The process

I realize that, in telling you all the little tidbits of recovery from open-heart surgery, I have failed to share any of  my own reflections about it. Time to start.

I had never considered the possibility that I had heart disease. I had never had a heart attack, I lived a healthy life, and I was uber-active. What could be wrong? The need for a new valve was imagined as a fault in the plumbing, something that would be fixed when the time was right. Apparently the time had been right just about the time I had a stroke in March 2013, so the surgery got pushed into the background. But the ailment didn’t, I discovered.

When the cardiologist was describing the problem to me over a printout of my current heart, I was amazed to see that many of the arteries on is surface were squiggly and narrow. That was plaque, apparently, and it had been there a long time, so it had calcified (hardened) which meant that a stent was out. (A stent is a tube inserted into an artery to open it up. It only works if the plaque is soft and relatively new. Mine wasn’t).

I heard the words Cardio-Arterial Disease for the first time. I had a heart disease! Me! The remedial action is called by-pass. What that means is that the old plugged arteries are ignored; they can’t be fixed.  Instead, veins are stripped out of your own body – the chest, and usually one leg, to make alternate routs for the blood to get to where it needs to go. They gave me a thick pamphlet describing the whole process, with color photos. I read about five pages, and then felt totally overwhelmed with the magnitude of the process and put it away.

The valve replacement was the easy part, it turns out. Bovine tissue is used to make a valve (who knows how?) and that is fitted. It’s good for a decade or more. So, if I live to 95, I’ll need another. And they do this with 95 year olds these days!

The magnitude of my problem began to seep into my brain. This was definitely life threatening. I should have had it last June, but the stroke screwed that up. I guess this is one reason why, instead of a “6 to 8 week wait,” I was called for surgery within two weeks. Very inconvenient, as Beatrix was having her own surgery just 5 days prior to mine! Another story…later.

We settled in at the hospital residence briefly. They called all of us slated for surgery on February 10 to be at the surgery unit doors at 5; 30 the next morning. When we walked into the waiting room, there must have been twenty people sitting around. Many looked very anxious; many others talked in a frenetic way. When the unit doors opened at 5:30, the rush was like those I experienced as a boy at an Eaton’s sale. It was a scramble. Turns out, they had beds assigned for each of us, where we hunkered down to be shaved. “Shaved” means every inch of the front of you, top to bottom, by an efficient and silent Filipina nurse. Then came the wait. Names were called, and gurneys rolled out. Time passed, and my name wasn’t called. I tried to relax, but more anxious. They had pre-warned us that a surgery could be postponed at a moments notice right up until they begin opening your chest!

By one in the afternoon, I was the only person left in the unit. Word came down: either you will be postponed or they will take you as a late surgery with the hour. I watched the clock with rising anxiety. I thought, “what would it be like to go through this tomorrow morning again…or next week?” Every concern of my reflection came rushing back, while I tried to look calm and ready.

It was just after two P.M. when they said, “you are a go,” and began to wheel me out of the unit. I was excited and pleased, AND, I was terrified. I was on the way. I would not be back in the Recovery Room until 8 P.M. that night. More later.

The pool…

The pool. Some weeks I just about live in the pool. I go at 6 in the morning to work out in the deep water, or at 8 AM to participate in a class workout. This is physical and social. A few times I have tried swimming, but this activity produced angina…so no swimming. As time went by I realized that as much as I enjoyed the deep-water workouts, I really wanted to swim. And this wasn’t going to happen on the pre-side of heart surgery.

As my surgery day approached…or what I thought would be my surgery day, I began to formulate a plan. Once I was through surgery, and then recovery (six months), I would set out to get back in shape in the deep water and then…when I was ‘tuned up’ more or less, I would get some coaching to improve my swimming style and to add a stroke or two, and then…I would begin to train to swim seriously. My goal: to swim a kilometer in our pool. That’s twenty lengths. It seems an impossibly long swim, since I’m sure that in the beginning I wouldn’t be able to swim even one length!

