Daniel's Journal

Hi Everyone! One year ago today, I went to Mt. Sinai Hospital in NYC and completed all my pre-surgery tests. Around 3PM, I was told tomorrow’s surgery would be on schedule - I passed all the tests. That night (12/6/2016), lying in hospital bed and wondering all different scenarios about my open heart surgery next day, I must admit I didn’t get much sleep at all. It was a rather difficult time in my life. Fast forward, one year later, I am happy than ever! I am also doing really well – both physically and emotionally! Yes, my recovery this past year had a few ups and downs. But, just like most other patients, I’ve overcome each and every challenge I encountered. Many many times, I came to the HeartValveSurgery.com site and found answers to things or questions that were bothering me. I’m really grateful to everyone who provided me guidance and helped me thru this challenging journey! As for my personal life, this past year has been wonderful: My wife and I moved from NJ to PA, enjoyed couple 3-week-long oversea vacations – one to northern Europe and the other was to China. While in Taiwan, I also participated in my university’s 40-graduation reunion and met many of my classmates from 40 years ago! But, most importantly, I celebrated my grandson’s birthday last month and was told my 2nd grandson will be born in coming January! How wonderful life can be after open heart surgery! Best of luck to you all!

Today, 4/7/17, marks 4-month post op for me. The good news is there isn’t much I can share with everyone. My recovery for the past month has been fairly smooth and un-eventful. I continue to have minor pains between my shoulder blades and upper spine. I am also still experiencing mirror stabbing pains from the protruding sternal wires. These pains tend to happen at the end of the day and then go away in the morning, after a good night sleep. The only other event worth mentioning is I had a CT scan done for my brain a week ago at Mt. Sinai. My cardiologist wanted to rule out aneurysm in my brain that may cause a stroke. The report came back negative which makes me very happy! That is all for this month. I will continue to view others post and post my own reports here, but, probably less frequently. I sincerely thank everyone who have been helping and encouraging me to go through this difficult journey of OHS and recovery. I wish you all the best!

Today, 3/7/17, marks the 3nd month post my OHS. This past month, again, has been relatively uneventful. While my incision and sternum continue to heal, after exercise or a long walk, however, the top of my incision tends to get warm, red and/or itchy. Different type of clothing can also make it itchy and warm. Furthermore, this past weekend, I started getting sharp or stabbing pains in some spots at the top of the incision area. These jabbing pains, lasting only couple seconds, can be triggered by arms or body movements. However, the pain does not happen often, it tends to hit me unexpectedly. Not knowing what was going on, I got very concerned. I called my surgeon Dr. Stewart’s office and was told to get a non-contrast chest CT scan. After reviewing my CT scan report which mailed him, Dr. Stewart stated that my “CT scan looks perfect. I think the pain you are feeling is just the normal healing process”. His statement took a big load off my mind – no surgery needed. Since I know how busy he is, I am rather grateful for his quick response and comments. So, I guess my lesson learned here is while sternum is healing, it can move bones or wire a bit and “create” pains. I continue to work with my local cardiology doctor to adjust my Metoprolol dosage. At this point, I am taking ½ of 25 MG pill each day. My average blood pressure is around 110/75 and my heart rate averages at 75 beat per minute. To lower my LDL (125), my cardiologist also wants to start taking “red yeast rice” supplement. I hope after couple months, my LDL can be lower to below 100. This past Monday, I started my cardio rehab. To my surprise, because my OHS did not involve any of my heart valves, Medicare will not paid for my rehab – who knew? I will be going there 3 times a week for at least a month. One thing I am still learning for my recovery is not to over exert myself. If I do too much the day before, I will be exhausted the next day. This phenomenon is something I never experienced before my OHS. So, I will keep reminding myself “steady as you go" this month, next month, until I am fully recovered. :-)

Today, 2/7/17, marks the 2nd month post my OHS. Unlike previous month, I am happy to report this past month has been relatively uneventful. Here are some of my experiences and observations that I hope others may find useful: • The one setback I did have was a small infection at the very top of my 5” incision. The infected area was a small hole measured 1/8” in diameter. It did have a bit of discharge initially. My cardiologist prescribed me 7 days of antibiotics (Doxycycline Hyclate - 2x100 MG/day). The infection cleared up after I completed the treatment. • Like many heart friends in this community, this past month, I have been struggling to make sense of the right dosage of Metoprolol to take. Prior to my surgery, my BP/HR was at 120/80/72 and I was taking Lisinopril 2x10 MG/day to control my high blood pressure. Metoprolol tends to make me dizzy and tired. It also lowers my BP. While at Mt. Sinai I was given Metoprolol 2 x 50 MG per day. At Riverview Medical Center (see my last post), the dosage was reduced to 1x50 mg/day due to the low BP numbers observed. When I visited my own cardiologist on 12/30, he cut my dosage further down to 25 MG/day. This past month, my primary care doctor and cardiologist both suggested to me to wean off Metoprolol completely - after they measured my BP personally. At this point, I am taking 25 mg every other day and my BP and HR on average are around 110/75/75. Since I still have aneurysms in my other arteries and my prior high blood pressure history, I am really not sure I should be completely off Metoprolol or not? Can high blood pressure be cured by OHS as a side effect? • Since last week, I noticed driving thru NJ’s many bumpy roads do not irritate my sternum any more. The only situation still can cause sternum pain is an unexpected sneeze. And, yes, it is still rather painful. I hope it will soon go away, too. • Some other improvements I noticed this past month: o Heart rate has been going back down steadily - from 110 at Mt. Sinai to about 75 now. o Hemoglobin and related blood test results are back to the normal range. o Digestive system seems to be functioning much better: fewer GERD symptoms and able to gain weight. o Lymph nodes have not been inflamed like they did before my surgery. I am not sure why. Yesterday was a rare warm and sunny day in NJ. It was a perfect day for me to get back to another daily routine of mine. I walked the 2 ½ miles trail in my neighborhood in 40 minutes – just like before. I felt really good afterwards! All in all, thank goodness, I am doing fine 2-month post op!

