Pulmonary Heart Valve Replacement : 2011 -6

My right forearm is raw from the veins out. They were flushed with saline on a regular basis during my hospital stay. I will type this posting as long as my brain or fore arms do not freeze up.

June 1, 2011, 5:15 am: Phil pulled up to the main entrance of the hospital. I got out and walked in. He took my car home to this week's body work.

I had done the 'night before shower' and the 'morning shower' using an anti-bacterial body wash. My allergy to chlor hex eliminated the hospital preferred method. I smelled of fresh mountain spring, when I normally go fragrance free. I was well fasted. Anything I could do to improve the outcome of the surgery was pursued.

I carried a canvas bag similar to those reusable totes used for groceries. It contained a toiletries bag, a Shutterfly book of our travels since June 2010, the information folder of what I would need to know when I could not think straight [such as the business cards of doctors I've seen], a copy of The Shack, and the prayer shawl, [well used during my brush up with cancer last Summer].

The elevator just inside the entrance took me to the third level 'same day surgery' area. I ended up in a hall behind a sign requesting I wait for the next available person. One of the people doing the admitting looked up and informed me she would be with me in a few minutes.

I felt like Daniel must have going into the lion's den. Things were closing in around me, and there was NO WAY I could stand in one spot for a few seconds, much less a few minutes. I backed up to one of the hallway walls and slid my butt down to the floor for the wait. I learned something new about hospitals. They do not like it when your butt touches the floor. And,(from the nurses I spoke with later in the week), there is a bunch of paperwork that is needed to be done when this happens. A chair was produced from somewhere. I stayed where I was because it was too much effort to get up to sit in a chair that did not look as comfortable as I was at that time.

Admissions was quick with a verification of who I was and the standard, "What is your birthdate?"

I was led to a patient waiting/transition room and given the clothes I would need to change into for surgery.

There was paperwork to fill out. There is one form that grants the hospital permission to dispose of tissue. I hand wrote in a request to see the original valve. It has tethered me for my entire life. I wanted to see what was so important about it. I cannot remember a time there not a shadow in the back of my mind weighing the pros and cons of an action relevant to how this valve would respond. I wanted to see the culprit!! I wanted to see how big it was... the reports gave it 3.8 cm diameter. Was that an inner or outer diameter? How long was it? What was the texture like? What color was it? I wanted to see it before it joined the scrap bin. I had no desire to take it home in a Mason jar.

My pastor showed up during the wait and provided comfort and company for a while. I sent him on his way. I needed time to finish rectifying my life to this point and what it would mean should I go to God leaving my remains to the cemetary in Northern Michigan where my husband's parents lie.

There is a man from my church who died this last Spring. He left our world for God's in a joyous dance, ever mindful of where others' were in their God quest.

My thoughts were: Where could I have grown more? I could not find one area. I chalked it up to my mind going a mile a minute with anticipation.

I began pacing the hall of the prep area. There was one other patient and no one seemed to care that I stay put. One wall of this area was glass. Bright sunlght streamed in and warmed my skin.

The next step was to go to a room for sugery prep. Here a line for IV was put in and I repeated my request to see the valve. A new nurse showed up and I repeated the request to see the valve. She told me it was not procedure. Maybe a picture would be possible.

I met the anethstesiologist for the first time. I understand why my surgeon chose him to be part of the operating team. He told me I would be taken to another prep room prior to surgery and he pointed to areas of my body where tubes - lines - portals - etc. would be put in. I understood he was describing where they were going to hook up the heart lung machine to my body, without him saying so outright.

The request for my heart valve viewing was requested and there was a quick conversation of my making the addition to the paperwork.

I was woken up ~ 5:30 pm. There is nothing in between.

Pulmonary Heart Valve Replacement : 2011 -5

I'M HOME!!!!!

Wednesday, June 1, 2011 I underwent pulmonary heart valve replacement.

Tuesday, June 7, 2011 ~ 3:30 I was released from the hospital to go home and recover. There are many things I experienced and will gradually blog as I am physically able. It is amazing how tiring that 20 minute ride was.

The picture above is June 2, 2010 documentation of warping up my loom for the first time in two decades. (There are more flowers in the camera from my morning walk in front of the house and a 'replace batteries' message.) The warping of the loom seems appropriate because I feel all tangled up inside, yet I know as long as I follow the plan everything will fall in line.

Today I will say my thank yous. I do not know if it was mentioned in the prior blog, but my valve is a homo-graft. Homo-grafts function longer than the other biological valves. So, beating within my heart is a remnant of a young person who gave me a much better future. This done by a family out of the depths of horrendous loss. Humbled is not a strong enough description of my gratitude.

Thank you to the surgical team. There are modifications needed to work on the pulmonary valve. I lost consciousness around 9:00 am. I was in the ICU by 5:30 pm. How many of us are at our best for 7 1/2 hours straight?

