Gettin' religion

When I woke up this morning, I had strange markings on my feet:















Jenn and I have 2 competing theories on this.

Hers: A nurse marked them yesterday for some clinical use (a road map for finding pedal pulses, perhaps)

Mine: Stigmata. I am the chosen one. Expect to hear from me about how you and everyone else should live their lives.

(Kidding, folks.)

Cath update

Fortunately, there's not much to add to Jenn's posting, as all went well (ie, no surprises). My coronary arteries are "pristine."

The first person to thread a tube into an artery (his own brachial, as it turns out ... the femoral artery in the groin is generally the preferred approach today), snake it up to the heart, and snap an X-ray was a physician by the name of Werner Forsmann, sometime in the first half of the 20th century. Crazy SOB, if you ask me. Flash forward to 2010, and this procedure is on par, experience-wise, with a trip to the dentist. This was cath #2 for me, lifetime, and I can safely say they're not worth sweating over. (You can't anyway - the cath lab is typically kept around 60 degrees.)

In addition to the arterial assessment, the cardiologists take some other measurements, and again there were no surprises here. My heart muscle overall is quite stiff, which is common in HCM. The resting gradient was 30, in line with what we've seen before on echo (remember folks - normal is zero). It spiked to 120-200 after he generated a premature ventricular contraction (a PVC, like a skipped heartbeat) by "tickling" the inside of the ventricle. This is called the Brockenbrough-Braunwald-Morrow sign, and it's just really cool how they do this: they place a catheter with 2 lumens, one in the left ventricle and one in the ascending aorta; force a PVC; and take pressure tracings. Differences in pressure after the PVC = gradient = obstructive HCM. It's what confirmed the HCM diagnosis in October 2008, and I made the cardiologist do it again today just to be sure.

Tomorrow is the last set of pre-op appointments, but no procedures or tests that I'm aware of. Both sets of parents arrive in Cleveland tomorrow afternoon.

Take care,

Michael

1 procedure down, 1 to go

Day 2 @ CC and the cardiac cath went fine. Doc came out to tell me (Jenn), "his coronary arteries look really good" and I told him that was" nice to know, but, umm, he's not here for that!". Michael reminded me that any time they're gonna crack ya open for heart stuff they check first to see if ya need other work too. Good news - he doesn't & we didn't expect any.
Great, so this is like a multi-pack discount or something? This isn't Jiffy Lube & he's not a Camry. ;-)

All's well though, he's resting & likely to get cleared in another few hours (they went in via femoral in groin this time so longer rest-up). More rest tomorrow & appt with big wig surgeon.

Peace
Jenn
Sent via BlackBerry from T-Mobile

And the Grammy goes to ...

With no medical appointments until 12:30, I spent this morning creating a "Healing" playlist from my iTunes library for background music while in the hospital.

I combed my entire library (minus jazz, classical, and other niche themes) for songs that weren't too fast, too loud, or too electric guitar- or drums-heavy, and that preferably had an interesting progression and a soothing vocal presence. I ended up with 169 selections. Here are some of the highlights, as selected by my personal Grammy commitee:

Most Apropos Title (tie): Stitched Up, John Mayer and Herbie Hancock; Fix You, Coldplay
Most Apropos Title (runner-up, also a tie): Better Days, Shawn Colvin (cover of The Kinks version that surpasses the original IMO); Every Breath You Take, The Police
Least Apropos Title (tie): Here's Where the Story Ends, The Sundays; Heading for the Light, Traveling Wilburys
Most Likely to Make Me Crave Something Other Than Hospital Food: Barbeque, ALO (Animal Liberation Orchestra)
Best Provision of Emergency First Aid: Walking on Broken Glass, Annie Lennox
Best Psychedelic Side Effect of Morphine: Life in Technicolor ii, Coldplay
Best Psychedelic Side Effect of Morphine (runner-up): Yoshimi Battles the Pink Robots, Part I, The Flaming Lips
Best Reminder of the Outside World: Snow, Grey Eye Glances
Best Reminder to the Nurse to "Read the %&*#%$ Chart": What's the Matter Here?, 10,000 Maniacs
Best Use of the All-Too-Revealing Hospital Gown: People Gonna Talk, James Hunter
Most Unlikely Inclusion on Pure Musical Merit: When You're Next to Me, Mitch and Mickey (from the soundtrack to A Mighty Wind)
Most Likely to Make My Brother Alex Roll His Eyes in Hopeless Despair (tie): Party in the U.S.A., Miley Cyrus; virtually all of my Jimmy Buffett collection

Welcome to Cleveland

It looks like Jenn may have stolen my thunder, so apologies if this is repetitive.

It's cold, blustery and snowy here, as expected. Fortunately the CC campus is self contained and there's little we need to do outside except cover the 2 blocks between the hotel and campus. And they know from plowing here in Cleveland.

Newark airport was a mob scene yesterday, and that's before the security breach that shut down Terminal C (which, fortunately, we missed). Nevertheless, we made it to Cleveland just about on time and got settled into the hotel - although we had to reject the first room we were given, as it was missing the standard microwave/fridge/kitchenette, but did feature a staggering interspecial variety of molds. Lunch at the hotel, and dinner at Lolita, a Michael Symon restaurant. We'd had this dinner reservation just about as long as my surgery appointment, and it was worth it. Yes, I had the charcuterie and the chicken livers ... please don't tell the doctors.

Today was packed with pre-op appointments. The EKG and chest X-ray went routinely. Next, the blood lab, where I just missed (again!) a fight between two techs, in front of patients. Next thing I knew, there were 25 people waiting and general chaos in the lounge. I finally talked my way into the head of the line (having a preset appointment list helped), and had multiple tubes drawn by 2 different techs. I suspect this isn't the first human pin-cushion impression I'll be doing.

