A Lot Has Happened in the Last Year

(The photo to the left was taken the first week of June when I spoke at Boys State for the 18th time in the last twenty years.)

Hard to believe that one year ago today, almost to the minute, my bypass surgery was beginning. In a way, it seems like yesterday, yet in another way, it is almost surreal.

So much has happened in the last year. There is no way I can chronicle all of the major events, suffice it to say, it has been an interesting ride. Lots of life changes have happened. Some good, some bad, but all in all, it is simply life moving forward.

As always, thanks for looking in on me. Plus, there are no words that can express how grateful I am to the members of my "Levy" family. I love you each one.

This Time Last Year

Just about a year ago, in June of 08, I was experiencing some very "heavy" feelings and other symptoms that at the time I had no idea were heart related. Well, as you know, they were serious warnings. On July 3, I was flat of my back getting whacked on.

This year has sped by. Lots has happened. I'm still having some minor symptoms that I have to keep an eye on.

Sadly, I've put a little of my weight back on, but dad burn it, it's hard to keep off. Especially with the sciatica stuff still lingering.

But, I'm still breathing and working. I will update more here a little later about some of the things still happening.

Thanks again to all of you who have kept in touch.

Steve

P.S. I still miss my little Candy dog terribly. Not a day goes by that I don't think about her and how much she helped me heal. I'm still sad that no matter how hard I tried, I couldn't keep her with me. About two months ago, I thought I was losing my other dog, Babe. She recovered from whatever it was that nearly killed her. She is nearly 13 now and I know that soon she will be at the Rainbow Bridge with all my other little critter friends. They will wait on me. I am anxious to be with them all again. The unconditional love they give is something that humans should learn.

Cardiology Appointment-First Post Surgery

Bright and early this morning I was sitting in Dr. Thomas Conley's  (photo left) office awaiting my first post-surgical visit to him and his lovely and accommodating staff.  

All in all it was a good report.  My lipids are good other than my good cholesterol is just a little low so he suggested I get on the Omega-3 Fish Oil routine which I started at lunch.

He also suggested I re-examine the fact that I have been on Neurontin.  So, I'm off on a research mission before my next visit to my primary care doctor to discuss its use.  It has seemed to help the numbness and tingling but apparently there are some side effects that Dr. Conley would rather I not experience.  

So, it appears things are going well.  I'm still struggling every day over the loss of my little helper dog Candy but time will make it all well.  In the meantime, my big dog, Babe,  and I have been spending a lot of time on the hiking trails of Arkansas.  You can visit a photo album of sorts by clicking here to go to a photo site I'm involved with.  There are some real pretty pictures there you are welcome to use however you wish.

Well, Dang It

It's been a tough two weeks for me and my extended family here. Remember my caretaker family who so graciously allowed me to recover at their home? Well the nurse helper has had some health problems of her own. A little cancer scare but yesterday she got an EXCELLENT report from her surgeon and it appears it was not cancer after all. That's good so she can go on tormenting her patients at the VA. ~~smiling here~~ Plus, a good friend lost their job for reasons so stupid I don't even want to think about it now.

And my little dog Candy died (see post below) which really hit me hard since she was so loved and helped me recover from my bypass surgery. My house has a little less love in it no

w but she was a sick baby and I'd done all I could for her.

About 10 days ago, I started getting some of the same signals from my body that came prior to surgery. Like the numbness and tingling in my face, neck and arm. Crazily enough, 

even in my ear lobes. In the last few days, the numbness and tingling and aching has moved into my left arm. It all sounds like classic symptoms of another blockage to me.

Yesterday I talked with Tami at Dr. Conley's (the cardiologist) and she doesn't seem too overly concerned since I've continued riding my bike and on Sunday took a very aggressive hour long hike over at Lake Ouachita State Park's Crawdad Island Road with no side affects such as shortness of breath or chest pain.

Lake Ouachita State Park is a beautiful State Park about an hour and 15 minutes from my house. My big dog Babe loves it. Since it is deer season here, we have to stay out of the National Forest so no one mistakes me for a big ass bear and shoots my old tired bones.

Back to my heart-- Everyone that talks to me and all the reading I've done indicates you may continue with some symptoms for up to a year after surgery, especially if they harvested your mammary artery (they did). Tami said it may be nerves healing. I've noticed the area in my leg that was so infected back in July is also aching a little lately so it might be the nerve healing thing. I hope. I did have my lipids done and all of my readings are excellent! That alone however, does not mean you could not have problems. Remember, LISTEN TO YOUR BODY AND WHAT IT IS SAYING. YOU KNOW IT BEST.

I'd hate to have to go through this again although one book written by a couple of cardiologists says that up to 15% of bypass patients require further tweaking. You know with my luck, I'll probably fall into that percentile group... I had a follow-up appointment scheduled with Dr. Conley on December 30, but Tami said if the symptoms continue or get worse, to call and they'd move the appointment up.

Other than the loss of my dog and the new little things happening inside of me, things are good. I'm staying busy at the job being part of a huge shift in the responsibilites of the agency I work for. Times are challenging for all of us.

Thanks again for checking in on me, and thanks for the kind comments about the loss of my companion Candy.

UPDATE:
Went to my primary care physician and they did an EKG and prescribed Neurontin to deal with some of the numbness. At least to try and deal with it if it is neurological rather than cardiac.

Also, click here for an interesting CBS report about how having a bad boss can increase your heart attack risk by over 50%.

Been there, done that. My original stent surgeon in 2005 told me there was no doubt my work environment contributed to my issues.

RIP My Little Helper Dog Candy

CANDY 1997-2008

On November 15, 2008 at 5:15, my little helper dog Candy passed away. She had been very sick for about ten days and her kidneys finally gave out. She died at the home of her most wonderful vet, Dr. Richard Allen of North Little Rock. Even though it was to have been a long week-end away for Dr. Allen, he returned early and met me and Candy at his office. She had had a horrible day. He started fluids and was taking her to his house for him to monitor. I carried her from the clinic to his car and I knew in my heart I would probably never see her again.

Ten minutes later, when I got home, Dr. Allen called me and told me that as he arrived at his house and opened the car door to get Candy out to take her in, she took her last breath. Dr. Allen had gone above and beyond in trying to bring Candy back from this sad time.

You might remember that Candy was one of three dogs who helped me during my recovery from the bypass surgery. Candy had so many issues, that she is all I focused on while in the hospital recovering as well as while I was home. She had developed diabetes in 2005 and required daily insulin and monitoring. Then she developed a seizure disorder. She was prone to bladder stones, and, she had more personality than any other five dogs (and most people) that I know.

Here's a post about her guarding us while we slept. Some said she was "mean". No, she just knew what she wanted, knew when she wanted it and pursued whatever it was with great zeal. She fought her way through every illness she had with her great tenacity. She just couldn't beat this last attack on her health, all of the different issues had taken a huge toll on her kidneys.

