Today (Friday, Aug. 11) I am home after a successful TAVR procedure at Scripps Hospital in La Jolla. My procedure was on Tuesday morning, and doctors not only installed a new aortic valve, but put in a stent where I had a partial blockage in an artery near my heart.
All I remember from that morning was being wheeled into the cath lab, and moving from the bed to the operating table. Then the anesthesiologist said he had given me some medicine to relax and the next thing I knew, I was waking up in the recovery room. I do remember Van Halen playing on the speakers in the cath lab as I was wheeled in, which I liked.
Later that afternoon, I was wheeled up to my private room in the Prebys Cardiovascular Institute. A bunch of family and friends came by to visit and support me. The sixth-floor room had a great view, but I couldn't see it because I had to lay flat on my back due to the temporary pacemaker that had been placed in my leg.
The hardest part of the whole procedure was having to lay flat without raising my head or bending my legs for more than 24 hours. I didn't really sleep much due to that, and the normal hospital goings on, vital signs, blood draws, etc., so I was exhausted by Wednesday, when the pacemaker was removed and I could sit up and move around.
But the important thing is that all the tests and indications showed the procedure was a success, and my new Medtronic aortic valve is working the way it is supposed to.
I was released from the hospital Wednesday afternoon. Apart from being a little tired and sore where the catheters were inserted in my groin area, I am feeling fine. I am walking several times a day around my neighborhood, and trying to build on that each day without overdoing things.
After a week, the restrictions on activity, driving, etc. will be lifted and I hope to feel a lot better when I exert myself. But so far, the heart seems to be doing just fine.
It is simply amazing to me that I can sit here in my kitchen typing these words, having gone for a walk this morning and then made French toast for breakfast, just 72 hours after a major heart procedure. I am also very glad to have this behind me, and want to thank my wife, Ava, my daughter, Salome, and all of my friends and family for their love and support.
Talk to you soon!
Friday, August 11, 2017
Sunday, August 6, 2017
Almost time
It's Sunday, Aug. 6, and I am two days out from my TAVR procedure. I feel a mix of excitement that the day is almost here, and of course, a good dollop of nervousness and anxious energy. I think I am less anxious than I would be if I were having open heart surgery, but still I know this is a complicated procedure, and there are risks.
I am happy because I have been waiting for this day for a long time, and I have high hopes that I will feel a lot better afterward, that I will be able to exercise and exert myself without feeling like I might pass out or my heart is pounding out of my chest. I just want to feel like my old self again, and be able to do things like ride a bike or paddle my kayak around Oceanside Harbor.
At the same time, I am stressed out because I want everything to go very smoothly. I'm optimistic but still worried. I'm sure these feelings are "normal" for what I am going through, but none of this really seems normal to me. These last few months have been a blur of doctor's appointments, tests, ups and downs and lots of stress. I'm more than ready to move on.
I keep thinking there are things I should do to prepare for my surgery and hospital stay. But really there isn't much to do. I have paid the bills, gone over the finances with my wife (normally I take care of the household finances so I wanted to get her up to speed), arranged for a friend to take care of our dog and talked to the editor of the newspaper I write for. I changed the oil on all three of our family cars, even though it wasn't quite time to do it!
I don't think I will be bringing much to the hospital other than my phone, charger and headphones. If all goes well I will only be in the hospital for a night or two anyway.
Tomorrow I will go to the doctor's office for my pre-op bloodwork, and meet with the nurse who will go over details with me about the procedure and what to expect post-op.
Then I will show up bright and early (5:45 a.m.) on Tuesday for my procedure. By Tuesday afternoon, I should be in my hospital room, beginning my recovery.
Very soon, I hope to be writing about my recovery and my life post-TAVR, and reporting about how much better I feel! Until then, I hope anyone reading this has good health and happiness.
I am happy because I have been waiting for this day for a long time, and I have high hopes that I will feel a lot better afterward, that I will be able to exercise and exert myself without feeling like I might pass out or my heart is pounding out of my chest. I just want to feel like my old self again, and be able to do things like ride a bike or paddle my kayak around Oceanside Harbor.
At the same time, I am stressed out because I want everything to go very smoothly. I'm optimistic but still worried. I'm sure these feelings are "normal" for what I am going through, but none of this really seems normal to me. These last few months have been a blur of doctor's appointments, tests, ups and downs and lots of stress. I'm more than ready to move on.
