A week of concerts

What a week! It started with a chorus concert with Veronika, and then two orchestra concerts with Allison on cello and Eddie on violin. Listen to Clap Your Hands (Nika), Celtic Dance (Alli), and Palladio (Eddie) and remember -- they certainly didn't get their musical talents from me!

Rehab is done, Christmas is nearly here!

I finished cardiac rehab this week, running my last mile on the treadmill to the tune of 'Rocky' (coincidence, but a good one). Learned a few things about EKG's and exercising along the way, and definitely regained a good bit of my endurance each week, but mostly glad to have my afternoons back.

Uploaded some pics to my Flickr account today. Having fun getting ready for Christmas!

Back in the swing, mostly

It's amazing what time does for recovery. Other than a small cold I'm fighting at the moment, I've been feeling great. Sure, I've been exercising 7 days a week for two months now, most recently at cardiac rehab (Monday, Wednesday, and Fridays), and at the gym. The kids and I have played racquetball, soccer, and Nerf football, and I've ridden my bike on the road and indoors on my rollers. But at least as much as the exercise has helped, has been plenty of rest and getting closer to the magical three month mark since surgery (which, incidentally is Christmas day :-)

I've also been back to work full-time for about 3 weeks now. It's great being back with my friends there and doing work I truly enjoy. While I can't make up for time lost, I've at least been trying to get back up to speed quickly (OK, except for forgetting a password or two!). Am hoping to put together a holiday party of sorts for January or February as I certainly do miss that from Aquilent (my former employer).

Things I'm Forgetting

So amazingly it'll be 6 weeks this Thursday since my surgery, and while I'm feeling better every day, I'm still not 100%. Just consider my memory.

• While walking outside or climbing stairs, I'm starting to expect to move as fast as I always did. About halfway up that short hill or near the top of that second staircase my lungs remind me -- not so fast, dude.
• While sleeping, I forget that just a few weeks ago it hurt like anything to lay down except on my back. I'll wake up on my side or stomach, and while I wouldn't call it painful, it's still a bit uncomfortable. And then I'll be like, oh yeah, I had open heart surgery not too long ago!
• On Monday I realized I hadn't taken my daily medication since Friday. Smooth.
• This morning we picked up my recent echocardiogram from my cardiologist's office, and I promptly forgot to bring it to the appointment with my surgeon.
  
• This afternoon I couldn't remember most of my nurses names when Ann Marie stopped to say hello (and thanks) at the hospital. I knew them all by heart when staying at the hospital -- they were awesome!
• Recently I realized I never posted the "OK to call our house and cell phones" message I should have posted weeks ago. Doh! Sorry about that.
  

Fortunately when I started driving again today I remembered all the important bits for that. I think my skills were kept sharp these past few weeks driving the radio controlled Ferrari F430 my colleagues at work bought for me. And heck, I even remembered what side of the road to drive on, despite all the British car magazines I've read -- thanks to my friend Sean for those!

Let's hope I remember the way to work -- I start back up tomorrow :-)

Key goal reached early

So one of the key goals of this surgery was to allow my heart to shrink in size. All those years of a leaking valve meant the heart, or more specifically the left ventricle, was growing -- after all, it's a muscle that grows from workouts like any other. Untreated, the heart would have grown so large it wouldn't do its job properly, and with surgery too late it would never truly recover.

Amazingly my echo cardiogram on Tuesday showed that my heart has already shrunk to what is considered "normal". This is even more incredible since my heart never measured that size since we started measuring it in 2001. And that it happened that quickly was a real surprise to my cardiologist - he doesn't believe he's ever seen such a quick recovery.

So, "big hearted" guy jokes aside, I must say I'm pretty psyched with these early results!

Is no news good news?

Well, I guess it depends on who you're talking about. Me, I'm pretty good. I've been feeling a little better each day, able to walk more (2-3 miles per day), and generally without pain until I sneeze, cough, or laugh too hard :) Sure, I get dizzy sometimes standing up too quick, and get winded walking up hills I never noticed before surgery. I do wish there were some real specific metrics I could measure up against to prove I was on track, but alas I must admit recovery doesn't work that way. If nothing else, I've had incredible weather to recover in since the day Ann Marie drove me home from the hospital. Almost four weeks now of sunshine and cool, dry weather. Not bad. Other than some tests this week, the next real milestone for me is a visit to my surgeon two weeks from today.

Other than me, though, there's a few other people that need taking care of.

My mom has been recovering well from surgery to address colon cancer, something she learned she had just days after my surgery. That she'd made the two & a half hour trip to see me in the hospital was amazing as, unknown to her, her illness was sapping most of her energy. Thanks to her husband Bill, my siblings, and her neighbors taking great care of her, she's in great spirits at home, and just yesterday celebrated her 80th birthday. I'm looking forward to seeing her in person when I'm able!

