Joy's Journal

Weeks 9 & 10 are behind me now. I just completed cardiac rehab session #23 last Thursday so that’s coming along. There was one blip during rehab last week. I was on the treadmill when suddenly two nurses were on either side of me asking if I felt OK. I did. Seems the monitor detected an irregular heartbeat so they had me stop, have some water & continue on. There were no other incidents that day or since. I self-monitor by taking my pulse several times a day & it’s always regular when I do so I believe that was a brief anomaly. Still, it’s a good example of the benefit of being monitored. I cut back again on Lasix & potassium a few days ago so now I’m taking one dose in the morning only. My weight is stable so it looks like I’m adjusting OK to that reduction. Fewer pills – yea! In short, I’m feeling good. I believe the larger sized aortic valve my surgeon told me he gave me has contributed to an ability to receive a deeper inhalation which I’m enjoying for sure. My sternum is going to take a while to be 100% but that’s to be expected. I just had an echo this morning & the tech commented that I seemed to be doing well after all that was done to me. I have to agree. For those reading this who are in my yoga class, I will be returning to teach on Tuesday, 7/23. I am looking forward to that!

Week 8 went by uneventfully, a good thing. I saw my cardiologist today. As I’d hoped, he OK’d discontinuing Amiodarone. He showed me how to take my own pulse & I am to become familiar with what’s regular & what doesn’t feel right & contact him if it seems off. I can do that. He also reduced my Lasix & potassium by 1/4. After 4 days, I can reduce it further unless I find I’m retaining too much fluid (by monitoring my weight daily which I do anyway). If all goes well, I’ll be taking ½ of the Lasix I do now in a few days. So, I’m way happy with that news. He ordered an echo for me which I’m hoping will show an improvement in my ejection fraction. Before the surgery, I was hovering in heart failure territory but as my surgeon puts it, taking the valves which are now replaced/repaired “out of the equation” might be beneficial with that as well. That would definitely be nice. I’ll see the cardiologist again in 3 months & absolutely feel I’m being monitored more closely after this surgery than I was in 2010. Part of that might be because of the “magnitude” (quoting the surgeon again) of this surgery but I choose to think I just have a really good cardiologist this time around. For those in my yoga class, I intend to start teaching again later this month. I’ll keep you posted via this journal &, if you’re on my e-mail list, I’ll be sending a notification shortly before.

Other than some minor sternum discomfort, week 7 has gone well. The lingering cough is completely gone now. It has been a good week with some socializing, enjoying great garden tomatoes & classical music CDs from yoga friends, lunch with a friend from teacher training, hearing from people who care about how I’m doing & more. As the t-shirts say, Life is Good. Cardiac rehab session #12 was last Thursday & it was time for my first evaluation. Basically, one of the nurses went over my progress which is on track. Even though I don’t have high blood pressure or blocked arteries, she went over those as if I did. There must be a check list of required topics to be covered & it seems to be geared more toward “regular” heart disease vs heart valve disease. That said, I am benefiting from the monitored exercise & that’s the main thing. I am scheduled to see my cardiologist at the beginning of July & hope he will reduce some of the many meds I’m still taking. Specifically, I’m hoping to say adios to Amiodarone & for a reduction or elimination of Lasix & Potassium. We’ll see if I’m being too optimistic.

I think that this week (week 6) I entered the “hey, I feel pretty good” phase of recovery. In the last few days, the cough I’ve had since I was in the hospital has lessened & is nearly gone. I sometimes still feel as though I’ve run out of gas but those times are becoming fewer & fewer. At least some of feeling better was due to seeing my surgeon on Wednesday. Naomi said her post-op felt like a graduation & that was a good description for mine as well. I asked for a copy of my 4 page operative report & attempted to read/understand it. Much of it is way over my head but, for what I can understand, all I can say is Wow. I’d been told my case was complex but reading the report made me even more appreciative of Dr. Kerendi’s skill as a surgeon. I also found out at the appointment that he had been assisted by the senior surgeon in their group. I knew that their group made a point of having 2 surgeons at each surgery but feel beyond fortunate to have had the 2 surgeons I had. I was given the go-ahead to drive & sleep on my side vs. only on my back. I can practice yoga as long as I’m careful not to stress my sternum & did exactly that when I got home. The tape that was placed over my scar was removed & I have to say, it looks darn good. It’s only 5 ¾ inches long & looks like it will be very discreet once it fully heals. I also got the OK to use a scar cream to help it blend into me a little better. My last time to see my surgeon will be in a few months when I have a CT scan to verify that all my dacron tubing is as it should be. The annual CTs I’ve had since 2010 will stop because my aortic aneurysm was repaired as part of this surgery & it no longer needs to be monitored. So, bit by bit, I’m starting to feel more like me again. Pete & I had dinner tonight with a group of friends who all lived in Colorado at some time or other. So - headed toward normal. Thanks everyone for all your support & best wishes for those with surgeries coming up.

