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Wednesday, February 06, 2008

The Return

February 6, 2008
5:49 PM

I suppose it was a little selfish of me. If it is any consolation the self-imposed guilt has been consistent if not great. Two years ago I began this blog as a means to keep friends and family posted on my progress through a personal trial; open heart surgery. What I did not anticipate is that both the daily writing I did and the regular feedback I got would be a salve equal to, if not better than all of the drugs, tests, incisions and sutures that would soon follow. And so you were with me along the way; and for what? So that I could abruptly stop writing with no warning, reason or sign-off? The last post from Anonymous was: “You still kickin’?” What a jerk I was.

At the risk of sounding as if I am diverting blame, I believe some of it came from one of my college writing professors. And seeing a pattern amongst some of the writers we had been studying, Hemingway, and Faulkner among them, it seemed as if the only way to write anything worth writing was to have a life no one would want. And by that I mean life experiences no one would want. And Dr. Ginsberg concurred believing that it was not possible to be a quality writer without having a trying life. So I faked it in college writing ‘fiction’. It was not until the late summer of 2005 did I finally have something worth writing about….my mortality. So I did and then I stopped. I stopped because I was out of the woods and I thought, “Who cares about what I write now? I had readers for the same reason that people watch NASCAR or reality TV. For the crashes, for the public humiliation, for the drama. No one admitted it, but the story would not have been nearly as interesting if I were going in for an appendectomy.

But something for me changed when I read a book recently. It is titled Sick Girl written, I think, by Amy Silverstein. So the jacket cover goes something like this:

A vibrant young woman entering the prime of her life discovers that she has cardiomypathy sp? (a dying heart, suffocating from the inside out one A-Fib attack at a time). At the same time she meets the love of her life; a reason to keep fighting. The only thing that will save her physical life is a heart transplant that she eventually gets. But rather than be grateful for the second chance at life she is angry at the doctors, the anti-rejection medication that makes her vomit and the never ending tests she must undergo throughout her life. Is the pain and inconvenience worth it?

I bought the book because I wanted to read about what she went through, which I will say with unmitigated reservation, is absolute Hell. Her story makes my ordeal sound like a teeth cleaning (just the polishing part). And so here is a woman who had plenty of misery and plenty of reason and fodder to write and while it was decent, she is no Hemingway or Faulkner (sorry, Amy). And so I will try a different philosophy. I will write for writing’s sake. And I will share what I observe, and see and feel. And I don’t plan on shooting myself or becoming an alcoholic or even having another heart surgery. I plan on living a boring life while still being a decent writer. OK, I’ve gotta run. I think I have to take the trash out.

~Joe

Sunday, November 06, 2005

Direct TV

You walk through first class when making your way to your impossibly small coach seat next to the restroom. The first class passengers who boarded first are getting mimosas and free copies of The Journal while another attendant hands out hot, moist washcloths. Some have already fully reclined in their plush leather seats.

The doors close, the curtain is shut and you are left to endure the 6 hour flight between the gentleman who smells of a land you’ve never been too and foods you’ve never tasted and his wife to whom he yells at in a language you cannot understand. You offer the soul mates an opportunity to sit next to one another, but they have no idea what you are saying. This is the one flight a year they take and they are just fine having you sit in-between them. You are not offered food due to cost cutting unless you want to pay $13.50 for a pre-fab salad from TGI Fridays. Mmm mmm. Overly cold, tasteless and sure to please no one, but it is a momentary diversion from the guttural spit that has had you in the crossfire since you sat down.

In Cleveland, after the first open heart operation and the drainage tube event but before the lymph-angiogram and the second open heart surgery, I was contacted by administrators from the Clinic. It seems it had been brought to their attention that I had been writing a very public account of my experiences while under the care of the clinic. I was told that there are “…many people paying attention to my blog and if there is anything that I am or have been unhappy with I should speak directly with a “patient advocate”. The conversation lasted about 30 minutes all the while my entire family sat around amazed that it was coming to this. I was never told to stop, lord knows they couldn’t say that even though it was strongly implied. So I shared with her my frustrations about it taking an hour to get a nurse to answer the call button, the inconsistency of information from the myriad doctors I saw each day, the consistently delayed schedule which had me staying longer than most of us thought needed at times, the absurdness of the pain scale and pain maintenance techniques and then some of what I heard uttered during my stay, such as a nurse saying to a colleague: “I have such a bad cold, I shouldn’t even be here.” And I shared all of this freely and then with anger. It angered me that at least I was physically and mentally able to be heard there in the hospital, but also to share my challenges with concerned friends and family via the blog. My capacity and my public record of the occurrences, I am positive, meant that I received better care and attention than the average patient. And the anger built as I realized how many people did not have the personal capacity nor the friends or family to stand in as their guardian.

