DAY 3 Pre-Op

I feel a need to defend myself here, least you make a judgment call that I've brought this whole broken heart thing upon myself by a total lack of discipline in lifestyle and eating habits. OK, so I'd never convince any jury of my innocence if they saw me sitting on a bar stool at Elmo's Pub stuffing myself with a triple bypass burger and a large order of hot just-out-of-the-grease homemade potato chips.  It's also probably not the best evidence knowing that if you dangled chocolate covered bacon in my face, I'd follow you anywhere and everywhere.  But, Your Honor, let me explain.  Recently a friend said, "If YOU can have a heart attack, anyone can have a heart attack."  She said this while standing before my 123 lb, 5-ft 6-inch body.  (I'll pause here to give you ample time to hate me.  No, I don't starve myself, actually I don't do anything, apparently it's a by-product of having my father's French genes. Go ahead, hate me even more.)  I was a runner, never smoked, a veggie lover, as a kid I could eat my weight in spinach, carrots and asparagus (I had lutein coming out of my pores, how did I end up with macular degeneration?) and I drink all the right juices.  OK, so sometimes I dilute them with a little vodka, but how bad can a clear liquid be?  So what more could a heart ask for? 

Two years ago when I called the pulmonary specialist because I had such shortness of breath I couldn't walk up a flight of stairs without taking a couple of breaks, both the lung doc and my husband told me to get my sweet self to a cardiologist.  Immediately!  That said cardiologist said I had to go to the hospital immediately.  Hospital?  Immediately?  No way, I had things to do.  The cardiologist said I wouldn't be doing anything if I was dead.  Since he put it that way, I said OK.  He said it was A-Fib (atrial fibrillation), an irregular heartbeat, an arrhythmia.  So my heart doesn't have the proper rhythm. That explained a lot.  There really was a legitimate reason why I couldn't dance, why people around me looked at me funny when we clapped to the beat of music, and why I couldn't make a Clapper lamp go off and on.  Whatever happened to that marching-to-a-different-drummer thing?

The cardiologist said I had to take lots of meds. I said I'm not big on taking lots of meds. He said Coumadin and I said no.  Way too many side effects.  Instead, I agreed to take a full-strength aspirin.  The meds plus the aspirin did OK for some time. I also consulted with my brother-in-law who is a cardiologist in Nashville. Then I moved to a new city and got a new cardiologist who replaced my aspirin with Multaq, a newly minted med.  It did fine for a while, but not for long and I ended up in the hospital two more times.  A cardioversion was done the second time. The electric shock burned the heck out of a spot on my back, but it brought my heart back to perfect rhythm … for all of 15 hours. After that things started getting bad, fast.  The doc and I were tossing around different ablation procedures.  A raging infection in a molar that recently had a root canal and new crown couldn't be controlled by five rounds of four different antibiotics, in addition to oral surgery.  My heart was not handling this well.  Since it's known that oral infections can play a role in heart disease, and even though I had invested $3300 (my hot tub money) in this molar, extraction was the only option.

What an improvement!  Why, oh why, hadn't we yanked out that tooth much earlier?  My heart returned to perfect rhythm, but I still couldn't dance.  I don't know about the Clapper light because I'd already taken it back to the store since it didn't work.  Well, actually it worked for my husband and sons, just not for me. 

Two weeks later I was planning to run a victory lap around my cardiologist office while telling him we could forget about that ablation stuff, but he stopped me in my tracks, telling me my heart was still in A-Fib.  Some people really know how to bring you down.  Admitting that my heart was way too stubborn for his expertise, he referred me to a cardiologists' cardiologist in a nearby state.  There we kicked around Tikosyn, considered the drug of last resort.  I'm generally a risk taker, but this med was way beyond my comfort level.  Initially it must be administered by a doctor specially trained in it's application, not many are, and it must be done in a three-day hospital setting.  We got back to thinking about ablation since we were running out of options, so the cardiologists' cardiologist referred me to a cardiothoracic surgeon. 

The least invasive ablation is non-surgical, using a catheter through the groin to gain access to the heart. I nixed that one because of its lower success rate, especially with my A-Fib being chronic.  It often needs  to be done multiple times and  I really wanted the person doing it to be able to see what they're doing not going through my leg to get to my heart.  A minimally invasive surgical ablation, where several smaller incisions are made along both sides of the chest wall instead of a large incision down the front of the chest and where the heart does not have to be stopped, looked like the path to take.  It’s sometimes not recommended for women because the incisions have a rough time healing since they are positioned right along the bra line.  That would be no problem for me since I rarely wear a bra. 

All that sounded well and good.  I was excited that we had a plan and I was thinking we were finally on the fast track to a cure when the cardiothoracic surgeon noticed something going on with my heart that all the other cardiologist overlooked.  He brought in another specialist and after more testing, it was determined that one of my four valves was messed up.  There it was, in a video on the computer screen, live and in color, plain and clear.  This malfunctioning mitral value could be the root cause of my arrhythmia.  Wow, now we were getting somewhere!  We were high-fiving all around.

The docs suspect I had undiagnosed rheumatic fever as a child and it caused damage to this valve.  After hearing from my cousin last night, I'm wondering if it could be genetic, although with mitral valves that usually isn't the case.  Almost everyone in my family dies of strokes, many at an early age.  My cousin shared that her mother and our uncle both had valve problems. My uncle declined surgery and died shortly after being diagnosed, her mother had surgery and lived another 15 years. 

Repairing the valve, rather than replacing it, is the better option and my surgeon feels certain he can accomplish that.  He'll also clamp off the atrial appendage as a prevention for strokes and do the Cox Maze III ablation procedure to bring my heart back to proper rhythm while he's in there. He gives me a 95% chance of success for a full cure. Pretty good odds, don't you think?  However he won't give me any guarantees that any of this will improve my dancing or my ability to operate one of those clap-on clap-off lights, but hey, an old gal can hope.

Meds: Diuretic, beta blocker, anti-depressant, vitamins and supplements