Jennifer's Journal

It’s been awhile, folks. All’s well nearly 4 years post-OHS MVR/maze procedure. Sometimes we must show gratitude for those who helped us get here and are no longer with us. ❤️🌺🙏🏼

Please check out my latest Heart Matters Blog post:
https://heartmattersblog.com/this-guy/

Has anybody out there had to deal with a 90% blocked carotid artery in advance of undergoing OHS to replace a leaky mitral valve? Asking for a friend. Thanks.👍🏻

By Jennifer John Around this same time a year ago, I was celebrating eight weeks’ post-op from heart valve repair surgery and about to start cardiac rehab. Everything turned out fine. Again. I had been under the knife for open-heart surgery once before, in summer 2001, to remove a cardiac tumor nearly the size of a tennis ball. Today is my 18th anniversary. Resembling a sinister collection of red blood cells, this silent monster growing inside my chest looked bad, almost certainly a secondary cancer that had originated somewhere else, according to my doctors, who shared that tidbit only after my surgery. Thank God it was benign. And thank goodness for Dr. Kevin Lobdell, my surgeon. Hemangiomas most often occur in the skin. You’ve likely seen one. Those raised, round birthmarks found on the faces of newborns. Or, if you’re a Russia buff, that purplish, misshapen splat on Mikhail Gorbachev’s head. They’re rarely found in internal organs, such as the brain, liver and your heart. The origin of these bad boys is uncertain, but primary hemangioma of the heart was first described in 1893. According to a December 2007 article in the European Medical Journal, fewer than 100 cases were reported in medical literature, and the incidence of cardiac hemangioma was 2.8 percent. Anyone who has gone through open-heart surgery knows how daunting even such favorable odds seem. It’s life threatening and frightening as hell. You get through it by keeping the faith and trusting the science. And with support. “The brotherhood of the cracked chest,” as Robin Williams dubbed members of his Zipper Club. In 2009, after his aortic valve was replaced, the late comic genius naturally bonded with other famous patients who had survived heart surgery, including David Letterman and Barbara Walters. Maybe that’s why Walters, who in 2010 was 80 when she received a new aortic valve, revised her will before being wheeled into the operating room. She even interviewed her surgeon. As I did for both heart surgeries. Not surprisingly, the first sit-down with the cardiothoracic surgeon sticks in my mind. Higher retention in my 40s. Me: “Um, what are the risks, doc?” Him: “Heart attack, stroke, death.” I left and vomited in the restroom. So how does an otherwise healthy, asymptomatic 41-year-old woman from the Motor City find herself harboring a rare cardiac tumor? No idea. Just lucky, I guess. Heart surgery patients are different. We are Warriors. Here’s what I know about traditional open-heart surgery: Your breastbone is cracked to open the chest wall for better viewing, your heart is cooled and stopped for 30-90 minutes, and you’re kept alive on a cardiopulmonary bypass machine, which functions as your heart and lungs during the surgery, usually lasting a few hours. You can’t be hooked up to “the pump,” as it’s often referred to, for too long because, well, you just can’t. I was lucky. I am lucky. Everything turned out fine. Twice. It wasn’t easy, but I’m still here 18 years later to tell you about it. Life is good with my partner, Rebecca, and Madison, our family and friends. Heck, I even started HeartMattersBlog.com! There’s still hope for these 60-ish brain cells. Just ask David Letterman. After his quintuple bypass surgery in 2000 and in a rare serious moment, the former late night talk-show host, said this: “You’re weak as a bunny. You’ve been hit by a train. I would find myself bursting into tears and sobbing uncontrollably – with joy.” Be still my heart. You’ll never hear that phrase the same way, will you? (Copyright 2019)

By Jennifer John Today is my one-year anniversary since having open-heart surgery to repair a mitral valve that didn’t fully close when my heart pumped blood. I am all fixed now. No more blood regurgitating backward from the left ventricle through the floppy valve into the left atrium, as the left ventricle contracted. At times my heart was so exhausted it pumped 140 beats per minute at rest. That sends you into something scary called atrial fibrillation, a.k.a., “A-fib.” Yet I didn’t feel a thing. As a friend says, “You never know what you’re walking around with.” Until you do. Now I’ve got two heart scars, and not one but two memorable cardiac surgery dates as lucky numbers for Keno. Life is good. I’m always a winner. On this 31st day of May, I wanted to do something special to commemorate my heart valve anniversary and the fact that I’m still alive. According to my Hallmark holidays cheat sheet, traditional first wedding anniversary gifts are made of paper. For heart milestones I’m not sure, particularly in this paperless universe. Suppose I could have just sent myself an ecard. Too easy. Instead, I built a blog. Brick by brick. Click by click. Using the incomparable WordPress software. Block by every friggin’ Gutenberg block. What a long strange trip it’s been. I swear, having heart surgery twice was less painful. My blog construction project took me awhile. About five months, but not nearly as long as most Michigan road work. Seems I had all of the right tools but not nearly enough knowledge. Thank goodness for YouTube. At one point I was so frustrated with my lack of progress that I plunked down a whole $20 to attend a daylong WordPress “Camp” at a Detroit high school hosted by dozens of tech-savvy millennials and their children. It was invigorating, maddening and definitely out of my comfort zone. Worth every penny. Enough about my diminishing brain power. First anniversaries also call for flowers. For this, our friends at Hallmark recommend a … pansy. Not exactly my first choice. But I think I know why pansies are front and center to mark a momentous 12 months of marriage and anything else worthy of note. Pansies symbolize: Heart – Literally and figuratively. Their colorful, heart-shaped faces and overlapping petals produce smiles all around. Who wouldn’t get an emotional lift from a bunch of these beauties? Strength – Pansies prefer cool breezes to the stifling heat of summer. They’ll survive a frost, bouncing back from even single-digit temps.If their blooms wither in the cold, the rest of the plant will often stay alive to bloom again. Flexibility – Interestingly, pansies can be annuals or perennials, depending on the climate. They’re born this way. Trust it or adjust it. Who knew? Not that there’s anything wrong with that. After the year I’ve had, I like to think of myself as a pansy. That’s pretty darn good company to be in, I’d say. With that, I’d like to introduce something near and dear to my heart-healthy self: HeartMattersBlog.com. Most of my blog posts first appeared in my Journal on this wonderful website, started by our fearless founder, Adam Pick. Honestly, my fellow heart valve Warriors, all of you and this website guided me like a shining light through the past year. I laughed, cried and soaked up your support like the sun but without the harmful UV rays. I’m hoping just one of my Journal pieces did that for you. My blog will contain more than just heart valve stories. A little of this, a little of that. We'll see where it goes. And I'll still be on this website from time to time to check on everyone. Stay well. Be grateful. Heart matters. (Copyright 2019)

