Bill's Journal

'Twas the night before Christmas and all through our house... The sounds of the season are cheering us, as I navigate the treacherous waters of holiday treats! Candles ablaze (except for the new battery versions that are safer, last longer, and don't emit anything bad as far as I know), a quiet but hearty dinner with neighbors and the happy memories of holidays past that sustain us and give us hope for the year ahead. For me, all I want for Christmas is a year without surgeries, a loss of sixty more pounds (to add to the 80 lost since my AVR) and for my spouse to find a satisfying job that will take full advantage of his many talents and skills! Is that wishing for too much? Probably, but it never hurts to ask! After all, the laparoscopic gallbladder/hernia repair procedure was a piece of cake after the AVR--NOT, and the tech economy is booming even it has yet to "trickle down" to our neck of the woods. But there is a another cloud on the horizon. One set of doctors have told me that the persistent numbness of two fingers in my right hand is probably an "unexpected consequence" of my open heart procedure. The ulnar nerve got impinged to the point of cutting the nerve signals to the muscles of my hand. They say if left unaddressed I will slowly lose muscle function and the hand will contract and be useless. Of course, there is always an operation that MAY fix it in a jiffy. But another anesthetic, a cast or splint, and the challenges all this brings to my limited mobility is more than I want to swallow at the moment. But there are always second opinions, alternative therapies, and ....well, something. Stay tuned for my Spring update! I am lucky. My heart is now tickin' like a fine watch and the energy I am finding with 80 pounds off is awesome. So I'm going to go hang my stocking (support hose, of course) by the chimney with care and look ahead to a great New Year for all of us Zipper Club elves!

My greatly reduced body mass decided to give me something else to worry about--but not for long. I had two painful gallbladder attacks in 2 weeks and I am going into the hospital on Friday, 22Aug for a little surgery. Hopefully laparoscopic and uneventful but they have told me the position of my useless little gallbladder may require a full abdominal approach. As my cardiologist said, at least I have a great heart now! And it's true--I am so pleased that these stones decided to wait until this year to give me trouble. And while the doc's at work he may even try and repair the hernia around my navel. I realize that getting these things fixed will further enhance my great recovery from the valve replacement surgery last June. I just wish I could have had gotten rid of 60 more pounds first...but the 60 pounds I've lost in the last year are bound to make things better on recovery. So I hope all you great and kind pre and post op citizens of Adam's Wonderful World of Bloggers will keep me in your thoughts Friday. I'll check back in when I can. A bientot--that's French for "see ya later"!

Just a year ago today I entrusted my life and heart to that wizard of heart valve surgery, Dr. Jeff Swanson and his team at St. Vincent Hospital here in Portland. The surgery went well, my initial rehab was very successful, and my commitment to lose about half of my pre-op weight continues--60 pounds down, 90 more to go! And perfect blood pressure, improved kidney function, perfect cholesterol and blood sugar--I'm on a roll. There have been a couple bumps--a torn Achilles' tendon while attempting a "power walking" program last Fall comes to mind. But now when I mount stairs without being short of breath or walk (or in my case roll with my rollator) around the museum or a park without feeling exhausted I know how lucky I am to have had my aortic valve replaced, and just in time! I have optimism that the road ahead will be smooth. I am so very grateful for finding Adam and the extended family that is what this blog is all about. You, who supported and encouraged me before, during, and after my surgery will have a special place in my life forever. I'll check back in from time to time "just to stay in touch" and keep you informed about my slow but steady weight loss effort. And I will follow and encourage others who will join us members of the Zipper Club, with the scars to prove it!

And for a lot of reasons, that is OK! But what joy and hope the next year represents. My heart is repaired, rejuvenated, and running well. My weight is "trending" in the right direction--down! (In fact I broke into another lower "decade" last week, but this is taking longer than I would like.) To all the wonderful commentators and friends represented on my blog I say--thanks so much. And to fellow survivors--both pre and post op--let's make 2014 the best New Year ever!

There were moments earlier this year when I considered the possibility that I might not be around for Turkey Day this year--but I'm here and doing better again. I have had an excellent PT practitioner to guide me the last few weeks since my boot came off and I started restoring my Achilles' tendon to health. Yesterday I walked(rolled) my first quarter mile since the injury! And my weight loss continues--albeit too slow in my opinion. But the best news of all is that my partner James of 25 plus years suggested we formalize our registered domestic partnership. Today we received our license to marry from the State of Washington and the event will be held on Dec 20 (my birthday!) before a district court judge in neighboring Vancouver, Washington, the closest place to be legally wed. Back in Oregon tonight at a favorite hotel overlooking the Columbia River in Astoria and counting ALL my blessings in 2013.