You always think nothing can replace a loyal friend like Candy, and that is true. Something will come along that will assuage some of my grief however and then I will remember only the happiest of times with Candy and the rest of my critters like Babe seen in the photo to the right with Candy. (This was taken on October 30 and was the last day Candy felt really well. I could always tell if she was feeling good because she would curl up her tail. It hadn't been up since November 3, not even for a second.)

Luckily, in this age of digital photography, I have many many photos of Candy that I will cherish and remember.

She will be waiting for me at the Rainbow Bridge along with all of everyone else's pets.

From The RainbowsBridge.com :

Just this side of heaven is a place called Rainbow Bridge.

When an animal dies that has been especially close to someone here, that pet goes to Rainbow Bridge. There are meadows and hills for all of our special friends so they can run and play together. There is plenty of food, water and sunshine, and our friends are warm and comfortable.

All the animals who had been ill and old are restored to health and vigor. Those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by. The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent. His eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.

You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

Then you cross Rainbow Bridge together....

Author unknown...

I love you Candy. Be happy and warm, we'll all be together again soon.

Middle October Update

If you are not familiar with blogs and want to read about the surgery chapter of my life, go all the way to the bottom of the blog, that is where the oldest entry is.  

All is well with me still.   Thanks for looking in on me.   It's hard to believe the surgery was nearly four months ago.  Steve

UPDATE

Hello again.  All is still going very well.  Back to work and life.  

Both of my legs are still a little numb.  I can't understand why my left leg is numb since they removed no veins from it.  In the book I spoke of earlier it said that the numbness in the harvest leg may never go away but that your brain just logs it away and you soon don't even notice it.  My left one is more numb than the harvest leg!  

Dr. Rayburn was funny on my last visit when he responded to my query about why the leg was numb by saying, "you're just the lucky one."  How appropriate for the way things had gone.

And--now I think I've got carpal tunnel or some kind of tendonitis.  When I extend my left hand and arm a sharp knife like pain occurs on the inside of my forearm between my elbow and wrist.  Holy cow it hurts!  But I'll be damned if I go to the doctor for it.   Any suggestions?  I'm told I shouldn't take too much ibuprofen since I'm on heart meds.  

Message from a great chest cracker!

I found that Dr. Rayburn took the time to comment on the blog-  might I say without his skill it wouldn't have been possible...  Here's his message:

Steve:

I've had occasion to see your blog through the process - many of the nurses would have it up in the ICU at various times.

Great recovery and good heart health in the future. You've been an excellent patient - much better than many (or dare I say MOST). Let me know if you need anything in the future.

Tom Rayburn

Released from Surgeon!

Got a great report today from Dr. Rayburn and his nurse Lynn.  My leg is nearly well and there is no evidence on x-ray of any more fluid build up in my chest.

He gave me the routine, "stay on a diet to manage cholesterol, keep a close check on your blood pressure, stay on statin drugs, get regular moderate exercise and keep on truckin' " speech all doctors are required to deliver. 

While I can tell I'm not back to 100 percent yet, I have been riding my stationery bike between 20 and 30 minutes a day and have lost over 30 pounds since this started.  My blood pressure is under control and I am on Zocor (statin).  So all in all, everything appears to be in good shape.

Thanks for all of your support and riding with me through this trip.  I will leave the blog up and will post as anything pertinent happens.

Rayburn released me back to the care of my regular cardiologist, Dr. Tom Conley.

Today's tip-  after the surgery be prepared for several weeks of the weirdest dreams you've ever had.  Some of them that I had were quite entertaining, others were quite disturbing.  Several people I've talked to that have had the bypass surgery all experienced these so it must be a fairly common thing.

Again, thanks for your interest and kind words and thoughts.  

Headed Back for More X-Rays This Tuesday

This coming Tuesday I am going back for another chest X-Ray and a visit with Dr. Rayburn to see how things are progressing. 

I've not been suffering from any shortness of breath (aka dyspnea) or other symptoms I was told to watch out for concerning the pleural effusion.  Hopefully that means they won't have to cram a needle in my back again...although it was sort of cool seeing all that stuff draining out of me.  

Also, I bought a great book yesterday called:

"Your Heart:  An Owner's Guide"  by John A Elefteriades, MD and Lawrence S Cohen, MD

It's a great guide for those about to have any sort of heart surgery as well as for those of us who've already paid our dues on the surgery slab.  

One thing I learned is the "bounding" heart I feel when I'm still or am in bed is a normal thing. Of course my worry-wart self was thinking the worst, you know, I was about to break back into atrial fib or something even worse.  According to the book, lots of people go through it.  There's lots of other tidbits in it too.  It's really a must read for patients and their families.

Ok, shameless commercial plug over with.  

Back to Work and Happy as a Pig in Slop

Started back to work Monday and all is going very well.  It is nice to be back in the swing of things and doing what I do best...sitting around issuing all sorts of wisdom.  Plus, I've lost 30 pounds since all of this started and I'm determined not to put it back on.  Energy level is great and I'm taking it easy.  

Drain Day

So today I report to Springhill for the doppler (top photo) to see if there was fluid on my chest as Dr. Rayburn suspected a pleural effusion  Boy was there.

The second photo from the top shows the drain actually in my back.  The next photo shows radiographer Jennifer after she removed the tube.

Finally, Radiology Techs Wendy (l) and Jennifer display the liter and half (about 50 ounces) of fluid that was removed today.  They stopped at that amount even though it was still draining.  This is standard since they don't want too much to drain which could cause complications with the lung. The procedure was only slightly painful, but it was an odd feeling as the Doctor fished the tube around and there is some residual uncomfortable feelings a couple of hours post-procedure. The leg drain (see below posts) was actually more painful.

I learned today that this is a fairly common event when you have chest surgery and chances are, unless my body can deal with any more fluids, that I will have to go back for another thoracentesis.  A second one is also a fairly common occurrence according to Wendy and Jennifer and about every nurse I spoke to.  

Dr. Conley, my cardiologist, dropped in to see me and told me the same things.  So, if you are preparing for a CABG, be prepared for these speed-bumps in your recovery.   

But, on a positive note, I get to go back to work Monday!

Thursday Surgeon Visit

Today Dr. Rayburn, the heart surgeon, found a possible pocket of fluid on the chest x-ray they took. He said this is a common occurrence (and if it can happen it will happen to me) after heart surgery. He did say my leg and my chest are looking very good however.

I go in tomorrow for another ultrasound, this time of my chest. If it determined there is fluid then they will perform a thoracentesis, which should be an outpatient procedure.  It will be an ultrasound guided procedure which according to this article is a little safer.

He did clear me to return to work on a limited basis Monday so at least it appears he is not real concerned about this new glitch in my git-along. It's a little disheartening because I've been being very good and following orders. Oh well, such is life. I will keep you posted.

Tuesday Update

My follow-up surgeon's appointment had to be moved to Thursday due to an emergency surgery Dr. Rayburn is having to perform.  

