Coda

Just one last post, as I feel like I ended my recovery as of today. 

Why? Running. My first run since January when I shifted to fast walking to prevent high pressure in the left atrium. 

It was interval training, one minute running followed by a 90 second walk, repeated eight times, but it was a run. Many surprised muscles but not always the ones you'd expect. And surprisingly easy to do. I remember doing this same C25k program when I started running two years ago, and every workout kicked my ass. While I was tired at the end of this first run back, it wasn't nearly as hard as it was the first time or as I'd expected. I may be back to running 5k by the middle of July. 

Next Tuesday will be eight weeks, five days after that will be two months. But I'm no longer ticking off seconds, just miles.

Recovered

As of Tuesday, Apr 26, I am officially "recovered" from my surgery.

Like with most official proclamations, this one deserves the quotes. I am actually more like 90% recovered with respect to my sternum. I am lifting things less than 40 or 50 pounds with no problem, although it's hard to get family and friends to recognize that I can actually do those things. I can get out of bed or up from a chair and use my arms, probably the hardest thing to get used to after being so diligent about *not* using them.

And, of course, I don't "feel" particularly recovered. It will take another six weeks or so for my body to stop freaking out about the surgery. In particular, I have a muscle running from the right side of my neck down into my ribcage on the right side that tends to be particularly sore, for example. My left hip also has been problematic, although I'm happy to say I seem to be getting over that and am aggressively walking again. I hope to start running in a few weeks, at least for a minute at a time, once I can walk at a 15 minute mile pace for a half hour. Right now it's around a 20 minute pace, and it's for 20-25 minutes.

I'm also looking forward to more Wii Fit activity, which I plan to do along with some hand weight work over the next month or so. I will get back to calisthenics once the unruly bits are back to form.

Considering how much I was dreading the recovery, this one has been easy and I'm glad to be within spitting distance of fully functional. Last Sunday I sang a two hour choir concert plus another 90 minutes rehearsal ahead of time, all without any lunch. Tonight I will accompany the same choir at a gig, and for a few hours there it looked like I would be packing my keys and amplification to the gig as well.

About the only weird thing has been having an INR result of 4.3, which is fairly high. This is how long it takes my blood to coagulate as measured in seconds, normal is about 1 second. With two valves, they want my INR at 2.5-3.5, which is actually higher than the 2-3 numbers I was looking for with a single artificial valve. I'm even taking the same amount of Warfarin that I was before, although exercise does bring the number down. More post-surgery body freakout wackiness.

And, with that, I retire this blog for the foreseeable future.

One Month Status

I feel like a one fingered pianist. All I do is talk about how easy this recovery has been, but the truth is that it's been a really easy recovery. Before surgery, I figured I'd start seeing light at the end of the tunnel, but I feel like I'm about five feet from the end of the tunnel, and that's just because I still can't lift much for another nine days. Then it's just a matter of getting back in shape over the following six months, but that's the fun part.

There have been some issues, like how my hip has a sore tendon that's making it hard to get up to the sort of walking speed and distance I'd like to be at. My torso is kinda sore and the muscles are still adjusting to not having to hold things together as much as before. That said, I sang for two hours at a rehearsal the other night, have gone out for dinner, have gone shopping. I'm even wearing jeans and shorts and letting shower spray hit my incisions. Hands over head!

At this point, I'm not going to post any more to this blog unless there's actual news. 

Thanks as always for the good thoughts. Recovery is always easier and better when so many wonderful people are pulling for you!

Three Week Status

Hard to believe it's been three weeks already, and at the same time hard to believe only three weeks have gone by. I'm sure that if this was my first recovery I'd think things were going more slowly, but knowing this is a model recovery I'm just enjoying it more than anything else.

Yesterday I drove for the first time, just to Chipotle for lunch and then to get my regular Surgical Recovery iPad Upgrade. I walked through all of the mall, plus another mile at home that afternoon. I'm already starting training to prep for a return to running, hopefully in three more weeks, at least in a small capacity. I'm also doing some light hand weight work as my upper body seems to have borne the main brunt of lack of use, my legs are in good shape considering.

Today I have lunch with my sister Jan and will play a little Star Wars role play game with my friend Connor. Plus walking! I just can't believe how good I feel.

Did I Pass?

Today I had my first appointment with my surgeon's nurse, who gave me a once over and discussed moving forward.

In a nutshell, I am rocking it. 

I am cleared to drive next Tuesday, assuming no opiate use for 24 hour prior. That's three weeks compared with four plus weeks the first time out, and then driving was difficult to a certain extent.

My sternal restrictions will be lifted after six weeks. Compare with nine weeks last time. That means, effectively, that my sternum is healed enough that I can perform normal activities. 

