Bob's Journal

One year ago this very minute I was in the most surreal moment of this experience. Having prayed and kissed the wife I was now in the final pre-op frenzy getting shaved and wired. It was a unusual emotion of having accepted by faith that, as my wife put it, I would wake up to see her or Jesus. I don't recall that they had given me anything up to that point to keep anxiety levels in check, but I was calm...........
Now, one year later, I am about to head to my favorite spot in the mountains to celebrate. Fore each of you that were here to encourage me (Adam) I thank you from the top of my heart. For you who are, I was 12 months ago, here looking for information and encouragement I give you peace and prayers. You too will be posting of your daily victories to recovery. God Bless you all.

Just for grins I'm posting the picture my wife took of my first full day at home following surgery with my staff of attendants looking after me.

Just had a contrast CT and Echo-cardiogram and met with the surgeons PA. My Edwards Magna Cow tissue valve and Aorta dryer ( the Dacron graft) vent are all working as ordered. I have been at full activity levels since the 8 week mark. Often have to remind myself that I had OPEN HEART SURGERY!!!! :0 Just for grins I'm posting the picture my wife took of my first full day at home following surgery with my staff of attendants looking after me.

Cardiac Rehab: Been there, done that, got the TShirt

Marking week 12 since my OHS to replace my aortic valve and graft to replace ascending aortic aneurysm. When folks ask me how it was I just say, "Easiest thing I ever did, in fact I slept right through it. Hardest part was the anticipation."

Just wanted to post an update to encourage all who like me were looking for encouragement for a very scary time. It will be so much better when you get on the recovery side. The trauma you are going through now and at the hospital becomes a distant memory very fast. You can do this and the pain is nowhere near what you fear. See you on the recovery side of life!

Going in to the 8th week post OHS, I celebrated by going to Cades Cove in the Great Smoky Mountains National Park. A favorite place my wife and I visit, this is our first trip since my diagnosis when I was told to stay close to hospitals because of the an

Hey Heart Valve Family, just hit the two month mark. Feeling awesome. Sternum pain almost negligible (almost being the operative word). For those of you in the pre surgery phase, it quickly becomes a distant memory so take courage and get it done.

Week 6. This is how I feel with my chest/body hair growing back in.

One day shy of 5 weeks and I get to go back to work starting tomorrow! Only half days for the first two weeks, not only grateful that I am ready, but that I FEEL ready.

With my wonderful surgeon Dr. Raymond Dieter

Well I went to see my surgeon for the final visit today, barring any future needs. Was told that I could start driving as long as I wasn't taking any pain meds, (Haven't taken any since I left the hospital) and can go back to work on a half-day basis starting next week. I am pumped!

Continuing with Cardiac Rehab, thanks to those who encouraged doing that. Even though I can do all of that at home, being monitored gives me more freedom to push a little further.

In fact I wanted to take a moment to thank all of you for being a part of this community, your mutual experiences and encouragement have made quite the difference. Especially thank you to Adam Pick for starting this website.

Ow

Well I just passed the 3 week mark yesterday. Went in for my cardiac rehab evaluation and walk test. I won't be able to do any upper body work for quite a while, but they said we can work on the rest getting my heart back to work. Hope this helps my attitude, been getting to be a bit of crank. Probably just a bit of cabin fever not being able to do much. It didn't help that after coming off some of the meds last week I put back on 4 lbs of what I had lost. I know it's just fluids, but still it sucks, though already a pound of that is gone. Wish I had more electrifying news, but there isn't much excitement in a marathon's half way mark.

Just two short weeks since I had my aortic valve and ascending aorta replaced. Feeling very little discomfort and that only on occasion. The time in the hospital is already a distant memory. I've managed to lose quite a few unwanted pounds, I now weigh less than I did 20 years ago. :). Having to stay home/not drive for the next month is going to be my biggest challenge. Visited my workplace yesterday and realized how much I like the people I work with. The one question that kept being asked is about my artificial Bovine valve. I just tell them that the only issues I'm having is wanting to chew my food twice, laying down every time a storm front comes through and a new found love for Chik-fil-A.

