On My Way

I don't mean to brag, but I can probably beat any living person in a foot race. I am practically a world-class marathon runner. I pretty much invented running. Actually, I started my cardiac rehab this week and I am feeling great. In actuality I can jog about three blocks before I need a break, but I added a little more normal to my life again.

I had a checkup with my cardiologist last Friday and I got good news. She told me my incision is healing well, my heart sounded strong, my blood pressure was normal and I needed to eat more steak. It might have been the best checkup I've ever had. I need the steak because I'm a little bit anemic right now. I didn't get any blood transfusions during my surgery and I'm still a little low on red blood cells. A steak is apparently a good way to get over that. I have taken that recommendation to heart and had a delicious lunch today. How many people go to see a cardiologist and get told to eat steak. I'm just that good.

I was really looking forward to this checkup because I expected the doctor to write up a recommendation for cardiac rehab for me, but it didn't quite go as planned. I asked about the rehab, but she told me that since I had done it before and seemed to be in decent shape that I should do it myself.

I remember most of what I did in rehab last time and I have a heart-rate monitor so I think I should be able to keep myself alive. I won't push myself too hard or let my heart rate get too high and I'll increase the amount of work I do and my max heart rate by regular intervals. If all goes according to plan I'll be back in good enough shape to start climbing again by sometime in December.

So far I've worked out twice. Now, I know it might be premature to say everything is going to be perfect, but I have felt great through both of my workouts so far and I'm confident the positive results will continue. I started both days with a five minute warm up of brisk walking to get my heart rate up. I followed that with a slow jog for as long as I could without raising my heart rate above a certain level. Once it hit the maximum I decided on, I slow back down to a brisk walk. I do those two exercises for a combined ten minutes and then cool down for another 5 minutes with a slow walk.

I'll stick to a cardio-only workout for the first few weeks and then slowly start incorporating pushups, sit ups and other light strength exercises when they won't make my blood pressure go up too high. When three months of that routine is said and done I'm willing to wager that my body will pretty much look somewhere between Brad Pitt in Fight Club and Arnold Schwarzenegger when he won his first Mr. Universe Title. I don't mean to sound conceited, but I'm gonna look amazing. I'll post pictures later once I'm in perfect physical shape.

According to Plan

I have not had the best luck making plans in the past. I end up needing open-heart surgery half the time I try to come up with something to do with my life, but I'm really banking on that changing. I've been spending a good amount of my recovery time trying to make some new plans for myself since my latest surgery cancelled the last batch I was working on.

I'm gonna focus my energy on short term goals for the time being and expand to longer term ones later on. My current goal is to start cardiac rehab. I don't want to jinx anything, but I'm almost positive I'll be accomplishing this goal next week. For whatever reason the recovery gods have seen fit to bless me with a rapid and pretty painless recovery so far. I have sacrificed many virgins in their honor to say thank you and I think that has really helped apease them.

During my last recovery I didn't start cardiac rehab (a monitored exercise program conducted by trained nurses and physical therapists specifically for heart patients) until the 12th or 13th week of my recovery. This time around I'm looking to start it during my 6th week. I would say that's a pretty good improvement from the last time around. I'm telling you, it's absolutely because of the virgin sacrifices. I am totally convinced of the power of blood offerings now.

Cardiac rehab is important to me because it's how I learn what my new limits are and how I feel when I reach them. Every time I have open-heart surgery I feel like I have a new cardiovascular system. I need to relearn what being tired feels like, how long I can be tired and how hard I can push myself to get there. I don't want to take it easy on myself and I certainly don't want to push too hard. I am determined to get back into shape as quickly as possible and I need to learn how hard I can work to do that.

I don't want to plan too far ahead, but I'm convinced that if all goes well in rehab I'll be climbing again by December or January. I am more than a little excited by the thought of climbing again, but I've been trying to keep it in check to avoid driving myself crazy. I really don't want these plans to get a wrench thrown in them so I refuse to plan past rehab, but I'm hopeful that rock climbing is in my near(ish) future. I'll have to round up a few more virgins in the next couple of months to keep myself in the gods favor.

Tick, Tock, Tick, Tock

Click, click, click, click, click, click. I hear it in the morning when I wake up, when I'm laying in bed trying to fall asleep and one hundred different times throughout the day. The sound might drive some people crazy, but not me. I hear something different. It's the sound of life, it means everything is ok and it's what my heart does 24/7 now.

I knew I'd be able to hear my artificial valve opening and closing sometimes, but I had no idea it would be so often or so loudly. At first I could only pick it up when I was surrounded by silence and concentrating. Now, even the TV can't drown it out. It began as a novelty. I was excited the first time I heard a click and I immediately wanted to show my family and have them listen to the distinct clicking sound my valve makes, but it has morphed into so much more. It's a reassurance that everything is alright. I love the sound my heart makes now. It's a reminder that it's working and that I'm alive.

I wake up to the sound of a properly functioning heart. It reminds me throughout the day that it's still working and I fall asleep to the sound of it continuing to kick ass. It's hard to explain, but I find a lot of comfort in it.

For as long as I can remember I've been told that I need to be conscious of and on the look out for signs that something might be wrong with my heart. My aortic valve has been the trouble maker my entire life. First, it was too small and misshapen. Then, it couldn't close all the way and it leaked a lot. Next, it wasn't functioning properly anymore, it was leaking and it was enlarging my left ventricle. There were some good times in the middle. I had a 10 year stretch when it was functioning pretty normally, but problems kept popping up. Now, it just opens and closes all day long. It doesn't leak, it's not too small and it doesn't malfunction. Now, it clicks away all day long and causes me absolutely no problems.

Maybe it's a comfort because all of my problems have been impossible for me to detect in the past. I couldn't feel any of my problems, I couldn't see them and I certainly couldn't hear them. Now, there's no mystery about what my aortic valve is doing. It's opening and closing, opening and closing, opening and closing. And, I know it's doing that because I can hear it working. As long as my heart continues to click I can rest assured that the valve that has caused so much stress throughout my life is finally just doing its job.

Spontaneous actions and a little bit of mystery might be fun personality traits for friends or family members to have, but it's not what I'm looking for in a heart valve. I want reliable, I want predictable, I want boring and I've finally found that. I'm looking forward to the rest of my heart's unexciting life. Don't get me wrong I love adventure, but I'm ready for it to come from a different source.

