John's Journal

Yesterday was exactly 4 weeks since I had my surgery. I would like to tell you that everything has gone well since we returned home but that is not quite the case. We returned home on Saturday, July 3 and things seemed pretty good until the following Wednesday, July 7. I went to the supermarket with my wife and wasn\'t feeling that great. My wife thought I felt warm to the touch and suggested I take my temperature. Sure enough, I had a fever of 101.2 degrees. We called the Cleveland Clinic and spoke to the nurse on call. I advised her of the fever and also that I had a knife like pain in my lower back everytime I took a breath. She suggested we go to the ER immediately. In the ER they took a chest x-ray, blood samples, and an EKG. The supervising ER doc had a gut feel that I might have a blood clot and ordered a CAT scan just to be sure. Well needless to say he was right. The CAT scan showed that I had a pulmonary embolism (blood clot in my lungs) and the chest x-ray showed I had a small amount of fluid in my lungs. I was formally admitted to the hospital in the wee hours of the morning. They started two IV\'s, one for antibiotics to address the infection and the other for Heparin (blood thinner). I was discharged from the hospital on the following Monday, July 12. As a consequence of the blood clot, I now must be on blood thinners (Coumadin/warfarin)for at least six months. I really was hoping to avoid this, but they told me I have no choice. The blood thinner will hopefully prevent any future blood clots from forming. As far as the existing blood clots in my lungs they should dissipate over time. I must say since being discharged from the hospital I seem to be improving each day. I am walking 2-3 times a day for approximately 25 minutes without any shortness of breath or difficulty breathing. My right side, at the sight of the incision is still sore but also improving. Once again, my purpose in sharing this is to help my HVJ friends who will be undergoing surgery to make them aware that the road to recovery may have a few bumps but it is important to keep the end result in mind. You will feel better as time progresses, so try to stay positive and upbeat. Take it one day at a time. Thank you and God Bless, John

Finally home, two weeks to the day from the time we left. It was a long day. We checked out of the hotel at 11:00 s.m. snd finally walked in the door at 9:00 p.m. Needless to say I was pretty well exhausted and quite uncomfortable by time we arrived home. Southwest Airlines was very accommodating, providing wheel chair service throughout the route and allowing us priority boarding which was very helpful. Another real nice final touch, for out of town patients, The Cleveland Clinic provides complimentary limousine service (including gratuity) from the hotel to the airport. At exactly 11:15 a.m. a very well dressed gentleman arrived in a Lincoln Town Car, took our bags and drove us to the airport. What a nice touch. We were both quite impressed. Well barring any unforeseen circumstances I probably won\'t be posting again until after I see my cardiologist on July 13. Thank you to all my family, friends and HVJ friends who have used this site to keep in touch with me throughout this adventure. Your messages and most especially your prayers have been uplifting. To all those awaiting their procedures I hope my experiences have helped you to better prepare for what\'s ahead. I know I learned a great deal by following the journals of others prior to my surgery and my goal has been to provide as much detail as possible to prepare you for what\'s ahead. Thank you and God Bless, John

Today was a good day. It started with an upgrade for breakfast to full liquids, which I was able to handle well. Then I was upgraded to solid food for lunch and again for dinner, which again I was able to handle well. Finally, they said I could be discharged. So I am now in my hotel room and will be going back home tomorrow. I have very little pain in my incisions now and I am walking quite well for short periods of time, but I fatigue quickly. I am looking forward to getting off that plane tomorrow and getting into my own recliner. Thanks to all of you for your support and kind words. It makes all the difference.

Good News! John was taken off of the IV fluids and was permitted to start eating clear fluids by mouth. He was very happy to be having broth, jello, juices and ice pops. So far he is tolerating the liquids well. Tomorrow will tell the tale if his bowels are working enough to handle the liquids and if so, they will progress him to more complex foods. If that works, we are hoping for discharge perhaps by Saturday.