(Editor's note: Warriors, this post is from a different viewpoint. Hope it gives you a chuckle. And remember to be kind to your own caregivers.) By Jennifer John Like most women my age, I have done my share of caregiving. Two loving parents who lived well into their 80s. Friends who needed help after a serious accident. Others looking for comfort while battling illnesses or emotional distress. I’ve also been the recipient of caregiving, surviving not one but two open-heart surgeries. My longtime partner, Rebecca, took care of me after last year's surgery to repair a leaky mitral valve. It was supposed to be “minimally invasive.” But scar tissue from the previous sternotomy in 2001 usurped that option, so my surgeon performed a thoracotomy. There’s nothing minimal about an 8-inch, C-shaped incision under your right shoulder blade. I experienced a long, sometimes difficult recovery. At times, I’ve since learned, I was a challenging (read: terrible) patient. Stubborn, argumentative, uncooperative and crabby. Not unlike my healthier self, I suppose. Luckily we got through it, and I’m approaching my one-year heart valve surgery anniversary May 31. Feeling eternally grateful, I have returned to most of my previous activities enjoyed before the blood, sweat and tears of 2018. It is now time to repay my debt as primary caregiver to Rebecca. On May 1 she underwent a full knee replacement, was discharged the following day and has since been recuperating at home, with me and Madison, our 11-year-old Havanese, serving as primary caregivers. That said, I have a confession to make: I’m a horrible caregiver. Truly. I’m not as nice as I think I am. It’s not about me, as I’ve learned repeatedly. I shouldn’t yell. I’ve been advised not to ask the patient but instead let her lead. Don’t ask, don’t yell. Got it. Perhaps I’ve lost my caregiving mojo. Rebecca’s been home a week. A home care nurse visited three times, and the physical therapist daily. We’ve set our phone alarms to remind us both when it’s time for her pills. There’s a lot going on. Luckily it’s a short-term sacrifice that will end well. Maybe I’ll feel better if I come clean and get this off my chest. Here are my caregiving transgressions: • Putting my phone on vibrate before going to bed, which led to not responding to Rebecca calling my name 27 times during the night or hearing her 14 texts or this voicemail at 12:48 a.m.: “Hey, I’ve really gotta go to the bathroom.” (What kind of monster am I?) • Selective hearing, despite actual high-frequency hearing loss in one ear, but the uncanny ability to perform a “perfect 10” Olympic flip from a sound sleep to save an overheating portable ice machine in distress. “Blip blip BADA-blip.” (Utterly shameless.) • Thinking bad thoughts to avoid dealing with anything Velcro, including the removal of her DVT plastic compression wraps on both legs, along with the aforementioned dying ice machine’s gigantic wrap from her new knee appendage. All the while feeling minimal shame by wishing, hoping and praying that she doesn’t have to pee. Ever. Again. (There aren’t enough novenas on the planet.) • Savoring potty time – yours and the dog’s – but not necessarily in that order. (Guilty and guilty.) I’m pretty sure next week will be better. Rebecca has made significant strides and feels stronger every day. It’s a remarkable experience to share. And that’s really what it’s all about, isn’t it? Sharing. Togetherness. Companionship. Love. For better or worse. In sickness and in health. We are so blessed, at least until she whacks me with her cane. Till death do us part! (Copyright 2019)

