open heart surgery

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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In honor of me getting my living will this afternoon…

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Some bittersweet political humor on the subject of living wills, shared on the occasion of me getting a living will in preparation for my upcoming heart surgery.

By ROBERT FRIEDMAN, Perspective Editor
Published March 27, 2005

Like many of you, I have been compelled by recent events (Terri Schiavo) to prepare a more detailed advance directive dealing with end-of-life issues. Here’s what mine says:

  • In the event I lapse into a persistent vegetative state, I want medical authorities to resort to extraordinary means to prolong my hellish semi-existence. Fifteen years wouldn’t be long enough for me.
  • I want my case to be turned into a circus by losers and crackpots from around the country who hope to bring meaning to their empty lives by investing the same transient emotion in me that they once reserved for Laci Peterson, Chandra Levy and that little girl who got stuck in a well.
  • I want those crackpots to spread vicious lies about my wife.
  • I want to be placed in a hospice where protesters can gather to bring further grief and disruption to the lives of dozens of dying patients and families whose stories are sadder than my own.
  • I want the people who attach themselves to my case because of their deep devotion to the sanctity of life to make death threats against any judges, elected officials or health care professionals who disagree with them.
Continue ReadingIn honor of me getting my living will this afternoon…

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.

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TEE Test Update

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My Transesphogeal Echocardiogram test went really smoothly yesterday. It’s a relatively painless procedure and all I have is a slight sore throat now which I’m sure will go away soon. And they drugs they give you to knock you out are fantastic. I felt really good after the procedure. I apparently asked Doctor Trippi the same question ten times, but I felt good asking it. Fortunately Stephanie was there to hear all the answers, or I’d be wondering today what the heck we talked about.

It was a little more complex than I expected; they stick you in a hospital bed and wheel it around from the cath holding area to the cardiovascular area to do the test. Any time you have to put on their clothes and they start moving your bed around, you realize this is a real hospital thing and not a simple “visit the doctor” thing. They also made me stay and eat dinner, which was pretty cool, except I was still high and ordered odd combos of stuff.

The results of the test: I cannot get out of open heart surgery. The valve I need repaired is my mitral valve, and some of the experimental catheterization surgeries they do are for other valves, like the aortic valve. So despite my insistence, they will still have to crack me open.
Also: exercise is bad for me, and I can’t do it before surgery. Elliptical machine? Bad. Lifting weights heavier than a pound? Bad. Walking up more than a flight of stairs? Bad. Carrying boxes of books? Bad. Opening stuck jars? Bad. Moving groceries into the house? Bad. Anything that involves strain? Bad. Short, casual walks around the neighborhood are okay.

The reason is that the mitral valve is anchored by strings of tissue that act like the cables of the golden gate bridge, or like the lines of a parachute. The keep the valve from being open permanently. Over time, because my valve doesn’t close correctly, these anchor strings stretched out, and one of them has snapped. The others are ready to do so, and will if I put pressure on my heart. If they do, I’ll be in the emergency room asking them for surgery as soon as possible.

Thank god I didn’t start tearing out the spare room and extra bathroom that I planned to work on this spring. Thank god I went to the doctor for a routine check up so they found this. Thank god I’ve been lazy and used the elevator instead of the stairs at work.

We weren’t able to talk to a surgeon and find out when they want to do it; it was too late in the day for that. But Dr. Trippi said that waiting around for a long time is a very bad idea. I need to get it done in the next couple of months. I have to say I agree, because if I can’t exercise or do anything I’m used to doing, I’m going to be bigger than a frickin’ house.

We have an appointment to talk to Dr. Beckman, who will be my surgeon, early on Tuesday morning to find out all the details of surgery, recovery and what day and time we need to do this.

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Transesophageal Echocardiogram Today

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I go in for my Transesophageal Echocardiogram (TEE Test) today at 3 at Methodist Hospital downtown. I had a big breakfast because I can’t eat 5 hours before the test, since they stick a tube down my throat to do an ultrasound from inside my body. They also have to sedate me, so Stephanie’s coming with me for the test so she can ask intelligent questions (which I’ve written down) and drive me home, since I’ll be loopy. After the test I should know a lot more about my condition, including when I would need to have surgery and what recovery will be like.

The main question I want to ask is whether I have to have open heart surgery, or if I can do some of the other heart catheterization surgeries that they’re doing for valve repair. I don’t deny I need to have something done, but if I can avoid having them crack me open like a walnut, I’d prefer that. I know Dr. Yee said that they couldn’t do the less invasive surgery because there are two valves, but I want them to go into detail about that.

I also want to know a lot about the surgeon. Like a complete biography, and how many times they’ve done the surgery. And if they’ve ever had someone die on the operating table. Because if this is someone who’s going to drastically alter the course of my life, I don’t want it to be some stranger I meet the day before and then never see them again.

It’s strange, because first I feel much better about this whole thing, but then I’ll get scared and start crying at really weird times, like right before going into a meeting at work. Which is just so graceful. I pick the strangest, most inconvenient times to fall apart.
There are some things I’ve done to prepare for all this though. Since I’ll be preoccupied and won’t be able to write regular scathing remarks about how retarded George Bush is, I took my little flight suit George Bush doll and hung him upside down and stuck pins in him. Not in anyplace vital, just his knees and elbows and stuff. That should hold him until I feel better. If we find out Bush suddenly has erectile dysfunction, you know who to blame.

Continue ReadingTransesophageal Echocardiogram Today