Not too much going on here that is why you haven\'t heard much from me. John is doing okay. He is just sitting around, IV in place, still nothing by mouth, not even water, and no pain meds and waiting for his bowels to wake up. He has had some movement of his bowels, enough to have less pain, but not enough to call him cured. The GI doc was in Monday and ordered an ultrasound of his liver and his gall baldder, just to rule out problems there. Those tests were negative. They draw blood every day, watching his levels closely. They also take a daily xray of his chest (checking the fluid level in his lungs--he has had a very little fluid since the mitral valve repair and this is normal and should be reabsorbed into his system in a short time) and an xray of his abdomen, checking for air in his intestines, which is still there and giving him grief. The Colorectal Doc was in Wednesday and ordered a barium enema on for Thursday morning to check for lower intestine blockages. If that is negative, then I think they will start to try him on clear liquids to see how his system handles them. They are pretty thorough here. They don\'t think there is a blockage, but they want to rule it out before they give him food or we could have more problems. In the meantime, he is trying to walk for longer periods of time and further distances because that will assist in dissipating the air in his intestines and help restart his bowels. He is up to about 700+ feet at a crack now before he gets tired. He incisional pain is better now, although it is very tender to the touch and it still hurts to lift his right arm. His abdominal pain is still there, but much better than Monday. So things are getting slowly better. I had booked a flight for Friday hoping to be discharged on Thursday, but it doesn\'t look like he will be getting discharged soon enough to catch that flight. I am going to wait until late Thursday afternoon before canceling that flight to be absolutely sure I can\'t make it. In the meantime, we are waiting, waiting, waiting...............

Today was our day to rest in the hotel and get ready for our trip home tomorrow. John had a little drainage from one of the surgery sites, so we went over to the clinic to check the drainage out. The site was fine, but John complained to the clinic staff about being more breathless and having difficulty with his bowels. His abdomen was quite distended and he couldn\'t even pass gas, so the clinic staff decided to take an abdominal xray. The xray showed that John has an ileus, which is a temporary absence of the contractile movements of the intestinal wall, or as the GI doc described it \"John\'s bowels have gone to sleep.\" The plan of action is nothing by mouth, not even water, IV fluids for nourishment and wait for the bowels to wake up. The average time is 24 to 48 hours. So John is back in the hospital, we have cancelled our flights home and extended our hotel stay.

Had quite a day today trying to get my bladder and bowels working. I had so many laxatives, I thought I would explode and still nothing. Finally, they gave me 1/2 of the laxative they give before a colonoscopy and it worked (or maybe it was the combination of all the laxatives that worked.) Continued to walk several times today, one time feeling a bit winded. Also wound up with a short 5 minute bout of dizziness, but it passed and have not had it since. They finally let me out at around 5 pm today. Went back to the hotel and sat in the lobby while my wife ran the prescriptions to the drug store. When I finally settled in, I took a two hour nap in bed. Unfortunately, when I awoke and tried to get out of bed, I realized that it would be extremely difficult. No matter how I moved, I was unable to sit up without extremely bad pain and it was too soon for another dose of pain meds. I was stuck. I finally gave it another heave hoe and with my wife\'s help, I wound up sitting over the side of the bed. I realized that I would not be able to sleep in a regular bed, at least not now. My wife called the front desk to inquire about the possibility of a recliner. Thank God, there was a knock on the door and housekeeping was standing there with a recliner. I was so grateful. What a difference the recliner is making. I can finally rest easy and not have to worry about getting stuck in bed. I am looking forward to a peaceful night\'s sleep.