Bu I remember my running days: When I began, I couldn’t run a single mile without many stops and walks. In the end, I was running 13 miles without stopping. So I know that I can do it if I live long enough and work steadily enough.  That’s my goal in the pool: 20 lengths without stopping; 2 kilometers.

Now I have only to wait until the Cardiologist gives me permission to get back in the pool. I know that the start will be hard, as my muscles have all turned to noodles. But work I can do, and time is all I need. So watch this space for periodic reports on my progress or lack of it. Lend me your support, if you’d lie. Write me a note, make a comment, tell me I’m crazy, whatever. It will be good to know that there are people with me. That’s the pool!

"Walking is your best friend"

“After this surgery, walking will be your best friend.”  Words spoken to me by one of the surgeons just days before my open-heart operation. He was referring to the benefits of walking as therapy for rehabilitation for a repaired heart.

I have been a walker for many years. Initially I was a runner, one who disdained walking as too slow and boring. I started running seriously in the late 60’s. In short order I was running up to 13 miles daily, from 5 until 7 in the morning, virtually every day. Yes, I know it sounds insane. I was told that many times, and looking back on it, I tend to agree. The practice, which I followed for 20 years, cost me two knees (now titanium), a double discectomy on my back (L 3/4 and L 4/5.). I spent countless hours in chiropractor’s offices, hot tubs and on massage therapist’s tables. But I loved it.

In 1989, my body simply couldn’t do it any more. The pain in my back and knees precluded that. So, after a frustrating hiatus of confusion and frustration, I began to walk. Yes, initially I found it boring. The scenery moves by at a much slower pace. On the other hand, it didn’t hurt, and I seemed to derive considerable benefit from it.

By the time we were settled in Calgary, in early 1990, I had route mapped one that took me over the LRT tracks, into the grounds of the University of Calgary, and back: well over an hour. And the surroundings were beautiful. The only drawback I experienced on that route was the odd time when a female student would come off LRT at 5:45 – probably on the way to a low level campus job, and I found myself walking 50 or 100 yards behind her, in the dark, along a wooded University pathway.  Very often these young women became highly anxious, being followed by an unknown male in this situation. Sometimes I would stop and wait until they had gotten far enough ahead so that I seemed to be no threat. Once or twice I walked along in fear that the campus police would show up, and I would be in the uncomfortable position of trying to explain why a man in his 5o’s could possibly have for walking on the University campus at 5:30 on a cold winter morning, if not to hunt unsuspecting females!

I continued this activity when we moved to Banff, walking the trail along the Bow River each day. Hiking in the mountains was much more difficult, because my knees had deteriorated t the point where required replacement. Shortly after moving to Ponoka, I had the first one “done”. The second followed a year or two later.

And then I began walking here. I laid out a course for myself – about 4 km long – on sidewalk, under streetlights, so I could walk in the dark. I began, gain, to rise early, sometimes as early as 4 AM, and walk my 4 km course. Part of the course is alongside open farm field, so the “brisk” northwest wind was often in my face. As a transplanted Manitoban, I loved facing the weather. I never let a cold or windy day keep me off the street. My record is -38 Celsius, with a stiff wind in my face. With a balaclava, a Canada Good parka, heavy mitts, long johns and insulated boots, I loved the walk! I would do it again tomorrow…except it’s the first day of spring.

So when the surgeon said, “walking is your best friend”, I just smiled. I’ve known that for a long, long time. I started my own cardiac rehab a couple of weeks ago with six minute walks, three times daily. By now, I’m up to 15 minute walks, twice daily. This morning I walked all the way to Tim Horton’s for coffee – 23 minutes, and that constituted my second walk of the day. Before long, I’ll be up to a half hour, and then an hour of walking. By then, I’ll be back in the pool. But that’s another blog!

Sleep…

Sleep is a cherished commodity in my life. I know sleep promotes good health and healing, but sleep has been a problem for me for decades. It began when I lived in Winnipeg under the flight path of “The Red-eye Special,” he overnight flight from Vancouver to Toronto. That plane roared over my home at 4:15 every morning, and never failed to waken me. That fact actually became useful when, some years later, I began running every morning at 5 AM. The plane got me up, and I got going…for two hours.

