Bob's Journal

I am 3 weeks removed from surgery. Everything seems to be progressing in the positive direction. It took a while but I now have home health care set up. With the home health care, I have a physical therapist and a RN come visit me twice a week. The RN checks my INR (blood thickness) levels and communicates with the anti-coagulation clinic to adjust my warfarin medication as required. The physical therapist made sure we had the house set up well for me and covered the basics of what I can and can not do. But more than that we covered my walking exercises. It turns out I was walking too slow and not long enough. I guess it was better than going too hard but now I feel like I am making some real progress. I am still having some numbness in my pinky and right side of my chest. I still have a small blind spot in my right eye. I still have episodes of heart palpitation or heavy heart beats and I still have episodes of low blood pressure. Even with all of that I am feeling good about my recovery and where I will be when all is said and done. I met with the surgeon today and he says that I am progressing ahead of schedule. I have been given permission to drive again (but Sonya still says I can not drive for another week or so.) I talked about all of my issues with the surgeon and he says they are all normal and should go away with time. He did however suggest that I go see an ophthalmologist to look at my eye just to make sure nothing serious has happened there. All of my restrictions will be lifted on Christmas day. I have a phone call with my cardiologist on Monday to get him all up to date with my recovery and he will be taking over most of my recovery from here on. My daily exercise consists of 3 - 10 minute walks at a pretty good clip. It surprises me how much I am able to do. The next step will be 2 - 15 minute walks. Hopefully my recovery keeps progressing in the positive direction and I am better than I was before the surgery. Thanks again for all the support and love, Bob

Well, let's get some things out of the way here. First and foremost, Wayne, I am sorry. Evidently Wayne didn't have as much to do with my crappy sleep as I thought. I did not sleep good at all. I think I am done with the norco. It gives me weird dreams and I don't feel very good on it. At this point I will be finding other means of pain relief. I woke up with an odd spot in my vision. It was similar to vision issues I get when a migraine starts so I don't think too much of it. Well at about 10 am the entire top field of vision of my right eye grays out, no vision at all, just a gray sheet in the top half of my right eye. My wife sees me doing goofy things with my eyes and asks me what I am doing. I tell her what is going on and she immediately calls 911. The call isn't half over and my vision is already back to mormal, but the paramedics are on the way anyway. They show up and check my vitals and everything seems reasonable. They suggest I go to the hospital to get checked out and offer me a ride. I hyme and haw for a second, and Sonya just says, "Yes, he is going." So I have my first ambulance ride, how uneventful. No sirens, no speeding, no running red lights. The only good thing is that I didn't have to wait in the lobby to get checked in. Probably worth the $1000 the ride is going to cost. Just like the day before, another round of blood tests and chest x-rays is ordered. The white blood cell count came back a little higher than the last one I had before being released from the hospital. Other than that, everything looked good. They have me an IV to up my fluids in case I was dehydrated (I filled their pee bottle plus a little more while I was there, i don't think I was dehydrated.) The ER Dr. finally gets a hold of a surgeon at my surgeon's office and agree I should be placed on antibiotics as a precaution. I am finally released from the ER a little after 2. Home bound once again, and once again, Sonya ends up taking the long way home. The rest of the day was rather uneventful. What amazes me is how much the way I feel can change and how quickly it happens. I can be feeling absolutely great, with no pain, or heart irregularities and 5 minutes later I feel exhausted, out of breath and my heart is pounding. I am trying to find triggers that cause these moments. I don't know that there are any, it may just be the nature of the beast that is recovering from heart surgery. I did notice that I had a major set back shortly after I took some Acetaminophen (which has caffeine), that may not be my replacement for the norco pain meds. Thanks again for all the support and Love! Bob