Today is a fairly good day. John continues to feel better. He is walking around 500 feet at a time and so far he has gone walking about four or five times. They removed the foley catheter this morning and he was given an 8-hour window to urinate. They will have it put back in place if he does not comply before the 8 hours. He hasn’t moved his bowels yet, so they have given him some Milk of Magnesia to help that along. The blood test results today continue to show improvement in his blood platelet count and his hematocrit and hemoglobin levels. He continues to have pain and pretty much relies on his meds to get him through the day. Those same meds may also be contributing to the bowel and bladder issues, but when weighing the pros and cons, he really needs the pain meds at this time. He know this because he did try to do without the pain meds this afternoon and lasted only about ½ hour before he had to ring for his meds because the pain was too bad. John has been drinking water all afternoon and trying hard to comply with the urination guideline, but is having a hard time. After several sessions of trying, he was just finally able to urinate (6-1/2 hours into his 8 hour window) and although it wasn’t much in volume, we think it will get better now that he has done a bit. He still hasn’t had a bowel movement and he may be looking at a suppository if he doesn’t comply. They have given him some Miralax to assist in the hopes of avoiding the suppository. John’s sugar levels have been askew since the surgery as well. Apparently, any surgery can cause this to happen as the body tries to heal itself from what was done to it, so they have been watching that pretty closely. If he goes beyond a certain level, they treat with an oral med or they have even used a small dose of insulin when he was in ICU. They are scheduling discharge for tomorrow morning. They will be taking another blood draw tomorrow morning to check out the hematocrit, hemoglobin and blood platelet levels. Apparently, heart surgery can cause a decrease in platelet levels and the heart lung machine technique also contributes. Also, it is customary to give anyone having surgery heparin to prevent clotting during the surgery, and this contributes to a drop in blood platelets as well. They do expect this to get better though, although he was a little low with platelets before the surgery so the levels may not come up as far as the norm. We are to follow up with the doc at home if the levels remain low, but they should be high enough to get home without problem. John wore himself out with all the walking and bowel and bladder attempts so he his sleeping comfortably now pending the arrival of dinner. He still does not have a good appetite, but I am told that this is not unusual. The food here is not that desirable; since they have him on a low fat, low carb, low salt diet. Since this is not his usual food of choice, we will have quite an adjustment when we get home. I was hoping John could resume the writing of this journal himself, but he doesn’t quite have the energy level yet. Perhaps in a day or so. Thanks again for all your support.

John is doing better today. He is up in the recliner, has been since about 5:30 am; he couldn\'t get comfortable in bed any longer at that time. He slept with his CPAP all night with oxygen attached to the machine (they put an adapter on the machine so that the oxygen could flow to his mask mixed with the CPAP air.) When they put him in the recliner, they left the oxygen off and he has been at 94% pretty much since then (you need to be at least 90%) so they haven\'t put it back on. He said that he walked to the other side of the hall and back this morning before I got here (maybe 40 feet each way.) He also said he finally spit up some more phlegm, which although gross, is a good thing. He is still sleepy and dozing in the chair. He is having problems with gas but they say the walking will help that and he still has pain at the incision site. He was able to walk again another 80 feet before breakfast and again about 100 feet after breakfast, so things are moving forward. He says he feels better after walking. He hasn\'t had an appetite so he has not been eating very much, but for lunch today he finally ate all of his meat. He still has the foley catheter in and they have not said much about it so far. We are still waiting for the hematology consult. The blood tests they took this morning continue to show his levels below the normal ranges, however, today\'s levels are a very considerable improvement from those taken in the past two days. So, overall he is improving.

