Mark's Journal

Hello to all, Has it been three months already? Seemed like the surgery would never arrive, and now it seems so long ago. My three month check up went well. My surgery was May 5 at CC for AVR, aorta root repair and a myectomy with a median sternotomy. My bovine vlave continues to perform very well. Post op, and through my 8 week check up I was experiencing moderate mitral valve regurgitation as a result of the physiological changes to my heart. As of today, that has improved to mild regurgitation and is no longer a concern. My cardiologist feels it will continue to improve, but is not a concern with the current measurements. I was very pleased to get that result. All in all it went well, and I do not have another echo for a year. It will be so very nice not to see a cardiologist for one full year!! As I look back it was an easier last three months than I could have imagined. I went to CC in early May expecting a minimally invasive procedure. My tests and needs indicated otherwise, and I was not happy about the sternotomy, but it was required for safety. It simply was not that bad. I had great care, a great facility and a wonderful family to help me through it all. I was probably back to 100% at 10 weeks, and am certainly there at 13 weeks. HVJ has been a wonderful resource for me, and I will continue to contribute where I can. If you are reading this as you prepare for your own surgery; relax, be positive and be prepared... if you do you will be jsut fine.. Best regards, Mark Keller, TX

Hello to all, Well this past Wed was 9 weeks post op for me. I would say at this point I am back to almost 100% and doing very well. I did finally make it back on the golf course this week, and felt nothing out of the ordinary from my sternotomy, and enjoyed 27 holes my first round. Back out this weekend. I have been back at work full time for four weeks now, and during the first couple of weeks I could tell at the end of the day I was tired, but that has improved as my body adjusted. A lot of travel during the first few weeks back, but no problems with that. it has cut into my walking, but still managing to get in four walks of 3+ miles per walk each week, added a little bit of running into the mix this week with no problems. The next few weeks will be busy as my son\'s 14U baseball team will have a heavy tournament summer schedule, so the days will be long and games into the evening, but I love watching him play baseball. (That is what I am doing in my profile pic) All in all I have been tremendously blessed. My surgery went well, my recovery has been extremely good. I will have a three month check up on 8/11, and hope to find the post op mitral regurgitation has improved with the left ventricle adjusting to the changes. The only thing I notice that is different is that at times I am aware of the sensation of my heart beating more than I was before the surgery. It is not racing or skipping, I just sense the feeling in my chest more than I did before. I received a Bovine valve, so no clicking, just aware of the heart beating which feels strong to me. My pulse and BP are text book normal and still on beta blockers for the time being, but that is my only med at this point. For everyone in recovery I pray yours will continue to progress, and for our friends awaiting surgery I pray you will be confident as your get prepared that everything will go fine for you. It is truly amazing what these doctors and nusrses can do to make sure you are up and running around again quickly. Best wishes, Mark Keller, TX

Greetings from Omaha, Ihope everyone continues to do well as you are in recovery and/or preparing for surgery. I enjoyed my 6 week anniversary of my AVR suregery on Wed, and also started back to work full time this week; as well as driving. With having had a median sternotomy I had to wait a full six weeks, although I did make a couple of short runs to the grocery store. This weekend I am in Omaha to enjoy some of the College World Series. Two of my favorite teams FSU (my duaghters alma mater) and TCU (my local Ft Worth school) kick it all off at 1 pm tomorrow. UCLA\'s team is staying at my hotel in Omaha and it should be a great weekend. All in all I have been very fortunate. My recovery is almost complete. For the most part I am doing everything I want, except playing golf which is still two weeks away, and excercising at levels I had not attempted in a decade. Do know as you are preparing to go through this, or working through recovery, there is a payoff on the other side of all of this - you get your health back and get to enjoy life more fully.. Stay positive and focus on the other side of all this and you will get there.. Well I am off to Rosenblatt\'s Stadium to watch batting practice wering a TCU hat and an FSU shirt. I hope everyone enjoys the weekend as much as I am going to.. Mark Keller, TX

