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One Year AnniversaryJust checking in to celebrate my anniversary. One year ago today (Tuesday 13 March 2012) the surgical team at Mount Sinai repaired my mitral and tricuspid valves. Hard to believe it's been an entire year! It certainly doesn't seem that long ago, when my family and I traveled to New York for a spring break healing trip.
"Lend me a heart replete with thankfulness!""O Lord that lends me life, Lend me a heart replete with thankfulness!" William Shakespeare, Henry VI, Part 2, Act 1, Scene 1 (spoken by the King)
6 Months Since NYC Heart SurgerySix months ago today (March 13) I was at Mount Sinai hospital in New York. All the waiting was finally over as my family and I headed down the elevator for the surgical theatre, where the team did an amazing job in repairing my mitral and tricuspid valves in my reoperation. In many ways, March 13 seems a long time ago; but in others, only yesterday.
Post-surgery running reportI'm continuing to realize blessings from my open heart surgery. The results from the holter monitor that I wore for 48 hours, June 14-16, were fine. My cardiologist reported that there were no heart rhythm irregularities or other concerns at any time. Since that report, I've stopped with the warfarin (coumadin).
3 Months after Surgery, Good NewsThree months and a day ago (March 13) to the hour, I was exiting surgery at Mt Sinai, hooked up to many pieces of equipment and just beginning to emerge from the anesthetic blackout. I've come a long way.
Two months since Mount Sinai mended my heartHard to believe it's been 2 months already since my spring break "heart trip" to New York City. I'm now 2 months post surgery and feeling better than I have in years. My resting pulse is in the mid 70s and has not changed in the last few weeks. During the first weeks after my discharge, my heart was really really fast -- resting pulses ranging from the mid 90s to mid 100s. That, luckily, was normal sinus rhythm. Mid 70s is still high for someone who wishes he was in good physical shape, but at least it's heading the right direction.
One Month Post-surgery UpdateTomorrow, Friday the 13th, I'll be one month on the right side of my valve repairs (mitral and tricuspid) and Maze procedure. But I'm jumping the gun and posting today, as this morning Donna and I went to my first appointment with my cardiologist, Dr Ouzts, in Athens GA since leaving New York, where I had my surgery on March 13 at Mt. Sinai hospital.
18 Days Post-surgeryWe've been back home in Georgia since Monday evening. That's a great boost. I taught my first class post-surgery on Tuesday, and even though my energy level was not great, I'm happy I did it. The engagement of preparing for class and teaching is helping to dissipate my post-surgery brain fog. But I'm taking it easy, only working several hours a day and getting in a midday nap every single day.
Returning to Georgia todayToday is Day #13 since my surgery (two repaired valves, one Maze procedure), seven days since my discharge from Mt Sinai hospital. Yesterday was my best day so far, and last night was my best night of sleep -- not normal sleep but moving in that direction. Last evening Mitch Friedman joined Donna and me for a farewell-to-New-York dinner at Ottomanelli Bros. restaurant on Lexington Avenue. We had a great time talking about out HV journeys and where we are headed.
Cleared to Fly Home to GeorgiaIt's me, making my first post after surgery. Many thanks to Donna for the awesome job she has done keeping all of you informed via my journal since my surgery. She has also read to me all of your guestbook posts. I deeply appreciate your thoughts and prayers and advice and encouragement over the past week.
Amazing new medical advanceThe things researchers and doctors are doing today are just amazing. Scientists at Yale regenerated a totally new blood vessel for this child:
best spring break ever?Jim' out of the hospital--left yesterday around 4 p.m. We got back to the guesthouse-it was a beautiful day and we walked from Mt. Sinai (about 2-3 long blocks--4/10 mile). Jim showered and took a nap. Then we had burgers in the neighborhood--me, Jim and our daughter Nicole. However, he really paid for that good food by being sick all night. So note: don't over-do the first meal after the hospital. We even had felt guilty eating well while he was "incarcerated" and brought him a bagel earlier the same day. Maybe not such a great idea. He's better today. Also note: don't let the patient walk by himself (we didn't; except for that moment on the front stairs where he tripped and almost fell onto the railing)--there's still unsteadiness.
Going home-to guesthouse-today!Everything's good except low magnesium and they're still working on blood thinners. So they're letting him out today! We're flying back to Georgia next Mon.
