Jim's Journal

Saw my cardiologist last Wednesday...told him I felt great. He was really pleased with how things are going. He said that if my surgeon agreed, I could play golf with no restriction. The surgeon agreed after a call that day, and I played nine holes that same afternoon! And I have played several more times since then. Feels so good! But I won\'t play today, as the high temperature is expected to hit 106! Like my pest spray guy said...\"If it were 85 degrees every day, you couldn\'t afford to live here.\" My cardiologist also took me off of amioderone (for prevention of atrial-fibrillation) and also took me off of coumadin...Wow. My surgeon said that 40% of heart valve surgery patients get atrial fibrillation, at least temporarily. My cardiologist says it is closer to 50%. He said it takes about 3-4 weeks for the amioderone go get out of my system, and that I will wear a holter for 24 hours after that to make sure there is no sign of a-fib. The cardiac rehab is going well after 12 sessions...they keep increasing the resistance and the duration of the exercises. The staff there is fantastic...friendly and helpful. I am so blessed to be having an easy recovery and feeling so well! Thanks to all my HVJ friends for sharing your hopes, fears and experiences...it has been a BIG help! I hope everyone has a truly successful surgery and recovery. Jim

Went to my first cardiac rehab session yesterday. Before going, they sent me 3 questionaires to fill out. One had questions about things like sadness, pessimism, guilty feelings, and seven more along those lines. The choices for \"sadness\" ranged from \"I do not feel sad\" to \"I am so sad and unhappy that I can\'t stand it\" Wow. The actual rehab session went very well, and I\'m glad I signed up for it. They have a well equiped fitness center, and they hook you up to a portable EKG rig that sends info about your heart to a computer that they monitor while you exercise. They also check your blood pressure in the middle of each exercise that you do. I go three times a week and Medicare covers 35 visits. I am thinking that after 10 or 12 sessions, I may have enough info about what to do, that I can stop going and do the same exercises at the fitness center here in our retirement community. However, it is nice to have the supervision of experts. Still feeling wonderful and walking 4 miles per day now. My scar is fading more each day...can hardly see the upper portion!

Had my first post op visit with my surgeon today at 3 weeks and 6 days . He was very pleased with my progress. Said I was free to drive a car! (all the web sites I saw about recovery said you won\'t drive for 6 - 8 weeks!). Also cleared for light house work and vacuuming, (Marcia will be happy!) but no heavy weights yet. Said I can walk as much as I want, just be aware if I seem to be doing too much. So, after we left, we went to a movie, then I walked 2 miles...then when we got home, I went to the fitness center here and treadmilled another 1 & 1/2 Miles. Surgeon also said no problem with chipping and putting for golf preatice! Still feel just wonderful. Don\'t know why I have been so lucky to recover so quickly and not have any complications after leaving the hospital. I feel for those of us whose journals I read who have serious problems, and wish you all the very best. For those still waiting for your surgery, know that it can and will go well, and that you will feel SO much better when it is over. Don\'t see the surgeon again for 3 months, and don\'t see my cardiologist for a month, so won\'t post more unless something changes. Thanks to everyone for your messages of encouragement, and for your positive thoughts and prayers! They work! Jim

Told my cardiologist that if I felt any better I would probably be breaking some law. He asked about my exercise, and I had to admit that I had been \"pushing the envelope\" a bit and doing more than recommended. He was just delighted with my condition and progress. My INR was up to 2.4, so he said to stop the Lovenox (no more self administered shots!} and to decrease the amioderone from 800 mg per day to 200 mg per day. Said to come back in 6 weeks, and we would likely stop the amioderone and see if the a-fib was gone for good. All good news. Next Thursday, my first post-op visit with my surgeon. Hope that I can drive soon, and start chipping golf balls!

