Hi everyone. I'm feeling quite fine with the residual Fentanyl-Versed cocktail from the day's procedure. Nicely stoned and well fed after tthe day of fasting.
The catherization process was quite interesting. They started with trying to go through the brachial artery (wrist) but found it totally blocked from when I had a catheterization at age 13. So they had to go through the femoral artery instead but when they lit up my circulatory system with the dye, they saw that my right forearm was "fully revascularized" with lateral arteries that had grown through the forearm on their own. The doc was really impressed, and this guy (Dr. Rade) has done a lot of catheterizations.
So the test revealed 70% blockage in one coronary artery and 50% in another. The first will almost surely get a by pass tomorrow, the second maybe. They will use one of my mammary arteries for the bypass graft. I guess those are superfluous in guys.
Besides being on much better drugs and a better trip than Charlie Sheen (whom I had to suffer watching on TV a zillion times today in the recovery room), he's only got two "goddesses" and they are cheap ones at that. I've got a universe of real goddess energy going for me and they are all only the best and most powerful.
Chris here. We are back at the townhouse after 10 hours at Johns Hopkins. Mark has recovered well from the angiogram and is resting now. Surgery is scheduled for Wed @ noon. Mark is waiting for the confirmation call from the surgeon, Dr. Duke Cameron. The whole JH team is very relaxed, confident and competent. Keep sending Mark your love, prayers and good vibrations! Mark or I will have another update tonight or tomorrow morning.
Installed now up in Baltimore, int he residential units next to the hospital. Mom and brother Chris arrived yesterday and we zoomed right from the airport to the White House for a West Wing tour courtesy of my friend Chad Maisel. Photo outside the entryway posted in the photo section of the journal here. (You're not allowed to take pics inside of course, but if you look at the seal above the door it proves we were there!)
While a heavy storm rained outside, inside it was a calm and quiet Sunday afternoon with nobody visible except the guards and a few other visitors. Because it was quiet and the President elsewhere, we got to stand in the doorway of the Oval Office and take it all in. It seemed both smaller than I thought it would be, and incredibly more charged with history and meaning.
This morning we visited my office and had a sweet little brunch party with the MRP homies and the Deputy Secretary. I feel that I work in one of the coolest, most human places within USDA.
So now we are just relaxing before the drill begins early tomorrow morning. 7:30 start time to show up and get prepped for my (outpatient) catheterization procedure. Catheterization scheduled for 9:30. This will determine if there is any significant arterial blockage. If so, that will add some intervention (e.g. bypass) to the aorta repairs on Wednesday. Tuesday night I'll stay in the residence and then early Wednesday morning be admitted and begin prep for the surgery.
It is great to have Laurie and Chris here. My brother has really stepped up hugely to be my advocate and organizer in all this. Thanks Chris!
I'll post tomorrow night through the post-sedative haze, and then turn it over to Chris to provide updates after surgery begins.
Thanks for all the powerful and loving thoughts and expressions wrapping around us.
For years during college, following my original heart surgery, I had a glossy poster of the Indian demi-god Hanuman holding open his chest to reveal his heart. I just sort of identified with the image and loved the vivid color. Didn't connect much with the Hindu scripture then, but thinking about it recently I had to google it up. So here is (a version of) the story:
After everyone had received their gifts, only Hanuman was left. Rama and Sita did not know what to give him, as his service to them had been so great. Sita had a priceless
string of pearls around her neck. She looked at Rama, and he nodded to her in agreement. She took the pearls off of her neck. She approached Hanuman and said
“Sri Hanumanji, there is no way for us to adequately express our love and appreciation for you. Please accept this strand of pearls.” Saying so, she placed it around his neck. Hanuman, who is as innocent and playful as a monkey, began fingering the pearls. He looked at them from one side, then another. Then he took them off the string.
Everyone was curious as to what he was doing. Then he took one of the priceless pearls and broke it in half! The whole audience was wonderstruck! What was he
doing, destroying Sita’s priceless necklace?
Someone said “Hanuman! What are you doing???” Hanuman replied “I am looking for Rama and Sita inside the pearls. If Rama and Sita are not inside, they have no value for me.” Someone else said “But Hanuman, Rama and Sita are everywhere and in everything. But that does not mean that you could see Them inside! We know Rama
and Sita are in your heart, but that does not mean you can see them there!”