Not a lot to report for week 5 except it was a full week of cardiac rehab. I can go up to 4 days per week & that's what I did. I start on a recumbent bike (no arm movement yet) & finish on a treadmill. The nurses take blood pressure readings before I start, on each machine & after I finish. They also have me put on the sticky things (sorry, I really should get the official name) so they can monitor my heart throughout. I have more energy this week so I'm going to attribute it to rehab & say it has been a positive step in my recovery.

Week 4 I saw my cardiologist’s PA, Neva, on Tuesday & she tweaked my meds a little. Amiodarone was reduced from 2X per day to 1X. My latest labs indicated that, while my iron is better, it’s still too low so I’ll continue the multivitamin with iron for a while. My platelets are a little high which she believes is due to having recently had surgery but she’ll monitor with more labs in a month. Potassium is in normal range. There have been so many changes to the potassium pills in the last 10 days or so that it’s hard to keep track. 2 per day, then 3 per day, & now a lower dose but 4 per day. Good thing we have a patient & kind contact at the local grocery store (HEB) pharmacy. I’ve had a cough since the chest tubes were removed in the hospital & Neva ordered a chest x-ray which indicated either scarring from the surgery or perhaps a mild pleural effusion. Mild is the key word there & I was reassured with those results. I’ll be seeing my heart surgeon on the 12th & the cardiologist on July 1. I started cardiac rehab Thursday. The program is 35 sessions. I have been up & down with my energy levels since my last post but there seem to be more ups than the previous week. I’m hoping cardiac rehab will keep that trend going in the right direction. Generally, all’s well & slowly improving. I’d like to thank everyone for your many expressions of support – here on the HVJ site, cards, e-mails, FB messages – all the ways you’ve reached out are greatly appreciated. Yesterday was Pete’s & my 44th anniversary & I can’t say enough about what good care he has taken of me through this. I am indeed a fortunate person.

It has now been 3 weeks since my surgery. I received a call from my cardiologist’s office yesterday that my labs indicated my potassium was still low so that has been increased to 3X per day vs 2X. I’ve been taking a multivitamin with iron & been eating more beef than I normally do to address the anemia. I’ll go for more labs in a week or so to see if all that has been effective. I’ve also started walking at the local fitness center’s indoor walking track. Works well for me right now as there are no hills that way nor is there the heat & humidity that one finds in Central Texas this time of year. I am scheduled for a cardiac rehab interview next Wednesday. Since my last update, I can’t say that I’m seeing daily improvement or that I’m feeling all that different. It’s a no worse, no better situation right now. Fatigue is a constant companion. Pete is still doing most of the cooking but I’m participating more & more on that front. We’re still going here & there each day with the requisite rest periods in between just like my last update so it’s not as if I’m an inert blob or anything. I think I’ve just entered that period that one of my fellow HVJ journalers from 2010 called “doing your time”. There’s a stretch where it doesn’t feel like there’s progress being made. No doubt progress is occurring on the inside nonetheless because one day you realize – hey, I feel pretty good. While today isn’t that day, I’ll be past this particular period before long & be better able to recognize improvements. I learned with my surgery in 2010 that, if I hope to sleep at night, I cannot nap during the day. I discovered that listening to a recording of yoga nidra (nidra means sleep) during the day helped me have enough energy to get through the day without napping. Yoga nidra is a meditative practice which includes progressive relaxation. You don’t fall asleep (or you try not to) so, while it’s restorative like a nap would be, it’s not a nap. So, I’ve been doing that again this time & again it is helping me sleep at night. I do better with recordings that are shorter – maybe 20 minutes long, no more than 30. If they get much longer, I find I get restless. I imagine other relaxation recordings would have a similar effect for any of you who are like me regarding naps preventing nighttime sleep. Thanks to everyone for your support. It helps to hear from each & every one of you.