Today, 1/7/17, marks exactly one month post my surgery. My recovery, while challenging at times, I am actually pretty happy with the progress I made, so far. Here are some of the notable events in the past month I’d like to share with everyone: On 12/6/16, I checked into Mt. Sinai to have pre-surgery testing done. The cardiac catheterization test found my coronary arteries are normal with no issue. The next day, or the 7th, Dr. Stewart replaced my 5.0 CM ascending aortic artery from root up with a Dacron stent graft. He looked at my valves and decided no repair is needed. Unfortunately, my left lung collapsed during the surgery and I had to stay in the hospital couple more days to get the extra fluid out and lung re-inflated. I was discharged from Mt. Sinai on 12/15 with minor pleural effusion and subcutaneous emphysema or air bubbles in my chest wall. I was feeling fine on 12/16. On the 17th around 3AM, however, I passed out in the bathroom. I was very dehydrated, dizzy, and I had severe allergy reactions to something which caused my hands and feet to swell up. I checked myself into a local hospital – Riverview Medical Center (RWC) ER room. Doctors there were concerned about my dropping HgB and red blood cells count. They were wondering whether or not I had internal bleeding. They called Dr. Stewart and he promptly answered all their questions on a Saturday morning. I was given lots of IV shots, steroid, and iron shots. Other than various blood tests, they also ordered many other tests on me:  A CT of head/brain and found no issue or I did not bang my head on the floor too hard.  A CTA of upper chest and found: • Moderate right and small left pleural effusions and subcutaneous emphysema left neck and chest walls (same as when I left Mt. Sinai) • No blood clot in my lung. I have no pneumothorax or pericardial effusion either.  Several stool samples were collected and tested for blood but all came back negative.  An endoscope was done by Dr. Grabowy - my primary care doctor. He did not see any upper GI bleed either. So, on 12/20, after seeing my HgB went up to 9.3 from 8.6 and I was no longer dehydrated, Dr. Grabory decided it’s time for me to go home. He did ask me to take another round of 10 MG of Prednisone to reduce any inflammation I might still have in my body. On 12/30/16 I visited my local cardiologist, Dr. Drout, for the 1st time. He examined my chest incision and was pleased with my overall progress so far. He ordered a chest X-ray to see how my lung is doing. When the results came back, it indicated the residual pleural effusion and air bubble were no longer visible which was very good news. Yesterday or January 6th, my wife and I got up at 7 am and went up to Mt. Sinai via train to see Dr. Stewart and Dr. Naib (my hospital floor cardiologist) for my follow up after my OHS:  After reviewing my latest X-ray and other reports, Dr. Stewart “declared” my aorta aneurysm is fixed. He told me that I don’t have other heart issue and I should go “live my life”. I thanked him for getting my health back. Dr. Stewart’s Nurse Practitioner, on the other hand, kept encouraging me to eat more red meat (steak) or the food I was avoiding before the surgery to get my HgB/red blood cell count up. I thought that was rather ironic.  Dr. Naib examined me and found both my lung and heart is in “great shape”. She sees no issue in my EKG results. She also answered all my questions very patiently. And, she suggested ways to continue to monitor other aneurysm that I still have. I will have follow-up visit with her in couple months. So, all in all, I am very happy with the progress I made in one month. For example, I am surprised that I could spend almost 12 hours run around in NYC all day yesterday. I hope my recovery for month 2, 3 and beyond will continue to be smooth and un-eventful. PS: I was given the OK to drive yesterday, so I drove home from the train station in my town to mark my one-month mile stone.

This morning, the 2nd X-ray results look really good. So I have been given the green light to go home. Thanks to everyone for your support & encouragement. I will do my best to kep posting my progress in recovery. Got to go. My ride home is here.