Given that sleep was relegated to 2-3 hours shifts, the next three days before discharge are actually one,,,,,,very,,,,,,long,,,,,,,day. The number of times I woke thinking I had had a full night's sleep, and another morning meant closer to going home, only to realize I had only slept a couple of hours were numerous.
It didn't take long before I realized I really didn't like the hospital bed. The inflating mattress would deflate and leave my rear in a hole. Unable to just scoot and adjust wasn't working for me, I called for help. The second lesson I learned is that nurses and aids don't necessarily do things they way you think they would. I just wanted a simple slide to the right and up about two inches. Next thing I know they have taken my pillows and started tilting the bed backwards much like they launch bodies from a ship burial at sea. When the falling sensation hit I tightened my chest and abs to get immediate confirmation that I had a full sternotomy and had chest tubes still installed. I didn't ask for that help again.
Now don't think I experienced any real pain while I was there or since. In fact the only pain I had to endure was a muscle spasm across my abs at the chest tubes. My sternum hasn't bothered me in the least, (well there was one sneeze after getting home), my biggest complaint was that I was sweating profusely. I mean dripping off of my head soaking the sheets sweat. What was hilarious was when you tell the nursing staff you are burning up they would check the thermostat to the room and even called in maintenance to check even though I was the only one hot. I requested a fan. Must have been a sale as the one they brought in I'm sure doubled for the wind tunnel test for Boeing.
It was soon discovered that I was in A-fib. Not sure how long it had been, but earlier the first night someone had unhooked my wireless EKG pack and forgot to hook it back up, I didn't want to be in the next staff meeting about that. In came the IV's with Amiodarone, I started feeling much better.
The rest of my stay was a flurry of activities of breathing exercises, walking the hall with PT with the only final trauma being the removal of the chest tubes. Oh and just in case you missed the announcement, I did have a bowel movement. No less than 2374 people inquired to the point that I wanted to put a poster on the wall to that effect.
So as I sit here now, OHS post op day 9 all of this is just a memory now, my recovery is going fantastic. Getting stronger every day with my biggest pain coming from my wrist where the Amiodarone IV blew loose and dumped a bunch under my skin.
If you are reading this while preparing for your own OHS I hope having the knowledge helps, but you'll still probably be nervous as can be. We will laugh about that when you get on the other side and in recovery.

When I actually woke, I found myself in the CICU and a young man I believe named Stephen introduced himself as my nurse. Sharp guy. Drugs were well on board as I don't recall a lot that afternoon. In the morning things started to happen.
I mostly recall wanting ice. I think the fear of coughing trying to drink in the laid back position. At some point they brought me jello. That would require sitting up and I just didn't want to go there. No pain. Just the thought of it.
Sometime along 7:00 a.m. in comes the portable X-ray machine. The young lady operating it was nice, but obviously clueless to my procedure or proper protocol. "I need you to sit up so I can put this x-ray film cassette behind your back." she said. "You may want to get some help to do that." "Just grab the rails on the side of the bed and pull yourself up." she replied as the stern voice of my wife burst across the room, "NO, he can't do that!!" I was thinking the same thing, but through the sedation wasn't really doing well communicating.
More sleep. I woke at one point thinking how convenient having a Foley bag on. Didn't have to worry about peeing. "Okay Mr Gillespie, we need to get you cleaned up and ready to transfer to the step-down room." my second shift Nurse Lanny said. "I'm going to take your Foley Catheter out now." Dangit.
Soon there was a cadre of nurses buzzing about the room including the first female that I recall. As they started unhooking and unplugging things she started the sponge bath, open door to allow humility a quiet exit. No sooner than she hit me with the first warm water towel I was also hit with the need to pee. Third shift RN Donnie did the honors. Poor fellow.
"Ready to sit up in a chair?" Donnie asked. "Not so much," I replied. "You have to sit up before we can move you to the step down." "Chair please." So I got to have my first struggle to sit up with out pulling my chest. Heart Pillow introduction.
Soon after I had my second urge to pee. Afternoon shift nurse Lanny starts to help when an emergency in another room called for him. He turned me over to Lisa to do the urinal chore, Wave goodbye to humility as it makes its final bow.

