John's Journal

Valve replacement surgery was almost 26 months ago; I had planned an update at 24 months...oh well. Have a routine echo exam tomorrow, which reminded me just how long ago my surgery was. The fact that I am up and active, and don't think about the AVR is testimony to the genius of the medical community, especially Cleveland Clinic. I did undergo two cataract procedures, with good results, and am basically sound. Still on metoprolol and torsemide, but a low levels. Lots of new faces on the HVJ site. Welcome to what can be a really neat experience. John Teftt AVR--CleveClinic--5-4-12.

Posting between cardio visits...next is early July, with echocardiogram. Only change since last post is continued deterioration in vision. Opthamologist has identified 1 cataract worthy of surveillance...and I am scheduled for 6 month follow up. Gonna get by with old specs I hope...would have to get corrective lenses if I were still employed.....Hmmm.... I have had no luck trying to engage the medical community in pursuit of a connection between OHS and vision/memory deterioration. Several unofficial comments from India/Pakistani students hint strongly that such a connection is being studied. Someone with a scientific inclination please follow up. Again, recovery from OHS much slower than \"as advertised,\" but the net results are there. Thanks again HVJ. J Teeftt, AVR, CClinic, 5/4/12.

Not only 90 days without the Cardiologist,this week marks TOTAL 8 months AVR Surgery. Everything is pointing in a positive direction. Next step is in 6 months, when an ECHO is scheduled. Caution to others: the vision deterioration and memory loss are more common than we think. If my memory loss stabilizes, no neurologist involvement is necessary. Decision on that is at next Cardio appointment. Not so with eye doctor. Appointment to follow. I hope someone more scientifically inclined will follow up these 2 problem areas. Access to Pakistan/Indian research would help. Old grouch that I am, I must admit that in spite of a long drawn out recovery, plus a couple of unresolved issues, I am much, much better than at New Years 2011, 2012, etc. Peace be to all...J.Teeftt, AVR, CClinic

It has been two months since my last doctor visit. That\'s a big deal. One negative has been a weight gain of five pounds in about sixty days. My January Cardio visit will hopefully confirm that this gain is NOT heart or lung fluid retention. I think the Toursemide works, and the gain is result of a heartier cool weather diet, and a lack of exercise. My walking has leveled off at 1/2 mile daily; the \"Silver Sneakers\" program kicks in January 2013, which may help. I envy those that report \"trouble sleeping.\" I often sleep 10 hours/day. The more I sleep the worse I feel. I was discharged by my employer after 6 months medical leave. This has been disappointing, and I suspect depressing. Mebbe I can blame weight gain and over sleeping on my ex-employer!!! Hmmm... For a guy who had such a miserable post op, my current stats are great.. BP a consistent 120/80 with resting pulse of 85. No A-fib since shocker 5 months ago. Stamina, skin tone, circulation WAY BETTER than pre-op. To all in Pre-op: Waiting is the worst part. To all in Post-op: Ain\'t this great!!! Thanx HVJ, you are my rock. John Teeftt, AVR, Cleve C, 5/4/12.

After September visits with Cardio and PCP, several meds were adjusted/cancelled. Unfortunately, Sept was a slightly backwards month, but we did learn enough to make more adjustments. Confidence is high enough that I am off the 30 day appointment cycle, and am now scheduled for early January. Cardiologist strongly hinted that as a result of this \"90 day free home trial\" I may get my discharge then. The only problem now, is to try and keep my job. Policy is to hold it open 6 months; I am looking at 8. Oh well, another challenge. To any other post-ops struggling with fluid retention on heart and lungs, ask your Dr. about TOURSEMIDE (DEMADEX). Worked great for me. Thank you HVJ. You are my rock. John Teeftt AVR 5/4/12 Cleveland Clinic.

