Tag: aortic valve replacement

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Learning How To Build A Better Boat

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Me and Cole circa 2005

A few days ago I finished writing about my aortic valve replacement surgery. For those who have read all the episodes and followed me through the approximately three months that led up to my December 17th open heart surgery, you may have figured out that it was the single biggest life changing event that I have ever had to deal with, both physically and emotionally! Even that is a gross understatement, to say the least!

For those of you that may not have read the seven part story that I have posted up on this website, you may want to spend a few minutes to check it out!

This morning I took time to re-read my work on the multi episodes involving my aortic valve replacement surgery. By doing so those posts triggered some new and different emotions within yours truly!

After further review, and much more contemplation, I have come to realize that my perspectives on many things have changed dramatically since December 17, 2019.

Over the last five years leading up to my open heart surgery, I was spending more and more time alone, for reasons that I will not delve into for this post. I wasn’t lonely, but I really didn’t mind being alone. More time than I would like to, but I was ok with staying home.

I have my brother and sister-in-law living just a couple of blocks away, but generally I spent most of my time by myself. For the four months of June-October I would spend the that traveling from Yuma up to Fresno, Sonoma, Coos Bay Oregon, back to Santa Rosa, over to Chico, to Las Vegas, and then back to Yuma caravanning with them in our motorhomes. I did that from 2011-2019 and had a fantastic time with family and friends.

The summer of 2019 kind of was a watermark summer. That is when I knew that I would be having my aortic valve replaced come the Fall. That summer was a time for me to begin my internal investigation of not what I was, but who I am!

Those two concepts, what I am and who I am, are totally different concepts and require a much different personal investigation. For most of my first 60 years I was really more focused on what I was. I spent most of my time focused my airline career and pursuing the almighty dollar bills. That is until May 16, 2010. On that evening an event occurred that would define my life up to at least this writing. After level off at 36,000 feet on my JFK-LAX leg back to my domicile my world lit up……..literally. My windshield caught on fire! The fire was within 36 inches of my face. Stick you arm out in front of you and at the tip of your index fire was a raging inferno! If you will follow the above link you will read my detailed accounting of that evening’s nightmare!

From that flight on May 16, 2010, until my surgery on December 17, 2019, there was a moving target in the medical crosshairs and that moving target was my heart!

As I have chronicled in my seven part series leading up to my aortic valve replacement surgery, it was, to use an ol Paul McCartney song title, “a long and winding road”!

Over the last four months recovering from open heart surgery, which has gone extremely well so far, I have had time to think about many things. There has been some subtle as well as some not so subtle things change with my persona.

I have always been a somewhat emotional guy, in that I have always worn my heart on my sleeve. I could get my feelings hurt easily, but I would not necessarily let you know that. I was somewhat stubborn when it came to some things, but I wouldn’t necessarily dig my heals in and let everyone know that I was raising “The Bullshit Flag”!

Since my surgery, however, some of those things have changed. I now realize that my time on this Earth is well past the halfway point, or even well past the two-thirds point, and I need to look out for myself. It is not so much as being self-centered as it is realizing that, at 69 years old, there is more of my life in the rear view mirror than there is left out the front window! That, my friends, is a tough pill for me to swallow! I say that because I have always thought of my self as a young man, after all I am the youngest of five children.

As previously mentioned, in the last four months things have changed and I have found that I have little to zero tolerance for falsehoods, prevarications, obfuscations, bloviations, fallacies, hyperbole, deceit, lies, or just plain bullshit!!!

Sorry Mom, but I gotta call it the way that I see it!

Whereas I used to just hold it all in and fume about it at a latter time, I now walk smartly over to the flag pole and zip up the ol Bullshit Flag as fast as I can hoist it up! To put it another way, I really cannot stand for someone to insult my intelligence!

One of my new slogans that sums up the way that I feel these days is: “Don’t Piss On My Leg And Tell Me It Is Raining”!

The other side of that discussion is that I have found that I have noticed that it doesn’t take much to get the damn to break and my emotions will find a way to escape through my tear ducts. It is quite embarrassing, but I can’t control that aspect of my life right now!

Now at my advanced age, 69 yrs old, I have to learn how to deal with this new hand that I was dealt in this game of life!

The one thing that I have always done, but I am putting even more emphasis on it now, is to tell my loved ones how much that do love them. Whether it is my kids, my grandkids, my brothers, my extended family, or just my longtime friends. I always tell them that I love them when we part. I want them to know that I really appreciate them being a part of my life, whether it has been for six days or 69 years!

What I don’t know is how much time is granted to me since my open heart surgery, but I do know that I want to enjoy every minute of whatever time is left!

Referring back a few paragraphs when I mentioned that there are two concepts that people have to struggle with as they grow up and old, what you are and who you are.