Some of these things that happen I can only talk about in the journal, as most everyone there will understand and sympathize. On my eighth day in the hospital, while in atrial fibrillation, my doc ordered a 48 hour drip on amioderone. They put it in a previously existing IV port which, it turned out, was not well taped down. After maybe 8 hours, during which my heart rate returned to sinus (normal), the IV came loose from the vein and began what they call \"infiltration\" or \"tissueing\". The drug then went directly into the tissue of my arm near the elbow. Before we discovered the problem, my arm and hand, below the elbow, swelled up like a small football. My doc saw that the next morning, and was not happy. He said, \"We\'ve got to get you out of here, we are just making you sicker\". A couple days later, I came home, and the next day, the arm was worse if anything, and was painful. So we went to my family doctor that afternoon. He prescribed an antibiotic as he thought I might have cellulitus, and sent me for an ultrasound which he arranged within the hour. After a 45 minute ultrasound, the tech called my doctor, then was allowed to tell me I had a \"deep vein thrombosis\" (clot) in my arm (not good). Then my family doc, who had also checked my INR at 1.5 while I was there, called and said I needed to go on Lovenox, a self-administered shot, twice a day for five days. He expected my INR to be up to beteen 2 and 3 by the time the 5 days were up, on the 3 mg dose I was on. Two days later, the home services nurse visited, and my INR had gone down to 1.3, and after another two days, it was down to 1.0. So the doc increased my coumadin dose to 7.5, and ordered another 5 days worth of Lovenox, which we pick up today. The swelling in my arm and hand has mostly gone now. So that is where it stands now. That first shot I gave myself in the love handles, was hard to do, but after 8 more, it is a snap. Will report progress assuming there will be some.

So maybe I\'ve figured out why it became important for me to come up with something special as a reward for getting though the surgery and the recovery. It is reminding me frequently that, yes,Jim, there WILL BE AN END to this adventure out there. I needed to know that while being scared of the impending surgery, while hating the breathing tube, while enduring the seemingly endless days in the hospital with the wires and tubes, while dealing with the a-fib, and while doing my walks in the forced slow recovery. So, knowing that next April I will fulfill a lifelong dream of walking the Augusta National Golf Course during the Masters tournament is my reminder that there WILL BE an end!

Home at last on Tuesday after 11 days the hospital! Got a new aortic valve, did one bypass, and repaired the mitral valve.Had some complications in the ICU resulting in a five day stay there. Then took a couple extra days to deal with the atrial fibrillation that I now know happens to 40% of heart surgery patients. But the good news: I feel wonderful physically, mentally and emotionally! Virually no pain around the incision, in fact, the first day out of ICU, cut back to two tylenol a couple times a day. Now at home, don\'t use anything! Using a walker for the first week, as the 5 days in ICU left me very weak, but getting stronger by the hour. Looking forward to the reward I promised myself for getting through all this... a trip to the Masters Golf Tounament next year ( from my bucket list!) I think it has been a help to have a reward to look forward to. The only downer was the extended stay in hospital...was going nuts by the last 3 days, with the wires and tubes and lack of freedom. Good luck to all!

This will be the last post before surgery on Friday. Tomorrow,we will drive into Tucson (we are about 25 miles north) and have dinner with my brother and sister-in-law. Then we will check into a motel a couple blocks from Tucson Medical Center Hospital and hit the sack early for our 6:30 am check in, and 8:30 am surgery. Lift chair was delivered today, and is all set up with the TV remotes nearby. We retired from Seattle to Tucson 9 years ago. But, until this year, I have continued to join 11 of my Seattle golf buddies for an annual March trip to San Diego for 6 days of golf. We play 36 holes a day for 4 of those days. So we call the group GTYP (Golf Til You Puke) and have shirts and hats with the GTYP logo. This year would have been my 32nd consecutive year...hated to miss it, but I\'ll be there next year! Twenty percent of the fun is the golf, and eighty percent is enjoying old friends. I imagine everyone has similar emotions before surgery...anxious and nervous, but looking forward to getting it done and having more years to live. Thanks for your comments and good wishes, and keep a good thought for me!

Surgery Friday...think we are ready. In response to my question about rewards, Steven in Calgary wrote \"how about something from your bucket list?\" Good idea...always dreamed about seeing and walking Augusta National golf course just once. Would be something to look forward to. Still not sure about how difficult recovery will be. We have a rental lift chair being delivered this week for a month. Will I sleep in it? For how long? What will I need beside it? How much will I need pain meds? My dear wife, Marcia, will be a saint, but it will be difficult for her, but good friends will be helping. Reading the other journals is a big help. so thanks to all.

Pre-op assessment on Monday...Surgery at 8:30am on Friday. Well prepared thanks to Adam\'s book, but anxious. Replacing aortic valve..checking Mitral valve, and one bypass as long as they are in there. Dr. Moulton says he has done thousands and instills confidence. Question: Has anyone planned a reward for themselves for getting through surgery and recovery?