Echo results good!Jim's echo came back perfect. We thought he might go home today; in fact, Dr. Adams and Dr. Chan stopped by yesterday (I missed Dr. Adams again! I think he may be a mythical figure, like a unicorn) and said that actually he was in good enough shape to have left yesterday but because the operation was such an intense assault on the heart (2 valves + a MAZE) they were keeping him in an extra day or two. Right now they want to work on his Coumadin levels--his blood's not thin enough yet. Another cardiac fellow stopped by and told him he has something called junctional rhythm; I had to google that one. All his tubes are out and his pacemaker is out. I think it's just watching and waiting, and working on the Coumadin.
Thank you Nancy!Thank you so much for the poem Nancy! Team Jim loves it.! This means so much to Jim and to us.
Day 3 Post-OpDad is looking even better today; still very tired and sore of course. They just took his vitals again and all looks good (still on the temporary pacemaker for now). Yesterday afternoon, his HVJ (Heart Valve Journals :) friend, Mitch Friedman came by for a visit, which he really enjoyed. It's a rainy and cold day today in NYC so Mom and I are staying inside visiting. Nicole (my sister) is on the plane now in route to the city, so we'll see her later this afternoon.
A Dr. Adams sightingI still haven't met Dr. Adams--we met Dr. Anwanyi--he was the one who came out (beaming) and told us the surgery went well. And Jim met Dr. Adams a few weeks before the surgery but I was sick and couldn't go. Anyway, today I saw a doctor who looked like him from the side and back (how many almost bald young doctors could there be in the cardiac unit at Mt. Sinai? lol!)--as I was getting off the elevators walking toward 7West, he was *running* toward the ICU, with another doctor following close behind. It was just like in ER or Grey's Anatomy!
Walked down the hall and back!Jim looks like he feels better today--he got most of his tubes out too. Pacemaker still in but his natural heart rate is higher so that's good. Jeff and Carol Shebovsky stopped by to visit him today--that really meant a lot to us. I can't believe how good Jeff looks--you'd never know he had heart surgery a week and a day ago! Jim walked the hall to a cardiac discharge lecture (not that he's being discharged yet, but they give this talk only on Tuesdays and Thursdays).
In a regular room :)We went to visit Jim this evening and found he'd been moved to a regular room on 7 West! He's very, very tired, and the place where his central line was removed is really sore. He was blowing into this breathing tube to help with congestion and to help his lungs. He did have to have a pint of blood transfused this morning because of low hemoglobin, but no transfusions necessary during surgery. His pulse had been down to 40 so they have a temporary pacemaker put it. (I'm not sure how or where)…but they're gradually removing stuff--they're removing the Foley catheter at 6 a.m. He's already asking us to bring back stuff we'd removed from his room before surgery--book, glasses…..so I know he's going to be fine!
Sitting up in a chair!They removed the ventilator at midnight. First thing he remembered was the ICU nurse saying we're going to remove the ventilator. He didn't remember our visit last nite tho at the time he responded to us.
Success!!Jim's out of surgery and they fixed everything. Dr. Anwanyu came out and reported nothing negative! No leakage; repaired mitral, put in new ring, repaired tricuspid and did the MAZE. Surgery lasted from 12:01 to 5:30. We can't thank you all enough for your prayers. Praise God for his great mercy!
Surgery In ProgressHi everyone,
The Adventure Begins!Well, they wheeled Jim in for surgery at 10:10 this morning--Kris, Eileen (Jim's MIL) and I were able to accompany him in the elevator to the 3rd floor where they left for surgery and we continued to the family waiting area. They give you a pager and then you hurry up and wait! The surgery was rescheduled to 11:00 a.m. because his "numbers were good", so I guess that's good--they leave the first spots for more serious cases, I guess. They will do 4 surgeries today, so Jim is number 3. His spirits are very good and he's ready for this.
Surgery Moved to 11:00 a.m.So….it's hurry up and wait!
Thank you Adam!Adam, thank you for your beautiful article and words about Jim and Jeff--that means so much to me; I read it to Jim and he was really moved so much, which was wonderful the night before his surgery. Bless you for starting this wonderful web site!
Monday at Mt. SinaiIt's a beautiful day in New York today! Our daughter Kris uploaded some new pictures--from the window in Jim's room (view of Central Park that Jim's roommate has), a picture of Jim when he checked in last night, and Jim and Jeff Shebovsky together. Jeff is getting out of here today!