After 69 years I now know WHAT I am! I am a retired airline pilot, a dad, a grandfather, and a brother.

But now I am in the process of discovering WHO I am! In this journey that has already embarked, as of December 17, 2019, I am trying to take it all in and to decipher what I see. As this journey meanders through life’s highways and byways, I will need the help of each and everyone of you who are in my life presently to interact with me, to share the ups and downs of my life, to keep me grounded, and most of all, to actively join in my journey and meet me at the destination!

My view on life used to be that it was the destination that counted, not the journey. But I have found that idea to be woefully inadequate of a description! Life is, in fact, about both the journey and the destination, my friends!

Will you join me in my journey to my destination? It should be one heck of a party as we proceed!

TIL NEXT TIME, KEEP THE SHINY SIDE UP!

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Wiggle Your Toes!

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Mile High Nationals about 1999

When the last episode ended my anesthetist had opened up the flood gate for “the happy juice” to flow through my IV. Additionally, I was about to grease another landing on in “Happy Valley”, the body tingling began, and then the lights went out!

ADIOS DUDE!

Those six hours that I was out and on the heart/lung machine seemed to only be seconds before I was coming out from under the influence of “the happy juice”!

As I was slowly coming out of the deep comatose of anesthesia I was having intermittent breathing issues. I could feel the breathing tube down my throat and ending at the bottom of my right lung. It felt like I had a glob of phlegm, a goober, some may call it a loogie, that would temporarily block the bottom of the breathing tube so that I couldn’t breathe! I was beginning to panic. In a few minutes, or so it felt like, the breathing tube was being slowly removed!

HALLELUJAH!!!!

Somewhere in this same time frame, while I was ever so slowly resurfacing, I heard my nurse tell me to wiggle my toes. I responded by trying to wiggle my toes. I thought that I could visualize a figure that resembled Jason near the foot of my bed. In fact, it was both Jason and Jim in the room! God, that was such a warm fuzzy feeling knowing that they were in the room with me.

As I found out later that night or maybe the next morning, Jason told me that he wormed his way into the ICU long before access was granted to the family. Apparently Jason was watching nurses, and other authorized individuals, come and go through that door and timed it perfectly when someone came out. He grabbed the door and held it open so that he and Jim could slip into my ICU cubicle. The ICU nurse was not happy with Jason, but allowed both of them to stay in my area for a few minutes to satisfy their concern!

As the effect of the general anesthesia was wearing off, I was thinking to myself, I made it! I don’t know how long that surgery took, but I made it! I am really alive! The emotions gushed all over me! I made it, I made it, I made it! They had fixed my heart and gotten me jump-started!

I AM ALIVE!

I guess that I am just lucky that way!

Soon I was able to keep my eyes open intermittently and my family was being allowed to come in to be with me while I was coming back to life.

I am not sure how long it took before all of my family was able to come in to visit me, but it sure felt good to be able to see them. I am sure that I probably wasn’t making great sense when conversing with them, but at least I was talking to them.

The worst was over and in the rearview mirror!

TIL NEXT TIME, KEEP THE SHINY SIDE UP!

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The Day Of Reckoning

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Kindergarden photo 1956

When we last gathered here I was relaying the story of my surgery being postponed because I had developed a UTI and the surgeon delayed the surgery so that I could get over that infection. What a huge emotional letdown that was, but it was much better that way than what could have been the alternative.

It is now the morning of December 16th and it is time, once again, to head over to La Jolla a day ahead of my scheduled aortic valve replacement surgery. This time Edie cannot come along because she had some medical appointments that she could not miss. No, this time it was just Jim and yours truly in my hot rod heading westbound through the desert to the Pacific Ocean! The other two brothers, with spouses with spouses in tow, and Jason (Jeremy was sick and I told him to stay home) were also heading to La Jolla to try this surgery support thing one more time.

This time, just like a finely choreographed dance movement, the four cars all arrived at the hotel within a few minutes of each other for checkin. We all took a few minutes to greet and hug each other. It sure made me feel a little more at ease to have my immediate family, once again, there for moral support.

We signed in at the front desk, exchanged pleasantries with the hotel owner, Maureen, unloaded our baggage into our respective rooms, and met back at the hotel office. Once we were all present, we headed down, once again to the taco joint, Puestos. It was a unanimous vote! Everyone was excited to get some more of those fabulous tacos there.

Following dinner we all adjourned to our respective rooms in preparation for my surgery in the morning at 8am. I pulled out the letters that I had written to my brothers and my son that were in envelopes. I instructed Jason to hand these out to my brothers for them to read while I was in surgery. He, Jason, also had a letter from me as well. I had decided a week prior to going to La Jolla for the first attempt at surgery that I wanted to express to each of my loved ones my inner most feelings, just in case the outcome of this surgery was less than the desired results.

