Paul's Journal

Friday 13th, 10 years ago today (Friday 13th Freddie Kruger by day😱) I was in surgery for a successful Complex Mitral Repair. Time has flown and the memories continue to fade along with my scar.  Sad that the early part of my blog documenting pre-op and hospital stay was lost during the transfer to the new system a while ago, but c’est la vie. Brilliant that Adam still keeps this website going strong and growing, it made such a difference at the time of surgery and the months post op recovery.
I was in NSR for 9 years after Cardioversion and then started atrial Flutter ~6-8moths ago just after my COVID booster - it may have just been a coincidence.   So I’m back on meds (20mg Rivaroxaban daily) while they work out what to do with me 😳. That said I’m pretty asymptomatic and only discovered the Flutter when my BP monitor alerted me. It could be so much worse. Otherwise, I am still fit & healthy and play golf 3-4 times a week - a leisurely 6.5 mile walk each time ⛳️🏌️😎 I remain so indebted to the NHS and the brilliant Dr Frank Wells from Papworth, to say he changed my life is an understatement.
For all of you awaiting your operations, hang in there, the results can be miraculous.  This site is a great source of support. Good luck and good health. 
Stay Safe
PaulStill a fully paid up member of the Zipper and Zapper club (awaiting a repeat zapper entry)

Friday 13th, 9 years ago today I was in surgery for a Complex Mitral Repair, but is seems much longer and the memories have faded along with my scar. Brilliant that this website is still going strong, it made such a difference to me and my family at the time of surgery and the months post op recovery. I have been in NSR for 8 1/2 years after Cardioversion. For anyone interested I not on any drugs, I am fit & healthy and now retired. My exercise now playing golf 3 times a week. I can’t thank Dr Frank Wells from Papworth enough, to say he changed my life is an understatement. For all of you awaiting your operations, hang in there, the results can be miraculous. This site is a brilliant source of support. Good luck and good health. Stay Safe Paul Still a fully paid up member of the Zipper and Zapper club

HI to all HVJ friends, I just can't believe it is now 5 years since my Mitral Valve Repair and 4 years 8 months since my DC Cardioversion which put me back into NSR and I've been there ever since - priceless!! just returned from playing a round of golf, walking on a hilly course with ease - now if only I could have scored better! Had a couple of instances where I thought I was in Afib, got checked and found I was only throwing ectopic heartbeats - no problem, nothing to worry unduly about and I still had my p-wave so a happy camper I haven't run for a yer after loosing my Mojo but I know I need to restart and will do ... Tomorrow😉 is a definite maybe for just doing that. I'm still pretty fit, healthy and enjoying life even tried my hand at kitesurfing - just maybe a new addiction It feels a little surreal that my Brother-in-law went in for a Mitral Valve Repair on Tuesday, but ended up with a mechanical valve. He's in recovery, so far good. I scared him a little with black humour when I rang him while he was waiting to go down to surgery and said I was about to celebrate my fifth anniversary of being dead (or at least my heart stopped for a few hours) and soon he would be able to join the zipper club and in twelve months celebrate his own anniversary but be much much healthier. It's a good job they had already given him the happy drugs😎 I now have only few memories of the surgery and can attest to it only getting better with time For those of you still waiting, it can feel scary but the benefits are enormous, and while it maybe daunting now, remember to take your time and look back and see just how far you have come especially during your recovery! find a surgeon you can trust and lean on your friends on this site, they (you) are an invaluable source of support. Thanks to all my HVJ friends who helped along the way, pass it on..... Paul