Checked into Mt. Sinai tonightJim was checked into the hospital tonight to get ready for all the pre-op tests tomorrow; he's hooked up to a monitor and is receiving a heparin drip. He's just down the hall from Jeff Shebovsky and talked with him, and earlier today Mitch Friedman came by our guest house at 102 and Lexington and visited, lifting our spirits! Now I (his wife), my daughter Kristin, and my stepmom Eileen are here and will go over tomorrow and visit. He's scheduled first on the list for surgery on Tuesday! So at 7:15 they'll take him down for prep, and the surgery begins 8:30. It's estimated to take 4-6 hours, but I don't know how much of that includes the prep. Thank you for all your prayers and good wishes--keep 'em coming!
Top 10 Heart Songs #1…My Heart Will Go On, Celine DeonMany of you have nominated "My Heart Will Go On," including Linda Dixon (my surgery mate on Tuesday). FIRST though was Jeff Shebovsky, who wrote in my guestbook more than a week ago, "Think about it....we ALL want our heart to GO ON...and ON and ON....just like she says in the song. It is also a beautiful song by a woman with a beautiful voice." The Major Award for the Top 10 Heart Songs contest goes to Jeff.
We've Arrived in New York City!Donna and I are here in New York. Travel went smoothly. It's a cool, crisp and beautiful spring day here. Sunny but the sun has a winter feel. Pretty windy. The small apartment we've rented at the Bubba & Bean guest house is ideal, and it's very close to Mt Sinai hospital. I really enjoyed an afternoon walk through Central Park. Just got a phone call from the hospital. They'll let me know tomorrow about noon when I can check in' the exact time will depend upon when a spot opens up in a regular room
Top 10 Heart Songs #2...In a Little While, U2 / Hanson"Slow down my beating heart" One day out from my check in to Mount Sinai. Then after a Little While, my heart will be "slowed down" on Tuesday. Donna and I are at the Atlanta airport now, leaving for NY in one hour.
Top 10 Songs#3..If I Only Had a Heart, Tin Man, Wizard of OzRes ipsa loquitur. Easily one of the greatest movies of all time. I was blown away when my mom first had me watch the movie when I was a kid. Still am. And it didn't hurt to have fallen in love with Dorothy (Judy Garland). Here's the scene from Wizard of Oz (1939):
Top 10 H. Songs #4 How Can You Mend a Broken Heart, Bee Gees"Please help me mend my broken heart and let me live again." What more can I say? The only thing I can't figure out is why this song is not number one on my top ten. But there are three more to come, including one that no one so far has proposed.
Top 10 H.Songs ... #5 Deep in the Heart of Texas, Perry Como"The stars at night are big and bright
Top 10 Heart Songs.. #6 You Gotta Have Heart, Damn Yankees"You've gotta have Heart!
Top 10 Heart Songs ... #7 Heart of Gold, Neil Young"I want to live,
#8 Don't Go Breaking My Heart, Elton John & Kiki DeeTop 10 Heart Songs: "Don't go breaking my heart
Top 10 Heart Songs ... #9 Achy Breaky Heart, Billy Ray CyrusRefrain: "But don't tell my heart, my achy breaky heart
Top 10 Heart Songs ... #10 Piece of My Heart, Janis JoplinReading Jeff Shebovsky's journal has inspired me. His entries show a highly organized and prepared man with tons of energy. Among his many preparations, he reports that he completed his surgery song playlist more than a week ago. I'm doing something slightly different. Right now I'm 10 days away from checking into Mt. Sinai hospital in New York, so I'm putting together a list of the top 10 "Heart" songs. Each day I'll announce the next song. I invite you to send song nominations to me on my Guestbook. The only rule is obvious: the song must include the word "heart" at least once.