(Editor’s note: Warriors, this was originally posted one year ago as I awaited my May 31 OHS surgery to repair a leaky mitral valve. Hope it brings some comfort and peace to those of you in the waiting room facing your own upcoming surgery dates.) By Jennifer John “Faith wouldn’t be real faith if you only believed when things were good.” I overheard this gem on a recent episode of ABC’s “Grey’s Anatomy,” which I normally half-watch between moves of my myriad Words with Friends matches. With respect to faith, I believe no one has ever improved on Emily Dickinson’s quatrain on the subject: “Faith is a fine invention For gentlemen who see. But microscopes are prudent In an emergency.” ​ In April, while vacationing in Fort Lauderdale, I met an affable priest who takes Harley-Davidson road trips and sips Miller Lite by the pool. ​“Please call me ‘Chip,’” said the Rev. George F. O’Neill, a tanned, 60-something pastor of St. Joseph’s Church in Brookfield, an affluent town in Fairfield County, Conn., about 45 miles northeast of New York City. As a lapsed-Catholic, the best I could manage was “Father” Chip. ​The priest had recently lost his mentor and best friend, the Rev. Msgr. Edward J. Scull Jr. — fondly known as “the Monsignor” — to pancreatic cancer. As the disease ravaged his body, the Monsignor required more help, so Father Chip moved into his home to be primary caregiver. Each morning, the 90-year-old Monsignor would wake up and ask Father Chip the same question: “Am I dead yet?” ​He wasn’t. Until he was on Aug. 26, 2016. ​Nearly two years later, Father Chip continues to grieve his loss, feeling a deep void as if he’d lost a parent. ​I wondered how Father Chip kept the faith during such a difficult time and if he ever wavered. Not likely, I’m guessing. ​It got me thinking how to remain faithful when life throws you a curve ball. As in, when you’re facing open-heart surgery to fix a leaky mitral valve and you’re scared shitless that it’s not going to turn out well because you’ve already had open-heart surgery once to remove a cardiac tumor so you know what it’s like and wonder how many times your heart can be chilled with ice chips and put on cardiopulmonary bypass. You pray it’s at least twice. My valve job is May 29 at the University of Michigan Hospital in Ann Arbor. I have complete confidence in my surgeon, who has performed thousands of these operations. And I trust the science. When I had my first heart operation in 2001, I was 41 and knew it wouldn’t be easy but was certain things would turn out fine. They did. The tumor was benign. Now, at 58, I’m not quite sure why I’m doubting the outcome. Or my faith. I’ve got a supportive partner, wonderful family and great friends. I posed the curve ball question to Father Chip, who replied via email: “Faith is a gift. But as with any other gift, it needs to be accepted, opened and enjoyed. Our generation and those before us had faith imposed upon us. I don’t mean that in a negative way, but it was ‘something we did’ as opposed to ‘something we are.’ As long as you did those certain things, then you were a ‘practicing Catholic.’ Good for when we were young or when life is going well, but when we get hit with a curve ball, those whose Faith (his capital “F,” not mine) was never personally accepted and embraced tend to go all wobbly.” And then the diplomatic slam dunk. “I do not want to be presumptuous, but you may be in this category.” So, now I’m a wobbly lapsed Catholic? Father Chip continued. “Our lives are a journey from and with God, and His will for us. When we recognize that what happens to us happens for a reason, that’s Faith that has been received, accepted and lived. It is a commitment that is deeper than any curve ball life throws because, in a sense, you say, ‘Go ahead, curve ball. Give me your best shot. Because the worst thing that can happen to me is death, and that is simply a rebirth into eternal life, which is what this journey has all been about.” “The worst thing that can happen to me is death.” I suppose I can live with that. Lucky for this Motown girl, Father Chip followed up his baseball analogy with an automotive one and a familiar Latin phrase meaning “forevermore.” “So, Jennifer, what’s it gonna be? It’s your call. Let go of the wheel, keep your hands off it ad infinitum. Let go – enjoy the ride.” ​Emily Dickinson was right: Keep the Faith — and trust the science. (Copyright 2019)

By Jennifer John You know you’ve become that “woman of a certain age” when your inbox contains these items on your special day: birthday greetings from AARP and WinnebagoOwners.com I’m 59 today. Heading into my sixth decade, as a close (older) friend texted this morning. She remembers my age because I was born in a “zero” year. Yep, 1960. Sent at 11:05 a.m. from “your friends at AARP,” and complete with an M&M-covered cupcake and lighted candle, I received best wishes because I’m a “valued member of their community” (read: old), and suggestions on ways to celebrate: -Enjoy a free meal, ice cream and more! (Capital Grille, Cheesecake Factory or Cracker Barrel. No, thanks.) -See a new movie! (“Movies for Grownups,” of course.) -Plan a celebration vacation! (“Pick a trip that fits your personality and budget!”) Then there’s the aptly timed email from the Winnebago Owners Online Community sent exactly 10 minutes after midnight. It reads, in full: “Hello JJohn0711, Happy Birthday to you, From your friends at WinnieOwners. We hope you have fine adventures, good roads and skies that are blue. And we wish you safe travels and cheap gas prices, too! Happy Birthday from WinnieOwners.com!” Nicely punctuated. Clever rhyme. Short and sweet. They must know me. But then I just got an AARP email about signing up for Medicare. Hey, now wait a minute ... (Copyright 2019)

