Refocused recovery plans…

Recovery has so many meanings. Until a short time ago, I was all focused on recovering from a stroke. And doing quite well at it. So well, in fact, that when a cardiac problem presented itself, a neurological exam proclaimed me a very fit candidate for major open-heart surgery. But recovery still goes on. It will take on a deeper and more painful turn when I begin recovering from the open-heart procedure. This is, apparently, a long and –initially – quite painful experience, I am told and have read.

I was pleased when the doctor encouraged me to continue walking, and engaging in water fitness, albeit scaled back 20%. Be as fit as I can be by the time I enter the operating room.

Of course, although I have plans for the time beyond surgery, I am aware that not everyone survives the procedure, and some don’t survive the recovery process. Death is always waiting in the corner for a moment of extreme vulnerability. So I began reading medical articles that deal with fatality percentages, and death rates. To date, I haven’t read a lot, but in the reading, two points have impressed me. By-pass surgery is generally more successful with elderly patients, than with younger ones. Part of this is due to the fact of early onset heart disease, the other has o do with percentages. If you are over 80, a 10% increase in lifespan is huge. If you are 46, not so much. This morning I spoke to a woman whose husband survived two open-heart surgeries, the first one at 46 years! He lived until almost retirement age!

I’ll keep reading, for interests sake, but I’m currently getting more wisdom from Grierson’s book What Makes Olga Run, the story of a phenomenal Victoria woman (raised in Saskatchewan, of course) who got bored with slow-pitch baseball after retirement, and at the age of 77, took up track and field. Currently, she is almost 95, and holds 17 world records in field and track events! As much as it is about one woman’s phenomenal body, it is a book about aging from the perspective of a cadre of folks who simply get old in a very active way, and are amazing because of that.

As a result of my reading thus far, I have refined my own post-surgical plan (which was to begin swimming hen I had the heart and breath to do it. Thanks to the example of my phenomenal son, I have now decided to ultimately swim a kilometer – 40 lengths of our local pool, even if it takes me half a day! My son Keith, aged 50, who has physical challenges of his own, swims 2 and one half Km. in an hour before he goes of to work each morning. My response was “Wow!” And then, “Hey, I could set a goal, and with his encouragement, meet it! Of course, I have to survive first, and at the moment, I am preparing myself for that initial struggle. Stay tuned!

On the way to the big game…

It has been a big week. On Tuesday, I had an Angiogram in preparation for cardiac surgery. The week before I had the required neurological exam to see if I was a good candidate for the surgery. I am…thankfully. The angiogram was fascinating to watch. I could see the monitor all through the procedure. At the end of it, the physician manipulating the line said, “We’re finished…and you have a problem.” This, of course, I knew. On the way back to my cubicle, Dr. Hui (my Cardiologist, whom I like and trust) joined me and told me that I would indeed, require a valve replacement, and “a bypass.” They will also “scrape away the cholesterol” in my heart…whatever that means. Dr. Hui did not specify what kind of bypass I would have, and my reading since then has taught me that there is a difference between coronary bypass surgery and a heart bypass. I don’t fully understand the difference. I ill ask my own physician on Friday when I see her.

I looked up an article online regarding the two procedures, and reading it brought the whole thing home to me with a thud. My heart may be stopped for a time…a machine may pump my blood…I will be in ICU for a day or so…I will have multiple chest tubes. You’d think after 32 years in hospital chaplaincy, I would know these things, but…

Well, I guess I did know them when I worked in the heart transplant clinic, but I have “forgotten” them since. I could blame it on the stroke, or simply my own denial mechanism. I keep reflecting on Dr. Hui’s comment: “This ill happen within the next three months.” I surmise that this means the situation is fairly critical. Thud.

The only reminder I have of the angiogram is the arterial wound in my right wrist, which must be bandaged for the next two days. If it bleeds, I have to call 911. Thud. The tape that covers it irritates my skin. I keep having my attention drawn to it because of the irritation. I remembered how my Dad was irritated by tape when he had surgery for an ulcer when I was a student. His skin blistered under the tape, and they had to peel it off him!

