Michael's Journal

Today is the 8th anniversary of my mitral valve repair. The day falls on a Sunday this year so I will not take the usual holiday from work. I am here to say to anyone with the procedure ahead of them that my heart function is something I rarely think about. My cardiology checkup every year is routine and I hope for the same for you.

My old best friend in my profile photo passed at age 15 about 4 years ago and now I walk 3-4 miles a day with my new best friend. He'll be 3 next month and I'm looking forward to years of walking together.

I'm checking in today exactly three years from the day I had mitral valve repair surgery. I'd like to be a supportive and encouraging voice to those awaiting surgery or in recovery by saying this: heart surgery does not loom large in my life today. I rarely think of it! The diagnosis and events surrounding the surgery was only a moment in time and there have been countless moments since. Some happy, some sad, some with feelings of success, some accompanied by frustration... all to say that life post surgery is just plain normal. Global pandemic notwithstanding, of course. My very best to everyone on this path.

On February 3rd, 2018, I had OHS to repair my mitral valve. My 60th birthday occurred in May and today, exactly six months after the surgery, I tell people that I feel stronger at 60 than I have felt for the last few years. The decline during my 50s had been gradual but the improvement was immediate because the day after surgery was when I first noticed that I could stand up from a laying position and not feel lightheaded. I had several weeks of cardio rehab, which I recommend highly, and returned to my desk job at the end of April. My thinking was still a bit fuzzy then but it's crystal clear now. 12.5 mg. of Metoprolol a day keeps my resting heart rate below 100. It's odd, but my resting pulse used to be about 65. After the repair it became elevated, but still of little concern to my cardiologist. Valve repair was one of the most exciting, interesting and life-changing events I have experienced. I'm grateful for Adam's demystifying book, for this community and for the many knowledgeable and skilled professionals in whom I placed my trust.

I am on warfarin for a few months now and it was suggested by the clinic that I consider wearing a medical alert tag or bracelet. Have other received this advice and, if so, what does your ID say? I suppose an indication of warfarin and the fact that I have a ring around my mitral valve as well as titanium plates attached to my sternum would be useful since I think that indicates that I cannot have an MRI.

I am still amazed by how generally OK I feel so quickly after such an invasive procedure. A testament to modern medicine. My resting pulse is in the mid 70s, which is maybe 10 BPM higher than before. My cardiologist says this is likely temporary and may have to do with my heart adjusting to the increase in blood volume now that 50% is no longer being regurgitated back to the atrium. Metoprolol Tartrate for now. One lingering effect, however, is that I find I tire quickly and naps are still an important part of the day. Something to consider as I plan my return to work. Even though I have a desk job, I can't imagine being at work a solid eight hours yet. I'm targeting 6 weeks post-op for my return. I am interested to read what others have experienced regarding return to work and energy, stamina levels. A foot of fresh snow fell last night. I love New Hampshire! Best to all, Michael

I am making these journal entries with the belief that they, like the others I have read, may be useful to future community members. Yesterday was my official post-op follow up at my surgeon's office. It was a short visit where the provider looked at my wound, pressed on my sternum and I acknowledged that I was in no pain and was experiencing very little discomfort. I was told that I am now permitted to lift my hands over my head, the 10 pound weight lift restriction was raised to 20 and if I want to, I can drive short distances. They also informed me that I am being released from their care management and into that of my cardiologist, who I will see next week. All good. The back muscle pain that I experienced, and others have as well, has eased for the most part. My daily non-stop walks are up to 20 minutes now and, yes, naps are still and important part of my day. One surprising thing had been what I felt to be a loss of mental acuity. When first home, it was somewhat difficult for me till follow long or detailed conversations… it was very tiring to focus hard. I was concerned about this since detailed, technical thinking is a big part of my job. This has improved some now and when I asked my provider about it yesterday she said it was not unusual and was temporary. She talked about being on the heart-lung machine and systemic inflammation in my body.

I would like to send a gift to the care takers on the cardiac floor of my hospital and welcome ideas and suggestions. I learned everyone's name and a bit about the background of each. Nurses, LNAs and NAs: Mia, Elaina, Christina, Mario, Kelly, Kira, Sandy, Tara, Danielle, Pam, Nicole, Michelle, Lizzy, Joanie. Nurse practitioners: Jayne and Carol. Physical Therapist: Tara.

Here in New Hampshire yesterday we were treated to 70° weather. Extraordinary for February, so I took my 15 minute walk outside. What a gift! Back to the 30s today. I've been sleeping in my bed for the past several nights, even laying on my side. I take no pain medication and have a regular daily routine. We have acquired a shower chair which enables me to sit under a warm shower with my back to the spray. It's a wonderful thing. INR is checked twice a week and warfarin dosage is modified accordingly. Warfarin will be part of my routine for three months. Appetite is fine, naps are still important. Next Monday, the 26th, is my first follow up appointment at my surgeon's office.

One week ago at this time I was in surgery. Today I am home in my recliner. I took 1000 mg of Tylenol this morning having not taken any pain med since 10:30 last night. I took a shower this morning, which may have precipitated the need for Tylenol. Appetite is good, home PT is no trouble and I climb a 14 step flight of stairs twice a day. Reading a Dan Brown page turner, listening to music and journaling to pass the time. Oh, and napping. Naps are good. I am sleeping in a recliner, which I find more accessible than my bed right now. That adjustable hospital bed was helpful. I had a slipped disc and sciatica two years ago. In comparison, a much more difficult recovery and painful challenge than what I am experiencing now.

February 13th, the other side. The short story: the L5 S1 slipped disc and sciatica I had two years ago was more difficult than the open heart surgery mitral valve repair I had 5 days ago. I feel good, I'm going home today on only Tylenol. Yes, it's major surgery with all kinds of technical components... but it is a well trod path. If you remain present and greet each moment of care with a grateful heart you may be surprised at how quickly you find yourself back on your feet. The details: We arrived at CMC at 5 a.m. on Thursday February 8th and as instructed, used the E.R. entrance and told the receptionist “I'm here for cardiac surgery”. I haven't yet found the words to describe the experience of total surrender but it began at that moment. The efficient professionalism of the nurses who prepped me. The strength and love in my wife's eyes right before I handed her my eyeglasses and was wheeled through the doors. The cheerful kindness of the nurse handling last minute paper shuffling. The warmth of my anesthesiologist, Dr. Kelly who, after shuffling his own papers, took a chair beside me and spoke calmly of what was about to happen and who became another voice describing the brilliance of my surgeon, Dr. Westbrook. The first set of doors opened into a bright hallway with at least a dozen O.R. team members, dressed in blue from head to toe, standing in wait for my arrival. The second set of doors led to another very bright room filled with equipment and as I was wheeled to what was a nicely heated and warm operating table (felt good!), the blue dozens began moving all around me. Dr. Kelly’s reassuring voice again appeared and one of the nurses and I talked about the joy of having Goldendoodle dogs. A few moments later, another face I recognized approached from across the room. I remember saying “Hello, Dr. Westbrook”. When I looked again, it was my wife's face in front of me saying “your valve was repaired, everything went well, isn't that wonderful! “ One day in ICU. Over the next few days tubes and wires were removed, I became less groggy since i did not need narcotic pain relief. I tired quickly but got stronger every day. Day 5, I am walking up stairs and heading home. You will be fine. Trust in science, medicine and the present moment. You will be fine.