Back at home, one of our kids has been sick since last Thursday, and after ruling out strep and tonsillitis, our pediatricians have given a diagnosis of -- get this -- mono. Hey, isn't that just supposed to happen to teenagers? Turns out kids as young as four can get this virus, and the good news is the younger you are the less amount of time it affects you. And while it's no fun having mono, I guess it's not so bad when your Mom and Dad are both home with you!

Last, our friend's son Peter has been having a rough Fall. It's a longer story than I could cover here, but please send your warm wishes for good days at school, fun trips to the track in his "race runner" (think wheelchair for running), great episodes of Sponge Bob, fun video games, and restful nights.

My name is Chris, and I'm a former narcotics user

Well it was somewhere around the end of last week that I went through the night without any pain medication. I hadn't taken any during the day since coming home from the hospital, but the nights simply required it if I'd hoped to get any sleep. But last week I simply felt that I didn't need it, and in fact haven't used since.

Wow, what a difference. Sure, some of the weird dreams stopped (granted, to be replaced by others), but that didn't surprise me. I had no idea how this narcotic was affecting me during the day until I stopped. I'm much more awake, have more of an appetite, have more energy, am less sensitive to temperature changes, and am less-likely to turn on Bob Marley music. Since then I've done a few 2+ mile walks and, get this, have stayed awake past 8:30pm! Wild, huh?

Now if only they'd let me operate heavy machinery - that would make me feel more like myself. Something like a bulldozer would be great, sure. I could knock some stuff down, then run over it. Yeah. Actually I cheated yesterday and drove my S2000 down the street and around the cul-de-sac. 240hp under my right foot is just the therapy I need! Fortunately Ann Marie took over and drove on some great roads, in great weather, with leaves falling and the convertible top down. I'll take that over narcotics any day :-)

Now that's a big family!

Photo from this summer's family reunion & my Mom's 80th birthday celebration.

Energy

Funny, I'd heard before surgery that despite patients being told ahead of time that they'll have very little energy during recovery, that they're still surprised how little energy they have. Uh, count me in on that. I'm still at about 10%. Enough to take short walks, watch a few movies, read some car magazines, play some games, and now sorting through old photos.

Random things from a phone call

I just spent some time on the phone with my sister, Carolyn, and some things came up in conversation that I thought I'd share with everyone. Basically it's stuff I never blogged about cuz, well, it didn't occur to me at the time :-)

• The breathing tube didn't give me much of a sore throat
• Recovery overall has actually been pretty easy; The rough spots all seem pretty surmountable, and if I can't fix them time tends to
  
• It'll be about a month before I see my surgeon for a checkup
• My heart's "perfect condition" for the Ross procedure was mostly a happy coincidence, and less attributed to my exercise or eating properly in past years; This is something no-one knew until surgery began
  
• Assuming all goes well, I'll have no restrictions after about 3 months; scuba diving, skydiving, motorcycle racing, stock trading, whatever!
• I'm walking a bit each day, not too fast yet, but looking for some new scenery already
  
• I've been told I look "pretty normal" since surgery, whether hours or days afterward; I guess "pretty normal" is good enough for me
• I was very very lucky to have Ann Marie, my Mom, stepdad, mother-in-law, and sister-in-law with me in the hours after surgery; I can't say I remember every moment, but those that I do remember were wonderful and funny too!
  

Fever? What fever?

Well, the blood test came back negative - that is to say it was a positive result that there was nothing negative in the blood (got it?) The fever is being explained by the physical exertion done just prior to the nurse taking Chris's temperature. Taking a shower and getting dressed is hard work right after open heart surgery!

I am glad to report that Chris's temperature is right where is should be today. As directed, I am taking Chris's temp twice daily, and both times he was within the 'good' range. The big indicators we are to watch, besides pain, or course, are his weight and temperature. Presumably, sudden weight gain could indicate fluid retention which is not good for the heart; and high temp could indicate fluid in the lungs, which could lead to pneumonia, not good for the lungs. Rest assured that we are watching both things closely, but have found all to be fine thus far.

Chris is all tucked into bed for the night. He did a fair bit of walking today, venturing half way down the street and back - even on a bit of an incline. He is eating well, and resting often.

Now to get the kids to bed...

A bit of a fever

Our visiting nurse picked up on a small fever I have today.  After speaking with my surgeon's physician's assistant the current thought is there may be a bit of fluid in my lungs.  They've taken some blood for testing, and in the meantime have prescribed more walking and more breathing excercises to rid the lungs of fluid, if any, plenty of fluids to drink, and a bit of tylenol to keep the fever down.

Generally though it's great to be home, and only waking up at night on my schedule, not the hospital's!

REALLY home free...

Well, our Crisco is officially on his way home from the hospital.

I talked to the patient just a moment ago, as Escort Ann Marie tried desperatly to avoid any bumps in the road on the familiar route home. Any sudden movement would certainly hurt like heck, so it's nice to know that Nurse Ann Marie is already taking excellent care of Chris. Not that we had any doubt...

