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.