In recovery/step down I wanted to try to write, but my medicated brain, fat thumbs, and an iPhone just couldn't get it together. After re reading some of the texts I sent out they probably shouldn't have let me have my phone anyway, LOL!
I somewhat hesitate in telling of the different parts of this adventure only because of those here that are preparing for their OHS. Everyone is slightly different and I don't want someone to get overly worried about something that happened to me happening to them. Don't worry over it (even though you will anyway).
Surgery day started at 3:30 a.m. and due to preparing there wasn't much to do except shower one final time with the sanitizing soap. I realized then that nothing was mentioned about shaving. Knowing that I wouldn't want to shave for several days I broke out a new blade and just shaved with hot water in case the shaving oil I used would be a hindrance to the surgery itself. We hopped in the van and arrived at the hospital in short order.
My pre op nurse was already looking for me when we stepped off the elevator. She leads us to the first prep area for me to change into my gown, instructs my wife on how she will be informed throughout the process. Ok, this is it. Time to kiss goodbye. We roll to prep.
Various people move about purposefully wearing surgical attire. I note about three others in the same room also being prepped, we exchanged glances but no chat. Nurse A begins methodically placing monitor pads, BP cuffs, finger monitor and IV lines. "This is John,"she says as a big baby faced man steps in to the curtain area, "he's going to shave your chest." John proceeds to run the clippers from my neck, all the way to my knees, no one had mentioned that part and then use tape to gather loose hair. "You didn't go to barber school for this did you John?" He just snickered.
Next up the Anesthesiologist, I rattled off name, birth date, what I was there for, who my Dr. is and that I had no known allergies for the umpteenth time wondering that if I gave them the wrong answer would they send me home. They install a central line in my neck just above the collar bone.
I don't know if they had already given me something when they did the central line, within seconds it seemed I was moving onto the surgical table and before I could say anything I was out.
Out in the waiting lounge the attendant pages Mrs. Gillespie. "They've started now." And then, "Mrs. Gillespie he's on bypass now." Then a few of the longest short hours later, "Mrs. Gillespie he's done with surgery and headed for recovery." Dr. Dieter then arrives to deliver the good news that all went as planned. The great news being I didn't require circulatory arrest.
One of the things I asked was would the vent tube be removed before I woke up. They assured me it would. Liars. I just remember banging on the bedside rail to get someone's attention and a male saying to relax, probably as he shoved a syringe into my IV tube. The next awareness was my lovely wife standing by my side, vent tube gone.

Part two of What a Ride will be coming soon.

My Zipper Club official photo

Well I made it through !!

Well, final day preparations are all in place. Took my wife over to the Univ of Tenn Med Center so we could get a layout of the parking and path to the admissions desk, the waiting lounge, elevators, cafeteria etc. It was really kinda cute the way everyone reacted when they saw us wandering and realized we were coming tomorrow as patient and family. They were very kind and helpful. Got the rest of the admissions paper work done too so we didn't have to fool with it at 5:30 in the morning.
Arrived home just in time for the start of the solar eclipse. Didn't want to take a chance of getting in the traffic and mobs to travel the 20 miles to get to see the "totality'', I believe it was 99% here at the house. Still pretty cool, for the 2 mins duration all of the automatic lights came on, cicadas and frogs started chirping. If you ever get the opportunity it would have been worth the crowds to get to see the full eclipse, unless you have an aneurysm. ;-). I want to thank Adam for this website but most importantly for those of you on here that have shared your stories and your 'been there' encouragement. You guys have been a God-sent blessing to me in facing this event.

Oh wow, I'm next on the list!

Last day at work before next weeks OHS. My coworkers (car salesmen) prayed over me today.

In my younger days I used to teach skydiving. When asked about the fear before jumping, we always said you can't avoid having butterflies in your stomach. The secret is to get them into a good flying formation!
Well there they are again. From sometime in the future, to seeing my picture on the Upcoming Surgeries board. Suddenly realizing that the pre surgery calendar starts today. The list of things to stop doing. The list to start doing. It's pre-jump butterflies time. Seeing my smiling mug on the list is like hearing the airplane engine crank up while getting on our gear.
But I have my checklist and everything is falling in place. But it's perfectly okay to do a second gear check, or even a third. Then do a buddy check. Time to head toward the plane. One last check, butterflies.......check.

After the post earlier when we discussed the way people comment "You'll be FINE!", like it's no big deal, and the immediate deluge from those of us facing and just through OHS. From Mark Wahlberg in the movie "The Italian Job". You know what FINE stands for?