I had a short walk yesterday, and a longer one today. Tomorrow, I will do the whole 4 km. slowly, and carefully. Dr. Hui tells me to continue my exercise routine right up until surgery, just cut it back by 20%. No excess stress. Thud.

On top of all this, I have postponed an assessment for cataract removal until next month, and tomorrow night, I sleep in the Sleep Lab in Wetaskiwin. They will try to find a way to get me to a healthier sleep pattern. A whole lot of health challenges all at once. Like I am falling apart piece by piece, rapidly. Thud.

However, “What Makes Olga Run?” is a hopeful book about such recovery and life beyond it. I have formed a plan. After recovery from the cardiac stuff (six months or so), I will resume activity in the pool. My goal: to swim lengths. More than that, to aim for the ability to swim one kilometer at one go, even if it takes half a day. That should keep me busy until I’m eighty-five! One payoff for swimming and pool workouts is the regular- and free – observation of women in bikinis. Where else do you have permission o check out the scenery like that?

It’s helpful to me to write all this stuff down. Helps me deal with the attendant anxiety, and remember that I am fortunate to be so close to Edmonton and the Mazankowski Heart Institute. A whole huge hospital devoted to cardiac problems: possibly the best facility in the country. At least that’s what I’ll keep telling myself until this is all done.

The big loss for me in all this speedy preparation is that I doubt that I’ll have the chance to visit the Manitoba branch of my family in the next 10 months. I am already missing them a huge amount. I want desperately to watch Angus look through his food carefully to see if we’ve tried to foist mushrooms off on him, and to experience another movie at home with Emma’s steady and intelligent running commentary. Only slightly maddening… and oh, so beloved.

Enough for tonight. Now, a shower and then to bed. Recovery; oh yeah, that. I’m going to have a lot of recovering to do over the next year. Stay with me on it. I’m sure there will be some long stretches hen I can’t write, but I will try and keep you on board. I need some on-board folks. Thank you.

Another step taken…

It has been a full week since I have written here. I began to wonder what it is that I am avoiding looking at, when I remember how much has happened in the last week, both externally and internally.

For starters, “recovery” is way on the back burner these days. The foreground of my life is preoccupied with matters cardiac, as well as matters “hyster-ectical,” to use a word that probably doesn’t exist.  As well the impending angiogram/angioplasty, I have also been through a neurological exam, which pronounced me a very fit candidate for cardiac surgery – brain-wise at least, and additionally, affirmed that I am sane. Some of you will want to question this last decision.

On top of that, there is the looming reality of Beatrix’ hysterectomy on February 5. We ponder together a worst-case scenario: each of us having major surgery on the same day, in different Edmonton hospitals. How do we get home? Who looks after us here? How do we get food, laundry, etc.? Of course, there is little chance of this happening. My process, once through the testing phase, will probably slow down, as I wait for surgical appointments, surgery date, and so on. The hope is that one of us will be well enough to look after the other once the two surgeries are completed.

We’ve had discussions about Beatrix postponing her surgery (I flatly nixed that), about bringing her church board members into the picture regarding home help, and reassuring one another as best we can. I will speak to some of my Lodge Brothers about the need for drivers and lifters for a number of weeks. There are at least two that I can count on.

In the midst of all these mental gymnastics, I have also been trying to fit in a night of sleep in the Wetaskiwin Hospital Sleep Clinic – which will happen hopefully on the Friday night of next week (Jan. 24).

I keep walking three times a week, working out in the pool (at 75% intensity) at least 4 times a week, all in the interests of being fit and ready for…whatever. In between all the reflecting, date planning and fussing, I do reflect on the possibility that my last visit to my children was…my last visit. An unavoidable thought, I suppose, taking into account all possibilities.

My Dad used to say, as he dealt with his 80+ year old body, “Getting’ old is not for sissies…” Amen to that, Dad.

"Cracked open…"

Monday morning I spent an hour with my cardiologist, after he read my Echo cardiogram. Knowing that I have a poorly functional aortic valve is one thing; having that translated into knowledge that then condition has grown more critical, so that surgery is being fast-tracked, is a totally different experience.