When I got to the hospital this morning, both John and his bed were gone. I found out quickly that they had taken him for a cardioversion procedure. Apparently, he was experiencing some atrial fibrillation. Atrial fibrillation is a condition where the top chambers of the heart do not beat normally because the impulses that tell the heart muscle to contract are not regular. These irregular impulses cause the top chambers of the heart (atria) to quiver which causes an arrhythmia i.e. a heartbeat that is not regular in rhythm. The danger of atrial fibrillation (a-fib) is that blood can pool because the atria are not contracting with a strong enough squeeze; and, that can result in blood clots that can travel to other places and cause problems, like stroke or heart attack. I was told that a-fib occurs in approximately 40% of the cases of mitral valve repair with the minimally invasive right throrocotomy approach. The cardioversion procedure is an attempt to shock the heart muscle to restore the normal heart rhythm. The nurse case manager came in to talk to me before John got back and told me that the procedure did not work. John was still in a-fib and they were going to try to control it with a medication called amiodarone. When John got back he was not feeling very well and he told me he had a very bad night. He was so disappointed that the procedure did not work. However, when the nurse came in to reconnect his monitors, she noticed that his a-fib seemed to have calmed down a bit. They decided to do an EKG to further check the status of his a-fib. In the meantime they put him on amiodarone. Before the case manager left, she told us that it looked as if he was back in sinus rhythm but she hadn’t checked the EKG yet. She said that if there were still a problem she would come back and talk to us. She did not return so it looks as if somehow John’s a-fib has gotten under control. I do think though that they will be keeping him on the amiodarone to keep things under control, because a-fib can come and go. In addition to the a-fib problem, John was also having a problem with a low blood pressure and a low blood platelet count and low blood count. Therefore, he was given 2 units of blood today to see if that would help the problems. They were also calling for a hematology consult to see if those docs can figure out why these counts were low and how to rectify the problem. We are still waiting for the hematology consult to occur. By the end of the day, John was feeling better than the morning, but because of all the new problems, he had only walked once and he still had the foley catheter in place, so there was no progress on those counts. It has been quite a roller coaster day for us. Fortunately, we had some dear friends who helped us deal with the ups and downs and get through the day. We are hopeful that day five will be better.

John is slowly starting to do more. They made him walk this morning, but he only went about 15 feet at best. He is still very tired and sleepy. They took him off the pain pump and put him on percoset, which is making him even more sleepy. He still has a considerable amount of pain even with the percoset especially when he has to move or cough. They also removed the foley catheter and told him he had to urinate by noon or they were putting it back. Well, noon came and went and no urine. They then started pumping liquids asking him to drink 2 hugh cups of water to see if that would give him the urge. They also took him for another walk and he went down to get an echocardiogram. He was up in the chair most of the day which they said would help expand his lungs. He was finally able to start coughing up some phelgm, and had at least 3 good productive coughs. He tried to give them some urine, but to no avail. Finally, late afternoon they put the foley back and said they would try again tomorrow. He was able to walk again later this afternoon, this time about 30 feet. His walking is slow and labored and he is slightly hunched over, but he is walking and although it hurts to walk, he said that he felt better after walking. He is still in a lot of pain with movement and coughing and absolutely needs his pain meds at this point. He continues to be sleepy and dozes on and off during the day. He fell asleep in his chair while I was at dinner, and when I woke him up, he had slept through his next dose of pain meds. As a result, his pain was up. He was assisted into bed and given his meds, but he was in more pain than usual when I left, so he put his meditation CD on and tried to relax, hoping the meds would take effect soon.

John has finally been transferred out of ICU and into a room. His chest tube is out. He still has the IV fluids which are also the mechanism for his pain pump. He also still has the Foley Catheter, which they believe they will be removing tomorrow. He is still in a lot of pain and continues to push the pain med button every 6 minutes or so, trying to keep the pain from getting too out of control. He has some secretions in his chest/throat, which he is trying to cough out; but, of course, it is painful to cough, so he needs encouragement to make that happen. They gave him a Cleveland Clinic heart shaped pillow to hold onto for support when he needs to cough. Currently he is on a low salt diet and has a fluid restriction, but that may change if he doesn\'t develop edema, which he hasn\'t so far. However, they do have him on a prophylactic dose of lasix to keep fluids down. Although he is being given regular (no added salt) food, his appetite has been less than normal and he is eating very little. He has been in bed all day and pretty much spent the afternoon sleeping. They did get him up into a chair for dinner, but it was very painful for him to get into the chair. After dinner, he was falling asleep in the chair, so they transferred him back to bed after a short time. Tomorrow the plan is to get him up and about more, once the IV and Foley are removed. Overall, except for the pain, he is doing reasonably well, although he did have a 5-10 minute episode of uncontrolled shivering again, which they again attribute to the anesthesia, which they say takes a considerable time to get out of your system. So again, for the most part things are proceeding as well as can be expected. Thank you all again for your support and prayers. They are much appreciated.