Today marks 2 weeks since my surgery & it has been a mixed bag. The first couple of days I was still in the hospital, coming home the Saturday before Mother’s Day. That morning, the amount of fluid in my chest tubes had finally decreased & the doctor in charge at the hospital pulled them out. The next obstacle was potassium levels which were low due to all the diuretics. The nurse loaded me up (8 pills) that morning & my noon labs showed a level sufficient to let me go home. The following Tuesday I had an appointment with my cardiologist’s PA, Neva. I’d been told to make an appointment 1-2 weeks after my release to bring them on the team & this was the closest they could come. I was happy to get in & happy when she reduced my amiodarone from 3X per day to 2X. I also found out I’d lost a lot of blood during surgery, requiring transfusions, & am anemic as a result. Neva told me to get some multiple vitamins with iron & focus on eating more beef. She also gave me a list of other iron sources, a good thing because, while I don’t dislike beef, I just can’t eat it every day. Dr. Wozniak (the cardiologist) also stopped by & pronounced me an “amazing human being” for having been through the surgery & doing as well as he feels I am. He said he’d been in touch with my surgeon regarding my progress via text several times. I’m sure he tells others they are amazing as well, but have to say, it was nice to hear. I am also relieved to be monitored by the cardiologist earlier in the process than I was my last surgery. I’ll be going back in 2 weeks & will see the surgeon about a week later. During this 2 week period, we’ve been out for short trips, carefully scheduled to not run out of oomph – the grocery store, to have some labs done for Neva, a movie, a restaurant. Little by little. Thanks to everyone for the support in all the ways it has been expressed. It helps so much.

Well, it was an 8 day stay at the Heart Hospital of Austin for me. I believe nearly everyone, or at least many of us, run into some hitches in our recovery & mine is no different. Specifically, while still in ICU (where I was for 6 days), I had a 2AM episode of A-fib. I pretty much got what felt like all the attention of the ICU staff for that. They set me up with with an IV drip of Amiodarone & I've brought home a prescription for that as well. My heart did get back in sync within a day. The longer issue involved the fluid that drains into the chest tubes. I had the same problem last surgery but was released earlier & wound up with a pleural effusion. Again this time, it just wouldn't taper off but finally did last night & I was released this afternoon. I'm tired & so is Pete but we're both glad to be back to our home base for the rest of the recovery. Thanks to everyone for the encouragement & keeping me in your thoughts.

My husband, Pete, posted those last 2 photos to practice with the journal using his phone because he’ll be doing updates when I’m in surgery & for a while after. Today’s pre-op took 3 hours & 15 minutes, an involved process. For those who haven’t had that yet, figure on spending a chunk of time there as they have lots to do. There were medical history questions to answer, medications to review, labs, chest x-rays, an instructional video to watch, a talk with the anesthesiologist, testing by a respiratory therapist & practice using the spirometer. Many forms to sign as well, some on a tablet & some on paper. I was given a bottle of special antiseptic soap to use in the shower tonight & tomorrow morning before I head down for the surgery appointment at 5:30AM. The nurse, Laura, was very organized & took us through the whole process start to finish.

In 2010, I joined this community & began my journal about my valve surgery. Nearly 9 years later, it is time for that valve to be replaced again. I am a part time yoga teacher & today I taught my last class for a while in preparation for surgery & recovery. Teaching & seeing my friends & students is something I will miss so letting that go for a time feels like a big step in the process. My surgery is scheduled for May 3rd to replace my aortic valve, repair my mitral valve, & remove & replace a section of aorta that is enlarged. Total feels like a kind of “here we go” moment, I suppose. My pre-op is May 2nd & I’ll be at the Heart Hospital in Austin at 5:30AM on May 3rd for the surgery. My surgeon tells me I’ll be on the heart lung machine for 1.5-2.0 hours & that his part of the surgery will be more like 6 hours. While I have been through this to some extent before, I’m sure there will be differences & I’ll be interested to see what those are. The first that comes to mind at this point is that, this time, I am symptomatic whereas the first time I was not. I look forward to reading all of your journals & wish all of us well.

