Brian's Journal

Hi everybody. Hope everyone here is doing well.

So it has been 14 months (!!) since my aortic valve replacement and aneurysm repair. Things are MOSTLY good. Performed in two shows, started working out, and am headed to game 5 of my over-40 baseball league.

However.

About a month ago (around Mother's Day), wifey and I both picked up a nasty upper respiratory infection. Since then, my heart has been randomly throwing premature ventricular contractions (pvcs). They are worst at night, or laying down. They IMMEDIATELY go away if I stand for a few minutes or exercise. Sometimes they leave for days, then return.

I've done a bit of research and found they are common, even in healthy adults. At my one year follow-up last week, my ECG was clean, and my cardiologist wasn't concerned when I brought them up. He told me to learn my triggers. So I've started to cut out the usual suspects: caffeine, alcohol, fatigue, antihistamines (which in MD in Spring kind of sucks).

So... anyone out there experience the same thing? As much as my doctor might sound unconcerned, these things remind me too much of what happened before and during my aFib attacks. I'd really like them gone, or at least to know if there's anything else I should be doing.

Hello, friends.

Yesterday marks the six-month anniversary of my aortic aneurysm repair and valve replacement. I thought I'd give an update, especially for any of you that may be at the start of your heart journey and are filled with anxiety about the unknown, as I was.

Spoiler alert: while it was a difficult recovery at the start, it got so, so much better. I'll tell you about it, along with a couple of truths I've learned.

The first month was, as I have journaled here, not great. Less than a week after returning home, I had to be re-hospitalized with a pericardial effusion and aFib. The fluid in the sac around my heart needed to be drained, and my heart brought back into rhythm. My lowest moment was two days before my heart converted back to normal: I recall holding on to my wife Mary on the end of the bed, sobbing. I was convinced my life moving forward would be a limited one, lurching from one complication to the next. My doctors were outstanding the whole way, explaining that complications were to be expected. Before I was discharged, I asked my attending physician what kind of recovery I could expect. I still remember is exact words: "your recovery will depend upon your activity." That, folks, is truth #1.

Truth number 2 is comes from Marc Wallace's book "Back to Life after a Heart Crisis." In it, he details an eight-point plan for getting back to being you. Step 8 is to "Train for a Huge Physical Challenge." Activity towards a defined, committed goal is always more effective than movement for movement's sake. After talking to my family and my doctors, I developed a two-phase plan to get back to the two hobbies I loved: theatre and baseball.

I was already committed to a role in "Sweeney Todd," but I learned during recovery that auditions were coming up for "The Producers," a musical adapted from Mel Brooks' first film. People, I LOVE this story. I've loved it since I was 19 years old and came across the original 1967 film in a directing class. So even though I was committed to one performance, I auditioned with the hope that both companies could make their rehearsal schedules work to accommodate me. Lo and behold, I was cast in the lead role of Max. My huge physical challenge was in place.

I started rehearsals for both productions at roughly the same time. In the beginning, I was still taking a lot of medications resulting from my aFib and effusion issues: anti-arrhythmia meds, anti-inflammatories, blood thinners, beta blockers - pretty much the whole spectrum of post-surgery prescriptions. They made rehearsing somewhat difficult; for example, if scene choreography required me to rapidly cross a stage, I'd get very light-headed and found singing immediately afterwards a challenge. But eventually I was told to discontinue the heavier doses, and the issue resolved itself.

On September 6, five months and four days after surgery, "The Producers" opened. We ran 8 performances in two weeks, including double-shows on Saturdays. It was glorious. One reviewer commented on my performance that "if you need to test Ruff's stamina, he delivers tenfold."

This weekend, "Sweeney Todd" completes its final weekend, where I will play Judge Turpin two more times. In the programs of both shows, I dedicated my performance to my health care team and my family.

Phase 1 of recovery is finished. It was hard, but so worth it. With the exception of the occasional soreness in the sternum, everything is back to normal. Scratch that - it's better. My ability to hold a note while singing is significantly better than before. Training for musical theatre has left me more flexible and with better core strength than prior to surgery.

This coming Monday, phase 2 starts - training to get back to playing baseball. I'm not sure how that will go. Despite having a rebuilt engine, I'm still carrying around a 52 year-old chassis, complete with a worn-out throwing shoulder. Regardless, we'll find out.

This was a much longer update than I expected, but if you've read this far, I hope all is well with you, and if you are indeed one of those folks at the start of the long road that is recovering from a heart crisis, please know that I was terrified at the beginning, despondent a month afterwards, but was ultimately saved by three things: activity, having a goal, and being surrounded by people who believed I could accomplish it.