I Think My Braincells are Dying

I believe I have discovered a brand new level of boredom. I'm beyond snacking because I can't find anything to do, I flew past watching TV shows that aren't very good and I even surpassed pacing. I'm so bored that I find myself wishing I had more laundry to do or dishes to wash so that I had anything to do. I'd even take a job I hate at this point. I need more things to do, or less time in each day to fill, or less restrictions, or a car, or unlimited amounts of money to spend. I would appreciate help with any of these things.

I've been watching movies, reading books, going for walks, helping keep the house clean, rehabbing my hand, taking the dog for walks, filling out applications, doing phone interviews and shopping for a new car online, but it's not enough. I could use twice as many activities.

I've been home for about three weeks now and my recovery has been going better than I could have imagined. I'm walking long distances, going up and down hills without any real problems and I haven't taken any painkillers in almost 10 days. I am thrilled with how smooth this recovery has been, but I am desperate to feel even better. With my current restrictions I'm allowed to walk. I can do stairs but not too many and I can do hills, but I need to be careful of getting my heart rate too high. I'm also still not allowed to lift more than 10 lbs. I can't even pick up my sister's tiny dog. He's tips the scales at almost 15 lbs and is beyond my limits.

Since I sold my car while I was still living in Korea I no longer have any means of transportation. My sister goes to class and then work until around 5 p.m. every day and my mom works full time as a first grade teacher. So, I can go anywhere I can walk to, but I can only bring along 10 lbs of stuff (or pick up 10 lbs of stuff from where ever I walk to). I need to buy a car and I'll do it eventually, but I need someone to take me on the weekend when they have time. Being dependent sucks.

I have some plans in the works for the near future, but they won't start until January at the earliest so I have a few more months to fill in the meantime. I should get a car in the next few weeks and I have a check-up coming soon that should lift some of my restrictions so I will hopefully have a few more freedoms soon. I'll be able to go hiking (at a reasonable pace) or for short car trips. I'm also planning on visiting my Grandma down in Florida soon. I want to start cardiac rehab as soon as I'm able as well so that I can start getting in shape again and open up a few more activity doors.

I have activities and opportunities coming, but in the meantime I spend too much time on the couch in front of the TV with an adorable little dog sleeping next to me (that's the setup as I write this actually). They say good things come to those who wait and I'm waiting. I don't even care if good things come my way, I just want things to come my way. Anything. Please.

Anything I Can Do, You Can Do Better

I am getting better every day, but there are a plethora of activities and actions that make me feel like an invalid on a regular basis. They are things that most people take for granted or would never think could be hard to do. Things like:

Standing up straight is practically impossible for me right now. All of the muscles in my chest and core area feel so tight that it's a stretch even trying to straighten my spine right now. The worst part of this problem is that my neck is constantly exhausted from holding up my gigantic head. My options are basically, let my chin rest on my chest and look at my feet all day or try to hold up my oversized melon and exhaust my neck muscles. So far I've been giving my neck the workout of its life, but staring at my feet is quickly becoming a more attractive option.

Raising my hands above my head is a downright painful endeavor once my hands get higher than my shoulders. The muscle tightness that keeps me from standing up straight also stops my arms from enjoying a full range of motion. The moral of this story is, if you want to hide something from me just put it on the top shelf. It's hard for me to look up there and it's impossible for me to grab anything that high.

Looking behind me is an entire body adventure. Because my neck is so sore and stiff it can only turn my head so far. I probably look like someone who should be in a neck brace any time I try to look around, especially since I have to turn my entire body around to see anything that isn't directly in front of me. So, if you put something behind me on a top shelf it has pretty much vanished from existence as far as I'm concerned.

Opening jars may be my biggest nemesis right now. My left hand is getting better, but it's still not as strong as it used to be and holding onto a jar is sometimes tough if it is big and full. If you add in my right hand trying to twist the top off it becomes so comical that even I laugh at myself. Not to mention the muscles involved in that twisting motion are still getting over the fact that they were cut apart about three weeks ago. So, if you really need to keep something from me put it in a jar on the top shelf behind me. I wouldn't even try. Putting a man on the moon was probably a less difficult task than getting that jar down and opening it would be for me.

Laughing, coughing and sneezing aren't technically difficult for me to do. I probably did all three yesterday, but they all make me feel like I'm exploding from the inside. If I have the time to find and hug a pillow to my chest they don't hurt at all, but I just don't carry one of those around with me 24 hours a day. I should probably just strap one to my chest so I'm always prepared. Or hire an assistant to follow me around with one.

Don't get me wrong I'm not saying I wish I hadn't had surgery so I wouldn't have to deal with any of these things. I meant this simply as an observation about everyday activities that are currently more difficult for me than the rest of you. I'd much rather deal with these inconveniences right now than be dead. I knew these were coming and I've handled them before. It was part of the deal when I signed up for surgery. I'm still going to whine about them though. I'm recovering from surgery and I'm allowed to whine a little bit, or a lot sometimes. The inconveniences do help keep me in line though. I can't push myself too hard or set my recovery back while these things are hard to do. I probably owe them a thanks for helping me maintain a slow and steady approach to healing. I mean, I'm not going to say thanks because the inconveniences suck, but I could if I were a bigger person.

My Hand Works (Better)!

A neurologist guessed that my almost useless left hand would be back to normal three weeks from the day she saw me. I thought she was full of sh!*. At the time I could open and close my hand and touch my thumb to my fingers and not a whole lot else. I had seen some improvement, but it wasn't happening quickly.

I've been out of the hospital now for about 12 days and with nine more to go before the doctor's three week estimate is up I think she may be on to something. I can actually use my left hand to do things now. I no longer begrudgingly make it do jobs for me in the hopes of getting it better, I can actually rely on it for real purposes. It's freaking amazing.

I no longer look at lefty and wish it was something useful like a hook or some sort of pinching tool. I'm happy I have two hands again. I'm even able to type with both hands now, although there is a lot more visual supervision and erasing than there used to be. Things definitely aren't perfect, but they're getting a whole lot better.