Hi all. I hope you’ve had a good week thus far. I taught my first post-surgery yoga class on Tuesday (then another today). I was so happy to see many returning students as well as a few new faces & I received a warm welcome back. Lots of hugs & kind words. One of the students, Celia, was kind enough to offer to demo some of the poses so it was nice to be able to rely on her help. I tend to verbally guide the class quite a bit & did run a bit short on air a time or two. I suspect that my lungs aren’t quite a strong as they could be after the fluid troubles a few weeks ago, but that will improve with time & usage. Cardiac rehab is going fine – I’m in week 3 of 6. They are increasing my time & intensity on both the treadmill & the recumbent cross trainer so it is more challenging each time. One day last week, the cross trainers were tied up & I tried one of the stationary bikes. I went the recommended speed, but I guess my heart wasn’t up to it & after about 5 minutes my heart rate went up to 135. I really didn’t realize it & was just pedaling away, feeling a little winded, but that was about it. The nurses were suddenly paying close attention to me, had me slow down, checked my blood pressure & stuck close by until everything normalized. So, there you go, that’s why we go to rehab – to be monitored. I haven’t been back on the bikes yet. Thank you all for hanging in there with me throughout all of this. Your support has been more than I could have asked for. I probably won’t post as often as I’m starting to feel like I don’t have that much to offer now. I’m feeling almost normal most of the time which is wonderful. Finally, someone left a note in my guestbook asking about yoga but did not sign a name. Please let me know who you are & I will be glad to respond. Have a good weekend everyone.

All good news this week. Yesterday, I saw my cardiologist for the last time, at least for 3 months. After reviewing chest x-rays to ensure I did not have more fluid build up, he said things looked good enough to send me on my way for a while. There is still a small amount of fluid around my lungs, but not enough to worry about. I’ll take one more week of Lasix, then cut back to ½ of a dose for another week, then stop taking it. Yea – fewer pills! This morning I completed my first week of cardiac rehab. I enjoy talking with the others in the program & am reassured by the fact that my heart is being monitored throughout. I plan to resume teaching yoga classes at the Sun City fitness center on Tuesday, 9/21. Although I’ll need to avoid any poses that would place stress on my sternum, I can do that & it should not be a problem. Yoga is infinitely adjustable. This is particularly good news for me & I am so looking forward to seeing everyone again! Have a nice weekend.

Today marks week 6 since my surgery & things are looking up since my last post. First of all, the 2nd thoracentesis done by my surgeon has proven to be successful. Since then, each day I’ve coughed progressively less & am now not coughing at all. Almost from the get-go, I felt better – reduced coughing, more energy, deeper breaths. When Pete & I left his office, we went to lunch & I actually wanted to eat for the first time in a long time. It sure felt good to enjoy food rather than forcing it down. So, somewhat to my surprise (after the first procedure did not last), 8 days later I’m ready to call it a success. This morning I had a follow-up with the cardiologist who said my lungs sound clear & that my recovery is on track. He said that, aside from the fluid problem, he felt my recovery has gone well. Maybe the best part was that he released me for cardiac rehab. Yea! I’m scheduled tomorrow for an interview & will begin the program from there. All good news this week. Thanks to everyone for all the encouragement. It helps more than you know.

Last Thursday, I went for a follow-up appointment with my cardiologist. I was feeling short of breath, coughing continually & had zero energy. The news - my pulse rate is too high & I needed to increase my dosage of metoprolol to try & get that down. OK. I can do that. Then, he told me that, in a small percentage of people, the body overcompensates for the trauma that occurs to the heart during surgery. As a result, more fluid is produced & accumulates around the lungs repeatedly. It’s called recurrent plureal effusion. He said I needed treatment for this, possibly with steroids, & referred me back to my surgeon in Austin. He offered the option of going to a local lung specialist, but I felt it better to go to someone who was familiar with everything that had been done to my heart valve & my aorta. He told me no rehab (or yoga) until the fluid situation is under control. This morning was my appointment with Dr. Oswalt, my surgeon in Austin. After a chest x-ray confirmed the fluid was back on my left lung, he did another thoracentesis in his office. He explained that there is a viewpoint in some the medical world that removal of most of the fluid is the way to do a thoracentis, but that his approach was to try & get it all. That way, he said, the space is no longer there for the fluid to come back again. He said that today’s procedure may take care of the fluid & that the steroid treatment may not be needed. Let me tell you, this was definitely a more thorough procedure & it wasn’t pleasant. At one point, he told me I’d feel like he was stabbing me – I did. He explained when the catheter was in the area of the pleura I would feel that the pleura has lots of nerve endings – oh yeah, it does. Ow. After it was over, there was 2100 cm of fluid removed vs. 1200 from my first procedure. My Lasix (diuretic) is doubled for 3 days to fend off the return of the dreaded fluid. I’m taking Advil for the areas where the catheter traveled. This afternoon, I am breathing freely & not coughing anymore. My fingers are crossed that this one will hold!