Well, today is a better day. When we got here this morning the ventilator had been removed, blood pressure and heart rate were in the normal range and John was awake and looking a lot better than when we left last night. He still had the chest tube in; and, it was still draining somewhat, but they just asked us to leave so that they could remove it. He still has the foley catheter, but I expect that will remain in until he out of ICU and transferred into a room. The had him sitting up in the bed (with back support). He was glad to see us and glad that the procedure is finally over. He has a lot of pain right now and can hardly lift his right arm because that is the side where they entered. He has a pain pump, which he is pushing every 6 minutes to keep the pain as well under control as possible. They expect him to be discharged to a room today (they call it their step down program.) He is very grateful to all of you for your prayers and support. Thank you all so much.

I am writing this for John at his request to keep you updated. We got to the hospital around 9:45 a.m. They took John back for the first level of preparation (dressed in gown, shaving, etc.) pretty much right away and he was ready to go by 10:45. He did not have any IVs yet, they do that in the OR. They let us in to see him and say our final good byes before taking him up. He seemed quite relaxed and glad this surgery was finally happening. Around 3 pm, one of the staff let us know that John arrived in the OR at 11:53 a.m. Eastern time. The prep work then began, i.e. inserting IV and monitoring lines, preparing the skin, putting John to sleep, putting the breathing tube in etc. Then the first incision was made at approximately 1:22 p.m., with the major portion of the heart work underway at about 2:22 p.m. We were told that it could be anywhere from another 3 to 5 hours longer from this point, after which we would get a call to meet with surgeon. At about 4:50 p.m. we got the call to meet with the surgeon, who advised us that everything went well with the surgery. He was able to repair the mitral valve with a minimally invasive procedure through the right side of the chest. It was expected that John would be in the OR another hour for the closing process and then transferred to the Cardiovascular Intensive Care Unit where it would take another hour for the admission and recovery process. They told us to go to ICU at around 6:30. We were finally able to see John at 6:45. He was still on the ventilator and he was sleeping. His nurse said that he started to awaken but he was in considerable pain so they gave him some pain meds which caused him to dose off. We left after 10 minutes because this is what they advised and change of shift was happening from 7 to 8, at which time there are no visitors permitted in the ICU. We got back in the ICU at 8:15 p.m.and John was still sleeping. Things were not progressing as nicely as they would have liked. He was still on the ventilator because he was draining more than they would like to see from his chest tube; and, his blood pressure was a bit too low, for which they were giving him fluids and meds. They also had to give him both blood platelets, because his count was low, and plasma. He did awaken at one point and started thrashing with his arms and shivering, which was a concern since these activities cause the heart to work harder, not a good thing at this time. They asked us to leave for a few minutes while they worked with him. When they called us back in, his arms had been restrained so he could not thrash; and, he had been sedated. There was still some shivering going on, which they advised was from the anesthesia. The anesthesiologist said that anesthesia wreaks havoc on the temperature regulation system and that it is not unusual for shivering to occur. The body thinks it is cold but it really is not. They were going to give him some meds to stop the shivering. He started to calm down after a several minutes and was sleeping peacefully when we left. They advised that they were hopeful that he could come off the ventilator sometime during the night or early morning. We were told to return tomorrow after 8 a.m.