I can open ziplock bags now, close ziplock bags, type, hold a cup, open my toothpaste, open my chapstick and even carry things that weigh more than 1 pound (none of which I could do while I was in the hospital)
. I still can't tie a pair of shoes, but I don't think that's a long way off. Maybe in a few more days I'll be able to trade in my sandals for a pair of loafers. Then I'll be a big boy again. It's weird asking your mom and dad to tie your shoes when you're 26.

There are still some problems, my range of motion isn't completely back with all the fingers and the strength isn't the same but I've got exercises from my therapist for that. Lefty isn't quite as coordinated anymore and it moves a little bit slower too, but I've got more exercises for that. Also, I still can't feel very much with the tips of a couple of my fingers, but the numb areas are getting smaller all the time. Pretty soon I may even be able top pick my nose properly again. It's uncomfortable digging in the left nostril with my right hand. It's just not the way God intended a man to pick his boogers.

Kicking The Habit

For the last two and a half weeks I have been on a very steady diet of narcotics to keep my pain levels tolerable and to let me try to live like a semi-normal person. Painkillers don't make the ouch go away they simply make it tolerable. The pain was always there, but I could live with it.

Even when I was on the strongest of my painkillers, morphine, I still knew I was in pain, but I didn't really care. I could move around and do people things as long as I was careful not to do anything too quickly or too far. By that I mean, I had to tone down all of my actions. I couldn't reach my arms up or out as far, I couldn't turn my head as much and I couldn't lay down flat. I could do all of those things, but I had to be careful about how I did them.

Painkillers are a powerful thing and I owe them a huge debt of gratitude for helping me after my surgery, but I will be so happy when they're no longer a part of my daily routine. Actually, I may have taken my last one this weekend. My pain has gradually been fading since the moment I woke up and it's been changing as well. What was originally an excrutiating pain in my chest that hurt every time I moved has faded into a lot of muscle aches, stiffness and an occasional reminder from deep inside that I'm still healing.

Since I stopped taking painkillers the muscle aches have increased a little bit and I'm definitely more stiff, but the bright, sparkling pain in my chest in gone. I definitely feel like I have taken a step or two backwards; I'm moving a little bit slower again and I'm more thoughtful about how I position my body; but I think I'll be back to where I was in a couple of days. I just need to get used to the new feelings.

After my last surgery I tried to stop taking painkillers unsuccessfully on two differnt occassions. It was awful. The pain didn't flood back and I wasn't paralyzed with it. The pain crept back slowly, but once it was back it never left. It was impossible to find comfort anywhere or anytime. It made having a body almost unbearable. Thankfully, that didn't happen this time. This time I'm just a bit more in touch with all the parts of my body, there's no more dullness. It's a little more uncomfortable, but I prefer not living my life dependent on pills to make it tollerable.

It's Time For A Nap

I'm not sure what the cause is, but it has suddenly become impossible for me to stay awake all day. I don't have a naptime or a schedule I keep, I just sleep whenever the mood strikes me and it strikes me a lot.

Since my surgery I have had one nap-free day. Maybe I get so sleepy in the afternoons because I get up twice a night to take pain killers and I never sleep for more than 4 consecutive hours as a result. Maybe it's the painkillers themselves that make me so sleepy. Narcotics do funny things to people. Or, maybe I'm simply turning into a 70 year old man. I'm not really sure I care to discover the cause though because I'm not really sure I care to stop napping.

I feel great after a nap. I wake up refreshed, in a good mood and ready to be productive (well, as productive as I can be right now). I may try to incorporate this into my everyday routine permanently. Eventually I'm going to have a schedule again, either from work or school, and I won't be able to nap whenever I feel like, but I think I coule handle scheduled naps as well.

The fun part about my inability to stay awake all day is the fact that I never know when my body is going to demand a nap. Sometimes it's in the morning when I'm done with breakfast, other times it's while I'm reading, yesterday it happened in the car during a two-hour trip. I've learned not to fight the feeling either, it's pointless to try. The nap always wins and so do I when I take the nap.

I know I'm not alone in this idea either, old people nap all the time and so do babies. That's a lot of people there. They can't all be sharing the same bad idea. Hell, there are even entire countries that practice "siestas" every afternoon. I think the moral of this story is, go take a nap. Do yourself a favor and stop trying to stay awake all day.

The Big Scar

Today's post is a little bit graphic. I'm finally putting up the big picture. I think a photo of my chest is long overdue. I'm not sure what took me so long to do this, but it's better late than never. I don't think this requires a lot of explaining either. On August 18th I had my entire sternum cut in half so that doctors could fix my heart. This is a photo of what it looks like after they put it back together.

As you can see there's a bit of dried blood on the inscision and a lot of tape but everything is just fine. The surgeons used some sutures under the skin and some wires to hold my ribs together, but the tape is what's keeping the skin together. It stays on for a few weeks and then just falls off. There's no real pain this time either. I've been having some muscle soreness, but that's about it.

How about a little closer view:

I think they're pretty neat.

I'm Almost A Real Person Again

I've been home for about half a week and I have been making some real improvements in that short time. I think it's safe to say I'm feeling better than I was at the same point in my last recovery. I'm definitely not perfect yet, but I'm getting there. I still need to take narcotics to get through the day feeling like a normal person, I can't stand up straight without feeling like a few things inside me are tearing, and I'm not allowed to lift more than 10 pounds or drive a car, but I'm still very happy because I can...

Poop every day without taking a laxative
That's right! I can have a bowel movement all by myself these days and I've been having one every day for the last five days! Being constipated was making me feel terrible and thankfully I don't have to deal with that anymore. I think it's finally over because I'm eating regular sized meals on a daily basis and I'm taking a smaller amount of painkillers than I was in the hospital. The nurses kept blaming the narcotics for my poopy problems and it has gotten better since I started taking less. I never knew pooping could make me happier than it did before, but this is easily the best thing that has happened to me since getting home.

Walk almost two miles without stopping
In the hospital I couldn't actually measure how far I was walking, I had to use time and the number of laps around my floor to determine my improvement. Now, with the help of google maps I know exactly how far I'm going and yesterday I set a new personal record when I went for a two mile walk without any breaks or stops. The whole walk was on flat ground, but I have lots of time to add in the hundreds of hills around my house to my walks. The last time I had surgery it took me almost two weeks to build up to the distance I hit yesterday. I feel so good this time around that I'm sure I'll be running half marathons by this time next week. I don't mean to sound over confident, but I think that's a natural progression.