On Friday 13 July 2012 Mr Frank Wells and his brilliant team at Papworth completely changed my life and my path to recovery and fitness was started. That day the team conducted my Open Heart Surgery and completed a Complex Mitral Valve repair, gave me Kevlar Chordai, an annular ring and a rather nice zipper line down my sternum (worn with pride) . The National Health Service (NHS) at its best. The change has been dramatic, from severe mitral valve regurgitation and persistent and debilitating Afib, where I could barely walk up three or four stairs, to being in NSR and fit. I now routinely run 15-30 miles per week and am capable of running 15.6miles cross country over some pretty tough hilly terrain, my distance Personal best (PB) so far! Last week on Friday I received great news from my Cardiologist, I passed my heart MoT (Inspection sticker for my US friends) with flying colours and was discharged - he doesn't want to see me for three years, yay!!! 😃 He said to just keep on doing what I'm doing as it's working. I've been off all medication for over 2 years. My Heart has remodelled (LV 5.1, Ejection Fraction 56%, resting HR 51, BP 120/80) and I've been in NSR (no Afib) ever since my Electro Cardioversion in October 2012. My heart is now "as good as new", I have no restrictions on what I do - The best news I could possibly ask for , ecstatic is an understatement 😎 For those of you who are waiting for Surgery, it's the waiting that is the worst part; the benefits can be literally breathtaking. Find a surgeon whom you trust, write all your questions down and ask them - you will be surprised at how much you can learn and the Surgeon should be more than happy to spend the time answering for you to understand - if not find another one! After the surgery take the painkillers, they help you recover faster. Keeping the pain under control makes it a much better experience, so don't be afraid of taking them, you will be able to move easier and heal faster. Start walking a little and add a few more steps each day. It's not a race, but it is good to set goals to shoot for. You will get tired but that's your body saying I need a rest, so take one. Gradually increase your distance and take the time to look back how far you have come - you'll be astonished😀 Sign up for Cardio Rehab and follow the plan, your energy and capacity levels will increase exponentially. Hard to say but be patient (it will be hard and often you think you know better), don't push too hard and follow the rehab teams advice - it's a faster way and slower and steady wins in the end. It takes quite a time for your heart to remodel. Get ready for a pretty emotional ride, but it's worth it. Enjoy life after surgery, the difference is palpable and pass on the support to fellow HVJ'ers. It's a great community which I am proud to be a part of👍

Hi to all my HVJ friends, Can't believe it is now thirty months since my Freddie Kruger day (Friday 13th July surgery) and over two years since my DC Cardioversion which put me back into NSR and I've been there ever since - yeahhh!!!   Just had my 30 month service check up with my Cardiologist and passed with flying colours 😃😃 Highlights still only minimal (trace) regurgitation Continued my new found addiction to running after starting a couch to 5K (3.1miles) running plan. Now running 20-30 miles most weeks and training for Half Marathon in March! Also finding time for the occasional squash game 😀 Stats look pretty good, 100/70 BP with resting heart rate ~55 and off all meds apart from mini aspirin. Fitter now than I have been in years. So for all of you still waiting, it can feel scary and that nothing is moving! Be patient and make and take time to recover, in no time you will be looking back and wondering what all the fuss was about , it's quite surreal 😀 Find a surgeon you can trust and lean on your friends on this site, they (you) are an invaluable source of support.  Thanks to all my HVJ friends who helped along the way, pass it on..... Paul

Hi to all my HVJ friends, Can't believe it is now over two years since my Mitral Valve Repair (actually 26 months and 17 days , but who's counting) and two years to the day since my DC Cardioversion which put me back into NSR and I've been there ever since - yeahhh!!! Highlights mostly good I had a 24 hr Holter monitor and Echo the results were excellent, minimal (trace) regurgitation EF has increased from 45 to 60! My work life balance back in check but have become addicted to running after starting a couch to 5K (3.1miles) running plan. I've progressed to 5K and 10K running putting in 15-20 miles most weeks and still going to my Cardio Rehab and playing squash again :)) At Rehab in an hour I cycle 10K on the stationary bike in 24 min, row 1K in 4 min and move 3,500 Kilo of weights for fun. Stats look pretty good, 100/70 BP with resting heart rate now down to ~55 (off all meds apart from mini aspirin and dropped 10lb of weight :-)) ). Prior to the op I just would not have thought that I could have regained this level of fitness So for all of you post surgery it only gets better, take your time - occasionally look back you can see just how far you have come. For those of you still waiting, it can feel scary but the benefits are enormous! find a surgeon you can trust and lean on your friends on this site, they (you) are an invaluable source of support. Thanks to all my HVJ friends who helped along the way, pass it on..... Paul

Hi to all my HVJ friends, a quick update as I cruise through 18 months post op. Highlights mostly good but have to get my work life balance back in check. Ended up overdoing it and a couple of weeks before Christmas ended in A&E with arrhythmia. The good news was it was not a return of the dreaded Afib and just skipping beats that seemed to be self fulfilling - the more I thought about them, the more I got :-(( So after 4 hours taking vitals I was sent home and told to go see my GP. The arrhythmia lasted about 36 hours until I had a large bag of wine gums (similar to gummy bears in the US) and it just kicked back in - go figure. Gave my GP a severe listening to on some facts about: only having one heart, one life, to chill out and back it off at work, reduce stress as I had been working insane hours, stop skipping the gym for work calls and get my work life back into balance! So for once I listened and took a few weeks vacation time. I had a 24 hr holter monitor and am awaiting the results and an appointment to see the cardiologist in March. All in all pretty insignificant compared with what Rach has been through. Gym regime is working well with pretty hard workouts. Prior to the op I just would not have thought that I could have regained this level of fitness - in an hour run 1.7K @10kph, row 1K in 4min, x-train 3-4K and cycle 5K and move 2,500 Kilo of weights for fun. Stats look pretty good, 104/73BP with resting heart rate 63. :-). So for all of you on the other side it only gets better, take your time - occasionally look back you can see just how far you have come. Thanks to all my HVJ friends who helped along the way, pass it on..... Paul