But like I said, the hospital is now a thing of the past. No more questionable meals, since Cook Ann Marie is quite gifted in the kitchen. Although Chris did say he enjoyed a tasty eggplant parmesan yesterday. His comment about the hospital food was that each meal's menu contained at least one really delicious item--it was just a matter of figuring out what that item was before you were served something that resembled a piece of soggy cardboard on a plate. But with no red jello being served at that particular joint, I wonder how difficult it was to find anything as yummy.

The good news is, Chris talked to his surgeon today, and was told that his Ross procedure was one of the best ever performed. That Chris' heart was in the perfect condition to receive the procedure, and that his healing process was moving along brilliantly.

But sorry, Dr. Surgeon. It's no news to us that Chris' heart is perfect. We could have told you that ages ago.

Welcome home, Uncle Crisco.

Thoughtful People!

Just a few examples of some nice things family & friends have done for us:

• Birthday gifts from kids to ease recovery: a tray for eating/reading in bed, a Ferrari model to build, a great handheld racing game - Grid - since I won't be able go drive a real car, popcorn and one of my favorite movies - 3:10 To Yuma - on DVD
• A new master bedroom, some comfy recovery clothes, and countless other things from Ann Marie
• Steak, beer, and The World's Fastest Indian (biographical motorcycle movie) made possible by friends Sean & Matt
• Gutter & roof repair, with all the excitement that comes with a 32' ladder, thanks to brother Ray & friends Matt & Sean
• Care packages for the kids from friends Lisa A. & Randi plus sister-in-law Maggy
• Meals for 1 month coordinated by friend Lisa R; Thanks to all of Ann Marie's helping others, the turnout was unreal - Lisa said she had to turn away about two months worth of additional meal offers!
• Care for our kids from brother-in-law John, sister-in-law Susan, and Ann Marie's mom Elsie
• Colorful cards & posters from my family to brighten my room
• An awesome pillow signed by my family and coordinated by our favorite middle child!
• A movie rental The Game and that much-desired Coca Cola from friend Jeff
• Blogging support from Ann Marie and niece Becky
• Books, music, cartoons, and photos from our kids
• Well wishes & offers of help from friends & family
• More stuff that I probably can't recall!

Thanks, everyone!

Perception

Well I've been up since about 5am after getting my vital signs checked (routine) and asking for the much-sought-after Milk of Magnesia.  That, together with prune juice last night (yuck), and walking about 1/4 mile will hopefully get things moving since the anesthesia, pain meds, and other factors have basically put those parts of me to sleep.  And while I could say "I'll be sure to share all the details as they happen today", something tells me most of you would want to Depend on me keeping the Serenity, Pampering you with other stories, and plenty of Huggies next time we see one another :)

Seriously, though, with recent blog comments you might expect that I'm looking like my usual self.  You should see me shuffling slowly through the hall in my slippers and robe, sipping my prune juice and wearing my seriously out of fashion eyeglasses for purely practical reasons.  You should hear the silly questions I've asked my nurses late at night, and the help I've had to ask for.   Heck there's even a patient here who learned just 4 weeks ago that she'd needed this same surgery, and with a few days more recovery than me makes her scar look like no big deal.  

Well I'm off to take a rest now. It's amazing how just a little 
activity can tire me out! 

He's off and, well, not exactly running, but...

Chris is up and moving! After a nice nappy, he did a slow lap or two. But after getting a little fuel in his tank at dinner, he posted a record 6 laps of the unit! Working first on duration, not yet worrying about speed, he maneuvered the course like a champion.

Obviously his energy is up from the slow start this morning. His pain has been very manageable, not pressing his 'feel good' button hardly at all this evening. Which is good, since I believe they plan on taking it away tomorrow, replacing it with an oral medication that packs less of a punch.

With all the exercise he has had today, I am hopeful that he will fall asleep well this evening. With a good night's rest, tomorrow should be a banner day. It is amazing to me (and to him I think) that he had open heart surgery just 2 days ago! His incision is looking really good - not at all what I expected to see. And he is able to get in and out of bed, or a chair, by himself. Being in such good shape before surgery is really serving him well now. Having strong legs and abs is really helping his maneuvering up and down. I am really proud of him!

Sleeeeeepyyyy....

Well, after many tired hours, I think Chris is finally sleeping. He is doing really well, post-surgery-wise. He just hasn't been very successful at getting his brain to go to sleep. This morning he was able to take a little walk around the unit, doing about a lap and a half. At 4pm I will get him up to do some more walking.

Basecamp

Well there's little doubt that heart surgery is like climbing a mountain.  If you are lucky like I have been, there's time to plan the trip, multiple routes to choose from, and plenty of experts to consult.   Once you set out, there are parts of the climb steeper or trickier than others,  surprises along the way, and hopefully when the trek is complete, a wonderful view from the top.