(Editor’s note: For ❤️ warriors facing surgery, recuperating at home or kickin’ it at cardiac rehab, be gentle with yourself. This final installment from our Florida trip may give you something to ponder.) February 22, 2019 By Jennifer John We left Anna Maria Island at 7 a.m. sharp and crossed the Georgia state line in five hours — a Guinness record when traveling by motorhome, aka, “The Beast.” More than 12 hours since we had left Florida — in what should have been about 500 miles in eight hours, including pit stops — we checked into the Hyatt Place hotel just north of Atlanta. Seems you never know what’s around the corner. Or before the next exit. Here’s what happened: After spending over an hour in a massive traffic jam at a dead stop in Unadilla, Ga., just south of Macon, the Beast’s warning display messages lit up like the Las Vegas strip with more acronyms than a teenager’s texts: ABS, ESP and BAS/ASR with a tiny tire icon -- all of which have to do with steering stability, the braking system and (horrors!) cruise control, which really ticked off Rebecca since backup support for each was now deactivated. A rather troubling suggestion, “Drive on with care,” appeared in the vehicle handbook, along with keen advice to “Visit workshop,” which apparently means “get your lazy American ass to a certified Mercedes-Benz service dealer ASAP” in German. For a minute, we thought we could ride it out. Sort of like the body surfing we did the day before in the Gulf of Mexico. (We did not do either.) But then on top of the parking lot on I-75, it started raining. Really, really hard. Suddenly, I recalled some specifics on the myriad system failures: “impairs braking distance, and increases risk of skidding and accidents.” Christ on a bike! Just then, the Beast started heaving and belching uncontrollably, so we pulled over when we could in Perry, Ga. Nice folks at a Jeep dealer helped us find a Mercedes-Benz dealer that repairs Sprinter vans. Yes! We were on our way. But it wasn't in Perry or nearby Macon. It was in a north Atlanta suburb called Sandy Springs, which sounds like a sanitarium. I may check for availability. Anyway, we have an 8 a.m. appointment Saturday to get it looked at and (we hope) repaired. If not, we'll stay another night or two or three. Right now, we're drinking small airplane bottles of various kinds of booze from a blue Jazzercise pouch we stashed in the Beast last year, and splitting a chicken sandwich with bacon, Brie and chips. Oh, and there were two beers in our cooler. Livin' the dream, as they say. That’s something 51-year-old Lisa Gibson can’t say today, tomorrow or ever again. Today she died of injuries from a tragic car crash. According to the Georgia State Patrol, there were four separate chain-reaction crashes along a northbound stretch of I-75 from Exits 136 to 134. Lisa Gibson and her husband, David, of Missouri were in the third accident. Police said the first crash happened at 8:48 a.m. just before Exit 136 north when a tractor-trailer ran off the road. The second crash was less than a quarter-mile behind the first, the third was a quarter-mile behind the second, and the fourth crash was about a mile behind the third, according to The (Macon) Telegraph newspaper. Driving a Jeep Wrangler, the Gibsons were in the third crash. Apparently, traffic was backed up from the earlier accidents, and a tractor-trailer was stopped in the middle lane. Their Jeep came up behind the tractor-trailer and couldn’t stop in time, reports said. David Gibson was driving the Jeep and steered left to try to avoid hitting the tractor-trailer. The Jeep’s passenger side door struck the rear of the tractor-trailer and then veered off the roadway. Lisa Gibson was the passenger. We were in that same backup for more than an hour. We got irritated, impatient and some fortunate warning lights. How lucky can you get? (Copyright 2019)

(Editor’s note: For those of you facing an operation, recuperating at home or just plain bored with winter, here’s another installment from our Florida trip. Proof that there’s life — and travel! — after heart valve surgery.) January 24, 2019 By Jennifer John The faded yellow sign on the door of the old fishing shack was deceiving. “Do not enter water,” it said. I read it twice before I understood. Thanks for the warning. Last night we had dinner with some friends at Annie’s Bait and Tackle in Cortez, Fla., just before the bridge to Anna Maria Island. It’s an old Florida treasure, complete with nightly regulars at the bar dispensing sage advice to anyone who will listen. On this Wednesday, two locals compared notes on ex-wives and determined they’d had five failed marriages between them. “My best advice?” the one guy said with confidence. “Always get a mediator.” “Better yet, just don’t get married,” the other guy added. They roared as if it was the first time they’d said it and ordered another round. Annie’s was a feast for the eyes, if you dared look too close. In a decorating twist, black-and-white target practice posters with fake bandits shot up like Swiss cheese covered the ceiling. They’d been dead a long time. The table closest to the door had a power drill (still in the box) as a centerpiece. Early Black & Decker? The place smelled like bait, beer and cigarettes — not necessarily in that order — with no hand sanitizer in sight. To ensure my gastrointestinal safety, I placed a napkin under my plate to form a “safe zone” between my food and the unlikely but frankly not impossible transmission of the Ebola virus. Our waitress Kelly was a sweetheart. Turns out, her family owns the place. There’s no one named Annie around any longer, though. Kelly’s mom was in the kitchen tonight; her dad sat on the first bar stool chain-smoking Marlboros. Who’s gonna tell him no? Ordering drinks was a no-brainer. No Jack Daniel’s, no Tito’s, no premium brews. How about a beer? Sure. We were the only patrons in the joint, which was more than a little unsettling at the dinner hour during tourist season in southwest Florida. But our grouper sandwiches were heavenly. Fresh, lightly breaded and seasoned to perfection. We’ll be back — and maybe sooner than we think. On the way out, I noticed a sign hanging in the back: “Free beer tomorrow.” (Copyright 2019)

(Editor’s note: For those of you facing an operation, recuperating at home or just plain bored with winter, here’s another installment from our Florida trip. Proof positive that there’s life — and travel! — after heart valve surgery.) January 19, 2019 By Jennifer John Stop me if you’ve heard this story. Or better yet, just hit delete. So after six uneventful hours on the road from Tifton, Ga., we’re five miles from Bradenton’s Budget rental car. Then, all traffic stops — for 45 minutes. Welcome to Florida. Now leave. It’s already noon, and we’re scheduled to pick up the car at 1 p.m. But we can’t find the $&!? Budget store even though we have “reached our destination,” according to my Australian Siri voice. (Note to self: Change that.) We ask some people washing their car where it is, and they say, “Oh, it’s in the mall, but we’re closed.” Then they say, “Oh, are you Jennifer John? We’ve been trying to reach you, but there was no phone number with your online reservation.” Yes. There was. I typed it. Turns out, they were all Budget workers heading home from work. God bless, America! So this really nice woman named Hendra gets out of her car, meets me inside the mall and pulls up the store’s metal security shade. She even gave us an upgrade. I rent the car, which is so compact it resembles something Fred and Wilma Flintstone might drive in Bedrock. My first thought is we’ll need more pedicures to keep up. Within 15 minutes, we’re on our way, me in the Shriner’s car following Reb in the Beast RV, heading to our rented condo. We unload the RV, and no one from the condo board says a word about it being an illegal vehicle just because it says “Winnebago” on it, or we would have to hurt them. Seriously. Tomorrow we’re sleeping in and not leaving the condo — except maybe for pedicures. (Copyright 2019)