May you find your activity, your why, and your people - and nothing can stop you.

Hi everyone. I'm officially at four months post-op on Friday from an aneurysm repair and aortic valve replacement. And I have an "is this normal?" question.

I've been cleared to restart my regular exercise program, and I'm in my first few weeks of lifting weights and cardio. Lifting is surprisingly fine - I didn't lose that much muscle mass over the last few months, which shocks me. The problem is with aerobic exercise. I will work to increase my heart rate, but get exhausted before I can raise it much higher than 100 - 110 BPM.

I saw my cardiologist Tuesday, and he discontinued both my blood thinner and anti-arrythmic medication (I was on Eliquis and Colchicine). He didn't seem much concerned when I mentioned my cardio training concerns, but did want me to keep an eye on whether or not my heart rate gets higher with exercise, mentioning to me a condition I've never heard of - heart block.

So, the question is: how many of you have experienced this after surgery? Did it go away with time - am I just being impatient? At what point would it be advisable to see an electrophysiologist?

Any personal experiences or advice from doctor visits are welcome.

Ten weeks post-op as of today.

Rehab is in full swing. Starting to do some light intervals on the treadmill where I alternate between fast walking and light jogging. I'm sore the next morning, but man, does it feel good to be sore again.

When I was preparing for surgery, I read Marc Wallace's "Back to Life after a Heart Crisis." (A book I highly recommend.) Wallace, himself a physician, chronicled his surgical recovery and developed an eight-point plan for getting back to himself.

Step 8 is to "Train for a Huge Physical Challenge." Per Wallace: "I will challenge you to do something truly amazing, something that proves to you, and others around you, that you are back and better than ever. I’ll challenge you to take on a major physical accomplishment such as a walkathon, endurance cycling event, mountain climb, long-distance bike ride, hike on the Appalachian Trail, or another symbolic feat."

Well... I found mine. Or, more specifically, BOTH of mine. I already knew I needed to prepare for performing as Judge Turpin in "Sweeney Todd: The Demon Barber of Fleet Street," which opens at the end of September. That will now be my SECOND show of the Fall - starting next week, I will also be prepping to play Max Bialystock in "The Producers," opening at the beginning of September. I'm psyched for both, but the chance to play Max felt like fate - I have adored Mel Brooks' first film since I was a child, and the musical version used to be something I played while dancing with my infant daughter in our apartment in the early 2000s.

I'll keep y'all posted on how it's going. Two joyous mountains to climb. LFG.

Eight weeks post-op as of today. First full day back at work. Fortunate that my commute is about twenty steps from my bedroom to my home office.

How am I? If you're of a certain age, you're probably familiar with the scene in "The Empire Strikes Back" when Luke cuts short his training with Yoda to save his friends and confront Darth Vader before he's ready. Before he departs, the spirit of Obi-Wan Kenobi says "this is a dangerous time for you... when you will be tempted by the dark side."

That's me today - sitting in a dangerous time. I feel... eighty percent? Good enough that I'm tempted to get on the floor and try a few push-ups. (I'm not going to. I like my sternum in one piece.) Good enough to mindlessly grab a second cup of coffee before my next meeting, or a cocktail at five. Not doing either of those, but the instinct is still there.

Lately, my six-word mantra is: "Have patience; you are still alive." Independence Day comes early this year - my physical restrictions end July 2nd. Three big goals wait: be useful in my personal and professional life, get back on stage, and get back on the baseball field. All in due time. I'm working on the first today, the second by September, and the last by next year.

Patience, patience, patience.

6 weeks post-op as of today. Went for a 2-mile walk for cardiac rehab, which considering I live in MD and it is May required walking in the rain (hence the face).
One question and one random observation.

My question: now that my sternum is noticeably healing, I'm starting to notice that it appears to be healing... unevenly? My left side is much more sore than my right. Anybody else get a sense their sternum didn't heal symmetrically?

Observation: I think OHS survivors all retain one privilege: we don’t hurry anymore. Want to make me laugh? Tell me to hurry up.
When I hear “hurry,” my brain translates it to “go at a speed you’ll mess up whatever you’re doing!” Maybe it’s being on a heart-lung machine; maybe age, maybe it's only being six weeks in. But hurrying ain’t a club in my bag anymore.
It’s like in baseball when a player “hurried the throw” - probably an error.

Hope all is well in your world.

Four weeks post-op as of today.

I'm cautiously optimistic. The further away in time I move from my complications after coming home (pericardial effusion and aFib), the more comfortable I'm becoming with the idea that the woods are behind me - or that I'm at least on the edge of them.

