Nathan's Journal

It has been over nine months since my open heart surgery (OHS). During that time I have experienced struggles, joy, failure, and triumphs but through it all I have had hope that I would become a new man one day. With the love and support of my family, friends, and most of all my wife Elizabeth, I can confidently say that I am better now than I was before I went under the knife August 20, 2013. Recently, I worked on a house project in the garage. It require a lot of physical exertion for over five hours. Before my OHS, a task like that would have taken two weeks to complete. I thought that was normal. I finished the task that afternoon, and still had more in the tank. I was blown away by my stamina and energy throughout and after the project. My quality of life is so much better now. I am so blessed to have a new "normal." I now run about 12 miles a week with a small group, play golf, and will soon start introducing more weights to my workout regimen. I have never been overweight, but have lost 16 pounds since surgery. Best wishes and lots of prayers to all that are about to have surgery, or are going through the recovery process. OHS will make a different person literally and figuratively.

It has been nearly four months since surgery. I am, dare I say, almost back to normal. I ran 3.5 miles in one day last week. It was an amazing feeling. I have also been able to play with Graham and Reid without reservation or concern. In addition, Elizabeth is thankful I am back to helping with diapers. Yesterday, I did something that I never thought was possible. I stopped taking the last prescription drug for my condition. If you know me well, I hate taking medicine. For the past eight years I have swallowed my aversion and two pills everyday, but now I am off all medication! I am, by everyones standard, a Christmas nut. I decorate in November, play a lot of Christmas music, and drink way too much egg nog. So I want to wish everyone preparing for, going into, and recovery from surgery a very Merry and Blessed Christmas season.

I am now three months past the most difficult day in my life. I never imagined being where I am currently on the road to recovery. I get emotional thinking about how many people have helped me along the way, and the lifelong friendships I have made. God truly does work in mysterious ways. Lynn, Jim, Ernie, and Aubrey keep up the good fight. You all are doing great. Adam, thank you for providing this amazing platform for heart patients to connect and share their stories. It has provided me with so much hope and comfort prior to and after surgery.

First, I want to recognize two people going into surgery soon. Jim and Lynn have their heart surgeries this week. Jim successfully completed his in New York yesterday, and Lynn has her's in California tomorrow. Even though they live across the country, this site has brought them together to support each other through surgery. What an amazing community! Our lives are getting back to our crazy Higginbotham way, but I am thankful to be worrying about things other than myself. Our eight year anniversary was yesterday. I think the biggest gift to her was being able to take out the trash again! I guess it is the little things in life. My recovery is starting to get boring. I am progressing on track. I jogged for the first time today! Weights are tough, but I am not in too much pain. The motto right now is, "Steady as she goes." Thanks for all your thoughts and prayers. Best of luck to all the patients having surgery this week.

First, I need to apologize to my friend, Ernie A.S. He is a fellow heart patient that underwent surgery about the same time. He has followed my progress closely, and has made me laugh a lot through this difficult time. He called me out on a recent post for not updating my journal enough. Writing out my thoughts and feelings is one of the most important pieces to the recovery process. I had not posted because I kept telling myself that I was too busy and did not have time. I am back on the horse now, and will make time to update my journal more frequently. On to the update... It has been two months since surgery! The next sentence usually says something like, "My time flies" or "seams like it was yesterday." I can't honestly say that time has flown by over the past two months. It has been hard. I try to stay as positive as possible in my journal post. It has helped keep my spirits high. I am thankful that, up to this point, my recovery has probably gone better than expected. However, no matter how much I want to be normal again, I am reminding everyday that I am not quite there. Rehab has helped a lot. I am in my third week, and starting to show signs of improvement. The exercises when I first started were too easy so I politely ask them to kick my ass. I guess the lead physiologist had a bad weekend because when I returned the next week she did that and more. I struggled to complete the workouts the first week, but now I am starting to get the hang of it. When I began rehab my heart rate would average around 150 during the exercises, but now it is around 140. Rehab has helped me feel less fatigue during the day. I have not needed a nap in two weeks, and credit my rehab program with this small accomplishment. I highly recommend taking rehab to any recovering heart patient. Thanks for all the thoughts and prayers.