(Editor’s note: For those of you recuperating at home or just plain bored with winter, here’s an installment from our trip to Florida last month.) January 17, 2019 By Jennifer John We left the house today at 6:30 a.m. It is nearly 10 p.m., and we are just now settled into a palatial Quality Inn near Dry Ridge, Ky. Let me explain. About two hours into our trip, the dreaded “Check Engine” light glowed on our dashboard like neon, along with this message: “Your vehicle’s DEF” — shorthand for diesel exhaust fluid — is too freakin’ low.” Luckily, the Beast had already experienced diminishing DEF on our 2017 leaf-peeping trip out East, and we knew what to do and how to fix it. “Good thing we brought that big jug of DEF,” Rebecca said with confidence. “That’s windshield-washer fluid,” I said, my left eye involuntarily twitching. After a quick stop at Speedway, $20 and as many frigid minutes pouring it into the DEF reservoir, we were on our way. Once refilled, the menacing orange light is supposed to go out, but it didn’t, so we looked it up in the owner’s manual. There are about 327 reasons for a Check Engine light to shine, none of which is good. So we called our friends at the Mercedes-Benz dealer in St. Clair Shores. Michigan, that is. Did I mention we were on South I-75 in Lima, Ohio? Our helpful pal Joanne gave us an M-B dealer in a place called Tiffin near Findlay. Jim the nice service guy assured us the Sprinter van was likely in need of a simple factory reset, adding that we were just 30 miles from Tiffin. South, that is. Thirty miles past Tiffin. “When can we expect you?” Jim asked. “Never,” I replied. Oddly enough, there was a Mercedes-Benz dealer in West Chester, just outside Madeira, where we planned to have lunch at our friend Gayle’s. (A very late lunch.) A quick phone call got us a nice service guy named Michael and an appointment with the hope that they could fix the Beast and send us on our way. We drove south for another 100 miles and arrived around 12:30 pm. So there we were, the three of stranded in a Mercedes-Benz waiting room near Cincinnati sipping foamy lattes and munching granola bars. The struggle is real. We met John, a Bronx, NY, native of Puerto Rican descent on his way back to Las Vegas from Harrisburg, Pa., with a new pre-owned Sprinter van for a 19-year-old gamer who earns $50,000 a month running a top video site. Maddie liked John, mostly because he smelled like bacon. It was going on 3:30 p.m. when Michael emerged from his cubicle to pet Maddie and tell us the Beast was fixed. He said it was the NOx (rhymes with “Pox”) sensor. “NOx stands for nitrogen oxide. A NOx sensor measures the amount of this compound distributed by your vehicle’s exhaust. Nitrous oxide is an environmental pollutant and is a factor in the creation of acid rain and smog. NOx sensors help protect the environment from damage and monitor your engine’s efficiency to ensure it is operating properly. Those pesky regulations,” he said. What’d he say? “NOx sensors are commonly found in diesel engines, and many Sprinter vans like yours contain Mercedes-Benz diesel engines,” he added. Yes, we do have one. According to Michael, one of the most common possible causes of a failed NOx sensor in a Sprinter van is the appearance of a “start countdown” timer. Say you happen to notice your dashboard light up with a “16 starts remaining” notification. It would be a good idea to contact your mechanic immediately so as not to be stranded during an important trip. No kidding. Which could be why at about this morning’s 200-mile mark, Rebecca wondered aloud what would happen if you used up all 16 starts. “No idea, hon,” I mumbled between bites of my tasty egg McMuffin. The most important part of this equation is that a NOx sensor repair is covered by a federal emissions warranty. We only paid for new wiper blades. (Copyright 2019)

By Jennifer John When my new cardiac rehab friend Jan started Troy Beaumont’s Phase III program, George W. Bush was U.S. president — in his first term. That was in 2004 — 14 years ago! — and aside from a few minor health issues, Jan hasn’t stopped exercising since. The Clarkston, Mich., resident says cardiac rehab keeps her mind and body strong and healthy, plus moving around beats sitting around at home. At the Troy, Mich., facility, Phase III cardiac rehabilitation includes a group-based, medically supervised exercise program, up to five days per week for one hour. Patients pay a nominal monthly fee not typically covered by insurance. Additional Phase III activities include balance and flexibility sessions, chair yoga, weekly educational lectures, and stress reduction and weight management. You’re usually ready to start Phase III cardiac rehab when your vital signs, such as heart rate and blood pressure, remain stable as you increase your workout activity. I recently resumed twice weekly low-impact Jazzercise classes. I’m ready for more. On Nov. 28, I started Phase III, after completing Phase II’s maximum 36 visits at Troy Beaumont Hospital. Some of the same exercise physiologists also work at Phase III, so it felt like old home week. At each session, you weigh yourself and check your resting heart rate and pulse oxygen percentage. They monitor your blood pressure weekly. In addition, your EKG is monitored monthly. As with Phase II, I’m probably the youngest person at Phase III. But being called “kid” never gets old when you’re pushing 60. After more than two weeks off and feeling the remnants of Thanksgiving gluttony, I began my first Phase III session on the Biodex machine, where I had left off: level 12 difficulty for 20 minutes. Man, could I feel the resistance. Then I walked on the treadmill at the same elevation and speed as graduation day: level 3.0 grade at 3.1 mph. Boy, that pace seemed fast! About 15 minutes into it, sweating buckets, I decreased to 2.9 mph for another five minutes. Stick a fork in her. She’s done. I’m pleased to report that a spot in the 9:30 a.m. session opened up just in time for me to fill it today. I’ll be back with bells on this Monday. Mornings are much better than going to work out at 2:30 in the afternoon, since I’ve been known to take a detour and end up at Trader Joe’s. Have a great weekend!❤️ (Copyright 2018)