Take the dog for a walk all by myself
Nothing makes you feel less like a man than a 15 pound perma-puppy being stronger than you, and that was the case when I first got home, but not anymore. One of the more painful parts of recovery from open-heart surgery is the muscle soreness in your chest and back over the first few weeks following the operation. Last Thursday my ribcage was cut and held open for about six straight hours. This puts a lot of weird pressure on all the parts of your torso and it takes weeks for all the little pains that it causes to go away. It also makes it really painful to do things that involve any of the muscles found in your chest and back. Pushing and pulling are almost impossible for the first few days. Today, though, I did an important test and found out that I can now handle the heavy strain and immense loads a very tiny dog can exert on a leash. Slowly but surely I'm getting my manliness back one small victory over puppies at a time.

Drowning In Darkness

I can hear voices. I can't make out what anyone is saying, but there are two or three people nearby. I push upwards towards the sound but the darkness is thick. I'm tired and the swimming is a lot of work. Suddenly the darkness starts to swirl and pull me back down. I kick harder and struggle to reach the surface. I want to let the voices know that I'm OK. There's an unexplainable need to make contact, but I'm slipping away, the voices are fading and it feels like I'm drowning in black. I'm not scared, just so tired.

This isn't a nightmare I had or a scene from the latest horror movie I saw, it's what waking up from eight hours of anesthesia felt like. I went through this process of general awareness of the people around me to fading away into darkness a couple of times before I finally woke up for the first time (that I remember). Who knows how many times I actually repeated these stages. I'm sure it happened a number of times that I have no memory of. It took me half a day to flush enough of the drugs from my system to remain conscious long enough to remember it.

There are no memories of out of body experiences, tunnels of bright light or opportunities for spiritual enlightenment. In my memory there is a lot of nothing; almost a lack of memory, highlighted by brief periods of lights, talking and physical sensations. It was a struggle to remain awake, and I fought unconsciousness with everything I had inside. It felt like a physical battle that I simply wasn't strong enough to win. It's almost like trying to wake up from a dream when you realize you're asleep and you don't want to be anymore.

It was an uncomfortable sensation and I desperately wanted it to be over. It was the only part of the surgery that made me nervous. I had total faith in the surgeons, I knew they would do their jobs, but the drugs scared me. They are so powerful that they stopped my breathing and my heart. Machines kept me alive for hours. I owe a huge debt of gratitude to the doctors who were in charge of monitoring me and the drugs flowing through my system. They have the scariest job in my opinion and they did it without any problems. They are modern day magicians. Witch doctors have come a long way since the times of spirit guides and sweat lodge operators.

The "First Steps" To Recovery

Here's what it looked like the first time I stood up and moved around after my surgery. It's probably a little less than 24 hours after I woke up. I was still coming down from the effects of anesthesia and I was heavily medicated for pain so I don't recall exactly what happened, but I had been moved from my bed to a chair. It might have been time to get up and move around or maybe the nurses were killing two birds with one stone and getting my bed ready for something and making me move around at the same time. It doesn't really matter what the reason was they would have done this to me anyway. Once the nurses get a patient out of bed and into a chair it's only a matter of time before it's time to start walking. It's really good for heart-surgery patients to get on their feet. and move around. No, that isn't sarcastic.

Walking might not seem like a safe thing or a comfortable thing to do so soon after surgery for a patient like me (and it's not comfortable, let's not make any mistakes about that) but it makes the healing process go so much faster and it does this for a couple reasons. First, the combined effects of anesthesia, laying for over 24 hours straight and surgery inside the chest cavity lead to a lot of fluid in the area and moving around helps your body get rid of it faster and push it out the drainage tubes sewn into my body. Secondly, the surgery also leads to a lot of fluid in the patients' lungs and making them breathe hard and deeply makes the lungs clear faster. Lastly, if you don't move around much you can get blood clots in your legs and those can cause strokes and heart attacks. Guess what! Walking around makes blood clots go away or never form in the first place.

OK with no further ado here is the video of me standing and walking. Take note of my beautiful IV tree. Also, the boxes my nurse is carrying connect to my insides via chest tubes and are used to drain away fluid building up in my chest.

Besides walking and sitting up to clear my lungs and chest cavity I was also encouraged to do breathing exercises every hour to increase my lung capacity and to cough. Both of those things hurt more than walking but, they helped get rid of all the fluid and ultimately made me feel stronger. The person who invented the phrase, "What doesn't kill you makes you stronger," was probably a heart-surgery patient because everything that helps you recover from it hurts like a bitch and makes you want to use inappropriate language, but in the end it makes you better faster.

Someone Really Should Tell You These Things

This is a short list of the three things that have been the biggest problems for me so far that I didn't anticipate. I really wish someone had told me these things could happen.

I Really Need To Poop
So, it turns out that anesthesia and pain killers really play a number on your digestive tract. It's been about five days since my last poo and that's all I really want to do now. I generally drop a deuce once a day and I enjoy that moment immensely, it may be one of my favorite parts of the day actually, but I am so backed up right now I think I can feel everything down there stacking up. It is unpleasant and I want it to stop. So, if the fairy godmother of taking a crap is out there, please send some love and the ability to take a poop again my way.

I Wish My Hand Would Work
I posted a video detailing the problems I have been having, but I would just like to reiterate how weird I think this is. Apparently, if the surgeons put you in the right pose (or wrong pose rather) for too long they can pinch nerves or create swelling that impairs them to the point where an entire appendage is no longer able to properly function. Waking up from open-heart surgery is bad enough, adding a hand that doesn't work is just mean spirited, but not that uncommon from what I have learned. I guess this happens kind of regularly. It's just not something they put in the pamphlet.


When Did Showers Become a Workout?
I took my first real shower yesterday and I haven't been so tired in a long time. If it didn't feel like my ribcage was exploding when I bent over I would have been hands-on-my-knees tired, but instead I settled for exhausted-in-bed tired.It turns out that holding and moving your arms around over your head is one hell of a workout. I guess my first shower after my last two surgeries came at points when I was in better shape because I don't remember them being so hard. It's also not a huge motivator to stay clean. So, if I bother anyone with my smell or lack of cleanliness in the next few days it's not my fault. Imagine a shower being the most exhaustive thing you can think of and tell me how excited you are about staying clean.