So I guess I can say I've made it to basecamp, and from here I can see what looks like a superb summit in the distance.  Indeed, I never guessed I'd be awake most of the day joking with Ann Marie and the hospital staff, and sitting in a comfy chair tonight blogging from our XO laptop.  Granted I'm a bit tired after a largely sleepless night last night, and after a diversion today to find the right mixture of pain medications I'm rather worthless.  But one thing's for sure -- I'm looking forward to tomorrow's challenges.  Who knows, maybe I'll blaze a new trail down the hallway!  

Great view from my new room

Great view from my new room. It's private too - boy I'm gonna sleep GREAT tonight!

Goin' Mobile!

Well, Chris was just transported to the Cardiac Progressive Care Unit. Adios CCICU! He was transported in his comfy chair, down one floor, and over one building. Mom and I am in the holding pen until they get him all settled in his new digs.

Before leaving the CCICU, he was served his first hospital meal - all liquids, of course. He loved the apple juice. Tasted the beef broth. And even ate the jell-o! Mmmmm...... greeeeen jell-ooooo!!

He is in great spirits, but dog tired, not having slept much since coming out of the anesthesia fog yesterday. He is looking forward to being in a more quiet environment than the always active CCICU. I have a feeling he is going to really zonk out as soon as he is settled in.

Just tried walking. Strong muscles,

Just tried walking. Strong muscles, but too light-headed for more than a step or two!

Aah... the wonders of modern medicine!

Well, Chris is looking much less encumbered today!  Like I blogged before, he is free from the ventilator and belly tube, and he also just had his central line IV removed.  I can only assume that this makes his life much more comfortable, being able to move his head without snagging anything.  

Now, most folks complain about hospital food, but Chris has been raving about the chefs supplying the CCICU selections.   They have supplied him with the most delectible ice!  He also started sipping water, which might have well have been a sparkling glass of Dom Periognon for as much as he enjoyed it.  He had dreams of going out to the local brew pub with his friend, Jeff, bellying up to the bar, and ordering a frosty glass of --- Coke!  It's the simple things in life....

His daytime nursing care has been stellar.  He had a visit this morning from the nurse he had when arriving at the CCICU yesterday - just to check in on him and say 'hi'.  She was really im pressed with how good he looked, and regrettted not being assigned to his care again today.  She was FABULOUS yesterday.  His nurse today is very nice as well, as are the rest od the staff I have met today. They are crackin' jokes with Chris, and keeping him as comfortable as possible. The night care, though,  could have been better...

The CCICU is getting him out of bed this morning, and sitting in his own comfy barco-lounger - Looks like he should have a remote in one hand, and a soda in the other (and maybe some clothes - the hospital gown kinda ruins the look!)  But sadly, no big screen TV in sight.  He will remain in the chair until they have a bed in the Cardiac Care Unit, where he will moved to later today.  Yea!

Good News & A Great Nurse

My 3rd IC nurse just said my incinsion is dry & has healed quite well. Can u belieue she's so cool she's happy with me blogging while she rebandages me!

Hello! It's me in the ICU

Hello! It's me in the ICU. Great hospital here. I'm having some great moments like typing this msg on my phone. Ann Marie is blogging soon.

Sounds like he had a good night!

It was great to spend hours with Chris after his surgery yesterday! He looked much better than I expected - looking liking his regular self, just with a little extra tubage :) Chris seemed to be tolerating the vent - the part he was least looking forward to in all of this. Though he couldn't talk, and his arms were constrained until the vent comes out, he did a great - and very patient - job communicating with me by spelling things out with his finger on the sheets. He is a remarkable guy - making me laugh, even while in the CCICU!

I stayed as long as they would let me last night - finally getting the boot at 9:40pm. He was going to sleep when I left, with pictures of the kids taped to his bedside, and ear plugs in his ears. He was sleeping peacefully at 11:30pm when I called to check on him. Then I did the same.

At 6:15 this morning, I was so happy to be told that he was extubated last night. He was apparently comfortably listening to his MP3 when I called. I can't wait to see him this morning. I expect he will be much more comfortable today without that tube in - and having free movement of his arms!

Gotta get ready to get on the road. More later...

home free

I just got off the phone with Ann Marie.

Chris (or should I say Crisco?) is out of surgery. According to his surgeon, everything went as planned, and actually couldn't have gone better. His surgery took a full four and a half hours, but Ann Marie got to receive regular updates in the waiting room, so time flew by quickly. At least on her end of things.

Now that he's off of the operating table, our favorite patient was just wheeled past his loving wife and whisked off to the cardiac intensive care unit, where he'll stay for the next 24 hours. Don't worry, it's typical procedure to treat him as though he's in critical condition, even though he's doing just fine. They'll keep him closely monitored since it was such a major surgery, but sometime tomorrow, should everything go well, he'll be moved to the regular unit. With the other regular people shuffling around in hideously ugly hospital gowns, spoon-feeding themselves green jello and moping about how their tiny TVs don't get any of the good channels.