Well, my atrib-fibrillation is not completely under control. It comes and goes but most of the bouts aren't too bad or last too long. I am staying on the oral meds to try to control them. The hospital has gone back and forth about letting me go or not with my cuomadin clinic not set up and my inr levels still fluctuating plus my white blood cell count has been on the high side. After my morning x-ray and blood work, the cardiologists decided my numbers were good enough for my condition, so I am headed home today! I am not sure how I feel about that at first. Am I ready physically? Am I ready with my meds still not completely worked out, who know what else. But, I haven't slept much here at the hospital and I think I will sleep much better at home. My roommate in the hospital, Wayne, was only supposed to be in the hospital for one night but he ended up staying all 3 night with my in recovery due to various setbacks on his side. Wayne was a nice enough fella, a bit of an old crotchety guy that didn't have any visitors. His wife had passed away a few years ago and maybe his other local family and friends didn't want to go to the hospital due to covid. He would text with a few people. I only know this because he was having a difficult time seeing and he would use the phones voice recognition to respond to texts. It was often entertaining as he would have to say the same thing 3 or 4 times before the phone translated his text properly. Anyway, my only true gripe about Wayne was his nighttime activities. He would stay up until midnight watching TV and use the incredibly loud nurse call for any willy-nilly need he thought he had. On the last night, it was sometime after one that he finally turned the tv off. He must have fallen asleep quickly as he started moaning in his sleep. This was new! It was a near constant moan broken up by very sudden and loud coughs, than right back to moaning. This is not a good night. I eventually get some ear plugs in and was able to sleep a little. Turns out Wayne was getting to leave shortly after me. As expected, the day went slow for checking out. Sonya showed up about 11. I had visits from the physical therapist and cardiologist. I took a shower and changed into real clothes. I did become a convert into the pee bottle! How nice is it to just grab the bottle, open it and place it in the right position and let loose, I don't have to get out of bed in the middle of night 2 or 3 times, get cold and uncomfortable just to go pee. Of course, the pee bottle goes along with the convenience of not wearing any underwear in the hospital! Check-out time finally comes around 1:15. I am still apprehensive about leaving but as soon as the door opens to go outside I know it is the right choice. I feel a rush of energy and health run through me. Sonya ended up taking the long way home on accident, so it was about 2 hours for us to get home and it was great to be there.

Well, shortly after I posted the Day 3 after Surgery post I had a mild setback. I started into atrib-fibrillation. Which means I have a very uneven heart rate and it feels like my heart is going to pound out of my chest. They quickly got me on an IV of meds to help control things. It takes a while but after about 6 hours they took me off of the IV and now I am just taking some oral meds to help out with the atrbl-fibrillation. Hopefully these meds will get my heart rate back into control and I can get off of these meds. The Drs. say this is a fairly common occurrence for this type of surgery and it rarely results in any long term concerns. The other concern I have at this point is setting up my coumadin program. When you get an artificial valve put in it increases the chances of blood clots which can cause strokes or heart attacks. Therefore, everyone with artificial valves takes some sort of blood thinner (typically coumadin) and it needs to be monitored very closely to make sure the blood is thin enough that it doesn't cause blood clots, but thick enough that it does not cause you to bleed to death. The heart valve that I got put in is under a study to use Eliquis as the blood thinner instead of cuomadin. Most people I have talked to think Eliquis is a much better drug to be on, so that would be a good thing if it turns out good. Anyway, my problem arises as this hospital can not get through to either my cardiologist or my general practitioner so they can't get a program set up until Monday. They are still holding out hope that I will be able to go home on Sunday, but we will see how this goes. The good news, I pooped yesterday which was one of the last steps I needed to cross to get the ok to go home. Thanks again for all the love and support. It means the world to me Bob

