David's Journal

Hi folks, Just a quick note here to say that it has been nine months since my surgery (Aug 22, 2011) and I am feeling fine! I just had a check-up with my cardiologist and the EKG read normal, blood pressure normal. Full-time office work keeps me busy, but I have been active with walks and hikes in the woods when I can and have begun working on our yard and garden. Karen and I are looking forward to kayak tours in our home town of Kingston as well as getting our bicycles tuned-up for the season. Deep heart-felt thanks go out to all of you who have offered support and continue to ask of my well being. I think of you while I keep the heart pulse in my band, Passero (passeromusic.com). Peace and good health to all, David

Well, I have just begun my second week back at work and I feel great. Today marks six weeks since my surgery. I\'m sorry if I\'ve kept you guessing about my health - it has been a while since my last post. I was indeed released on September 9th from Columbia-Presbyterian after being successfully treated for the infection. Fortunately it was not serious and my new valve was not in jeopardy. The infectious disease doctor and my surgeon concluded that it may have been a mild form of pneumonia. Whatever it was I responded well, I have finished my oral antibiotics and I am feeling really good. I am no longer on pain meds and any discomfort with my incision and my mending bones is diminishing more and more each day. I had a follow-up appointment with my surgeon on September 23rd and he happily gave me the all-clear to drive again and to return to work. After my first day back to work last week I enjoyed a brief walk on the Walkway over the Hudson, enjoying the incredible views. I have been taking the stairs up to my 5th floor office, sometimes making the trip a few times a day as I run errands to other parts of the hospital (I work at Saint Francis Hospital in Poughkeepsie). Most of all I have enjoyed the look of happiness on the faces of my friends when they see how well I am. I am grateful for the miracle of modern medicine that has allowed me to enjoy good health, but more importantly I am grateful for the miraculous power or prayer. My circle of friends and family has given me tremendous support and I feel that I am living proof of the blessings of healing prayers. I cannot say enough to thank you all!

I am being treated at Columbia-Presbyterian with a cocktail of antibiotics via IV and I am feeling much, much better! They want to perform a TEE (transesophageal echocardiogram) this morning to get a clear image of my heart. If all goes well I hope to be going home tomorrow. Karen has been with me since the night I arrived (by bumpy ambulance ride all the way from Poughkeepsie) and has been a great support. Thank you for all your prayers!!

The feeling of frustration being back in the hospital, especially after a successful operation and with my recovery at home going so well, has brought me to tears. I just want to be home going for walks in the neighborhood as I had been doing, sharing meals and intimate times with Karen and friends. I had not had a chance to spend time in the woods, something I really long for. I am hooked up to a monitor and an IV with antibiotics treating the infection [that may be in my lungs as a mild pneumonia, or in the mediastinum which contains all the chest organs except for the lungs].* I am at Saint Francis, my hospital, but I will be transferred today back to Columbia-Presbyterian in NYC. The weather seems to reflect my mood as the remains of tropical storm Lee is still having an effect on our region bringing more rain. My heart was soaring with joy, renewed by the bovine valve that has replaced my tired-out bicuspid aortic valve. Now I am feeling the depths of sadness at this latest challenge which may go on for several days more. My temperature had spiked somewhat on the 31st of August, nine days after surgery, but went back to normal within a day. My surgeon\'s PA said it would be of concern if it went to 100.6 F or higher (it had gone up to 100.0) Then on Sunday night, September 4th, it went up to 100.9, and after consulting with the physician on call, Dr Pavels, I was advised to get checked-in at Saint Francis Hospital. So, here I am, for now. As I am writing this I asked a Tech if she was from Jamaica. We spoke briefly of our favorite Bob Marley songs and she began singing lines from \"Everything\'s Gonna Be Alright.\" My temperature has been normal today and Karen and I feel hopeful that this is just a bump in the road to recovery. I expect I will continue with the antibiotics and have further tests at Columbia. Visits from friends and co-workers have also boosted my spirits. Gail and Larry, my office mates, Sr. Rose Marie Mullen, Fr. Mali and Dr. Keith Festa were all here to see me and to wish me well and offer prayers, opening my heart to the big spirit of family here at Saint Francis. I am infected with love, giving me strength to carry on. \"Don\'t worry about a thing,
 \'Cause every little thing gonna be all right. \"Don\'t worry about a thing,
 \'Cause every little thing gonna be all right!\"
 Rise up this mornin\', Smiled with the risin\' sun,
 Three little birds
 Pitch by my doorstep Singin\' sweet songs
 Of melodies pure and true,
 Sayin\', (\"This is my message to you-ou-ou:\") Singin\': \"Don\'t worry \'bout a thing,
 \'Cause every little thing gonna be all right.\"
 Singin\': \"Don\'t worry (don\'t worry) \'bout a thing,
 \'Cause every little thing gonna be all right!\"
 Rise up this mornin\',
 Smiled with the risin\' sun,
 Three little birds
 Pitch by my doorstep Singin\' sweet songs
 Of melodies pure and true,
 Sayin\', (\"This is my message to you-ou-ou:\") Singin\': \"Don\'t worry \'bout a thing,
 \'Cause every little thing gonna be all right.\"
 Singin\': \"Don\'t worry (don\'t worry) \'bout a thing,
 \'Cause every little thing gonna be all right!\"