In between this trip to San Diego and the last attempt at surgery I had completed the Power of Attorney forms so that Jason could make all the necessary decisions, if needed. I handed them to him in our hotel room and gave him a few instructions. I don’t think that it fully sunk into his head what this Power of Attorney means! It will strike him when they roll me down that long hallway for surgery, I will bet!

Prior to lights out in my room I receive a phone call from a phone number not listed in my phone and I debated on whether to answer that call. But it was an 858 area code and that was the area code for La Jolla. So I thought that I should take this call and not let it go to voice mail. I am very glad that I took the call because it was from my surgeon, Dr. Tyner. When I heard his voice I knew that something was up. He said that there was an opening in the surgery schedule slightly earlier in the morning and he would like for the surgery to occur during that time slot. Could I get to the hospital at 5am for a 7am surgery? I replied in the affirmative that I could be there at that time. So now I have three less hours of time til the show gets on the road. I notified everyone that I must be at the hospital at 5am, so we all set our alarms appropriately so that we could caravan over to Scripps.

So now it is time to go lights out and get some all important sleep before the big show happens bright and early in the morning!

The 3am wakeup call and alarm arrived within a blink of an eye, my friend! My routine began with shaving and taking a shower with this extremely strong ant-bacterial soap, just like the one I took just prior to climbing in the rack and grabbing some really valuable shut-eye.

I was trying to be a quiet as I could be so that Jason could sleep til I woke him up for the drive to the hospital. As I stepped into the shower a million thoughts ran through my mind. First and foremost was the thought of “yep this thing is really gonna happen”! Then I started thinking about what was really going to take place in that surgery room in about three hours. My heart began racing at supersonic speeds, my knees began to quiver, my mind was racing like a top fuel dragster, and the emotional flood gate opened up big time! Once again, my hair was on fire and I was having a hard time keeping it together in the shower. Thank God I was all by myself in there and nobody could see or hear what I was dealing with! I have to appear to have it together this morning and be fearless. Don’t let Jason and my brothers know that I am scared SHITLESS!! Put on your Pilot’s face Captain Blowdri…….do not let them see you sweat!

I was thinking just please just tell me when it’s over!

I drove the car with Jim and Jason along over to Scripps, which was quick and uneventful. THANK GOD!

Walking into the hospital I had another round of knees quivering and again the emotional rollercoaster had just left the loading station! As I rounded the corner and saw the receptionists desk where I needed to sign in, the emotional rollercoaster reached that first high peak, was now rocketing downhill, and my mind was having a hard time staying fixated on the paperwork that I was filling out!

As I finished the paperwork and walked over to where my family was seated the emotional rollercoaster subsided, at least temporarily.

Within about ten (10) minutes of completing the paperwork I was called back to begin the surgery prep. When that happened the ol body became overrun with the jitters. It was getting closer to a reality, this open heart surgery thing.

It took about 15-20 minutes to get me all prepped up for surgery. I stripped down to the ol birthday suit and slipped on that designer hospital gown that conveniently gives everyone a nice view of the ol flat saggy butt! At this point I really could care that, if I moved too quickly, I would be photographing the entire nurses station this morning. The unmistaken fact is that, unless they all had binoculars or a telescope they couldn’t see a thing. As George Costanza from Seinfeld so aptly put it……shrinkage was in affect this morning!

My brothers came in to talk with me and lend their support and express their love. Jerry and Sue came in and we prayed for my surgery to be successful and for my quick and complete recovery. When Jason came in I could tell in his eyes that he had grabbed the gravity of this event and appeared to be moved. Again, I expressed a few of my thoughts and requests to him. I told him to deliver the letters to the brothers once they rolled me down the hallway.

Shortly after I got those items off of my chest to Jason the surgical nurses came into my room and announced to me and Jason that “it is showtime”! I wanted to crawl out of that bed and slither out of that hospital, but I also knew that I have to have this procedure done if I want to live to a ripe old age. Jason squeezed my hand, gave me a kiss on the forehead, and told me that he loved me. It was extremely difficult for me to keep it together as they rolled me out of the room! I kept thinking don’t let him see that you are falling apart. You are the dad, be tough, be strong!

The ride down that hallway to the OR seemed to take an eternity. It was enough time for me to see my entire 68 years run by in my head. Along the route there was a left turn, then a right turn, and then we stopped in front a set of double doors. I think that this is where “the show” will be happening.

One of the nurses hit the button that opens up those doors to reveal this well lit, high tech, surgical room where I will spend the next 5 or 6 hours this morning. It was a busy hub of activity with 5 or 6 surgical nurses at their workstations preparing for my surgery. Once my two bed chauffeurs got me transferred onto that extremely narrow and highly uncomfortable surgical table, the process for me began.