F reaked Out
Insecure
Neurotic
Emotional


LOL

Nurse 'M'

Following yesterday's setting of the date, some more affirmation and encouragement came today as I went for pre op tests. First, I know there are several different beliefs in this community and I will preface my remarks by stating that I am a follower of Jesus Christ and so many of my observations are from that viewpoint. From the very beginning of this journey I have had many life events that most would call 'bad' that I now in hindsight can see were guiding my steps and redirecting me to this point.
As a quick background to allow you to see that path, I had bladder cancer 5 1/2 years ago that led me to the Internist I now see as my primary care Dr. His intuition led to the early discovery of those tumors that were dealt with and have not returned. Last year I discovered I had Melanoma on my face which also was caught early and is now clear. Because of that he insisted that I have an annual low-dose CT scan the first of which uncovered the aneurysm which then uncovered the regurgitating aortic valve.
The rest of my journey up to today is in the preceding posts.
While at the surgeon's office yesterday they attempted to get me a quick appointment for the pre op work up but it didn't work to suit my schedule so we set it up for this morning. Nurse 'M" called me back. As we were headed for the exam room she suddenly stopped while looking at my chart. "I go to church with your family and live next door to your sister!" If the plans for the day before had happened she would not have been the RN to do my work up.
From that point throughout the tests I learned from 'M' that she had a thorough knowledge of my surgeon. The number of difficult cases she had witnessed that had proven out his skill. His personality and professionalism. That he had worked on several members of her family to great success. She also would be the answer to my parents prayers as she could answer the questions and be a close personal support for them.
Then she affirmed that I was definitely making the right choice of doing it now.
It was then that I recalled all of the events that led me to this point, the fears that I had laid out in my morning prayers. And that my concerns of 'Did I pick the right time? The right Surgeon? The right Hospital?' were being answered through nurse 'M'. Finding this community of fellow 'heart' patients who have gone through this before is also part of the affirmation that I believe has come from my Lord. Affirmation and encouragement=Hope.

Hearing yourself utter the words, "Let's do This," reality gives you a swift kick in the behind.

This is real, this is happening.

More verbal affirmation, "I want the bovine tissue. Can I see the valve? Can I see a sample of the Dacron Graft?" "Is it going to be a mini or full Sternotomy ?

Then comes the next reality check. This is a big deal surgery. There is a possibility that they may have to put me into full Circulatory Arrest. Scary stuff. More of the required disclosure of the risks, death, stroke, heart attack, kidney failure. Started to sound like a medicine commercial.

Enough with all of that. What if I don't have the surgery? Okay no, I don't want to continue with the shortness of breath and exhaustion for no reason. Aneurysm could dissect, heart enlargement, heart wall thickening, more tired, less oxygen. Sucky life and early death.

All right then. August 22nd.

Let's Do This

Replying to all the well wishes while getting ready for the cath lab.

