Duane is done with the procedure and Dr. Accola reported that everything went well. The doctor was able to drain about 500 cc of fluid off of his heart and was also able to 'zap' his heart back into normal rhythm. Duane will be in ICU tonight and back to a regular room in the morning. He was much more lucid coming out of the anesthesia this time. When we were leaving him right after our post-op visit, the nurse was feeding him ice chips. We heard him say that ice chips were his favorite recipe. I'm thinking I could save myself a lot of trouble at meal time by just feeding him ice chips when we get home!
Thanks for your prayers!
Duane just had an ecocariogram and they found fluid in the pericardial sac. There is enough fluid that the doctors decided the best thing is to insert a drainage tube into the pericaridal sac to drain off the excess fluid. So, at 5 p.m. this afternoon Duane will return to the OR for this 15 minute proceedure. Besides inserting the tube, they will also shock his heart back into sinus (regular) rhythm. He will spend one night in the Cardiac ICU before returning to a regular room.
Fluid around the heart is not all that unusual, but Duane's situation is complicated by his Protein S deficiency and the blood thinners he is on.
The good news is that the blood thinner is working and his INR levels are at good levels. Another good thing is that the ecocardiogram showed that the valve repair looks great and the blood flow is good.
Please continue to pray. This road we are on looks a little different than the one we expected, but we are confident of One who is leading the way.
We have had a bit of a set back. Last night Duane's heart rate zoomed up to 159 and the nurse immediately identified that he is in atrial fibrillation. The doctor was contacted and an IV was hooked up with medication to bring down the rate and get him back into a normal heart rate. The medication was started about 1:15 this morning and he is still in a fib at 7 am with a heart rate in the 140's. He is exhausted because a heart rate that high makes his body feel like it has been running all night. The nurse took Duane's blood pressure a few minutes ago while he was standing and it was 73/40. Duane felt the blood drain from his head and he was faint and clammy. He was immediately put back to bed until the doctors get this under control. The nurse is confident that the a fib will be righted today, but I must admit it makes me a little nervous.
Thanks for your continued prayers.
Love, greetings, and thanks to all! Duane resurfacing here! First off, hasn’t Peggy done an amazing job communicating? She has been my angel and soulmate since our teens, and now I know we can even love each other more. Right now I almost can’t even look at her without tearing up with gratitude and love. I’m sure I will all too soon enough return to being a jerk to her sometimes, but I at least hope that will be a slow process.
Thank you, everyone. No other words to use. No way to express the inexpressible. We certainly did not realize how much we would need the real-time prayer support that we did. But, without all the immediate, urgent prayers, I honestly don’t know where I would be today. Wow! I had a stroke! I make myself say those words to try to cope with it and own it.
To all heart valve patients everywhere: I am so sorry for any additional fear or anxiety I may have added to your own apprehension. I so did not want to do that. I wanted to sail through a very routine but rapid surgery and recovery and greatly inspire and comfort everyone. I think my case is a reminder to us all that, even though open heart surgery has became such a successful modern medical miracle as to seem routine, open heart surgery is never routine. Complications can occur even with the finest surgeons, hospitals, and caregiving. Blood clots and strokes, though thankfully uncommon, are still risks. Every patient is different. It’s not all uphill. Sounds like Adam’s book.
Adam, thank you again for your book and resources, and thanks again for all the contributions from fellow patients. Most of the steps of surgery and recovery were just as expected and right on track. We felt so well prepared. However, I’m not sure anything could truly prepare you for “Hallo, Mr. Hunt? My name is Ronald, and I’m here to clip you!” My body is so ugly right now. I laugh hysterically every time I’m in front of a mirror. Hey, I’m alive! I made it (though perhaps just barely)! Ugly is the new beautiful! Overall, I look like bruised lemon chicken. I have various bruising colors of purple, blue, and green all over. My left forearm took three attempts to get the original IV in before my heart catheterization. I am covered in stubble. There is absolutely a zero percent chance I will ever get into the body waxing or shaving fad. My incision looks surprisingly good and not gruesome. I have posted some pictures on My Photos.
Wow, I have learned that I hate post-surgical nights. I had two of them—heart surgery, brain angiogram and intervention. Those are just so miserable! The clock does not move! I remember begging for ice chips. After getting nauseated, I remember my nurse saying I had lost :my ice chip privileges.” Still working on my forgiveness issues with that. Peggy probably has gone into some detail on all this, but I’d like to share some of the patient perspective. After the mitral valve repair and reconstruction surgery, I remember waking up with the ventilator; I remember my family; I remember being told I was doing great and them taking out the ventilator after only 2-1/2 hours. By Friday mid-day, I was doing so well I had been released to the PC unit, but there were no open beds. Saturday, I was still doing amazingly well and just waiting for a regular room. In a very short time, I recall having one of the breathing treatments (I call it the smoking peace pipe), when all of a sudden people were mobbing me, asking me stupid questions, like they couldn’t understand me, or could I touch their finger and the end of my nose. I heard a Code Gray called throughout the hospital activating the Rapid Response Team. I knew it was for me. I kept hearing someone say, “get this man’s wife now.” I was aware throughout it all, though perhaps not terribly clear. It was very frightening. I have done enough caregiving to know that I was having a stroke. At times I could not feel my left side at all or see through my left eye. And, well, I didn’t much like it.