I keep thinking there are things I should do to prepare for my surgery and hospital stay. But really there isn't much to do. I have paid the bills, gone over the finances with my wife (normally I take care of the household finances so I wanted to get her up to speed), arranged for a friend to take care of our dog and talked to the editor of the newspaper I write for. I changed the oil on all three of our family cars, even though it wasn't quite time to do it!
I don't think I will be bringing much to the hospital other than my phone, charger and headphones. If all goes well I will only be in the hospital for a night or two anyway.
Tomorrow I will go to the doctor's office for my pre-op bloodwork, and meet with the nurse who will go over details with me about the procedure and what to expect post-op.
Then I will show up bright and early (5:45 a.m.) on Tuesday for my procedure. By Tuesday afternoon, I should be in my hospital room, beginning my recovery.
Very soon, I hope to be writing about my recovery and my life post-TAVR, and reporting about how much better I feel! Until then, I hope anyone reading this has good health and happiness.
Friday, July 21, 2017
Sitting in limbo
Hi all, as usual, it's been a while since my last post. I know I say that every time, for some reason I have been lax about updating the blog. Maybe because we are now in the hot, muggy days of summer and it's hard to get motivated? Or maybe I'm just lazy. Or too stressed. Or all of the above.
I named this post after one of my favorite Jimmy Cliff songs, and it captures exactly how I feel at this moment. I am waiting for some major stuff to happen, and it all has to take its own sweet time. There is nothing I can do to move things along any faster.
At the top of the list, of course, is my heart valve operation. Since I last wrote an update, I met with Jennifer Lutes, the nurse practitioner for Dr. Stinis, the cardiologist who will perform my TAVR procedure. She said my procedure had been approved by the medical committee, and is scheduled for Tuesday, Aug. 8.
That was welcome news, and I would have been totally elated, except for the little tagline at the end. "When we did the CT scan of your body, there was an incidental finding, some enlarged lymph nodes. It's probably nothing, or related to your history of Hodgkin's disease and radiation..."
That felt like a gut punch just when I was ready to hear some good news about the TAVR procedure, setting a date and talking about my recovery.
I know I am kind of a glass-half-empty kind of guy, but that information cast a shadow over things, and I found it hard to focus on the excitement of finally moving forward with my needed heart procedure.
My family doctor then ordered some blood work, which came back mostly normal, so that is reassuring, but she wanted me to see a cancer specialist to be sure. So that appointment is set for next week.
In the meantime, the date for my TAVR is just over two weeks away, and I am waiting to hear from Dr. Stinis's office on my pre-op tests and other preparations. I am both excited and nervous about that, but much less worried than if I was facing open heart surgery.
On top of all that, I am eagerly awaiting my daughter's return, in just under two weeks, from her study abroad year in Germany. Both my wife and I can't wait for her to come home, it is so exciting to think about our daughter being here for the rest of the summer, until fall classes begin at UC Santa Barbara.
As a self-employed free-lance writer, my work is dependent on assignments from my editors and clients, and right now we are in a typical period of summer doldrums, which means I have even more time to sit and brood and imagine worst-case scenarios.
So in between sparse work assignments, I am doing little home projects, taking lots of walks, playing my guitar for the first time in a long while, watching soccer and baseball and trying not to be too impatient about the things outside of my control.
As Jimmy sings:
"Sitting here in limbo, waiting for the dice to roll,
sitting here in limbo, have some time to search my soul
well, they're putting up resistance
but I know that my faith will lead me on..."
I named this post after one of my favorite Jimmy Cliff songs, and it captures exactly how I feel at this moment. I am waiting for some major stuff to happen, and it all has to take its own sweet time. There is nothing I can do to move things along any faster.
At the top of the list, of course, is my heart valve operation. Since I last wrote an update, I met with Jennifer Lutes, the nurse practitioner for Dr. Stinis, the cardiologist who will perform my TAVR procedure. She said my procedure had been approved by the medical committee, and is scheduled for Tuesday, Aug. 8.
That was welcome news, and I would have been totally elated, except for the little tagline at the end. "When we did the CT scan of your body, there was an incidental finding, some enlarged lymph nodes. It's probably nothing, or related to your history of Hodgkin's disease and radiation..."