October ends, and so has my need to wear the AirCast boot! I am glad to see it go. It seems to have done its job and the tears have mended. I still have PT to rehabilitate and stretch the Achilles scheduled till Thanksgiving. Everything else is working just fine and maybe I will be able to get my stalled weight loss program restarted. No gain, but only four tenths of a pound lost in the last two weeks is a disappointment. No ""trick or treat" candy for me tonight!

I can't believe I haven't posted since September 10. Things are better! No new medical issues, off Warfarin for a month, and healing occurring slowly but surely for my Achilles' tendon injury. This all makes me smile with joy. The orthopedic doctor did tell me that there must be no endurance walking for six months so I won't see the track again until the Spring. But I am doing other things to bolster my strength and heart stamina through an aggressive PT regimen. The cardiologist says my heart looks so good it will outlast the rest of me! Huh?! As I look back over the last four months I have a new sense of relief at what I have survived. And gratitude for the skilled medical team, my attentive family and the incredible friends who have given me both the means and the inspiration to "re-boot" my life--with a new heart and a fresh start on my "golden" years--may there be many more!

It seems that is my experience. First, it was the UTI and a heavy round of antibiotics. Next it was tearing my Achilles tendon while walking the track. Now for the third and hopefully last complication it seems I have developed an umbilical hernia. Severe abdominal pain last week sent me to the Emergency Department. After a CT scan the diagnosis was umbilical hernia with protruding intestine. This is not good. I had an appointment with a top \"general\" surgeon yesterday and here is the plan. it will not fix itself and it needs to be surgically repaired. But with everything else on my healthcare plate -- recovering from aortic valve replacement surgery and rehab, the injury two weeks ago to my Achilles tendon and the AirCast boot, and the Warfarin therapy--the hernia repair is not as urgent RIGHT NOW. I am no longer in pain. However, that could change in a minute. So I am being vigilant about any abdominal symptoms and might still have to face an unplanned surgery. Continuing my weight loss effort is the number one thing I can do to help insure the best outcome whenever I have the surgery. So I will do my best to keep the weight going down. Keep that thought!

that my recovery was stopped in its tracks--literally! As those who follow these notes know, my surgery, rehab, and home care experiences have been overwhelmingly positive. The main rehab focus has been that I walk...more and more, farther and farther. Thus last Monday at the track I was halfway into the second lap of my half mile goal when suddenly my left heel was hit with truly excruciating pain. Bound and determined to finish the lap, I limped on around and got to my car. When icing and elevating did nothing to help I called my orthopedic podiatrist who saw and x-rayed the foot and ankle the next day. Not liking what she saw I had an MRI on Wednesday and the final diagnosis on Thursday. I have a torn Achilles tendon at two points where it inserts into the heel. I must now wear an AirCast boot except at night for the next six weeks and have to limit walking to around the house. I am devastated to have my first good exercise program in ten years pulled out from under me. Is this when \"cardiac depression\" can occur? I think so. Driving doesn\'t seem safe, I need help getting the boot on correctly, and I am still having to arrange weekly visits to the anti-Coag clinic. To date, I have followed precisely all the instructions from the team of doctors who got me this far. A chronic weakness in my left leg, the edema, and a bone spur are being blamed. I guess I should have known not to push so hard for that \"mile by Labor Day\". But it\'s Labor Day and I\'ll be lucky to just get around the house. I\'ll check into Cardiac Rehab options next week, but right now the logistics seem rather daunting. I think I\'ll end this note now before I really sound too negative. I\'m going to keep trying to make things better and not waste the effort I\'ve already made. Wish me luck!

It’s Monday so I decided to walk around the school track twice—that equals one half mile! And I did it with no discomfort and very little effort. I’m continuing to lose weight, my Coumadin level seems to be stabilizing, and life is good. It\'s been a very challenging couple of months, but in all honesty it’s not been that bad. Or not that I can remember. Does anyone else find that the details surrounding those first couple post-op weeks seem to fade? An item of note: on Saturday my brother Ivan Dean flew back to Indiana. I promoted him from “brother-in-law” because only a brother would have given up a full month of his retirement to provide the care and inspiration to succeed in my recovery that he gave me. He will remain forever in my heart!

Well, make that a quarter mile. Walking on the track of a nearby high school. Two days in a row! And rolling, not walking since I must use a \"rollator\" if I want to safely walk from point A to point B. At seven weeks post-op some of my \"Zipper Club\" heroes are jogging 3 or 4 miles a day. I wish I could run with you. But since I can\'t, i am very pleased with my two quarters of a mile in two days. I guess that makes a half! As we like to say on this blog \"keep on tickin\'\"!