So Chris, as you recover, we'll be thinking of you and praying for a speedy recovery. Hoping you at least get cherry-flavored hospital cafeteria jello. That's by far the best kind.

Update from Ann Marie ....

Update from Ann Marie .... Got another call from the OR - Chris is off of by-pass and doing great. Should be done by 3pm.

Update from Ann Marie ....

Update from Ann Marie .... Just got update from OR-all is going well. I was happy to hear the Ross procedure is underway.

Update from Ann Marie ....

Update from Ann Marie .... Just spoke with Dr. Cameron-he is starting the surgery now, and Chris is doing fine.

Update from Ann Marie ....

Update from Ann Marie .... We're on our way to Hopkins. Glad to get the ball rollin'...

Speaking of 7:30am ...

I'm now scheduled to get to the hospital at 7:30 tomorrow morning (surgery is something like an hour afterward). Hey another 2 hours of sleep compared to what this morning was supposed to be like! Never got a call back from the disability insurance company, so I enjoyed the day off today :-)

Isn't technology great?

I was listening in on a corporate "town hall" meeting several years ago where a brand-new VP was taking questions -- admirable for a guy just a few weeks on the job. Things hadn't been going well for the company as the Internet bubble burst, and some of the employees on the conference call were clearly frustrated. One person asked in great detail why our flagship e-procurement software had a particular bug, one likely attributed to some of the lofty goals, new technologies, and short deadlines behind our product. The employee rattled off the background of the issue in such great detail that there was really no way for the VP to answer intelligently. The first words out of the VP's mouth? "Isn't technology great?".

With that, I've heard the email feature on this blog isn't working as advertised. Sorry about that! A few things to check before you give up:

• When you subscribe you'll need to respond to a confirmation email
• If you don't see the confirmation email be sure to look in your spam folder
• If you still don't see it, it's OK to re-try subscribing

If you've responded to the confirmation email but still aren't receiving emails, I'll just have to ask that you visit the blog web site instead of waiting for email. Then some day when it's working again you can say "Remember the days when we actually had to open a web browser to read someone's blog?"

And out west it's 7:30am

With the wheels of short-term disability underway, I called the insurance company earlier to see if I'd screw things up by working today. Now, granted, while I've been known to have a decent work ethic, I'll also admit I have a great job -- so working today seems natural to me. Anyway, it turns out my case manager wasn't in her west coast office yet, so I've got some time to hang out until I get the word. With that, I'm taking my Mom's great advice -- start reading a good book before going in the hospital -- then, when you're feeling lousy, it'll be easier to convince yourself reading is a good idea, and the hours will fly by :-)

Not today

Stay tuned!

Still waiting

Mostly likely I'll be bumped to tomorrow, but I'll know more in about an hour. For sure, it's nice not to be the emergency case! In fact, when my surgeon asked yesterday "so how have you been feeling since we last saw each other" he was pleased to hear I was well enough to go mountain & road biking for about 20 miles on Sunday :-)

Delayed ....

Delayed .... An emergency case is bumping me off my early time slot. Woohoo we get to sleep in! Will know new time later.

"Blogging, loud and clear..."

So, friends, I am one of the people that a certain Mr. Krahe has asked to blog on his behalf over the next couple months. I suppose a little bloggy hello is due.

Shall I introduce myself for those who have no idea who they're dealing with? I'm Becky Moseley, Chris' oldest sister's third child. You follow? So, Mr. Krahe is actually Uncle Chris to me. Or Uncle Crisco, as my little sister would call him.

I guess when my siblings and I were a wee bit smaller--okay, a lot-bit smaller, considering my brother towers over just about everything at 6'9"--our Uncle Chris would come out to California on business every so often. One of those times, my sister Grace was confused by his absense either during a family dinner or trip to the beach. She simply asked, "Where did Uncle Chris go?" Then giggled because it sounded like "Crisco". The name stuck. We must not be very exciting people if a name sounding similar to shortening that usually just takes up space in the back of our kitchen cabinets brought on as much laughter as it did.

But alas, we silly few seek to find humor in just about anything. And I am here, blogging away, trying to keep things light and fun amidst a pretty serious surgery. That's what Chris requested of me, so that's what I intend to do.

We're behind you every step of the way, Uncle Crisco! Goopy shortening and all.

Us 1, Hospital+Insurance 0

Long, but successful day. After many phone calls, messages, and discussions over the past 4 months, we finally have the insurance straighted out. All of Ann Marie's ground work, and my I'm-not-leaving-the-hospital-today-until-this-is-resolved, payed off. Here are the funny bits we experienced.

• We started the approval process in May, like what, 4 months ahead of time.
  
• All summer long we got plenty of "it's underway, we'll get back to you next week".
• Early September the hospital says "oh, we have you down as 'self-pay'".
• Soon after the insurance company confirms an authorization letter was mailed to us.
• Today the insurance company says they didn't mail an authorization letter, but not to worry because "it's approved". They give me the authorization number, and, at my request, read the procedure code and description.
  