Say Hello To My Little Friend

Before you read any further or play the video please be warned that there is some adult language. So, if you have delicate sensibilities or are easily offended you may not want to proceed.

Now, I'd like to introduce the world to my disagreeable and uncooperative left hand. I don't have any footage showing it at its worst, but this should give you an idea of what I'm dealing with.

Welcome To My Humble Abode

This is my home here at Motts Children Hospital.

As far as hospital rooms go I have a very sweet deal going on. During my last stay here I had three rooms and that means I had to move twice during my recovery. I don't think it did me any harm, but it was kind of a pain in the ass and I had to be careful I was going in the right room when I would come back from walks. I also had three different roommates, the last being a crying infant. This time around I have been placed in an isolation room. None of my nurses have shown up in hazmat suits yet so, I don't think I'm carrying any weird or dangerous diseases that need to be quarantined. I think I just got lucky; either that or they didn't think any kids wanted a giant man-child as a roommate. Either way is fine by me. Now, I only have to put up with my own crying and whining.

Let's take a more detailed tour. This is my mom's nook:

She usually spends her time with me reading, making lesson plans for her upcoming school year, or trying to decipher my narcotics induced ramblings. I'd say she's been successful at all three.

Here is my bathroom:

I can pee and shower all by myself, and I am very proud of both of those facts.

Finally, this is my bed and/or command station:

This is where I spend 80% of my time right now, but the more I can walk the less time I have to sit here!

Be Nice to Your Nurses

Since my surgery I have talked to a couple of doctors and roughly 1000 nurses every day. Those nurses are the secret army behind every successful recovery and there are literally millions of them around at all times doing every job known to man. I think I even saw one constructing a log cabin today. Unfortunately, I'm not sure I've been the most pleasant patient for them so far. Despite my attitude my nurses have been nothing short of fantastic and I owe them all an infinite debt of gratitude. I have had some complications with my left hand since Thursday; basically it doesn't work at all and nobody can tell me why. While I've been trying to deal with that and not freak out imagining my hand paralyzed for life, all of my nurses have been helpful, supportive and cheerful.

The doctors performed my surgery and corrected my bad valve and they deserve all the credit for physically fixing me, but I'm recovering as quickly as I am because of my nurses.They are the ones who are around all day and all night at a moment's notice and they are responsible for the amazing care I have received. I'm not sure I can ever thank them enough, but I can certainly stop having baddittude while they are around. So, I would like to formally apologize to anyone I have given lip to or been unpleasant towards and say thank you. Thank you, thank you, thank you, thank you, thank you. I promise not to be a turd anymore.

Hospitals Really Do Make You Better!

It's (almost) finally here and I'm ready to go. Over the last week or so I managed to make myself pretty nervous about this operation, but today I used the magical healing power of the hospital to make myself feel a hell of a lot better. I didn't get any medication or special counseling either, all I did was have an x-ray, have some blood drawn and talk to a few nurses and doctors. It's the hospital itself that makes me feel better.

I love the way problems are treated in a hospital. My latest heart condition isn't a life threatening and dangerous situation, it's a well understood problem with an answer. Doctors and nurses talk about it the same way they would talk about an in-grown toenail. It's a well understood problem and it has a solution. They break down what the problem is (not matter how big or small), why it's a problem and how they can fix it. The solution to my current problem involves a bit more risk than an in-grown toenail, but I've been given the percentages and the odds are in my favor by a landslide. That makes me happy.

I was excited for my first surgery; ridiculously excited. I had been living with a lot of physical restrictions for 14 years and I was ready to start running, jumping and playing like a normal kid. I was tired of sitting out during activities in gym class and watching my friends play sports. I couldn't wait to try to keep up. I was excited for my second surgery too. I had been living with physical restrictions for another year and I was ready to start running, hiking and backpacking again. The surgeries meant freedom, they meant I could take part in things that I had been missing out on and they meant I didn't have to censor my behavior anymore. I never had any doubts about either of the first two operations.

I've been having doubts this time. Maybe it's because of how much of my life this surgery has changed. I had to quit my job, I had to move back home and I lost all of the plans I had been making for the next few years. Or, maybe it's because I haven't had as much time to process this situation. I had fourteen years to prepare for the first surgery, a year to prepare for the second and three weeks to get ready for this one. It's a very different situation this time.

I'm still not excited about this surgery, but I'm ready for it and I'm not nervous anymore. The people and attitudes in the hospital are a huge reason for that. Everyone I encountered today was wonderful. They talked about my surgery in a very matter of fact way and then they talked to me in a way that gave me an overwhelming sense that, "Life goes on." I am having open-heart surgery tomorrow, but life will go on. I can't help but smile when I write that.

My Recovery Plan pt. 2

I am not one to be satisfied with a single course of action when a problem can be attacked from multiple angles at once. I showed off the first part of my recovery plan in a previous post, but that's not the only thing I'll be doing to nurse myself back to health. Another key component to my recovery is a small, black and brown fuzzball that we affectionately refer to as Riley. He is a ridiculous little dog with more personality and attitude than he knows what to do with.

During my last recovery he would spend his mornings sitting next to me, always careful to stay away from my chest, before our afternoon walks. In the early stages of my recovery I'm not really sure if I was taking him for a walk or if he was taking me. He would walk out in front and then turn around and watch my slow steps as if he was making sure I was OK. He was incredibly sensitive to my condition. He never tried to jump on me and stayed calm in my company for hours at a time. He would run and bark and play with everyone else in the family, but he knew that he couldn't act that way around me.

I look forward to our lazy afternoons on the couch that are coming up in the next couple of weeks and our walks to the end of the block and back. For a spoiled little fuzzball he's not so bad to have around for company and support.

A Dark Sense of Humor

I've heard that it's healthy if you can make jokes about your problems. I don't remember where I heard that or what the reasoning behind it is, but it seems to be true enough to me. Maybe I just have a dark sense of humor, but it's always been an effective way to bring up or acknowledge the scary parts of having a heart condition. I know the jokes can make some people uncomfortable. Maybe they don't like talking about the scary stuff in life, or they tend to ignore the tough parts in general. Ignorance is bliss right? I'm not like that. I've developed a nasty habit of speaking my mind and talking about the things that bother me. I had a moment like that while I was on the phone with someone from the University of Michigan hospital today. I thought I'd share it.