As those who maintain a journal on this site know, we lost one of our own on Thursday, Lori B. I live in a small town north of Austin & subscribe to the Austin newspaper, The Austin American-Statesman. There was a nice article about Lori B. in that paper this morning that I thought I’d share. I’ve attached a link to the article &, in case that does not work, I’ve copied the text of the article below the link. http://www.statesman.com/news/local/advocate-for-educating-children-with-down-syndrome-dies-870874.html?cxtype=rss_ece_frontpage When people remember Lori Barta, they talk about her boundless energy, laughter, big heart and care for others. They talk about how she was passionate about educating children with Down syndrome, how she wanted to leave the earth better than she found it and how she passed that lesson on to her three girls. Barta, 39, who served as the president of the Down Syndrome Association of Central Texas in 2008 and 2009, died Thursday after complications following heart surgery. \"This is truly a catastrophic loss for us,\" association President Suzanne Shepherd said. \"She was our heart and soul.\" Barta was involved with the association for six years after the birth of daughter Hannah, 6, who has Down syndrome. Barta educated and trained teachers and parents and set up programs that taught children with Down syndrome math and reading, Shepherd said. She also put together conferences and seminars that provided state-of-the-art educational research for parents and teachers, Shepherd said. \"Lori cared about every child, not just her own,\" Shepherd said. Barta and her husband, Adam, had two other daughters, Emma, 7, and Sarah, 3. The family lives in Northwest Austin. In the 1990s, Barta earned a degree in communications from Texas A&M University and a law degree from the University of Texas , family members said. She loved dancing and the song \"Dancing Queen \" by ABBA , her family said. Besides her husband and daughters, Barta is survived by father and stepmother Jerry and Susan Tullos of Livingston; brother Michael Tullos, and his wife, Erin, of Bartlesville, Okla.; brother-in-law Mark Barta and his wife, Barbie, of Toronto; four nephews; and one niece. Barta was preceded in death by her mother, Mary Tullos . Visitation will be from 6 to 8 p.m. Monday at Weed-Corley-Fish Funeral Home, 3125 N. Lamar Blvd. A memorial service will be held at 2 p.m. Tuesday at the Episcopal Church of the Good Shepherd, 3201 Windsor Road . In lieu of flowers, her family asks that donations be made in her name to the Down Syndrome Association of Central Texas.

Hi everyone. Week 4 has been the week of working on fixing the fluid build-up. Lasix helped for the first few hours after I took it, but before the next dose was due, it was back to coughing & difficulty breathing. After 3 days of that, I called the cardiologist. Yesterday morning, he had me go in for an echocardiogram, which indicated a larger amount of fluid around my left lung – too large for the Lasix to be effective. In the afternoon, I went for a thoracentesis, a procedure where a catheter is inserted into the thoracic cavity to draw out the excess fluid. Now that was definitely effective – more than a liter of fluid was removed which made plenty of room for breathing. The plan now is to continue the Lasix to reduce the fluid on my right lung where the accumulation is less. Right now, I’m enjoying deeper breaths & less coughing & I hope to heck it stays that way! Pete said that last night I was breathing in & out more slowly & regularly as I slept. I believe that breathing better will also give me some more energy as it has been very low lately. Surely that’s related to the inability to breathe fully. My scar is trying to blend into me. The bruising is long gone. There’s no pain. In short, once I get the excess fluid out of me, I believe I’ll be back on track. I’m thinking cardiac rehab is right around the corner – I have my first meeting about that tomorrow.