What's missing now is confidence. I feel as though I'm still learning how this newly rebuilt engine works. I take it out for walks every day, trying different speeds, watching my Apple Watch as I go. The distances I'm traveling are vastly improved from coming home, but pushing for a faster pace often greets me with resistance, either from the medications or the recovery; not sure which. I'm chomping at the bit to get into cardiac rehab so I can learn more and move with some coaching and a degree of safety.

That's all for now. Still here. So are you. Still all that matters.

Three weeks post-op today. Out to lunch with the missus, whom is well on her way to sainthood.

We grabbed lunch, did some shopping and grabbed a long walk, which was easier than yesterday. Little pieces of normal are coming back. I hope and pray I can savor each one of them for the rest of my days.

Now 19 Days post-op. One of the stronger days so far. After coming home from the pericardial effusion and aFib, I'm beginning to feel for the first time like I can take a full breath again. I never thought I would enjoy taking a deep breath as much as I do today.

Two other small victories: getting a haircut, and helping my wife grocery shop in addition to the normally prescribed daily walks. It was a day of enjoying the little things. And for quietly praying the complications have stopped.

Hope all is well in your corner. We're here, and that's what matters.

Today I am 15 days post-op. Recovery days 11-14 did not go well.

I'll just give the straight story at the top, but fair warning: it may have some dark moments. If you need some positivity, you might want to keep scrolling.

On Saturday I awoke after a terrible night's sleep to a sensation of strange shortness of breath - a kind that felt like something was stopping me from expanding my chest and lungs. I also felt slightly feverish. By the early afternoon, My wife had driven me to the ER.

I had developed a complication known as a pericardial effusion, or a buildup of fluid around the heart, which required draining. By the next day, I was wheeled into the cath lab at Saint Joseph Medical Center in Towson, MD, where the fluid was drained. The procedure did its job, but sparked a new, more common issue I had to date ducked - atrial fibrillation. My heart rate was in the 100s while sleeping (when I slept), and any physical activity shot it into the 150s. Going to the bathroom felt like jogging. Walking down the hallway felt like sprinting uphill. As of 12:15 AM this morning, the cocktail of drugs I was receiving converted my heart to normal sinus rhythm, and my body felt SOMEWHAT back to its recovering self.

That's the factual summary of events. The emotional fallout? Having gone back into the hospital so quickly for emergency complications, complete with new fears, new pains, new doubts - the weight of it broke me a bit for a couple of days. There were instances where I sat on the side of my bed and just sobbed into my wife Mary's side. At night, I spent hours lying awake (sleeping with a HR over 100 is challenging at best), believing that I just wasn’t making it home again. Too many bad maternal genes inherited from a Mom with a laundry list of cardiac procedures. My maternal grandfather gone from a massive stroke at 59. One dead Uncle after another. I can't outrun my DNA. That's just how it is.

I need to draw an important distinction here - at no time did ANYONE who treated me lead me to believe any of that nonsense. Everyone was cool, professional efficiency: problem, analysis, plan, communication of plan (including how common these complications could be), implementation of solution. My wife was reassured, and reassuring. I just got to a point where my sleep-deprived, still-adjusting-to-life-post-surgery brain began running what Mary calls "the parade of the terribles."

With each up and down of this recovery process, I'm trying to come out with a lesson learned. I might have more to say on this later, but here's what I have so far: if you hit a low point, and have some long, dark nights of the soul, sometimes there's nothing to do but let go and trust the professionals. Let go and allow your people to carry you. Remember the lesson of Victor Frankl: the last and greatest human freedom is to accept one's circumstance and decide how to respond to it. I didn't do well with that last part over the past few days.

I hope putting my story out there might cut down a few thickets of doubt and fear for the next person behind me.

We're still here. That's the only thing that matters.

OHS+10. Hard to believe that it has been ten days. It was a "take the good with the bad" kind of day: I woke with a steadiness on my feet and clarity in my mind that hasn't been there since even before the surgery, with anxiety taking so much of my consciousness. Mary and my duaghter dodged raindrops with me again, finishing our walks for longer distances. Also did two sets of two-flight staircase climbs. All of this movement is loosening what stubborn mucus is still in my respiratory tract. Harder coughing has given way to more oxycodone needed to dull my cough pain enough that I can take hard, productive hacks.

Today's question: How long did many of you retain what feels like a nasty chest cold? For how long? Assuming there's no fever, I would like to know if there's a moment where teams decide that the danger from pneumonia has past.