Hi to all my HVJ friends, it has been a while since I last posted. Friday the 13th July a year ago today and sooo much has changed. Twelve months have absolutely flown by since my Freddie Kruger day when my chest was opened and my heart (valve) repaired. I haven’t felt this healthy for a long, long time! It’s hard to know where to start other than say a big thank you to my wife for her total dedication and support, Mr Wells and his team at Papworth Hospital who fixed my dickey ticker and a special thanks to my HVJ friends for their support throughout. In January I met with my local Cardiologist (Dr Achan at Frimley) who agreed that my BP was too low and I was taken off the Ramipril effective immediately, over the next month it moved up and then started to slide down again with almost the same symptoms – review with Cardiologist, same symptoms instructed to stop Bisoprolol effective immediately. No ACE no BETA and what a happy camper was I :-) It was amazing watching the effects of weaning off the drugs on my iPad Heartrate and BP App tracker which proved very useful in discussions with the Cardiologist. You could see the BP and Heart Rate go up for about 1-2 months and has trended down since now averaging 103/74 BP and 66 Heart Rate. Since stopping the meds the frequency of dizziness has reduced significantly and I have no more occurrences of \"Amaurosis fugax\" (see earlier post)! Last week I had my 12 month service check up with my Cardiologist – including a 24 hour Halter test and Echo. Passed with flying colours, although his registrar was a little concerned that my Heart Rate hit 171 and some triplets just after - nothing to worry about though, luckily I was running a couple of miles at that time and the triplets were during recovery. I still had my P-wave, round of cheers!!!! I remained in NSR, an even bigger roar and goodbye to Warfarin and hello to low dose Aspririn :-)) – I could not have asked for more. My discharge from the Cardiologist with strict instructions to keep doing what I am doing. Ecstatic once again does not come anywhere close to describe my feelings at that news. A few things come to mind though that I wish had been made more obvious at the start: 1) Take it easy along your road to recovery as your heart needs time to remodel after the surgery. When the Rehab team say slower it is not a competition, I did not comprehend that my pushing the level of exercise was not helping. My heart muscle needed time to recover and reduce in size. It seemed counterintuitive to me, it was really hard to get my head around this and hold back. 2) The meds do not have to be for life! The exercise program has helped lower and control my Heart Rate and BP to the point that I don’t need them anymore 3) Emotions are much more pronounced after the surgery. Since the operation I have found more emotions at times than I could deal with. 4) Mr Wells was right, I did not need the maze operation for my Afib. After my Heart remodelled and a Cardioversion I have been Afib free. I remain compulsive on taking my BP and Heart Rate! But Afib feels like the sword of damacles hanging over you and unfortunately any and every blip or misfire is greeted with apprehension. To everyone waiting, it is definitely the worse part but bear with it, the results are life changing. Reach out to fellow HVJ‘ers it’s a great place for support.

Belated Happy New Year to all. Who said Friday the 13th is an unlucky day, yes 6 months has flown by since my Freddie Kruger day in July when my chest was opened and my heart fixed. New Year and back to work full time and then…. after running up a couple of flights of stairs to see a colleague I experienced a painless loss of vision in one eye for a minute or two….. best described as \"curtain coming up vertically” into the field of vision and very disconcerting. I did not think much of it until a couple of days later when my wife insisted I call the Health Advice line. That was a bit of a shock to be told to contact my Doctor immediately and in the next two hours an emergency hospital appointment. After a rash of tests my Ophthalmologist diagnosed \"Amaurosis fugax\" which is not something to be taken lightly as the symptom usually heralds serious vascular events, including stroke. I passed all the tests and still have 20/20 vision, but need to come back in a month for a follow up! Met with my Cardiologist who agreed that my BP was too low (90/70 average over last 3 months) and was taken off the Ramipril effective immediately – so far BP has risen to 107/80 and much less prone to dizziness. I have a great iPad App that tracks my BP and Weight which proved very useful in discussions with the Consultant. Then even more good news - my Echo showed only a trace of regurgitation and my quote very enlarged Left Ventricle had remodelled and along with my EF were back to normal – no need to worry! I was cleared to return to play squash and just about anything else I wish to do :-) Ecstatic does not come close describe my feelings at that news. I remain in NSR and need to continue on Warfrin for another 6 months and then hopefully a 24 hr halter test to see if still in NSR, before reassessing stopping Warfrin. In the meantime I will change from Bisoprolol to Metroprolol to see if it reduces some side effects. Then re-assess phasing off in 6 months. My fingers are crossed. All in all great progress,Valve working and in NSR To all of you waiting, it is definitely the worse part but bear with it, the results are life changing