A-MAZE-ING addition to my surgery planPun intended. My surgical plan now has an addition: a cryo-maze procedure. This morning a bit after six o'clock I emailed my surgeon, Dr Adams, to follow up on email conversations that I initiated earlier between my Atlanta cardiologist, Dr Randy Martin, and Dr Adams. In less than 3 hours, one of his team members (a postdoc at the Mt Sinai School of Medicine) phoned my office. I was able to return his call before he entered surgery, and we had a conversation about cryo-maze, which answered all of my questions. The cryo-maze procedure will use a cold probe to draw traces over my left atrium, which will serve to interrupt re-entry circuits that can cause atrial fibrillation. Adding this procedure to my work order will lengthen my surgery by 15-20 minutes; not bad. The potential upsides are considerable. Many valve repair patients have some post-op AF. The real measure of success for the cryo-maze is 3 months out; the prediction is 80-85 percent success due to the cryo-maze. And a related advantage: if later intervention is necessary (e.g., ablation) a prior cryo-maze increases the probability of success. If anyone wants more info that’s available online, there’s an article, for which Dr Adams is a co-author, titled “Surgical treatment of atrial fibrillation using cryothermy in patients undergoing mitral valve surgery” in an Oxford Journal “Interactive CardioVascular and Thoracic Surgery.”.... Getting all this info so quickly has increased my already-very-high confidence level in the Mt Sinai team. We're continuing to move the ball forward. Surely we've passed midfield by now.
Last "Walk in the Woods" before SurgeryMy apologies to Bill Bryson for borrowing the name of his book. Today was my last hike before surgery (we travel to New York a fortnight from today). Last year my daughter Kristin and I joined the Georgia Appalachian Trail Club. Actually, we paid dues and became "prospective members" because the Club requires the completion of three activities before admittance as a member. Today I completed my 3rd activity (second for Kristin, she still needs to volunteer for a trail maintenance outing). We picked a 4.5 mile hike through the trails at the Elachee Nature Center near Gainesville, Georgia. Rolling hills, well-maintained trails with wooden bridges over creeks and wetland areas. Brilliant weather - clear, in the 40s when we started, mid 50s when we ended close to noon. I especially like winter and spring hiking when the trees are leafless; you can see so much more. It's a very different feel than hiking in the South in the rest of the year, where you're in a green tunnel for a high percentage of the time. In My Photos I've added a pic from today's hike.
Exercise prior to Valve SurgeryLast October I discovered that I had atrial flutter, that my mitral regurgitation was severe, and that my left ventricle (LV) ejection fraction (a measure of pumping efficiency) was way too low. At the time I was not in good aerobic shape. I had not run effectively since May, and wasn't doing much else. After my atrial flutter was corrected by ablation in October, I was eager to return to running, but my cardiologist vetoed that plan. He encouraged me to exercise, but not exceed a pulse of 120 per minute. So I've taken brisk walks, usually 6-7 days per week, ranging between 30 and 75 minutes per outing, using a heart rate monitor. To stay under the target heart rate, I really have to slow down when I go up any hill of significance. On some days I use a stationary bike at the gym instead. Although I'm not happy with this limitation (one reason I want my surgery date to arrive fast), I realize the purpose: let my heart rest and hopefully recover some of its efficiency prior to the surgery, and hold down cardiac risk that might result from the stress of hard workouts.
Spring break can't come fast enoughSpring break starts on March 9. More than a few of my friends at the university have commented that I'm planning an unusual spring break trip! The days are going by so slowly for me (but not because of an upcoming beach trip). For awhile after my Feb. 1 consultation with Dr. Adams, I hoped that an earlier surgery date for me would open up at Mt. Sinai. But the hospital hasn't called, and at this point Donna and I have made all of our travel plans to New York, including renting a very small apartment for two weeks. Plus I've arranged my work schedule to make the March 13 surgery date fit, and my daughters and Donna's stepmom have made their NY travel plans as well. So if I get an offer of an early date now, I'll reject it. It's clear to me that medically, there would be no appreciable plus for having the surgery this month, rather than in March. It's just that I'm tired of the waiting. Luckily, I have full days at the university to occupy my time, plus plenty of chores to do around the house and yard (per usual, my list is long, and tends to expand rather than contract).
Risk of Atrial FibrillationOne month from today (Sunday March 11) I check into Mt. Sinai Hospital. I wish it were sooner.
Consultation with my SurgeonBelow is a note that Donna emailed last week to family and friends with info about my consultation with Dr David Adams and the Mt Sinai team:
Planning our trip to New YorkHere's my first journal entry. Donna and I are now working on planning our trip to New York City for my surgery. We've booked a flight from Atlanta to NYC on Saturday, March 10. The next day, Sunday the 11th, I'm to check into Mt. Sinai hospital for pre-surgery testing and to begin a heparin drip.
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