The two that brought me into the surgery room began to attach all kinds of electric probes to my upper torso. They were very professional, but had a great sense of humor. I think that they could feel that I was petrified. So, they kept up the levity as they were doing their job.

Then something happened that I have never seen before. I have had a few surgeries in my day but this team was really unique. One by one each of the surgical team stopped what they were doing, walked over next to me, put their hand on my shoulder, introduced themselves to me, and explained their role in the surgery. The very last one to come over was the guy who was behind the big machine to my right. His name was Matt and he had the single largest impact on me.

He said, “Mr. Hammack my name is Matt. Do you see that big machine over there? That is the heart/lung machine and I will own you for the next 5 or 6 hours. I promise you that I will take very good care of you!”

WOW!!! That blew me completely away. I was astounded!

Now that the introductions were made they all went back to their workstations. I could tell that the preparations were rapidly coming to a conclusion. The anesthetist had arrived on scene and talked and comforted me as well. He said that he was giving me some thing to relax me a little. My two bed jockeys asked me if I would like to listen to some music while they were finishing up prepping me? Quickly I remember Dr. Tyner stating that he doesn’t allow any “noise” during the surgery. I said that I would like to listen to some music. I was asked what would be my pleasure? I replied do you have any Eagles tunes? Like magic my absolute favorite Eagles tune comes over the sound system…….. Hotel California!!!

How did they know?

Somewhere about halfway through this 6:36 classic rock and roll tune, before the Don Felder/Joe Walsh classic guitar solo, the anesthetist said to me, Good Night Mr. Hammack! With that announcement the curtain was beginning to fall and I didn’t get to hear the best part of the song……the guitar solo!

As my body began to tingle and I knew that the light switch was about to be thrown, my last thoughts before I greased on another landing in “Happy Valley ” was……..

Just let me know when this is over!

This saga continues.

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The Reality Sets In

Leon Hammack

As you remember, I left off the last installment where my cardiologist scheduled me to go downstairs and get my pre-surgery chest x-ray in preparation for my impending open heart surgery. Additionally, Dr. Adams told me that she would get in touch with Dr. Tyner’s office to arrange a pre-surgery consult with him, as well as inform Tyner that I would like to get on the surgery schedule for November 21st.

As I stepped into the elevator to go down to the first floor and check in with the imaging department, my whole being was in unbelievable turmoil! My hands were trembling, my heart was racing, my brain was desperately trying to keep my emotions in check, and my legs were as weak, rubbery, wobbly, and very unstable like a jar of SMUCKER’S strawberry jelly! I was thinking to myself the bad dream that I have had now for the past thirteen (13) years is finally coming to fruition! Even though I had the whole summer of 2019 to think about this surgery and prepare myself for it, I was woefully ill-prepared emotionally for what I was beginning to experience.

H-O-L-Y C-R-A-P!!!

The elevator door opened, I stepped into the lobby of the imaging center, marched over to the receptionist, announced my name, and she told me to take a seat, they would call me back. So I followed those simple instructions, dutifully stepped over to a vacant seat, parked my nervous and quivering body into one of the extremely uncomfortable chairs that are always in the waiting rooms of medical offices.

Within just a few minutes I was beckoned to follow this imaging person back to the waiting x-ray room. The chest x-ray took all of about 5 minutes to accomplish and I was set free to go as I came.

The three hour drive from La Jolla to Yuma seemed to have taken forever, when in fact it is just a three hour drive!

As I started up the ol Sequoia in the underground parking lot, backed out of my parking slot, drove out of the medical facility, jumped on the interstate for the drive back to Yuma, my body and heart were having an all out war for control of my brain! In racing terms I was having the dreaded helmet fire! Another description of this event would be that my hair was on fire! What was worse is that I couldn’t call 911 to put out the flames, because the flash point for this fire is deep inside my scull!

I really don’t remember much of the drive. I don’t remember driving through the city on I-5 and then heading out East on I-8, through and over the mountains that separate the towns of El Cajon and Lakeside from the Imperial Valley. Nor do I remember much about the drive through the Imperial Valley and on over to Yuma. I obviously was trying to cope with, and put into perspective, the events that were now beginning to sequentially fall into place.

What I do remember of that lonely drive back home was me thinking about all the things that were about to unfold. The reality that I was less than four weeks from having the open heart surgery that I have been thinking about off and on for the past thirteen (13) years. But those thoughts were always that it was way far off into the future, not in the here and now.

I would, from time to time, think about going through this pre-surgery routine, how I would greet and deal with the news that it was time “to get ‘er done”. I thought that I would have everything all in check, that I would be this rock steady, even keeled old man that people would say ” man, he has got this all under control”!

SURPRISE!!!!!

It just ain’t happening that way, brother!