Apologies for not updating for a while, but not had much to Journal! Good news is that I’ve still got rhythm… in NSR (Normal Sinus Rhythm) for 2 months now or as I have worked out have the “P-Wave” in my heartbeat :-) No P = no NSR. That zap really worked. I am however, close to wearing out my wrist with the number of times I take my pulse every day just to make sure! Now all I want for Christmas is to get off the meds…. But that needs some negotiation with my Cardiologist. Is anyone off Beta Blockers and ACE inhibitors after their Mitral Valve Repair – or is it for life? :-(( Have found a great iPad App that tracks my BP, heart rate and weight that I hope will help with the argument. Cardio Rehab is going well, have learned not to push it too much. Formal plan currently: 10 minute warm up, 6 min rowing machine level 5 (1.5Km or just under a mile), 6 min cross trainer slope 10, level 5 (0.5Km) maintaining 100 - 110 step per min rate, Weights (4kg each, 15 hand chest presses – really slow), 5 min treadmill level 2 @ 4mph), Weights (4kg each hand 15 arm raises), 6 min cycle at level 7 with 80 revs per minute 10 min cool down 20 min relaxation. I can now handle 7.4 METS per hour 4 days a week comfortably….. target is 13 METS for SCUBA  Numbness in my fingers has gone… and Sternum is virtually pain free, only little nips if I have not exercised for a day or two, amazing when you consider just how short a time has passed. Not sure we pay or thank the medical teams enough Half way through my phased return to work plan, crafted with the occupational health and my Company HR teams. Still have the anchor out back trying to moderate the return speed though. For all of you waiting... its by far the worst part of the event. For all of those post surgery... take it slow and steady at your body\'s pace and may you have an uneventful recovery.

Yesterday I visited Papworth to have a DC Cardioversion – a synchronised shock to stop your heart and then let it restart in rhythm. For it to go ahead my Blood had to be within the INR 2.0 to 3.0 range for 6 weeks, now to say I cut it fine is an understatement as the blood test just before I was allowed to go to theatre came back at 2.0! The Junior Dr that was to perform the procedure (under supervision) was not quite in panic when he found out, but was not sure whether to move forward, a quick consult with the Senior Registrar and it’s a go! Next piece of fun came when the trainee Anaesthetist attempted to insert the Canula – two attempts and a great bruise later I’m ready to go.... My good deeds for medical training as a little repayment. Next two iced contact pads were then stuck to me, one to the right pectorial and the other to my waist on the left. Then General anaesthetic applied and I was out. While I was asleep I was belted with 200 Joules of DC current, to put that in perspective it’s about half that needed to start a large Diesel engine! After my heart was shocked, it rebooted into Normal Sinus Rhythm (no AFib) on the first try. Well I can now say that (time to sing along)… I’ve been shockin I’ve got Rhythm Who could ask for anything more… Well actually I can, and would really like to stay in NSR. It was really strange to be sitting in the Hospital bed after the Cardioversion and feel a normal (for most people) heartbeat…it is a wonderful feeling after a year in AFIB. I did not get much sleep last night as my brain was racing, my chest was a little sore after the jolt and a little red where the contact pads where (lightly singed but not medium rare). I lost count of the times I would wake up and take my pulse again, just to make sure I was still in NSR, and pleased to say it has lasted over 24 hours so far. Not raising my expectations as the stats say only 20% stickiness with the procedure, not too high, but if I fall back into AFIB I will be getting another shock then a DC shock! While I was at Papworth I called in to see the friendly faces of Critical Care and High Dependency Unit nurses with more goodies and thanked them once more… I don’t think I will ever be able to thank them or Mr Wells and his team enough… they will be getting bored with the visits soon. So all in all shockin good news day.

I now have my Cardiversion appointment scheduled for 1st October at Papworth, over 2 hrs drive each way and I have to be there for 8am :-( for a day surgery that will be truly shocking! The zap is intended to kickstart my heart electrics into rhythm using a direct current electric shock and hopefully back into NSR. I will be under anesthetic when they apply the paddles and shout \"clear\".... Practically speaking I\'m tingling at the thought but trying to keep expectations in check and not raise my hopes too high.

