I need a button!

One that says I’ve just had open-heart surgery. This first occurred to me a couple of weeks ago when we were at the timeshare in the desert. I stood in the parking lot and watched others watch me as I watched my sister in law lift large, heavy suitcases in and out of the car! I felt like a useless tit. I felt like I should lift up my shirt!

Caduceus gifts

As part of our trip back to LA we took a “short” excursion into Joshua Tree National Park. During a climb to the top of Keys View, a popular and accessible lookout, I was easily passed by, how shall I say, “elderly” folks. It would have been nice to whisper the details of my situation into their hearing aids as they passed me. Perhaps then I would have gotten a little sympathy instead of just looking like I’m really out of shape.

During the trip to my cardiologist last week I had to endure two, half hour bus rides on the airport shuttle to UCLA. With the trip to the Salton Sea a few days earlier I had learned starting and stopping while a passenger was quite painful to the chest area. Even as Sue adjusted her driving style to accommodate me the back of the car was not the most comfortable of spots. Unfortunately, those rides with her seemed like a walk in the park compared to being on the bus with a driver determined to weave in and out of freeway traffic in the hopes of cutting 5 minutes off our trip. The whole time I was bracing myself for the swerves, sudden braking and acceleration I couldn’t help but think what the other two people on the bus were thinking as I winced in pain many times over. I sure could have used a button on my shoulder to put their minds at ease and let them know I wasn’t loosing it. I don’t think it would have really made any difference to the driver, he seemed pretty intent on being aggressive, but, at the end of the trip, I came very close to approaching him with my shirt off and saying something like “Thanks, thanks a lot, that was really comfortable – NOT!”

Caduceus gifts

In all fairness without mentioning anything or wearing a sign no one would suspect there is an issue based on how I look. So no hard feelings! I’m actually still amazed I can withstand public transit in LA only 4 weeks after surgery! Life is good.
Then there’s the frig’n crossing signals. You know, the little white man and the red hand on the other side of the road. Unless you’re a jogger there’s never enough time for someone to cross the entire street under the watchful eye of the crossing guy. Now, the change from white to red seems especially quick and it becomes even that much more irritating when you get the type that actually counts down the seconds remaining. As if I’m not already aware of my slow pace. I don’t need a green poll to rub it in. I know I’m not going at lightning speeds here but hey, I’m doing pretty well.

See my button, I’ll get there, I have an excuse!

I really needed one the other day as I was returning from the grocery store. I had picked up a few things to cook dinner for my hosts Dave and Sandy. I’m not supposed to carry anything heavier than about 3 pounds in each hand. When I left the store I could feel I was pushing it so I tied the plastic bags to the belt loops on my shorts to take the weight off. I thought it was a pretty creative way of dealing with the situation but, I must admit, it did look pretty odd especially with them swinging from side to side.
No worries, it’s only a few blocks home, no one will see me and if they do I won’t care since I’d probably never see them again. Just then I turn the corner and watch as two very attractive ladies approach. Now I don’t care how old you are or whether you’re happily married or not when faced with this situation you really do want to do everything possible not to look like an idiot. With the bags tied to my waist I looked awkward trying to “carry” them. In general I just looked stupid. As I passed I could do nothing but offer a friendly hello and contemplate lifting my shirt to show the fresh battle scars and offer up my excuse. I’m sure in the end they probably didn’t notice or even care but that’s when I started to wonder what kind of reaction I would get if I just walked around topless. No question I think I would get a lot more attention and perhaps even some extra special treatment. Come to think of it I’m sure there are some women out there that have thought the same way.


For those of you coming into this little open heart surgery discussion a little late you can find all the posts easily by clicking on the Open Heart Surgery Labels at the bottom of this post or by clicking on the links under open heart surgery over on the right hand side of the blog. Those ones are listed in chronological order!