As I read other HVJ\'s, and compare my own experience and recovery, there is definitely a bell curve for this as most things in life. I have been most fortunate as my surgery/recovery, albeit with some complications, has been to the far right of the curve allowing me to get back to my life with some degree of normalcy very quickly. I had a three week follow up with my local cardiologist last week to evaluate the pericardial effusion, and it has improved as expected. Slight change to beta blockers but otherwise all is well. My local cardiologist was somewhat miffed that I had chosen a biological valve over his recommendation for a mechanical valve due to my age. I had told him months ago this was my desire as I had no intention of going on Coumadin. So, i will likely have a new cardiologist before the three month check up. One other thing as a result of my AVR, root replacement and left ventricle myectomy is it has really changed how my heart has to work, and how hard. My aortic valve was so stenotic my left ventricle was working very hard to get the blood flow through. Now that the stenosis is gone, and the flow through the bovine valve is normal; my mitral valve has been impacted and is showing mild to moderate regurgitation. the expectation is that my heart function will adapt to the new valve and adjust its workload and the mitral valve regurgitation will lessen or resolve itself. Keeping my fingers crossed that the three month checkup indicates improvement here. I have upped my walking to three miles a day, and decided to skip cardiac rehab as I am more active now than I expected. I feel so much better than before the surgery and did not reallize how the stenotic valve had slowly worsened over the years and had really impacted my life. In another few days I will add some low weight resitance training; and already have a tee time for the last Saturday in June. I think for each one of us, this experience is a little different. I feel blessed to have skated through with relative ease (or at least I hope I have) while others have dealt with more issues or complications. I attribute a lot of this to having Adam Pick\'s book and this resource at HVJ to fully educate myself on what to expect, and how to improve my opportunity for a successful outcome. Every step of the way was in line with what I expected and felt I had the tools and knolwedge base to deal with the curve balls that came at me. The support and encouragement from family, friends and strangers here has been outstanding as well. Thanks to everyone, and my prayers and thoughts are with everyone out there who is about to undertake HVS or is dealing with recovery at this time. You are going to be fine, just trust yourself and give it time. Mark Keller, TX

Well my first five days back in Texas have gone quite well. Just two weeks post op, and I feel very well.. I was able to discontinue the Percocet on Sun, right after getting home from Cleveland with no pain what so ever. I feel I have been most fortunate. I beleive my pericardial effusion continues to improve as my pulse has slowed to around 91 after hanging at 102 through Monday. Echo next week will confirm. I am able to get out and walk, and did three 1/2 mile walks yesterday after 3 days of 1/4 mile walks. No faintness, no troubles, not pushing it too fast. I went into my surgery expecting optimal results. Adam\'s book, and conversations here, gave me a full understanding of what was going to happen step by step and I felt very prepared for everything that happened. Granted, it is not a pleasant expereince, but in my case it was not as bad as I had imagined. Even with the need for a medidan sternotomy, vs the minimally invasive approach I had hoped for; I feel very good. I do not know why the expereince is so different for so many of us; but I do attribute part of my recovery to the fact I anticipated and expected to get through this successfully and quickly. If you are preparing for your upcoming surgery do go into it with complete confidence. Statistics tell you that you are going to be just fine. I had complete confidence in my hospital and my surgeon, and even though my surgery had an added twist or two there at the end; it went just fine. I expect my recovery over the next few weeks will continue to be on the high end of the curve. I truly beleive in the power of positive thinking, mixed in with a little praying, is very powerful medicine. Keep your cup half full as you approach this and you\'ll do just fine. Mark Keller, TX

Exactly one week ago this exact minute I was on the operating table in The Cleveland Clnic being initiated on the heart/lung machine as my heart was being stopped... That really seems such a long time ago. Earlier today I was finally released.. I was ready to check out on Sunday, but the echo showed some inflammation in the pericardial sac, so we had to watch that for three more days before they were ready to discharge me. I have to hang around Cleveland in the hotel for two more days and get one more echo and then fly home that evening or Saturday morning. Looking very forward to getting home. Everything, other than the fluid build up, went better than expected. I had very high expectaions going in so that was difficult for them to achieve, but they did such a wonderful job in Clevelnad, from Dr Gillinov, my 18 hours in ICU with Menchi, my nurse and angel last Thursday all the way thorugh the Step Down Unit with all of the great nuses and staff who were so positive and encouraging. Evertone who entered the room from medical staff to cleaning people took an interest in me, my family, and my path to recovery. The recovery has been very easy thus far. The first couple of days each hour gets better, and each day is som much easier than the one before it. I have been very fortunate with pain. It was only moderate in ICU and improved daily. At this point I am only taking 2 Percocet a day over the last two days. I think I could have gotten by on only one yesterday, but we watched \"Ellen\" on the TV in our room which was a \"Dennis Quaid\" episode and I laughed so much I had to have a Percocet when the episode was over. I will provide some more details around the processes of each day, b ut as we walked in the hotel my wife pointed out the time on the clock and I wanted to anniversary that moment.. Thanks so much for the encouragement from friends and family, and especially the folks who had preceded me into the operating rooms with their thoughts and encouragement. Folks it is scary as it all starts to happen, but trust me as someone who was just there; your fears are much worse than reality. You will surprise yourself a week afterwards. I promise you. Mark Keller, TX (Thanks to my daughter Sara for taking over for a few days)