Soon I was having a CT scan and hospital personnel were pushing Peggy and me to decide whether or not to have an angiogram and interventional neurology. This is much like a heart catheterization, except instead of going from the groin into the heart, they go from the groin into your brain! I remember the options as explained—do nothing and see how well I recovered with time and some rehab since I seemed to already be getting a lot of function back or go for the interventional neurology. The words of risk I recall included “a bigger stroke” and “death.” I vividly recall grabbing Peggy’s hand and calling out to God in prayer asking Him to guide us in what to do. An angel nurse nearby, Kathleen, took our hands and led in prayer as well. Another tech came to see me yesterday and burst into tears when she told us how hard she was praying for us in that room. I signed permission for the aggressive approach, saying, “Doctor, I can’t stay like this.” Soon I was on the table really having the “OK, Lord, I’m completely in Your Hands” conversation again, and again I experienced God’s peace and presence. They were entering the groin again on the other side. I remember being thankful I had recently updated my wills and life insurance! I also remember introducing myself and trying to learn the name of everyone in the room. You probably won’t believe me (?), but I don’t think I stopped talking until they put me out again. I think it was important to me to “prove” I hadn’t lost it all. Not sure how effective that was!
Coming out of the procedure was misery. My upper neck was swollen and painful due to the probes going up into my brain. Raging headache. I was soon aware that everyone was rejoicing that there had been a miracle. The neurologist had dissolved two clots from my brain; one he had to leave because of the location, but felt that the blood flow was very good around it. Looked like Duane was back. Lucky world, eh? So many have commented to me in the last few days, “oh you’re the miracle boy” or something like it. Been a long time since anyone has talked like that! Today the Superman neurologist, Dr. Frank Hellinger of Orlando Neurosurgeons, came in and reevaluated me and feels that there has been complete reversal and no permanent damage from the embolic stroke. Wow, all praise to God, and all gratitude from me and my family! I was so emotional as I struggled to express my appreciation. I will likely be on Coumadin for at least a substantial time span, if not life. I also will always have elevated risk of another stroke. That is something I will have to live with. But hey, I’ve got a pretty good built-in excuse now when I have a brain fart. “So sorry, but you do know I’ve had a stroke, don’t you?”
So where am I now? Yesterday was a great day—5 laps walking, first shower, first bowel movement with all its accompanying drama (I am not kidding)! Today, more walks, more spirometer, more patient education, more steps forward. All the doctors tell me I’m doing great. They are working to get the thinness of the blood right, and it looks probable for a Friday homecoming. The teams of doctors from the different medical disciplines are all weighing in on long-term/life-long Coumadin. They are not all yet in concurrence, but they are working together for my best interest. I do have some blood protein C and protein S issues which may have contributed to the clot. They’re still trying to get to the bottom of why the clot happened, but we may never know.
Glad to be back, All! Hopefully from now on, I can be an UP’per and not a DOWN’er to this forum. You guys are all the best! I so often remember during the hazy surgery and post-op days asking Peggy what had been posted about my fellow valve patients. I have been praying for you all too. Thanks!
Five days, 1 heart surgery, 1 heart cath, 1 angiogram, 3 blood clots in the brain, 4 waiting rooms, and many prayers later we are finally in a regular room on the Progressive Care floor in the Cardiac Care unit of the hospital! It sure feels good!
Before we left the ICU Duane took his walk. He was strong and steady. Later he was put on blood thinners. As far as anyone who has examined him can tell, he is completely, 100% recovered from the stroke! We are grateful indeed!
Duane plans to return to his position at the computer tomorrow. Many thanks to all have encouraged and supported me during these last several days. I have truly been aware of God's peace through the storm!
I have just scrolled through the recent messages that have been posted on the journal and I am encouraged and uplifted by the outpouring of support and prayer. Thank you all!
Dr. Accola came by this morning to see us. He is very pleased with Duane's recovery (both from the heart surgery and the stroke) and he says Duane will go a regular room on the Progressive Care floor of the cardiac unit today. Whoo-hoo! The doctor did say that, though it is a possible complication, a stroke is unusual. We may never know the cause of the stroke, but the thinking is that when his heart was a bit out of rhythm post op (called junction rhythm, I think), the blood might have pooled a bit, creating a clot. Duane got a pic line about an hour ago for easy administration of the blood thinner. We were encouraged when Dr. Accola said he may not have to be on blood thinner for life. It is possible that it will be a short-term thing. Depends on the lab reports and how hyper-coagulating his blood is.
Duane is exhausted but I think he is pleased by his progress. He is supposed to get up for a walk today (2nd walk since surgery / 1st one since the stroke). I think that will do him good to be a bit active. I will be glad to see him on his feet. I eager to have my baby back!
I'm sitting here next to my miracle and thanking God for what He has done for us! The neurosurgeon came in earlier and said Duane appears to be 100% okay. The nurses continue to reiterate that everything seems fine. As someone who knows Duane quite well, I do not see any problems with his speech, thinking, or behaviors. I realize that we are still in the "time will tell" stage, but we are greatly encouraged and very, very thankful for God's intervention in Duane's life.
We are realizing that most hospitals are simply not equipped to treat strokes at this level. Under most circumstances, Duane would have been treated with blood thinners and observed. Because we are at Florida Hospital that has such incredible facilities, only 2 hours elapsed between the onset of the stroke and the point where he went in for the angiogram. Indeed, the speed with which he was treated and the outstanding care of the medical staff - together with God's grace - have made for an apparent complete recovery!
