Well, It's Time

PHOTO: Happy listening to the Wanamaker Organ

My surgery is tomorrow. It's been a long time coming. People often ask me "how do you feel?" Or they ask "how are you handling this?" Or, "how do you keep your spirits up, stay positive?" I usually respond that I feel fine and that having a wonderful husband, pets and a great life keeps me positive.

Dan points out that this whole thing, finally getting to the point of needing surgery, hasn't happened the way we thought it would. We figured I'd get progressively weaker and symptomatic, and that one day I would collapse like a friend did when his aortic valve went bad. But that didn't happen in my case. I think of my experience as more than a little surreal. This is because, with the exception of my serious episode last December 9 and a few lesser episodes over the moths and years, I usually feel just fine with minimal symptoms. I can still lift heavy things, walk five to six miles a day, and in short, do just about everything I want. I get a little winded once in a while climbing steps, but other than that I feel perfectly normal. So yes, it feels like I'm in some sort of surreal dream wherein I'm fine, a dream that never ends ... but I have to get this heavy duty operation anyway, that will rob me, (hopefully only temporarily,) of the strength and conditioning that I've worked so hard to maintain into my senior years.

There's a hill that I climb every day on my morning walk on my way back to the house. I've always said to myself that the day I can't climb this hill will be the day that I need to have surgery. But that's not the way it worked out. I can still climb the hill today but I won't be able to do it (for a while) after surgery. So now I say to myself, the day that I'm able to once again climb that hill...that will be the day when I'll feel recovered.

Made The Top Of The List!

All by myself...scheduled for Monday. The other photo shows the hand shower device and shower seat that I got to make life a little easier during recovery.

Eleven Years After Diagnosis: I'm Still Here!

PHOTO: Underwater selfie in St.Barth

I am in a great place (mentally) all set for Monday...no worries, bring it on. I have a busy weekend with a social event Friday evening, and Saturday and Sunday performances to attend. And I can drink my Sake until Saturday evening, how great is that? Finally, my weight...194.2 down 2.0 since last week and I made my target weight for surgery of 195.0. I have asked Dan to take many photos on Monday and Tuesday and to bring me my laptop as soon as I am out of the ICU. But who knows what condition I'll be in or whether I'll want to deal with it. We'll see. It's been quite a ride these past 11 years since my diagnosis. But like Sondhiem wrote ....I'm still here.

Household Preparations

We've tried to prepare for the next month or so by stockpiling groceries, especially heavier items that I won't be able to lift for a while after surgery. I also rented a power lift medical recliner to rest and sleep in. I won't be able to use my arms to push out of a chair, so the chair lifts you up half way to where you can stand without using your arms. Having the reclining function should aid with rest since I won't be able to sleep in my side, my usual sleeping position. Dan has also arranged for animal care help and he is looking into hiring a housekeeper so that the household burden will not be on him alone. It won't be a picnic but we should be able to manage the situation.

Intense, Busy Day With Pre-Op Testing

PHOTO: "Sternal Lok Blu" Rigid Sternal Fixation

Today was pretty intense. First I met with my surgeon's right hand man, a nurse-practitioner named Bill. Bill has been very helpful since I first met with him. Today he answered the follow-up questions that I had such as about the total number of incisions I would wake up with post surgery (7 or 8 including three or four drainage tubes, two regular IVs, an arterial IV, and a neck incision for a cardiac catheter!), what medications I would be on, probably at least six including a water pill, something for my bowels, a pain killer, a beta blocker for blood pressure medication, aspirin, and coumadin. I also asked Bill about the relative complexity of my procedure. On a scale of 1 to 10 with 10 being highly complex, my procedure a "Button Bentall" is an 8 or a 9. That's why you go to a major university center like Temple or Penn, a heart center of excellence, to get this type of surgery. Bill also explained the timings that my husband Dan can expect for my procedure. The operation will last between six and eight hours including prep time and post surgery housekeeping before I will be transferred to the ICU. If my procedure starts as scheduled early Monday, Dan can expect to get a report from my surgeon Dr. Wheatley sometime between about 1 PM and 3 PM. Bill also commented on the general anesthesia used. Two different agents are administered. One knocks you out and the other paralyzes you.

After meeting with Bill I met with my surgeon Dr. Wheatley. By this point in the process most of my questions had already been answered. I did disucss the possibility that I might require a permanent pacemaker post surgery. Dr. Wheatley told me that there is only about a 10 percent chance of that. Since I blog about BAV disease and aneurysms and my own situation, I might want to write further about it at some point. In this connection i asked Dr. Wheatley if he planned to take photos of my procedure. He indicated that he did not do this routinely but he would try to make some media available for me.

After meeting with Dr. Wheatley it was time for pre-admission testing. This included an examination by a nurse-practitioner, blood work, and chest X-rays. I got anti-bacterial body wipes that I must use the night before my surgery and also on the morning of the surgery. I also asked if I could see the cardiac intensive care facility and the step down unit, but apparently Temple Hospital does not allow casual visitors to these facilities.

Finally, Dr. Wheatley asked me if I would be interested in participating in an evaluation of an alternative sternal closure device, "Sternal Lok Blu," which are metal plates screwed to the sternum instead of wires. Dr. Wheatley feels that this method is superior to the wires. I agreed but since it is a study only half of the participants will receive the rigid sternal fixation devices and the other half will get the usual closure with wires. I'm hoping to be one of the lucky recipients of the Sternal Lok Blu closures. I won't know until after the study ends, though, in about a year.

So now I have only four days before surgery happens. The train has left the station and I'm on board. There's no getting off now.

Health And The Weather

One genuine concern leading up top surgery is how to keep healthy and avoid getting a cold, or worse, the flu. So I wear a face mask at cultural events and wash my hands so often that they are dried out. The weather is another concern, Luckily, the most severe weather seems to have headed well to the north of Philadelphia.

Busy Last Week Before Surgery

Got a good view of the Philadelphia skyline from the Camden, NJ Adventure Aquarium on Sunday. This final week before surgery will be busy. I'm meeting with my surgeon Wednesday followed by pre-admission testing. Having a medical recliner delivered this week. Dan and I will be attending two performances over the weekend, and we will be going out with friends for dinner on Friday evening. In the meantime I have to finish getting organized for my anticipated one week post surgery hospital stay.

Dr. Wheatley: Medical Arc de Triomphe (or Why your Aortic arch is unique)

My surgeon, Dr. Grayson Wheatley at Temple University has published another informative essay on the aorta: http://badaorta.com/

Wearing Red For Women's Heart Health Day

Surgery Listed At HeartValveSurgery.com

I must be getting close...

Getting To Fighting Weight Pre-Surgery

Photo: no scar...yet!

My current weight: 197.0

From the internet:

Based on the Robinson formula (1983), your ideal weight is 185.8 lbs

Based on the Miller formula (1983), your ideal weight is 176.7 lbs

Based on the Devine formula (1974), your ideal weight is 196.4 lbs

Based on the Hamwi formula (1964), your ideal weight is 207.0 lbs

Based on the healthy BMI recommendation, your recommended weight is 156.0 lbs - 210.8 lbs

Two More Weeks Until Surgery

Many people say that the waiting is the hardest part. I know what they mean. I would really rather have the surgery over with and be starting recovery. It's exhausting just waiting and thinking about it.

Dr. Wheatley: Part 2 On Treating Aorta Coarctation

Another very informative post from my surgeon Dr. Wheatley:

What's a little "kink" amongst friends? (Part 2) http://badaorta.com/