Hello all, Got some news from my mom today. They did an Echocardiogram on my dad earlier this morning and found out he has fluid surrounding his heart. He was supposed to be released today from the hospital but it looks like he will be there for the rest of the week. They don\'t know too much information yet, as the doctor has been in surgery all day, but we will know more information by this evening on what all will need to be done. Hopefully they can do some sort of procedure that is non-invasive to get the fluid out but for the mean time, they are staying in Cleveland until further notice. Other than that, my dad has been doing well and is eating solid meals and getting plenty of rest. I\'ll post more details once I know more - Sara

My dads progress post-surgery has been very good. They woke him up yesterday morning and got him to eat a popsicle and some apple juice for breakfast and later moved him from the ICU to his own private room. They also had him sit up in a chair for a few hours as well to change positions. Both my mom and grandpa took turns visiting him throughout the day and last night my grandpa spent the night in the hospital with my dad to keep him company. My dad said on a scale of 1-10, his pain level is about a 3 which is great. He is more uncomfortable than anything but he thought the pain would have been a lot worse than what he has been experiencing. Today he has been able to eat solid foods and the nurses are keeping him on a strict diet for the time being. They also had him walk twice today and both times he walked further than what the nurses thought he could do (show-off haha). The one thing my dad was looking forward to about his surgery was being able to catch up on tv shows but especially being able to watch golf all day. Ironically they don\'t have the golf channel in the hospital (sorry dad, looks like you\'ll have to catch the highlights of The Players on ESPN!) So far, he\'s been doing well and just taking it one day at a time! - Sara

Hi all, My dad has designated me as his co-blogger the next few days while he\'s recuperating so I wanted to give everyone a quick update post-surgery. Everything went as planned and thankfully there were no major complications. His surgery lasted almost 4 hours and as you know he had to have the more invasive surgery done with the bigger incision to make sure and correct everything. Dr. Gillinov replaced his aortic valve which had an aneurism in it (a normal aorta is 3 cm and my dads was 5.5-6cm). They have moved my dad to the ICU but since his surgery was so late in the day, he is still under anesthesia and not awake. They are having a nurse staying in his room tonight to monitor him which is a relief to myself and my family knowing he will be under constant care through the night. Tomorrow they\'re planning on getting him up and walking him around. I spoke with my mom and grandpa who are up there with my dad and they were very pleased with Dr. Gillinov and his staff. On behalf of myself and my family, thank you for all of your prayers and kind words for well wishes on my dad\'s surgery. Please continue to keep him in your thoughts the next few days as he begins his journey on recovery! - Sara

Had a very good meeting with Dr. Gillinov this AM to map out my surgery which is Wednesday morning. Just now got my report to time of 10 am. I was hoping for the 5 am; but I know of two other people up here with me who appreciate the 10 am time just fine. My surgery will be via a median sternotomy. I was hopeful for a minimally invasive incision, but the aortic root repair will require a little more working room and thus the bigger incision. Just means a little longer time till I will get to play golf again. All of the tests came back great and I expect all to go well on Wednesday. Overall my heart is in great shape, and I have a lot to look forward to. Dr. Gillinov was adamant in his iteration that my life will be more normal than I have ever known. He told me that I do not have Heart Disease, but what I have is a a little plumbing problem, and he is going to fix that for me. My heart is just fine. I will be having a bovine valve replacement in my surgery. Fully aware that this valve will wear out in my lifetime, and have to be replaced. This doesn\'t necessarily mean the same surgery in 15 or 20 years. The field is advancing so rapidly that my next valve may very well be replaced via a catherter, which is currently being tested in older patients who are not surgical candidates. Had hoped to go to the Rock and Roll Hall of Fame today, but as it turns out I was the only one sleeping the past two nights and my \"support network\" needed to take naps. Meeting and talking with my surgeon helped them as well. It gave me a chance to read Adam\'s book one more time.. \"The Patients Guide to HVS\" has certainly made the journey a much easier one. Thanks Adam!! OK... Here we go... Mark Keller, TX