The antibiotic I'm on has some side effects I don't like.  It dries out your mouth and effects the taste of food.  I'm not sure if it is causing my blood pressure to spike or not, but the BP is becoming somewhat of a concern to me.  I'm monitoring it very closely and working with Dr. Conley, my cardiologist, on tweaking my meds.  I've heard that after bypass surgery it sometimes takes a while to get the BP leveled back out.  I only have a couple more days on the Zyvox (antibiotic).

Blood pressure is something that everyone should monitor very closely.

A Little Sunday Leg

Here's a shot of the leg on Sunday afternoon.  It's looking, feeling and doing a lot better.  You can scan down a few posts to see how it looked last week.  I'm happy with the progress and I hope Dr. Rayburn will be as well.  Again, thanks to all of you for your support and thoughts.  This has been quite an adventure.  

Update--Friday

Been home from the leg debacle for a few days now.  Dr. Delap put me on the antibiotic Zyvox for a ten day run.  This drug for twenty pills cost $1700.00 at Walmart.  I am one of the lucky Americans who has a fairly good health policy and my co-pay was only sixty bucks.  I just can't imagine someone without insurance having to make these purchases of life-saving drugs.  

I'm having to keep my leg wrapped in an ACE bandage and that really is uncomfortable but I was told it is important to keep the fluid from coming back.

I'm also having a little trouble getting back into a regular sleep cycle.  After all, being in the hospital for a total of about 3 weeks gets you sort of messed up because as you all know, you do not get to rest in hospitals.  They are in every other hour for something or the other and that sticks with you.  

Hopefully, I'll be back on track soon.  I go to my chest surgeon's office on Tuesday for my follow-up visit and I think I will be released on that day to go back to work at least on a part-time basis and I can hardly wait for that.  Being off work without pay isn't too good of a feeling.

HOME

Got home about 2 PM.  More to follow.

More Monday

I went and had the leg wound drained.  They got out a bunch of goo and left this drain in place and said it would be in a week having to be flushed 3 times a day with strict instructions not to get it damp in the slightest way because if it got wet it was almost a sure thing that more infection would set up shop.

Then Dr. Rayburn came in to see me and he said, "I'll be taking that drain out tomorrow, you don't need it."  To which I said, YAY!  Then Dr. Delap came in and said that she would be examining the fluid they removed to see what sort of oral antibiotic I should be placed on upon discharge which in all probability will be tomorrow after she and Dr. Rayburn confer one more time once they review all the lab results.  The good news from both of them is that I should be able to return to work next Monday!  Which is great news for me--and my creditors.  

Now, if Dr. Delap finds some bacteria or infection she doesn't like, Dr. Rayburn will have to open up my leg which will have to be left open to allow it to heal from within.  I'm hoping against that, but the way my luck runs...Anyway, keep thinking positive thoughts for me.  I want out of here in the worst way.

Oh yea, the best thing that happened today?  I talked Dr. Rayburn into ordering me a regular diet rather than the horrible low-fat low cholesterol thing I have been on!  Not that the "regular" diet is much better.  I do have a friend bringing me a chocolate Elvis from Planet Smoothie this afternoon and I can't hardly wait.  

Quick Monday Update

Photo taken Sunday of RN Safonda flushing my PIC line after they finished with a round of Vancomyicin

Dr. Rayburn's nurse Lynn came in this morning early and has ordered another doppler scan of my leg.  If fluid is present they will try a needle aspiration.  Then, knock of wood, I'll be going home with orders to wear a leg stocking and will be placed on a strong oral antibiotic.  This is the best case scenario and it is what I KNOW will happen.  I'm so ready to be out of here.  I've been in nearly as long for this leg business as I was for the actual bypass, which several folks up here tell me happens a lot.  You'd think they could figure out how to prevent it.

I'm also waiting on Dr. Susan Delap to come in and give her final thoughts about all of this as I had a very good feeling about her abilities and I respect her knowledge and forthrightness.  I'd hate to get out of here without her looking at all my latest lab work and chart from over the week-end.

More later as it develops.

10:30 AM update-  The ultrasound shows I do need to have some fluid drained so I am back in my room awaiting the call to come to the "specials" room in radiology to have this procedure done.  I'm also still waiting on Dr. Delap's visit and don't know if it will be before or after the procedure, which I also don't know the timing on.  Hospitals seem to be "hurry up and wait" in nature.

Sunday and Nothing New

Well, it's Sunday, my fourth day in the hospital with this leg infection business.  I have had so much antibiotic that if a flea bit me I'm sure death would be in short order for the little critter.

Dr. Martino was in this morning but no decision has been made.  My blood work will be done later today to see how my white blood cell count is and so forth.  The leg appears about the same.   Dr. Rayburn should be back tomorrow.  I know this though, I'm ready to get out of here but must abide by what those much smarter than me think and say.  I just know I miss my dogs...and my friends.

Afternoon Update:  Dr. Delap's partner, Dr. Hammack was in this afternoon to take a look at things.  He said it looks as though it is progressing and explained the process a little more about the antibiotic therapy.  Dr. Delap and Dr. Rayburn will be in tomorrow morning and will be making the final decision about what is going to happen.

The IV

RN Steve prepares to start another dose of "Zosyn" antibiotic which I get three times a day and probably will through at least Monday. I learned this afternoon that Dr. Martino had come in this morning fully planning on cutting my leg open and draining the wound creating a whole new scenario, but after examining me, he opted to continue with the current line of treatment. I am glad for this and hope all continues to go well.

He's got legs and he knows how to use them--sort of

Here's a photo of the reason I developed a high fever on Wednesday. Apparently there was a high powered infection cooking in my leg where the veins were harvested. It had probably been cooking for a while and finally boiled over on Wednesday requiring hospitalization.







In photo to the right RN Safonda cleans up the leg in preparation for examination by the surgeon (photo left), Dr. Martino who was taking call for Dr. Rayburn who was out of town. A lab tech also prepares to draw a blood sample.

In the photo below, Safonda continues her clean-up of the draining wound.

I was then taken to surgery where an indwelling PIC line was placed so I could be zapped with heavy antibiotics which is going to be the course of treatment. I will probably be in the hospital until at least Monday to be sure the infection is nipped in the bud. The surgeon called in the infection doctors who are consulting closely about the cause of this little speed-bump.

Dr. Delap (infectious disease doctor photo right) said this just happens in some cases, and of course, I drew the short straw, but it does give me more stories to tell. Her advice was just as the surgeon's, we will just keep taking on antibiotics by IV before a decision is made to surgically intervene.

Day 20 post surgery

All is apparently still good. My blood pressure is getting a little high mid-morning and they may make some adjustments in my meds. Also, my leg where the veins were removed is a little more sore and stiff this morning than it has been. Probably just healing. It's less than a week to my first follow-up appointment with Dr. Rayburn. I suspect I will learn much more about timelines and such on that day.