By Jennifer John “It's the circle of life
 And it moves us all
 Through despair and hope 
Through faith and love Till we find our place
 On the path unwinding
 In the circle …
 The circle of life” — “Circle of Life,” from Disney’s animated film, “The Lion King” What a difference a year makes. This time last November, I was lying on an ER gurney, my heart revved up to a resting rate of 135 beats per minute, fluttering in and out of something called atrial fibrillation. “A-Fib,” as it’s commonly known, is an irregular and often rapid heart rate that can increase your risk of stroke, heart failure and other heart-related complications. Sometimes you can feel it. Other times you don’t. I didn’t. That morning, my beloved internist had noticed the sky-high heart rate during a routine annual physical. Turns out I had severe mitral valve regurgitation. And to think I was worried about getting a darn flu shot. Today – exactly 365 days from the infamous A-Fib episode and the official start of my heart patient journey – I am feeling better than ever and healing nicely, thank you very much. Today – exactly six months since my mitral valve repair surgery/maze procedure on May 31 at the University of Michigan Frankel Cardiovascular Center in Ann Arbor – I am the proud owner of a mitral valve that seals shut like a bank vault along with a fierce yet steady heart that will literally stop A-fib in its tracks, if it dares to come back. Honestly, it’s been a helluva long road. Heart monitors, blood thinners, pre-op tests – including X-rays, ultrasounds, CT scans, MRIs, transesophageal echocardiograms – anxiously awaiting a surgery date, having the date postponed two days, the surprising level of incision pain, post-op visits with more tests and an eight-week summer recuperation, which often meant walking room to room indoors because it was too hot to go outside. Twelve weeks of cardiac rehabilitation ended last week. It’s over. They say I’m a rock star. Can’t argue with that. With all of that, the hardest part was waiting several months for my surgery. It seemed like an eternity. Square breathing calms you down. Writing distracts you. The support of family and friends keeps you sane. Elton John and Tim Rice wrote a hit song, “Circle of Life,” for “The Lion King,” Disney’s 1994 animated film detailing the adventures of a young lion, Simba, the heir to his father, Mufasa. (Spoiler alert, if you’ve never seen it.) Unfortunately, Simba’s wicked uncle conspires to usurp Mufasa’s throne by luring father and son into a stampede of wildebeests. Simba escapes, and his father is killed. But Simba returns as an adult to reclaim his homeland with the help of his friends. The circle of life. Despair and hope. Faith and love. Till we find our place. At this stage of my life, I understand now more than ever how nature has a way of taking and giving back. How the supremely divine universe can sometimes challenge us and be downright unfair. And how the death of one thing gives new life to another. Talk about full circle. Since February, I’ve written a collection of essays about everything from the power of faith and trusting science to dispelling your fears and going braless. I have tried to capture the highs and the lows of surviving heart valve surgery with a touch of humor. Here’s what I’ve learned: • Sometimes things have to get bad before they get better. • Setting reasonable goals makes sense when you can’t put on your own pants. • Elimination can be a good thing, especially if involves excess fluid or IVs. • Bravery does not preclude you from sometimes being pitiful and whiny. • Asking for help is more difficult than you may imagine. • Walking is the best thing you can do for your heart. • Faith is powerful even when it’s blind. • Love is definitely the answer. Tonight Rebecca and I will raise a glass, count our blessings and toast to life – the Circle of Life. (Copyright 2018)

Graduation Day Nov. 13, 2018 (This is an update to a shorter piece and includes more details to help cardiac rehab patients.) By Jennifer John Cue up “Pomp and Circumstance.” Today was my last day of cardiac rehab. I even received a nifty certificate of recognition for completing the program. Three months. Twelve weeks. Thirty-six visits. A necessary physical and emotional adventure filled with lots of sweat, some tears of joy and a lasting sense of accomplishment. Looking out the window from my usual M-W-F spot on the treadmill, I saw hundreds of trees in full bloom when I started this rehabilitative journey in August. Birds swooping under bright blue skies held my attention more than daytime TV or a playlist titled, “Rehab.” My initial pace of 1.7 mph with 0.5 (barely) elevation was painfully slow. I know that now because I tried it again today, my last day. Yet on my first day, walking in place at a turtle’s pace proved to be more than moderately difficult. Plus, I was tentative and afraid of falling. How silly all of that seems now. On this final Friday, those same trees are bare, stripped of the leaves that absorbed blazing summer sun, turning from all shades green to red, yellow and orange hues, and then falling to earth one by one from their strong branches. Unlike the dried-up dead leaves, I am alive, having successfully returned to my better self, regaining strength and movement I once took for granted. Surpassing my rehab goals, I can have a conversation while walking briskly on the treadmill at 3.1 mph with 3.0 elevation – a 95 percent improvement from Day One. Honestly, I couldn’t have done it without the Troy (Mich.) Beaumont Hospital Cardiac Rehabilitation staff. Their encouragement, support and occasional gentle “nudge” to do better got me through the early days when I was tired, weak and just plain over it. They were young professionals well-versed in treating ailing people with kindness. Sometimes you find yourself in a situation where you can’t help but develop a bond with perfect strangers. This was one of those times. I’m speaking of my fellow cardiac rehab pals, most of them 10, 20 and 30 years my senior. The majority of them have already “graduated.” I hope they’re serious about staying in touch. I know I am. Somehow it seems fitting that I’m ending my recuperation from open-heart surgery as we begin November, the month of Thanksgiving, a time of gratitude, appreciation and faith. That will never be lost on me. Meantime, here’s a tip: If your doctor suggests cardiac rehab, go. Don’t hesitate for a second. You won’t regret it. You’ll feel better. And you might even make some new friends. (Copyright 2018)