The first time I came up from ICU I had a semi private room and in the bed next to me was Mr. Patterson. I learned nothing of his ailments, his past or his hopes for the future. Mr. Patterson was 89 years old disheveled long white hair and a bushy mustache. He was disturbingly emaciated and had no visitors or calls for the 3 days we shared quarters. I thought his agony would ease once they got him settled the first day. As they transferred him to his bed he let out wails of pain and crushing despair that made no discernible words but it was plain enough to know what he was saying. And so this continued for 3 days and 3 nights. The wails would reach deep into my soul when they were loud and seep agonizingly into my head when they were low but either way their cadence continued. The nurses aides changed his bed linens each day and laughed and joked about different men they were dating and other nondescript trivialities. And all the while Mr. Patterson moaned, and they laughed.

And somewhere during that period I began to question my own humanity for all though I called the nurses on Mr. Patterson’s behalf when his pain seemed to spike, I wondered after they arrived did I call them because Mr. Patterson needed help or because I need a respite from his cries of despair?

So the blog gathered critical mass and shortly after the call from the administrators Dr. Gillinov was so kind as to offer me to move to the VIP floor which I gratefully accepted. And here in a 1200 square foot room with two refrigerators, two televisions with Direct TV and original art work on the walls I sat as “room service” was brought for meals. And then one of the cleaning ladies asked who I was because this was the same room Lebron James of the Cleveland Cavaliers stayed in the same room a week earlier because a case of Pleurisy. “Do you watch soap operas? I asked. “Oh yes, I sure do.” “Which ones?” “I really like the Young and the Restless and I also likeGeneral Hospital. I’ve been watching that one for over ten years.” “Oh well,” I said. “I’m just starting out. I’ve been on Days of our Lives a few times but they told me I’m going to be a regular." And shortly after she left, looking more shy than when she first came in. And then the smile fell from my face because Mr. Patterson couldn’t write a blog and now he didn’t have Direct TV.


~Joe

Surgery #1: 31 days post-op
Surgery #2: 17 days post-op

Thursday, November 03, 2005

2 weeks


It has been two weeks since the second surgery.

If anyone needs any beta blockers, ace inhibitors, iron supplements, acid reflux suppressors, diuretics, pain killers, swelling reducers or anything else, just let me know. The picture above is what I take each day for all sorts of things. When I test positive for steroids I will have an alibi. I’ve stopped taking the pain meds mostly because the pain is now bearable but also because they were giving me night sweats. At least I think it was the pain meds and not that reoccurring dream of the scary clown offering me parenting tips.

2 weeks seems to be the turning point. It was after the first surgery too. That is when I was the most ornery in the hospital. That is when I finally said, “I don’t want anyone touching me that doesn’t know what they are doing. In fact here is a list of the people that I refuse to have contact with.” This was the best thing I could have done, I just should have done it sooner. But that was then; let’s consider the here and now. Following is an inventory of what I can and cannot do at two weeks post-op:

I can walk around the block before becoming winded.
I can raise my arms above my head.
I can sleep more than 3 hours in a row.
I can spend 20 minutes on the phone with HP customer service before giving up.
I can dress myself and not just in gowns.
I can make a meal that consists of more than 2 ingredients (but not more than 4).
I can breathe somewhat normally.
I can fold laundry though I still don’t enjoy it.
I can sleep on my right side.
I can check email and occasionally regular mail.
I can read the NY Times but am a little slower than usual at catching the CIA leaks.
I can fit into my “skinny” jeans again now that I’ve lost about 12 pounds.

I cannot make small talk unless I know you well in which case we wouldn’t be having small talk anyway.
I cannot sneeze or cough without enduring brutally sharp pain in the center of my chest.
I cannot sleep on my left side or stomach.
I cannot walk the dog.
I cannot lift anything more than 10 lbs.
I have zero appetite for any fish.
I still cannot play the piano.
I cannot drive or sit in the front of a car.
I cannot feel my toes.
I cannot believe that they are already playing Christmas commercials. I feel bad for Thanksgiving.