Unfortunately for Duane, I am now neurotic! A few minutes ago he started to doze off in the chair. I saw his mouth go slack and I panicked! Poor guy. He just wanted to take a nap. I am definately going to have to take a 'chill pill'.
Many thanks to all for the countless expressions of support and assurances of prayer. Words cannot express our gratitude!
Good morning! They did a follow up CAT scan on Duane this morning and it is all clear. No bleeding. The report is that they were able to remove 2 of the 3 blood clots and the 3rd one has good blood flow around it so they say there is no damage from it. That is excellent news! In fact, this morning I asked the nurse if they were going to assess the damage from the stroke today and the nurse looked at me and said, "There is no damage." Truth be told, I will feel better about all this when I see Duane up and moving, but I am greatly encouraged. I do see tremendous improvement. The numbness on his left side, his thickened speech, the droopy lip, and the labored speech are all gone. He has all his feeling back and his speech and cognitive abilities all seem completely normal to me.
Duane is discouraged by the set back. He was thoroughly prepared for heart surgery. However, the brain part was unexpected. He knows his hospital stay will be longer than anticipated. We are in a 'take one day at a time' mode for now. These next 4 days are critical as they watch for bleeding.
Please continue to pray. Thank you!
The Internist just gave us an update. Duane is doing very well and looks good. As far as they can tell now, he has full motion and is speaking well. She (the internist) said he has 100% blood flow. She said - and I quote -- "You have seen a miracle today."
We are not out of the woods yet, but we are greatly encouraged. Please keep praying!
The angiogram was 2 hours long. The doctor found clots and worked to remove as much as he could. He feels he got all but one (in the anterior part). Only time will tell the extent of the damage. They will keep Duane in surgical ICU for 3 days before releasing him to a regular room. I'm not quite sure how cardiac rehab and stroke rehab work together but we'll figure it out. My understanding is that the next 3 days are critical. They are watching for bleeding, swelling, additional clots, and restoration of function (both physical and mental). Please pray for complete healing.
I went in to see Duane at 1:00 and they think he was having a stroke. His left side went numb, his speech was slurred, and he seemed disoriented and bewildered. By the time they wheeled him out to get a CAT scan, the droopy lip had improved, but the numbness on the left side was still there. I am so aware of God's hand in all this. We have been anxious to get out of ICU for the past 24 hours and have had to wait and wait and wait because there were no openings. Finally a bed had opened and they were coming to transport him to a regular room. The wheelchair was next to him and was all loaded up for the transfer when the respiratory therapist watched his behavior change. The nurses and doctors were on it in a moment and within a few minutes he was wheeled out the door for a CAT scan. Had he been in a regular room when that happened, it could quite possibly gone unnoticed for a while, causing more damage.
Please pray. I'll let you know as I find things out.
It's after 9 pm and Duane has been sitting up in a chair since 5:30 this morning. We are still in ICU, just waiting for a bed on the regular floor to open. He has enjoyed visits from his family during the limited visiting hours but he is anxious to be in a less restrictive environment. The hospital is very full today so he may have to spend a 2nd night in ICU, simply because of space. The doctor ordered a sleeping pill for him since he has been unable to sleep more than a few moments at a time all day. I pray he can get some rest tonight.
I am going to attempt to add some pictures to the photo page. However, my training from Duane was only in "How To Make A Journal Entry". I never got the class in "How To Add Pictures" so if you check out the photo page and don't see any new pictures, then you will know that I have not quite mastered it yet.
Hopefully we can report on the move to the regular floor in the morning.
Love to all, Peggy
Duane is sitting up and eating regular food. In fact, he is all ready to be moved to a regular room, as soon as one is available. The drainage tubes and catheter are out! Yipee! He had a rough night, but is doing much better today. He is in pain and is extremely tired, but we are all thrilled at the tremendous progress he is making!
Thanks to all who have responded with well wishes and support. He is glad to from you and will enjoy reading through the journal once he is able.
My job is the be the "Visitor Police" and I would like to ask that you limit your visits to 15 minutes for the first little while. As much as he loves and appreciates all who care, he needs his rest and it's my job to be sure that happens. So... please help me help him get better.
We hope to be in a regular room soon.
Thanks so much!
We have been in to see Duane 3 times since the surgery and each time we hear from the staff that he is doing great. However, he doesn't feel too great! The breathing tube was removed after 2 1/2 hours (which we were told is excellent). He is terribly parched and asked for ice chips. Unfortunately, they made him feel nauseous so he lost his 'ice chip privileges'. That made him sad, so he tried to bargain with the nurse. "How about we just forget any of this happened?", he begged her, hoping she would recant and give him more chips. (she laughed.) The respitory therapist decided to delay her visit due to the nausea. However, she assured him that she would come back later. "I may not be here!", was his response. "Oh really?", she asked. "Where will you be?" Emphatically he replied. "I might run away!" More smiles from the staff. A few minutes later his lower lip came out with a 'puppy dog' face as he tried to convince the nurse to give him ice again.
Earlier he told his daughters that he felt like he'd been hit by a truck. "I won", he told the girls. "You should see the truck." His humor is intact!
Before I left the room, I asked the nurse how he really is doing. She said he is doing exceptionally well. Getting the breathing tube out so soon is remarkable. Duane is asking for pain meds and he is getting them. However, the concern comes with balancing the meds with his low blood pressure. She is watching both carefully.