That felt like a gut punch just when I was ready to hear some good news about the TAVR procedure, setting a date and talking about my recovery.
I know I am kind of a glass-half-empty kind of guy, but that information cast a shadow over things, and I found it hard to focus on the excitement of finally moving forward with my needed heart procedure.
My family doctor then ordered some blood work, which came back mostly normal, so that is reassuring, but she wanted me to see a cancer specialist to be sure. So that appointment is set for next week.
In the meantime, the date for my TAVR is just over two weeks away, and I am waiting to hear from Dr. Stinis's office on my pre-op tests and other preparations. I am both excited and nervous about that, but much less worried than if I was facing open heart surgery.
On top of all that, I am eagerly awaiting my daughter's return, in just under two weeks, from her study abroad year in Germany. Both my wife and I can't wait for her to come home, it is so exciting to think about our daughter being here for the rest of the summer, until fall classes begin at UC Santa Barbara.
As a self-employed free-lance writer, my work is dependent on assignments from my editors and clients, and right now we are in a typical period of summer doldrums, which means I have even more time to sit and brood and imagine worst-case scenarios.
So in between sparse work assignments, I am doing little home projects, taking lots of walks, playing my guitar for the first time in a long while, watching soccer and baseball and trying not to be too impatient about the things outside of my control.
As Jimmy sings:
"Sitting here in limbo, waiting for the dice to roll,
sitting here in limbo, have some time to search my soul
well, they're putting up resistance
but I know that my faith will lead me on..."
Friday, July 7, 2017
Decision time
Well, here I am a few days after the July 4th holiday, and I am awaiting a big decision point in the treatment of my aortic stenosis.
As I have written about in previous posts, I have been pursuing the possibility of a TAVR procedure rather than open heart surgery to replace my aortic valve. Most importantly, my history of chest radiation in the late 1980s puts me at potentially greater risk during open heart surgery, because the radiation may have caused damage that would be unknown until the operation begins.
On June 27th, I met with a surgeon, Dr. Tyner, for a second surgical opinion on whether I would be a candidate for TAVR. His opinion was that TAVR should be my first option.
So a couple of days ago, I spent most of the day at Scripps Clinic in La Jolla, undergoing a battery of tests known as the "TAVR workup." As I understand it, the tests are both a planning tool for the TAVR procedure, and a way of making sure there would be no impediments if I were to have the procedure.
The tests included a breathing or pulmonary test, in which I inhaled and exhaled into a mouthpiece to check my lung capacity; a "frailty" test which included a number of questions about my physical condition, a grip test and a walking test; a very extensive echocardiogram; and a CT scan of my heart.
Because the last two tests required contrast dye, I was turned into a human pincushion, getting three needle sticks for IVs.
But all of the tests went smoothly, and I was on my way home in the afternoon.
The next step is a meeting with Dr. Stinis, the interventional cardiologist, who would be the doctor performing the TAVR. On Tuesday morning, a committee of doctors will review my case and determine if TAVR is the best course for me. Later in the morning, I will meet with Dr. Stinis and his medical assistant, and learn which way the doctors want to go. I am hopeful we will get the green light for the TAVR procedure, and maybe even set a date!
I have to say that I am a bit nervous right now, while trying to maintain an optimistic outlook that things will work out the way I hope and expect.
Either way, whether I end up having the TAVR or surgery, I am looking forward to having the valve replaced (and my coronary artery blockage treated) so I can feel better and return to my previous, more active, lifestyle.
As I have written about in previous posts, I have been pursuing the possibility of a TAVR procedure rather than open heart surgery to replace my aortic valve. Most importantly, my history of chest radiation in the late 1980s puts me at potentially greater risk during open heart surgery, because the radiation may have caused damage that would be unknown until the operation begins.
On June 27th, I met with a surgeon, Dr. Tyner, for a second surgical opinion on whether I would be a candidate for TAVR. His opinion was that TAVR should be my first option.
So a couple of days ago, I spent most of the day at Scripps Clinic in La Jolla, undergoing a battery of tests known as the "TAVR workup." As I understand it, the tests are both a planning tool for the TAVR procedure, and a way of making sure there would be no impediments if I were to have the procedure.