At six weeks post operation, I am substantially better than when I was released from the hospital. It has not been easy. There has been some minor set backs, but overall I am encourage about the way recovery has gone so far. Cardiac rebab started today. I went in for an initial consolation. It was sobering to see all the \"older patients.\" Every doctor and nurse I met asked me why I was there. The lead physiologist said that I was the second youngest patient she has ever worked with in rehab. I was excited to hear that they were going to tweak their routine to move more in line with my age and activity level. The program is for one hour, three days a week for 12 weeks. I am looking forward to seeing where I will be at the conclusion of the program. I start the process of returning back to work this Thursday, Oct 3. I am anxious about returning to work, which is only natural for not being able to work for almost two months! Elizabeth said it is similar to what she went through returning from her maternity leave. At the same time, there is excitement about getting back into the swing of things, and getting on with my life. Best wishes and continued support to those about to go through or recovering from surgery (Ernie A.S., Lynn, and Jim.)

One month ago today was one of the biggest days in my life. I laughed, cried, hugged, loved, and, oh yeah, I had open heart surgery! At 31 years of age, you never imagine having to go through something like this. It is still hard to accurately describe the emotions from that day, but I thank God every morning I wake up to start a new day with Elizabeth, Graham, and Reid It has been a difficult road, but I am thankful the way everything fell into place for a successful surgery. Everything happens for a reason, and you trust have to trust in God throughout the journey. Thank you to everyone that have supported me along my journey. Your prayers, thoughts, and words of encouragement have given me the strength I have needed. For that I am forever indebted. I am feeling as good as can be expected. I had my most active day last Saturday, and consequently my worst day since surgery Sunday. I am walking about 1.5 miles every morning. I don\'t need a nap every day, and my energy level is improving. Cardiac rehab starts next week, and I should be back to work the first week of October. Good luck to all future cardiac surgery patients, and many positive thoughts to everyone currently recovering from surgery. (specifically Ernie A.S.)

I am SO happy to be back home with the kids. It was hard to be away for that long, but I know it was for the best because trying to recover with 4 year old and a soon be 1 year old in the house is tough. Graham and Reid were waiting for us at the airport . There were a lot of hugs, tears, and slobber . Graham has been great with my scar. He is very thoughtful and conscientious around me. He is quite the kid. Reid, however, wants to maul me. Every time he sees me he starts grunting and crawls at me with the intent ripping my face off. I know that is his way of saying, \"I missed you dad.\" I can\'t believe he will be 1 next week. I have not been feeling well since my return. Traveling cross-country has taken its toll on me. I feel like I have regressed quite a bit. I hope this will pass, and I can get on with recovering. I am sure jet lag is not helping at all. If you see Elizabeth, you will probably notice a gold ring floating above her head because she is a saint. She is having to raise two little boys and a really big one , all the while working full time. Yes, she is an amazing woman, and I love her very much. I have my follow up with my local cardiologist on the 20th and can also start driving then. Looking forward to that!

It has been a crazy day. Needless to say there was some anxiety waiting for the final appointment. The appointment went flawlessly. He was very impressed that I kept a running tally of all my vitals on a phone app called Health Tracker . My scar looks good. I am healing appropriately, and my vital are within range. That means I AM GOING HOME!!!! Graham was so excited when we told him that we were coming home. I cannot wait to see my boys. Finally, A big THANK YOU to the Melander Family and Dr. Smith and his wife Sherry for everything they have done for us. They took us in like family. I am so thankful God put them in our life. We are eternally grateful for their kindness and generosity. All told, we have spent 28 days with the Melanders. It safe to say we are officially family. In addition to providing us such sanity through this whole process, Elizabeth said they also had us in parent bootcamp on what to expect in raising two boys. They have two awesome sons (brothers now)- Ryan and Matthew. Chuck and Sheila have given us all the tricks of the trade to raising kind, respectful, aware kids that have become such great people. We are thankful we have gotten to know them both better through this stay and hope can instill the same traits in Graham and Reid. Nathan