Interesting reading on this snowy Friday ... thoughts? From The New York Times: How Emotions Can Affect the Heart In “Heart: A History,” Dr. Sandeep Jauhar argues that doctors need to devote more attention to how factors like unhappy relationships and work stress influence heart disease. https://www.nytimes.com/2018/10/30/well/live/how-emotions-can-affect-the-heart.html

Unlike my other Journal posts, this one has nothing to do with heart valve surgery. But I thought I’d share it anyway, since it comes from my heart and may warm yours: Something happened on Election Day that has restored my faith in humanity. It had nothing to do with a wave — red, blue, purple or otherwise. It had everything to do with honesty, character and kindness. You see, yesterday I inadvertently lost my red leather wallet. OK, I was in a hurry to get somewhere, but first I had to let the dog out, so I set the red leather wallet down and then likely drove off with it ... on the hood of my car. I know that now because a nice woman driving by saw it lying just beyond our driveway in the middle of the street, picked it up and brought it to my front door. But I wasn’t home. Luckily, our high-tech “Ring” doorbell captured her on video — with my red leather wallet in hand! — and sent an alert to my cell phone. But I didn’t see it because I had turned it off. I watched the video three times but didn’t recognize the pretty, dark-haired woman in green medical scrubs. So I posted it on the Ring site to see if anyone knew her. Then I posted it on Nextdoor, a private social network for neighborhoods, hoping it would be seen by members of my subdivision. Within minutes, a good neighbor replied, saying they recognized the woman and provided her full name and street. I found her address in the latest homeowners association directory. Turns out, she and her husband lived around the corner. As I pulled into their driveway, a car drove up behind me. “Can I help you?” he asked. “Don’t worry. I’m not here about the election,” I joked. He looked relieved. “This is going to sound weird, but I think your wife has my wallet.” He looked puzzled but invited me in. As he called her at work, their teen-age son at the kitchen table looked up and away as if this kind of thing was a daily occurrence. Their large dog was happy to see me. Turns out, his wife worked for a dentist about a mile away. “Thanks,” I said. I was damn near giddy walking into that dentist’s office. The receptionist was beaming. My new best friend appeared like an angel, clutching my prized red leather wallet. I bear-hugged this perfect stranger and thanked her at least 27 times. Despite my insistence, she refused a reward of any kind, adding that what she did was just the right thing to do. “Pay it forward,” she said. If you cannot find faith in humanity, be the faith in humanity. And put your phone number in your wallet.❤️

“Oh, great, it’s the braless wonder. Who does she think she’s kidding? Look at her; she’s totally out of control.” – Elaine in the 1996 “Seinfeld” episode where she runs into her high school friend-turned-nemesis, Sue Ellen Mischke. By Jennifer John It’s time to end the cover-up. Call TMZ for a full exposé. In this age of alternative facts, I’m compelled to come clean: I’ve gone braless for months. That’s right. A regular bra hurts my scar; even a running bra is uncomfortable enough to make me gag. Not surprisingly, in French a bra is called a soutien-gorge (literally, “throat-supporter”). Early versions resembled a camisole stiffened with boning. Sign me up. (Gentlemen, you may stop reading here. But you’ll likely regret it.) I’m not wearing a bra while typing this at my kitchen table. No one cares. Not even the dog. Don’t judge me. We all have our secrets. Some are more uplifting. Truth is, since my May 31 mitral valve repair surgery, I like having the “girls” roam free. It’s liberating, exhilarating and really, really … comfortable. Depending on the occasion, I wear a cotton tank top under a T-shirt or a sleeveless camisole under a button-down shirt or blazer. This fashion naturally makes me think of “Nonna,” my Italian grandmother, who was always cold, even in the summer, and wore what she called “flanellas” under her simple housedresses and little pink sweater. I am my Nonna. In case you’re new to this planet, here’s the reason bras rub me the wrong way: To fix a leaky mitral valve, my surgeon performed a thoracotomy. It was his Plan C, given that he couldn’t do (a) the sternotomy (because I had one in 2001) or (b) the less-invasive side incision (see previous reason plus, too much scar tissue). So, I’m not only a Zipper Club member, but I’m also on Team Thoracotomy, sporting a half-moon sideways “C” on my back about the length of a medium turkey sub under my right shoulder blade. It ends directly east of my right breast, punctuated by two round smudges that once housed drainage tubes. You won’t find any backless gowns with plunging necklines in my closet. Shoes and a few skeletons, maybe. But I digress. While researching the subject of going braless, I found that ditching them actually has some scientifically-backed benefits. In fact, a 15-year study in 2013 by a sports science expert from the University of Besançon, France, found that wearing a bra does more harm than good. It won’t reduce back pain and weakens the breast muscles, resulting in greater sagging. That’s right. Your breasts will actually sag less if you don't wear a bra because not wearing one exercises muscles on both sides of your chest. Who knew? Along with more lift and comfort, the study concluded you’ll have better posture, not to mention more money in your pocket since you don’t have to buy bras. Historically, as crowd-pleasers and all-around nice gals, women have bowed to pressures of societal expectations. Wear this harness, and you’ll look perky. Can you imagine if men were forced to wear tighty-whities instead of boxers? No, you cannot. Because they wouldn’t. These days YouTube has an entire section of videos called, “Why I Don’t Wear a Bra,” where bold, busty millennials mock those repressive over-the-shoulder-boulder-holders with tweets under #freetheboobs on Twitter. One video had nearly 6 million views! With that, I’m confident at my age, I will make no apologies for going braless. This is not a third-world problem. But I do feel a little sorry for German scientist Otto Titzling, who originally invented the bra, until Frenchman Philippe de Brassiere stole Otto’s idea in 1912. Even Bette Midler sang about it. “The result of this swindle is pointedly clear: Do you buy a titsling, or do you buy a brassiere?” The Divine Miss M would not lie. Of course, this historical snippet would all be very interesting if any of it were true. Had you going, didn’t I? (Copyright 2018)