Went in to have my pre-OHS heart cath yesterday. I pictured in my mind it as a test run of the big day. I'm starting to notice there is a difference between going in for any other doctor appointment as compared to going in for heart appointments. Very little waiting around feeling ignored, you are the star of the show and everyone greets and assists you whether you are their assigned patient or not. As we (my dear wife and I) approached the CVR (cardiovascular recovery) Two different folks in scrubs passed, smiled, and offered help in directing us to the right place.
With a quick verification of who I was and what I was there for (be ready to answer that to everyone who steps up to work on you) we were escorted in to what was to be my room for the day. Quick change into the bottomless gown. I know now that you should take care of any bathroom business before they get started. No sooner than I climbed in the bed my assigned RN with her rolling desk arrived to start the process.
Verify what I'm in for, what brought me to that point, how was I getting home, who was going to be with me, etc. etc. Then came the ice cubes they told me were just the pads to hook up the ekg. If I was going to have a full arrest it would be from the jolt of those cold things being placed in the most tender areas of your body.
I didn't realize that nurse Kim was having a tough time getting a vein on my left arm because her assistant (a young man about 6'2" 280 and a giant smile) was on my right working on prepping my skin. I asked if he was assigned to assist on the chance I might make a break for it. Doubt I could get passed him. So the gentle giant breaks out the clippers and begins removing two-thirds of my body hair. The plan was to do the cath through my right wrist, but no sooner than he had clipped all the hair and used tape to collect the trimmings from my wrist he turns his attention to my right leg, telling me they wanted to have the femoral artery prepped as a back up in case the wrist didn't work. Now, I didn't mind the cutting on my thigh, but when he started moving up to my naval and working his way down to the pubic area I began to panic. Seeing my distress he smiled real big and explained that they stick a very large piece of plastic over the area and any hair left would go with it. Somehow his explanation didn't calm my fear of what that clipper was doing.
It was at that point that nurse Kim was calling for back up as she wasn't getting a good stick in my left arm. I took note of the first two places she had tried as she failed on three. In came nurse 'A', a very big smile on her face, she seemed to work up the vein like she was coaxing a scared animal out from under the bed. The stick hurt, but was a success.
I happily took the pills of benadryl they gave me to preempt possible reaction to the dyes they were going to use since it meant I was going to get some water on my now desert dry tongue. Kim was quick to take the cup away before I tried to drink the entire amount.
All prepped, nurse Kim turns on the TV. Thinking I was going to get to watch something to get my mind off of things, she turns on a documentary type production of "Your Cholesterol". It started out with the testimony of a dozen heart attack survivors. Good stuff. In walks Dr "K", super nice, he greeted me to let me know he was first year (then corrected himself as 'second year' resident since the year changed on July 1st) and informed me that he was doing my procedure under the guidance of my cardiologist. I didn't feel uncomfortable with him though. More questions to affirm why I was there along with squeeze tests and double checking of the chart.
In short order a very happy and pleasant RN "C" strolled in to take me to the lab. Her demeanor was comforting as I kissed my wife and "C" rolled me down the hall. Turning in to the cath lab was met with the low lighting glow of a super-large screen monitor and the other monitors and large vacuum tubes and whirs and hustle and bustle of the team. More introductions of the staff that was there to perform my cath. As I slid over onto the 'ironing board' as they called it I was pleasantly surprised that it was heated, very comforting.
The next part of the prep was slathering my arm and groin with the ice water, err...betadine. "You should talk to the ultrasound people," I suggested. "They have warmers for their bottles." Which got a lot of chuckles from the room. At that they laid on the plastic sheeting I was warned about.
I must've gotten my sedative about that time, as from that point everything was dream-like. I recall feeling the heat from the shot into my wrist, I recall feeling them doing something at my arm, but I couldn't see from the shield lowered in front of the doctor. I then noticed the monitor, I could see ribs and a jawbone. I opened and closed my mouth to confirm that I was seeing myself. I laughed and moved my head to see my jaw move on the screen, then giggled thinking I was about to be scolded for moving. Fade out, fade in I see the wire on the monitor moving around, see the dye released, feel the warmth as the dye flowed up my carotid arteries. Wished I could stay more lucid as I found the whole process fascinating.
Fade out, fade in. They pulled the plastic sheet from my arm and groin, I smiled as I quietly thanked the smiling giant for doing a good job getting that hair trimmed back far enough. It still hurt a little. Fade out, fade in and I'm being moved back to the gurney. I saw one picture frozen on the monitor and asked if I was seeing my aneurysm. No, but I was too foggy to grasp what they were saying the doctor called it. They said something about 'bovine' and I just replied that maybe that was the sign that I needed to go with the bovine valve. Fade out.
Fade in and I'm back in my CVR room, smiling wife, nurse Kim bringing me a coffee. Then came the stark reminder they had stuck pads all over my upper torso, made mental note that those areas had not been shaved, saw the hair that was removed with them.
A ham and cheese sandwich, another coffee, get dressed, wheelchair ride from the gentle giant. I thanked him for a good hair cut and we laughed.

Met with my cardiologist, Dr. T. Overly, Univ of Tenn Hospital, and now am scheduled for a heart cath next Thursday, 13 Jul 17.
Following a successful Catheter test I will meet with my surgeon on the 26th.
I was excited to get to meet the Dr. that is going to be my cardiologist going forward. He is a Cleveland Clinic, Vanderbilt trained doctor. Very encouraging meeting. One of the things he said in passing was that he and the surgeon had already discussed my case. Nice to know they are communicating and that my case was not just another mark on the calendar.
Dr. Overly confirmed that I am dealing with a 'Root Aortic Aneurysm' along with Aortic Insufficiency and that I wasn't a candidate for valve sparing surgery but would be getting a new valve.
I'm still struggling with which type of valve, mechanical or tissue. It was first stated that at 56 I should just go mechanical and coumadin to avoid having to have a second procedure. Having to deal with bleeding/blood clotting for the rest of my life just doesn't sit well with me.
I have already dealt with bladder cancer and melanoma and I have postponed some big dental work since this issue came up because of finances, being on blood thinner would certainly be of concern going forward.
My second concern of a tissue valve is which type, porcine, bovine or equine. After watching Dr. Stewart I was thinking I wanted the ATS 3f bioprosthetic, but cannot find any any information about it any newer than 2011. Even the ATS Medical web address doesn't work, is it still out there? Were there problems?
I know I will ultimately trust my surgeons advice. A friend had an AVR by the same surgeon two weeks ago. He went with the porcine.
Will have more following the heart cath next week.

God's Blessings

Bob