Echocardiogram was next, and I've had enough of these to know the drill and semi-interpret what I'm seeing on the screen as the tech completes the ultrasound. The obstruction (gradient) is still there at rest (35-50 mm Hg), and they gave me inhaled amyl nitrate to simulate stress on the heart muscle. This caused the gradient to skyrocket to 120 mm Hg, and made me feel quite crummy indeed.

Lunch at the hospital cafeteria, which actually was pretty decent. Then the appointment with the cardiologist, Dr. Desai. He went over my test results and the plan of action (surgery), with not much surprise. He did detect a potential abnormality in the papillary muscles, which tether the mitral valve, and is therefore recommending a dual operation: a myectomy and papillary resection. This catch should improve my outcome, and it's the reason I'm at CC instead of anywhere else. In all my echocardiograms (and even a cardiac MRI), until now no one has suggested the obstruction might have more than one cause. Fortunately it should be evaluable and correctable at surgery.

I'm scheduled for a cardiac catheterization tomorrow, and surgical clearance and outpatient visit on Wednesday. I'll post daily with updates.

(Post-original-post scheduling update: the cath will not happen until mid afternoon Tuesday, so there may be little news tomorrow.)

Take care,

Michael

Pre-op Day 1- a.m. 2

Knew as soon as we got it that today's schedule was unrealistically tight. Like those class schedules in HS where you have to go from Calc in far corner, 3rd floor of North Quad to Art on 1st floor West in 3.25 minutes. Our schedule must have assumed no other patients would need same darn tests at same darn time - yah right! It most definitely did NOT take into account the techs in the bloodwork lab getting into a fight, causing a 20 person back-up & as M said "a poisonous atmosphere". Also didn't plan on them "losing" part of M's records, or having them expire b/c this whole thing has been planned so far in advance. Huh.
But it's still the best heart center in the world. :-)
Peace

Pre-op Day 1- a.m.

We're here at snowy CC. And that alone may be our first lucky break because we got out of Newark Sunday before all hell broke loose apparently with some fool slipping past security & shutting everything down. We had to move rooms at the hotel b/c of 162 "suites" with promised fridges, microwaves, etc - we got the only room without! Instead we got a toilet that wouldn't shut up, wet carpet & funk smell. But we're good now.

We even got a stellar meal in last night at Michael Symon's Lolita, with great bang for the buck.

This morning I'm (jenn) doing the sit & wait round 1 while he's off for xrays, labs, then EKG & Echo before lunch break & more appts. Hopefully more pithy & informative posts will follow.
Peace.
JEB

Merry Christmas, a day late

I hope Santa was as generous to you as he was to us. We're now pretty much equipped for the surgery and recovery: loose sweats and sweaters, music, books, crosswords, PS3 games, and a new Ipod speaker system with a remote that I can bring to step-down in Cleveland.

We're in Kentucky, enjoying family and down time. Jenn's brother Patrick is newly engaged, and he and Libby are here for a few days. It's nice to be able to spend some time with her and get to know her - she's terrific (as expected, since Patrick is a man of discerning taste).

My friend Laurie could use your thoughts - she's with her cousin's wife, with whom she is very close, and who is sadly dying of cancer. They're doing their best to muddle through the holiday season. Follow them here, and post a comment if you're inclined.

Take care,

Michael

No news is good news

Nothing seismic to report, but I felt like I should check in. (Is anyone out there?)

I'm wrapping up things at work for my leave. It's going to take 3 separate people to cover all my responsibilities at the office. I don't know what to make of that ... maybe I need to ask for a raise when I get back.

The 'Cats are headed to the Outback Bowl, and so are we! And those who know me know that any excuse to go to Tampa is a good one as long as there's time for dinner.

18 days to surgery, and I'm about as set as I can be. I'm loaded up with medically essential items and books and crosswords. Santa's elves tell me more is on the way, too. It became a little more real last week at the dentist's office, where they signed the required dental clearance; and when my leave was officially approved.

Jenn will be posting here in near-real-time during and immediately after the surgery. I'll have my laptop with me out there as well, so don't expect me to be offline for too long at all.

Happy holidays, everyone!

Take care,

Michael

I (heart) NY

We spent this weekend in New York City, thanks to my employer, which saw fit to name me winner of a contest sponsored by Corporate Communications. They sprung for round-trip car service, one night hotel at the Renaissance at 57th and Lex, and theater tickets. I really do like my company!

Saturday was spent being active: walking the streets of NYC, riding the subways (read: lots of stairs), and touring the Guggenheim (read: long, spiral uphill path - it's an amazing piece of architecture). Then a nice dinner (pretzel-crusted crab cake and "lobster steak", anyone?), and the theater. Sunday morning, a little more of the same.

I find it interesting - and frustrating - that if I pace myself, I can make it through an activity-packed day or 2 like this, but that it definitely catches up with me. By noon Sunday I was beat, and I've been way sluggish since we got home, both physically and mentally.

It's all part of what Laurie calls the "new normal" - a typical touristy day takes a whole lot more out of me than from someone else.

As the surgery date approaches, days like Saturday remind me that I'm better off than a lot of people with this condition. Yay! - I can make it through a Big Apple weekend. But the term "make it" sets the bar a tad low, doesn't it? And let's not even get into the question of exercise, which I used to love, and now equally fear and loathe for the way it makes me feel. Here's hoping the surgery restores my quality of life to the point where I can walk around the city all day and not pay for it the rest of the week.

Take care,

Michael