The tests included a breathing or pulmonary test, in which I inhaled and exhaled into a mouthpiece to check my lung capacity; a "frailty" test which included a number of questions about my physical condition, a grip test and a walking test; a very extensive echocardiogram; and a CT scan of my heart.
Because the last two tests required contrast dye, I was turned into a human pincushion, getting three needle sticks for IVs.
But all of the tests went smoothly, and I was on my way home in the afternoon.
The next step is a meeting with Dr. Stinis, the interventional cardiologist, who would be the doctor performing the TAVR. On Tuesday morning, a committee of doctors will review my case and determine if TAVR is the best course for me. Later in the morning, I will meet with Dr. Stinis and his medical assistant, and learn which way the doctors want to go. I am hopeful we will get the green light for the TAVR procedure, and maybe even set a date!
I have to say that I am a bit nervous right now, while trying to maintain an optimistic outlook that things will work out the way I hope and expect.
Either way, whether I end up having the TAVR or surgery, I am looking forward to having the valve replaced (and my coronary artery blockage treated) so I can feel better and return to my previous, more active, lifestyle.
Thursday, June 29, 2017
One day at a time...
It's been a while since I've had a chance to update my blog. Over the past couple of weeks, I've felt like I was a bit in limbo, as I worked through the system to continue pursuing the TAVR option for replacing my aortic valve, as opposed to open heart surgery.
My concern with open heart, which has an excellent track record for decades as a way of treating heart valve problems, is my history of chest radiation for Hodgkin's Disease. Doctors have told me this is a "wild card," because the radiation may have caused damage that could complicate surgery and make it more risky.
In order to be considered for a TAVR procedure, which would allow me to avoid some of the potential risks of surgery in my situation, I needed a second surgical opinion that put me in an "intermediate" risk category. (The first surgeon I saw considered me a "low risk" patient for surgery, meaning I would not qualify for TAVR, a procedure in which the new heart valve is installed via a catheter inserted in my femoral artery.)
This week, after a few starts and stops, I met with a second surgeon who in fact agreed that due to my history, TAVR would be a good option for me.
Now things are moving full speed ahead. Next week, I am scheduled for the full TAVR workup, a series of tests to prepare for the TAVR procedure. The following week, a panel of doctors will review my case and, hopefully, give me a green light to move forward. I have an appointment with the TAVR specialist, a doctor who has done more than 1,000 TAVR procedures, and if all goes well we will set a date for my procedure.
I am definitely less stressed out now that we have a definite plan of action. Until this week, I was anxious because things were so unsettled. I will feel even better once I have a date in hand and can prepare myself both mentally and physically for the upcoming procedure and the recovery beyond.
I am seeing a therapist to help me maintain a positive attitude as I work through this, and also continuing to practice my Buddhist chants and listen to guided imagery tapes to visualize a future in which I have a new, fully functioning heart valve and can resume the level of physical activity that I am accustomed to.
It's still a challenge for me to get a full night's sleep, as I was never a great sleeper in the best of times. I've tried Melatonin, and also Ativan, which my doctor prescribed, with mixed results. Any suggestions from those who have dealt with similar issues would be greatly appreciated.
Best wishes to everyone approaching their surgical date, or now in the recovery phase. Keep heart!
My concern with open heart, which has an excellent track record for decades as a way of treating heart valve problems, is my history of chest radiation for Hodgkin's Disease. Doctors have told me this is a "wild card," because the radiation may have caused damage that could complicate surgery and make it more risky.
In order to be considered for a TAVR procedure, which would allow me to avoid some of the potential risks of surgery in my situation, I needed a second surgical opinion that put me in an "intermediate" risk category. (The first surgeon I saw considered me a "low risk" patient for surgery, meaning I would not qualify for TAVR, a procedure in which the new heart valve is installed via a catheter inserted in my femoral artery.)
This week, after a few starts and stops, I met with a second surgeon who in fact agreed that due to my history, TAVR would be a good option for me.
Now things are moving full speed ahead. Next week, I am scheduled for the full TAVR workup, a series of tests to prepare for the TAVR procedure. The following week, a panel of doctors will review my case and, hopefully, give me a green light to move forward. I have an appointment with the TAVR specialist, a doctor who has done more than 1,000 TAVR procedures, and if all goes well we will set a date for my procedure.