Got no Rhythm! Mr Wells has referred me to a Papworth Electro Physiologist consultant who has been out for a couple of weeks and is just getting back – I seem to have now collected a few consultants and seem to pick them that way! So still waiting to schedule in for a heart re-boot and hopefully back into NSR (Normal Sinus Rhythm). I assume that I will have to go for a face-to-face before that. Had a couple of sneezing fits that certainly highlighted the sterniotomy had not completely healed. Not sure if that is why my Zipper line is still crusty in a couple of places, or if it’s due to Warfarin slowing healing - so still not waterproof! Had a runny nose which seemed to coincide with the final weaning from the Pain meds but not sure if that was a cold or getting of the drugs – My Primary Care Dr did not know either. Either way I’m off all the pain meds and only on the Beta Blockers, ACE inhibitors and Warfarin. Unless I kick the Afib habit it’s a life sentence, or until medical technology catches up :-{ Rehab started yesterday (queue for Amy Winehouse song), the two month anniversary of my Freddie Kruger day Friday 13th surgery … A couple of controlled hours at the gym, starting with an nice easy warm up followed by treadmill, stationary bike, weights, rowing machine, weights, and stationary bike, cool down and relaxation session. Still feel as if I have an anchor being thrown out behind me, but they have been in the heart business longer than I have – and I will be patient, a new experience. The automated pulse detection on the equipment struggled with the Afib. Heart rate steady at 120 ish during exercise with sudden excursions to 180 as it could not handle the Afib sessions. Good news on blood pressure side as it dropped 5 during the exercise, but I assume that is also helped by the Meds. Cardio Nurse was not sure if I would be able to return to SCUBA, and if I did, I might be depth restrictions – Is any one still SUBA diving after an Mitral Valve repair, if so are you under any restrictions?

We met with Mr Wells and his Senior Registrar yesterday, it turns out that my procedure was more complex than anticipated, but I am luckily and extremely grateful that I had one of the best surgeons in the world who would not give up on the repair! He is very pleased with my progress to date. I will be undergoing a Cardioversion in the next couple of weeks to try and put my heartbeat out of AFib and back into sinus rhythm now that it has started to heal, literally shocking! A day procedure where I am sedated and shocked to hopefully get get to Normal sinus rhythm NSR. If it doesn\'t work I will have to stay on meds. That said he did say that I can expect to return (not straight away) to doing all of all my travel and sports activities I did in the past (from High Altitude Skiing to SCUBA and all my sports inbetween), only better:-)) I am also now cleared to start rehab and pleased to stop the Amiodarone : -) I feel extremely lucky to have been the beneficiary at an NHS sale, where do I start: I ended up with 8 new Kevlar Chordia, 5 sternum wires visible under X-Ray, a 3 for 1 deal on sections of my mitral valve repaired and Mr Wells plus his new Senior Registrar for my consulting review at Papworth yesterday plus an annular ring (also visible under X-Ray) and the zipper line to complete the set! After the consulting review we drove from Addenbrook (a sister Hospital where Mr Wells uses consulting rooms) over to Papworth to deliver Chocolates for the Nurses, I started to look for Fiona and Kevin at the Critical Care Unit and several of the Nurses recongized me and greeted warmly as they remebered caring for me following my Freddie Kruger day surgery (Friday 13th), I asked how they knew me as I recalled that there were the only two Critical Nurses looking after me in one of three beds, what a surprise hear that there 32 beds served by over 200 nurses in that area, I\'m not sure what proposals I made whilst sedated! I was then greeted by the High Dependency Unit nurses on Mallard with the comments nice to see you but what are you doing back here, then smiles and a catch up when it was a non-emergency chocolate deliver;-)) Both CCA and HDU were touched that we called in, and appreciated seeing their work standing in front of them looking much, much healthier. It was great to say thanks again to them.

On Thursday met with Sue from the Cardio Rehab Clinic team. She has put me at ease over some symptoms and reset some of my expectations. Initially I will be on a 12 week “level 3 plan” starting after my meeting with Mr Wells (Consultant Surgeon) on 30 August, if he says OK to go – I am expecting him to. Sue made it quite clear that I need to slow down and not push as hard – the objective is to rebuild body and heart fitness at the same rate and not over push things, doing so is counterproductive. Sue warned me that I am likely to get very frustrated with not being able to push quite as hard as I want, but that I need to go steady and get there on a plan that will be optimised – I will comply! If Mr Wells clears me I get to meet my personal trainer week after next! Apparently 50% of the Cardio Rehab Teams time is spent pushing people in rehab, the remainder trying to keep overenthusiasm in check – I fall under the latter! I need to change my approach to walking exercise – goal now is to walk shorter distances faster, concentrating on talking as we walk to the point where I have to concentrate on breathing and start to get breathless, then back off – so my strolls in the park are now to be replaced with quicker walks with Joan. I have been using www.geodistance.com for finding out just how far I have walked. It is easy to use and can quickly work out the distances (yds, miles, KM) all you have to do is enter (mouse click) your route. My strong painkillers are now down to 2x 30mg Dihydrocodeine per day with a personal goal of being off them completely next weepk. Next step will be weaning off the weak ones (currently 8x 500mg Parecetomol per day). The pain management regime has worked really well. Fingers still tingling, but improving ;-)) All in all not a bad week!