~Joe

Surgery #1: 28 days post-op
Surgery #2: 14 days post-op

Wednesday, November 02, 2005

Happy belated Halloween...

from Maggie the Super Bulldog and her trusty side kick, Max the Ear of Corn.

Monday, October 31, 2005

Dedication

My mother stepped into the room holding a mascara stained tissue. “He is doing OK. The doctors said they got it all and that he was going to be fine. Joseph, do you want to go see your father?” Well, of course I wanted to see him, but I want to see dad before the brain surgery, not after. I want to see the man who never took a day off of work, who never got sick, who knew all the answers to Trivial Pursuit.

I took my mother’s hand and walked down the hall of Cornell’s neuro-surgery wing. Upon entering the room I was awash in sunlight that was streaming in through the westside window. The heat felt good on my cool skin. And there in the bed sitting up lay Dad though it looked nothing like him. I stood at the foot of the bed for a moment and surveyed the scene. His head was shaved for easy access to the cranium. Staples then ran from the top of his head forward to the highest portion of his forehead and then back to his left ear. His face was completely purple from the nose up. His eyes were swollen as if he just lost a prize fight. I stood there at the foot of the bed for a long moment and felt this cold clammy rush to all of my exposed skin. I made my way around the bed and my mother quickly got a chair for me. “Sit down, honey, you don’t look so good.” Um, Mom have you seen dad lately?

My father had a brain tumor the size of your fist that was wrapping itself around his left retina. It was benign, but I don’t see how that word applies considering what I surveyed that day. Oh, it’s a friendly tumor!

My father did turn out to be fine. Even today, twenty some odd years later you can barely even make out the scar. But the lasting impression from that day is that Dad isn’t impervious to the outside world. That mortality does apply to him too. That maybe he won’t know who the king of Prussia was in 1772. Every child comes to this realization at some point and it is a sobering moment after years of being intoxicated on childhood innocence. I thank god that Max was too young to remember these last 3 weeks of me in such vulnerable states.

There are two good friends with whom I work that were unfortunate enough to lose their fathers over the last few months; one through illness and another through bizarre happenstance. Neither more tragic than the other. And it is for this reason that I dedicate this post to all the fathers. You are forever invincible in our hearts.

~Joe

Post-op #1: 24 days
Post-op #2 11 days

Thursday, October 27, 2005

Scatching the Itch

I recommend looking for the rack with the out-of-season clothes. This usually allows for many options in Marshall’s. As an example, today I ended up behind the shorts and t-shirts in the men’s section. I waded through ladies’ pants suits and the woefully inadequate shoe department and on to the rack with the shorts. It was here that I indulged. First it was nonchalant as my eyes darted back and forth. I started with the right knee and before I knew what I was doing I was scratching my crotch as if I were washing laundry in the river. Moments (or hours later) my eyes rolled forward again just in time to catch a horrified woman in her 70’s with a shopping cart filled with control-top fishnets. I smiled and slinked away.

I suppose I should give some explanation beyond my baseline depravity. You see, one of the things they don’t tell you about with heart surgery is the shaving. The body shaving. For those that know me, you know that I’ve got a fair amount of body hair; more than average but far from Wookie. And if natural selection played out with hospital visits, those with less body hair would fair quite a bit better. For my operations my entire chest and abdomen was shaved, which I expected. What I didn’t expect was to have a 4 inch strip on the inside of my right leg shaved from the ankle to the knee. Both of my thighs, as high as they went, were also shaved. It seems they wanted to have access to the veins in my legs if the surgeons decided they needed them while they were inside me. Additionally, many of the tubes I had inside me were taped to my thighs so I wouldn’t accidentally pull them out if I rolled over. Inevitably the hair grows back in but not without its trials and tribulations.

And this is how I found myself in the clearance section of a discount retailer with my hands trying to satisfy an insatiable itch.

In all I was there 15 minutes. I was exhausted. I found Allison coming out of the changing room. She put Max and I in the backseat of the car and I went home to take a nap…and scratch.