OHS+9: 9 days post-op from Aneurysm repair and AVR with bovine tissue.

Today’s scary moment was brought by a HR spike to 135 this morning, just as I was taking the morning round of medicine. I did the same thing as while in the hospital and just pounded water while my meds kicked in. My pulse eventually dropped to around 85.

Weather on the east coast has been awful (a.k.a. “April”) so only one walk outside today while dodging raindrops. Still getting in the steps, just around the ground floor (and up and down the stairs).

Today’s lesson: you cannot hydrate enough, especially while finishing LASIX.

Recovery week one is in the books. My wife (Mary) and I have fallen into a schedule:

Up and mediations/breakfast/decaf coffee at 9am. Walks at the top of most hours, followed by spirometer work at 20 past and deep breathing/coughing exercises at 40 past. We try to eat 4-5 small meals, one of which for me is usually a protein shake. Appetite is improving slightly, walks are down to the end of the block and back. Evening meds at 9, bedtime at 9:30. Not going to lie - sleep is tough. I'm a side sleeper, and trying to retrain your body to sleep on your back just doesn't happen overnight.

Something about which no one told us that maybe I can spare someone anxiety by putting down here: You have to move in some form or another every 45 minutes (during non-bedtime hours). Your body receives all kinds of fluids during open heart surgery, and if you don't move regularly things can get... weird. Hands and feet appear mottled. Also, your heart beats faster and your BP can drop. Stay still too long, and you look and feel like garbage. Move regularly, and things get closer to looking and feeling better. I try to sleep, but if I'm awake I'll do a few laps downstairs, stretch my back, and try to sleep again. Repeat.

More soon. Hope everyone is well.

Recovery Day 5. Good things:

1. Thinking much more clearly than expected.
2. Energy levels for walking are good.
3. Pain is not nearly as bad as expected (although this can rapidly change if I move incorrectly).
4. I’ve been home for over 12 hours and my dog refuses to leave my side. It moves me to tears, unless he thinks I can resume my walking/distributor of treats duties, which is unavoidable. He’s a dog.
5. Family and friends have been rocks.

Expected Difficulties:

1. I am epically backed up. Bowels are moving, but only producing gas. I have been Dutch-ovening my entire downstairs. Sorry for that image.
2. My appetite sucks. I’ve lost 10 pounds in a week.
3. Soreness and aching are presenting a real problem for sleeping. Even with spending the night in a power recliner, I slept 2 hours tops. Counting the days to being a side sleeper again.

Unexpected difficulties:

1. It’s hard to regulate my body temperature for some reason. I’ve been running hot and cold. A cup of coffee this morning gave me the sweats.
2. This seems to be going away, but fingers on my left hand would look bruised and go numb. Shifting positions helps.
3. My knees are killing me. There are lots of causes possible here, so it’s more annoying than alarming.

Hope all is well in your corner of life. We’re here. That’s what matters.

“Come, my friends,
'Tis not too late to seek a newer world.
Push off, and sitting well in order smite
The sounding furrows; for my purpose holds
To sail beyond the sunset, and the baths
Of all the western stars, until I die.
It may be that the gulfs will wash us down;
It may be we shall touch the Happy Isles,
And see the great Achilles, whom we knew.
Though much is taken, much abides; and though
We are not now that strength which in old days
Moved earth and heaven, that which we are, we are,
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.”

Alfred, Lord Tennyson, “Ulysses”

Talk to everyone soon. Dr. Bavaria and I are gonna go kick the $&!@ out of this aneurysm and fix this aortic valve. Tomorrow is Independence Day.

2 days to go. Last 3-mile run for a while is done. They tell you to exercise as much as you're allowed prior to surgery, and I've been fortunate to be able to lift light weights and do aerobics for the past several weeks.

According to my fitness app, I've logged 1,602 minutes of exercise from the time I learned I would need surgery to today. I've trained for this. Nothing left to do but put my faith in God and the experts.

Hi all: so I’m set for surgery to repair my aortic aneurysm and aortic valve on Tuesday, and could really use some encouragement. My biggest worry at this point is no longer physical, but mental. I’m already cast to perform in a musical production of Sweeney Todd, with rehearsals beginning in July and performances in October. My surgical team has insisted that it is 100% realistic to be able to do this. What scares me are cognitive issues. Will I be able to memorize lines? Remember choreography and lyrics? Anyone else had a challenge set up for 5 months after surgery like this?

Hi everyone:

I'm now T-minus 18 days pre-op, and one issue that's starting to become more important is watching out for illness in the house. My wife is immunocompromised, and consequently gets colds and sinus infections rather easily - and has one now.