Two Week Follow Up

On Tuesday Denise and I had my follow up visit with my surgeon. The only downer about the day was I didn’t actually get to see him. That was definitely a disappointment. However, I did have the opportunity to finally put a face to a voice when I got to meet Susan. She’s the one who runs the office taking care of all the scheduling and insurance matters. Every time I call she’s juggling this and that or on another call but she’s always given me her time and on this day was even able to make it over from her office to meet me in person.

Susan and I finally meet!

Dr. Reemtsen was in the OR working on another human who needed a life saving intervention so I’m not going to wallow in self pity but I was looking forward to seeing him. Of course it’s really no hardship being looked after by Anita and Vicki. They’re the pediatric cardiac surgery Nurse Practitioners who help take care of his cases. I‘ve had the utmost respect and confidence in these ladies from the beginning and have felt extremely comfortable in their care.

Anita was an ICU nurse for many years prior to becoming a NP and has now worked for over a year; most, if not all of it, under the guidance of Vicki and Dr. Reemtsen. The day before I was discharged Vicki told me how she and Dr. Reemtsen recently came over from Los Angeles Childrens Hospital in order to set up a successful pediatric cardiac surgery program at UCLA. A big factor in her decision to leave Children’s was the challenge of building a successful program as well as the opportunity to continue working with a top-notch surgeon in Dr. Reemtsen.

Anita and Vicki two weeks after surgery!

As far as my check up everything checked out A-OK. My heart sounds good, chest and lungs are clear, the incision is healing well and the holes from the chest tubes are now stitch-less and closing up. Two weeks after surgery the heart muscle has healed to the point where bleeding is highly unlikely, there’s no rub or murmur, swelling of the ankles or anything else I need to be concerned about.

So naturally the conversation turned to pain. What’s your pain like on a scale of 1-10? This one is a tough one to answer because there really is no horribly intolerable amount of pain in any one specific area. In comparison to my broken elbow a few years ago this is nothing. That said everything from the waist up is uncomfortable. This is especially true under the shoulder blades and in the sternum area. I was reminded how my body was spread out and opened up on the table for a long time. As if I really needed a reminder! I was also reminded that I’m going to be sore and uncomfortable for a good 6 to 8 weeks as this is how long it takes for the breastbone to fully heal. It will also likely take that long before all the aches and pains work themselves out and I’m feeling normal again. Along those lines it could take as long or longer for the numbness and tingling in my right hand to go away. I’ll write more about this soon but it’s not uncommon and is a result of irritation to the nerve caused by the position they put your body in on the table.

I mentioned in my last post that Adam Pick the author of “A Patients Guide to Heart Valve Surgery” suggests in his book that the single most important factor for people to consider prior to undergoing open-heart surgery is the confidence they have in their surgeon. The story of how I got Dr. Reemtsen is an interesting one and one I will detail when I get around to continuing the background as to how all this came about but for now suffice to say I’m extremely happy the stars aligned and our paths collided.

Unlike Adam who had to search through many surgeons before finding the one he wanted, I only had one visit with one surgeon before I felt like “If this has to be done, he might as well be the guy”. Thinking back to that day I remember leaving his office feeling like I had asked some good tough questions about the necessity of some aspects of the procedure and that I had really made him think in terms of whether he would do what was being asked if he was me. In addition, I had the feeling that he really understood what I was going through on a family level in terms of the risks and fears when it comes to having young children and a wife that depend on you being around. Dr. Reemtsen and I are about the same age and he has 3 kids. Specifically with regards to the Cox Maze procedure (which I’ll talk about more another time) I asked him to put himself in my shoes and tell me if he would do it if it were him. His answer was a thoughtful but confident yes and in fact he said he uses that analogy in every aspect of every procedure.

Dr. Reemtsen and I 3 days after surgery

Another big factor in feeling comfortable with him was that he was able to relay what needed to be done, the risks and what I could expect in a way that was immediately at my level. I’m a pharmacist with a pretty decent level of understanding for medical issues and his description and our discussion about what was going to happen took this into account. I did not feel like an idiot, nor did I feel like he was treating me like a less educated patient who could really only comprehend the basics.

