam has created here.

CTA it is!!

January 20, 2012

Thanks to all of you who wrote back. Some had cath and some had CTA. I have decided after feedback from fellow "valvers" (is that a term?), and doing some research and speaking with a radiologist friend, that I am fine with the CTA. Also, my surgeon recommended this and when I told him I decided on doing this test he said he was "happy to hear that". So, that will be next Tues.

CTA or Catheterization - HELP

January 17, 2012

If anyone out there can help, I have a little dilemma. My surgeon recommends a CTA (CT Angiogram) to check my coronary arteries before surgery, however my cardiologist recommends a cardiac catheterization. Can anyone speak to what they were recommended prior to their surgery? From what I gather CTA is very accurate, however according to my cardiologist if there is a “new lesion” that is not yet calcified, it may not show up on a CTA whereas it would on a cardiac catheterization. I am 45 years of age and the surgeon says usually in that age group we are fine with the CTA, since I'm not high risk for blockage. I should also note I am in excellent overall general health other than a bicuspid aortic valve. I just want to be sure we don't miss anything like a blocked coronary or partially blocked coronary that could have been corrected during the valve surgery at the same time.

CTA

January 17, 2012

Well, I'm going to get a CTA done. That is, a CT Angiogram, to check my coronary arteries. They'll be looking for any blockages. The reason this is done is because while they are in there fixing my valve, if there are any blocked arteries, they can repair that at the same time. I will get this done in the next week or so. I've already sent the CD's of my latest echocardiogram and CT scan of my aorta for the surgeon to look at. As mentioned before, I'll be up there with February 2nd to meet with him and will schedule surgery after that, assuming all goes well at that meeting. I've already checked on available dates for surgery through February and March. At this point, I want to get this done and get it over with so I can move on with my life. Trying to "time" open-heart surgery and subsequent recovery is certainly not the easiest thing. Luckily, I'm asymptomatic and have the luxury of planning when I want this done. With a busy life of work, kids, planned vacations, and so many events and so forth, it is certainly a challenge to find the right time. Of course, health comes first, especially something as monumental as this.

Great Feedback

January 10, 2012

Glad I joined this website and started my journal. I have already had a few great conversations with some great people. Thank you! I just heard from a gentleman who has the Ross Procedure done by Dr. Stelzer and is doing great. He had it done 5 years ago, and 4 months post surgery he ran a 10K. Prior to that he could not walk even a few blocks without being short of breath. And of course, Adam, who runs this website had his 'Ross" done 6 years ago and is also doing very well. All that being said, I am still thinking of meeting with Dr. Gillinov at CC. I hear great things about him. Fact is though, if I go with a Ross procedure, there is simply no one with more experience doing it than Dr. Stelzer in NYC. If anyone reading this has seen Dr. Gillinov, I would love to hear your feedback.

New Year - New Valve?

January 7, 2012

January 7, 2012
It looks like this will be the year. The year I get open heart surgery and have my aortic valve replaced. Hard to believe since I am so healthy otherwise. I have never been in a hospital and never had any surgery in my life. I rarely even get a cold. Very rarely! I guess I saved the best for now. When I do something, I guess I have to do it BIG! I am doing my research and I have big decisions to make - like what valve is best for me, what procedure and of course what surgeon and where to have it done. I am meeting with a surgeon on Feb 2nd at Mount Sinai Medical Center in NYC. His name is Dr. Paul Stelzer and he specializes in the Ross Procedure. This is a special, highly complex and technical operation in which my own pulmonary valve is removed and is placed in the aortic position and then a cadaver pulmonary valve is put in its place. The benefit of this is that I will not have to be on blood thinning medication the rest of my life like with mechanical valves. Also, this may last 25 years (I hope that and more) and is a good choice for younger patients like myself who also want to stay active and athletic. The down side is they have to do surgery on 2 of my valves now as opposed to just one. Dr. Stelzer has done more of these than just about anyone in the world, currently at 502 of them. To learn more about Dr. Stelzer and the Ross procedure you can go to www.ps4ross.com. I will write here periodically and post as I go through surgery and recovery to keep you all updated. I am thinking I may do this in April or maybe wait until the summer sometime.

Jeff