My first follow-up with a cardiologist was yesterday. He did not think my cough was caused by the metoprolol but is letting me wean myself off of it. He said I looked pale & after checking under my eyelids, ordered some blood work to check my blood count since I needed transfusions during surgery. I’ve had more shortness of breath & been more tired the last couple of days so he ordered a chest x-ray to see if I had any fluid around my lungs & heart. Apparently I did while I was in the hospital. So, off we went to get the x-ray & blood work. We had to stop at two different places for these & I was beat when we got home. Today, his nurse called – sure enough, I do have fluid around my lungs & heart. So I’m back on Lasix, a diuretic to try & get rid of it. What would have been a 2 week follow-up is now 1 week which is good as I want to be closely monitored for this. No word on the blood tests yet – might not hear about that until my appointment next week. A bummer & a set back, but I’m encouraged that it has been identified & can be addressed. Thanks everyone for your notes in my journal & for staying in touch with me in other ways. It helps to have your support.

Hi everyone. Progress in week 3, I think. I’m still sleeping well at night. I have a bit more energy in the morning than I did at this time last week although mornings remain the most challenging part of the day. We’ve been out for short excursions – stores, restaurants, movies. I’ve used the indoor walking track at the local fitness center as it’s too hot right now to walk outside. Whenever we go somewhere, Pete drops me off out front & picks me up afterward in order to limit my exposure to the heat which really zaps me. I’m cooking dinner again & doing a few more things around the house. One difficulty has cropped up – coughing. I’ve had a slight cough since I was in the hospital, but in the days 7-10 days it has worsened. It’s an odd one – reminds me of a cough that comes at the end of a cold when you’ve been coughing so much that you just keep on coughing – like a habit your body can’t shake. Makes it hard to have a conversation. Also, it’s not too bad in the mornings, but worsens as the afternoon rolls around. I cough through the evening, but once I go to bed & am still for a few minutes, no more cough. The next morning, the cycle begins again. I’ve tried the Fisherman’s Friend cough drops & they do offer temporary relief. I suspect the cough may have something to do with the beta blocker medication I’ve been on since the surgery – Metoprolol. I read on the People’s Pharmacy website that it could cause bronchspasm. I have a follow-up appointment with a cardiologist tomorrow & intend to ask if I can start weaning myself off of it. Has anyone else experienced a cough that may have been caused by Metoprolol? Other than the cough, I’d say my recovery is pretty much on track this week.

I wish I could say there was a huge difference in how I feel since last week, but that is not the case. There have been some improvements though. I am sleeping fine now. The key was to eliminate daytime napping so I’m sufficiently tired & can sleep at night. In the place of that nap, I substituted a relaxation tape because I was tired & in need of rest in some form. I imagine any relaxation tape would be helpful, but I chose some that were yoga-oriented (of course). Specifically, the practice is called Yoga Nidra, which means Yogic Sleep. The idea is to progressively relax without falling asleep. At the end, you should feel more refreshed than you would after sleeping. I have to say, it works for me. I’m not groggy like I am after a nap & when I need to sleep later on, I can. I find I’m such a slow starter in the mornings since the surgery. For several days, I tried getting up & taking a shower first thing. The shower just took every speck of energy I had. The last couple of days, I’ve had breakfast before showering & find that having something to eat first helped – still tiring, but not quite as much. I’m hoping this improves with time. I mean, really – should a shower be such a big energy drain? I’ve been out of the house some – grocery store, a couple of movies, fitness center walking track etc. Short trips, but I enjoy getting out (and I don’t wear my PJs, Jenny). So, just mini-steps this week, doing my time. Oh – I can open a mayonnaise jar now too – couldn’t do that last week. We’ll see what next week brings.

My post-op appointment with my surgeon was yesterday. The first thing he told us was the most encouraging – he heard no murmur. He reassured Pete that the way I now breathe when I sleep is normal (I exhale somewhat forcefully & quickly). He said that I’m probably just getting a deeper breath than I used to, then relaxing & letting it go all at once. In 2 to 3 weeks, I can ease into practicing yoga, taking care not to stress the sternum (for example, no down dog for a while). Anytime I see a dentist going forward, I will need to take antibiotics. I can lift 5 pound items now & add 5 pounds each week to that limitation. I can reduce my blood pressure medication from ½ pill in the morning & evening to just ½ pill each day. I may be able to get off of it altogether if I can maintain my blood pressure at or below 120/70 (resting). Wouldn’t that be cool? So, I said goodbye to Dr. Oswalt as future follow-ups will be with a cardiologist. Pete & I went to lunch afterward & I was not as tired as I have been other days. Pete’s theory is that getting out did me good & he’s probably right about that. I’m sleeping better now – guided relaxation in place of napping during the day enables me to sleep better at night. Also, each day I’m more comfortable in the bed. Step by step.

