It should be recorded that She Who Must Be Obeyed was checked by her cardiologist last Friday and given the go-ahead to go back to work and to drive her car. Of the two, She was happiest about the driving bit; the going back to work was greeted with mixed feelings. She returned to the office Monday (Jan. 11) and is doing quite well.
I walked into her hospital room tonight to discover two doctors talking with her. So, straight from the doctors' mouths… She Who Must be Obeyed is to be discharged tomorrow morning!
She is a bit feeble still, but able to walk steadily for short distances without assistance. We'll get details about post-discharge medications, suggested exercise, limitations, upon discharge.
I think She should stay home and out of sight: Her neck is all bruised and has puncture marks; her arms look that way, too. I might be accused of spousal abuse! Hmmmmm…. it is turtleneck sweater weather!
Her heart may not be bionic but it has been rebuilt so, look out world, here she comes!
Sitting in the Heart Center's Au Bon Pain 24-hour restaurant for a late dinner the other night, I was aware of the Christmas holiday background music playing. I found it both ironical and darkly amusing that just before leaving I heard someone singing, All I Want for Christmas is Your Heart.
I don't have a time when the surgery was completed but at 3:30 Friday, She was in the CVICU, still intubated, and sleeping.
Dr. Gillinov was able to use minimally-invasive ("robotic") techniques and repaired, rather than replaced, the failed valve. It was a long surgery, even Dr. said it was long, and had me worried by the end but the approach and the results appear to be worth the extra effort.
Gillinov first repaired the mitral valve which, on a scale of 1-4 with 4 being the worst for the amount of leakage, rated a "4." He "removed the defective piece of the valve and placed a cloth ring around the circumference — like a washer" to effect repair. Post-op, the valve's rating is now a "1," considered normal for a healthy person.
The tricuspid valve also warranted some attention, rating a "3" on the scale. It had apparently been damaged by forces generated by the failed mitral. He applied a ring as part of that repair.
I've yet to be briefed by hospital staff but her life ahead should be good and long with her heart restored to normal function without the issues involved with synthetic or natural valve replacements.
Because the surgery was less invasive, She spent the night in CVICU, was expected to move to the "Step-Down" unit (more of a regular hospital room) later today. She should be discharged next week perhaps as early as Tuesday. Since her sternum is intact (thanks to the technique used) I expect she will recover much faster than we feared going in and She should return to her normal activities very soon.
The mitral valve surgery has been scheduled for tomorrow, Friday, Dec. 4.
The surgeon is A. Marc Gillinov, MD who met with She Who Must Be Obeyed this evening. She said there was a good conversation and felt a good connection with him.
Gillinov told her he fully expected to be able to repair the valve — something others had led us to believe was improbable. He said that in the unlikely event that the valve needed to be replaced after all, he would advise biologic tissue over artificial valve; the reason being that, though it would last only about 10 years, he expected there would be superior alternatives a decade from now. So we're hoping for repair, will get biological tissue if needed, and much of what we've been led to believe up to now has been reversed!
The surgeon also told She that he would not make a decision about "traditional" vs. robotic surgical technique until the operation actually begins. A bit surprising, again, but he's the doctor, and apparently a darned good one! We think She will be in very good hands.
For her part, She says she's not worried at all and was in excellent spirits tonight. I've said it before and I'll say it again, if she was dressed in her civvies and you were talking with her you'd never even know she was in ill health.
The catheterization went fine. She Who Must Be Obeyed was unconscious for the entire procedure and that was okay by her! The most painful part of the whole thing was they had trouble setting an IV and tried several times in several vein areas; she's sore and bruised all over her arms and hands! Yikes!
The findings are that the heart's artery pressures/cyclical changes are good indicating the valves are also good. Coronary arteries are clean and clear. The mitral valve is the single culprit — one doctor not giving any clues; the other doctor that spoke with us kind of let slip that the valve simply wasn't working (was "wide open") and that replacement, not repair, is near certain. I believe I was told the left ventricle is enlarged –not good– and caused by the valve failure and congestion and that they'll be monitoring that post-op hoping to see improvement. We'll see what the surgical team comes up with. Hypertension was ruled out as the root cause — one doc simply saying She doesn't have hypertension. Real reason for the bad valve isn't known but that it was likely in slow decline and just hit a tipping point triggering this crisis. She's supposed to get another sonogram today. It's now considered a bit optimistic to expect surgery will be tomorrow and it certainly hasn't been scheduled as yet. I may or may not get more information this afternoon during or after surgical rounds.
The Eee-PC was warmly welcomed, but… I set it up, even used it in the waiting room today. There's Wi-Fi on the patient floors in the satellite waiting rooms but apparently NOT in her room just a short distance away. I'm terribly disappointed — she was giddy about the netbook until we couldn't get online in her room! If they let her get out of bed tonight (recovering from catheterization for six hours) I'll be happy to get an email from her. Hopefully her surgical recovery room will have wireless access since she'll be there for several days. In the mean time, it's something new and she can keep her mind occupied playing with it.
She Who Must Be Obeyed is in hospital as I write this. Over the last week what appeared to She and I as effects of a cold turned out to be among of the symptoms of congestive heart failure.
She's hard to get to the doctors' and by the time she finally did, she was completely out of breath simply walking up stairs. This from a woman who walked miles with me this summer and previously was a recreational cyclist champing at the bit to go-go-go!
An explanation I heard from a physician's assistant who did her emergency room workup: chronic hypertension strained the mitral heart valve which produced the situation. On emergency room examination, her systolic and diastolic blood pressure numbers were triple-digit, something like 150/125. It's a wonder she didn't stroke out right there! In retrospect the symptoms I observed over the weekend along with those uncovered by medical tests and those She finally disclosed were all checklist matches for congestive heart failure … including that oh-so-obvious hacking cough that kept us both awake at night.
So today She, resting at hospital in improved condition, will get a heart catheterization so surgeons can determine the condition of the arteries and what sort of damage the valve(s) has suffered. Then, perhaps as early as tomorrow, it's major surgery for either valve repair or replacement. Sometimes, heck, often I'd love to put a good bit of distance between me and Cleveland, Ohio. Times like this, however, make me a little happier to be near… She is being treated at the world-renowned, prestigious and expensive Cleveland Clinic Heart Center. Having excellent medical insurance is a very good thing — I won't have to wind up stealing food from our cat when all is said and done. Not having access to treatment of this caliber? Well, you can probably tell where I'd come down on the national health coverage debate.
Though She has a phone in the room, She's been feeling completely out of contact without email. To help her with what will quickly become a boring stay and to put her back in touch, I picked out an "early Christmas gift." After visiting her last night I stopped in at a nearby Best Buy store and purchased an Asus Eee-PC "netbook" — miniature notebook computer. She'll get to use it today and then, depending upon when surgery takes place, go "offline" for a day or two. During her five days or so in hospital for recovery, I'm certain she'll get some good use out of the sweet little Eee-PC; I know I've had fun setting it up for her.
Heart surgery? A heck of a way to earn a nice little gift!