Enough for tonight. His folks and I are in a motel adjacent to the hospital and we're going to get a good night's sleep. The first visiting time is 9:00-9:30 in the morning and we'll be there bright and early!
Dr. Accola just came and spoke to the family. Good news! He was able to repair the mitral valve and all is good! Thank God! As anticipated, both leaflets were damaged and the doctor was able to cut off and removed the damaged tissue and completely repair the valve. He placed a ring in to hold the shape. Dr. Accola was very pleased with the 3 hour surgery and now we just have to wait until we can go back and see Duane. I feel like I can breathe again! :)
We were just called back to say good bye to Duane as he was being wheeled into surgery at 11:40. We didn't realize it, but he had been in a holding room, awaiting surgery. So... now the wait begins -- again.
They just took him back for surgery at about 10:15 and I am sitting here surrounded by family and friends as we wait.
Our morning started at 4 am with a blood draw and vitals and then the full shave at 5:30.(Duane has very cute legs!)
We had a great time of prayer together around his bed when the kids and parents all arrived. Very precious! We continue to be impressed with the level of care at Florida Hospital and we have heard repeatedly that Dr. Accola is the best! God's peace has been surrounding us, and we are very aware of His presence. Now it's time to wait. More when we hear an update.
Post-Cath Surgery Eve; Surgery moved to 10:30 (as of now)
Journal posted on January 28, 2010
Duane back at the keyboard. Isn't Peggy amazing?! Can't believe I have been so blessed to have her for my wife for 32 years! Right now we are in my room on the 8th floor of the Ginsburg Tower. It's almost midnight, so I am eating and drinking everything in sight before I'm cut off.
What a day! Driving the 50 miles from home to Orlando was really tough this morning. I really thought I might have a heart attack from anxiety before I got to the hospital. But we breathed deeply, prayed hard and made it.
Florida Hospital Orlando is just so amazing. I can't say enough wonderful things about everything so far. And everyone tells me that Dr. Accola is the best!
After the initial checking in hoops, I have just really felt a sense of great peace. God is so present and so near. And the people are the best. Peggy and my parents have been with me all day.
The catheterization wasn't bad at all. They succeeded on the 3rd attempt to establish my IV line, so that was no picnic. I was pretty loopy and tired after the cath. Every time I turn around someone is shaving--excuse me, now it's called "clipping"--me somewhere else. The day included laying still for 4 hours post-cath, blood draws, EKG, a trip around the hospital to chest x-ray, urine donations, a 10:00 room change, followed by a pre-surgery scrub shower and ointment up my nostrils.
I'm about to lay down for a while. Peggy is on the couch bed in my room. The nurse just offered me a sleeping pill, but I'm going to try to do without it. Surprisingly, (at least right now) I feel less anxious and fearful than I expected to. "Peace I leave with you; My peace I give unto you (John 14:27)."
Next on my upcoming attractions are blood draws around 3:00, my full body "clipping" (they're already off to a great start) around 5:30, and another pre-surgical shower scrub.
My scheduled surgery time has been changed from 7:30 to 10:30. I am told "they're coming to take me away" around 9:00.
An awesome thing this afternoon and evening! Two of our five kids and their families live locally; three do not. We knew in advance that our daughter from New York City was flying down for the surgery. Tonight our son from Nashville and our son, daughter-in-law and youngest granddaughter from Panama City Beach surprised us by showing up. Those were the most tearful moments of the day. All five of our children will be here in the morning. What a great family I have! What a blessed man I am!
Thanks for all the calls, visits, guestbook posts, and most of all prayers. I am ready to get this done and I am at peace. Until I resurface...
P.S. Check out My Photos for some pix we posted from today.
Duane is done with the heart cath and he came through fine. The doctor noted that there is some plaque build up, but not enough for a stent. He is all set for tomorrow's surgery.
Everytime I see him he has less hair! Right now he looks like he is wearing furry knee socks! According to the nurses, all hair from the neck down will be gone by surgery time. This is a Duane I've not seen before! :)
Tonight we will get the details of tomorrow's schedule. As of now, we are still on for 7:30 a.m. That means pre-op stuff will begin between 4:00 and 5:00 in the morning.
More later. Thanks for your prayers!
Hi! This is Peggy. I am sending a practice message. Duane has just given me my lesson in 'journal entry'. We are about to leave for Florida Hospital. I'll be updating the journal as we go along. Thanks for your love and prayers!
Just over three months ago (Oct. 21), at a routine physical, my doctor detected (for the first time ever) a heart murmur. And here I am on the verge of open heart surgery. Sometimes it still seems surreal, but it is sure real. Like the Bible teaches, life is short and fragile, and we never know what tomorrow may bring. That’s why it’s important to live for higher things. “So we fix our eyes not on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal (2 Corinthians 4:18).”
Peggy and I are busily readying the last preparations before leaving for Florida Hospital Orlando first thing in the morning. Mowed the lawn; got the church as prepared as I could; had meals and phone calls with my children; got a seriously short haircut. The hospital called and pre-admitted me a little while ago. Still have a bunch of bills to pay ahead. Last night we went out for a bite of southern BBQ, and I have to confess, I ended up eating a whole chicken! Guess I’m expecting to not eat much the rest of the week!