It is hard to believe that 4 weeks ago today (Friday 13th), I was just leaving the Operating theatre with a broken heart repaired. So glad I am not superstitious ( touch wood)! It feels like yesterday, but so much is changing daily although doing the two steps forward and one step back tango. Have to be careful if I have been sitting down for any length of time and stand up quickly or pushing it too much uphill on the walk – either can end up with a light head for a while. Fingers on my left hand are still tingling but starting to feel a little more normal – am I getting used to it, or is the nerve repairing? Still do not like my trips in the car (to date only weekly 15 minute drives to surgery) as the bumps feel like I’m being gang tackled, I find these short drives really uncomfortable and am not looking forward at all to my two and a half hour (each way) trek to meet with the Mr Wells (Consultant/ Surgeon) on 30th. I occasionally zone out watching TV, talking or reading and then realizing I have no idea what was going on for the past few minutes – I am blaming the drugs. Memory and concentration both fuzzy and it was a good job that I asked the Cardio Rehab Clinic to send written confirmation of my appointment as it is on the 16th not the 18th! Rehab starts with 6 weeks of 2x week visits to get me back up to speed. Sleeping is improving, as I get plenty of practice! Looking to reduce the strong pain meds this week  Walking up to 1.5 miles each session and sometimes twice per day (OK I did it once) – although the hills bring me to my knees and Joan has said I am not walking as much as strolling, just a little motivation!! Have received a gold medal from Heather and Pat for my efforts to date – will get a picture uploaded. INR now back under control at 2.2 and trying to get my Iron in place and out of Anaemia, as Joan ensures I get all the right foods. Starting to enjoy the benefits of being an ex-regurgitator and looking forward to further improvement.

Three weeks post-surgery and still on the roller coaster. Still have the annoying pins and needles in two fingers (pinkie and ring) on my left hand. Feeling as if I am treading water and getting nowhere - not sure if I have been pushing too hard or not enough. The last two days I have taken easy and still exhausted, I have not felt like doing anything other than sleep, no energy and lackadaisical. In addition someone has stolen all my cognitive reasoning, I spent an hour trying to enter a payment for car insurance on line and just could not get my password and numbers entered in the right boxes – so frustrating, will try talking to a real person tomorrow! It just might be those drugs! On the positive side I have cut back further on the strong pain meds and my INR is back under control. Started the diet changes to try and increase my Iron levels to combat the anaemia. The Cardio Rehab clinic called me and set my first meeting for the 18th,I think, and just in case I’m wrong I asked them to send me written confirmation as memory is quite short right now.

Upside, now at 17 days post op and walking continues to improve; made it to over 2,000 steps (just over a mile) in a single stint today (the last 700 flying solo – amazing Birthday present!) and felt good enough at the end to have continued walking:-) The exercise seems to help me get to sleep. Pain management is working well, and is good enough to start to back off the Dihydracoedine now down to half dose. Downside, apparently I am anaemic with my iron down to 12.1, My GP said that this could be due to the surgery and that I should eat red eat meat (I don\'t do this often), green leafy veg or a vitamin supplement. So Joan started my red meat regime last night. I will just have to watch Warfarin and the INR levels – INR at 4.1 last Friday although the Anticoagulation Clinic have reduced the Warfarin dose and will be rechecked again this Friday Have times when I struggle to project my voice, only way to describe it is as if there is not enough air accelerating across my vocal chords and feel a little breathless? Getting up first thing in the morning can also be challenging, woke up last night doing an impression of a beached whale, on my front and well and truly stuck. After a little rock and role managed to right myself! Next step is to join Cardiac Rehab clinic

INR moved up to 4.5, Warfrin reduced to 2.1mg daily, retest appoint scheduled for next Friday. It used to be rock solid at 2.1 INR on 3.0mg. Talked to Papworth and they assured me it is OK, but to follow up next week.  My recovery is moving along, not as fast as I want but still better than I could of imagined. Yesterday recorded my longest walk day so far at over 1600 steps, my wife alongside the whole way. Still felt the cold in 28C, ~85F. Taking it easy today as a reward. I have beeen contemplating a late entry to the Olympics and started to wean off the painkillers in advance of drug testing just in case,  albeit a little too quickly and promptly paid for it last night with a kick in the rear.  Repeat note to self, only try and give up 1 pill at a time! That is the second time I have been caught out, I should have learned by now! Received a suprise call from Papworth Cardiac Support team today to see if i was ok and how everything was going. Two weeks after operation and one week after discharge. Perfect timing as I had a few concerns that were quickly answered.  They really do have wonderful staff there, but I guess you knew i thought that already.