~Joe

20 days post-op #1
7 days post-op #2

Wednesday, October 26, 2005

This is how I spent my day:

http://www.twinkiesproject.com/

~Joe

Tomorrow



Tomorrow I will shave and shower.
Tomorrow I will sort the mail and pay the bills.
Tomorrow I will survey the fridge and lament its contents.
Tomorrow I will curse the neighbor’s dog while praising mine.
Tomorrow I will savor the twilight between sleep and consciousness.
Tomorrow I will hold Max tight to my chest while Maggie licks my feet.
Tomorrow I will notice how the leaves changed and how little the grass grew.
Tomorrow I will have coffee with Allison and look forward to washing the cups.
Tomorrow I will see the same dust bunny in the corner and pass by it yet again.

Tomorrow I will do these things because Tonight I am home.

Tuesday, October 25, 2005

Pssst.

Don't tell anyone, but I'm gonna make a break for it.

Monday, October 24, 2005

Getting sick/hurt strategically.

At the rate Max is growing he'll have a beard like mine by this time next week.

The health machine moved pretty slowly today. The echo that was supposed to happen by noon didn't occur until 4:00pm by a radiology tech named Shar. That name and the pink highlights should have been warning enough that she wasn't going to be gentle. Don't get me wrong, echos are harmless, basically an unltrasound of the heart. But this was the first one I would categorize as uncomfortable. Perhaps one of Shar's 13 cats peed on her bed again last night because she found just the wrong spots inbetween my ribs to jam the "wand".

The physician's assitant apologized about not being able to take the tubes out until tomorrow 8:00AM because as she said, we don't remove tubes after 4PM, "just in case something happens we want to be sure the right people are here to help." And she has a point. It isn't as if this is a world renowned hospital or anything.

Please, if you take nothing away from this blog, take this:

DO NOT GET INJURED OR ILL AFTER 4PM ON WEEKDAYS OR ANYTIME ON WEEKENDS....There. You have been duly warned.

The Good News
The results of the echo showed no appreciable gain in volume compared to the echo immediately following the second surgery. This means Dr. Gillinov and his team did what was needed to close up what was leaking. Thank you, Dr. Gillinov. In fact he told me that during the surgery they (he, 4 other surgeons, a few cardiologists and the rest of the team) injected more cream into my thymus, put me almost perpendicular to the ground and proceeded to watch me (while split open presumably) to see if there were any other leaks. There were none and today's echo proved all to be well.

So tomorrow I am keeping my fingers crossed that we will get our walking papers. We'll let you know for sure when we know and when I get over the Homeric sorrow sure to accompany the loss of my tubes, wires and tethers.

~Joe

15 days post-op

3 week old beard & 9 week old Max


Sunday, October 23, 2005

These are the Days of our lives in General Hospital.

Met with two different doctors today and things are looking positive though I won't allow myself to jump ahead at all in the process. Turns out my triglicerides number in the fluid needs to be below 100 and is currently at 67. Three times a day a nurse comes in and collects the fluid from each of the containers labeled "1" and "2" respectively. So if the trend continues and the echocardiogram shows no further accumulation of fluids then tomorrow they will remove the tubes from my chest. They are actually in my stomach area just below the center of my rib cage which makes using my abs more than uncomfortable. I envision the scene at the end of Braveheart when William Wallace is finally captured. William Wallace woulnd't flinch at this though. And what will get me through it is that it should be the last painful thing to manage before I get the hell out of dodge.

I've been here nearly 3 weeks have had 2 showers 3 decent meals, many laughs and smiles from Max, innumerable hugs and kisses from family, countless heartfelt calls, made the bed 0 times, made no meals, feel as frail as an 80 year old, cursed out "kids" twice, thought about Maggie the super bull dog 53 times, took out the trash 0 times, read the comments on this blog 81 times, have watched 105 hours of television (30 minutes of which included Oprah), shaved 0 times and have said, "I can't believe how much grey I have in my beard" 12 times.

So that's just a sampling...when I'm feeling more industrious I'll give you more details, but despite football being on the tube today I am behind my tv quota and therefore need to go.

Hope to have good news for you all tomorrow.

Joe

~15 days post-op

Saturday, October 22, 2005

Golden Arches and Clear Liquids

Today gets us one day closer. I saw two doctors who while both noncommital seemed to be the most positive since they've arrived on the scene. The Echocaridogram I had today showed a "trivial" amount of fluid which is expected after a surgery like this. Also, I still have those tubes draining out of my chest so a little more coming out and no, I'm not letting anyone adjust these. They will likely come out Monday after my body has had a few days to heal around them. So that will be a another enjoyable experience.