This afternoon, after my left lung tube was clamped for more than 4 hours, another X-ray was taken. The Technician read the image in front of me and gave me an early Xmas present- both lungs are fully inflated with almost no excess fluid. He texted Dr. Farkarsh, Dr. Stewart's Fellow Surgeon about the results. An hour later, on duty Nursery Practicitioner came in pulled the lung tube and sealed the cute with glue. I am free of tube, finally! Another X-ray tomorrow AM, if lungs remain inflated, I'm going home! BTW, it appears most OHS here at Mount Sinia go home on the 5th day. I guess I am an exception.

The X-ray results shown I still have some air pockets between tissues. In short, it appears that I need to stay couple days more so the doctors can be sure I have a cleared lung to go home with. While it is dispointing, especially being shown the discharging package that I needed to fill out. But I rather be sure I'm truly ready to go to avoid future ER visits, especially during holidays. Tomorrow will be another great day to improve my future health.

Last night was "uneventful" which is what I wanted. Just had my echocardiogram and x-ray done. I also walked couple times between 7 West & 7 East. My weight is at 148 lbs or before the surgery. Hopefully, there will be no new surprise and I get to go home later in the afternoon tomorrow.

I was moved to room 111A of 7 West on the 8th. Since then, 3 issues I have been dealing with: fluid in my left lung, high blood sugar (110-150), & high heart rate (120 bpm). I'very been given insulin shoots, 25 MG of Metoprolol & Lasix to control these problems. There were two success stories I could report: 1. After 5 days of trying, I finally was able to go this AM, 2, I did climb the 4 steps stairs near nurses station which turned out to be rather easy to do. Since these days I live in a 3 stories townhouse, the sooner I can climb the stairs the better.

Had all my pre-surgery tests done. No new issues found. Coronary arteries are fine. Had my surgery this past Wednesday, December 7th 2016. Went well according to the Fellow surgeon. But my left lung collapsed and had to be blown up by inserting a tube in my left chest. The incision to the sternum was about 5 inches. Got moved out of the surgery recovery room on Thursday. Recovery so far at 7 West has been mostly smooth, except for last night, when I fell asleep on my side, which caused the lung tube to hit the nerve. Had to increase Percocet from 1 to 2 pills, which seemed to solve the problem. Today, 2 of the tubes for the heart were removed. At this point, only the lung tube and an IV remain. If I am lucky for the remaining days, I should be out of the hospital no later than Tuesday.

Just go a call from Mount Sinai. I need to be there at 9AM to start pre-surgery testing. I will be staying at the hospital overnight. I assume the actual surgery will be early Wednesday morning. Will do another post as soon as I am able to - probably next week sometime.

For me, the decision to have an OHS surgery was made when I visited Dr. Allan Stewart of Mount Sinai Hospital in NYC on 9/26/16. While I only have mild regurgitation and some calcification for my aortic valve, the big problem is my ascending aortic artery, now at 5CM, has been growing too fast. This aneurysm is like a ticking bomb in my chest. There is simply no choice but to deal with it head on. Since the decision was made, several “life events” happened to me: My 1st grandson was born on 10/16 - such a joy! I retired from the company I worked since 1983 on 11/18. And I successfully navigated thru a Health Exchange Market Place my company uses and added Medicare supplement plan and drug plan to my Part A & B – believe me, it wasn’t easy. Additionally, in order to get dental clearance which Dr. Stewart has as a prerequisite for OHS, I had to have one of my infected wisdom tooth pulled. Yesterday, I called Ms. Debbie Segreti - Dr. Allan Stewart’s Office Manager, and she confirmed that all my paper work is in order. I will have my pre-surgery tests on 12/6 and surgery the next day. While I still don’t know exactly what the actual procedure will consist of, I do know my ascending aortic artery, including aortic root, will be replaced with a (Valsalva?) Dacron stent graft and my aorta valve, hopefully, will be repaired, not replaced. At this point, I am both nervous and yet eager to have this surgery done. Thanks to everyone inputs and discussions, I have been learned so much about OHS in the past couple months. I know OHS will be very challenging - both mentally and physically. A lot of patient will be needed during the recovery phase. However, it is very encouraging for me to read most folks agree that fears about the surgery were much worse than the actual experiences. I hope I will feel the same way several weeks later. Wish me luck, thanks!

Last night, my wife and I had a great pleasure and honor in meeting with our neighbor (5-minutes apart) and first heart friend Darlene Smith. Darlene was such a kind and generous lady. She held nothing back in sharing her mitral valve repair experiences that was done by Dr. David Adams at Mount Sinai Hospital. We spoke more than an hour and half until the Ice Cream place we were at closed its door. Darlene answered each and every question I asked in details and added a lot more her lessons learned for us. Oh, by the way, in our opinion, as a 3-month post OHS person, Darlene looked really fabulous and healthy to us. For the hour and half conversation, she was very energetic and happy which of course, gave us hope for better days to come after OHS. Finally, I also want to thank Adam Pick for setting up the heart-valve-surgery.com and brought us together!