cardiovascular medicine

Cognitive Decline?

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In writing about my upcoming heart surgery for IndyScribe, I stumbled across some information during research that is really disturbing, and may change my mind about having open-heart surgery. According to research, being on a heart and lungs machine during the operation can cause “cognitive decline” in 42% of patients — in other words, brain damage. Given the number of medical resources quoting the study, it appears to be a valid one.

Another source

A source that says it’s caused by endotoxins

Duke Med News Source

Given this, I’m not sure I want to have the surgery this way. I’d rather go some other route than risk the possibility of losing any of my mental ability. If that means insisting on a less-invasive procedure or foregoing surgery altogether, I’m going to consider those options.

UPDATE: I talked to my surgeon Doctor Beckman’s assistant, Michelle, this morning about this. She said that there isn’t a way to do mitral valve surgery without using the heart & lungs machine, which I guess I could have figured out on my own. (Duh; they have to stop my heart to cut into it, whereas with bypass surgeries they can sometimes avoid that.) She also pointed out that the studies were done on heart bypass patients who had clogged arteries, and that is thought to have had an effect on their situation. Also, the amount of time I will be on the machine is shorter, and they won’t have to cool me down as far or as long, which are also contributing factors. The other factors are that I’m very young to be having this surgery, and that I have advanced cognitive abilities now, which means my risk of losing them is much less than for people who are older and less educated.

I felt a lot better after talking to her. I’m still going to be doing logic puzzles and math stuff after the surgery, though, because now I’m paranoid.

Michelle also said she was very happy that I’m researching information about my surgery online, and that they wished more patients would do that. Heh. I didn’t mention that I’m also WRITING about it online. I should tell them that. Especially since if you Google “Dr. Daniel Beckman” my website comes up at the very top of the list. Hee hee. I wonder if he ever googles himself?

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Tired

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I started to leave for lunch to get some sunshine a little while ago. Unfortunately, although I remembered my wallet and key card, I forgot to take my car keys with me. And on my car keys is the elevator fob to get past the security block on the elevator. So to get back to my floor, I either had to climb the stairs and use my key card to get in, or ride up the elevator with someone else going to my floor.
So I started back inside, and although I called out to a woman from my floor to hold the door, she didn’t bother, and I couldn’t get on the elevator. So I waited around 10 minutes, but never found anyone else who worked with me. So I reluctantly climbed the stairs and came back to my cube. I think I should have waited longer for the elevator. I’m exhausted. I was planning on getting my keys and heading back out, but I think I’ll sit here instead.

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Living Wills

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Stephanie and I met with an attorney last night to arrange to get living wills. She’ll draw them up and then send them to us next week. She charges $230 an hour (wow!) and it should take her a couple of hours to get it done. Ouch. But it’s better than the alternative.

Here in Indiana, living wills don’t address the condition of persistent vegetative state, which is the situation Terri Schiavo is in. Indiana living wills cover only terminal conditions where extra-ordinary care would be taken to prolong an unquestioned terminal condition.

So I’ll only be able to specify my wishes legally in that case. So let me say it here, so there’s no question or mistake — if I were in a persistent vegetative state where I had no brain activity and a large portion of my brain had atrophied, like in the case of Terri Schiavo, I would rather be taken off life supporting measures and allowed to cross over peacefully into the afterlife, instead of lingering indefinitely.

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Frustration

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I think the thing that bothers me most right now is that there are so many things I’m not supposed to do. In any given day, I do probably 40 or 50 things that are now on the list of restricted activities that aren’t allowed lest they give me congestive heart failure and leave me in a Terry Schiavo-like state. From carrying groceries in the house to climbing out on the roof to replace the bulbs in my security lighting, stuff I do all the time is a big fat no-no. And it’s making me pissed off at life.

I know my house isn’t the cleanest house on the planet, or even the most organized, but I do have some pretty stiff routines and things operate like clockwork. And now the springs seem to be popping out of the clock and I can see stuff falling apart all around me.

I know lots of people have volunteered to help, (my girlfriend most of all) and I appreciate that a lot. But actually asking them to do that is hard. And when I do ask, sometimes it’s hard to coordinate getting the work done, because they have their own lives, too. And god love ’em, I don’t think some of them have any concept of the amount of stuff I do in a single day. I have a list of furniture that I need to move around to make my recovery more convenient, and one of the people I asked said, “oh that will only take a couple of hours.” Unfortunately it will take about 7 or 8, actually.