Since my last post, we have changed diuretics, with awesome results. Torsemide (aka Demadex) did the trick. Substantial weight loss, with obvious fluid loss in legs and ankles. Apparently, same was true with heart and lungs. My old nemisis, shortness of breath, although still with me, has signifigently decreased. My daily walk routine is now 4 to 5 times greater than July.(We are talking feet, not yards or miles !!!). Got a clean bill from the Pulmonary specialist, noting very minor fluid. Cardiologist has reduced Torsemide to a \"maintenance\" dosage, and has started to reduce other meds. There is a glimmer of hope, that after 4 months, I may be coming out of this after all. No re-hab scheduled yet, but it can wait, as I see progress. Thank You HVJ. You are my rock. John Teeftt AVR 5/4/12, Cleve Clinic

I had \"hung my hat\" on starting re-hab in early August as the final option to solve my shortness of breath problem. Well, a setback occurred, and the re-hab was delayed (I refuse to say cancelled). I am now scheduled with a pulmonary specialist in late August. Cardiologist is reducing his role. I\'ll repeat from July...\"this better work, as it appears we have run out of alternatives.\" Will post again after meet with specialist. Thank you HVJ. You are my rock. John Teeftt AVR, 5/4/12, Cleve Clinic

Cardiologist visit 7/11 not very exciting. No answers or advice on \"shortness of breath\" issue. Had chest X-ray 7/13 to make sure there is no fluid on lungs. Soooooo off to Re-Hab we go. Schedule is 12 weeks with orientation 8/3. This better work, as it appears we have run out of alternatives. In the interim I have developed my own little \"walking program,\" which is showing mixed results. Thank you HVJ. You are my rock. John Teeftt AVR, 5/4/12..Cleve Clinic.

Had Cardio visit 6/29 with another mini echo. Finally, GOOD RESULTS. The A-Fib has been gone 7 days as a result of Cardioinversion; heart appears stronger (what a shocker). The heart fluids are now 90% gone. Instructed to step up walking efforts (get it?), and will discuss in 2 weeks. Old pre AVR \"piano legs\" condition is back/not to worry, yet. Interesting history on blood thinners...started with coumadin. Terrible results...rollercoaster ride. Went to an expensive innoculant(forget name) which I vetoed due to cost ($1200/week,uninsured). Settled on predaxa--reasonable cost, no diet restrictions, no testing. You figure it out. So, I finally got a passing grade. Thanks HVJ

After my 6/14 post, cardiologist decided \"can\'t wait\" on medicating out of A-Fib. Back to hospital 6/21 for \"cardioversion\" and further tries at getting INR readings to acceptable levels. Insurance denied on one blood drug. What mass confusion. Anyhow, the Cardioversion\" worked. I am 3 days out of A-Fib with noticeable improvement. This is shocking (get it?)\' and I am racing fast towards normal recovery. Will post again as soon as INR goals met. Thanks for being here, HVJ.

After the ER visit, things got worse. Fluids have worsened, and I am in full A-Fib. Trying now to medicate out of both problems, plus coumadin to minimize A-Fib related clotting. Hospitalized 6/5 thru 6/8 to get started. Missed 6/11 coumadin target by a mile, so add another roly-coaster ride to my routine. I read journals daily, and envy those with prompt, problem-free recovery. With your help, I am refusing to give up. Thanks for being there, HVJ.

Thursday was to be my four week gala after AVR surgery. Instead, a trip to the local ER after 4 bouts with chest pounding breathlessness. After X-ray, CT scan, and review of vitals, I was sent home with advice to monitor the small fluid deposits on heart and lung. No real answers on short of breath issues. Today I reviewed same with hotline at CClinic. Advised me to accelerate cardiologist schedule, but otherwise not to be concerned. So, I wait it out pending my 6/5 cardiologist visit. Otherwise, I can report several areas of improvement, most related to circulation. Better exercise program started today. Appreciate the HVJ support.

Somewhere in HVJ, long before pre-op, someone said to get an old fashioned heating pad. So I did, then I forgot it. Now wrestling with shoulder and hip muscular pain. Reluctant to go the percocet route. Dug out the pad and added as my right shoulder shawl or napping aid. Results are excellent. Clinic phone nurse said \"twenty minutes at a time.\" I get 40 minutes of solid relief from the 20. Try it. John Teeftt, AVR, 5/4/11

Wan\' t to ask today about \"being loopy,\" a phrase often cited by others but one I never fully understood. Now I get it. I am 15 days post anesthesiology, and using less than 50% allowable pain killer. It takes me forever to do things logically. 4 tries to access my email account??? I have about given up on my two daily loves, sudoku and crosswords. Can\'t even balance my checking account. What a mess. Anyone else as limited as this? Any shortcuts???