UPDATE: Well, things weren't so good. About 11 AM on Wednesday I developed a fever of 102.5 and by 9 Wednesday night I was once again staring at the ceiling in Springhill Baptist Hospital's Clinical Decision Unit.  The photo taken by a friend shows my unhappiness at being banished to the hospital again.  But, wadda ya gonna do you know?

Sleep and Thoughts and Thanks and Hugs

I actually got a pretty good night's sleep last night and it was the first night in a bed since the surgery (19 days ago now).  I didn't have to put my feet up, but still had to sleep on my back.  The only drawback was the Cyclops dog, Candy, she wanted up about every two hours to go on "bug patrol".  She is quite the bug chaser and I guess the heat has driven some bugs from the outside to the inside.  So, up and down and up and down.  It was sort of like being back in the hospital with one of the nurses coming in every two hours for either blood, vital signs or just generally to be sure you weren't getting any rest! 

Anyway, it was the beginning of some good nights I hope.

On another note, if this surgery is looming for you or someone you love, fear of the unknown is going to be natural.  You will worry yourself sick over things you really can't control.  You will read about all the bad things that can happen and so forth.  My advice is to take them into consideration and brush them off because the outcomes now-a-days are so much better than before.  This surgery is almost like an assembly line.  Each person does have their own risk factors though, such as diabetes and smoking and a completely sedentary lifestyle, but those are in your hands generally.  Maybe one day we will eliminate the need for any sort of heart surgery.  The younger your age when you start doing the right thing in your life, the better off you will be as you get older.

Thanks again to all those following me through this and I know your prayers and positive thoughts have been instrumental in making my progress so speedy.  And don't forget, tell those you love that you love them every single time you see them.  Hugs help too.  People need hugs.

Sleeping at the U and the Leg Vein Removal Progress

One thing to be thinking about if you are going to get this surgery done, you will be sleeping at the U.  Or at least in the U position.  You will have to have your head and shoulders up and if you develop swelling in your feet and ankles, they will have to be above your heart.  I've learned to become a contortionist in my sleep and you will too.   My ankles and feet swelled up like a water buffalo earlier this week and by getting them above my heart, it was gone overnite (along with 6 pounds!)  No kidding, I lost six pounds overnite and I'm sure it was related to the loss of the swelling.  I was one step away from getting me a pair of those fuzzy slippers and dragging around Kroger shopping.

And here is today's photo of the progress my leg is making.  Remember this is where Dr. Rayburn removed some veins to use in my bypasses. 

Ouch

Yesterday I must have twisted a little funny which put a torque on my sternum which in turn sent shooting pains.  Ouch.  Did I learn a lesson there.  Other than that minor temporary reminder to be careful all is still well.  

After Sunday, I will be on my own with no helper but the pups.  We will see how that goes.  After about a week of that, I go to the surgeon for a follow-up on July 29 and will see what sort of clearances they give to me then.

Puff Puff Puff

Today is day 15 after surgery and I am doing well. 

One of the most important aspects of recovery is getting your heart back into shape.  I'm up to 8 minutes three times a day on the treadmill.

Next week, I'll be switching to the recumbent bike.  I'd love to get out in the woods, but folks, if you ain't from Arkansas, we're now in the 3H time of the year, Hot-Hazy-Humid.  

The heat index will be running in the 105 range from now until Christmas. (Well, not really, but it seems that way.)

14 days ago

Here's the "zipper" scar this morning, exactly 14 days after surgery.  Everyone who sees it says it is progressing along nicely.  

All's Well on Day 13

It's day 13 post surgery and things are moving along nicely.  Doing about 6 minutes 3 times a day on the treadmill since it is much too hot to get outside to walk.  Soon I will add time on a recumbent bike to the mix.  

Still having some pain when I cough but my lungs are all clear and I am sort of getting used to sleeping on my back in a recliner.  The pain meds I take usually make me break out in a sweat. Lynn, Dr. Rayburn's nurse, says this happens to some men.  (It is only natural it would happen to me.)

The dogs are driving me nuts leaving me no time to get depressed.   You know, "let me in, let me out, no let me in, no let me out," that routine I'm once again enjoying a cup of coffee in the morning, although it is half caffeine, half caffeine free, it beats nothing.

Blood pressure seems controlled by the Toprol XL.  I'm no longer taking Lisinopril or HCTZ and that evaluation will be made as time rolls along.

Thanks for keeping up with me.  S/

Like So Many Americans

Cardiac Rehab seems to be something that everyone in the medical field feels is important, and I agree.  The rehab is a series of meetings (3x a week) where you go to the facility and you exercise and receive classes in nutrition and basically, just getting back into the groove.  It is expensive at $125.00 a visit, less of course, what your insurance might pay.  In my case, my share would be between $30 and $45 per visit.

But, here's the deal.  In March I changed from one job to another.  When I left my old job, I had to give back hundreds of hours of sick leave.  I have no sick leave built up at the new job so essentially, I am on my own during recovery until I can get back to work.  I simply will not be able to afford my share of the rehab so I must forego it until I get back on the job.  

Essentially, I will have no income at all until I return to work.  I will have to use every penny simply to make my bills.

I am thankful that I will still be covered by my health insurance but I will have to make the premium payment.  I am luckier than most.

The state of our health care costs in this country are a major contributor to the reason many people find themselves in dire straits.

Here's my "mansiere" or "bro" (Thanks Seinfeld)

Here's the nifty little gadget I got while still in the hospital.  You put this on similar to the way you put on a back pack and tighten it down using the velcro straps.  The two hard plastic handles near the bottom of this are used to pull your chest walls together when you move, or feel a cough coming on.  This prevents you from having to carry a pillow around when you are mobile.

I've been doing well on my weight and it is important you weigh in each morning to be sure you are not retaining water.  Since being home, I've lost a little over a pound a day and I am eating well, trust me.  Lynn gave me the "30 day" dispensation and told me to eat whatever I wanted for about a month before I get to the serious diet.  

Even with that, I've still be kind of careful and am already adapting to a heart healthy diet.  I figure if I super size everything for a month it will just be that much more work to start taking it back off.  A couple of friends did do up some great steaks and baked potatoes this past Saturday and it was a wonderful meal.  Today is the 11th since my heart was in Dr. Rayburn's hands.  

Rayburn's Discharge Instructions

Here are the instructions given to me when I left the hospital.  Today is Day 10 post surgery.  Pretty amazing.  In lieu of one of my treadmill workouts today, I opted to people watch and shop a little at Walmart.  All went well with that.  

I am sure each surgeon uses some variance of these discharge instructions.

Discharge Instructions For
S. Thomas Rayburn, M.D.
Office: (501) 223-5757
Medical Exchange: (501) 663-6900

RETURN OFFICE VISIT:

You will be seen back in Dr. Rayburn's office in approximately three weeks. An appointment card is on your chart and will be given to you the day of discharge, along with your prescriptions.

