I had my pre-surgery blood testing and checkup today. As part of the process, a nurse practitioner came in to review the procedure with me and to see if I had any questions. During the review, she described the procedure, and showed on a little drawing where they were going to cut into my chest to perform the operation.
There was only one problem with that – the doctor and I had already agreed that the procedure wasn’t going to go through the center of of my chest, but was instead going to go through my side since – in the doctor’s own words – “nobody opens up the chest for a repair any more”. Going through the chest involves cutting the sternum, and spreading ribs, and literally wiring things back together. It’s a longer recovery, and then there’s the little detail of leaving extra metal in my chest for the rest of my life. I’m already going to have a plastic ring sewn to the outside of my heart to keep my valve snug; I’m trying to minimize foreign objects inside me.
After having a talk with the NP, who then in turn called my doctor’s assistant to confirm what was going on, it was left up to me which procedure was being done. I opted for the “minimally invasive” option of going through the side, and my day continued.
Before I left, I texted my wife to let her know what was going on, and she told me to make sure I was getting the non-invasive surgery. I replied with one of my better texts:
“It’s all going to be invasive. It’s just that one leaves me held together with chicken wire and the other doesn’t. I’m a farm boy at heart, but not that close to my heart :D”
She thanked me for the laugh.
So last week was another six month follow-up for my ongoing heart valve saga. I went in first thing in the morning, and the tech did another echo test of my heart – basically an ultrasound, with the wand and the gel and all, as well as a few EKG pads glued to my furry chest. They were going to get the results to my cardiologist, and she would compare them to the trans-esophageal echo that was done six months ago. (I didn’t even tell you about that, did I? For *that* one, they literally knocked me out, then stuffed an ultrasound wand down my throat and did a scan from the *inside*, where they could get more accurate measurements. Great fun!)
So I got cleaned up (that gel gets everywhere), headed out of the office, got breakfast, and came back a few hours later. I was led to an exam room, played twenty questions with an assistant about my medical history, and waited for the doc to show up. When she did, her first question – asked with an oddly knowing tone – was: “So, have you been feeling any worse recently? Any new symptoms?”
Well, shit, I thought, that’s no way to start an “Everything’s good, see you in six months!” conversation.
When I told her no, I’ve been feeling about the same – maybe a little more inclined to take a quick nap after work – she smiled and nodded her head. “Yep, that’s not a surprise,” she said, as she and her now-pregnant belly took a seat (it had been six months since we last met, after all). I must have shot her a “Oh, come on, you can’t be serious” look, because she then said something to the tune of “We’re going to need to talk about surgery.”
The exact words escape me, but that’s pretty much how it went down. No gentle chit-chat about results or how I’m feeling otherwise, just that, and then right into “we’re looking at more enlargement of your heart”, and “eventually that’s going to affect your heart’s performance” and “it would be good to get it done sooner rather than later”, and “before things get worse and you suffer some permanent damage”. She suggested that due to my condition (relatively healthy) and my symptoms (relatively symptom-free) that a valve repair would be much more likely than a valve replace. This would mean an easier surgery on me, and a quicker recovery, both of which sounded fine to me.
But still, it meant surgery. On my heart. I’m not a Time Lord, so it’s not like I’ve got a spare one as a backup. Either surgery – repair or replace – means, quite literally, putting me on life support, pumping all the blood in my body out into a machine and then back in to me, then *stopping my heart* while they poke at it with sharp things. I would be lying if I said the whole concept didn’t bother me. At least repairs can be done without cracking open the whole chest, like would be done for a replace. There’s laproscopic procedures that can be done, like they did to take out my gall bladder – just a few small cuts to stick in tools.
I guess I took this news remarkably well, since the doc seemed a bit surprised at my lack of external response. I told her that it’s not like I didn’t expect that surgery was a possibility in my future… I just didn’t expect the future to get here so soon. And anyway, my dad’s had four pacemakers installed and had a few heart attacks, and he’s still kicking, so I should be fine.
So next week, on the 22nd, I have an appointment with a heart surgeon to discuss my situation, and I would assume when and where I might be having surgery. It’s not like I don’t have options – our hospital does them, as well as the UM hospital down the road, and then there’s the Cleveland Clinic in Ohio, which is a bit more of a trek, but still the top place to go for heart surgery, from what I understand (with UM and my hospital being second and third, respectively). I honestly don’t know yet what sort of time frame is involved, but I’m hoping that however it goes, that I’ll be able to attend my Penguicon convention at the end of April. Meanwhile, I wait for the 22nd to arrive, so I can figure out where I go from here.
For those of you who have been following me on other social media platforms, rest assured that this will not be another rant about hives.
With that being said…
Several years ago, after many years of successful and ongoing treatment for high blood pressure, my doctor diagnosed me with mitral valve prolapse. To put it as simply as possible, one of the valves in my heart would occasionally fail to seal properly, allowing some blood to pool in a chamber instead of cycling through normally. Most of the time, I never even noticed it, but sometimes it felt like my heart would “skip a beat” as it moved the “extra” blood through my system. I was put on the “wait and see” program for this, since it isn’t an immediate concern – lots of people never even know they have this condition, and many that do live their whole lives without being treated for it.
