I wanted to give you all an update on everything as we are now just two weeks out from surgery. First off, I am still feeling fine. The only thing that I have really changed about my routine is I have not been exercising as intensely as I was. I have found that though I feel fine, it makes me really anxious to get my heart rate up above 160 or so. Being anxious complicates getting your heart rate back down, so I figure that for the next two weeks 45 min on the treadmill walking 4-5 days a week will be fine.
I am nervous, of course I am. But I have really felt the strength and peace of all of your prayers throughout this. My family and I are confident in the ways that God has blessed us throughout this so far and will continue to carry us though. I am blessed to have been equipped with lots of stress and anxiety reducing practices from my experience in medical school. I already know things that work for me and things that don't. Journalling, yoga, and (don't laugh) deep breathing really help me focus on the here and now versus that hypotheticals that can drive me in circles. If you have never tried taking a 5 second inhale, pause, 5 second exhale, pause... for one minute, you might be amazed how much that can refocus your thoughts towards more productive things. [If interested in my personal technique, I'll attach it to the end of my post.]
Now for some details about the surgery. It will be August 25 at 8:00am at Vanderbilt in Nashville. Dr. Michael Petracek (Pet-race-ick) will be the surgeon. He has done over 2500 of these surgeries and does 4-5 of these approaches per week. By "approach" I mean right chest incisions described below. He and Vanderbilt itself, are widely regarded as being excellent at what they do. Dr. Petracek is the chair of department of cardiac surgery. I asked him how long I would be out of work for and he said, "one week at least." I thought I had misheard him, but he clarified, "I've had a doc go back to clinic a week after surgery. You will be really sore and I don't recommend it, but you could go back after a week if you needed to." We agreed that four weeks (the increment my school makes the easiest) should be good but we will obviously take more time if I need it.
As far as the actual surgery, there will be about three incisions. They will hook me up to the heart and lung bypass machine through my femoral artery. This will keep my blood pumping and oxygenated while they work on my heart. There will be a catheter in my neck called a Swan-Ganz that will snake down to my heart and help them drain part of the heart for the surgery. Finally the main incision will be on my right chest through my ribs around where the bottom of a bra sits (image on the right versus zipper on the left). That will be where they push everything aside to work on my heart. They will get everything working, cool my body down to decrease metabolic demands, and then paralyze my heart. They will enter the heart through the right atrium and sew a bovine pericardium (covering of a cow's heart) patch into where my septum should have been. When that is in place they will start everything back up again (Whew!) and check with ultrasound to make sure that there aren't any leaks. Then they will back-track and sew everything up. The surgery will take between 3-4 hours all together.The main risk that I will be facing after surgery is an arrhythmia. The heart conducts electricity to make it beat but you can't see the wires with the naked eye. They know about where everything plugs in, but there is always a risk that they could nick a wire and upset how my heart is beating. Most likely this would put me into a rhythm called atrial fibrillation (which some older people go into because they are old). The main risk of this is blood clots because the blood gets jiggled around and get sticky. So if this happens, I will probably be asked to take an aspirin to thin my blood until my heart heals and flips back into it's normal rhythm.
We anticipate that I will spend 24-48 hours in ICU and then 4-5 days in the hospital. We are going to wait and see on coming back to Memphis. But that is the plan. If you have any other questions, just let me know. Thank you all so much for the prayers and support!
Praying and Breathing:
I actually learned breathing practices by a different name from my training to go to American Samoa in 2008. During that session, we were praying an abbreviated "Jesus prayer" and encouraged to match it with our breathing. Breathing in, we pray "Lord Jesus Christ"; breathing out "have mercy on me, a sinner." Actually, according to a Ph.D. psychologist at Vanderbilt that I met this week, taking a longer exhale than inhale helps to relax the body. So naturally, the extra syllables of "on me, a sinner" prolong the exhale to provide additional benefit. The benefits of praying are obvious, but I would add that this provides a cadence so that you don't need an app with swirling lights or a clock to time your breaths to.