Emotionally, I felt surprisingly upbeat on Sunday and am pretty much in the zone of “let’s just get ‘er done!” I know it’s getting tougher for my wife. Though I’ve been grateful to have had some time to research, decide, and prepare, it’s been enough. I’m relieved it’s here, to be honest. Sleep has been a bit harder to come by the past couple days, and tears are not far from either of us. I rather dread the next two nights, not that the third one will be all that great. ;-)
I love the balance in Psalm 56 between emotion and volition: “3 WHEN I am afraid, I WILL trust in you. 4 In God, whose word I praise, in God I trust; I will not be afraid. (Psalm 56:3-4).” A core value for me is being real and transparent. Sometimes I crack up when people tell me “you’re just so human.” Well, duh! It’s okay to have feelings. It’s okay to struggle. It’s okay to be vulnerable. I have endeavored throughout to face the overwhelming anxiety of this journey honestly and with faith. Faith is a chosen response to our feelings. In John 11, when His friend Lazarus had died, verse 35 (a favorite memory verse because it’s the shortest verse in the Bible) simply states, “Jesus wept,” and then He raised Lazarus from the dead.
My deepest thanks for all the wonderful and touching guestbook entries, calls, and promises of prayer support! Thank you, all friends, new and true. No words can describe how much that means! And thanks again to Adam Pick and this community for making the vast unknown much more known, and thus manageable. Though I’m better aware of what to dread, I will better know what’s going on, and that makes me less fearful and out of control. Speaking of control, I am just about done doing all I can do, and I am about to surrender myself completely into God’s hands and the hands of those to whom He has led me. I am a blessed and grateful man.
The heart catheterization is scheduled for 1:00 tomorrow. I will try to post my final pre-surgical update at the hospital; we’ll see. Peggy will be taking over updating the journal with real-time reports during and after surgery and throughout early recovery. Of course, being a control freak, I will strive to resume the posting myself ASAP once I resurface. We still plan to take and post some pix for those not faint of heart, so check out “My Photos” periodically if you’re interested.
“God Is It True (Trust Me)”
By Steven Curtis Chapman
From his latest CD, “Beauty Will Rise”
God, is it true that you’re thinking of me at this moment?
God, is it true that you hear every prayer that I pray?
God, is it true every time my heart beats, you know it?
Well, if it’s all true, then that must be you I hear saying, “Trust Me.”
God, is it true out of all things you’re doing on this planet,
Could it really be true that you’ve counted the hairs on my head?
God, is it true, every day of my life, you have planned it?
Well, if it’s all true, then that must be you I hear saying, “Trust Me.”
Trust Me, Trust Me
I’ll never leave you
I’ll never forsake you
Just trust me
God, is it true that your love for us is never ending?
Could it really be true that you’d die before letting us go?
God, is it true that not even death can separate us?
Well, if it’s all true, then what can I do but put all my hope and all my trust in you?
Well, I know it’s true and I know it’s You I hear saying, “Trust Me.”
I hear you saying, “Trust Me.”
For interested family and friends and as a potential resource for other heart valve patients in central Florida.
10:30 am Report time to Florida Hospital Orlando
1:00 pm Heart catheterization scheduled time, followed by admission and pre-op testing
7:30 am Mitral Valve Repair surgery scheduled time, starting with a TEE (transesophageal echocardiogram) performed in OR before
Florida Hospital Orlando
Cardiovascular Institute, Ginsburg Tower
601 East Rollins St
Orlando, FL 32803
See map in the “My Photos” section of my Journal
The Florida Hospital Cardiovascular Institute
One of the leading centers of excellence in the nation when it comes to cardiac and cardiovascular health issues, the Florida Hospital Cardiovascular Institute is one of the busiest cardiovascular centers in the United States. The institute is: #1 in Cardiology Volume, #4 in Open Heart Surgery Volume. The institute’s new 15-story Ginsburg Tower is designed to create a total healing atmosphere that reduces stress, rejuvenates the spirit and promotes a speedy recovery. The facility, which features views of Lake Estelle, is light and airy with lots of open space. Nearly two years in the making, the tower’s design offers patients comfortable, private rooms that are focused entirely on the needs of the patient, their family and the caregiver.
Kevin D. Accola, MD
Cardiovascular Surgeons, P.A.
217 Hillcrest St
Orlando, FL 32801
My Heart Cath Interventional Cardiologist:
Chin Kim, MD
Florida Heart Group
1613 N Mills Ave
Orlando, Florida 32803
Link to an illustrated description of my surgery from Cleveland Clinic:
Link to a video explaining the TEE:
Link to a video explaining the Heart-Lung Machine:
Link to a video of Mitral Valve Repair by Dr. David Adams, Mt Sinai, NY:
Link to a video of a Mitral Valve Repair surgery at Wake Forest Baptist from OR Live/Medline Plus (great video, long at 57:00, not for the faint of heart):
Link to a video (with transcript) of my surgeon, Dr. Accola, and a mitral valve repair patient’s story:
Link to a Florida Hospital Cardiovascular promo video featuring Dr. Accola:
Go to the blue Videos Box in the center. Below the player, toggle the arrow until you find “Heart Care at Florida Hospital (3:04).” Click the play arrow. The video icon is Dr. Accola onscreen.