The fear of the unknown will bite you directly in the ass, my friends! It will take total control of your life and put a whoppin’ on you! (More to come about that idea in another installment.)

So now I have approximately three weeks to prepare for the absolute biggest, scariest, event in my life, of which I have very little to absolutely no control over!!! Let that wash all over your body for a while and see if your hair catches on fire as mine did for the whole three hour drive home! I am sure that I appeared Zombie-like to other drivers as I navigated my way home! Because I was totally overwhelmed by what was beginning to happen in my life.

Some of the drive home I felt nervous and scared because I live alone, I knew that I was going have to take care of myself during this recovery process. There were some of those gut wrenching emotions rattling around inside of me that somehow wiggled and worked their way through my head and escaped through my eyes, which made it very difficult to see as I drove home.

Some of the drive home I was consumed self pity. I mean how could this damn thing happen to me…….why me Lord? I have always felt like I was a healthy dude most of my life, now things are just taking a healthy DUMP! I have zip, nada, zero control of this, and I have always been in solid control of my life! Well, dude that is not the case for me now! I am in the passenger seat along for this whirlwind ride that is about to commence!

As quickly as those self pity thoughts came into my head they vanquished. Replacing those thoughts, for a time, was the idea that I am so lucky that my abnormal aortic valve (I had a bicuspid aortic valve) was discovered and that I am having it replaced before it could fail completely and kill me! What a lucky dude I am!!!

Then, I would think yeah right I am going have my chest split wide open, my sternum sawed in two pieces, put on life support (a heart and lung machine), have my heart cut open, have my aortic valve removed and replaced with a bovine tissue sewed in its place, and then put back together. Oh damn I sure am lucky!!!!! (Does the sarcasm flow through here?)

The other prevailing thought on that drive was that I really need to get all my affairs in order, assign a power of attorney with Jason being in charge……..just in case……….you know just in case… you know what may happen. There goes the emotions erupting everywhere again!!!

I was a babbling fool by the time I arrived at my home that evening! But I got it together, at least til bedtime.

I am much too young to feel this damn old!

There will be more to follow shortly!

TIL NEXT TIME, KEEP THE SHINY SIDE UP!

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Fast Forward To Scripps 2018

Leon Hammack

From my visit with Dr. Jeff Tyner in the Fall of 2015 through the Spring of 2018, everything seemed to move along swimmingly, or so I thought.

In the Spring of 2018 my cardiologist in Yuma, I relocated my cardiologist from Fresno to the city where I was living, relayed to me that there appears to be some indications in the latest echocardiogram that warrant a closer look. He wanted to send me to the local hospital for testing. I had decided that I was about to fire him because he appeared to be practicing in the 1950’s! So with new curiosity I decided that I would take all of my tests over to Dr. Tyner at Scripps La Jolla to have him take a close look at these echos.

It was really good to re-establish contact with Dr. Tyner and to get his expertise again on my tests. After he scrutinized the different material that I brought to his office, he concluded that he could tell that the aortic valve is beginning to degrade, but not enough to schedule surgery yet.

Whew!!!! I am buying more time!

He informed me that instead of making the trip over to La Jolla when I was tested again, I could just have my cardiologist send them to him for his review. That is when I relayed to Tyner that I was about to fire my cardiologist and I want to establish a cardiologist within the Scripps campus. I asked him if he had any recommendations? (I had already done my research and had a list of five doctors I was considering.) He paused a moment and asked me if it mattered if the cardiologist was male or female? I replied that it did not. I just want the best cardiologist here!

He then said that was good and that he will work on getting me an appointment with Christina. I looked into my notebook and found. Dr. Christina Adams and asked if that was the doctor that he had in mind? He nodded affirmatively and replied that he was pleased that I had done my homework!

In about 3 weeks I got an appointment with Dr. Adams, so I hopped in my car and headed over to La Jolla for the consult with her. She is a very pleasant, extremely competent, and kind physician. She went over all of my meds, she looked at Dr. Tyner’s comments, and she came up with the plan. As she walked me out of the office towards the front door, she reassured me not to worry about my aortic valve. She continued saying just let her and Dr. Tyner worry about those medical needs! As I walked out to my car, I told myself that is exactly what I need to do.

Six months later, November 20, 2018, I returned to her office for and echocardiogram, consult, and review of the echo. After the completion of the echo I had about and hour till I saw. Dr. Adams so I grabbed a little light lunch in the basement cafeteria. Up in the office, Dr. Adams enters the room, we again run through my meds, and she talks a bit about my aortic valve. She indicated that the valve regurgitation has worsened and things are beginning to degrade, but leave the worrying to her and Dr. Tyner. She further added to enjoy the upcoming holidays with my family, and that she would see me in 6 months, in May.