INCISION CARE:

Chest Incision:
⁃ You may shower. No tub bath until you have been seen back in our office
⁃ Watch for any drainage from the chest incision. Call the office if this occurs.
⁃ You may have drainage from the drain sites. This is okay.
⁃ You may have a knot at the top of your chest incision this is normal and will disappear as healing occurs.
⁃ Do not use lotion, powders, creams, or ointments on your incisions.
⁃ You may also have shooting pains, numbness, and tingling from your incisions as the tissues heal.
⁃ Sutures will come out or dissolve on their own, steri-strips (paper tape) will be placed where the sutures came out. Wash over these, if they come off, do not replace. If they remain longer than 5 days, your must remove them yourself.
Arm & Leg Incisions:
⁃ You may continue to have some drainage form these incisions for several days after discharge. Your arm or leg may swell for several months after the surgery. This is normal. Typically, swelling will increase as the day goes on but will diminish over night; however, it probably will not totally disappear during the night. You need to call if they feel hot or turn bright red. Elevate your arms, legs and feet while sitting. Remember to reduce swelling, you must elevate your feet higher than the level of your heart.

INSTRUCTIONS:

⁃ Do not lift anything heavier than a gallon of milk (8-9 lbs.) until you have been seen back in the office.
⁃ Do not drive a car or other moving vehicle until you are seen back in the office. You may ride as a passenger in a car. Do wear your seatbelt. In fact, we encourage you to get out.
⁃ Appetite may be decreased for a few weeks. Eat small meals several times a day.
⁃ You may feel depressed after you get home, this feeling is normal and temporary. Set yourself a schedule, stay active, get up, shower, dress, and do a few small task daily.
⁃ A low grade fever is normal. We do not need to be contacted unless it reaches 101 degrees.
⁃ You will be tired. We want you to stay as active as possible. But it is not unusual for you to tire easily. Do not be discouraged, your strength will return, but it will take some time. Meanwhile, while you are tired, STOP AND REST. When you feel better, resume your activity.
⁃ Shortness of breath is normal. It should get better when you rest. Call with any increased shortness of breath or if it does not go away with rest.

EXERCISE:

⁃ You may begin exercising the day after you go home. Walk 1/4 mile twice a day. Try to increase the distance you walk from week to week by 1/4 mile. Listen to your body. Pay attention to what it is telling you. If you are exercising and you feel your heart start to beat really fast, you get short of breath, or your knees get weak, you know you are doing too much. Stop and rest. The next time you go for a walk, do not try to go as far. Steps and stairs are okay too.
⁃ Watch for signs of over-activity. If any occur, they are your body's warning signals that you are overdoing it. Simply slow down and rest.

SIGNS OF OVER-ACTIVITY

1 Pain or discomfort in your chest or leg.
2 Shortness of breath
3 Unusual fatigue
4 Pounding or skipping heartbeat

MEDICATIONS:

Your prescriptions will be given to you prior to leaving the hospital. You may or may not have changes in the medicines you took before surgery. You are to only take the medicines outlined for you at the time of discharge. Please do not change or stop taking any medicine without a physician's approval. Pain prescriptions will not be refilled on weekends.

If you have any questions or problems our telephone numbers are listed at the top of these instructions. We ask that you first re-read these instructions. We then ask that during the week you call the office. If it is after hours and your problem can not wait until the next business day, you can expect to be sent to the emergency room.

Atrial Fibrillation

While still in the hospital one evening, I noticed my bed was shaking.  It wasn't the New Madrid Fault...it was my heart nearly pounding out of my chest.  My heart rate reached and held in the 160s for about 30 minutes, then fluctuated between 90 and 140 for a few hours.  It scared me senseless being as how Dr. Rayburn had only recently stitched in bypasses.  

Turns out atrial fib is something that effects 1 in about 3 patients nationally and about 1 in 6 or 7 of Dr. Rayburn's patients.  

I will tell you this, every single nurse handled this with the greatest calming skill.  They made me aware I was not in any danger and began treating it immediately.  Over the next couple of days they kept me on both oral and I.V. meds to deal with the anomaly.  I left the hospital with a thirty day supply of the oral medication (Pacerone) to treat it and more than likely, after my follow-up visit on July 29, I will be removed from it.  Knock on wood, I've not had a problem with it and this is day 9 post surgery.

If you are reading this, and are undergoing CABG, be prepared for this quite scary, but common, heart arrhythmia.  

Hard Lesson Learned and Sugar

No matter how macho you are, or at least think you are, do what the professionals tell you.  Even if you think you feel great, don't over-do things.

I've been pretty independent all my life and certainly want to return to it, but this recovery from major heart surgery is a science and the pros know the ropes.  

Take frequent breaks, drink lots of water.  I'm swollen up like a water buffalo and this is a natural part of the process.

The photo was taken after a trip to a couple of places where I spent a little too much time walking and shopping.  Believe me, I paid for it.

My little cyclops dog likes to sit next to me when we're resting and I dare you to get close.  One eye and all, she is like Cujo when you interrupt our sleep cycle.

Notice the heart pillow?  It's a nice little "take-home" when you leave the hospital. All my RNs signed it for me.  Now, it's purpose?  You've got to use it when you cough, or sneeze or do anything else that might cause pressure on your chest walls.  It is also used when you rock yourself out of a chair or the bed.  I also got a "mansiere" and a photo of it will follow.

I mentioned the other day about them giving me insulin while in the hospital. This, of course, required them checking my glucose levels several times a day.  In the photo they are sticking me yet again.  This went on all night long too.

The reason?  Dr. Rayburn is a firm believer that high sugar levels in you promote infection.  Most surgeons, as I understand it, only keep you on the insulin for a couple of days post surgery, but I got a shot only several hours before discharge. Most everyone I spoke to had high praise for Rayburn and his "cutting edge" philosophy.  

Before & After & Having a Heart

Many of my friends have always wondered if I have a heart. Here's proof.

These are a series of photos from my surgery exactly one week ago this morning.

I won't pretend to know what is happening in each of them but I know that it is an amazing thing.








From now on, when one of those peace oriented sorts tell me to "look within", I can truly say, I have, literally.










This photo is how the scar looked DPS (day post surgery) 6.

All of the incisions under the primary vertical incision are from various drains and tubes that are placed and removed day by day after surgery.

Since I'm getting to shower now, I am finding other places where some sort of tubing was attached.




And here is the site on my leg where Dr. Rayburn removed vessels to use during my patch-up. He did the endo version of vessel removal (see previous post) and I can't imagine having an incision running from my groin to my ankle. Dr. Rayburn is an amazing man with amazing talents.

I'm not going to pretend it is a walk in the park. There are up days and down days. My advice is to listen very closely to what your care takers tell you, especially if one of those is RN Lynn, Rayburn's nurse.

This case is fraught with weird connections. It turns out Lynn's father is an old police friend of mine from my days as coroner of Pulaski County.