It\'s about 9:00 a.m. on Monday morning and since I don\'t have to report in until 10:00 a.m. have an opportunity for one last post. After that I think things will start happening pretty quickly. As I look out the window from our hotel room it is a beautiful bright sunny day. I can see the hustle and bustle of traffic on Carnegie Avenue and can\'t wait to get back in the flow of things again. I feel pretty calm, no real anxiety, just a feeling of let\'s get this done already. I think the next few days will be hardest on my wife and oldest son who are here with me. Presumably, I will be pretty much sedated and out of it but they are the ones who will have to sit and wait and deal with their emotions. Well for now \"that\'s all folks\". Talk to you again in a few days. If she feels up to it, my wife will be posting the next few days with updates. Once again thanks for the prayers and well wishes. John

Well the waiting is almost over now. We arrived in Cleveland yesterday (Saturday) and settled into the hotel. Got the phone call this morning from surgical scheduling advising me to report at 10:00 a.m. tomorrow morning. This means that I will be the second surgery. Somewhat relieved since if I were the first I would have had to report in at 5:15 a.m. At least now we can have a little more relaxing start to the day. Not much more to say right now. Just looking to get this over with so that I can get on with my normal life again. Not looking forward to the recovery but am anxious to get it started. Thanks for all the prayers and well wishes. Talk to you soon. John

We got back from Cleveland late last night. We left home on Tuesday morning, had a full day of pre-op tests on Wednesday, met my surgeon, Dr. Gillinov, on Thursday and traveled home on Friday evening. Quite a whirlwind. Eventhough my surgery is scheduled for Monday, June 21, we decided to make a pre-surgery trip to Cleveland for the pre-opt testing and to familiarize ourselves with the Cleveland Clinic and surrounding area. We were concerned that waiting until right before the surgery date to travel to Cleveland and conduct the pre-op testing would be much more stressful. We are so glad we decided to do this. We are now much more comfortable with the hospital and surrounding area. The Cleveland Clinic is an amazing place. We knew it was a large hospital but did not fully appreciate how large a facility it really is. However, it doesn\'t feel like a hospital, but rather more like a college campus with many buildings and expansive landscape. There are lots of people coming and going but we never felt lost in the crowd. They have these so called \"red-jackets\" all over whose job is to answer any questions and direct you to where you need to go. The unique thing about them is that they don\'t wait for you to ask for assistance. If you happen to be standing around for even one minute looking lost or confused the next moment there is one of these \"red-jackets\" standing at your side asking how they can help. Also, we never seemed to have to wait very long for any of our appointments. When we reported in to a paricular department for a scheduled test or meeting we never had to wait very long in the waiting area. We were called almost immediately into an exam room. Even when we got way off schedule they were very accommodating. Everyone on staff was very polite, pleasant and extremely outgoing. It was really refreshing. We did however have one surprise. Late in the day after all the testing was completed and we met with the surgical nurse we were informed that the planned surgical procedure was Mitral valve repair and single artery bypass. At first we thought that there was a mistake since no known had said anyting about the need for a bypass. This was a total shock and somewhat disconcerting since it meant that I was not a candidate for minimally invasive or robotic surgery, and would have to have my chest \"cracked.\" Needless to say Wednesday evening turned rather melancholy and we both had a sleepless night. When we met with Dr. Gillinov on Thursday morning he explained that based on the pre-op testing and a review of the Catherization imaging the surgical team had come to the conclusion that my Right Artery was 60-70% blocked and therefore required bypass surgery. He explained to us that if I did not have bypass surgery in conjuction with the Mitral valve surgery there was a much higher risk that I could suffer a fatal heart attack during the Mitral valve surgery. So in the long run we are now convinced that this may have been a blessing in disguise. In two weeks from now we will be returning to Cleveland for the real thing. At this point we feel very confident with the Cleveland Clinic and my heart surgeon, Dr. Gillinov, and the rest of the staff. I welcome your well wishes and prayers. They are always so uplifting. Thank you and God Bless.