Links to other videos featuring Dr. Accola:
Duane’s Top 10 Things to NOT Look Forward to with Heart Valve Surgery:
10. Interruption of my normal coffee flow! (Can you hear the screams?! It’s a 2-for-1: heart surgery AND Detox!)
9. Displaying the moon while I shuffle the halls in my stylish hospital gown.
8. Being dependent and needy, inactive and invalid during recovery (bet my dear wife can\'t wait!)
7. One word—catheter! Excuse me...you’re going to put that where?!
6. Driving Mr. Duane--being chauffeured by my wife (poor girl!)
5. No you-know-what for how long?! (come on, I’m human, married, and still alive!)
4. Waking up with the ventilator tube in the ICU.
3. The run-over-by-a-train feeling every heart valve surgery patient mentions!
2. Full body shave…yep, everywhere you can imagine, and then some!
And tied for Number One…
1. The heart-lung bypass machine. Cooling, stopping, recharging my heart?!
1. The sternum + saw combination!
Duane’s Top 10 Positive Things to Look Forward to with Heart Valve Surgery:
10. An extended V-A-C-A-T-I-O-N, oh yeah!
9. Extreme Attention! There’s got to be an easier way to grab the spotlight!
8. A forced slow-down period for God to teach me patience and stillness (good luck with that!) and a forced time of dependence and receiving to teach me greater humility.
7. I’ve never even been drunk or high, so this is my big chance!
6. Adam Pick, his book, this website, blog, and journals, and the comradery of fellow heart valve surgery patients, The Fellowship of the Valves (yeah, I know, it’s really dumb!)
5. Extreme ministry training! Better compassion, grace and care for those facing surgery and life threatening health situations. “3Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, 4who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves have received from God (2 Corinthians 1:3-4).”
4. The blessings of today’s God-given medical technology, a renowned surgeon, and an excellent hospital.
3. My loving and caring wife, family, and friends and all the support, prayers, and tangible care.
2. A heightened spiritual journey by experiencing God’s peace, presence, control, healing and shepherding (Psalm 23) like never before, and by better relating to Jesus’ suffering and scars by now having scars of my own.
1. A fixed heart! A greater appreciation for the miracles of life, time, and health! A better man!
In the Gospel of John 14:27, Jesus says, “Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid (NIV).” Thanks, my troubled and fearful heart needed that!
My wife and I are finding the emotions are getting more difficult to manage as the days advance. Honestly, after church last Sunday, we both emotionally spiraled down. Most pastors naturally experience a letdown after Sunday services. Piled on top of the usual, I guess, was the realization I only have one more Sunday before the surgery, and we were entering our final full week before it! Already?! Thankfully we had already made some plans that we stuck to, even though we didn’t feel like following through. We spent Sunday night away in Titusville, Florida, poised to spend all day Monday at Canaveral National Seashore, one of our favorite places. As a teacher, Peggy had Monday off in celebration of Martin Luther King Jr. It was a beautiful day that we spent alone together wildlife watching, hiking, and beaching (no, we did not go in the water! Only Yankees do that down here this time of year!). Precious time to refortify. Good call.
As I type this journal, my mother-in-law will be having a heart catheterization at Winter Haven Hospital tomorrow morning. We are praying all goes well. A week from right now, I will have undergone my own heart catheterization and will be anxiously awaiting surgery Thursday morning. I have still struggled a bit with a lingering cough and light sinus congestion, so my doctor started me on an antibiotic yesterday. That’s gotta go!
Still so much to do before next week! And yet, we have made a myriad preparations. We have both read Adam’s book and read many blog entries, done extensive internet research, chosen a world-class surgeon in Dr. Accola and the excellence of Florida Hospital Orlando, set up my journal to communicate, redone our wills, durable power of attorney for health care, and advance directives, and have bought slippers, sweatpants, loungewear bottoms, the Incision Shield, Mederma, Peri-Colace, and a recliner. I have been anointed and prayed over, and I believe in God’s healing and in His control. We are readying. But, like Jesus said, “the spirit is willing but the flesh is weak.” Can one ever be emotionally ready for something so overwhelming? I choose to live out faith through the bouts of fear and anxiety. “We walk by faith not by sight.”
"Courage is not the absence of fear, but rather the judgment that something else is more important than fear." (Ambrose Redmoon)
“Courage is being scared to death— and saddling up anyway.” (John Wayne)
First off, thank you to everyone who has checked out my journal or who has signed up to receive my journal updates. Your concern and prayers mean more than words can express. These journals have the dual purposes of helping facilitate communication between patients and their support teams and of adding to the cache of shared experiences and resources from fellow heart valve surgery patients. Therefore, some of what I post will be more pertinent to one of these groups or the other. If you’re interested, do check out My Photos. I plan to upload some resource images and to photo document my surgery and recovery journey, hoping it will prove helpful to others. Look at your own risk, though. Some of it will definitely not be pretty!
Well, two weeks from right now I should be feeling pretty rough, several hours post-surgery and in the ICU unit. Ironically, as I am writing this entry, tonight’s episode of Grey’s Anatomy features a heart valve replacement surgery! How about that?! In the last 8 days a gentleman from my church has had a heart catheterization and an EP study of his heart, and is being steered by his cardiology team to check out the clinical trials for a transcatheter aortic valve replacement at the University of Miami. Last night, Peggy and I took my mother-in-law to the ER with a racing heart, atrial fibrillation and spiked blood pressure. Everything has stabilized now. She is staying overnight for observation and is expecting to go home tomorrow. Everywhere I turn, it’s cardiac, cardiac, cardiac!
It’s been hectic making preparations for my surgery, both personally and preparing the church for my absence during my recovery. The frenetic pace has been a blessing in many ways and has made the time go by fast until surgery. Still so much to do!