Finally when it became obvious that he deals more with the pediatric patients I asked whether that would make any difference in the OR. Do you get used to working on the little ones so you get a little rusty on the bigger ones type of idea. His answer was no and in fact he then drew a line on the white board with one end representing the toughest of his tiny heart cases and the other end the easiest, least complicated cases. He then drew an X very close to the latter end and said this is you. He didn’t say it like, “yours will be a snap” but rather he made it clear he had the confidence in himself to know he could handle pretty much anything my heart was going to throw at him while recognizing that nothing in his business is routine.

I remember walking out of the visit feeling secure. Scared as hell since the ball was now rolling towards actually having this done but confident in knowing that he was the one who would have my life in his hands. It was not until after the surgery where nearly every discussion with every caregiver turned to a similar question in the form of “how did you get Dr. Reemtsen”. The question always phrased like or followed by “he’s one of the best and usually only deals with the difficult pediatric cases”. In fact one fella who worked in the ICU actually asked if I was a friend of Dr. Reemtsen and if this was how I got him as my surgeon.

How our paths crossed is a story of its own and I’ll save that for when I pick up where I left off in “A Racing Heart and a Realization” post. It was an interesting journey to say the least but ultimately I, unlike Adam, hit the bull’s eye with my first arrow when it came to finding my surgeon and I couldn’t be happier with the care I’ve received from start to finish.

For those of you coming into this little open heart surgery discussion a little late you can find all the posts easily by clicking on the Open Heart Surgery Labels at the bottom of this post or by clicking on the links under open heart surgery over on the right hand side of the blog. Those ones are listed in chronological order!

Adam's Guide to Heart Valve Surgery

Tomorrow, exactly two weeks after my surgery, I will head back to UCLA for a follow up visit with my surgeon Dr. Reemtsen. I’m hopeful that he’ll give me the green light for stepping up all aspects of my recovery and that I’ll get reassurance regarding the few concerns I have. It still boggles my mind that I’m doing as much as I am in such a short time after open-heart surgery. In fact today, as we prepare for Denise to head back to Saipan next week I walked around Toys-R-Us for nearly an hour. Yesterday was a full day too. We spent the morning packing up and moving to another temporary “home” here in LA and then the rest of the day visiting our good friends Dave and Sandy in Redondo Beach. Although there is really nothing very stressful about watching Dave BBQ up yet another delicious meal they do have two young tykes capable of tiring anyone out just watching them AND I did miss my afternoon nap!

(This was a pre-operation BBQ at Dave and Sandy's, no less delicious!)

Besides looking forward to the reassurance that everything is on the mend tomorrow I’m also looking forward to once again extending a great big thank you to the surgical team and expressing my gratitude for such good care. At this time I’d also like to extend a big public thank you to someone I’ve never met but who has already had a significant impact on the success of my surgery and speedy recovery.
About 2 weeks prior to surgery, I came across a web site selling a book related to heart valve surgery. I believe purchasing The Patients Guide to Heart Valve Surgery by Adam Pick was the single most important thing I did to prepare myself for this ordeal and I cannot recommend his book enough for anyone who will be going through open-heart surgery (or caring for someone that will). Adam is a double heart valve replacement recipient who is fairly young and, as I’ve recently found out, also a Scuba Diver! Adam also has a very informative blog that continues right where the book left off with real life success stories and answers to questions his readers have posed over the years. He also manages to help patients keep up with the advancements in care in a straightforward, no-nonsense sort of way.

According to Adam, the single most important thing one can do in preparing for open-heart surgery is to take the time necessary to find a surgeon with which you have the utmost confidence in. After tomorrow I hope to write a post that will express just how lucky I feel to have met Dr. Brian Reemtsen and his team.

For those of you coming into this little open heart surgery discussion a little late you can find all the posts easily by clicking on the Open Heart Surgery Labels at the bottom of this post or by clicking on the links under open heart surgery over on the right hand side of the blog. Those ones are listed in chronological order!