Not much new to report since my last posting. I got my dental clearance from my dentist attesting that I am infection free. They are real adament about this at CC. Not sure about other hospitals/surgeons. I also downloaded the Guided Imagery relaxation audio tapes from CC. They are very good and I have been listening to them regularly. Yesterday was one of the first times I can actually say that I may have recognized finally having some symptons related to my leaking Mitral valve. Not that I have been looking forward to experiencing them. I mowed the lawn as I have done on countless other days, however, after I was done yesterday and came in the house I was exceptionally fatigued. I asked my wife to check my blood pressure and pulse and everything seemed to be okay, but I was totally exhausted for the rest of the evening. Had no difficulty catching my breath or anything like that, but was totally wiped out and sort of felt like a very slight throbbing in my head. Although I am not looking forward to having the surgery, the waiting and counting down the days is getting old. The weather has finally started to get nice here and there is so much that we want to do outside but have decided to put off because of the impending surgery. It\'s like time is just wasting away. Can\'t wait to get this behind us so we can get on with our life. God Bless, John

It is now only 60 days until my surgery date at the CC with Dr. Gillinov. I am both anxious and apprehensive. Since I currently still don\'t have any symptoms it is hard to fathom that in 61 days from now when I am in recovery mode I won\'t be feeling anywhere as well as I do currently. Thus far I have been very favorably impressed with the CC. My contact at the CC has been a nurse in the Cardio Thoracic Surgery department named Cathy. She has been so very helpful in answering my questions and has promptly returned my calls. During our first conversation she spent a considerable amount of time on the phone with me and provided so much useful information. She was so calm and pleasant she made me feel so relaxed and confident in my decision to travel to the CC for my surgery. Two days later a packet was delivered to my front door from Lisa at the CC with the appointment schedule for my pre-op testing and other pertinent information. I have already received several entries in my guestbook for which I am very grateful. This is such a great resource and source of encouragement and support. I am already heeding some of the advice suggested in my guestbook. I have started to walk on a regular basis. I am currently walking one hour a day, which equates to approximately 3+ miles, 4-5 days a week, trying to get in better shape prior to my surgery. Thank you all for your support and kind words. God Bless, John

One of the hardest things for me was deciding where to have the surgery performed and by whom. I contacted family and friends for referrals, conducted research on the internet, queried Adam Pick\'s Heart Surgeon database, read with great interest these patient journals, and met with three local heart surgeons. I also sent all of my pertinent medical history and copies of my echocardiogram and catheterization (angiogram) to the Cleveland Clinic to be evaluated by Dr. Marc Gillinov. One of my major concerns was the thought of having a sternotomy. Based on the results of my angiogram my local cardiologist thought I might be a good candidate for minimally invasive robotic assisted surgery. However, two of the three local surgeons I visited felt that due to the potential complexity of my Mitral Valve repair they did not think that I would be a good candidate for robotic assisted surgery. They did not even address any other minimally invasive techniques. However, the third local surgeon I consulted said that robot assisted surgery was the approach he would use and was definitely the preferred method for me. Soon after, I received a call from Cathy at the Cleveland Clinic who relayed the results of Dr. Gillinov\'s evaluation. Dr. Gillinov advised that my Mitral Valve could be repaired and that he would be able to perform the surgery using a minimally invasive technique. It would either be done robotically assisted or manually, but in either case, it would be performed through a small incision between the ribs on the right side of my chest. The ultimate decision, whether robotic assisted or manual, would be dependent on the results of the pre-op testing that would be done prior to surgery. A minimally invasive approach confirmed my research and definitely is the method I had been hoping for from the onset. As I mentioned in \"My Story\" after much deliberation I have chosen to have my surgery conducted at the Cleveland Clinic. Surgery is scheduled for Monday, June 21 and will be performed by Dr. Marc Gillinov. Having made the decision I am now relieved and feel like a great burden has been lifted from my shoulders. I am happy, confident and at peace with my decision.