Once I discovered that, I understood her character completely! Just listen to them when you get out. Read your very detailed discharge instructions and don't expect them to treat you like a baby, even though some of us need a little of that from time to time.

Next blog I'll re-visit the hospital and talk through some of my various tests, for example like; why did they test my blood sugar and give me insulin everyday I was there even though I'm not a diabetic. S/

People Helper Puppies

Feebi crashes after her first night with the patient they are helping out with. It was a tough training session for this little "Duck Toller". She's the baby of the three dogs.

Feebi belongs to my principal after-care family where they have so un-selfishly agreed to let me recuperate. Plus, Feebi's granny is a nurse which comes in very handy!

She is a rescue dog too, and it was only recently discovered (thanks to RN Brent) that her breed is a "Duck Toller".


Babe is just as worn out. Babe rescued me in July of '98 and is one of the best hiking companions I've ever had. In 2005 I spent 2500.00 on the installation of a titanium knee after she blew it out.


Candy is the dog that RN Jonathan nicknamed "Lucky" and here's why-- In February of 2005 it was discovered she was diabetic. That requires her to get 26 units of insulin a day.

Also in February of '05 she went blind in both eyes. That was another 2500.00. She is prone to bladder stones and has had two surgeries to remove those, the last one this past March and there were 32 stones one the size of a quarter.

During that surgery she developed complications in one of her eyes and I had to rush her to Memphis to try and save the eye. It did not work and she now only has one eye (her nickname in the neighborhood is "Cyclops"). In December of '07 she also blew out a knee but since she is 11 and doesn't do any hiking, I opted to just let her limp. Oh, and she also has arthritis in her back. She gets a nightly NSAID for that.

Plus, last year, she started having seizures. So there, her name should indeed be "Lucky" but she is my baby, whadda ya gonna do? I know all her doctors (and their creditors) surely love to see us walking in the door of their clinics!

A big part of recovery is dealing with depression, my dogs are helping me do that.  Keep your mind busy with positive things.  That's why I chose to journal this period in my life.  

KNOW WHY THESE THREE GUYS ARE SMILING?

Here are three of Baptist Health's best. RNs Brent, George and "Big Russ" who appear very happy on this morning during report. (Brent is a day nurse and George and Big Russ are overniters).

Russ is my first night's nurse, the one who recovered me and got me through the first night after surgery. Brent took care of me most days (including removal of the dreaded pee tube) and George was my final care taker on Monday night.

Why are they smiling so largely? Because my ass was going home and they were happier than me about that!

Seriously, thanks to each and every one of the people in the cardiac unit. More will be following. I'm off on my first day's little excursion for a couple of blocks.

I'm HOME!

Got out before noon.  I'm a little tired (natural reaction) today and will be posting a long blog tomorrow morning.  Thanks for your thoughts, prayers and words of kindness.  Now I'm off on another HUGE leg of this journey of mine.  S/

Steve gets ready to leave

I don't know who is more ready for Steve to leave the hospital. Steve himself, or the nurses. Here is Jonathan, R.N. for days two and three, "checking" Steve's pulse.

Otus the Head Cat Sends Letter

Mr. Steve,

Owner informs me you only had to endure a double bypass. Sadly, that precludes you from joining the Quintuple Club wherein belong Owner and David Letterman and many other distinguished folks. Note: Acclaimed French actor Gerard Depardieu is our Euro President. Hisquintuple was performed in 2000, the same year as Owner's.

No. No. I'm sorry. We even turned down President Bill when he could onlypull a quadruple. Regis Philben tried to use his previous angioplasty to score
"frequent flyer miles" toward the Quintuple Club, but his triple bypass didn't even get a glance from the membership committee. Neither did Henry Kissinger's trey.

They had to let Larry King in after his quintuple, but nobody likes him much and they took him off their Christmas card list.

The admissions committee has been extra vigilant since it accidently allowed Star Jones to join after her bypass surgery only to discover it was gastric bypass. All bypasses are not created equal.

I can, however submit your name to the jolly "I Survived a Urinary Catheter" club. They have neat T-shirts and ball caps and a secret handshake that, frankly, I find a bit too intimate.

At any rate, a speedy recovery to you and thanks for your blog site. The first-hand account should be distributed to others facing your situation. It puts a human face on the ordeal and would go far to ease trepidation.

I remain,
Yours in Kalaka,

Otus the Head Cat.




Michael Storey
TV Columnist
Arkansas Democrat-Gazette

In the first 24 hours...

This is only an abbreviated history of Steve's first 24 hours at the Hospital. I'm sure he will expound upon the events when he gets back online.

Steve started the morning out bright and early with these lovely faces. Jancie (right) was Steve's Pre-Op nurse, preparing him for the surgery. Leigh and William (left and center) were part of the surgical team.







Dr. Rayburn during surgery, which lasted more than four hours.






By 1 pm, Steve made it to his room in CCU where he was dutifully cared for by Melissa (left) and Stephanie (right). Apparently, Steve was "wild" coming out of anesthesia and had to be sedated throughout the evening.
















By morning Steve finally came-to and had the breathing machine removed. By lunch, Dr. Rayburn had come by and explained the surgery and the recovery process. Dr. Conley paid a visit. And by dinner, Brent (Steve's day one nurse) had Steve sitting up in a chair for over an hour.






And, of course, Steve quickly jumps back onto his blackberry to catch up on anything he missed.

More to follow...

SSS/

Update

STEVE'S SURGERY WAS A SUCCESS

The surgery lasted more than four hours.  Dr. Rayburn decided to only do a double bypass rather than a triple or quadruple bypass.  All signs are positive.  More updates are to follow.

--Steve's Support Staff.

I Should Be Under

As this posts, I am under the knife and care of a group of dedicated strangers.  I hope there will be an update posted here by 3 PM Central time.  Thanks for your prayers and thoughts.  Steve

Keeping Up With My Homework

I've been keeping up with my breathing exercises on the little gizmo (left in photo) sent home with me last week. I can only imagine how this is going to feel after the surgery tomorrow.

The bottle of Hibiclens was also given to me when I left from my pre-testing day last Thursday. I was told to bathe with it both the night before surgery and the morning of surgery. I guess that's my share in reducing the possibility of introducing germs into the hospital surgery suite.

UPDATE: I was called back in to the hospital for some more pre-testing. Another chest x-ray and more blood work and another EKG since it will have been a week since my last pre-test and the rescheduling of surgery. All should be good to go for in the morning.

Wish me luck.

A Funny Note From My Friend Michael Storey of the Arkansas Democrat-Gazette

Michael Storey, of Otus the Head Cat and Television Column fame at the Democrat Gazette dropped me a nice note, I thought you would enjoy it:

Steve,

I passed my dreaded annual stress test yesterday. Dr. Tilley always makes
me pedal harder than I think humanly possible, then tells me that was the
pace kept up for six hours by the Tour de France guys.