In May I return to Scripps for another echocardiogram and consult with Dr. Adams. This time there was something different about Dr. Adams and how she entered the room. It was at this time that she indicated to me that surgery is just on the horizon. The aortic regurgitation. has worsened and the ventricle wall has began to thicken. That really knocked that crap out of my happy-go-lucky attitude that I was exhibiting! My stomach immediately knotted up and began twisting like wringing out a bath towel! After I gulped once or twice I asked her does that mean that I need the surgery ASAP? Her reply was that I didn’t need to cancel my annual summer RV trip to Oregon. However, I need to be keenly aware of any chest pain, swelling of the ankles, and or shortness of breath. If any one of those conditions presents itself, load up the ol RV, get on back home, and give her a call!

Well, the summer of 2019 went extremely smooth!

Once I returned back home, got all my stuff offloaded from the RV and put away in my house, it was time to go back to Scripps in San Diego for yet another echocardiogram and consult with Dr. Adams.

This visit was an eye opener! After reviewing the echo she again asked me when was the best time to do the aortic valve replacement surgery? I had all summer to think about the answer that I gave her. After I found my tongue, grabbed my chin from the floor, I looked at her and told her November 21st. My heart was dieseling, my stomach was knotted up, and I had a hard time controlling my emotions as my words came out!

She said to me since you are going to need a chest x-ray pre-surgery, and it was within 30 days of my surgery date choice, would I be willing to go down and get that done since I am already in San Diego? I thought that was a good idea. She called down and reserved an appointment for me. Additionally, she told me that she would arrange a pre-surgery consult with Dr. Tyner.

All of the sudden I realized that I am not bulletproof anymore,

I don’t go all in but I’ll take the gamble
And I don’t burn both ends of the candle anymore
I take the corners, slower and steady
This chip on my shoulder, it ain’t so heavy anymore

We still fly like gypsies
Just a little closer to the ground
And we still love our whiskey
But now it’s just a little watered down

More to come!

TIL NEXT TIME, KEEP THE SHINY SIDE UP!

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I Was Born That Way!

Cole's 5th B'Day 081
Cole and I on his 5th B’day 2007.

Just about at the time that this photo was taken of me and Cole back in 2006 is when I went to see a cardiologist about my blood pressure. During an FAA physical in the spring of 2006 it was noted by that FAA doctor that my blood pressure had begun to creep ever so slightly upward, and that this doctor had heard a murmur while listening to my heart. He advised me to go to my primary doctor and get it checked out. This also coincided with me leaving Denver and moving back to my hometown of Fresno, CA.

Once that I got moved in and established back in Fresno I sought out a cardiologist, Dr. John Nelson, who had saved my brother’s life after having a massive heart attack a few years previous to this time. So once I got into to see Dr. Nelson he began to delved into why my BP (blood pressure) was creeping up, and what was the origins of my murmur.

Through the Summer and into the Fall of 2006 my doctor set me up for several tests, one of which he wanted me to do was and angiogram. I immediately squashed that idea because I did not want that on my medical record to go with high blood pressure and I was also diagnosed as a borderline diabetic. My health appeared to be taking a tumble and I didn’t want the FAA to ground me because of these early heath warnings.

So Dr. Nelson began his best impression of Monty Hall! We bantered back and forth trying to make a deal about different types of tests he thought would be beneficial in nailing down my particular issues. After much discussion he asked me if I would agree to do a 64 Slice. He said that at that time it was a very cutting edge test. Unfortunately, he informed me that more than likely my insurance would not pay for it. I asked him what it entailed? With a name like 64 Slice it sure sounded very invasive to me and my guard was already way up!

He informed me that it was a type a CAT scan, and he thought that it may help in nailing down the origins of my heart murmur. It would enable him to see my heart with a much higher resolution. He said to be me, “if I can get you in for free will you do it”? “You will have to go to San Francisco to get this done”. Long story short, within a couple of weeks I was driving up to SF to have my 64 Slice!

After reviewing the results of the 64 Slice, Dr. Nelson noted that there appears to be an issue with my aortic valve and he had just one more suggestion. He wanted me to submit to a TEE. I asked him what the heck was a TEE? He informed me that it was a trans esophageal echogram. There was an idea that my aortic valve was bicuspid, two leaflets, versus the normal tricuspid or three leaflets. I was informed that the aortic valve lies right next to the esophagus and they (the doctors) can have a real good look to see if my aortic valve was bicuspid or not from the TEE.

After accomplishing the TEE is was proven that I have an abnormal aortic valve, bicuspid. It was something that I was born with, but took 55 years for it to rear its ugly head! At that time Dr. Nelson informed me that, in time, I would have to have my aortic valve replaced. So it was decided that my cardiologist was going to keep a close watch on my bicuspid aortic valve.