But the take away here is positive. The fluid doesn't appear to have any more triglycerides in it and therefore the most recent surgery appears, so far, to be a success (everyone, please knock on wood).

My diet was changed again briefly, just long enough to get my hopes up and then burried under an ashen colored salisbury steak (I still don't know what the hell this is).

After breakfast (chicken broth, cranberry juice and orange jello) the two doctors came in and both said I can have a regular diet again....and this makes a big difference now b/c the floor I am on actually has decent food. I was supposed to have Filet and Shrimp for dinner if you can believe that. I was allowed to have a lunch of turkey salad, tortoloni soup, salad and chocolate ice cream for dessert. Oh, thank God. At least now I can look forward to meals.....That was until dinner arrived and it was: Beef broth, orange jello, raspberry sherbert and diet gingerale. "Well they must have this wrong" I said. "I'm getting filet and shrimp." "I'll go let them know," declared Allison as she walked out of the room. Moments later she returned with the nurse who began an apologetic explanation. "I'm sorry Mr. Salvati. Dr. Gillinov wants you to stay on this diet until we get the results back from your drained fluid, so you need to stay on the clear liquids diet." "Just so you are clear, a "Clear Liquids diet" is not a diet. It is fasting and I am not protesting anything here. Can I just have a damn ham sandwich?

You know the reposnse already so I drowned my sorrow and dissapointment in a couple of Darvaset and am looking forward to an Ambien shortly.

As an tangential to the whole food thing, take a read below...I personally can't believe this.

The following press release was posted on the Cleveland Clinic's web site in September 2002. Take a quick look at it.

http://www.clevelandclinic.org/heartcenter/pub/news/hot/mcdonalds9_02.asp?firstCat=1&secondCat=429&thirdCat=526

Now to me the fact that the number one heart center in the world would want to be on the same press release as the icon for the unhealthy American diet is one thing. What is even stranger is what I saw the day I arrived here.

I had a full day of tests with a break for lunch and during that time I searched out the cafeteria. There was quite a bit to choose from: a decent salad bar, an "Internation Corner" which either had stir-fried rice, rice and beans or paellea. Apparently the only thing eaten outside the US is rice. Then there is your proverbial deli bar, sodas, and meal accessories like pretzels, chips, etc. But, if you chose not to partake in any of the usual offerings the clinic did have partners which offered other options.

Starbucks - Who wouldn't want a strong good cup of Joe while in a hospital

Subway - Jared lost something like 800 lbs so that must be good for you right?

McDonald's - Yep. The golden arches. The subject of the movie "Supersize Me" The imitaded restaurant in the movie "Coming to America". In all of its glory it presents itself like a dining oasis in a desert of healthy options. Big Macs, fries, Double Quarter Pounder with cheese, Filet-o-Fish (which makes it neither a filet nor a fish) and the ever popular McNuggets. How they raise chickens in those same 6 shapes I'll never know.

Am I the only one who finds this a little strange; A McDonald's on the first floor of the Heart Center at the Cleveland Clinic? Is it meant to keep business up? ( Board Meeting: Damn it, George, these quarterly numbers are in the toilet! We are either getting the message across too well about heart disease or we are losing them to competitors. We need to think outside the box. Get that clown from McDonald's on the phone ASAP.) Maybe it is a going away present..You'r heart is healthy again. Stop by the McDonald's on your way out to treat yourself...oh, and here, don't forget your free supersize coupon for coming to the Clinic.

Whatever.


~Joe

14 days post-op

Friday, October 21, 2005

Quick Update

Allison apparently did an excellent job recounting our latest surgical exploits.

Last night was rough. Woke up around 2:30AM with pain that wouldn't let me go back to sleep. It was like going through the same surgery twice. But they think they got all of the leaks and tomorrow we'll have another echocardiogram to find out.

They had to break the original 7 ribs they broke for the first surgery so that was fun.

I have pain in those ribs and my side when I breath deeply...they say this should go away soon....I told them I should go away soon.

My feet don't hurt anymore but they are severely swollen and a lovely shade a blue.

If things stay positive from this point on the last painful experience I should have is the removal of the drainage tubes in my chest. They are smaller than the one they used for the open heart surgery but now there are two. I feel like cyborg.