TGIF! Four days and counting until I get to go home to Kentucky and be with the kids again. We have enjoyed our time in California, but we are ready and anxious to get back to the kids. I am disappointed that I will not be able to play golf the rest of the year, and will not be able to go skiing this winter either. My sternum and ribs will take 4 - 6 months to properly heal. If I over exert myself before they are healed, I run the risk of them not healing in the right spot or popping out of place, and I definitely do not want that to happen. I cannot say thank you enough to our support group. They have done so much for us while we have been away. My sister-in-law and brother-in-law moved into our house, and are keeping the kids. Our neighbor\'s kids have been mowing our lawns, and my in-laws, Don and Sara, have been coming up every weekend to keep the kids. My mom and sister-in-law have also come up with my nephews to stay with the kids too. I cannot thank you all enough for the things that you have done for our family. So we decided to order a swing set for the kids that wasn\'t supposed to be deliver until two weeks after we got back to KY, and of course it was delivered on Wednesday. Thankfully, our neighbors picked it up off the street and put it in the garage. In addition, two good buddies, Lee Ferguson and Ed Corfman, are putting the swing set together for us. I am so thankful that they are putting it together, but I feel like I am missing out on a right of passage in fatherhood. You are supposed to struggle, cuss, and hurt yourself trying to put up a swing set for your kids. It is all apart of earning your swing set daddy badge . Thank you Lee and Ed. You will have pizza and beer on me for life ( now you have that in writing). For all the future cardio thoracic surgery patients, I wanted to compile a list of activities that are either harder or easier than expected post surgery. Easier: Lying down: I read a lot that lying flat on your back was very difficult post operation. I have surprisingly discovered that not to be the case. Walking: I feel like I can walk all day without issue. I have been careful not to walk to much on steep inclines, but walking has been a great release. Harder: Anything Involving the Chest: Here is a list of activities that I have found difficult... 1) Opening and closing car doors 2) Sneezing (the worst!) 3) Coughing 4) Laughing 5) Drying off after a shower 6) Sitting up 7) Putting on seat belts 8) Lying on my side Of course, I am not testing my limits and have been taking it easy, but I wanted to list simple activities that have surprisingly proved difficult to do.

The asterisk is because my two week anniversary was actually yesterday. I felt awful all day, and did not make a journal post. I have my follow up appointment with the surgeons office at USC Monday, September 9. If all goes well, we will be on a plane Tuesday morning for Kentucky. Next Tuesday will make 28 days removed from the kids. That, by far, has been the hardest part of this whole ordeal. Thank goodness for technology and being able to FaceTime. Elizabeth gave me a watch after I returned home. The watch is meant to signify the beating heart. She is the most thoughtful person I know. Thank you so much Wifey! I still was able to get in a mile walk but my activity level was half of the previous two days. I walk a combined 4.9 miles Sunday and Monday, went to three soccer games, and visited the Reagan Presidential library. Yesterday was a different story. I had a mild-to-moderate level of pain all day, low energy, but most importantly my muscles felt fatigued. I was told that if I felt good and was active one day the next would be a struggle. That is precisely what happened yesterday. I have been researching the level of calories burned during the recovery process. Evidently, in order for the body to heal itself, it has to consume massive amounts of calories. Therefore, a diet rich in protein and less processed simple carbs is best suited to fuel the recovery process. I would also recommend to graze all day long with a bunch of little meals. On several occasions, I have become very dizzy and nauseous from a lack of food. I would also like to give my friends from Somerset High School a shout out. They have planned a reunion for this coming weekend. I would have loved to make the trip to Somerset, KY, but I will not be coming home until next week. I am thinking about you guys. Have a great weekend, and I will see you all soon! Nathan

I am amazed at what the human body can do. The recovery process is going well. I feel a little better each and every day. Today is the my tenth day removed from surgery. It is amazing how fast time as passed. Here is a quick update (note: I am being very descriptive because it is for the benefit of the future heart surgery patients reading my posts). - Itching: Thankfully I was warned of this step in the recovery process, but it is does not diminish the urge to scratch my chest. Think of a scabbed over rug burn times a Million! It was explained that early on you will not feel much pain from the chest incision. As it heals,nerve ending that were severed start to reconnect. Believe me they are reconnecting in a big way. My pain level is as high as it was the first day back from the hospital. I am still not taking pain meds, Advil seems to do the trick at this point. - Walking: For all of those who are facing surgery, make it a priority to stay active. I would suggest doing it in spurts. To help me track my progress, I have purchased a Nike Fuel Band. It has been amazing. It tracks activity, steps, calories, and miles. Having the ability to track and show my progress to others has been a great tool. I highly recommend getting a Nike Fuel Band or something comparable such as a FitBit or a Jawbone to track your progress so that you can set goals and track your progress. Ten days post surgery, and ten days until I get to see my kids again. I am half way home. Love you Graham and Reid. See you soon. Nathan