Last week, on January 6, I gave a unit of my own blood for myself (autologous) at Winter Haven Hospital Blood Center. They will transfer it to be in place for me at Florida Hospital in Orlando. As a regular blood donor for many years and well known to all the blood bank staff, this seemed just like an ordinary part of my life. Wait a minute—the blood is for MY use?! Dr. Accola estimates the chance I will need a transfusion during surgery is 10-15%, but he likes to give the patient a unit of his or her own whole blood to help boost their recovery. So I will be receiving the blood back while hospitalized. Thank you to those who have offered to donate directed blood for my use. We’re all covered.
I have never had any surgery before (except for wisdom teeth extraction when I was 18)—no tonsils, no appendix, no hernia, no V (chicken!), nada. I only do things in a big way! So this surgery virgin got a bit unnerved once this week and called Dr. Accola’s nurse with some more questions and for some hand-holding. Annette was very reassuring and calming. Overall, Peggy and I are doing well, moving forward full speed ahead and trusting that God is in control! I have had a bit of a lingering tickle cough and congestion lately; please pray that I will be completely healthy going into the surgery.
My thanks to some new friends at the Gibbs Law Firm in Seminole, Florida, for pointing out a Bible verse to me. Though the Hebrew word translated “fixed” in the KJV has a literal root meaning “to stand erect,” and thus to be steadfast, established, ready, I am finding great strength in both of the translations below.
My heart is fixed, O God, my heart is fixed: I will sing and give praise.
Psalm 57:7 (King James Version)
My heart is steadfast, O God, my heart is steadfast; I will sing and make music.
Psalm 57:7 (New International Version)
SOONER rather than later! Surgery January 28, 2010
Journal posted on December 23, 2009
Peggy and I went to my appointment for a second opinion and consultation with Dr. Kevin Accola of Cardiovascular Surgeons in Orlando on Monday, December 21.
After studying my echocardiogram films he met with us for at least 20-30 minutes, diagramming and explaining everything with great clarity and detail.
--Both leaflets (anterior and posterior) of my mitral valve are severely prolapsed.
--My mitral valve is badly misshapen, a more circular shape as opposed to the correct capital "D" geometry.
--My mitral regurgitation and insufficiency are severe and indicate surgery now.
--He said surgery was not an emergency so I had some time to prepare but was inescapable and, when pressed for his timetable recommendations, should take place within about 3 months.
--He gave me 98-99% odds of mitral valve repair over replacement.
--When asked about my cardiologist's "watchful waiting approach," he said it's my choice. But, as he put it, the "older way" of thinking was to wait until heart damage and symptoms got to a certain level of severity before proceeding with surgery, but the "newer thinking" is to, when surgery is inevitable, proceed before the heart is significantly damaged and before the valve further deteriorates. This made perfect sense to us.
--When asked about minimally invasive surgery, he called that terminology a misnomer, since no surgery entering the heart could be considered minimally invasive. He could do a thoracotomy if I choose, but he feels a mini sternotomy is the safest and best approach for a successful outcome. I said with trepidation, "so you're going to crack my chest open." With all seriousness, he replied, "no...we use a saw." (Oh, I feel better now). ;-)
--My echo indicated some mild aortic and tricuspid Valve regurgitation. He feels that once my mitral valve is repaired, the pressure in the heart will be reduced, and this should not be a future problem for me.
--I will bank 1 unit of my own (autologous) whole blood in case I need a transfusion (10-15% chance); if not needed during surgery, they will give it to me post-op to help perk me up and facilitate my recovery. I have a Jan. 6 appointment to give the blood locally.
--He foresees a full recovery with no adverse affects on my longevity.
--General expectations post-op for me: 1 day in ICU, 3-4 more days in the hospital, 3 weeks no driving, 4 weeks to be back "in the pulpit" but still with somewhat light duty overall.
We also spent considerable time with his Physicians Assistant Mike Butkus and his surgery scheduling nurse Annette Gonzalez. Everyone was wonderful! Dr. Accola even gave me a big hug before leaving the consultation room.
My surgery is scheduled for Thursday, January 28, 2010 @ 7:30 a.m. @ Florida Hospital South in Orlando. On Wednesday, January 27, I will report to the hospital for a heart catheterization with Dr. Chin Kim of the Florida Heart Group. After that I will be admitted and then undergo the series of pre-op tests, spend the night, and be ready first thing in the morning.
With all our (admittedly lay) research, my wife and I were not surprised with his recommendation. Actually, with this just hanging over my head, I'm just ready to move forward and get 'er done. (Of course that's in the moments when I'm not plotting my escape to hide on some remote island somewhere.) I'm glad it will be a hectic month getting ready for a month-long absence from church ministry. That should keep me too busy to completely lose my mind, what's left of it.
After the appointment, we went to Florida Hospital, nosing around a bit, getting better acquainted with it, and trying to digest it all.
Emotions can be all over the map. Overall, we feel that God has so clearly led us, and we are in the best hands possible, most of all God's. We are confident and feel His peace and goodness. We couldn't be more impressed or comforted than with Dr. Accola and the hospital. Florida Hospital's mission is "Extending the Healing Ministry of Christ." I love that! Yet, there are times of tears and apprehension. I wish I could turn off the dreams!! (An assembly line of heart valves! Bizarre!)
We believe that God is in control, and even though it's sooner rather than later, we are moving forward with faith. Okay, sometimes I am curled up in the fetal position.