Thank you to the cardiologists who guided me through the pre-op testing and decision making.

Thank you to the arrhythmia cardiologists who beamed happiness when their drug therapy brought the results needed.

Thank you to the physcian assistants who knew what to expect. They gave me a clear headed view when I was having trouble forming a noun verb noun sentence.

Thank you to my personal Primary Care Physician, who showed up with the intern-of-the-month to pay a visit. Every time I had a test or visit I was asked who my Primary Care Physician was. She was getting updates and came to check out what the results were.

Thank you to my gynecologist's office who fielded questions on Monday morning, via telephone on non heart related issuses

Thank you to the Chaplaincy from inside the hospital and my beloved local churches. They brought God to me when I was too muddle headed to feel Him.

Thank you to the nursing staff. I began compiling a list of their names Sunday. Initially I was looking for a repeat of names. Instead it turned into a baby name directory: Veronica, Linda, Adala, Tacy, Heather, Judy, Andrea, Melissa, Jessie, Eric, Michell, Shella and Melissa Part II. This is a very incomplete blended list of RN and nursing assistants assigned to me. They work nasty hours and are pleasant and encouraging to those they care for. Try asking your spouse for a glass of ice water at 3:30 am. It always came with a smile.

Thank you to those who know me and still called, sent cards and visited.

Wisconsin Malibu 1 : Michigan doe 0 -- Game over

11:00 am on a Sunday. Clear sky. Sun shining. Just North of Iron Mountain, Michigan and the gravel pit on M95, two deer ran across the highway. I missed the fawn and hit the yearling doe. A conservation officer pulled up as Cassie and I ran back to pick up the pieces from the car grill before they caused problems for other drivers. He finished off with his side arm what I started with my car grill.

I was Soooo angry. Stupid deer.

I asked for a permit to keep the meat, which he issued. Then we got in touch with my local brother-in-laws who hunt. They said to leave it in the ditch because the meat is not worth eating until July. It is tough and stringy with the flavor of lichens and moss. I followed his advice.

One more new skill for this city raised girl.






We were following about 20 minute behind Larry. He is having problems with his Explorer. He was driving it to his brother's where it will be put on a flat bed. His brothers will bring it home so it can be fixed.

Cassie took off with the car to go pick up Larry and bring him back. I stayed on the side of the road with the conservation officer while the Dickinson County Sheriff showed up and took information for the accident report. It is needed for the insurance claim.

Above is me caught in the pictures taken by Larry.

Kristine graduates from high school

The graduate. The last of the generation. Now, let's see where God leads her.
The three girl cousins. This was a generation to break tradition. Sisters... and cousins for the paternal line. It took 3 generations in North America.

Pulmonary Heart Valve Replacement : 2011 -4

The picture is Lake Superior, Memorial Day weekend 2009, Presque Isle, Marquette Michigan.

I am leaving for the Upper Peninsula from work this afternoon. Larry and Cassie are leaving this morning. We will look at two more houses on Saturday. It seems odd to be looking for a second home when faced with surgery in a few days. One of our coping mechanisms is to plan past the surgery. That reduces the overwhelming-ness of what our family is going through. It gives us a 'normal' in a situation that has an unknown outcome.

One of the questions asked by people is what are the symptoms I have been having. I went from the fatigue of radiation to the fatigue of heart valve failure... and saw an improvement in my health. My cardiologist says I do not tolerate exercise. Here is a list of what most people can do and I cannot.

- winded after walking up a flight of stairs.
- winded feels like there is not enough air getting into my lungs. I want to take deep breaths. Anything I can do to open up my chest helps. Improving my posture, pushing my shoulders back, leaning forward to realign my internal organs just a tad, putting my hands behind my back, putting my hands above my head, putting my legs up and my head down, unhooking my bra, leaning over with my hands on my desk, ... ... ... They all give my right atrium room to work.
- can walk distances with no problem, given time. Cassie and I walked her 5K training route on Mother's Day. It took 2 hours and 20 minutes.
- cannot stand for any period of time. I put my selection back on the rack at Kohl's because I could not stand in line without wanting to lay down.
- sitting and standing I am tired. Laying down I am wide awake.
- tired to the point of tears after minor activity
- low frequency vibrations aggravate the feeling... bass guitar bouncing off smooth surfaces, industrial heating/AC blowers at work, bass in the car radio. All sounds you 'feel' my heart is disturbed by.
- transitioning from walking to standing/sitting takes time for my heart rhythm to adjust. I thought it was a side affect of the atenolol. Maybe not. I park in a lot that requires me to walk through a tunnel. ~ 5 blocks from car to desk. 17 steps on one end of the tunnel. 18 steps on the other end. It takes ~ 3 minutes to steady my heart rate once at my desk. A drink of water helps.

Pulmonary Heart Valve Replacement : 2011 -3

I love the flowers of Spring.