Yesterday was my first full day of recovery. There were more ups than downs, but it is apparent that the road to recovery is going to be long and have many bumps along the way. Here is a list of the good and the bad so far.... Positives: - I pooped! I know this is TMI for most (Elizabeth is embarrassed now), it is a big step since I have been on a lot of medication that slows the bowel process down. I only passed one bowel movement the entire 5 days at the hospital!!!! - The pain has been manageable. I have not taken a single pain killer since coming home. Advil has been able to manage the chest pain. - I walked 0.8 of a mile! Elizabeth and I went on two .4 mile walks. I felt great getting outside for some exercise. Less Positive: - Sleep - I can fall asleep great, but I wake up several times a night sweating profusely. The reason is that my body is in repair hyperdrive. It is creating the necessary antibodies required to heal myself. My body temperature is extremely elevated. In fact, it is considered normal for me to maintain a 100 degree temperature. I do not have a fever until 101 degrees. - Stamina - Because I have none. After a 1/2 mile walk, I have to nap. It is all correlated to the healing process. My body is using so much energy to heal there is not much leftover for other things. All in all, so far so good, and easy does it around here. Incredibly thankful for the Melanders and their hospitality to Elizabeth and I. I cannot imagine a recovery in and out of a hotel. They have truly made their home our home and have treated us like family (not that we would expect anything different). I am not sure what Elizabeth or my parents would have done without them while I was in the hospital. While it has been extremely difficult being far away from home, it was probably best to not have 100 visitors in the hospital. Also, another positive of being far away is that Graham isn\'t scared by my slow recovery. Hopefully by the time we are back in KY I will be closer to back to normal and it won\'t notice that much difference in his daddy. Not so sure what he will think of my battle wound though... My follow up appointment with Dr. Starnes is September 9th. We have flights booked to fly back to Louisville on September 10th after I am cleared to fly. Two weeks and counting until we are home. Thanks again for all the prayers/ encouragement and well wishes. Nathan

I just got my pacemaker wires taken out! That means I get to check out of the hospital after they observe me for three hours. I will do another (longer) post once I get home. Thank you all for your thoughts and prayers. Two more weeks in sunny California before I get to go home to Graham and Reid!

Nathan had another good night last night. We got the news the last chest tube is coming out today and pending any surprises we are heading home to the Melander\'s house tomorrow. Nathan has his appetite back and looking forward to getting back to \"normal\". He has been walking the halls for 10 minutes at a time. We will see Dr. Starnes in two weeks to be cleared for Nathan to travel. I was really hoping it would only be 1 week so we could get home to the boys. We have been gone 12 days from the boys and it will be 27 days total time away from them. That has absolutely been the most difficult. We have been FaceTiming everyday with them. I am so happy to see their faces, but it makes it harder to say goodbye each time. I hope the next two weeks go by very quickly. As Darrell mentioned Adam Pick came to visit yesterday. He wrote a blog post about his visit with us as well. Check it out: http://www.heart-valve-surgery.com/heart-surgery-blog/2013/08/23/valve-sparing-vaughn-starnes-md/ Thanks again to everyone for their continued support. Love, Elizabeth

What a day! Trying to figure out the best way to make the report so here are some bullets: Nathan\'s Progress As we were leaving last night, Nathan was being prepped for two units of blood. Appears the blood loss was tied to the chest cavity issue previously discussed. Explains why his heart rate would elevate to 140 when walking. His resting heart rate was also too high. Walking heart rate down to 115 and resting rate now in the 90\'s. Still looking for improvement in both. This morning on arrival one chest tube was being removed. Nathan felt good yesterday but the transfusion definitely helped. He is now walking on his own and we are having to ask him to slow down. Walking is more effortless and he\'s walking longer. Anticipate the last chest tube to be removed tomorrow and discharge on Sunday. Team Nathan continue to be in and out all day. PT says he is right on target. RT has set a target on his breathing test and he just met it as I\'m writing this post. Adam Pick stopped by for a visit. If that name rings a bell, look to the left of this post and you\'ll find his book \"The Patient\'s Guide to Heart Valve Surgery\". Adam visited for quite awhile and shared some of his experiences and what he has encountered during his journey through discovery to surgery to recovery and now life after heart valve surgery. Nathan was very fortunate in that his bicuspid valve continues to function very well and all the valve needed was a \"tune up\". Nathan\'s surgery was replacing the ascending aorta with a Dacron graft. Adam had the Ross procedure which was a possibility for Nathan. Everyone got to meet Adam. It was great to hear from someone so involved with educating heart valve patients and their families on the condition. Possibly Adam\'s greatest contribution is this website and the journals to keep family, friends and loved ones connected. Nathan has also heard from several \"guests\" that have had surgery in the past and some facing surgery in the near future. I want to tell the \"guests\" that your comments meant more to Nathan than you know. You are the only ones that can speak to him from personal experience. Even though we were sitting in the same room, he was no longer \"alone\" with his condition when reading your posts. Thank you once again for sharing your comments and well wishes on this journal. He reads them all. We are most grateful for the many prayers that have been offered our way. There is a peace that comes from knowing that prayers are being offered and you know He is listening. God has blessed us in many ways and words cannot express our thankfulness. Darrell