I am definitely less stressed out now that we have a definite plan of action. Until this week, I was anxious because things were so unsettled. I will feel even better once I have a date in hand and can prepare myself both mentally and physically for the upcoming procedure and the recovery beyond.
I am seeing a therapist to help me maintain a positive attitude as I work through this, and also continuing to practice my Buddhist chants and listen to guided imagery tapes to visualize a future in which I have a new, fully functioning heart valve and can resume the level of physical activity that I am accustomed to.
It's still a challenge for me to get a full night's sleep, as I was never a great sleeper in the best of times. I've tried Melatonin, and also Ativan, which my doctor prescribed, with mixed results. Any suggestions from those who have dealt with similar issues would be greatly appreciated.
Best wishes to everyone approaching their surgical date, or now in the recovery phase. Keep heart!
Friday, June 16, 2017
A rotten week
Okay, I know I wrote earlier about the importance of maintaining a positive attitude. And I really have been trying to do that. But this past week has been a real test. And my attitude has taken a beating.
A quick recap... last Saturday night, after a very nice day in which I went for a walk at Miramar Lake and felt great, I started having a rapid heartbeat later at night and ended up going to the emergency room. When a blood test showed that my my cardiac markers, called "triponins," were slightly elevated, they decided to admit me for observation. They pumped me full of meds and by the time I was discharged on Monday, everything was looking pretty good, in terms of my vital signs, etc. But still a scary and not fun experience.
Later in the week, I developed a toothache and a trip to my dentist revealed that I have a damaged molar that will probably have to be pulled. I'm worried, of course, that it could delay things in terms of fixing my aortic valve and blockage. One more thing to fret about.
The capper came on Thursday afternoon, when I got a call from the surgeon's office. I had an appointment on Friday morning to get a second opinion that is required if I am to have the TAVR procedure instead of open heart surgery.
I was hopeful this consultation would help clear the way for me to move forward with the TAVR (transcatheter aortic valve replacement, in which the new aortic valve is threaded through my femoral article and put in place.)
Instead, I was told I had things out of order, and that I need to get a battery of tests BEFORE I see the surgeon, which is the final checkoff. Never mind that I had been told by my doctors that I had to see the surgeon first.
So now, at a glacial pace, (to me) I have to wait for next week till I can be scheduled for the tests I need, etc.
It was a blow that left me reeling, very depressed and having a hard time dealing with the entire situation. I know in my head that this only puts me about a week behind where I was, but it doesn't feel that way. It feels frustrating, and scary and just overall dispiriting. I cried for a while this morning.
One side note. A friend had offered us tickets to see the Dalai Lama speak Friday morning at UC San Diego. When I scheduled the appointment with the surgeon, we had to pass on the tickets. As it turned out, we missed both the Dalai Lama and the appointment with the surgeon. And I can tell you, I could have used the inspiration.
In the big picture, I just need to get things back on track and I will be fine. If the TAVR route doesn't happen, I will go back to the tried and true method of open heart surgery. A little riskier for me than TAVR, I believe, because of the radiation treatment I got in the 1980s, but still very doable.
So either way, my valve will be replaced and I will go on to a brighter, healthier future. Right now, though, I'm having a hard time embracing the positive. Hey, no one ever told me this would be easy.
A quick recap... last Saturday night, after a very nice day in which I went for a walk at Miramar Lake and felt great, I started having a rapid heartbeat later at night and ended up going to the emergency room. When a blood test showed that my my cardiac markers, called "triponins," were slightly elevated, they decided to admit me for observation. They pumped me full of meds and by the time I was discharged on Monday, everything was looking pretty good, in terms of my vital signs, etc. But still a scary and not fun experience.
Later in the week, I developed a toothache and a trip to my dentist revealed that I have a damaged molar that will probably have to be pulled. I'm worried, of course, that it could delay things in terms of fixing my aortic valve and blockage. One more thing to fret about.
The capper came on Thursday afternoon, when I got a call from the surgeon's office. I had an appointment on Friday morning to get a second opinion that is required if I am to have the TAVR procedure instead of open heart surgery.
I was hopeful this consultation would help clear the way for me to move forward with the TAVR (transcatheter aortic valve replacement, in which the new aortic valve is threaded through my femoral article and put in place.)