My name is Duane Hunt, and I’m a 50-year-old Pastor from Winter Haven, Florida. My wife Peggy and I have been married for 32 years and have 5 grown children and 8 grandchildren.
I am a very active and reasonably fit person, have intermittently jogged throughout my adulthood, but in the past 11 or so years have very much concentrated on health, fitness, and diet. I try to lift weights at Gold’s Gym a couple times a week and run 2-3 times weekly. These goals have tapered some over the past few months. When I do run, it’s usually about 7 miles. At age 40, I day hiked to the summit of Mount Whitney in California with 3 of my teen kids, a 22-mile roundtrip hike with about an 8,000’ elevation gain then loss. I’ve hiked to the top of Half Dome twice in the past decade, plus the summit of Clouds Rest in Yosemite. About a year and a half ago, one son and I hiked to the bottom of the Grand Canyon to Phantom Ranch and back up in one day (pretty grueling stuff).
Every 6 months I have an appointment with my family physician, who is a good personal friend and a member of my church family, to monitor my health, check labs, and monitor my cholesterol, which has been high but has been reduced with statins. He has listened to my heart many times. At my annual routine physical on October 21, a day after a new granddaughter was born and 4 days before a son’s wedding, my doctor listened to my heart with different attention and body language than I had afore noticed. He detected a significant heart murmur. That had never before been noted by any physician. He asked about symptoms—chest pains? Palpitations ( I didn’t even know what that meant)? Shortness of breath? Nothing I had noticed.
Last March I had to have an EKG performed in my home as part of the application process for a new life insurance policy. No problem was detected, and I was approved for the policy with an A+ health rating. There is some family history of heart disease (maternal grandmother, 2nd cousins), but nothing of a heart valve nature.
After detecting the murmur, my doctor sent me for a chest x-ray and an EKG the same day in the clinic. An echocardiogram was scheduled for October 27. The echo revealed a severe mitral valve prolapse with moderate to severe mitral regurgitation. I was floored. I don’t recall ever even hearing these words before then. At that point I began to do my research, including www.heart-valve-surgery.com and www.heart-valve-surgery.com/heart-surgery-blog, youTube, Mayo Clinic, Cleveland Clinic, Web MD, etc. You know. Wait a minute…open heart surgery (?)…is in MY future??! This couldn’t be me. It had to be someone else, right? I have my Echo report, but I’m not sure what all the numbers mean.
For the uninitiated among my friends and family: The heart has four valves, which serve as gates and seals to keep the blood flowing in the right direction as the heart pumps, and to prevent backflow in the wrong direction. The mitral valve is between the left atrium and the left ventricle. Freshly oxygenated blood flows from the lungs into the left atrium, through the mitral value and into the left ventricle. From there it is pumped through the aortic value out to flow throughout the body. A mitral valve prolapse (MVP) means that the value is leaky and does not seal properly. It is not an uncommon condition and is not necessarily anything to be concerned with unless mitral regurgitation becomes significant. When that is the case, as with me, it is normally progressively degenerative and, without surgery, leads to congestive heart failure. The backflow overload causes the heart to work harder and harder, enlarging and weakening it over time, and eventually leading to failure. Ideally surgery is performed before the heart itself is significantly damaged. Repairing the valve is greatly preferred to replacing the valve. This is open heart surgery and has traditionally been with the sternotomy. In recent years, less invasive surgical techniques have been developed.
On November 11, I had my first appointment with a cardiologist (I have a cardiologist?!), beginning with another EKG. He reiterated what my research had revealed. My left atrium is a bit enlarged; my left ventricle is not enlarged but the EKG showed increased voltage. I then had an exercise stress echocardiogram test (the same day), and the cardiologist said it was “perfect” as we consulted afterward. He seemed surprised that I was asymptomatic. In retrospect, I have experienced some heart palpitations and fatigue, but heart issues never even crossed my mind. Now that I know, I don’t want to create the symptoms via anxiety, if you know what I mean.
My cardiologist felt that the prolapse does not currently warrant surgery but that surgery was not IF but WHEN and would be likely within “a couple years.” He recommended watchful waiting for now, with another echocardiogram in 6 months to see if the condition progresses. Exercise is okay. No restrictions noted. He told me to contact him immediately if I started developing shortness of breath especially.
With all of my research, I decided a second opinion would be in order. Though there are very good hospitals and physicians nearby, I also decided, when the time comes, I want to go to a high quality, high volume heart surgery center with much expertise and experience with heart valve repair surgery. In my area, this points to Florida Hospital in Orlando (50 miles away). I also personally very much appreciate their faith based approach to health care. Thanks to this web site treasury, Adam’s book, and other research, I decided that Dr. Kevin Accola, Cardiovascular Surgeons, Orlando is my surgeon of choice. Of course, I am very much hoping and praying for a mitral valve repair (rather than replacement) using minimally invasive surgical techniques. I have an appointment with Dr. Accola on December 21, taking all my labs and reports with me, and I am very anxious to learn his assessment. Regardless of the timing of the surgery, at least I will already be established with and known by him.
As many of you know, a diagnosis like this is very overwhelming. I so appreciate all the contributions made by Adam, this web site and blog. Thank you. For me right now…only the beginnings. Unless God chooses to heal me first, I am heading for surgery sooner or later; I just don’t know at this time if it will be sooner or later. Thank you for your prayers.