Discharged 6:30 pm Thursday, for a total of 14 days, twice the time I had hoped. Sugar went goofy, oxygen absorption was a problem, on and on. Arrived home, hit the sack. How exciting. Today I have sorted thru old e-mails, plus tried to organize my drug regimen. Have 11 scrips plus percocet, which I limit to 50% of allowable. Weather will be nice today, so I\'m planning a sun bath party

Since I took the iPad home with me (sorry!), I\'ve been faxing Dad his blog and Guestbook entries from work! I\'m nothing if not resourceful! The last few days have been uneventful for Dad. Typical recouperating. However, his oxygen absorption levels are still low or less than required. Tonight, they are going to do a test of sorts, and allow him to walk without the oxygen for a length of time, then test the levels and then determine if his release from stepdown can be accomplished by sending him home on oxygen, temporarily. I think this is right...Sounds to me like a pulmunary issue that should (?) resolve itself soon. All Dad cares about is getting out! The results of this should determine his release date. He\'s still in good spirits, keeping the nurses on their toes, I\'m sure. He\'s depleted the stash of \"healthy\" dark chocolate I left for the nurses by handing it out to them. I figured they deserved a treat when they visited him. I hold nurses in the highest regards, after this experience. Doctors, too, but Nurses are there ALL the time! Thanks to Brooke & Terri for visiting him last night. Very thoughtful and much appreciated by me! I forgot to ask about his sugar, which wasn\'t leveling out either, but now that gives me something to ask tomorrow for the blog.

I have no idea how to write in Dad\'s voice! Anyhow, here\'s a synapsis of what he gave me while I was on the road (for two really long days!) Blood pressure is good. Oxygen levels are good. Been walking around the room a bit, still tight in the chest (phlegm?) spirits are good, marked improvement every day. It\'s quiet on the weekends here. Sugar is giving me some issues, but we\'re playing around with the medicines. Yep, that\'s it. Still debating the extended skilled facility. I will fight tooth and nail with him on this. I\'ll probably lose, but he knows what he\'s doing. Thanks, everyone, for the kind words. I think Dad did a good job, but I\'m a little biased :) And Happy Mother\'s Day to all the moms who follow Dad\'s blog!

As you can see, Dad had his first experience with the iPad this afternoon. Since I do have to return to Nebraska tomorrow, Dad and I made a deal. He calls me every day, and I will update the blog in \"his voice\". I will also read him each guestbook entry, so keep \'em coming. We discussed that many heart surgery patients suffer depression. I think social media such as this helps stave off that feeling of isolation. And while it won\'t be the same as his lovely daughter visiting him daily, it will help. Dad is doing MUCH better than yesterday. Marked improvement in all areas. He\'s now free to walk about as he\'s only encumbered by 1 tube...oxygen. Yay! Thanks to \"the Ninja\" who visited today. Sorry I missed you and good luck on your surgery as well. I should return to the Cleveland area in a few weeks to check on the patient. Thankfully I\'m comfortable with the progress and look forwards to talking a walk around the neighborhood with my Dad soon!

Typing on this thing not like mom\'s prewarUnderwood. I\'m not sure where earlier days went,but thursday found me comfortable on the other side of the tower,beautiful room,fantastic view of horizon . Spent Thursday Chasing the irregularities that remained from surgery, and today finally started on REHAB. Walked fifteen feet Tomorrow, Jenn starts home, and I get to interview prospective skilled nursing facilities. End of message.