By Jennifer John There’s more than just sweat on the tiny white Detroit Tigers rally towel I used to wipe my sparkling forehead throughout last Thursday’s Jazzercise workout. Maybe some tears, too. It was my first day back in six months, after stopping to focus on preparation for May 31 heart valve surgery. I was actually nervous before class. Somehow worried that I’d forgotten how to plié or chasse or, worse yet, participate at all. How silly is that? Not entirely after what we’ve been through. Time flies, but muscle memory fades after 50. Of course, I stood in my old spot (upper left corner, front row) under the ceiling fan right next to Rebecca, who checked on me during the entire hour whenever she slid to the left, as if I wouldn’t notice. (Thanks, hon.) Our instructor good-naturedly advised the rest of the class not to watch me. Funny. The songs were faster and mostly new, as well as the routines. But that didn’t matter. I was patient and took it slow and steady. If the pace was too quick, I downshifted to half-time. Too many twists and turns? I marched in place. But I did it. One hour low-impact Strike class. Fifty active minutes. Nearly 300 calories burned. That’s 3,000 steps forward. My Fitbit app was pleased. At the end, everyone welcomed me with open arms. And a bouquet of beautiful flowers, no less. My eyes were sweating, too. This often painful wellness journey has been long, familiar and worth every Tylenol extra-strength gel cap I’ve swallowed. It feels so good to be back on this road to recovery, even with a few sore muscles tagging along. (Copyright 2018)

By Jennifer John Today marks four months post-op. Might be a good time to talk about something most of us would rather ignore: cardiac depression. In summer 2001, I had open-heart surgery to remove a tumor the size of a tennis ball from both atriums. After seven weeks, I returned to work. Life was good, except it really wasn’t. At 41, my body overcame the physical challenges of heart surgery. Yet I felt sad, irritable, anxious and overwhelmed. I just wasn’t myself. Perhaps, I reasoned, this lingering dark cloud was from the horrors of 9/11, an unthinkable tragedy occurring the week before my medical leave ended. The world had gone mad, and terrorists were flying planes into tall buildings killing innocents in the name of ... what? I was an emotional wreck and buried myself in work. That wasn’t hard to do amid constant deadlines and endless projects as a senior writer for one of the country’s largest industrial unions. I trudged on, barely getting through each week.  By Christmas, my mood worsened, and it was time to address it with a professional. I went to see my internist, the same physician who discovered the benign tumor (known as a “hemangioma”) during a routine exam. Sitting in her office, nervous as a cat, I’ll never forget what I said: “Something’s wrong with me, doc. I’m just not myself. Everything bothers me. I can’t sleep. I’m not hungry. I’m completely overwhelmed.” She paused, then gently responded. “Well, Jennifer, it’s not like you haven’t been through something.” My symptoms, she said, were associated with post-traumatic stress disorder (PTSD), something I’d never even considered. Although PTSD is usually associated with extreme trauma, heart surgery and heart attack survivors can experience similar symptoms — including sleep disorders, panic attacks, irritability or anger, depression and difficulty concentrating. According to the University of Michigan’s cardiology website, heart health is linked to emotional well-being and vice versa. Addressing both elements is crucial after a cardiac event. Studies also show that one in eight heart attack survivors experiences a PTSD reaction. I was relieved. There was a reason for the gloom and doom. My doctor put me on the anti-depressant Zoloft, which took several weeks to kick in and worked well with minimal side effects. Oddly enough, cardiac rehab was not recommended. Nearly two decades later, that same doctor witnessed a lone episode of atrial fibrillation during my annual physical last fall. The diagnosis: severe mitral valve regurgitation. My MV repair/maze procedure was a success. At 58, I’m happily partnered, retired and life is good. Doctors say by the end of this year, I should feel like a million bucks – perhaps better than ever. Truth be told, a couple of months after my May 31 surgery, I didn’t feel like myself. And I don’t mean physically. Anxiety, sadness, dread. It was happening again. But this time I knew why and what to do about it. Two months of cardiac rehab have made a remarkable difference in healing my mind and body this time around. In his book, The Patient’s Guide to Heart Valve Surgery, our website founder Adam Pick describes his battle with post-operative cardiac depression in Chapter 16: “I was noticing an emotional shift in my behavior and attitude toward my health. Since I began reducing my pain medication, I found myself crying more frequently. The smallest negative thought or negative feeling could set me off into a downward spiral that typically generated a rhetorical question that teased and taunted me. That question was, ‘What is wrong with me?’” Indeed, a healthy mind and body are crucial to your recuperation from heart surgery. Thankfully, the mind-body connection is no longer up for debate. Although the stigma of mental health issues has decreased, there’s still a long way to go. My advice? Don’t be afraid to acknowledge what you’re feeling. Talk to your doctor. Go to cardiac rehab. Make a point of talking with your fellow rehab warriors. Or join a support group. The worst thing you can do is nothing. (Copyright 2018)