Terry called early in the afternoon to talk about my little upcoming trip to Ann Arbor. She had some questions she needed to ask and she made herself available to answer any questions I might have as well about my upcoming surgery. One of her questions was, "Who is your cardiologist?" I didn't really know how to answer that one. I mean, I had a cardiologist growing up, but he's a pediatric cardiologist and seeing as I'm not longer considered a child (despite how I may act) I am no longer allowed to see him. Since we parted ways I have seen a few cardiologists for adults, but none of them have really seemed qualified to oversee my care and they didn't stick.

I'm a special kind of patient, perhaps in more ways than one, but most notably for the fact that I am an adult with congenital heart defects. Most adults who see a cardiologist do so because they have slowly developed a problem over time from things like smoking, eating poorly or lack of exercise. They are also usually much older. The first adult cardiologist I saw actually told me that I was his youngest patient by decades. I was 23 years old when he told me that.

Well, what I learned from Terry was that this is a fairly common problem for patients like me and that the  field of cardiology designed to handle patients like me is relatively new. Patients with congenital heart defects are not new, we've probably been around forever, but medicine and surgical techniques keep getting better and better. So, when Terry told me that there aren't a whole lot of cardiologists qualified to see me and that the field they belong to is fairly new I asked the question, "Is that because we're sticking around longer?" And we both had a pretty good laugh. And the reason the joke was funny is because the answer is yes! People like me are living longer all the time. In the not too distant past I would probably be dead by this age from heart failure, but thanks to modern medicine I get a shot at a normal life span. Having my heart condition is pretty scary at times, but that doesn't mean I can't celebrate a brighter looking future and that's exactly what that joke was about. It's my twisted way of getting excited about being alive.

After my joke Terry went on to tell me about a 64 year old patient who had a valve replacement earlier this week and I couldn't help but smile. I look forward to the day that I am a 64 year old heart patient. Maybe by then I'll have had enough time to develop a normal problem for my heart and I can get lectured on eating properly and staying active just like the regular heart patients.

Recovery Plan pt. 1

If you drive as far North as possible in Michigan, then turn around and drive back just a little bit you can find my father's house. It's a log cabin on a lake that connects to Lake Superior. It's just down the road from the middle of nowhere and across the street from peace and quiet. He has offered to let me stay with him while I am recuperating and I think I just might take him up on the offer. Here's a short video I shot from his back porch. I'll let the video speak for itself.

What do you think? I bet it might just be relaxing enough to help me get back on my feet.

This Is What My Insides Look Like!

The title of this article isn't totally accurate, it should probably read, "This Is What My Insides Will Look Like" because this post is dedicated to the amazing invention know as the mechanical valve. I have always wanted to be part robot and recently started giving the subject some serious thought and so I've decided to go ahead and mechanize at least a portion of my heart. It just seemed like the logical place to start. Most people opt for artificial knees or hips, but I wanted to stand out so I went with something a little less common (especially in people my age) and picked out a mechanical valve. The only problem is once I get it I'm kind of stuck with it. So, I've been doing some research.

I wish this was just something I had decided to do because then everyone I know could talk me out of this foolishness. Unfortunately, it's more of a do this or die decision, but you know what? I'm going to make the most of this and embrace my new mechanical bits. First, let's take a look at what my heart looks like right now and talk about why it's bad and why I need to get it fixed. Here is a picture of a prolapsed valve:

This is a picture of the mitral valve, I have a problem with my aortic valve, but prolapse for either one looks pretty much the same and this is the best picture of that condition I could find. Technically speaking, I am suffering from aortic valve insufficiency. Simply put, this means that the valve isn't functioning properly. Instead of closing the valve is folding back into the heart and blood that was pumped out is flowing backwards into the heart again instead of out into my body. This has lead to my heart dilating, or growing in size, because it's working harder to get the same amount of blood out into my body. If my heart increases in size enough it will eventually start to fail. It's an easy problem to fix though, all I need is a valve that closes and doesn't leak and all the bad things stop immediately. This is where the mechanical valve comes into play.

Let's take a look at a few examples of mechanical valves:

From top to bottom these are a caged ball valve, a tilting disc valve and a bi-leaflet valve. I will be getting one that looks most like the bi-leaflet valve. The other two are older designs. They are less efficient, more dangerous and not really used anymore. For you history buffs, the caged ball design was introduced in the 1950s and was the first successful mechanical valve implanted in a human. The tilting disc design followed in the 60s but was pulled from the market after a number of them broke while inside patients. The bi-leaflet design was introduced at the end of the 1970s and according to the information I've found is still the most popular design today. It has been improved upon in a couple of ways with better materials and a more efficient design, but overall it's the same concept. I'm very interested to find out if I'll be able to hear it opening and closing when I'm quiet. I may tick when this is over.

Mechanical valves are very safe today. The only real risk they come with is the chance that they might develop a clot. If a blood clot were to build up and break free from a mechanical valve it could lead to a heart attack or stroke. I'm not interested in having either one of those, so I will be joining everyone else with a mechanical valve and take a drug called Coumadin, or Warfarin. It's commonly known as a blood thinner, but it's actually an anticoagulant. The goal of the medication isn't to thin your blood, but to increase the amount of time it takes to coagulate. That way the blood doesn't have enough time to form clots around the mechanical valve. It's pushed on before it can start.

The downside of Coumadin is that I will have to be careful about bleeding. If I ever start to bleed heavily I probably won't be able to stop it on my own, I'll need to go to the hospital. There is also a greater chance of internal bleeding. That's the hazard I will need to be most careful of. If I get a big gash that starts throwing blood around like a Friday the 13th movie it'll be pretty obvious I need to go to the hospital, but I can't really see internal bleeding. I've already come up with a solution to this though, I just won't fall down again. Ever! Problem solved!