This morning pattern continued for 20 years, so by then I could waken spontaneously even before the plane approached. When I let that home, and the city, the pattern continued. By 5 AM, I was awake and ready to start my day, running, walking or whatever. That was now 30 years ago, but the pattern still continues. In fact, over the past two winters, when I walked 4 km every morning, I was often on the street by 4 AM!  It seems not to matter whether I go to bed at 9:30 or 11:00. Between 4 and 5 I am awake and ready to go.

Some years ago, I was tested for sleep apnea, and was diagnosed as a sufferer. One of the remedial steps taken was to put me on a C-PAP machine, which keeps a constant pressure in you nasal passages all night, thus preventing the hundreds of brief awakening that occur to the apnea patient. I can’t recall now when or why I stopped using the machine, but once again recently, I was diagnosed as a sleep apnea sufferer. I will likely be put on a C-PAP machine (modern edition) again. This will guarantee at least good sleep while I am asleep.

However, all this is ‘back story’ to my present dilemma. Since having open-heart surgery< I am required, for now, to sleep on my back only, not my side, as I usually do. I waken at least 3 or 4 times a night to empty my bladder – another ‘gift’ of the ‘golden years.’ Since arriving home from the open-heart surgery (a new aortic valve and a triple by-pass) I awaken completely at least once every night. At first, I just lay there and stared at the ceiling. Another time, tried listening to the radio – which was interesting that it kept me awake even longer! Now, I simply get up, make myself some tea, and read for an hour. I can the return to bed and get to sleep. There’s something hypnotic going on there, I think.

The consequence of all this is that in the morning, I am wiped out, and find it hard to rise and have breakfast at 7 – an impossibly late hour for me! After eating, I now usually return to bed at sleep another hour or more. When I do get up, I am groggy and slow until I get outside for my first 15-minute walk of the day. Walking! That’s another blog!

Another day…

Today has been a good day, mostly. When I woke this morning, I found that I had actually slept all night, which was a first for me in awhile. However, I was so groggy, that after I hate my homemade breakfast of steel cut oats, prunes, wheat bran and fruit (see yesterday’s implied comment) I fell back in to bed for another three hours of sleep. 

I brought that to a conclusion with a 12-minute walk in brilliant sunshine and a brisk and cold west wind. I was certainly awake when I arrived home. I added a second walk after lunch, and got a third one in walking part way home from Tim Horton’s until Beatrix picked me up.

It’s important when you are in recovery from such a dramatic procedure, as I had to pay attention to every little offhand comment that comes your way.  For example, someone commented to me in hospital “if you have a too-strenuous day, you will pay for it the next day.” I heard it, but it didn’t register until the other day. It was a fine day. Visit to the MD in late AM, lunch at Tim’s, followed by a stop to buy groceries, and then another walk later. Feeling so good, I decided we should take in a movie downtown! “Mr. Peabody and Sherman.” Great fun and three-D as well.

The next day I felt completely wiped out, drained and unwell. I then recalled the casual comment, only not so casual now. I had experienced the wisdom in person. And I filed it away for another day. Tomorrow, for example, I have a standing AM date for coffee with a group of men at 10:30. That usually lasts until noon. If I get in a 12 or 13 minute walk beforehand, and another on the afternoon, I’m going to be really bushed when it come time for the final walk of the day after dinner.  Sounds like a nice day, doesn’t it? And it will be. But in the world I currently inhabit it sounds like a BIG day, and I will need to be ready to take it very easy on Saturday, without guilt.

It’s weird the role guilt plays in all this. I’m used to full and active days, a mixture of enjoyment and work. When I can’t fulfill that pattern, no matter what my brain tells me, I feel like I’m slacking off, and I feel somewhat guilty. It’s a mental and spiritual change I will have to negotiate soon, if this recovery is to be smooth.