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.

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.

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.