The doctors say everything went very well, unfortunately, I did not stay at a Holiday Inn Express last night so I have no way of disputing them. I was standing and took a short walk on Wednesday, by short I am talking 50 - 75 feet. Yesterday I went a little further and this morning I got myself out of the bed and walked to the bathroom with the help of a walker. All little steps in the right direction. The day I showed up, I did a baseline breathing test to see how much air I could breath in at a steady rate in one breath. I measured about 2500 ml. Now I am struggling to get 1000 ml but that is to be expected, it is very uncomfortable to expand the lungs. I was on an IV morphine when i first came out of surgery and for about the first day than I transferred over to oral pain meds. They have me alternating between Tramadol and Nor-co. The first time they gave me the Nor-co it was a double dose and I did not like the way it made be feel so now they are only giving me the normal dose. For the most part, I don't have too much pain except for when I am moving about, sitting up in the bed or coughing are probably the worst. I think I am going to get to take a shower today so that is pretty exciting for me. I was in the ICU unit for the first 2 nights, then, last night they moved me to the general section. I don't know they way it normally is, but the ICU room was way nicer than this room is and I was the only person in the ICU room. The nurses in the ICU unit were much more attentive than they are here in the general rooms. I am sharing my room with an elderly gentleman who I believe had eye surgery yesterday. But given the fact that he could barely see anything anyway, he had to have the lights on all night. UGH, sleeping is hard enough without that nonsense going on. Yesterday the surgeon said I would probably go home on Sunday, but i will need to get a poop out before they let me out of here. That's about all I am up for now, so I will let you all go. Thanks again for all of the love and support. Bob

Not too much to add today. I went down for my covid test on Saturday. As expected, it was very quick and this time it was less invasive to my nose. The giant q-tip was only inserted into the area that most people would consider "the nose", where it was rotated for 10 seconds, then placed in the other nostril for another 10 seconds. All in all, I might have been there for 5 minutes. The good news, I received word today that the test came back negative. I have received a couple of pre-check in calls the last couple of days. I am not sure how many times they need to verify that I am not allergic to anything or that I am taking the 2 same medications I was 48 hours ago. I will say, everyone has been very nice and friendly and I would rather answer these question a hundred times to make sure all goes smoothly. Sonya, Dax and I are heading down to Roseville this evening to stay with a friend. I have to check in tomorrow at 4:45 AM! I am not allowed to eat or drink anything after midnight, so I will be up eating bacon, Twinkies and donuts until the bell strikes 12! I am still feeling relaxed and confident that this will be a positive journey. I am not sure when I will be up to posting again. I am hoping it will be day 2 or 3 post operation. Again, I can't emphasize enough, how much the support and encouragement helps me. Talk to you soon! Bob

The count down has started. I am feeling comfortable with all of my decisions so far. I notified the surgeon (Dr. Robert Kincade) of my decision to go with the ON-X mechanical heart valve to replace my aorta valve. There is currently a study going on where recipients of an ON-X valve are taking Eliquis as opposed to Warferin. I am not sure if the Eliquis is any better than the Warferin but at least it is a possible option. For those that don't know (I didn't until a week or so ago) these medications are a form of blood thinner used to prevent blood clotting at the mechanical heart valve. If that blood clotting occurs it can cause stroke or a heart attack so everyone who has a mechanical valve is on blood thinning medication for the rest of their lives. That is the main reason people choose to go with a biological valve instead of a mechanical valve. I have to go down to Sacramento for a Covid test tomorrow. The hospital requires all patients to be tested 2 to 3 days before being admitted at a drive thru testing site at the hospital. No options for testing at an alternative site. So yeah, I have to drive all the way to Sac, stay in my car, have my nose violated for 15 seconds, and drive home. On a positive note, the hospital has changed their visitor policy since I had my appointment with the surgeon. I can now designate 2 people to visit me during my stay, of which, one can visit me each day for and hour, but not on the first day. Oh, and they need to make an appointment to visit. But at least I can have some visitation. I have been feeling a little more fatigued as the day wares on and when I get up too quick from resting I get light headed more frequently than I typically would. It also feels as if my heart is pounding at times, usually when I am laying down tying to go to sleep. I don't know if this is from my heart issue, getting old (shut up!), or that my cardiologist (Dr Stephen Masa) instructed me to stop exercising. While it is nice not waking up at 4:45 in the morning to go to the gym I do miss the feeling of exercising. The outpouring of support has been amazing. Sonya has been the main conduit to let everyone know what is happening with me and I can't thank her enough. In fact, she is the one who encouraged me to write this journal as a way to keep all of you (yes all 3 of you) up to date with my condition. I can't say enough about how much she has helped my so far. I am going to try to keep this journal as up to date as I can but please, no editing of my grammer and spelling, I am an engineer after all. Thanks again for all of your support! Bob