Thank you all for posting on my guestbook. Elizabeth has been reading them to me. They have made me laugh, given me strength, and inspired me. Dad, mom, and Elizabeth have done a remarkable job keeping everyone updated. Dad, has discovered a new passion, blogging! I am sure he will keep everyone updated throughout my hospital stay. I love you all, and can\'t wait to see you soon.

All Nathan\'s progress as been pretty well documented. Last night was a reminder of the complexity of the surgery and how conditions can change suddenly. This will not be a description you will read in a medical journal but I will summarize the best I can. The body generates a lot of fluid following an extensive surgery. Chest tubes are meant to allow this drainage to occur. The sitting position Nathan was in allowed the fluid to build and in some cases the blood was beginning to clot. This build up was causing the pain we witnessed when we returned yesterday afternoon. The medication relieved enough pain to allow him to get up and moved around. This movement released the fluid that had been trapped. Unfortunately the clotting led to some complications and ultimately the chest tubes remaining in place. I can\'t call it a setback since it can be expected with the surgery. We certainly would have preferred to have avoided it but the good news is there appears to be no continuing complications. It is being closely monitored In spite of the above issue, Nathan continues to progress. He walked further today and more erect. He still has the Tim Conway shuffle but it is so good to see him walking on his own. The only assistance comes from holding onto his IV stand. His mother was keeping a very watchful eye on him and was a half-a-step away. Elizabeth is at the Melander\'s getting some much needed rest and a break, albeit a brief one. She can\'t stay away too long. Team Nathan has been in and out all day. RT, OT, and PT (respiratory, occupational, and physical therapies). I like to watch the expression on the faces of the newbies. Those are the ones that haven\'t met Nathan yet. \"You had your surgery when?\" That\'s one of the more common questions usually followed by a \"wow\". Again, the quality of the staff, especially the nurses, continue to astound us. Israel is on duty today and he is not only well-trained but provides the appropriate medical instruction in a very conversational manner instead of the \"go down the checklist\" approach. His personality makes it easy to get comfortable with him. Nathan is resting now after having a very active day. I wasn\'t really expecting the alertness or positive attitude but I should have known better. The irreplaceable expertise and comfort from Sheila Melander has been a blessing to us all especially as we tried to understand the events from the night before. Nathan got to shave with assistance from OT. He was beginning to look like the man on the Brawny paper towel package.....well, a slim Brawny paper towel man. It\'s great to see \"our\" Nathan emerge from surgery. Almost forgot....flowers in the room. Several have asked about sending flowers. Nathan prefers a couple of options: a) make a donation to your local American Heart Association; or, preferably b) get involved in an AHA or heart health wellness event; form a team or fund raiser but find a way to make a difference. Someone somewhere developed the procedures or trained the professionals who have delivered Nathan a better, healthier, future with his family, his children, and his friends. He would prefer in some small way you help him return the favor. He\'s asleep now. Resting up for another new and active day. Darrell

