Jim's Journal

Today is the Feast Day of Saint John of God, the Patron of Heart Patients. I always remember Saint John of God in my Prayers and I will remember all of you as well, as I always do. God Bless each and every one of you on your journey. Jim

Call me a sentimental old fool. I saved every text message that my wife sent to me while I was in the hospital for 2 weeks in Cleveland. Many of those were while she was gone back to Cincinnati to care for our girls. The memories came flooding back. Memories not of the pain, loneliness, fear, and uncertainty; but more memories of the deep love that we shared during that period and continue to share. Reading those messages brought a tear to my eye even today. I don\'t think that I will ever be able to delete those messages. I don\'t know how I would have made it without her. I\'m glad I didn\'t have to figure that out. I am one lucky man, on so many levels. Four months out tomorrow. I would say that I feel about 95% back to my old self now. God Bless each and every one you as you continue on your journey. Jim

First some good news...I went to the ophthalmologist and got a totally clean ocular bill of health. My eyes are totally normal. However, he diagnosed with amaurosis fugax. That is transient monocular blindness. A TIA by any other name would not smell as sweet. My vision always completely returns to normal. So what seems to be happening is a small plug of aggregated platelets that embolize from my graft or valve and travel into the small arterioles in my eye. I go blind in that eye for 5-10 seconds and then my vision clears. He suggested that I add 81 mg aspirin to my regimen of meds. Since adding the baby aspirin, I have had no further problems. Hopefully as my after market cardiac parts endothelialize, this problem will go away. Otherwise, I feel great. I can cough and sneeze at will now. I am running and playing tennis again and will soon begin training for my first marathon in 3 years. Life is very good. Things do get better. For all of those out there who wonder about the \"ticking\" noise, now it is almost comforting. It is a normal noise that I have come to understand and welcome. It doesn\'t bother me or my wife at all. Thanks Adam, I will \"keep on tickin\' \" Jim D

As I said yesterday, I am now 9 weeks out from my composite St. Jude Mechanical Valve and aortic conduit. I am doing great. With only very minor snafu. On 4 separate occasions now since my surgery I have had strange vision disturbances in my left eye. It seems like someone starts with a can of bright almost brilliant white spray paint and paints my entire left visual field. I have no pain, no headache, no associated numbness or tingling. It lasts about 10 seconds and goes away quickly and completely. I also notice that it seems to move with the movement of my eye after some vision is restored. It first happened on post op day #1. I thought I was having a stroke. It happened again in the hospital and then once fairly soon after I got home. It happened again yesterday. It seems like scotomata (those bright lights preceding a migraine or seizure). I do take coumadin, my INR is within range. I was just wondering if anyone else had similar problems. Jim

My fourth full week back to work started today. It is hard to believe that tomorrow will be nine weeks since my AVR and Aortic graft. I feel very good and getting better weekly. I am running again and generally feel very strong. I had my first weekend of being on call complete with two night calls. I am a blessed man indeed.

I have a big week. I had an ECHO today, I turn 40 on Friday, then back to work on Monday. I am ready. I am still a little bit apprehensive about work, but I think that mentally I am ready and I am as physically ready as possible. I now realize why people stop posting. You have to get back to your life. I have seen many go before me and don\'t hear much from them now. I suppose that I too will fall into the \"has been\" category. I am truly blessed. My wife was and is always right by my side. My faith is strong and was put to the test at times, prayer was my main companion and solace at times. I look forward to the future with my eyes wide open. I was given a second chance. I suppose that this will be my final post. I will keep all of you in my prayers. God Bless you all. Jim

Today marks four weeks since surgery. Walking at least five miles per day. I feell really well right now. I still have some pain around my incision, not too bad. My feet remain a little numb, but that also seems to be slowly improving. I bought a home INR monitor and it came yesterday. My palpitations have improved dramatically. I am still taking naproxen twice daily for some mild pericardial inflammation. I actually feel like I might be able to go back to work on time on 10/31. If I have learned anything about recovery, it is to expect bumps here and there. You simply have to roll with the punches. My \"ticking\" is less and less noticeable. Not ready to swing a tennis racket right now. Not ready to run again. Dr Miller thinks it might be December before I can comfortably run (my apologies to Pink Floyd) or play tennis. Oh well. I seem to be stronger each day. My thoughts and prayers are with each of you as you prepare for surgery or recover from surgery. Life does go on, things do get better...I promise. Jim