• It turns out I'm authorized for the wrong thing! While the authorized procedure includes the expected words "valve replacement", it also includes words that explicitly exclude the exact type of procedure I'm having.
  
• The surgeon's office admits the hospital submitted the wrong procedure code.
• We leave messages for our hospital admissions representative, the one who is the liason to our insurance company.
• After calls go unanswered, and Ann Marie encourages me to be persistent, I learn that our assigned admissions person left the admissions group early this month!
  
• We ponder whether the "we have you down as self pay" ball-drop has anything to do with the departure since, it turns out, that was the person's last day of working there.
• I meet our new representative, and with her excellent help, straighten the whole thing out!

Wow. While it's difficult to imagine how those without the time or energy handle this stuff, it's good knowing that the excellent medical care at our hospital more than makes up for its administrative woes. There's no doubt in our minds that even if the insurance mixup wasn't detected and resolved ahead of time, that our surgeon would have performed the RIGHT procedure, regardless of what the paperwork said.

Update from Ann Marie ....

Update from Ann Marie .... Well, i'm at JHU waiting for Chris to finish his pre-op blood work. I guess this is just a warm up...

Responsibilities

Several times during the last few months people have said to me "you seem so ready for this surgery ... you seem to have everything covered". Well if we ignore for the moment that I generally like to be prepared for things, and that I have had several months to prepare, it's easy for me to explain why I've been so motivated to be so "ready". It's because I see it as my responsibility.

First and foremost I've got a responsibility as husband and father. Knowing I had a heart condition all these years, I did my best to stay in shape and eat generally well (except of course for the occasional Costco hot dog ;-). Sure, the kids got tired at times playing soccer or some other high-cardio sport that got me the exercise I needed. Who knows, maybe they'd be shuffleboard champions if it wasn't for me. One of them will even tell you of when I rode my bike around the block like 12 times while they timed me and raced me down the hill in front of our house. It was my way of including them, and having a heck of a lot of fun, while at the same time getting a vigorous workout. And for sure Ann Marie held down the fort while during my many trips to the gym. But while all that exercise couldn't prevent surgery, it's great knowing my good health is part of what qualifies me as a candidate for the procedure I'm having -- that is, one that greatly reduces the likelihood of another heart surgery in my future.

Of course, responsiblities go a lot further than exercise, and extend further than Ann Marie and my kids. Things like prepaying bills, fixing gutters, straightening out finances -- and making sure we have fun along the way -- all factor into my motivation. The less my family has to take care of these tasks, the more they can recover from surgery just like I'll need to. And the better I listen to my doctors and nurses, focusing on recovery and walking after surgery even when I don't feel like it, the sooner I'll be able to come home, talk with family and friends, and eventually return to work.

So, no, it's not that amazing that everything seems "so ready". It's just my job.

How's Chris?

If you haven't guessed it already, this blog will be the place to get updates the day of my surgery and during the days and weeks that follow. I've even convinced a few lucky souls to be my co-authors while I'm unable to get anywhere near a keyboard. Perhaps they'll pop in with a pre-surgery blog post just to say hello :-)

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Great times

It's always been important to me to work very hard at things we must do in life to make time for the things we want to do. Work hard, play hard, I guess you could say. This comes mostly from my parents and siblings, who I've watched put endless energy into the things they love. It also comes from time I lost as a kid in front of the television, watching game shows and bad sitcoms. What I wouldn't give to get those hours back to put to better use!

It should come as no surprise that during the summer there was plenty of "must do's" before my scheduled surgery on September 24th. Ann Marie and I have been tackling them together, dealing with the hospital administration and health & disability insurance companies, getting our finances in order, creating my living will, fixing things around the house and with the cars, setting up a second computer at home, buying comfortable post-surgery clothes, and even setting aside blood for surgery.

So what I made sure of when I wrote each "to do" list, was to mix in the fun stuff. And I'm happy to say we've just about got it all done. I've got to say, that feels great, not to mention how blessed we feel to have had the time, and good health, to do so!

Here's a taste of the high points:

• In July we enjoyed our first official "staycation", which meant doing day trips from home instead of traveling for vacation. The kids said they loved it cuz we'd be able to re-visit the fun places we found -- what a great perspective! Finding fossils on a beach, riding and piloting a schooner on the Chesapeake Bay, paddling kayaks in Annapolis, watching the 4th of July parade and fireworks in our Nation's capitol, have some great battles in bumper boats & laser tag, kids competing in Maryland track & field event, and swimming in some great water parks. Wow.
  