For the next four years everything seemed to remained status quo. My aortic valve regurgitation, aka murmur, remained in check and did not grow any more severe. My heart appeared to be operating perfectly normal, with that one exception of a murmur.

However, on the evening of May 16, 2010 there was an event that was going to change everything!

For those not family or close friends, and are not familiar to what happened that night, you must read the above link to understand what a traumatic event can have on your heart!

Stay tuned for Part 2!

TIL NEXT TIME, KEEP THE SHINY SIDE UP!

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I Have A Broken Heart, No Really!

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It was the best of times, and it was the worst of times! Isn’t that how The Tale of Two Cities begins? Well it is very apropos in my tale as well.

It was the Spring of 2006, I was 55 years old, when my life took a hard left turn, quite unexpectedly. I was taking my bi-annual FAA physical when the doctor was listening to my heart and suddenly looked up at me and asked me a question, that appeared quite out of the blue!

The doctor asked me “how long have you had this heart murmur?” I was completely stunned by his question. My eloquent retort to the doctor went something like this. “What murmur, I don’t have no stinkin’ murmur”!

The doctor then sat down beside me and explained what a heart murmur was and that, yes indeed, you do have a heart murmur. He then explained to me what to listen for through his stethoscope as he positioned that on my ears and over my heart.

I heard just exactly what he had heard! I did in fact have a murmur at 55 years old. How could that be? How could this just now show up? I have physicals yearly for twenty years, and for the last ten years a physical every six months.

In addition to the heart murmur, the doctor had detected that my blood pressure was creeping up. He suggested that I see my doctor regarding all this news. I was getting ready to move back to my hometown, Fresno, in just a few weeks so I thought that once I was all moved in I would contact a cardiologist. I decided I would make an appointment with the cardiologist that saved my older brother’s life a decade previous.

I was caught completely off guard. My first 55 years had been a cake walk.

Now, all of the sudden, “Houston we have a problem!”

After getting into to see Dr. John Nelson, he began to prescribe some medication that he thought would get my blood pressure down. Then he got down to brass tacks to try to find what the cause of my heart murmur to be. After an echocardiogram the doctor was beginning to get a feel for the culprit. Dr Nelson told me that the echo seems to point to a bicuspid aortic valve as the problem, but it wasn’t conclusive. He wanted for me to have and angiogram and that would help to flush out the answer. I had heard about that procedure and that you are awake when it is performed. My answer was “no Happy Valley, no angiogram!”

He didn’t like my response. So he sat back down and mulled over another plan. He asked me would I be interested in getting a 64-Slice? After he explained that it was non intrusive and that it was, in effect, a very strong xray, a Cat Scan type of procedure. At that time it was very leading edge. He would like to get me into this new test program in San Francisco that was cutting edge at the time and give him a better look at my aortic valve via that scan. He was pretty sure that my insurance would not cover the expense, but that he could get me enrolled for free,

I agreed that if it wasn’t going to cost me a thing, and that there was no adverse conditions or pain, I would do it.

It took several weeks to get my schedule and the facility’s schedule worked out. But, we made it work and soon I was off to downtown San Francisco for my 64-Slice.

It was a very simple, interesting, and basically a non-invasive procedure. It was like an enhanced x-ray with contrast. That was a very important piece of the puzzle to gather in order to make the proper diagnosis for me.

Having gathered the info from the 64-Slice, there was just one more test or piece of evidence required to nail down the reason for the murmur. Dr. Nelson suggested that I have a TEE (Transesophageal echocardiogram). I agreed to have that procedure at the hospital with Dr. Sandhu (you may hear more about this doctor later in this series, he was a trip)! I found out that the aortic valve lies right next to your esophagus, and this procedure allows a very up close and personal look at the aortic valve.

In a few days following the TEE Dr. Nelson concluded that I have a bicuspid aortic valve (two folds or flaps), normally the aortic valve is tricuspid or three fold or flaps. My bicuspid aortic valve is genetic. As Lady Gaga sang, “I was Born That Way”! It is genetic, in that, I received this from either my mom’s genes or my dad’s genes!

The results of the TEE gave Dr. Nelson the vital piece of knowledge to fully understand and diagnose what was to come down the road!

Now realize that this all happened in the time frame of late 2006 and the Spring of 2007.

What lies ahead for me will be eye opening and life changing!

This post will the first part of a several part series that I am in the process of writing to bring you up to date as to what is currently happening to me……… open heart surgery in the next six weeks.

TIL NEXT TIME, ROGER, WILCO, OVER AND OUT!

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Tissue or Mechanical?

Have you ever been asked that question?