I still retain my anticipation for having this procedure done, but it isn’t quite as enthusiastic as previously. Now it is quite real, graphically so, and there is a rough timeline, and a sense of urgency around it. The experience knocked me for a bit of a loop: this is a life-threatening condition, and the surgery, while routine, still carried risks.

In short order, over the next few weeks, I must have a neurological exam – presumably to ensure that the stroke site is truly resolved. Then I will have an angiogram – doesn’t that deal with the state of the arteries around the heart, in this case? Then a surgeon will be introduced, another exam will ensue, and a date will be set. When? Who knows…before summer, I hope.

Dr. Hui is a straight-shooting, very open person. I got the whole picture, including a brief, but graphic, description of the surgery. The part that shook me most was the description of the entry. “They crack open our sternum, and clamp it open so they can repair the valve and anything else that may present itself.”

Dr. Hui was clear that the healing of the sternum was the longest part of the recovery in this type of surgery. It is wired together, and takes over six weeks to be secure. The point being that too much exercise before this time can compromise the integrity of the bone. The soft tissue will heal faster, but the patient’s recovery is predicated on bone healing.

I don’t remember too much more of the visit. I have been digesting the impact of the surgery and the lengthy recuperation all week. This information gives “recovery” a whole new meaning. Not only is my brain damaged, but also my heart is broken as well, at least physically. So I continue to digest this news, for now.

In threes…

My mother had a saying, which I heard almost every day: “Bad things come in threes.” She could always point out situations in which that happened, and when a couple of negative events occurred, you could count on her to warn you that a third one was on the way. When something else happened, she would point it out somberly…hut in some senses, gleefully. “See, I told you!”

These days, I have been pondering this myself. First, I suffered a stroke (March 2013), then, a condition that was diagnosed some years ago (narrowing neck on my aortic heart valve) demonstrated its worsening condition (Nov. 2013.) I noticed that my vision, corrected with new glasses in May, before I could get my Driver’s License renewed, appeared to be not so good as it should have been. So I had another eye test. Sure enough, the left eye is worse. Perhaps new glasses were coming…then, in addition, it turns out that the cataracts growing on my eyes are severe enough that perhaps I need to have them surgically removed, before thinking about new glasses – January 2014. Have you been keeping count? That’s right: three items. My mother is nodding wisely, “See, I told you.”

The central significance that I take from all this is that as one’s body ages, it begins to deteriorate, sometimes slowly, sometimes quickly. All of which underlines the importance of keeping oneself as fit as possible, because that slows the process considerably.

So, my medical appointments are stacking up. Monday, I see the Cardiologist in Edmonton, where a plan of action vis a vis my heart problem will be mapped out. January 22, I see the eye guy regarding the advisability of cataract removal. That’s two potential surgeries in the near future. It’s like keeping track of your dance card, for those of you old enough to know what a dance card is…or was.

I have been moving toward the Cardiology appointment with a lively anticipation, thinking beyond it to the possibility that I may be able to actually swim lengths in a few months. Great attitude, but…

Yesterday I became aware of how anxious I am about this meeting. I focused my anxiety on the problems of getting there. My appointments begin at 8:30 Monday morning. I didn’t relish the thought of a 6:00 AM start in the dark. So I booked a room in a lodge for Sunday night, so I could drive in tomorrow and have lots of time…but

The weather Sunday night promises to hover around minus 32, with a wind-chill of minus 37 or 38. And the ledge has no plug-in capability. That’s where I put my anxiety. As I became aware of it, I finally asked Beatrix if she would take off the day and come with me Monday morning at 6:00 AM. Not necessarily to dive, just to “come with.” She agreed quickly, and my anxiety began to abate, or at lest to switch to the negative possibilities of my Monday meeting. How serious is “serious”? What game plan will work? Will I need surgery? How dangerous is that? Am I about to become a Cardiac cripple? And so on.

At least I’ll start in a warm car, which will start, and I’ll have support, Asking for that is a big step for me, but it makes me feel oh-so vulnerable. I’ll leave it at that for the moment.