In fact, ever since the doctors (it took 2) figured out what antibiotic and how long it was needed to eradicate the UTI bug, each day has been better. Which has been my experience throughout this journey. To celebrate we had an impromptu Margarita party on the patio. Of course the Margaritas were only Crystal Lite lemonade but the chips and salsa (the first I\'ve had since before surgery) tasted great. My thought for the day--Olé!!

Home is great. Sleeping well, walking more and more until YESTERDAY! That\'s when a nasty UTI materialized and I\'m stuck in bed taking Tylenol for a fever as high as 102. This all came on as I was having my final visit with my wonderful surgeon who says everything is perfect. Except for this urinary tract infection. A new team of specialists is working on it, and I luckily have an appointment with my PCP this afternoon. Stay tuned for the next update!

...I walked into the hospital. Today I easily climbed the steps to our home, discharged from skilled nursing care after 20 days of excellent rehab. The whole month is still a little blurry, but there are highlights. Daily visits after work and on weekends from my light and strength, James. So many wonderful calls and cards from friends. And my friend forever Linda who is always ready to make whatever I need happen. I still have lots of work to do if I want to keep the fragile progress I have made. Walking is number one and I have my fabulous brother-in-law Dean to coach and assist me for a couple more weeks. I think I have about 30 pills a day to make sure I take at the right time. But being home and petting my kitty Hermione makes it worth the effort. I wonder when my CNA will bring my dinner? Oh! I don\'t have a CNA anymore.

I am having a lesson in patience...specifically, how to accept disappointment and not let the roadblocks thrown up by an Aortic Valve Replacement blip in an otherwise fantastic rehab pull me down. Tuesday has come and gone at this lovely facility and I\'m still a \"guest\". It has to do with the latest medical anomaly--falling blood pressure, rising pulse rate. It set off enough alarms that I spoke directly with my brilliant cardiologist who ordered an echo cardiogram which showed that everything is working perfectly in that region. So I will be very surprised if I\'m still here tomorrow night. But as I\'ve learned, nothing is certain in AVR recovery! I\'ll let you know when I am once again in residence on Sunset Boulevard. PS: it appears the Coumadin is close to the correct therapeutic level. Stay tuned.

Yesterday was frustrating because after thinking I was ready to leave the rehab facility today (Saturday), my plans were thwarted by a too low INR reading. This is a number that represents how we are doing managing my blood\'s clotting time. The new departure date is Tuesday and while rehab has been excellent and helpful, I want to go home! As a consolation prize I am going on a \"field trip\" today to see the cat and try out a new method for safely going up and down the outside steps. So things aren\'t all bad for sure. But it\'s like getting to Christmas Eve and then having the big day moved forward four days! Stop it!

If I\'ve missed a couple days it\'s because I\'m spending a lot of time each day trying to increase my endurance by walking. For me, this is the key to having a positive outcome from the surgery. Since other issues keep me from \"normal\" exercise options my best hope is walking all the time with my rollator, keeping the right posture. Each day has seen an increase in the number of feet I\'ve rolled. And trunk strength is improving too. And for a special bonus point I demonstrated to OT that I could safely give myself a shower! Got an A-plus!

Here\'s the evidence. Fantastic Portland summer weather. Not too hot, not too cold. A good PT session that was hard but productive as I build up my strength and endurance. Thank you Mark. And the grand finale was a live visit with fellow Zipper Club member Theresa who has been following my journal and encouraging me every step of the way. We had the same diagnosis, surgery and surgeon one year apart.I should look so good a year from now! We share a fondness for kitties and she even brought delicious home-made cookies to speed my recovery. It\'s working! I feel better already! Making connections like this demonstrates the power of the process Adam has created for us. Thanks again, Adam.

Yesterday marked a new level of post-op walking for me. PT Dennis had a great insight on how my rollator arms should be set and suddenly my endurance and strength were better than before the surgery! Of course I was exhausted last night and slept \"hard\", but my body\'s ability to renew itself and heal amazes me. I wasn\'t in great shape pre-surgery, but I am beginning to think I actually will be able to do more, as so many other Zipper Club members have experienced.