 Singin\': \"Don\'t worry about a thing,
 \'Cause every little thing gonna be all right\" - I won\'t worry!
 Singin\': \"Don\'t worry about a thing,
 \'Cause every little thing gonna be all right.\"
 Singin\': \"Don\'t worry about a thing, oh no!
 \'Cause every little thing gonna be all right! - Bob Marley * these facts stated within the brackets were learned after I arrived at Columbia-Presbyterian.

Hello all! Karen and I are home and doing well. The ride home was smooth thanks to my cousin Russell. It had been a stressful week, especially for Karen, but my heart is functioning very well and I feel good overall except for the site of my incision, but I know that will pass. I had excellent care while I was in the hospital and according to Karen the PA was bragging to other hospital staff about my post-op x-ray. My first ten-minute walk this morning was barefoot across the dewy grass - how pleasant! It\'s great to be back! Love to all! David

Hello all. This is day two, post-op. David\'s surgery went \"perfectly\" in the words of his surgeon. Luke and Vicki were with me during the surgery and we were allowed in to see him in the surgical intensive care unit, where he had his own nurse. She was excellent... totally competent and personable with a good sense of humor. The first time we went in he was still under sedation with a breathing tube. The next time, they were reducing the sedation and he \"came to\" slowly as we watched. His color was good and by the end of the day he was fully awake and sitting up. The second day they removed the breathing tube and he was sitting up in a chair. The tube is irritating to the throat and left him sounding like Barry White... very entertaining for me. Later that night he was moved to a cardiac \"step down\" unit. He is now in a double room with another patient who also had open heart surgery. At this point David has been sitting up, eating food and has had his first short walk on the unit. His color is good, his attitude is positive and he is bringing his usual patient calm to this experience. Thank you all for your prayers, good wishes and loving friendship.

Karen and I went to see surgeon Michael Argenziano at Columbia Presbyterian Medical Center last Friday, July 15. It had been a bit of an ordeal selecting a surgeon. Dr. Sommer, the cardiologist we met there, had recommended a few surgeons, but none of them participate with my insurance plan in the end, though one of them was attempting to sign on with my provider, but was denied. Finally we learned that Argenziano, who is on the same team as the other surgeons, works with my insurance, yet when I checked with my insurance representative, I was told that he was not on the list. I expressed my frustration to my insurance representative and, after they dug a little deeper, they revealed that he was indeed on the list. Persistence pays off. Argenziano was very late for the appointment, which concerned us a great deal, but once we met him we felt reassured. He showed confidence and professionalism while he spoke about me getting a bovine valve to replace my badly leaking, bicuspid aortic valve. Karen and I, with the help of a lot of friends and professionals, did research and got different opinions which helped us decide to go with a tissue valve instead of a mechanical valve. With a tissue valve I will not have to be on Coumadin, a blood thinner, for the rest of my life. If and/or when it comes time that I need a new replacement valve due to this one wearing out, hopefully not for 15 years or more, technology will likely have advanced enough for me to have a new valve inserted through an artery (the TAVI procedure), instead of open-heart surgery. This would not be possible if I should get a mechanical valve if it needed replacement at some time in the future. The surgery date is set for Monday, August 22. I will likely be in the hospital for 4 or 5 days and be out of work for 4 or 5 weeks. Karen and I had been feeling a lot tension these many weeks and we now feel a little more at ease with a date to focus on. Keeping up with insurance claims after all the testing and doctor visits has been an ordeal on top of our already busy lives, contending with such things as the brakes needing fixing on my old truck and having fleas in our house. Nobody told me there\'d be days like these, to quote John Lennon! \"Strange days indeed!\" We somehow manage to keep our sense of humor even though we get edgy at times. Friends and family have been a great help to us, pledging their support and assuring us that we will make it through OK. We feel truly blessed with the overlapping circles of community we are a part of. Some friends have even organized fundraisers to help take up the slack where our insurance will not provide. And Karen is my guiding light! It truly touches my heart ... the love I feel coming from her. I do not know how I would be handling this without her. Karen, I love you dearly!