Gayna and I arrived in Cleveland late Sunday in advance of all day testing today. We are staying at the Hilton Garden Inn downtown, great CC rates and free shuttles/car service back and forth to the Clinic.. We took advantage of our Sunday arrival to visit the Clinic and figure out how to get from point A to B.. The hospital is incredible.. Everything is right at the front of the building, just depends on what floor you need to be on. The building is only a year old, and it is like an Epcot adventure. Food selections are great for the family while they are visiting.. Testing went very well, with no surprises. Consult with a staff cardiologist and anesthesiologists went fine. If it is possible to be even calmer a scant 36 hours before surgery I am. I feel so good about having picked Cleveland Clinic. I wish I was able to convey that sense of calm to my wife and father, who still have worried and frightened concern in their eyes. I am sure if it was them facing surgery I would be scared for them as such, but for me I have great confidence in the outcome.. We meet Dr Gillinov early tomorrow to map out Wednesday\'s surgery. After that the Rock and Roll Hall of Fame.. I will let you know how it goes.. Mark Keller, TX

Well my wife, Gayna, and I leave for Cleveland on Sunday morning. Last night my mom arrived in Ft Worth from NC to hold down the fort here with our kids. My dad will be joining Gayna and I in Cleveland on Sunday to help out on that end, so it will be good to have that support. Each year when I would have my annual cardiology check up my parents would anxiously await to hear if anything had changed or not. Each year I would tell them everything was status quo, and I wasn\'t planning on anything changing until after they had died and I had \"my inheritance\" to spend on my eventual surgery. Well, they have been mostly uncooperative on that part of the deal and since they won\'t give me my inheritance as planned I thought we would put them to work during this time. (Yes, my family has a sick sence of humor) It will provide a great deal of relief for Gayna, me and the kids to have them with us helping out. I guess I am glad they did not take the first option I had solicited for.. Mark

I remember my first heart cath 37 years ago when I was 12 at Duke Univ. and it is not a fond memory.. But today, for Heart Cath number two, in prep for my surgery next Wed in Cleveland it was really much ado about nothing.. The procedure itself is prety much what you have read about, mine was through the femoral artery in my groin. It was very uneventful, and I would have been more than comfortable without the 25 milligrams of Benadryl and 2.5 mg of valium. Thorughout the procedure my cardiologist, Dr. Willard conversed with me and I could see most of the event on the multiple screens. Unlike 37 years ago there was no sensation whatsoever as the dye was injected. No heat flash that traveled through your body like last time, I had to ask my doctor if he was even doing the injection. Everything was positive, no blockage concerns or need for any bypass to be considered.. Came right home and ate pizza, no salads tonight.. After the procedure a 2-3 hour process of waiting to ensure the artery closes properly then sent home.. A really easy process all in all and the team at Harris Methodist in Ft Worth was great!! Mark

Here is a question for some of you who travelled for surgery.. I am travelling from Fort Worth to Cleveland for my surgery. My local cardiologist says he will not need to see me for siz weeks after my aortic valve replacement surgery on May 5? If Cleveland Clinic tells me I need to see him sooner I will, but what about surgery wound care and medicine scrips post surgery? Did you go to your regular doctor, a local surgeon, or what? Who wrote your scrips post surgery? Any guidance would be apprecitated on what you did.. Thanks.. Mark

I have had aortic stenosis with a bicuspid valve since birth, which worsened somewhat at age six due to rheumatic fever. I have known since the age of ten that someday, around my late 40\'s, it would have to be repaired surgically. I have had mostly annual cardiology appointments since then to track and monitor my valve to detect change as (when) it occured. Really in 2009 my cardiologists said the clock was ticking, and I had about a two - three year window in which to expect surgery. My next check up in Jan 2010 indicated significant change in pressure in the left ventricle. A Trans Esophageal Echo confirmed degradation of the valve leaflets with high levels of calcification, and just like that the window had shortened and surgery was imminent. One of the nice things about having 39 years of \"heads up, you are going to need valve replacement surgery someday\" is it gives you a lot of time to research and plan. For the past decade I have known that when it was time, I would have the surgery at The Cleveland Clinic. While there are dozens of excellent choices around the country, and right here in the Dallas area, it was comforting to have made that decision nearly a decade ago and have it reaffirmed annually when checking heart hospital ratings. Nearly three years ago, I had decided my surgeon of choice would be Dr. Marc Gillinov. It was also reassurring last year when Robin William\'s needed surgery he selected \"my surgeon\". Although at CC, I firmly believe any of their staff surgeons would be on anyones short list. After my tests were reviewed ay CC in March, they concurred with my cardiologist that now was the time. I was relieved that the surgery was scheduled for 6 weeks out, but the days are slowly ticking by, and it is almost upon me. I will have aortic valve repalcement surgery with an aortic root repair on May 5, 2010 at The Cleveland Clinic. I am very much looking forward to getting my valve replaced, and for the first time in my life, getting to expereince what normal heart function is supposed to feel like! Mark 49 years old, and lots more to come!