Hanuman had a very logical mind. He said “Oh, is that true? Let us test your belief.” So saying, he ripped open his chest, revealing his heart. Blood gushed everywhere.
Everyone was astonished Hanuman would do such a thing!
Everyone says God lives in the heart. But this is not the physical heart. If a surgeon opens the heart of a Rama devotee, he will not see Ram there. In order to see the
heart where Ram lives, one needs to have a pure heart and be able to see what is called the astral plane. It is on the astral plane, which is composed of light particles,
that one can see what is called the lotus of the heart, where God resides.
Because of their deep love for everyone there, Rama and Sita allowed everyone to have the vision of the astral plane. Everyone was staring at Hanuman with his chest
open. On the physical level, they saw all the blood and gore. But on the astral level, they saw something very beautiful. In the lotus of Hanuman’s heart, Rama and Sita
were sitting. Everyone saw that Ram and Sita really did live in Hanuman’s heart. That was the only thing he valued. Everyone was deeply moved by the depth of devotion of
Ram touched Hanuman on the chest, healing his gushing wound. When Hanuman left the Earth Rama asked Hanuman to stay behind to protect His devotees.
Whew, less than a week to go. So many thoughts and details to process still.
My sis Elaine ran my chart for the scheduled day of surgery. Here's her take:
"here's the chart for Wednesday - moon in Taurus (ruled by venus), mars return (start of a new 2-year cycle of action and manifestation), north node exactly conjunct your ascendant (soul evolution and identity; new 19-year cycle). Lots of Pisces = universal consciousness = feel the love!"
19 years sounds pretty good to me! See the arcane details here if these things mean anything to you:
Strangely this is exactly ten years to the week from the beginning of my cancer episode. Got the first inkling of something wrong one morning, stopped at the urgent care on my way to work, got an ultrasound and went to the office. By the end of the day I had a preliminary diagnosis and everything changed.
I don't know what to make of these seeming cycles. I feel that I have led a charmed life, not a troubled one. These periodic submersions in the medical vortex have enabled me to keep on ticking, and that seems to be part of the mission I am grateful to have. I have been blessed many times over for the challenges I've been given.
That's not to say I'm not scared or grumpy, because both of those are certainly present in the muddled mix of my emotional state. But it helps to to at least imagine that there is a larger purpose or progression to it. The fear (terror!) and anger (this really sucks!) can be framed and acknowledged for what they are, but inset within a bigger, more expansive, more beautiful picture and so limited in their power.
And I do "feel the love"! Thank you all so much for the support and prayer and connection.
For the record, my recovery goal (one of them) is the Giants at the Nationals here in DC April 30-May2. Actually I'm pretty sure I'll have some nice Spring days at Navy Yard before the WORLD CHAMPION GIANTS get here, but I will be at those for sure.
I'll try to get a little more content going here before going to Hopkins. First of all is to say mahalo to everyone for writing, for sending good vibes, for worrying (but please try not to). You all and each and all our connections mean so much to me. You can imagine that these feelings only feel more acute and poignant, being framed by the this situation. I keep intended to just start plowing through and replying to everyone individually but so far that has not happened. Anyway, directly back at you all.
Surgery is now less than two weeks away. Time seems to be speeding up even more than usual.
I still have a lot to do, but finally starting to hand off stuff at work. I have to do some grieving about stepping away from my job, which is still more fascinating every day. But it will (probably) still be there for me to return to.
(There is some uncertainty about a certain government shutdown/contraction that will occur while I'm on this hiatus. Looks like one or the other or both from here. Just adds a little plot twist to the whole adventure.)
Trying to get in some meditation and exercise every day until preops on the 8th. A lot to do and a lot to think about. Meditation requires some not thinking about all there is to do and think about.
Thinking a lot about being open, all the levels of openness that life requires and invites. All the things this brings, all the love, the rewards of risk, the rewards of giving, and all the sorrow and loss too. The more open we are the more it all fuses into something else beyond love and loss.
Which comes back, perfectly, to baseball of course.
A regift to you all:
Ariane found the song "My Jalopy Heart" by David Wax Museum. You can find nice Tube of live versions but get the studio cut to hear it really pretty.