Hi Folks, I just wanted to post this item from Columbia-Presbyterian\'s web site for those interested. I know I am not a candidate at this time for a catheter based aortic valve replacement, which is currently in clinical trials, but my hope is that it will be an option if I need it in the future. Here\'s the link: http://ps.columbia.edu/news/heart-valve-patients-may-be-able-avoid-surgery-trial-shows Here\'s an excerpt: Heart Valve Patients May Be Able to Avoid Surgery, Trial Shows June 6, 2011 Less invasive catheter-based aortic valve replacement and open valve-replacement surgery have a similar one-year survival for patients at high risk for surgery. Results from the PARTNER (Placement of AoRTic traNscathetER valves) trial — the world’s first randomized clinical trial of a transcatheter aortic heart valve — were published June 5 in the New England Journal of Medicine. “These results show that a balloon-expandable transcatheter valve replacement in patients at high risk for surgery is as safe and effective as open surgery, which is the ‘gold standard’ for most patients,” says the study’s first author, Dr. Craig Smith, chairman of the Department of Surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center and the Johnson & Johnson Distinguished Professor and the Valentine Mott Professor of Surgery at Columbia University College of Physicians and Surgeons. The study was conducted at 26 centers in the United States, Germany and Canada. ...

Yesterday Karen and I went down to NYC to meet a cardiologist, Dr. Robert Sommer at Columbia University Medical Center, to discuss surgery options. He\'s a really good doctor who took the time to discuss different surgery options - very straight forward, with a good sense of humor. Meeting with him has led us to return to our original thought about choice of valve replacement - get a tissue valve such as a pig valve, no blood thinners needed, and perhaps in 15 years or less when I may need another valve replacement, the technology will have advanced enough to allow a minimally invasive procedure instead of open-heart surgery. He said that getting the valve replaced is important, but it is not dire that it be done soon, so later in the summer will be fine. We had gone down to learn more about the Ross procedure. Dr Sommer explained that while the Ross procedure is good for children with severe aortic valve problems, it is not necessarily the best choice for someone like me because there are often cases where the pulmonary valve develops leaks after a number of years in the aortic position. And just the fact that it\'s a double valve replacement, far more complex than a common tissue or mechanical valve surgery, is a big mark against it being the right choice for me. Having a mechanical valve is the least attractive choice because of needing to be on blood thinners and having monthly tests and diet restrictions, plus, if a valve replacement is needed again sometime down the road (it does happen with mechanicals), a minimally invasive procedure is not an option because you cannot remove a metal valve through a catheter. As a final note, there were two things that really impressed me about Dr. Sommer - he came out to the waiting area to greet us, immediately putting us at ease, and while in the exam room, he invited me to listen to my heart through his stethoscope! No other doctor had done that. The next goal now is to decide on a surgeon and a date - perhaps sometime in August. Dr. Sommer has us convinced that Columbia is indeed the place to have the surgery.

I\'ll be seeing a cardiologist in NYC on June 3 to find out if I am a candidate for the Ross procedure. Dr. Sommers will be working with the surgeon, Dr. Quaegebeur, who performs the Ross procedure for aortic valve replacement. http://en.wikipedia.org/wiki/Ross_procedure Perhaps we\'ll know then when I will have surgery?

Last week I had a CT scan of my brain and chest on Monday and a Cardiac Catheterization on Thursday. There were no surprises, really. The CT scan confirmed the aortic stenosis and severe regurgitation. Included was evidence of some scarring on one of my lungs (I will ask my doctor about that). The catheterization showed that, aside from my aortic valve disease, my heart is healthy. Now I am waiting to hear about getting an appointment with Dr. Jan Quaegebeur in NYC.