Instead, I was told I had things out of order, and that I need to get a battery of tests BEFORE I see the surgeon, which is the final checkoff. Never mind that I had been told by my doctors that I had to see the surgeon first.
So now, at a glacial pace, (to me) I have to wait for next week till I can be scheduled for the tests I need, etc.
It was a blow that left me reeling, very depressed and having a hard time dealing with the entire situation. I know in my head that this only puts me about a week behind where I was, but it doesn't feel that way. It feels frustrating, and scary and just overall dispiriting. I cried for a while this morning.
One side note. A friend had offered us tickets to see the Dalai Lama speak Friday morning at UC San Diego. When I scheduled the appointment with the surgeon, we had to pass on the tickets. As it turned out, we missed both the Dalai Lama and the appointment with the surgeon. And I can tell you, I could have used the inspiration.
In the big picture, I just need to get things back on track and I will be fine. If the TAVR route doesn't happen, I will go back to the tried and true method of open heart surgery. A little riskier for me than TAVR, I believe, because of the radiation treatment I got in the 1980s, but still very doable.
So either way, my valve will be replaced and I will go on to a brighter, healthier future. Right now, though, I'm having a hard time embracing the positive. Hey, no one ever told me this would be easy.
Friday, June 9, 2017
Change of course
Big news! Yesterday, I saw my cardiologist, Dr. Charlat, who was very supportive of my interest in pursuing a TAVR procedure to replace my aortic valve, rather than open heart surgery. He agreed that, because the potential tissue damage I may have incurred due to radiation many years ago, it makes sense to look into having the TAVR procedure. He was also on board with having the procedure done by Dr. Stinis and his team, who have done more than 1,000 TAVR heart valve procedures since 2008.
After meeting with Dr. Charlat, I came home and called the office of my surgeon, Dr. Stahl, to put off the surgery for now and cancel my June 27 surgical date. I need more time to complete the workup for a TAVR procedure, which consists of a series of tests to make sure I am a suitable candidate, help the doctors determine what size valve I need, etc.
In order to go this route, I need a second surgical opinion, and I set this up with Dr. Tyner, who is head of the division of thoracic and cardiac surgery for Scripps. Dr. Tyner comes highly recommended from a number of sources, including my wife, Ava, who worked with him at Scripps Green Hospital in La Jolla.
So, I am feeling cautiously optimistic that the TAVR procedure is a possibility for me, which would of course mean a less invasive way of replacing my aortic valve, quicker recovery, shorter hospital stay, etc.
If I do have the TAVR, Dr. Stinis and Dr. Stahl, the surgeon, would team up to carry out the procedure, and I am very comfortable with that.
Through all of this, I am trying to maintain an even keel in spite of the stress from the barrage of information I am dealing with, and the factors that are out of my control. To that end, I am taking advantage of a program offered through Ava's work, which allows for a limited number of sessions with a therapist. I'm hoping this will help me manage my stress and keep a positive attitude through all of this. I met for the first time with a new therapist yesterday, and it went well, so I will probably continue meeting with her periodically.
After meeting with Dr. Charlat, I came home and called the office of my surgeon, Dr. Stahl, to put off the surgery for now and cancel my June 27 surgical date. I need more time to complete the workup for a TAVR procedure, which consists of a series of tests to make sure I am a suitable candidate, help the doctors determine what size valve I need, etc.
In order to go this route, I need a second surgical opinion, and I set this up with Dr. Tyner, who is head of the division of thoracic and cardiac surgery for Scripps. Dr. Tyner comes highly recommended from a number of sources, including my wife, Ava, who worked with him at Scripps Green Hospital in La Jolla.
So, I am feeling cautiously optimistic that the TAVR procedure is a possibility for me, which would of course mean a less invasive way of replacing my aortic valve, quicker recovery, shorter hospital stay, etc.
If I do have the TAVR, Dr. Stinis and Dr. Stahl, the surgeon, would team up to carry out the procedure, and I am very comfortable with that.
Through all of this, I am trying to maintain an even keel in spite of the stress from the barrage of information I am dealing with, and the factors that are out of my control. To that end, I am taking advantage of a program offered through Ava's work, which allows for a limited number of sessions with a therapist. I'm hoping this will help me manage my stress and keep a positive attitude through all of this. I met for the first time with a new therapist yesterday, and it went well, so I will probably continue meeting with her periodically.
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