I think it\'s time to express \"loud and clear\" how grateful and blessed I am to have had the support of some really special people who are getting me through this. My core support team of James, Dorothy,Steve and Is who have nearly 150 years of knowing and caring about me all told! And then my friend and volunteer sister Linda who has given as much and more time to me as she gives to everyone else she cares about. There is my Cookie Empress VeAnna and Flower Arranger Extraordinaire Pam who have held my hand both before and after this thing called \"heart valve replacement\". Dr Swanson\'s expertise has made my recovery practically pain-free. Staff members here at the Pearl like CNA Nick and Nurse Patti whose voice in a room makes the day shine brighter. PT expert Dennis and OT Tammi make me believe all will be well eventually. And so many others from the hospital to the Pearl to my wonderful friends and neighbors. Thank you thank you thank you!

Two weeks ago tomorrow I rolled into Providence- St Vincent Medical Center and said \"take me over and fix it\", knowing that would be quite a challenge for the team. Here I am, out of the hospital a week and feeling very good about how things have gone so far. Pain: nearly nothing to speak of at the sternal incision. They plan to take out the staples tomorrow (question to other Zipper Club members --is that going to hurt bad? Should I pre-medicate?) The worst pain I have had has been behind my right shoulder which is probably related to positioning during surgery. Rehab: this continues to be a challenge as I am fighting profound weakness. Today I was able to rise from the bed correctly (sternal precautions) BY MYSELF! Appetite: along with taste, it\'s coming back. I could taste and really enjoy the Belgium waffle with cinnamon apple slices! I stressed pre-op over the vent removal (no memory), the urinary catheter (what if I can\'t go on my own again?), nausea ( I haven\'t had even 5 minutes of nausea)... So all in all I am sooooo very fortunate. Don\'t you agree?

If it was, I\'d be rolling around the hallways collecting lots of juicy stories about surviving AVR surgery. Instead ten days post-op is more about appetite loss, swollen ankles and some profound fatigue. If this changes before Friday Night, I\'ll let you know. Otherwise, count me out from Beerfest and Happy Hour this week! No, It has not been piece of cake. Everyone says I\'m doing fine, but then my hip bone will remind the rest of my bones about how they all should hurt together and \"here we go again\"!

Bill got moved to the rehab facility on Monday and is making excellent progress. He is at The Pearl at Kruse Way Room 18 if you want to visit him or give him a call. He has PT twice a day and OT twice a day. He has regained his appetite but unfortunately his taste buds aren\'t quite yet working correctly! However, he is enjoying his meals now that he is off almost all the pain meds. If you want to visit just call ahead to see when his PT and OT are scheduled. The direct line phone is 971-255-4027. James

Today I had the ultimate luxury...into a shower where the nurse did all the work and I enjoyed it. After 6 days it was a dream. After all the wires, drains and tubes, you are eligible for this wonderful experience. Then I had to make 2 loops around the unit which was not as exhausting as the shower, strangely enough. Dr. Swanson joined me after all this work and is pretty sure I will be going to rehab tommorow at The Pearl on Kruse Way. It\'s a small skilled nursing facility with an emphasis on rehab near James\' office. Now comes the really hard work but its time to do it! (Dictated by Bill to James)

Had the wires removed and able to walk out into hallway about 10 feet!!! Did not get short of breath and did not have to stop. Still working on improving kidney function but appetite is coming back and he was able to eat all of his breakfast and all of his lunch!

Bill is gaining his strength back and stated that today is his best day so far!!! He is gaining his appetite back and had 1/2 a banana, yogurt, a bran muffin and a plate of fresh strawberries for breakfast. Orthopedic surgeon gave him cortisone shot in left hip last night so he should be up and walking today. Oxygen saturation was 96% this morning which is excellent!! Heart rate is in the 70\'s which is where the doctor wants it to be. No high pulse and no more \"pump head\"!!

Looks like Bill will be heading to The Pearl for rehab on Monday. He was wide awake when he called me at at 7 this morning to see where Dorothy Jane and I were. He was able to get into a chair this morning with minimal assistance. He had cream of wheat and a banana for breakfast and ate really well last night at dinner. Currently heading down to x-ray. Blood pressure and heart rate are excellent and blood sugar level has come down and is off the insulin. More updates later.

Nurse this morning said Bill is the \"perfect patient\"! Making really good progress and he was able to have some oatmeal, pancake and fruit this morning. He had a good night and currently is napping. He was able to get the spirometer up to just over 1000, which is a big improvement since yesterday at 850. He did claim to see Jesus\' face in a raisin bu then sister Dorothy ate it!!! He had just had a pain pill which might explain it!

Bill successfully moved to cardiac rehab room this morning and has had a round of physical therapy. We have been visiting with him and he\'s in really good spirits! Still very sleepy but conversing with us. All his numbers are looking very good. He\'s currently having lunch.