Last note: On my diet decathalon.....they switched things again. I am now on a "Clear Liquids" diet. This means anything you can see through. The broad spectrum of choices include:
  • Tea
  • Water
  • Jello
  • Beef Broth
  • Ginger ale
  • Popcicles
  • Cranberry Juice
  • Italian Ice

So, as you can imagine I've been indulging quite a bit. Not even Mom could cook like this.

Joe

~14 days post-op

Thursday, October 20, 2005

Thursday night's "Survivor"

Hi everyone! I am making another cameo appearance until Joe is up and out of bed (he promises he'll be back tomorrow).

His surgery went very well this morning...here are the details:

A large team of surgeons and cardiologists gathered today at 6:30am to open Joe's chest back up along the initial incision made only 13 days ago. With a bit more blue dye and the presence of the half and half surging through his veins, they were able to pinpoint the general location of the hole in the thymus and put in a few stitches. Then, for good measure they put in a few more and topped it off with some sort of glue substance to make doubly sure they closed it off. Then, as Dr. Gillinov explained to me on his post-op call, they all stood around for 40 minutes and just watched this tiny little vessle (no wider than a strand of hair) to see if it would leak. It didn't.

After sewing him back up, they put him in the ICU for a few hours and I escorted him back to his room at 5pm this evening. Other than being a bit loopy from the drugs (starting sentences and then falling asleep before he finishes his thought) he's feeling good. The pain in his feet is gone and we are incredibly hopeful that this is the last hurdle he will have to face here at the Clinic. Please God...let it be over.

At this point, we anticipate he will be observed through the weekend and could potentially be home early next week.

On a side note...one of my happiest memories of these past 16 days is of this past Monday night when Joe and I sat at the computer here on G71 and read all of the hilarious comments made by many of you in response to his "play along with my low fat diet" blog entry. We laughed harder than we had in a long time. For that, I am so grateful.

And finally, because I'm a proud Mommy, I have to fill you in on my precious baby boy. Max is growing like a weed!!! His feet are hanging over the end of his carseat (which he has spent WAY too much time sleeping in over the past few weeks) and his smiles have turned into small giggles and "coos". Talk about grateful...he has truly been our saving grace and has allowed all of us a perfect diversion from the stressful hours normally filled with waiting and praying.

And now, I must get back to the room to my amazing husband...a true Survivor. We have a "date" to watch tonight's episode of the reality show that makes 40 nights in a South American aligator infested jungle look like a walk in the park.

~Allison

13 days post-op

Wednesday, October 19, 2005

Milking as much as they can out of me.

Disclaimer: This post is being written while on Darveset after a long day.

Maybe it is because I am in a customer service business but it will never cease to amaze me how poor most people and instutions are at managing expectations.

Much to my dismay, I did not recieve any pain killess prior to going for the lymphangiogram. No verset, no phentenol, not even damn leather strap to bite down on. "Oh, the dye is cut with 50% lanacaine, a topical analgesic that will numb you as it goes it" says the NURSE who did the injections. F-ing great. Not only is it not Dr. Griesen who is doing the injecting, but it is a nurse who isn't much for negotiating. "Don't worry" she says, " most people say they feel a little pinch and then its over." At this point I am already down in radiology on a gurney watching this woman unwrap the syringes. It is an open area with stations partitioned only by curtains.

Moments earlier this boy of about 10 came in with his parents. They moved into the station directly across from me. And I thought, "Damn it!" I can't make a run for it if the kid is sitting still. Granted, he wasn't being stuck with needles, but he seemed happy as clam (never understood this analogy but will use it nonetheless).

So I re-engaged the joyless nurse. "How many injections do you need to do? One, two?" "Actually, no. We need to do an injection between each one of your toes, so I guess that makes it 8." "What?!!" "Don't worry. It'll be quick and it won't be that bad." "Tell me nurse...when was the last time you were on the recieving end of this treatment?" "Well, I haven't but this is what people tell me."

Just for the record: There is no way in Hell that anyone who undergoes this feels "just a little pinch". You want to know what it feels like? It feels like getting a needle shoved inbetween each one of your toes. That's how it F-ing feels!

But wait there's more! What I also wasn't told was that after the injection the Dr. then needs to make an incision in one of the vessels in my foot and inject more dye. Oh, Happy Days!!!