Yeah, but I've got 30 years and about 100 pounds on those freaks of nature.

It's been seven years since the quintuple bypass and I'm still feeling healthy.
Clean living and pure thoughts are credited.
I've still got to get the body mass index down. It's harder to lose weight
taking the lopressors or whatever they are. The metabolism and heart rate
just doesn't get up as high as it did when I was 30. Or 40 or even 50.

Well, maybe 50.

At any rate, I'm headed to Beverly Hills on Sunday for 17 days in a hotel
previewing the new TV shows and chatting up comely starletts. I'll still
try to find time to take a brisk walk every day, although they look at you
as if you are some sort of alien freak or up to no good if you are afoot
in Beverly Hills.

I fully expect that by Sunday you'll be ready to be shuffling up and down
the block. I still recall the sense of accomplishment when I walked to the
end of the street and back after my surgery. Since then I've walked the Oklahoma
City Marathon and the Tucson and Little Rock half marathons. I've given those
things up for hiking because a marathon takes me 8.5 hours at a brisk walk
and I've already proven I'm crazy enough.

I'll be following your recovery from my balcony overlooking Beverly Hills
High. The pace is hectic - 14- and 15-hour days, but us grizzled ol' press
tour vets know how to pace ourselves.

Best of luck with it and don't refuse any pain killers just to be macho.
And try not to throw anything at the dang respiratory specialist who'll pester
you about every half hour to blow into a tube.

Onward,

Michael
Michael Storey
TV Columnist
Arkansas Democrat-Gazette

It's In My Jeans...err, Genes

As I mentioned in a previous blog, don't assume because you have good numbers on a cholesterol test that you are in the clear. A great deal depends on who your family was and what their medical history is.  

For a 56 year old, my lipid numbers in February were excellent, yet these symptoms of Coronary Artery Disease (CAD) began appearing not long ago.

They've actually been building in me for years. Even being on a statin drug since February of 2005 only slowed the process.

Plus, I wasn't really controlling the controllables, like keeping my weight down and getting the right amount of exercise.  

I had recently changed jobs and the new one required lots of sitting and reading, this is a habit you fall into.  Be careful.  Eat right.  Walk a little more.  Keep up with your blood pressure and most of all, listen to your body.  In March of 2006 mine was talking to me and I ignored it thinking I was suffering from either heartburn or just nervousness.  Dr. Conley offered to do a heart cath back then but I opted out of it.  What is that they say about hindsight?

More relaxing and reading in store for today.

Last Cup of Joe For a While I S'pose

This morning I enjoyed my last cup of coffee for probably what will be a long time.  I know the pre-surgery instructions given to me say that there should be no-caffeine for at least one day before surgery, but I'm stopping now.  

I'm feeling pretty good, same sensations still, no pain but I'm already bored having to just sit around on the "big wait."  

Relaxing with the BP of a teen-ager

Yep, that's 90/56. It was actually this morning, the date on the machine has always been one day fast and I can't fix it.

Been feeling ok. Still have the tingling and numbness with a little light-headedness that passes quickly. Just sitting and waiting mainly. Not able to do much per the doctor. I have studied all the books and other data provided so I am ready as one can be.

I will just spend the next few days hanging out with my dogs and reading. Come on Thursday...

The Packet

On my pre-test visit last Thursday, Baptist Health provided me with a packet full of information for patients and family. The booklets are done very well and provide day by day and week by week expectations.

This is going to be a difficult but worthwhile experience. As everything in the packet says, it's basically one day at a time that you must handle with great resolve.

Much of your recovery is in your own hands. Perhaps this delay is good. I am going to start using the diet recommendations in my homework packet. I am also practicing the methods of getting in and out of bed and a chair that they suggest will be necessary while recovering.

I just can't imagine a family or patient faced with a CABG immediately with no time to prepare. It must be very scary. At least I am having time to research every nuance of this surgery which is done about 500,000 times a year.

In the meantime, the tingling and numbness in the face comes and goes as does some left arm pain. It's more worrisome than painful. I was told to not do much and stay in. Don't worry.

I was a little bad last night because a group of old friends came calling and of course there was dip and chips and other horrible finger foods to be had. I did however eat lots of grapes too, so at least it was balanced. I'm so bad.

CRAP

Wouldn't you know it, after being all psyched up and ready to go, today Lynn from Dr. Rayburn's office called and due to the fact that a patient who has suffered a heart attack, and subsequently is in a greater need than myself, has presented to them, my surgery has been delayed to Thursday, July 3rd.

This sucks but there is nothing that can be done about it I guess. I do wish this patient the best.

At least it must mean I'm not gonna drop dead, or at least they don't think so. If there are any changes, I will post an update.

Tests a Success

I aced all my tests!

The photo of me to the left is after I scored in excess of 100% on all my Pulmonary Function Tests. I never made an A+ on a test before.

If you've never had one, they are interesting..."breathe breathe breathe BLOW!" ordered Respiratory Therapist Miss Kathy. When we were done, she said I scored nearly 120%. Not bad for an old broken down coroner.

Here's Therapist Kathy exclaiming, "these are wonderful numbers." She was such a pleasant person and made this frightening adventure a lot better for Mr. Nervousosity.


She even gave me homework-- a breathing exercise machine called a "volumetric exerciser" that she said Dr. Rayburn likes his heart patients to "practice" with since it will be important after surgery to start taking big deep breaths almost immediately. So be it.

Yeesh. Here's what I was dreading, the ABG (arterial blood gases). This test requires arterial blood rather than venous blood. Ouch.

But Kathy actually did an admirable job of keeping me occupied while she gingerly got the 5cc of bright red blood she needed.


Next, the doppler on my carotids. This is one that I was fretting over because had I failed, Dr. Rayburn would have had to do a procedure to clean out and open my carotids. Michelle was great at her job and we joked that if she discovered a baby during the ultrasound that she and I would both be famous-- me for having a kid and her for discovering it.

The red "blob" you see in the long dark area in the middle of the screen is arterial blood flowing through the carotid.

A radiologist will review the results of the test to be double sure that it is how we perceived it to be. Michelle has a beautiful sixteen year old daughter who she is very proud of who wants to be an orthodontist. Way to go mom!


And next, a new old friend. Linda the R.N. and I knew each other in another life, 30 years ago in Hot Springs, Arkansas when I was the coroner and ran the ambulance service there she was a new R.N. at one of the hospitals. I knew something was up when she correctly said my last name.

We had a great chat about old times as she performed her chores getting me ready for next Monday. She went about ordering labs, verifying information and getting me oriented to the process.

More importantly, in the photo of her, you can see that she is opening me a piece of cheddar cheese that I ate with crackers she brought. I needed it since I'd been there since 9:30 a.m. and it was now 2 p.m. Now that's a nice thing for them to do, you agree?