This brings up the question for the folks in recovery: how hard did you lock down before the operation? With my own schedule, I'm taking COVID-style precautions: essential trips only, masking, no crowds. What about my family? Outside of my wife I have two college-age children with active social lives who come and go. Do you start keeping your distance? If you catch a cold, does it potentially delay you?

Surgery in 20 days. I know it's been discussed ad nauseum, but any updated advice out there for recliners that are good for recovery? I was looking at a Gladiator power recliner, but there are tons out there with a wide, wide price range.

Hi there - are there any private pilots out there who have completed heart surgery? Have you been able to maintain a private license? (For context, I am learning to fly a Cessna 172 at a nearby airport.)

V-Day minus 29: less than a month to open heart surgery. As of now, anytime I feel like a beer or cocktail, I’m just going to read the Cleveland Clinic’s passage on how alcohol abstinence prevents anesthesia interference/complications and speeds recovery. As the saying goes: sounds like good advice.

Hi everyone. So the last week has been a roller coaster. Last Wednesday, I met with my cardiologist, who described my aortic aneurysm and concluded that it was about 4.8 cm in diameter. He then proceeded to tell me, in more words than this, that I needed to scale back my activities - no sports, no running, no weight training. Walking and light activity only. He then referred me to a heart surgeon (Who is actually chief of cardiac surgery at St. Joseph's in MD.) I met with him today and he concurred with the size of the aneurysm, and also that I did not need surgery YET - but he did NOT concur with the cardiologist's opinion of what my activity level needed to be. He thinks sports, cardio and lighter (no max loads) weight training is fine! He believes exercise helps to keep these issues at bay and wants me to live my life. As appealing as that is, I'd like to get a better perspective than a "split decision" between my doctors in terms of what I should and should not be doing. I want to live a full life, but I also want to be around for my kids and not risk rupturing this aneurysm and dying!! Any thoughts from the community out there concerning what you would do if you learned that you had a moderate aneurysm and received conflicting advice on how to live moving forward? Just how at risk is this for rupture if I follow the cardiac surgeon's advice?

Hi everyone. So I had a meeting with my cardiologist yesterday, and it was a mixed diagnosis with a bad outcome. Apparently the reason I have a leaky aortic valve is because of the fact that I have an enlarged aorta altogether, or an aortic aneurysm. (I believe I have the thoracic kind, but I will be verifying that.). This can be life-threatening, but my aneurysm is not large enough (yet) to warrant that kind of concern, or any surgery. I am seeing a surgeon in the next two weeks, but all signs point to a "watchful waiting" period where they monitor how quickly the aneurysm grows. This is driving me crazy for two reasons. First - during this waiting period, my activity is severely restricted - no running, no weights, no sports. The aneurysm may not grow again, so I could be in this waiting period for the remainder of my life. So in other words, there is a very real chance that I just have to live with the lifestyle of a 75 year-old, thirty years early. That might sound whiny, but it leads into my next concern: why NOT fix it? I accept that there are significant risks to the surgery - but there are significant risks to leaving an aneurysm in your body! I feel like a time bomb. So - anyone out there have experience with these? Any advice on coping or finding some kind of activity level that will keep me out of danger but also keep me sane? I've relied on working out as my primary means to relieve stress for 25 years. It seems completely unreal to me that it could be simply here one day and gone the next.

Hi everyone. I'm brand new here. I'm a 45 year-old professional, who spends his spare time playing and coaching baseball and lifting weights. Two weeks ago I was rushed to the hospital after a treadmill workout caused my heart rate to spike to 270 beats per minute. They were able to calm down my heart until it settled into a normal rate but atrial fibrillation, after which it converted back into a normal rhythm. The hospital cardiologists expected me to recover completely and get back to normal (albeit with medication)... until I had an echocardiogram that revealed moderate to severe aortic valve regurgitation. That has since been confirmed by a second echo with a new cardiologist recommended by my neighbor (who has had two heart attacks and a valve replacement). Next up is a TEE procedure on 7/7, where hopefully we'll get a final diagnosis and plan of action. Until then, I'm kind of stuck in Dr. Seuss' "waiting place." I need to stay as sedentary as possible until the 7/7 procedure. Considering my maternal side of the family's cardiac history (name it and it's there), I should have expected a possibility of something, but... at 45? As an athlete? Looking at losing an entire year and then having to rebuild all over again? I'm still reeling. Pardon the expression, but this has been a bit of a dick punch. Since I'm at the beginning of this process - any other sports people out there been through this and come out the other side?