I have roughly 3 weekends left before surgery to accomplish everything I need to do. Stuff that’s an absolute must:
– going to court to testify against the guy who was stalking my girlfriend (April 4)
– a sleep study to figure out what to do about my sleep apnea (April 5)
– implementing all the recovery guidelines and recommendations, which includes…
– re-arranging furniture so I can sleep and so care-givers can help me
– cleaning the house a certain way to ensure sanitary conditions
– getting a living will
– getting my taxes done
– a weekend trip
– considerable work on my website since I won’t be able to touch it for awhile

The other thing that sucks about this whole deal is not just that my day-to-day routine stuff is disrupted, but my big one-shot projects are all on hold, too. It’s not just that I won’t be able to mow the lawn every week, it’s that I planned on aerating the lawn this spring and putting down 40 pounds of grass seed. It’s not just that I have to weed the flower beds each week, it’s that I need to put down 800 pounds of mulch on the flowerbeds.

Stuff I planned on doing this spring that I now will be delayed in doing, due to my stupid heart:
– aerating the lawn
– mulching the flower beds
– cutting the pipes out of the kitchen
– repairing the drywall behind the kitchen sink
– painting the kitchen cabinets and walls
– repainting the foyer in a different color
– jackhammering out the stairs at the side of the house and the useless stairs in back
– hauling the extraneous queen box springs to the dump
– refinishing the small book case and the large chest of drawers
– tearing the bathtub out of the working bathroom downstairs
– helping Stephanie cultivate and plant a garden at her house

GRRRRRRR.

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April 22nd – My Surgery Date

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So my surgery will be April 22nd. From what Dr. Beckman and his staff told me, it won’t be nearly as difficult a recovery as I’ve been expecting from the reading I’ve been doing. I’ll only be in the hospital about 5 days. After that I will be home, but I won’t be bedridden. I’ll be able to be up and walking around, going up and down stairs, etc. in the first week after being in the hospital. Every day after that will be an improvement. They are still recommending that I take 6 weeks off work. There are restrictions on lots of upper body exercise for quite a while while my sternum heals. And it will take me 3 months before I’m completely healed. But I won’t be bedridden, which is the impression I had.

He said that it’s a 90% chance that this will only be a valve repair, not a replacement. They will know for sure once they’re in, but he says my chance is good for the repair. If that’s the case, I won’t need to be on anti-coagulant drugs, which means that I would be able to be on the Amazing Race. No, we didn’t specifically ask about that. 🙂

He and his staff were very upbeat and positive about the surgery, and made me feel much better about it.

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Animal Instinct

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The other day when I was sitting in the Cardiologist’s waiting room, there was a video playing about health issues and medical breakthroughs. One of the stories was about a woman who had devastating epileptic seizures and who couldn’t live on her own because of them. They came without warning and rendered her helpless, so she had to live with her mother all the time and her movements were very restricted.

Scientists discovered that animals can sense when humans are unhealthy. In this case, they were able to train a golden retriever to recognize by scent when the woman was about to have a seizure, even when she didn’t know it herself.

Several times a day, the dog would come and lick the woman’s hands, and if she were about to have a seizure, the dog was trained to jump up and lick her face. She then had enough warning to prepare for the event; she could call someone to help, lie down so she wouldn’t be injured and take other steps to keep herself safe. That enabled her to live on her own and to go out and shop, spend time with people, and even work. So the dog’s ability to see things that humans can’t gave her freedom.

It’s funny because every morning I wake up and find all of my cats curled up around me, which they’ve never really done before.

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Dr. Daniel Beckman, M. D.

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Here’s some information about Dr. Beckman, who will be my heart surgeon, apparently. And here’s another bio page on him. Also, here’s some info on some rare procedure that Dr. Beckman is pioneering (not what I need done). Here’s a video [real player required] of Dr. Beckman talking about some rare procedure he’s done on a website about heart surgery. And in this IndyStar article, Dr. Beckman is being interviewed about a surgery he performed. And here’s a mention of him on Channel 6 news’s site about a surgery he performed.

And a couple of medical articles he’s authored or co-authored. One of them is titled “Pain levels experienced with activities after cardiac surgery – Pain Management” — and it’s all about how pain can get in the way of recovery. Yikes! Shouldn’t have read that. And some other paper he wrote, that makes no sense to me at all, but sounds really impressive.

I go to meet with him tomorrow morning at 8:30 to find out more about when my surgery will be and what all I will need to do to prepare for it.

Sounds like I’m going to be in good hands.

UPDATE: I was. He did great.

Continue ReadingDr. Daniel Beckman, M. D.