This all means that by the end of April, my recovery will be more or less complete. Sooner, actually, as six weeks from my surgery date of 3/15 will be 4/26.

This recovery has been so effortless that I've taken to calling it the Slight Inconvenience. 

The lesson for us all, if you don't mind a bit of free advice, is to get in shape and eat right now. Because when you need to be in good shape is probably when you won't be, as I learned last time. 

As for the surgery itself, the big time issue was removing the scar tissue from around my aorta. There was a lot. I was also on the heart-lung machine for a somewhat longer than normal amount of time. Fortunately, neither of these issues ended up having a negative effect, and again the condition of my body played a big role in improving my odds. 

Also, I have a delightful picture of one of the two mitral valves. I may post it later, but suffice it to say that it looks like a cat midway through being shapeshifted by the alien from The Thing. I am calling it Hans. The rest of the valve they more or less just built over with the prosthesis. 

I'm also delighted to say that my lungs are in excellent shape. Getting them working again after being on the heart/lung machine is a big part of recovery, and I'm doing very well in that regard as well.

The best news of the day is that I can go down to one iron pill a day for the next couple of weeks. Yay. Those things suck.

Of course, being in good shape is not everything in recovery. The other big factor, at least for me, is knowing that so many people are thinking good thoughts on my behalf. Thank you all.

Now it's time for first lunch. 

Time Dilation Effects Of Mitral Valve Replacement Surgery Recovery

Time is a funny thing. We all move through it, apparently in one direction, but we all experience it differently. As anyone struggling to finish a test on time (or someone waiting for their partner to finish looking at Every Shoe In The Store) knows, how quickly we perceive time's progression definitely seems to be related to the individual experience.

So here I am, two weeks to the hour since I was in mid-surgery, and I have to tell you that my sense of time is completely screwed up. I thought I had trouble telling what day of the week it was before!

As I've mentioned, a big part of how I dealt with pre-surgical stress was simply to focus on where I was going to be at point X of my recovery. In a week, in a month, etc. Having had that experience once before, I figured the stakes might shift a bit, but I'd still be looking at the same sorts of mileposts at more or less the same amounts of time since surgery.

Not even close.

Two weeks seems like forever. Two weeks ago I was lying on a table with a bunch of highly trained medical professionals looking in my thoracic cavity and thinking, "Wow, that's a lot of scar tissue!" I remember going into the surgery thinking that in a week, I'd be home, and in another week, I'd finally be comfortable sitting up in a chair, finally be able to prepare my own food, in other words starting to get back into the swing of things. I thought that I'd have made ten trips to the anti-coagulation clinic, and be struggling with light-headedness whenever I went anywhere. I'd just be to the point where I could walk comfortably.

Well, we're about three weeks past all of that. No light-headedness, very few trips to the hospital, I'm walking a lot more, I'm able to get into and out of bed without assistance and have more or less four days after surgery. I'm comfortable in a wide range of chairs and seating. I'm laying flat in bed at night, with some occasional side sleeping.

My legs are strong enough for me to drop down with my upper body vertical enough to pick up things I've dropped. My core is strong enough for me to sit up from a horizontal position without any arm assistance.

Even the scars from the various holes and incisions are looking amazing. Groin excepted, that one is going to take a while because it runs across bendy bits (fortunately not the occasionally bendy bits, though). And it's looked gnarlier than anything else pretty much from surgery on.

About the only thing that hasn't really improved is consistent sleep. Admittedly, we are in bed by 9, and asleep by 10pm, and then shooting for an 8am breakfast, but I am definitely awake for an hour or two.

I'm also looking forward to getting off of the Oxy, which has been fine and I have been good about keeping my pain down to nothing most of the time. I do notice that I have trouble with a bit of short term memory, especially when it comes to whether or not I've taken my pills, but I have various methods to keep track (like leaving the "extra" pills, not taken at 9am/pm, in a dish so I can see what I've taken already). I definitely feel like I'll be able to rotate my upper body easily to look behind me when I can drive again in, oh, more than two weeks.

Sorry to be so boring. No major complications, no wondering what I should eat, no massive shifts in drug regimens. Just getting back to normal at a surprisingly fast clip. And trying to remember that while I feel great I still have this enormous broken bone (or equivalent) that is pretty damned central to my structure that's held together with titanium wire right now. To be fair, it's been very good about reminding me that I'm not back to normal yet, just mostly.

I've even signed up to sit in as an accompanist for the Balladeers at the end of April for a few rehearsals and possible a gig, pending how I feel in a couple of weeks of course.