Posted a few photos of Hospital stay. Nothing gory and now somewhat surreal NR at 4.1 oops.... quick reduction in Warfarin plus another visit for INR check scheduled for Friday. Getting invincible days indispersed with the overwhelming teenager syndrome... do I really have to get out of bed..... 1,000 steps program stalled as it\'s just too hot to go outside, unless in the car with air con. Had an emergency meet with my MD (Primary Care in US) yesterday. I was deep breathing and felt a strange sensation, difficult to describe other than akin to water mooving inside a sponge through my body as I inhaled or exhaled while lying down. Brain worked overtime on way too many potential causes,.. and lots of not so positive thoughts went shooting through my head.... My conclusion .. there must be fluid on my lungs.. not bad without a stethoscope,...... did I say I like these pain killers... MD checked me over. clean as a whistle, no fluid but you might want to try these laxatives as had not been for three days... after reassurance much calmer now and much releived (I know way too much information!). Wounds looking good, and aches easing, except when chauferred in the car. Oversensitive, all the bumps are huge, mountain climebers seen practicing on some and much bigger that I recall.. did I say I like these pain killers.. Now need to start Agile planning for elimination of the meds. Still have the tingling in my left hand pinky and ring fingers. Had it from the opeartion onwards. Registrar said probably some nerve damage associated with the sterniotomy and with time it would ease. Has any one had anything similar? Looking forward to the start of the Olympics and proxy participation.

Back home a few days now and my rate of posting the Journal has slowed - all to do with sleeping from midnight to 8am versus working on my iPad. Eating like a horse at this point but really do feel the cold. After the shower you would have thought I had been in mid winter conditions the way I shivered. My excercise and stretch routine has started - my goal to add 100 steps a day (and modify if too much/ little). Longest walk was last night at 750 steps breaking a 1,000 step day for the first time.. Celebration was to sleep like a log ! Tommorrow is first INR check since leaving Hospital Friday.

Just had a three and a half hour ride back from Papworth to home in some abysmal weather and traffic. it usually takes less than two. Joan was a nervous wreck trying to make a super smooth drive in traffic with some real idiots on the road and a less than confortable passenger. She had intended to come back home midweek to get ready instead of staying. I am glad she didn\'t as she has been great support picking my spirits up with ease. Going to bed early tonight to see if I can sleep past midnight at home, not sure if it was a coincidence that midnight was the last meds round and i was always wired for the next 4-6 hours. l

The escape committe has been working feverishly on several approaches: 1) Keep pain levels under control allowing sleep and faster recovery. This allows more energy for... 2) Training to walk enough yards under you belt to climb up two flights off stairs. you will feel invincible at times, usually just before being figuratively kicked in the rear end for overdoing it. 3) Don\'t hand over total control (ok on some bits you have to, really difficult doing the technical surgeon Bits) - you are one very important patient who is part of the get you well team with lots of wants, but sometimes others needs should be addressed first 4) Listen carefully, tiny mistakes can be avoided and directions given by Consultants and other specialists to the ward staff. If you think that it was misinterpreted, do not get intimidated, it\'s easy to just ask and they will get clarification and you will feel more in control 5) do practice those annoying and sometimes painful breathing, walking and stretching ,exercises. Your body will thank you very quickly 6) realise you (the patient or the visitor) are on separate emotional roller coasters, and that some innocent things said can just be totally devastating to those close to you, tbut those blues will pass. 7) getting good news is often as just emotional as bad. 8) Health Care staff are tremendously undervalued. They do a fantastic job and take any chance to remind them of that. 9) having an independent advisor, Jerry, who you can trust and will cut through hospital speak and translate the answer into digestible facts 10) having a \"Nicky\" for her daily visits and keeping Joan sane at night. Checking out of the Heartfix hotel is the end of the start of a new beginning. All my checkout papers are complete and now it\'s time to stand up and thank all the team at Papworth for everything they have done for me and so many others over this last week, They have been inspirational and are without doubt dedicated heroes. Thank you also for the support of my friends, family, work colleagues and HVJ who have been invaluable and especially my wife Joan who has been my rock throughout.