My apologies for the late entry. Between working and trying to keep track of Dad, last nights entry just didn\'t happen. Dad got into a very nice room about 3:30 - 4 PM yesterday afternoon. Again, he has super nice nurses and caregivers. He is in MUCH better spirits, ate dinner, and when the Sudoko book came out, my presence was quickly forgotten... LOL! Anyhow, it appears that all will go well, with the exception of the fact that I have to return home and leave my Dad. I have obligations that I must keep. And it breaks my heart. Needless to say, we tried to \"schedule\" this, knowing that it probably work out. But again, I know he\'s in the best hands possible. Additionally, by the amount of texts I have gotten from his friends, I know he won\'t be alone. As I went to the gym this morning, I realized that I need to make more changes in my life. I am truly my fathers daughter, with a few exceptions. I hope my dedication to working out and eating better will be a model for Dad. But seeing what he went through made me realize that I need to change some of my ways. I can run a 5K, but I still smoke. Dad quit smoking years ago, and yet... here we are, just having had the big surgery. My only concern now is aftercare. I\'ve tried to \"compromise\" with Dad about his rehabilitation. I want at least 1 week of aftercare in an accredited facility so that I can fly back and take him home. He\'s independent and wants to go home. I get it. But we need to think about what\'s best for his recovery, not what appears to be easy. My concern is the length of time that he was in ICU. If that is any harbinger of how long his rehabilitation will take, then any added assistance will only help. I also get that rehabilitation in a skilled nursing facility is also an \"old age home\" in his mind. And in no way is Dad OLD!!! I\'ll go visit him this afternoon and I\'ll take the iPad for him to see this. He looks forward to the guest book entries. Thanks HVJ family, for your prayers, thoughts, kind words for both Dad and I, and mostly for your advice! Jen

If this was Facebook, I would \"like\" all your Guestbook messages. Please know that I share them all with Dad, plus they are there for prosperity so he can review at his leisure when he gets home. Dad asked me tonight if I was posting. I hadn\'t because everything changed after Monday night. My father\'s over all health is poor, at best. And there are some mitigating circumstances that aren\'t my story to tell. Due to circumstances of his health, he remains in ICU. I (or we) made the mistake of not bringing his CPAP machine with us to the hospital. We asked if we should, several times, but they assured us they had the same things available. However, they have newer masks and such, and none of them were comfortable to Dad. The other medications they gave to calm him caused his respiration to become reduced, his oxygen levels dropped and he needed to be intubated again. They extubated him this afternoon. When I saw him tonight he looked smaller, somehow, and defeated. There\'s very little I feel that I can do for him. He asks me constantly to get him out of there. It\'s heartbreaking. I brought in his machine and I hope it works out better for him tonight. The nurses have all been wonderful and supportive. I know that these things take time. I hope to bring you better news tomorrow.

I took my iPad to Dad in the ICU at lunch today. I asked permission first!! He read my posts and them promptly went to the guestbook! I\'m supposed to tell everyone thank you for their thoughts and well wishes. I\'m sure Dad will be back online in no time. Today is better. I went in to see him at 6 AM and he was good. He had a really goods nights sleep. I told the nurse to call me if he needed me, since I opted to stay at the hotel last night. I got a call about 9:30 saying that he was sitting up in his chair and that he would like me to come over, because he knew he\'d be tired later. So I did, and you\'ve never seen anyone more proud. But I could tell it wore him out. I went back at lunch and he\'s still good. Not getting out of ICU today, but that\'s OK. His vitals are improving, they\'ve weaned him off of several IV meds and have moved on to oral meds. Drainage is good. Just need to keep that blood pressure constant. I\'m headed over there for dinner, although he said he wasn\'t cooking (go figure!). Again, thanks for keeping him in your thoughts and prayers. Jen

Sunday has turned into a very long day. At some point last night, Dad\'s heart rate became erratic. I know I will spell this wrong, but his heart went into atrial fibrillation, which they tell me is not at all uncommon. Additionally, they are having issues getting his blood pressure up and maintained. Again, I am assured that this is normal. They did take 1 of the 2 drainage tubes out, which is good. Dad is in decent spirits, I suppose. He\'s not complaining to the nurses at all, but wants \"out\". I saw him twice today. He\'s semi-sedated, of course, from the chest/back/shoulder pain. And a bit disheartened by what is going on. His nurses (wonderful people!) have been upfront and honest with him, and have told him that he may not be getting out of CVICU until Tuesday or Wednesday. I\'m stressing positive thinking and even joked about sneaking in his beloved Sudoku books in. I\'ve opted to get a room at the hotel attached to the Clinic. That way, tomorrow morning, when the PA\'s and then the Doctors do their rounds, I will be there. I felt that it would in my best interests to be well informed and to show my Dad my support. Thank you for all the well wishes, prayers and virtual hugs. We are not disheartened, just a bit frustrated. Dad likes his plans/schedules, as does his daughter!!!