Saw my cardiologist today. ECG was okay. Coumadin is within range. Walking more, now up to 6 miles per day. Dr Miller wants another ECHO. He is confused about my my resting heart rate being 30 bpm higher despite the same dose of beta blockers. I am a little confused as well. All in all things seem to be progressing well. I think I am off caffeine for good. I haven\'t had bad palpitations since staying off caffeine. Oh well, I think Starbucks stock will go down like a $2 tire when I stop going! Jim

This one is probably on me. I had a rough night of palpitations until I finally fell asleep around 1 am. Anyone who knows me knows that I am a coffee snob. I made some French Press coffee (Anniversary Blend from Starbucks) and drank two diet Mountain Dews yesterday. I wonder why I had all those palpitations yesterday?? Hmmm. That one might take Scooby and the gang to figure out. Feel better already this am. Gonna take a caffeine break today and see how that works out. Otherwise, still getting my walks in and feeling better. My feet are still pretty numb, not swollen, just numb. If that would go away, I would almost feel pretty dang normal. Jim

I walked 5 miles total yesterday. 3 miles in the morning and another 2 miles in the afternoon. I kinda paid for it too, my feet were a little swollen and tingly last night. Had to wear some sandals. All in all, I seem to be doing pretty well. I certainly do not want anyone to misinterpret my journals. I have been very blessed. I am recovering nicely and doing everything in my power to get better. I had a very eventful post operative course with the HIT and all, but still consider myself to be very blessed. My wife is an angel (we\'ve been over this I know). She was always right there with me even though she can hardly stand the sight of blood. I don\'t know how she did it sometimes. What I would like to impart is patience. Something that I am woefully deficient of. I was mentally prepared for pain, limited mobility, and the surgery. You can\'t mentally prepare yourself for complications. When I developed HIT, I almost became angry, maybe even incensed. I was tired of being poked, prodded and new IV\'s started. Most of all I was tired of being a hostage. Which is exactly what I felt like. Dr. Svensson was the best. After my run in with the cardiologist, he came back on a Friday night, two weeks ago tonight, to re-assure me. He told me that he had a patient in his office two months ago with almost my exact dimensions of valve and aorta. He wanted to put off surgery. Unfortunately, he dissected and died before he could be repaired. He also told me that 12% or 1 out of 8 aneurysms has ruptured at a dimension smaller than mine. I know that I made the right decision. All the prayer and thought I gave this has to be right. I guess in the end, I would counsel my colleagues to TRY to be patient. Hopefully, your recovery in the hospital will be smoother than mine and you will not spend 14 days in the hospital. Hopefully I soaked up some of the bad post operative luck for a few of you and you will recover smoothly. I am a blessed man with a beautiful family and wonderful friends. I will never be able to thank each of you enough. I know that at times, I must have sounded vulnerable and perhaps pathetic. My thoughts I posted were genuine. I am not one to let my deepest emotions be heard and expressed. However, I felt like my emotions needed to be heard. If only perhaps serve as a guidepost for someone else along this journey. God Bless and always remember the Prayer of the Journey to Emmaus...\"Stay with us for it is evening and the day is almost over...\" Even at the depths of despair, God is always with us. I have absolutely no doubt about that. I have no idea how those with no faith can get through something like this. God is with those as well. Take care and God Bless each and every one of you. Jim D.

Feel pretty good today. Went to the coumadin clinic, still low at 1.8. Another shot of fonduparinux. Thank Goodness for good insurance. Continue same dose coumadin for now. Took a nice walk this afternoon with my daughter up and down lots of hills near my home. Feeling stronger each day. Actually able to sleep in my own bed last night and have not needed to sleep in the recliner as yet. It is wonderful to sleep with my beautiful bride again. Noticing the ticking less and less now, as I am \"Cogsworth\" according to my daughters. For those of you who don\'t know, Cogsworth is the little clock character from Beauty and the Beast who is constantly ticking. To those awaiting surgery, I wish you God Speed and Good Luck. It is nice to be on the \"other side\" so to speak. Now to let the healing begin, my chest, my heart, and my poor veins. It was nice to go the coumadin clinic because, it is where I practice. So I was able to see my friends and colleagues again. Wonderful people. For me, my life has changed, but not completely. I am still the same man that I was. I am very different about my wife, family, career. I now have reshuffled my priorities a bit. My family is truly my source of power and inspiration. Each day gets a little better, a little stronger, a little easier. Jim D.