Nathan was finally able to have a good night\'s sleep last night. Everything is still going well and progressing normally. The doctors said this morning that he should have his chest tube disconnected by tomorrow at the latest. The pain is being managed well and we had another great nurse Elvin last night. He will actually be back tonight and Friday which is great to hear since he knows us all now (not to mention he was so wonderful). Most likely Nathan will go home from the hospital Saturday or Sunday. Dr. Starnes assured us last night we would absolutely be back in Kentucky for Reid\'s first birthday (September 18th). We thought we would be back all along in time for his birthday, but great to get confirmation from the man himself. Being away from the boys has most definitely been the hardest part of this, but I know it was absolutely the right decision to be in CA for the surgery. HUGE shout out to my sister and brother in law for giving Nathan and I such piece of mind that the boys are ok and getting lots of love. The journal posts will likely be a little less frequent than the past couple of days. Hopefully Nathan will be writing an entry today or tomorrow as well. I\'m sure Nathan\'s dad will have more witty commentary later as well :) Thanks so much for the continued support, prayers, texts, guestbook comments, etc. Nathan has been reading all of them an truly appreciates the outpouring of support from everyone. Elizabeth

Nathan continues to progress very well. We were only gone a few hours and so much improvement could be seen immediately when we entered the room. Chest tubes all that remain. Hoped to see those gone but still some drainage which is normal. Nathan has spoiled us. He is advancing so quickly that normal seems to be a negative. We have to pause for a moment and remember that a little more than 24 hours ago his heart was stopped and a machine was keeping him alive.....for almost 4 hours. To be fair to Nathan, this is still no cakewalk. He\'s recovery is ahead of schedule. It\'s great to see him up and walking to the bathroom.......but he is assisted 100% of the time. He moves from discomfort to pain. When we entered the room he was definitely in pain. The wait for the medication can be annoying but the staff has a protocol. However, the response was not bad and the medication chosen was administered by IV so relief was almost immediate (easy for me to say). Can\'t pronounce the medication so I have no shot at spelling it but it would be ibuprofen on steroids. Maybe there\'s an endorsement deal for A-Rod? Some of the post-op issues are beginning to surface such as shoulder pain (feels like it was dislocated) and what is best described as a crick in the neck. As I write this he has moved to a chair. His movement is less labored and his voice is much stronger. It\'s still surprises me to see this much improvement and we were only gone about 5 hours. His communication is much more fluid and response time much quicker...except for the timing of his jokes. What a minute. That is normal. I\'m sure he doesn\'t realize how much more flexibility he has in his neck movement but the range of motion is much better. A few quips from this afternoon. \"I had my first sponge bath and it was by a dude.\" \"I can\'t wait to get my boxers on.\" I\'m sitting across from him and I can\'t wait either. Darrell Oh, I thought my wife did an admiral job of posting during my absence. I only saw one mistake. She accidentally typed \"not\" in front of funny.

Sorry I am not the writer my husband is but I will give this a try. Nathan now is I guess is in the club house after his 18 holes and waits for his trophy, in other words to a regular room that he will stay in until he is discharged. He is doing great, he actually walked himself across the hall to his new room ( because his wheel chair was not large enough for his tall frame) he did great. They have taken most all wires connected to him off, he is eating well and is even trying to make funny comments, which I tell him all the time is just like his dad in that area ( not funny ) The night shift of Elizabeth and Darrell is getting much needed rest and will return soon. So the expert blogger will be back at his post and will continue to keep you well informed and entertained. I would like to thank everyone for their kindness, prayers and support. We are truly blessed to have such great people in our loves. Denise (Nathan\'s mom)

\"Phenomenal\" is the word of the day! You have instincts and we thought he was doing great but the physician said his chest X-ray and vitals were \"phenomenal\". \"Great, can I go to bed now?\" Nathan didn\'t say it, but I know he was thinking it. If that bed stays empty much longer, I will be in it! Breakfast is on it\'s way and he can go back to bed after he eats. They are disconnecting some of the medication lines as I\'m writing this post. Chest tubes go out today. Catheter will be out any minute. The line in the neck that measures heart pressure comes out today. Once this is done, he will be up and walking today! Originally planned to start walking tomorrow so that is another step in the right direction. (Sorry.....couldn\'t pass that one up) Nathan and Elizabeth got to talk to Graham this morning and a little FaceTime too. Mom was careful to keep the phone close so not to show all the lines and monitors hooked to him at the time. Papa got to join in Face Time with Reid. He\'s so cute. We haven\'t approached Face Time with Graham yet. He\'s doing so well with Mom and Dad being here, we chose not to complicate it for him right now. Nathan\'s brother and sister (Dayne and Amber) spoke to him this morning. Drew was already in class so I couldn\'t call him. Nathan\'s asking for the menu. He\'s not that hungry, he just wants to go to bed. He\'s already executing his strategy! Now that\'s a confirmation he\'s getting better! Darrell

Nathan is sitting in a chair in his ICU room. Sitting is good for his lungs but he\'s not a happy camper about it! I can\'t say I blame him. Between the medication and the energy expended from getting in the chair, he is very tired and sleepy. They need him to stay sitting until the doctor makes the round. She is on the floor but not to the room yet. I\'m hoping he can go back to bed when she leaves. I don\'t want to ask the nurse. I\'m afraid if the answer is no he will hear it. Will post again after the doctor\'s report.