• Also in July we celebrated my Mom's 80th birthday with a reunion. A great photo slideshow tribute, some Euchre, swimming, outdoor games, and plenty of visiting with the ~60 or so that made it!
• We've also done some biking, both on nearby mountain bikes trails and into DC on the Capitol Crescent trail. After a few too many falls I decided to replace the pedals that lock my feet down to traditional pedals, albeit with good traction. Sure, I might eventually learn to ride with my feet locked down, but something tells me now's not the time to be injured doing so!
• Ann Marie and I had a wonderful weekend away near the Virginia / West Virginia / Maryland border, taking a day trip down Skyline Drive in idyllic convertible weather, and stopping at the place where we were engaged almost 17 years ago! Staying on 400+ acres made us feel like we really got away.
• We made a few visits to nearby Silver Spring for church, a movie at a great theatre, shopping, and lunch.
• Ann Marie, sister Susan, and kids travelled to Cleveland to visit family and friends.
• I drove to New Jersey to spend time with great friends from years past, and even had the luck to see my Mom, sisters Patty and Carolyn & families, and brother Bill.
  
• I continued to Lime Rock Park in northwest Connecticut for vintage auto races featuring Ferrari, Bugatti, Lotus, Porsche, and other classics. Perfect weather, camping for 3 nights, and great roads to & from made for a wonderful trip. And in an effort to make the most of my time, I worked each night from about 4 until 10pm -- it sure helped having a laptop and wireless Internet at a nearby restaurant :-)
  

So, two weeks to go and still more to do. Sure, the chores are a bit of an uphill climb, but honestly I wouldn't trade these good times for anything!

Better than just 'recovery'

My thinking is that the word 'recovery' isn't quite sufficient to describe the time after my surgery. The word implies that I'm working toward feeling as good as I felt beforehand. But in this case, I'm working to feel much better than I ever would have felt otherwise. To be better, stronger, and faster, all without the benefits of bionics or superpowers!

With that in mind, what's the time after surgery supposed to be like? One surgeon has described it like being a puppy. Sleep, walk around a bit, maybe eat a little, and then sleep some more. That sounds OK I guess, as long as I don't develop a need to chew on shoelaces or similar :-)

After preop tests a week beforehand, I'll check in to the hospital the morning of my surgery. I'll head home after 5 or 6 days or so. I'm sure it'll be a great feeling to be back in my own bed at that point! I'll rest at home and slowly rebuild my strength over the next 4 weeks, taking some walks and enjoying the Fall weather. I may have a visiting nurse during those early days, but Ann Marie and kids will be my real caretakers during this time. At the 5 week mark my surgeon will check up on me and tell me it's OK again to drive, as long as he doesn't learn my driving style, that is :-) At roughly 6 weeks after surgery, I'll probably be ready to return to work. Knowing how much I like my work (honest), I'll have to be careful not to jump in sooner than I should -- I don't want my only real energy of the day to be spent at the office.

After all of this, and a bit of good luck, I'll have no restrictions. Watch out, mountain bike trails of Maryland!

It's great to have options

With three cardiac surgeons and a cardiologist each recommending surgery this year, it's pretty obvious that while surgery in 2008 is technically an option, it's the only option that makes sense. But what is an option for me, fortunately, is the type of valve with which my surgeon will replace my aortic valve. Who would've guessed there'd be options here? I'll give the quick rundown, for those of you who are interested.

One option is a mechanical valve, which is a man-made valve that is built to last a lifetime (and then some). The big negative here is the necessity for a lifelong blood thinning medication, coumadin. With a blood thinner the annual risks of uncontrolled bleeding and stroke total about 4%, and considering I intend to be around for at least another 40 years, the math just doesn't sound good to me. Plus while the valve itself doesn't wear out, there's a chance tissue could grow around it such that it interferes with the valve operation, a resurgery would be necessary. And last, the constant "ticking" noise might drive me crazy (or more crazy, as the case may be).

Another option is a valve made from pig or cow tissue plus some plastic. While these don't always carry the burden of lifelong medication, the big problem here is that these valves wear out, especially for younger people. So for me we'd be talking a valve at age 42 (this year), ~52, ~64, and ~80 years of age -- possibly 4 valve replacement surgeries in my lifetime. Ouch. And not to mention that as these valves wear out you go through the same phases of not feeling well, having reduced physical abilities, and deciding when is the right time for surgery, which of course you realize, is never.

A relatively new option is a "freestyle" valve, which again is pig tissue but is a replacement for the valve and the aortic root (the base of the aorta that attaches to the heart) as a single unit. While this valve and root unit perform together "as God intended", replacing it down the road is a big unknown -- too few replacements have been done worldwide to have good outcome stats, and surgeons that have done it have realized it's a particularly delicate procedure. Oh, and it's not a forgone conclusion that my root needs replacing anyhow.