It has been exactly one week since my 7/21 surgery. While I’m far from feeling great, I’m sure as heck better than I was that day. I’m not taking the prescription pain pills I was given because they are what caused the nausea in the hospital. Tylenol Extra Strength seems to be sufficient. I run around the house all day in PJs which are soft & do not irritate my incision like heavier clothing does. I still have 5 pounds of hospital fluid weight in spite of a couple of days of eating nearly nothing & still having a so-so appetite. My morning shower wears me out, but I feel better after breakfast. I have very little energy – I do a little something & rest, do a little something & rest. Most of my walking is around the house since it’s hot here although I have walked an indoor track here at our fitness center a couple of times – 3 small laps today. Pete drives me there, walks with me, & transports me home. One of my walks was a brief stroll through a local farmers market where there were still some Texas peaches to be bought. The biggest hurdle is sleeping. It is impossible to get comfortable. I’m not comfortable at any setting of our sleep number bed. I’m not comfortable in a recliner or on the couch. The best compromise has been to place a higher than normal pillow under my head (helps me breathe better) & pillows under my knees to reduce the strain on my back. Throughout the night, I use pillows like yoga props to change positions slightly & that helps some. I also found that I’d better not take a nap during the day. I tend to oversleep if I do that & then, with it being so uncomfortable, I’m not sleepy enough to fall asleep once night comes. Yesterday I tried the no-nap approach & did manage to sleep better. Enough whining – there’s plenty of good to acknowledge. I’ve received so many encouraging communications – e-mails, posts in my journal, cards. My friend Chris brought over a beautiful plant. Friends have been so good as to bring us food. My friend Diane brought over dinner that has lasted more than one night & my yoga class has organized a series of dinners this week & next. My husband is patient with my every need. I’m alive & on the mend. What more can I ask?

Ahhhh. Home.... While my surgeon & the staff at the Austin Heart Hospital are great (highly recommended by me, in fact), I just know I\'ll really start getting better now that I\'m home. I know it won\'t be quick, but it\'s another & step & that\'s a good thing. Pete brought me home at about 4:30 PM & I promptly feel asleep for an hour. After a little while, he had dinner ready. It\'s just so nice to be here. Thank you all for your notes in my journal guestbook, the e-mails & cards, your thoughts & prayers - everything. Although Pete brought them to me at the hospital, I plan to read through them again to savor all that kindness.

Things are looking good today. Joy no longer has any nausea, has very little pain, and is anxious to come home. We walk a few times each day without stopping to rest. She\'s like a caged tiger ready to spring out when the door opens. The last hold up is her blake. A blake is a flexible, hollow blub attached to a hose that is inserted into her stomach to drain the discharge that comes as a result of the operation. The amount that gathers is less and less each time, but still not low enough to send her home. Maybe tomorrow. I hope so. Pete Vera

Lots of strides today. We had to control the nausea that continued to be a problem. First, the doctor agreed to take her off the heavy-duty prescription pain pills that she was taking, and replaced it with two tylenols. That really helped as soon as the old stuff was out of her system. Then, we scheduled all of her duties. She has to blow into her spirameter ten times each hour, walk around the corridor 4-6 times a day, take a shower, eat three meals, allow constant nurse visits and monitors, see the doctor once a day, and allow the maintenance staff to clean the room. All of this makes her tired, and, at this point, she needs to rest between duties. We scheduled these duties throught the day with a rest period between each, instead of the previous 2 or 3 in a row. This also helped a bunch. When I left her tonight, she was perky, talking, reading and happy. She gets less tired, too. Tomorrow should be better. Pete Vera