The good news is that for the next 2 months my will be the same shade of green as the 18th hole at Augusta. Also, if I shed any tears or sweat, they will both have a blue tint to them. This is like X-Men One when the senator get's turned into that gellatinous mutant. (If you saw the movie you'll get it.)

So my feet are still swollen and I'm going to head to bed soon, but I am yet to share any news of consequence, so here goes. If you've been skimming, now is the time to read. The dye DID reveal a small leak in the thymus, but it was not well situated to undergo the second part of the procedure (through the liver). So what is plan B?

I'm so glad you asked. Tomorrow morning at 7:00 I will be wisked away once again to the nether regions of the hospital. Dr. Gillinov is going to open me up again through the same incision he created for the mitral valve repair. He is then going to try to suture the offending gland. That's right ladies, and gents, another surgery. It should last about an hour an I have been told the recovery will be nowhere near as rough as the original heart surgery, but at this point, who the hell knows.

The only funny part of this whole thing is that this evening I was told that I had to change my diet. This time they want me to eat as greasy food as possible. By doing this, when they go in tomorrow, they should see more than a drip from the thalamus. So, I ordered: tortollini with alfredo sauce, a sirloin steak, fresh cut fries, and half a glass of olive oil to be sopped up with bread. Somehow they didn't think this was enough so they started bringing me a juice glass full of whipping cream every two hours that I had to finish. Ever bet someone that they can't drink 1 gallon of whole milk in an hour without puking? If not, you can make some good money while betting the bravado. It can't be done, but by midnight this evening I think I will have ingested 1 liter of whipping cream.

I will be in the ICU again tomorrow night so look for some sort of update from Allison, who by the way, is a rock. Honey, I love you with all my triglicerides.

~Joe

12 days post-op

Tuesday, October 18, 2005

Keep your lymph nodes crossed.

Tomorrow morning around 7:30AM I will be going to take my latest test, a Lymphangiogram.

A short time prior to the procedure I will be given Phentenol and Verset which will control pain, but I will be awake for the entire procedure.

The procedure itself will then be in two parts with Dr. Gillinov overseeing the entire process.

Part 1:
Dr. Geisenger of the Cleveland Clinic will inject a high contrast blue oil-based dye into the webbing between my toes...yeah, you read that right. Over the next 2-3 hours that dye will make its way through my lymph vessels in my legs and chest. My body will then be x-rayed to see where the dye and lymph is traveling. If everything appears to be "normal" with no leaks or drips from the main system, this is where the procedure will stop.
Duration: 2-3 hours

Part 2:
The second part of the algorythim would play out if the dye and lymph is shown to be "leaking" from my thymus, as has been posutlated. In this case, Dr. Sands will insert a needle and catheter somewhere into my torso, pass through my liver and into my thymus. Dr. Sands will then endeavor to reach the leak and glue/caulk/plug it. Once the leak has been remedied, the Dr. will back his way out.
Duration: 2 hours

So by the time most of you read this I will likely be done with part one and either getting ready to get back to my room or begining part two.

Needless to say, with my most recent experience this past week I am a little anxious about the entire procedure. However, I trust Dr. Gillinov.

There is no question that Wednesday will be tough physically on me and challenging both for my family and I mentally but I promise you all this...Each time I feel nervous, tired, discomfort or doubt, I will think of the posts, calls and emails you have sent my way over the last several weeks. If this is another required hurdle to get back home to friends and family of the caliber that I have, then I say:

BRING IT ON! What's a little needle and dye between your toes!? Catheter through my liver? Is that the best you can do? Another needle through my chest? Whatever!!! I may wince and I may cringe, but I will not stop here and this is excatly why I know that this too shall pass. Because although I cannot control everything that I will experience, I can control how I react to it. And in one form or another I will be here tomorrow night to share with you how things went.

Keep your lymph nodes crossed for me.

~Joe

11 days post-op

Play Along from Home.

Good Morning, Everyone.

I've received my dietary options. In addition to the below I will need to take 1/2 an ounce of Medium Chain Trigliceride (MCT) oil per meal. Apparently it is very difficult to come by. The street value of this stuff is $30/ounce. So here are all of my options for all meals:

  • All Fruits and Vegetables
  • Skim Milk
  • Fish (grilled or broiled)
  • Baked Potato
  • Rice
  • Fat Free Sour Cream
  • Fat Free Cottage Cheese
  • Fat Free Salad Dressing

And that's it. I suggested Atkins as an alternative and after a great deal of consideration they decided against it.