From Doyle's "Wet Engine":
"... Or think of the heart as a music machine -- not a far-fetched idea, for the heart runs on electric impulse and does so in a steady 4/4 rhythm. A musician friend of mine maintains that that the 4/4 rhythm, standard in popular music, feels right, feels normal, because it is the pace of our hearts, the interior music we hear all day and all night. We are soaked in the song of the heart every hour of every year every life long."
Welcome to Mark's Heart Journal, hosted by Adam Pick's heart valve surgery guide.
I will soon be taking my jalopy body to the shop for some new heart parts. This journal will try to be a place for info, updates and reflections and discourse on human engine repair.
I was born it seems with a somewhat broken heart. An apparently congenital defect of the aortic valve was identified when I was just two yrs old. I was watched and studied all my life by heart docs until as expected, end of adolescence changes called for new plumbing. I received a Bjork-Shiley disc valve implant in 1977. Surgery by John W. Kirklin chief of cardiac surg @ U. of Alabama, Birmingham, then perhaps the leading center in the country.
Kirklin's valve job has lasted many many miles, undaunted by the challenges of farming, marriage, earthquakes, cancer, divorce. It still is working pretty well, but the adjacent parts are wearing out and a rebuild is on the agenda.
After living the last 27 years at Molino Creek Farm (Davenport, CA) I came to D.C. in 2010 for a two-year work commitment at USDA. Engaging new providers to do my regular monitoring brought up some new diagnostic issues. Whether simply a different medical perspective or physical changes from moving to the East Coast/DC/urban/big job, hard to tell. No doubt some of each.
In any case, the immediate concern is an incipient aneurysm of the ascending aortic vessel. My artery was measured at a diameter of 5.45 cm in October, just verging on the range where intervention is usually expected. When the aorta enlarges like this it threatens to blow out or create catastrophic diversions ("dissection"). See www.slrctsurgery.com/Thoracic%20aortic%20aneurysms.htm.
Mine has seemingly been always been somewhat large but has gradually been getting bigger for the last few years at least. Laplace's Law will be enforced. (See hyperphysics.phy-astr.gsu.edu/hbase/ptens.html#lap)
This is an elective, preventive procedure. I'm not in any acute distress (quite as healthy as I've been for the last 5 or 6 years) but getting this done before it goes bad is the goal. Once there is a problem, the likelihood of a successful fix goes down quite a bit.
THE REPAIR JOB
The main procedure is a Dacron graft onto/replacing the weakened part of the artery to prevent breakdown. This may or may not entail replacing the existing prosthetic valve and the whole aortic root around the valve. (Dr. Cameron says he will decide when he's looking at it close-up.)
It's major, open-heart, split sternum deal. Also includes Hypothermic Circulatory Arrest. (My previous operation plus the radiation treatment to my chest for cancer 10 years ago add complexities).
Here's some general info on the surgery:
After zeroing in on this situation with various tests and discussions through the summer and fall, my DC cardiologist (Joel Rosenberg) began referring me to surgeons.
After seeing two surgeons in DC I finally got a visit with Duke Cameron at Johns Hopkins in Baltimore, whom the others had also recommended. He's the top guy on the East Coast and one of the most experienced in the U.S. A couple weeks before my visit he had been named "Cardiac Surgeon in Charge" at JH.
www.hopkinsmedicine.org/news/media/releases/johns_hopkins_medicine_appoints_new_chief_heart_surgeon. Hopkins is consistently rated in the top three spots nationally for heart surgery, with Mayo and Cleveland Clinics. So I feel very good about where all this has led and know that I've really got as good a situation as possible.
I'm scheduled for the operation on March 9th. Expectation is one week in the hospital. Then a full six weeks of intensive recuperation. From there it's one-six months more of gradual strengthening.
I'm not planning a specific date to return to work but hopefully I'll be ready to start part-time in early May.
SUPPORT & SHARING CARE
I've got a good village here in DC and my mom and siblings and others will also rotate in to be part of the team. In the next week my brother Chris and I will be working out a plan for recuperation care.
So it's going to be another adventure in medical miracles, healing and discovery. Please come to this journal for reports and thoughts on the process and to send messages through the Guestbook.
Thanks from all my heart parts for your care and support.
Keep the Beat,
(p.s. thanks to Beth for the perfectly poetic, "jalopy body.")