Well, looking back on all the segments of my life, there have been many questions that have been asked of me.  Questions like how do you like your steak?  Would like paper or plastic?  Is this cash or charge?  Would this be credit or debit?  Would you like cheese on that?  Would you like that super-sized (my answer to that was always of course)?  Are you married or single?  Do you have any children?  Are you a  Republican or Democrat?  Are you conservative or liberal?  These questions get asked of most everyone very frequently, but not mechanical or tissue?

Well, now I have to really start thinking about how to answer what quite possibly might be the single most important question for my future.

Would you like tissue or mechanical, Captain Blowdri?

Aortic Valve Replacement Picture Using Bioprosthesis Valve Device

This mechanical aorta valve will last forever.  However the the patient must take coumadin for the rest of his/her life.  There are some really serious possible side effects from prolonged use of this drug:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); back, side, muscle, joint, or stomach pain; black, tarry, or bloody stools; blood in the urine (pink or brown urine); bloody or coffee ground-like vomit; chest pain; decreased urination; dizziness; fainting; fever; numbness or tingling; pain, unusual color, or temperature change in any area of the body; pale skin; purple, dark, or painful toes; shortness of breath; skin sores or ulcers; stroke symptoms (eg, confusion, slurred speech, vision problems, one-sided weakness); sudden severe pain in your legs, feet, or toes; trouble swallowing; unexplained swelling; unusual bruising or bleeding (eg, nosebleed, unusual bleeding from gums, increased bleeding from cuts, increased menstrual or vaginal bleeding, coughing up blood, bleeding at the injection site); unusual headache or weakness; unusual pain, swelling, or discomfort; wounds or sores that do not heal properly; yellowing of the skin or eyes.

Additionally the following may occur:

  • Fatal or nonfatal hemorrhage from any tissue or organ. This is a consequence of the anticoagulant effect. The signs, symptoms, and severity will vary according to the location and degree or extent of the bleeding. Hemorrhagic complications may present as paralysis; paresthesia; headache, chest, abdomen, joint, muscle or other pain; dizziness; shortness of breath, difficult breathing or swallowing; unexplained swelling; weakness; hypotension; or unexplained shock. Therefore, the possibility of hemorrhage should be considered in evaluating the condition of any anticoagulated patient with complaints which do not indicate an obvious diagnosis. Bleeding during anticoagulant therapy does not always correlate with PT/INR.
  • Bleeding which occurs when the PT/INR is within the therapeutic range warrants diagnostic investigation since it may unmask a previously unsuspected lesion, eg, tumor, ulcer, etc.
  • Necrosis of skin and other tissues.
  • Adverse reactions reported infrequently include: hypersensitivity/allergic reactions, including anaphylactic reactions, systemic cholesterol microembolization, purple toes syndrome, hepatitis, cholestatic hepatic injury, jaundice, elevated liver enzymes, hypotension, vasculitis, edema, anemia, pallor, fever, rash, dermatitis, including bullous eruptions, urticaria, angina syndrome, chest pain, abdominal pain including cramping, flatulence/bloating, fatigue, lethargy, malaise, asthenia, nausea, vomiting, diarrhea, pain, headache, dizziness, loss of consciousness, syncope, coma, taste perversion, pruritus, alopecia, cold intolerance, and paresthesia including feeling cold and chills.

Rare events of tracheal or tracheobronchial calcification have been reported in association with long-term warfarin therapy. The clinical significance of this event is unknown.

Priapism has been associated with anticoagulant administration; however, a causal relationship has not been established.

Let me just add that if I were to “suffer” from priapism I could start a whole new professional acting career and make a ton of money down in the San Fernando Valley!!  (I understand that the adult film industry, just like the United States Marine Corps, is always looking for a few good men!!!)

Now my other choice for aortic valve replacement is a tissue valve.  The tissue replacement may come from the patient, from a pig, or from a cow.  Life expectancy of the tissue replacement valve is approximately 10 years.  Therefore, at my present age, 59, there is a possibility that I might have to endure two of these surgeries, when the decision to replace my aorta arrives !

Now having researched these two options still doesn’t make the decision very easy.

Let me review these choices:

If, when the time comes, I select a tissue replacement from either a pig or a cow there are some serious humanitarian concerns.  What are the ramifications to society for consuming either a very finely grilled prime rib, rib eye, T-bone, porterhouse, an In-N-Out burger, or some really great pork chops?  Would that be a tabu thing to do in our society?  Would I be considered a cannibal?  These are questions that I want the surgeon to clear up before I ever have to make this particular decision!

Similarly, if the decision is made to have the mechanical valve relacement, and I was confronted with the dreaded side effect of priapism, would I be considered an outcast if I decided to capitalize on that “misfortune” and move to the San Fernando Valley to start my film career?

What is your view?  I need your help!  Is it mechanical or tissue?

I’ll get by with a little help from my friends!!

httpvhd://www.youtube.com/watch?v=tZcWTYZFHGc