After my snack, Linda took me to meet with my gas passer, Dr. McLeane. Of course, he is the anesthesiologist. He took a very thorough medical history, reviewed all of the test results from today and then went into a very comprehensive, yet fully understandable explanation of what would be transpiring when I reach the surgery suite on Monday morning.

Basically, they're going to dope me up like a fiend on "narcotics" and other heart surgery drugs and I will drift off into a very deep state for surgery.

When I'm out, Dr. Rayburn will begin his magic of harvesting the veins and arteries that will be used when he bypasses my diseased vessels in my ticker. They'll crack my sternum and Rayburn will work his magic.

When I wake up, McLeane said not to be alarmed by all of the devices, sounds, drips, tubes and activities. I will have a ventilator breathing for me until my lungs are ready to take over which shouldn't be long after I recover.

One more thing, even if you have had a blood test that shows your cholesterol numbers are within normal ranges, be on top of your health anyway. My lipids in February were "like a 25 year olds" according to my primary care physician. I had been on a statin drug since my stent event in 2005. If your family has a history of heart disease, or you smoke or live a sedentary lifestyle, you are at risk. Take evasive action NOW.

Oh, and I'll have you know I've lost 18 pounds in  about 15 days.  ~~pats self on back~~

Whew. What a busy day with many more to come. S/

It's Test Day and a Peek Into An Artery

The above photo is of one of the culprits that Dr. Rayburn will be going around. Isn't technology amazing?

Today is pre-surgery test day. I report in to the pre-admission area of Springhill Baptist-North this morning to begin. They will be performing the carotid dopplers and pulmonary function tests and a series of x-rays. I stayed up all night studying for my tests and hope I ace them!

NOTE: When you visit the blog, be sure to look at some of the previous posts as I frequently update and edit them. I added a video in post #3 about the type of vein harvest Dr. Rayburn is planning on doing on me.

I will report in later. S/

Surgery Monday June 30

Just left Dr. Rayburn's office where Nurse Lynn and Lou Ann took care of my nervous self before I talked with the surgeon. He doesn't waste much time...short and to the point, "you need surgery." He said "we're going to get you well." To that I say, cool.

On Thursday, I'll be going in for some "pre-testing" of various kinds including a doppler exam of my carotids to be sure there is no chance of a stroke while he is tinkering with my ticker. You can read about carotid artery disease here. Also PFTs which are pulmonary function tests to be sure I can get the air, and some other tests that I will report on Thursday night because I can't remember what the nurse said now. Yeesh, everything I read says one of the side-effects of this surgery is short-term memory loss, hell, I can already hide my own Easter eggs every year so I hate to think that might get worse!

When all of these tests are good, I report for the CABG Monday morning at 0530.

Dr. Rayburn (photo right) said he will be doing three grafts for sure and the fourth is a 50/50 and he won't know about it until he's in my chest.

He also said the chances of having to make the huge incision on my leg to gather veins is slim and that more than likely he will be doing a ENDOVASCULAR VEIN HARVEST (Caution, this is a video of actual harvest) and those incisions will be several inches long and on the inner aspect of my knee.

If that is the case, recovery must be eased somewhat. He also put me on a timed release nitro to dilate the heart vessels so the heart doesn't have to work quite as hard to oxygenate itself. It is called ISOSORBID MON ER TB 30 mg to be taken once a day. This should eliminate these tinglings and other sorts of angina, including a feeling in my lips and gums that mimics the feeling you have as the novocaine a dentist deadens you with is wearing off.

WEDNESDAY UPDATE- The Isosorbid did eliminate many of the angina symptoms but man, what a headache, actually, it was my neck. Lynn at Dr. Rayburn's said this is typical symptom and told me to take a couple of ibuprofens to deal with it. So I did.

Remember, don't ignore your body and what it is telling you.

So there you have today's report. S/

Today I visit the Surgeon

Some angina continues but I am working at my desk and hope to do so until the big day comes. I should know about the timing today after I visit the surgeon's office. Since I am the nervous sort, I spent several minutes on the phone with my cardiologist Tom Conley's nurse, Tami, yesterday. She has a way of calming one down and getting you re-focused on the "plan". I've always heard a doctor is only as good as his nurse (s) and Conley has a good one.

An update will be coming along this afternoon when I get back to the keyboard. Wish me luck, I'm going to ask all the pertinent questions today, like how long it will be before I can get back to a week-end hike with my big dog Babe. S/

Click here to get to a great blow by blow description of what is about to happen.

The Big 2008 Adventure Begins

To all my friends and family-

This will be the place for you to get pretty regular updates on the current chapter I am writing into my book of life--- "Joining the Zipper Club".

For the last few days or so I've been getting warning signals from my chest and body. I misinterpreted some of them, but so did my doctor (s) but that probably has to do with my failure to fully explain the situation, although an ECG at both my primary care physician's and at my cardiologist's office were normal. Ironically, the ECG done in the ER upon my admission was also fine. Follow your gut instincts though. You know your body best.

I also ignored some of the signs-you know, all that macho crap about not needing a doctor. Don't do that.

Wednesday night I went to the ER and was admitted to Springhill Baptist for observation for angina. The next day, Dr. Tom Conley, my cardiologist, did a heart cath and determined that stents put in in 2005 were not blocked necessarily, but areas beyond them were and in Conley's opinion, bypasses, "three perhaps four" were in order.

When I asked about the possibility of more stents, he candidly said, "Steve, I put stents in for a living, if they were possible, I would do them."

Plain enough for even me to understand. Conley finished by saying that I would continue to have some of the numbness and tingling I was experiencing until this was accomplished. A lot of this stuff felt precisely as though I had neuro issues like a feeling of coolness and some tingling in both arms and my face, so I just blew them off.

Back to my recovery room and on to the next phase.

I came home late Thursday night after having been referred to Dr. S. Thomas Rayburn III of Little Rock, as a good chest cracker. His nurse called me and told me to come to their office on Tuesday. I asked her if this could be put off for a while, and she urged that I consider it sooner than later. Her and Dr. Rayburn have already reviewed all of my tests from my admission. I told her I would consider things and talk with them Tuesday.

On Saturday I began to have a little more of the arm numbness and tingling so I called Rayburn's office and Nurse Lynn returned my call. She urged me to take things easy, use my nitro to relieve the symptoms and go to the ER if they get worse. I told her that I had made my mind up to move forward. She told me to discontinue the Plavix I have been on since the stent implants in January of '05. I will have to be off of that for at least five days prior to surgery, which puts my admission date to this coming Thursday, June 26.

I will make another entry after I visit the surgeon's office on Tuesday afternoon.

While I'm here though, let me say two things:

1. If you are living a risky lifestyle, just STOP IT. You can control it. You know the drill, if you smoke STOP. If you eat bad food STOP. If you don't exercise, START.

I won't be preaching anymore about that because if you are smart enough to get to a blog and operate a computer, you're smart enough to know you have to simply do the right thing for your own good.

2. Tell those you love that you love them. Don't let a day go by without telling them that.