Went to visit Dad today. He\'s alert and flirting with the nurses! He\'s being a good patient, in his words! Having a little issue stabilizing his blood pressure, so his stay in ICU may take another day, but they say it\'s normal. The nurses at CCF are the best! I told him that I updated the blog, and he was glad for that. Wants to keep you all informed of his progress. I got another nap in today, so my spirits are good as well. Thanks for the well wishes and prayers. They are much appreciated.

So, my Dad asked me to update his blog. This is Jen, his daughter. I was pleased to see my Dad embracing technology and shocked to hear he was blogging! Thank you, HVJ, for your shared input, useful tips and for giving my Dad an outlet he hadn\'t previously had. I also added a picture, which I\'m sure he\'ll LOVE :-) Dad\'s surgery was rescheduled for 6 AM Friday. We arrived, on time, and had a short wait until they took him into Pre-Op. After he was checked in, etc., I went back around 6:45 AM (Dad is big on the timeline, so I will try to approximate how he would update you all). I felt that he was rather relaxed, considering. All the nurses and intake specialists were WONDERFUL; cheerful, pleasant, cracking jokes. Met with Mike, the Clinical Navigator. Dad will have to explain this role later, but essentially, Mike was a liaison between the OR and the OR Waiting room. Wonderful man! At 7:35, Dad was wheeled up to surgery. This was the easy part, for me... I went to get coffee and breakfast. To the families and support groups of those undergoing surgery, here\'s my advice. Take time for yourself. The Clinic tells you this as well, but I will try to explain why a bit later. I was given a pager and told to stick around and the informational \"class\" was between 9 AM and 10:30 AM. Plus, if there are issues, you want to be near. At 9:46, the first incision was made. The Clinical Navigator gave me this information, not the the pager. At 10:44 AM, Dad was placed on the heart/bypass machine. And by 10:30, I was in the recommended class, learning about (but not retaining) what was going on behind closed doors. I commend the Clinic for trying to keep the family/support group informed, but honestly, I was not processing any information. As I sat in the waiting room, imagining what was going on, I realized that I had a grave error in judgement. I came alone. I thought, well, I have my kindle, my iPad, my laptop, my cell phone... what other needs could I have? Turns out, quite a bit. Several people had offered to come and sit with me, but I thought that would be a waste of their time. I learned that it wouldn\'t have been. And while you will share war stories with other people in the waiting room, you will NEED to have something to occupy your mind. I found that reading made me want to sleep, the games didn\'t keep me amused and as sleep deprived that I was, TV had no interest to me. If at all possible, bring someone with you! Around 2 PM, I was starting to worry. All surgeon\'s have different practices, I learned. Many will speak to the family when the surgery is done, but prior to closing (I think because they have other doctors close the incision). Not our Surgeon. He won\'t speak to the family until the patient is admitted to the CVICU. You know all is well, because no news is good news, but it seems like EONS before you get the page. I like Dad\'s surgeon. He\'s plain speaking, direct and personable. We had a frank discussion about circumstances surrounding my father\'s recovery, my concerns about the fact that I don\'t live in the same state, let alone the same region of the country as Dad. Have your questions written down when you go to see the surgeon. Make sure you ask WHEN you speak to him next. If he says he will talk to you during rounds, and you know you won\'t be there at those times, ask if you can get updates through his office and get the phone number. As a doctor friend of mind told me, doctors LOVE an informed patient/family. And they love to see you bring notebook and pen! I was allowed to see Dad around 4 PM. And if you think you\'re prepared, you are NOT! There\'s water gain, there\'s the breathing tube and there is a lot of activity going on in the CVICU (CardioVascular ICU as they call at CCF). But, I thought that Dad looked good. Remember, they can HEAR you, even though they are still someone under the affects of the drugs, so watch what you say. The first visit is short, as they are still monitoring, setting up and possibly working on the patient. Dad\'s color was good and he wasn\'t as puffy as I thought he\'d be (they can gain vast amounts of water weight from the fluids from surgery). What they didn\'t tell me what that there are inadvertant grimaces of what I thought was pain. But they assured me that it was reflexive. I then took time for me. DO NOT FEEL GUILTY ABOUT THIS. I heard several peole in the waiting room saying they didn\'t want to leave, that the patient needed them there. Uh... No they don\'t. The patient has NO CLUE. As as the Nurse Liaison told us, the patient will be cranky the next day as they have been poked and prodded all night and the brreathing tube will annoy them and if YOU are cranky and not well rested, then... day 2 will be a rough day for the both of you. Take time for yourself. I came home and took a nap, ate a good dinner and just decompressed! I went back around 9 PM. Dad was having issues with his blood pressure (low) but was doing well on the CPAP tests, which was a clear indicator that the breathing tube would be removed sooner rather than later. I went back in around 10:30 PM and said good night. He nodded his head yes and no and I left him in the capable hands of his night nurse (sorry I can\'t remember her name). CCF give you an update via phone at 6 AM the following morning. Ours was good. The breathing tube was removed during the night and Dad was calm and responsive. Still working to get his blood pressure up and they had given him several units of blood during the night. I asked if this was normal or of concern, they said normal. I will head down there this morning and, judging by Dad\'s response to me, will decide how long I stay. I\'m looking forwards to hearing that he\'ll be off the CVICU floor maybe tonight or tomorrow AM. Then the work begins!