Rough night. The first setback was to be told that I needed to stay for a couple of extra days while they run a study to see if I reacted to Biisoprolal and aminadrome.   Both were being taken simultaneously with forisamidel. Have to forgive my spelling here. They want to iliminate the options goiing forwasrd.  The Biisoprolal depletes potassium which seemed to have been a contributor.  I am hooked to ECG and have pacing wires still in just in case I crash.  I\'m hoping not to. By the end of the day decided to keep an ECG on all night to make sure I did not go Brady again. In the middle of the night muscles started to spasm in my back. Got even better drugs (morphine) but they didn\'t help.. Pain subsiding, suspect it was break through pain as some of my meds were unintentionally cut back by me when asked 1 or 2 ... the irony, as i was fully intending to stay at max for at least a couple of weeks, full strength now and feeling much better. Took the two flights of steps challenge from physio and flew through. Which only left the echo... Fantastic shots, hardly any regurge, can see some of the artificial chordia and yet again a woNderful,feeling. trying to get a couple to post on the blog. Still in Afib, but did not like the efficacy of maze or ablation, and wanted to try the valve repair first, allow remodel and then let technology catch up on it. The Afib site has loads on maze, ablation and others, it is interesting to see that long term is often not well defined. And really why put more scars in now, when technology is moving so fast  Next meeting with escape committee is Friday

I know everyone was warning about there being the potential to get a little muddled, but this is ridiculous I went in on Freddie Cruger day for a zipper installation and removal of regurgitation and came out with that plus a mitral valve repair, the inability to rember what day it is AND I can\'t count to boot. So officially today in the UK (5 time zones ahead) is July 18 less July 13 = 5. I think it\'s time to start weaning of the other drugs while I can...... ok next week... I wasn\'t hallusinating, but all functions are severely impaired.. Hopefully normal service will resume soon :-) Just met the Mr Wells Registrar and I still have proximal Afib, but the valve repair has no leakage..  I am having the pacing wires removed today and will leave most likely tomorrow pm for R & R. I will be posting all the Photos of exterior and theatre shotswhen I get home. But need Microsoft not iPad for that. Thank you all for proving me and Joan so much support. It has been very assuring knowing I have the best in my corner I am literally in tears just now  I have been on a real roller coaster and it just hit me. For all of you who are preparing. Hope everything works out as you expect if not better. Rember that it is light at the end of the tunnel and not a train, but occasionally surgeons making more tunnel for you. Paul

Pacing has been turned off now on monitoring for next 24 hrs with a halter.... eating critical care food turns out is not bad after all. Occasional forays in the anti-vomiting drawer work wonders and paid dividends. As is taking all the meds to help my body sustain repair versus fight the pain. Still have AFib, but it looks much better to a layman... and loads more energy to boot. Need the heart to remodel, but that will take months not days , I\'m more than willing to give it a go. All the catheters, drains and wires removal has been wonderfully pain free. The final wires come out tomorrow, then the homework starts. Still have the tingling in my left hand.. Hopefully that gets fixed too. Training started, 2 loops of 150m and heart rate did not budge. Recovery great. Feel soooo much better Pictures will be loaded after I get back home, unless anyone knows how to upload from the iPad 3 to this site?

Hardly slept all night listening to to pacer beeping away. that and struggling to write the blog. Woke up with blurry eyes and bradytacic (sp?) pulse, alarms going off everywhere. You not supposed to have a 25-34 bpm, especially after surgery. Dr scared the hell out of me saying I would need a pacemaker. Tuned out that the furosemide removes potassium, and that goes to Afib and Brady! Now all fixed and all but the pacing wires removed, get those out tomorrow and drp the fluids of as I\'m up 4 kg (9pounds for US). Scare is over for now, can\'t help thinking what a lucky escape. Oh and just for kicks managed to 50yards and in planning with the escape committee

Catheter out without pain. weaned off dopamine and just can\'t stop smiling. Fleetwood Mac come to mind singing \"don\'t stop thinking about tomorrow\"

I\'m sitting or rather lying in CCU and listening to the rate machine keeping me in NSR. In some ways soothing, but can\'t sleep with a watch in the room let alone this incessant clicking. The difference really is lday and night. Don\'t be put off by your watching others go through it. It\'s your journey, you have control. And this wonderful community to fall back on for support. Stats B/p 103/72. Pulse 77

Tough night sleeping, lots of fluids passed and lots of checks all night so much so that they had to supplement my potassium. Now the exact opposite. Staff really are amazing, great attitude, can\'t help enough. That first bed bath really does the trick, looking forward to getting the catheter out.... So stats BP 111/61. Pulse 72, and most the time in NSR... Will it last is the question