On Tuesday, I went for a follow-up checkup on this condition, getting an echocardiogram – basically an ultrasound of my heart. I felt fine, the exam seemed to go fine, and I was on my way without a question or concern.
On Wednesday, I got a text from my wife saying the doctor’s office wants to speak with me right away. (I ran out of minutes on my cell phone, so they called the house, and she happened to be home sick.) They told me that as a result of yesterday’s test, they want me to contact one of their heart specialists to set up a consultation about the “dilation” they detected in my heart, and to discuss a possible surgery.
I’d known that valve surgery was an option as treatment; I know someone that had a valve replaced long before I’d even been diagnosed with my problem. Still, it’s not comforting news to hear. The rest of my day at work was spent doing not a lot of work, and trying to do not a lot of worrying, and trying really hard not to a lot of research online about my new diagnosis. (From what I saw, dilation refers to the heart swelling from being overworked, and is a step along the way towards heart failure (which doesn’t mean that it STOPS, it just functions below acceptable limits to keep one feeling well and healthy).)
I called the doc, and set a “first available” appointment for August 1st – ten days from now. After I hung up, I went through all of the symptoms I’d had in the last few months, and wondered if they were signs I missed (probably), or if the antibiotic I took back in June had anything to do with this (possibly), or how I’d deal with surgery… which actually didn’t bother me too much. I mean, I’ve had my gall bladder out, and my tonsils, and wisdom teeth. My dad’s had four different pacemakers installed, and just had a hole drilled in his head for a new cochlear implant hearing aid. I guess we’re sturdy stuff, and if it’s gotta be done, it’s gotta be done.
Still, the options I’ve seen for replacement boil down to: an artificial valve, which will mean taking blood thinners for the rest of my life (yay, more meds!), or a natural tissue valve, which won’t need thinners, but won’t last forever – another surgery to replace the replacement in the future. I also found valve repair as an option – plastic surgery, basically, to firm up the valve and make it fit better. Still, my condition is described in my paperwork as “moderate to severe mitral regurgitation”, so what are the odds that repair is an option? I had to keep reminding myself – don’t fret, don’t worry, it doesn’t help to worry, focus on the next step…
I made it home, promptly flopped down on the bed next to the wife, and took a short nap, too tired to bother fretting any further. After getting up, I did some more research on surgical options, and found a video of a woman who was in much worse shape than I am currently in (she couldn’t go up a flight of stairs without running out of breath), and she got away with just the repair surgery, not a replacement. So, that quieted down some of the more panicked voices in my head. A chat with Doctor Mom helped as well – they’re going after this early, you’re not showing serious symptoms, we’re here for you, etc.
So now I just have to get through the next ten days until I can see my new specialist about what to do next. I apologize in advance for anyone that I might annoy with any further fretting. I’ll try to keep it down.
Pam and I have been talking about the possibility of replacing our janky old under-the-sink dishwasher, so we ended up at Lowes tonight window shopping. (Well, dishwasher shopping.) After quickly concluding that just getting a new washer might not be an option (since only one company makes them to fit our specific environment, and they are hella expensive), we started looking at options to re-configure the countertop and move the sink.
We ended up getting a little slap-happy once we allowed ourselves to freewheel the idea of redoing the entire bottom half of the kitchen, and I started riffing on the idea of tearing out the old cabinets and worrying about how out of code things might be once we get in there. “Yeah, we need to get the Property Brothers in on this! I can just imagine Johnathon in here with a sledgehammer – ‘Yeah, this is way out of code, there’s… wait, what? How do you even have knob-and-tube *in* your sink?'”
And then Pam sort of broke, and she giggled and snickered and sputtered like she used to do back when we weren’t so stressed about everything in the world.
I may also have come with a new curse phrase.
25 years ago(!), Rush released an album titled “Roll The Bones”. On it was the song “Dreamtime”. The chorus went as follows:
When we are young
Wandering the face of the Earth
Wondering what our dreams might be worth
Learning that we’re only immortal
For a limited time
Strictly going on the math of it all, this would have been in 1991. I would have been 21 at the time, working a 3rd shift job in a photo lab, and attending community college during the day, seeing my girlfriend (not even fiancee at that point, I think) on the eigth day of my seven day week, and pushing myself headfirst into a nervous breakdown. This was before I was diagnosed with high blood pressure, before a doctor had ever called me a hypochondriac, before I had ever heard the phrase “obsessive compulsive disorder”. Long before I was diagnosed with a weak valve in my heart that lets blood leak instead of pump it properly through my veins.
That chorus was stuck in my head for weeks, and all I could to survive it was tell myself “Yeah, that limited time probably runs out around 40. Long time from now – you’re good”.
I’m 46 now.
Robin Williams has died. David Bowie has died. Alan Rickman. Lemmy. Patty Duke. Garry Shandling. Abe Vigoda. Glen Frey. Natalie Cole. Dan Haggerty. Merle Haggard. Chyna. PRINCE. And as of this posting, today, Michelle McNamara. She was only 46.
I’m 46 now.
I am sure as shit not ready for my immortality to be up.