When I arrived at he hospital today, Joy was up, in a chair, talking, and trying to eat a little. She really looks a lot better. She was moved out of intensive care and into her own room. Most of the monitoring equipment was removed. We walked around the corridor twice today, and she continues her breathing excerices. However, her ribs are really painful. She thinks that it\'s from being at such an awkward position during the 2 1/2 hours of the surgery. She is also having trouble eating. She eats very little and has a hard time keeping any of it down. She tires easily, but that is expected. The doctor, however, seems to think that her progress is excellent. In fact, he told us that she will go home this weekend. Tomorrow should be a better day. Pete Vera

Joy\'s operation started at 8:30 this morning and the doctor talked to me at 11:00 and told me all went well. There were no problems and no surprises. He added a bypass line to go around the plugged area of the aerotic arch. He also replaced her aerotic valve with a horse valve, stintless, that measured 23MM. When I left the hospital for the day, she was free from the tube that they stuck down her throat, she no longer needed the mask for oxygen supply and now uses the smaller tube under her nose. She wakes up now and then to shift positions and talk. She is fairly alert but drifts in and out of sleep. She does have some pain and has to take medicine for that. Everyone says it is normal, especially 4 hours after the operation. They say it will get better over the next few days. They have her blood pressure very low till all gets working better. I saw a low of 96/60. Yikes!! That is all for today. Pete Vera

My pre-admission & pre-op was this morning. After the paperwork, 3 nurses reviewed my medicines, completed tests & x-rays, had my husband & I watch a video on what to expect during & after surgery & went over more “what to expect” with us personally. We also spoke with the anesthesiologist. I was also able to see my surgeon, Dr. Oswalt, for a few minutes to get some last minute questions answered. In the morning, we’ll head back down to the Austin Heart Hospital. I’ll need to arrive there at 6 AM to prepare for surgery at 8:15 AM. This will be my last post until I get home in a few days. Pete will post some updates while I\'m in the hospital. Thanks once again to each of you – your support is a gift that I deeply appreciate.

Now that I’m less than a week away from the surgery, I am reflecting on what led me to this point. I think I’ve experienced just about every emotion there is since I found out in January that I had aortic stenosis. First came disbelief. That probably lasted the longest. I felt & still feel, fine. Unlike the 30+ years I spent in a corporate environment, I have very little stress in my life. I feel my lifestyle is healthy – how could I possibly have something like this now? Since then, lots of negative feelings have come & gone – sadness, fear, anger, frustration, you name it. On the other side of the coin, I have also experienced profound gratitude. I live in a time when heart surgeries are a reality &, once mine is complete, I will very likely feel better than I ever realized I could. I was lucky enough to come across Adam’s book, web site & these journals where I can read about & learn from the journey of others who are going through the same thing. I have the most supportive husband that anyone could ever ask for. One of my friends reminded me of that recently – the “best caregiver in the world” I believe she said. Which brings to mind something else I’m grateful for – my friends, old & new, my yoga kula from teacher training, those I’ve met here at HVJ. I taught my last pre-surgery yoga class today & am grateful for everything about our class. Each time I teach I receive more from my students than I give. They were thoughtful enough to give me a card with their signatures & words of encouragement & have all been so supportive since I first found out I needed surgery. So, I have to say that the negative feelings have long passed. Life is good & will continue to be.

It’s July, the month my surgery is scheduled & something about that milestone has made it more of a reality. Most of my to-do list is done except for a few odds & ends. I’ve read most, if not all, of the journals on this site which have helped immensely in preparing. Your descriptions of your experiences, your successes & struggles, your advice & encouragement – all are so helpful. Pete & I went to see an exhibit at UT in Austin this weekend – “Our Body, the Universe Within” & saw an actual heart with the aortic valve visible. I could readily see all 3 leaflets whereas I’m told mine has only two. I’d seen a similar exhibit a while back, but it was before I knew I had any problem with my aortic valve so it was more meaningful this time around. I’ll teach my last yoga class on 7/15 & my friend Cheryl is set up to sub during what I anticipate to be my recovery period (thank you, Cheryl!). My pre-op is set for Tuesday morning, 7/20, with the surgery scheduled for 8:15 the following morning. So, for the most part, I’m ready. I’ll be glad to get this behind me as it has tended to dominate my thoughts & plans. As Pete puts it – I’ll be “going into the shop” on 7/21 for repairs. I like thinking of it that way – fix me up & put me back on the road.