The final option, and the one I'm going with as my first choice, is something called the Ross procedure. With this procedure, my surgeon will replace my aortic valve with my pulmonary valve. Because this replacement valve is my own tissue, this means there's no rejection, it performs wonderfully so my heart will keep up with all my sporting intentions, and if all goes well it will last forever. There is, however, the issue of replacing my pulmonary valve. This is done with a donated human valve, something that works pretty well for pulmonary valves but not for aortic valves. Unlike the 100% chance of resurgery in 20 years on a pig or cow tissue aortic valve, the chance here for resurgery is about 30% in 30 years. That I can deal with. The negatives? The Ross procedure, which takes me from being a "one valve patient" to being a "two valve patient", is delicate and requires a longer surgery.

Certainly my options could change at the time of surgery, if things aren't as everyone has guessed, and the tests have indicated, thus far. But thus far, options are good -- I can go in with a plan A and B and hope for the best.

Feeling fine, except ...

As springtime progressed this year, I expected that I might not feel my best in the months leading up to September. Minus feeling a bit more tired now & then, having a little discomfort before getting on a diuretic, and over-analyzing the beat of my heart that hasn't changed in 41 years, I actually feel pretty darn good. This is great, I couldn't ask for more.

But what I didn't expect in 2008 was that my 12 year old son (and his friend) would handily beat me in a running race for the very first time! No, it had nothing to do with my heart condition - it was a ~25 yard sprint that is well within my limits. I had my sneakers on and was ready to go ... but darned if that kid isn't super fast these days! Actually, he's always been fast, as have our girls. In fact if we were to sit down to calculate their scale speed, we'd find they've been faster than me all along :-)

And kudos to our kids for finishing so well in a recent county track-and-field day. Despite being on the younger end of their age groups and competing with kids on track teams, they were awesome. With finishing in the top end of 50 and 100 meter dashes, and surprising the judges with 2 golds and a silver in the standing long jump, I think this Dad better sit back and watch from now on :)

Plan A

It was back in 2001 that my doctor first said I had a heart condition that was "worth keeping an eye on". Officially, it was known as an aortic insufficiency, and generally meant that the heart had to work extra hard to pump the right amount of blood. Surgery, we figured, was "perhaps in my lifetime", though admittedly we didn't consider what surgery afterward would be like ;-)

Since then I've felt great. I could ride my bicycle as fast and far as I wanted, could run up 10 flights of stairs without losing my breath, and could out run just about anyone my age. That I'd been pretty good at exercising regularly, staying thin, and eating mostly healthy things hopefully helped. As recently as last year my doctor said my stress test results showed me in better shape than most other 40 year olds. Well, that is, except for my heart.

On a brisk day early this year, however, things were a little different. I was taking a class for coaching ultimate and we were finishing the day with a short game. I did fine in warm-up and practice, but after just 10 minutes on the field I was winded like I'd just run the Boston Marathon. That I hadn't been to Boston in years, which I should really do since it would be great to see my brother and family there, confirmed that it wasn't a marathon, but something that just months earlier was no problem for me. Clearly something was changing.

So with more tests, recommendations from my cardiologist and three cardiac surgeons (at Johns Hopkins, University of Maryland, and Adventist), and the wisdom of my wonderful wife, we've decided that 2008 is the year for fixing this. September, that is, the 24th.

The procedure, if you're curious, is an aortic valve replacement. I haven't convinced my surgeon to use the nifty valve technology from my Honda S2000 yet, but I'm working on it. Really I am. ... Well, OK, actually I'm not, but it's nice to think about. Especially variable timing and lift, which means easy efficiency at rest and power on demand when needed! Seriously, though, I do have some options to consider. I'll get to those later.

For now, I'm quite focused on being as ready for surgery as I can be, tying loose ends up at home and work, more or less. June & July will fly by with deadlines of painting and mapping, a fun day at the track with a seriously fast car, a local vacation, PA family reunion, new home computer, and assortment of financial and legal tasks. In August, I hope to enjoy time with my family, relax, catch some movies, read some good books, take a few drives, ride bikes, hang at the pool, and look forward to a great recovery in the Fall.

So, that is my plan A. I must say it's nice to have the luxury of making a plan, of having the time to consider everything, of meeting smart doctors, and having the wonderful support of family and friends.

So, what do I mean?

So, what do I mean by "A Car Does Not The Driver Make"?

Years ago I owned a Nissan Sentra. While having a particularly good balance between power and handling, it was nothing close to what anyone would mistake as a sports car. With 68 screaming horsepower, it was best to turn off the power-grabbing air conditioning off to avoid holding up cars behind me on hills!

It was with this car that I began autocrossing, a competitive event where you race against the clock through cones, typically in a parking lot. And it was at this point that I realized it didn't matter so much the kind of car you drove, but rather how well you drove it. In a lively discussion with friends regarding the Porsches, BWMs, and similar around us, I soon said the words "a car does not the driver make", meaning, well, that even if you have a good car doesn't make you a good driver.

These days I'm often reminded of this. Tools do not make the carpenter. Education does not make the student. Technology does not make the software developer. And so on. And now that I have a real sports car, I still have plenty to learn before I can drive it as well I'd like!