The meet and greet with the surgeon took place on Tuesday. He was on vacation last week and was doing what needed to be done to catch up. I met him about an hour after the appointment time and was not disappointed. The time he was in the meeting with me was for me to understand what he brought to the solution. When he finished what he needed to tell me I had a sheet of questions that he answered.

The valve will most likely be human. They are harvested and kept frozen in liquid nitrogen until needed.

The surgery will provide the ability to use the groin replacement method in the future should the valve need to be replaced. I don't think I will need a replacement because they last ~ 40 years and I am 55.

The time-line for healing is a couple days in ICU. About a week total in the hospital. 6- 8 weeks healing. 6 weeks no driving. Mid September to return to yoga. My breast bone will be cut during the surgery and will need time to mend.

Wednesday the office scheduler called with a surgery date and instructions for pre-admission testing. Surgery is scheduled for June 1, 2011. Arrival at 5:30 am. Surgery to begin at 8:30 am.

Phil will drop me off. Larry will go to work at 4:00am and come to the hospital after work. He may actually be there before the doctor is through with me. It does not benefit anyone for Larry to sit in a waiting room for 8 hours.

Wednesday there were all kinds of voice mails at home from pre-admission testing. I called back when I got home and clarified their information while they gave me direction for Thursday's testing.

Today the hospital called me at work and I spent half an hour going over pre-admission preparation, along with clarification of allergies and reactions. There was an envelope with this information when I got to the pre-admissions testing after work.

The pre-admissions testing was non-fasting. X-Ray. Urine. Blood draw. There is a test that can identify sugar spikes 3 months ago. There is a test for a bacteria that infects wounds, but is common in the sinuses of the general population. Should that be found I will have to undergo some nasty upper sinus topical antibiotic. Yep, that is how it is applied. Then I went to another location in the hospital for a carate artery unltrasound. My doctor is making sure anything that is in need of attention is done with this one surgery. So far the only thing on the agenda is the pulmonary heart valve.

Below is what my arm looked like 4 days after the heart catherization. The red dot on the top of the hand near the wrist is the entry location for the probe. It beats the old method that required bed rest and stitches. I don't forsee an oportunity for any more medical type photos beyond this one.

Pulmonary Heart Valve Replacement : 2011 -2

May 20, 2011: Yesterday at 5:30 was my heart cauterization. I arrived just before 3:00 and everything spun into motion.

The plan was to work 'flex' beginning at 6 am and leaving at 2:30 pm. Phil picked me up at the nearest exit at work and dropped me off at the Hospital main entrance, then returned home anticipating picking me up the this morning. I put my overnight bag on my personal luggage cart and pulled it behind me through the hospital. That allowed me to walk the distance inside the hospital without a problem.

There was the obligatory pre-operation screenings and bloodwork. I dropped 2.5# since the Tuesday weigh in. Of course, most of yesterday was spent fasting.

Cassie biked in from home to visit for half an hour then left just before I was taken to the 'procedure' room. She had a church softball game to keep score for.

The journey to the procedure room included a length of hallway with windows on one length. There was an early Spring terraced garden on the outside of the glass. It must be beautiful year round.

One of the hardest things for me when having a medical surgical event is just before it begins when I am in the the operating room. All this activity is going on around me and I am laid out like a slab of meat waiting to be carved up. I want to jump up and bolt for the nearest exit. It is a relief when I notice the anesthesia taking affect.

Somewhere in the conversation I picked up that I would be going home that night, not the next morning. OK. I would take care of transportation later.

The procedure was a radial cauterization. A probe (?) was inserted through the radial vein in my right wrist to explore the veins / arteries of my heart. A die was used to high light this on the x-rays. The actual procedure took ~ 10 minutes. All the rest was prep.

The result of this procedure was verification that I have 'normal' heart veins and arteries. 'Normal' in the sense of generic population 'normal', not middle aged woman with heart disease 'normal'. Nya, Nay!!

A pressure band was put around my wrist to prevent any bleeding while the lidacaine (sp) was clearing my body. After two hours the pressure was gradually released using a syringe inserted into a valve on the band. There was numbness in my thumb and the thumb side of my index finger. That gradually went away. The doctor was called to verify it was a nerve that had been pressured along with the artery, waking up.

Larry came to visit after the softball game. I had just returned to the room. No phone call was needed to get a ride home.

A codein laced tylenol from last year's lump-ectomy and a colase set me up for the night, in my own bed.

The doctor who did the cauterization was the same doctor I initially saw. He remembered me and said, "This is what I heard when I listened to your heart." He knew on the spot what was going on inside my chest. It took since February to dot all the I's and cross all the T's. Most of this was because I was not convinced this was needed and they wanted to make sure I was ready emotionally, not just physically.

The meet and greet with the surgeon is set for Tuesday the 24th of May.

The header photos are from a post card in yesterday's mail. I think I would like to attend. It is a public meet and greet with my cardiologist and his support team.