I am absolutely positive that the majority of my fast recovery is because I was in such good shape before the surgery. At this point 30 months ago, I felt like a very old man. Now I feel like I did about six weeks into my couch to 5k running program less than 24 months ago. And looking forward to running more than I can tell you.

For now I'm going to limit future posts to reports after seeing my various doctors, with an occasional status update if there's some time between them. I see the surgeon's nurse on Friday, and that is my first real professional data point since leaving the hospital. Then it's a couple of weeks more until I see the surgeon in mid-April, followed by my cardiologist and GP.

In other words, I'll see you in the future, and for both of us I'm guessing it will have seemed like both an eternity and a few seconds...

Doug

Don't Hate Me Because I'm Pretty!

Sorry to not be posting much. It's not because I don't feel good or things aren't going bad, rather that things are going quite well and I was working on a very long post (and that is me saying that) and thought... Nah.

So here's a quick update. 

One week ago, I should probably have gone home from the hospital, so I'm going with one week home. 11 days ago I had surgery. Not even two weeks. And this could not have been a more different experience for me than before, and I considered that a pretty good recovery at the time. 

What's different?

First off, mental state. Last time I was struggling with terrible dreams (I still have stress dreams, but more of the "I was so mad that I'd broken my iPhone that I smashed my iPad Pro" type). No huge adrenaline surges like before, although there were a couple of same "aha!" moments that preceded them. I'm not in the least afraid to sleep. 

Second, and this really covers a lot of territory, I have been through all of this so I knew what to expect. Kind of. You hear this sort of thing all the time, like "don't chase the pain" and "One day at a time" but this one is very true - Every recovery is different. It's a little like the difference between the first time you play any piece of music and the first time you play something different, now you know there will be notes but the way your hands move provides a lot of commonality to build on. By far the biggest gain here was diet and exercise, not to mention the blood thinner regimen. All of those things took months to internalize, now they aren't even on the radar. That gives a lot of brain space for other things.

Third, I was not at all prepared for either a) how good of shape I was in, especially for my age, and b) how large of a factor that would be in recovery. I have never thought of myself as being in good shape, other than a brief period in my late 20's that was more about body building than fitness per se. Now I'm realizing that I was in the shape of my life, and perhaps of many people's lives. It just took a recovery like this to make me realize how important being in very good shape is. If I was talking to a person going into valve replacement, I would strongly recommend they do whatever exercise and change their diet as appropriate before surgery. 

And, I cannot stress this enough, much of the time you are not going to know you need surgery until you need surgery. Or you won't be able to get into shape easily. My mitral valve issue was a limiting factor on my exercise, so much so that I spent a good part of the last four months winding down. Had I not been in the good shape ahead of time, this would be a much different recovery. 

So where am I at?

Yesterday, Mel and I walked the length of Washington Square Mall and back. Not at "mall mode" speed, but fast for a guy ten days out of major surgery. 

My chest incision looks more like a bad scratch than anything else. Nearly every other hole in my body, and there are a few, other than the groin incision (which, admittedly, does look Frankensteinian, but then it covers a portion of skin that gets bent quite a bit in a given day) and the drainage tube holes, which just look like big scabs. 

Aside from lifting and bending tasks, such as laundry, putting/taking dishes into/out of the dishwasher, and walking on sloping elevations, I am largely self sufficient. [Edit: And since I began this entry, I walked a couple of blocks on sloping elevation outside, which is awesome because walking in circles inside the house sucks.]

I still have a sore core, but nothing like last time. I could barely sit in a chair for a good month, and then only on my computer desk chair. Now I sit on sofas and upholstered chairs regularly. I even sit and stand using solely my core and leg muscles with minimal effort. 

Part of this has also been fortunate timing or good planning. Buying the 84th Ave house couldn't have come at a better time. No more taking five minutes to get down the stairs only to realize you'd forgotten something upstairs you need. That happened five or six times a day. I've only done set of steps at a bloodwork lab yesterday where we couldn't find the elevator (we barely found the lab!), so I can do it if I need to, but I'd rather focus on less stressful options. I've also found that "practicing" the things I'd need to remember doing (like standing up and down, or showering to avoid direct spray on incisions) has made it easy to do them right now that I need them. 

The craziest thing, and for those keeping track from last time, is my attitude toward opiates. I was very concerned about addiction before, now I am not at all. The biggest mind shift is that if you are in pain and waiting to take the next dose, then you are psychologically "rewarded" for taking the pill. If you aren't in pain, and just take it because it's time, that doesn't happen. This both makes complete sense but is so counterintuitive all at once. As a result, I am dosing as recommended, planning on tapering off as things heal up, and expect to be off of these things before the end of the month. 

Now, what I need to do is start sleeping through the night. That said, nap time. I'll probably post in a few days to a week if I have new things to report.