Buddy hung around today, kept my mind active. Made my last little list, with prompts for all the gargle, jells, and Antimicrobials. I am not forgetting a thing. Fear is out, organization is in. Jenn picks me up at 5:00 am... thanks for thinking of me, HVJ John Teeft

I spent the last three days just moping around. Made \"to do\" lists, then did nothing. I have poured over CClinic notebook, Adam Pick\'s delightful blog review of that institution,and many,many HVJ postings. They really do help calm the soul. Thank you all so very much. Surgery report time is 5:15 AM, may 4th. No partying on the May 5 holiday. John Teftt

Got a lot of good feedback when I asked a few weeks ago.Decided to go farther. Limiting factors: I am categorized as \"morbidly obese,\" I have a relatively weak lower back. I live alone. I felt that a lift chair was warranted under those conditions. Eliminated the lever arm recliner type immediately. Found a niche class of chair--INFINITE POSITION LIFT CHAIR. This chair is marketed to knee/hip immobility people as an upgrade to \"lift chair.\" Able to buy a quality chair on-line less than $650.00. It is comfortable. I can see myself \"living\" in it a week or so post-op. No insurance (yet), but well worth it.

An error in my 4/25 post. TCI is not cute!!! This was to be the easy day. Was told by staff dentist that an extraction had to be done , or NO OHS. So at 11:00 they yank two stubs lurking under my dentures. Been there 15 years....today they gotta go....the rest of TCI was informative, but less eventful. Met with my Surgeon with bloody gauze pack in mouth, denture in shirt pocket. Didn\'t bother him. Jumped right into discussion of potential bypass surgery. Very clearly over-riding reccomendation of Cath Lab Doctors. I opted to do the bypass at the time of AVR. By this time I was completely sold on Dr. Lytle. As expected, we go with pig or cow. Risk analysis better than 2%. Drove home in traffic with head spinning, full of details. Surgery next Friday, early, I hope. John Teeftt

Completed 2 of 3 preop days. 4 pulmonary tests, chest xray, electrocard, blood work (8 vials--ugh) cardiology staff visit. 2 vascular exams, echocard, and last but not least, the dreaded Heart Cath. YES I AM TIRED. CClinic handled very smoothly.Only once in two days was I off schedule, and then at most 20 mins. Routine tests--basically to build a current file for the Surgeon. Heart Cath duplicated two year old results.Up to Surgeon to ignore, or do bypass at same time. Like a 2 for 1 sale. 35-40% blockage on one artery. Leg veins measured. cath comment #2: I have lots of groin scar tissue. Dr explained that if this was a problem, last choice would be wrist, due to risk of stroke. Hmmmm. But did get thru on first groin try Tomorrow is several hours in the TCI (to come in) unit...how cute. Visit with Anesthesiologist, Nurse Practitioner, and finally, My Surgeon. Then, 7 more days of waiting. John Teeftt