The night shift at Keck is as impressive as the previous one. This is no accident. Management can set the mission but it is the quality of the staff and their dedication to patient care that truly makes the difference. I serve on the foundation board of a top 100 hospital. I know the amount of commitment and years of consistent delivery to establish a culture I\'ve witnessed at Keck. I am most impressed with the effort to \"treat\" the family as well as the patient. Jing is our RN now and we are so at ease under her care. Back to Nathan: He is becoming more alert after each \"nap\". We finally convinced Denise and Sheila to go home and get some rest. They will relieve Elizabeth and I in the morning. Nathan should be in a step down room when we return later tomorrow. Usually at this point, I will find something to aggravate or tease Nathan about. As I sit here in ICU, I see a very strong young man. It has been 30 years since he was diagnosed with his heart condition. I went through all the X-rays with him which was very unusual. Mom was pregnant and it she wasn\'t very happy being left out. It took 30 years to get to this point but an amazing 3 weeks from shock and dismay to surgery in California. I will remember Nathan\'s strength should I face a similar challenge in the future. I will remember Elizabeth\'s faith, love, commitment, patience and gratitude should I need to be Denise\'s support. 13 hours since surgery started; 9 hours since it ended; each hour and the hours to come, know we speak of you often and how much your prayers and support mean to all of us. Don and Sara, Catherine and Ryan: you are our home team and without you Denise and I could not be here. We are so grateful. Nathan is sleeping. Such a strong young man. Great job mom. :) Proud Dad

We just left ICU and he\'s more alert.....thirsty, too. He\'s communicating we\'ll. I would best describe his current condition as very tired, probably more a result of the medication. We just went through a shift change and were so fortunate to have Grace. Anyone from Keck Medical following this journal, please let her superiors know. Elizabeth or I will post more tomorrow especially about the outpouring support we have received from colleagues and co-workers. They represent software, energy and finance. Our products may vary but we share a common culture of truly caring for colleagues and employees. There is a presence of family from each and each should be very proud. It\'s just after 8:00 PST but its bedtime for this Kentucky boy. May post again this evening. The accommodations are fine for a waiting room but for a hotel room....not so impressed and I have roommates! :)

Surgeon has been by to see Nathan. He is sleeping now. He\'s been alert and talking. Very thirsty but not allowed water yet, just ice chips. Recovery is on track but will be in ICU overnight which is standard protocol. We expect he will continue to progress and will be moved into a room tomorrow. We learned they moved the Right Coronary Artery which was referred to,as \"buttoned\". This is an improvement over the prior position, not a problem. Please continue the prayers, they are very much appreciated. Darrell

Elizabeth and Denise are in ICU with Nathan. Things are moving quickly now. IV medication is slowly being removed. Checking blood work for oxygen level so the ET tube (breathing) tube can be removed. Respirator is off and he\'s breathing on his own. Trying very hard to wake up and not very patient. He wants the tube out now! Each time I go back, he is more alert. Nurse said this is a very uncomfortable time for him. Hopefully he will have the tube pulled in the next 10-15 minutes. Darrell

Dr. Starnes just came down and let us know that everything was going well. They were able to repair his aorta and save his valve. That means no Ross procedure or any artificial valve in his body...a best case scenario. They are wrapping up the surgery now, and should be done shortly. We are so thankful we were able to get Nathan in surgery so quickly. Dr. Starnes said his aorta very very thin. God was watching over Nathan without a doubt. Will post an update once he is in recovery. He is expected to be in ICU through the night once he is out of recovery. Elizabeth

Nathan hasn\'t signed his card but the scoreboard says an under par round! He\'s in the tent signing his card now. We are waiting for him at the 19th hole. - Darrell (Nathan\'s Dad)