The Big Day

I received a very important phone call today from the office of my surgeon. They have juggled a few patients, worked some scheduling magic and set a date for my valve replacement. The big day is Thursday, August 18th. I need to head down to Ann Arbor and the University of Michigan hospital a few days earlier for pre-op checkups and other routine things, but the 18th is the important day. The stuff that happens before is actually pretty boring. It involves walking all over the hospital for three or four tests and sitting in a bunch of waiting rooms. Then I'm not allowed to eat or drink anything for 12 hours and I sleep like shit.

To be honest, I was hoping the date would be set a little sooner, but I'm happy that I know the day and can really start making definite plans. I'm not sure I have enough material to blog about for another two weeks before the surgery so I may try to spread the material out a bit and not post every single day. Or, maybe I'll just ramble on a lot and let everyone who is reading sort through the mess.

I'm In a Glass Cage of Emotion

It's been over a week since I got the bad news about my aortic valve and I'm still not sure how I feel about everything. I don't know if I've come to grips with all the different aspects of what just happened. It all feels a little bit fuzzy in a general kind of way. I know exactly how I feel about some of the specifics, but when I try to think about the situation as a whole everything seems muddy. Let me try to elaborate.

For example, on the subject of not seeing my students again I am sad. I wish I could go back to Korea and teach them for the next seven months like I'm supposed to, but I can't. Knowing that they are in good hands makes me feel better, but I'm still sad. At the very least I would like to go back and say a proper goodbye to them all. I don't think that's asking too much. I'm not confused at all about my students.

As far as my upcoming surgery is concerned I am determined to get through it quickly so that I can get back to fun things. I feel ready and a bit nervous, but unafraid. I know the risks and I know the benefits and the good that it will do outweighs the bad by an infinite amount. There's no disputing the fact that surgery is a good thing and I'm ready to get better. There's no confusion here, I want to have this operation.

Separately I have no doubts about my feelings, but when I think about these two subjects together things get messy. I want to have this valve replacement and I want to have it now, but at the same time I want dearly to go back to Korea and see my students again. I can't have both and I've made my decision, but I'm not thrilled about it. So, maybe I do know how I feel about everything, but I'm not entirely happy about how it's all working out. I've made my decision but I don't want it to be a grey-area decision. I wish it could be a clear-cut, black and white decision, but it can't. Being an adult and making mature decisions sucks. I'd rather roll around on the floor kicking and screaming for a bit until I feel better. Maybe I'll try that next time I'm faced with a difficult decision that kind of sucks even when I make a good choice.

When In Doubt Make a List pt. 2

Here are the top 5 reasons why surgery isn't the worst thing in the world right now. This time in reverse order from least important to most.

5: 101 Facebook friends
I was stuck at 99 friends on Facebook for the longest time. I'm relatively new to the social networking world. I opened my account in January of this year, and I've been accumulating friends slowly but steadily over the last eight months. At least it was steady until I got to the number 99. I was stuck there for over a month I think. I must have stopped meeting people or being interesting enough to induce a friend request once I got a step away from 100. It's never been my goal to build up a giant list of Facebook friends and brag about it or feel like I'm really popular, but the number 100 seemed important for some reason. I'm not sure why, maybe because I think it legitimizes me as a Facebooker. At 100 I'd no longer be a newbie or an amatuer. I'd be a legitimate social networker who knew some people. I'd have connections, and those are supposed to be important when you grow up and become an adult. 99 connections was child's play, but 100 means I'm growing up and really becoming a somebody. Well, since I came home about a week and a half ago I received my 100th and 101st friend requests from people I went to high school with. I can't say I actually feel anymore grown up or any better at facebook than I did last week, but I'm still proud of myself for being at least acquaintances with 101 different people. Things are definitely looking up this week.


4: I get to fix the problem right now
For my first two surgeries I had to play the waiting game. I waited 14 years to have the aortic stenosis I was born with fixed and there was a year between the time my doctors found my aneurysm and the time I had it repaired, but this time there is no waiting. I have been blessed with a problem that requires immediate action. The prolapsed valve that I have now will most certainly lead to heart failure if nothing is done, but I'm not suffering from heart failure now (another little bonus) and to prevent it I need surgery right away. That means no living with physical restrictions while I put my life on hold. This time I'm just putting my life on hold for the surgery and recovery. I get to focus all my energy on productive things like not dying and then getting better.


3: I was home when doctors found the problem
I have nothing bad to say about Korean doctors or healthcare. The few times I had to see a doctor in the past 18 months were pleasant experiences, but I like my cardiologists here in Michigan. I've been very lucky to have one of the best cardiothoracic surgeons in the world perform all of my surgeries. He will also be performing my valve replacement that's coming up and I couldn't be happier about that. I trust him, I believe what he tells me and perhaps most importantly he makes me feel comfortable with everything that has to be done. He is straightforward and honest and doesn't sugar coat things. He speaks to patients the way they deserve to be spoken to. Although, I must admit, I hope I never need to see him again. He's a great person to have holding the knife when things are bad, but I'm not a huge fan of bad. I'd prefer to be in good health. The less I need to see my surgeon the better.

2: I'm still covered by my mother's insurance

The state of Michigan has been facing tough times for quite a while now. The economy is down, unemployment is up and people employed by the state have had to accept pay freezes, pay cuts and fewer benefits in some cases. That been said, public teachers are still very lucky to have the healthcare plan they have. It costs them more than it used to, but without it who knows where I'd be. My family never could have afforded any of my operations without insurance and thanks to the recent changes to healthcare I am covered by my mother's policy until I turn 27. My birthday is in less than 9 months. If I had completed my teaching contract and traveled through southeast Asia like I had planned and had put off coming home and getting a check-up I would no longer be covered by my mother's insurance and I would have to spend the rest of my life trying to pay off the bills I'm about to accrue for this surgery. Children are expensive, but I think I qualify for a different level of expensive. When all is said and done, I think my three open-heart surgeries will have cost about half a million dollars. That's a shitload of money!

1: My friends and family

I'm about to write some things that are relatively sappy and mushy. If you have a weak constitution for such material and would like to stop reading before causing yourself nausea or any other malady please know that I am grateful for all the support I have been given and stop reading now. If you have the courage to proceed please take note that you have been warned.