So, please play along from home. Give me your creative suggestions of how to combine the above and I may just have it as my next meal.

~Joe

10 days post-op

PS. Damn it. I should have had that burger when I had the chance.

Monday, October 17, 2005

Maybe I’ll wake-up to discover I was abducted by aliens.

The Bill Cosby show made its debut and Madonna’s, “Like a Virgin” was blaring on the radio. Leg warmers were being worn even when it wasn’t chilly and guys’ collars were turned up as the term “yuppies” made it into everyday lexicon.

The year was 1984. I was 13 and hadn’t even found out yet that I had a heart murmur. My hair was probably feathered (I had enough then to do that) and I likely had more than one pair of corduroy OP shorts.

1984 was also the most recent documented medical case that is similar to mine…and that occurred in Australia.

I’m going to run the numbers when I have the patience (pun not intended but noted), but suffice to say it sure isn’t common. Fluid around the heart after Mitral Valve repair is, in itself, a 1 in 1000 occurrence. Fluid containing triglycerides just doesn’t happen. Well, maybe once every twenty years. I guess I should buy a lottery ticket with those kind of numbers, huh?

So the surgeons, cardiologist and other specialists have been conferring with one another on the game plan and here is what comes next.

Starting immediately: No Salt, No Fat diet….Yummm! No fat, no salt hospital food! Whoo hoo!!!
Tuesday: Savor saltless Salteens. Read next couple of chapters in “Devil’s Teeth”
Wednesday: Undergo new test. Only three facilities in the US can perform this test. They will inject a dye into my lymph system via my foot and then watch with a ‘special’ monitor that allows them to track the dye. If the integrity of my lymph system has been compromised they will be able to see both where as well as how quickly it is leaking.
Thursday: If the test shows the leak to be in my thalamus as has been postulated, Dr. Gillinov will operate on me again through the same incision and try to find and repair the leak. At the same time they will drain the fluid again.
Friday: Recovering, Echocardiogram
Saturday: Recovering
Sunday: Recovering, Echocardiogram…..

I thought this was going to be a sprint…feels more like wind sprints.

I’m tired. Really tired, more emotionally than physically at this point but my support system is strong. Allison, Max, my Mom, Dad and Father-in-law, Norm are all here and they have been my beacon in the storm.

We’re going to make it and we’ll be stronger because of it.

~Joe

10 days post-op


PS. Maybe I’ll wake-up and just realize that I was abducted by aliens. http://www.alienscalpel.com

PPS. I’ve moved rooms again so my new number is 216-444-1348.

Sunday, October 16, 2005

Sunday evening - change of scenery

It's Sunday night and Joe is finally sleeping soundly in his new room. After a day of absolutely no doctor visits and very few nurse-related interactions they came by at 9pm to tell him he needed to move into another room (some explanation was given but it's just not worth going into it). So, my Dad and I (who, bless his heart, flew in from Denver today to be here to support all of us) hauled Joe's belongings down the hall to room #2. His new number is 216-444-1467 if you want to give him a buzz.

So as to not make your visit to the blog a complete disappointment, I'll fill you in on a few of today's highlights. Overall, it was a pretty uneventful day. We passed the time watching the Giant's lose and the Broncos win. My Dad tried to prepare Max that over time he would "bleed orange" in support of his Opa's favorite team. Max pooped shortly after in a nice shade of poppy -- Opa is taking that as a good sign. The highlight, however, was that Joe got a hallpass to go down to the main hospital lobby for an hour to spend time with Max for the first time in 6 days. Max could tell there was something familiar in the sound of this strange man's voice but underneath the blue baseball cap, behind the dark rimmed eyeglasses, and behind the Grizzly Adams beard...he didn't recognize his Daddy for a good 10 minutes. Once he did though, he was full of smiles and "coo's" which was the best medicine Joe could have been given today.

Another echo is scheduled for Monday morning so please continue to send Joe your good vibes. The goal is to see if the fluid has redeveloped, which we will hopefully know shortly after the procedure. If nothing has collected we are hoping to get walking papers out of this joint. If it has, we will talk about "next steps" with the team of surgeons and cardiologists.

We'll keep you all posted....

~Allison

9 days post-op