I feel like an INR hostage. My INR actually went down last night to 1.4. I almost feel like laughing. My family is still here and making this much easier. Down to labs just once daily. CAPITALLY FRUSTRATED. I can\'t even begin to describe my frustration. I don\'t want to seem ungrateful for my very good fortune. Surgery went great. I had a mechanical AVR, wasn\'t counting on that. But I\'m okay with that. Coumadin is tea leaves and chicken bones. No rhyme or reason at all. Jim D

If I knew then what I know now, I would have stayed home for this. I am at the end of my rope. INR today 1.5. At least my family is here. But for how long? At this rate I could be here several more days. I simply can\'t bear that thought. I have considered requesting a transfer back home to a Cincinnati hospital. My visit to CCF has not been a completely pleasant experience. On POD#2, I essentially had a cardiologist ask me why I had this done. Are you serious?? Even if you thought that, why would you ask a 39 year old man, who felt great before his surgery, that question. As a physician, even if you felt that way, keep that to yourself. Jim

Despair is slowly coming on me. Waiting on my INR to come up. I know all the right answers, that the hospital is he best place for me. Blah, blah, blah. As a patient in the hospital, you are absolutely helpless. You are at the whimsy of others all day. The loneliness is crushing. Despite being lonely, you don\'t really want any company, because you\'re rotten to be around. REALLY STRUGGLING. Prior to my surgery, I felt great. I knew an AVR was possible but seemed very unlikely. Guess what, new valve. Oh okay, no HUGE big deal. I can handle that. Oh really, now I have HIT. Are you freaking kidding me! I feel I am adrift in a raft in the middle of the ocean with no land in sight. My family is coming up to see me for the weekend. Hopefully they won\'t leave without me. Jim

You never imagine that what may delay your discharge are silly things. This journey is like a fun house. Except it\'s no fun. At least Missy and my girls will be back tomorrow. They promised they wouldn\'t leave Cleveland without me!!! Jim D

Despair is a form of idolatry, which is a sin. Thank goodness I am a sinful person anyway. Feeling pretty good. Only taking Tylenol for pain. Incision looks good. Hopefully home soon. I have developed a right bundle branch block since surgery. I have heard from people who have actually had to have pacemakers after this surgery. I cannot begin to tell you all how much I appreciate all your thoughts and prayers. It is indeed humbling. My love and best wishes to all. Wow I don\'t know how I rated the \"Patient spotlight\". I am humbled again Adam. Jim D

My wife and I decided to have my surgery done at Cleveland Clinic. About 300 miles from our home. Today is day 9 in the hospital. Sent my wife home yesterday to try to resume family life. A few post operative snags will likely keep me here through the weekend. Missy is going to bring the girls up this weekend and I can\'t wait to see them. I simply cannot bear (?sp) the thought of them leaving Cleveland without me. Going to a center like Cleveland Clinic is a blessing. Knowing then what I know now, I might have stayed closer to home. I have received top rate care please don\'t misinterpret (minus a few hiccups here and there). But I really miss my family and friends. I still really have no end in site. Maybe Sunday??? Starting to get a little down. I suppose that simply making it through my surgery should be reason enough for thanksgiving, and it is. My faith has not been shaken as yet, only stirred a little. Jim

Missy went home today to be with the girls. I am still in Cleveland trying to stay sane. My chest has minimal pain. I only took four Tylenol yesterday and two were for a headache. Blood is now thin on bivalrudin. Hopefully now to resume coumadin tonight. I want to go home so bad I can taste it. If I have to stay here much longer I may go see Lloyd down in the Overlook lounge for a drink. (you fans of Stephen King or The Shining will appreciate that I hope)

Another thing to always keep in mind about recovery is to expect the unexpected. Today I was diagnosed with heparin induce thrombocytopenia. Heparin is off and I am n bivalrudin. My coumarin has to be reversed and I have to be fully anticoagulated with coumarin again. Maybe another week in the hospital. Just trying to stay positive and be strong. Missy is going home tomorrow tomorrow to be with the girls. Will keep everyone posted Jim