I am blessed by the amount of well-wishes, positive thoughts and words of encouragement I have received in the past and over the last week and a half. Thank you to everyone who has offered to help or had a kind word to say. I appreciate it all more than I can express. This problem was a big surprise and difficult to get my head around at first, but it gets a little easier every day as I have time to process it and plan for the future. It's also made easier by every word in every message I've received. So, thank you again. I appreciate everything.

When In Doubt Make a List

Here are the top 3 reasons I'm less than pleased about my upcoming open-heart surgery.

1: I may never see these kids again

This is the kindergarten class that I'm leaving behind and quite possibly my favorite part of the past 18 months in Korea. I may be a bit biased, but these are probably the cutest and smartest children alive. If you can look past the silly faces all of them seem to be making in this picture I'm sure you'll agree. I told them all I would be back soon when I left for my (now extended) summer vacation. That I can't keep my word makes me saddest of all.

2: I don't get to do this for a while

Dear multi-pitch climbs on Insubong,

   I know we only just met, but I can't stop thinking about you. We made eye contact from across the national park and it's been fireworks and angels singing ever since. I hope this isn't too forward, but I may be in love with you. You complete me. Though fate seems to be against us I swear we will be together again. Nothing will keep us apart.

Sincerely,

Marc

3: Putting my life on hold (again)

Before my last surgery I waited through almost a year of physical restrictions before the doctors finally decided it was time to fix me up. That was not fun or easy. This time around I get to have surgery right away, but it's happening at a very inopportune time. I'm not sure there's ever really a pleasant time to have a valve replacement, but I had some plans in the works this time. This is happening in the middle of my current teaching contract and now I have to break it. Bummer. Also, I was really excited to help out with the fall classes of a climbing school put on by Sanirang Alpine Networks this year. Now, I won't be climbing with San this fall and it's probably going to be five or six months before I can climb anything. Double bummer. Finally, I was starting to put together a pretty cool set of plans for the next couple years. The plans haven't been canceled, but they've got to be put on hold and I'm sure they're going to change at least a little. Double-and-a-half bummer.

What the F$#* Just Happened?!

This is supposed to be a vacation. I was going to see my family, visit some friends, go camping and fish for the first time in years. I've actually done most of those things, but this vacation sucks. I was excited, I was happy, I was only planning on staying for nine days. Now, I'm not sure how I feel about anything, I'm going to be here for at least four or five months and I need surgery. What the f$#* just happened?

I have been living in South Korea for the past year and a half teaching English to kindergarten students. South Korea was/is wonderful. I fell in love with the country, culture, people and, more importantly, my new job. It turns out that I really love teaching. The first year passed too quickly. So, I resigned my contract and began a second year. Things were going so well; I had found new passions in rock climbing and teaching, I was thinking about staying for a third year, tentatively planning some extensive traveling through southeast Asia and enjoying all the time I spent with my new friends. I was very happy.

I came home this July to see my family for the first time in 18 months and to get a checkup with my doctor. I felt, and still feel, great. I'm in the best shape I've ever been in thanks to all the climbing I've done, but it didn't matter the checkup did not go well. I am on track for heart failure. That is a bad thing. My aortic valve is leaking, severely, because the valve is no longer able to close. Instead, it folds back into my heart and lets the blood that was jumped pumped out flow backwards back into my heart. It's called prolapse. This is now the way it's supposed to work. As a result of the prolapse, my heart is working too hard and has grown about a centimeter in the past year and a half from the extra exertion. The increase in size is what will lead to heart failure, as long as the problem persists my heart will continue to grow. The only solution is to replace the malfunctioning aortic valve.

For the third time in my life I am preparing for open-heart surgery and all the hard work, uncertainty and pain that comes along with it. I'm not excited about this, but I'm ready for it. I want to get this over with and get back to making plans and living my life. This is most certainly going to suck a lot. It's going to hurt and it's really f$#*ing up all my plans, but it's going to get better. Since I was born I've been facing problems like this and it's always gotten better.

I was born with a condition called Aortic Stenosis. Basically, my aortic valve was too small and a bit misshapen. As a result, my heart had to work harder to pump enough blood to my body and brain through the smaller opening. This overworking would have ultimately lead to heart failure from an oversized heart. As I was growing up I had a lot of restrictions put in place on the amount of physical activity I could do. That was a bummer, I had to quit little league because running the bases was too much exertion, but I was terrible at baseball and I found other things to do like math club, reading a lot, wearing tapered Wrangler Jeans and having a bowl cut for way too long. I had the problem fixed when I was 14 years old, in July of 1999, and I was in good health for the next 10 years. That was my first open-heart surgery.

In the fall of 2008 I decided I wanted to join the Peace Corps and started the long application process. Because of my medical history I needed to pass a few tests and get cleared by a cardiologist before the program would accept me. It seemed totally reasonable and I felt great, physically, so I made the appointments as soon as I could. During the first test I got some bad news. My aortic artery was dilated to over 5.5 centimeters; that's about 2 cm too big. I had an aneurysm. In the simplest terms possible, an aneurysm is a blood vessel that starts to expand and look like a bubble or balloon. As the bubble gets bigger, the wall of the blood vessel gets thinner and the chances of it breaking, or rupturing, become greater. The only way to fix such a problem is through surgery.

Because of the size and location of my aneurysm the doctor decided it was best if my activity level was reduced to "occasionally walking at a brisk pace for short periods." That meant I couldn't do anything but walk at a reasonable pace; no more running, no more hiking, no more swimming. Awesome! The reason for the restrictions was the fact that if my aneurysm were to rupture I would be dead before I even knew what happened. That's how quickly I would bleed to death. So, maybe the restrictions weren't so bad after all. I ended up using the free time to learn how to make beer, and now I have another fun hobby.

From the time I learned about the aneurysm it took about one year before the surgeon would operate because the risk of having the aneurysm needed to outweigh the risk of surgery. On August 27, 2009 I had my second open-heart surgery. Afterwards, I changed gears and got focused on teaching English in South Korea instead of the Peace Corps. It ended up being one of the best decisions of my life.

I don't have to wait a long time for this latest surgery. My surgeon is actually juggling his schedule and rearranging previous appointments to fit me in as early as possible. I get to solve this problem right away. I am very thankful for that. And, who knows, maybe my current setback will help me make the next "best decision" of my life. It doesn't hurt to hope.