Mark's Status
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Formerly in blog format with latest first, but NOW in chronological order, first things first...
Sept 24th, 2014MATTERS OF THE HEARTI know some of you are probably unaware: I have Aortic Valve stenosis. Or classic heart valve stiffening. It has been watched for over 3 years but has now progressed to the point of surgery to replace it. The opening is usually the size of a nickle. Mine is the size of a pencil diameter. I met with my cardiologist Wednesday Sept 24th and -- besides being a Flight Controls Engineer turned heart surgeon -- he gives my prognosis for full recovery at 94%. We talked about the risks vs benefits of new technology in heart valve materials. He is very current on the latest techniques; his experience level spans 20 years and >700 of these mechanical heart valves and >2000 patients for other heart surgeries. In the meantime he suggested that I be cautious in my exertion. My diagnosis is classified as heart failure. It is because the valve that is giving me trouble is a primary part of the heart. It is even different than if I had coronary artery blockage, which would be classified as a secondary failure. The best news I have heard is: I have no coronary arteries that are constricted. Therefore, no bypass surgery needed. This news makes things very uncomplicated! Either way I do not have much energy right now! It is very surprising to have deteriorated this quickly because I just finished shoveling and wheelbarrowing 10 yards of beauty bark into my yard back in June where I was not this easily fatigued. I thought retiring was going to be a leap of faith. Putting your whole life into the hands of one man is the biggest leap of faith I have ever experienced. So many other healthy factors have aligned themselves now that I am a very low risk for this surgery. Lost weight, reduced stress, diabetes under control...etc I know the Lord has prepared me for this giant leap of faith. One of the benefits of this surgery and the hospital stay is: I stand to lose up to another 20 lbs. What a wonderful starting point. That will be the cumulative of 40 lbs lost since I retired. Right now it is still best that I stay at ease. It is to the point that even getting up in the morning is a very slow progression to keep from getting light headed. My afternoons are much better. My surgery is scheduled for Oct 9th. My endurance is going to be taxed. I have no idea how quickly I will be mobile since I've never had my chest cracked open before. I'll be out of this in no time. That's the latest. Sept 30th, 2014All my friends:It soon became very clear to me how many well wishers I have. I'm very grateful for all the friendships I have garnered over time. There is one thing that LIFE has taught me: It has a big "IF" in the middle of it. True joy comes "IF" you live life to the fullest. Isn't that why we are enjoying this life? What I have heard more than once from some of you is that we live in an age of great strides in medical advancements. My cardiologist says this type of surgery has been the gold standard for the past 60 years. Now isn't that peculiar: I just turned 60 last year. I think that is sufficient time to gather enough knowledge and apply enough wisdom to my situation. We can talk about statistics and probabilities until we are all blue in the face. Having had a lot of experience in the aerospace field in redundancy and failure analysis- think of it this way: Would you get on an airplane that has a 94% chance of landing successfully? Those are my odds. In this case, I have to say, YES! Let's go! Life is like a postage stamp: You can get cancelled, misdirected, delayed and stuck in the corner. If you just stick to it you will arrive at your destination. Albert Einstein said: "Never think of the future - it comes soon enough. The only way to properly address your future is to be as present as possible 'in the present'." A person can become quite philosophical when faced with uncertain prospects such as these. It's natural. We are staying out of large groups of people to keep from catching any kind of virus before surgery. While I'm secluding myself I am really enjoying my time in front of my ham radio. Check out the HAM RADIO link in the sidebar on the right. It shows my current setup and one of the high-tech experiments with a crazy loop antenna I've been working on this summer. I have made contacts all over the world with it. Thank you all for the influence with which you have touched me. Mark Please pass this along. My brain is so full of people I knew, I know I will have failed to remember everyone. It's an age thing. Oct 3rd, 2014Mark's day at the spa...S urgery P reparation A ssessment, or something like that. He had blood drawn, and three bouts with a blowhard device (not the technical name), and chest x-rays, and ultrasound soundings of his carotid arteries. A first look at the infamous red post-surgery pillow he must hug whenever coughing or rising up or sitting down. And lots of instructions and advice. More details of the day may be forthcoming, in his own words. 
Oct 8th, 2014How did Mark spend his last day before surgery?Chumming with his brother Mike who drove seven hours yesterday to come hang out. They picked two large bowlfuls of tomatoes from the garden, and last thing in the evening chopped them up with onions and jalapenos. The jalapenos came from the garden too, so this salsa may not be as hot as Mark likes. Our peppers usually don't reach that zing you get from hotter climes. Thursday Oct 9th, 2014We hit the road long before the break of dawn, driving through heavy fog and light traffic to Overlake Hospital. Got admitted. Mark got wheeled through the sprawling complex to a prep room. Got all prepped for surgery.The surgeon walked in ten minutes before Mark's slated 7:30am start of surgery time. He was quite upset. The On-X valve he'd ordered on Monday and expected to arrive on Tuesday... hadn't yet arrived. He'd never had that happen before, and apologized profusely. He wanted to reschedule the operation to Monday. Yikes! We just want to get this over with!!! Fortunately the local On-X rep had one at home, and made a rush trip from Redmond to the hospital in Bellevue. All systems go, after all. Off Mark went on his gurney with attendants in attendance. The surgeon's assistant assured that she'd call every hour to give update on his condition. At 8:30am she reported all was proceeding well. At 9:30am she reported that his old valve was out, and they were preparing to put the new one in. At 10:30am she reported that he was coming off the heart-lung machine. At 11:05am she reported that they were wrapping up and that the surgeon would be up to talk with me within half an hour. At 11:20am the surgeon came to the waiting room. It turns out Mark has a bicuspid valve (1-2 percent of the population) instead of a tricuspid. It's a congenital condition; since this is an inherited trait, everyone else in the family should be on the alert. "The incidence of bicuspid aortic valve can be as high as 10% in families affected with the valve problem." (Wikipedia) This is the most common congenital heart disease, according to another online source. It's common for a bicuspid to wear out around the age Mark is, the surgeon says. Things look well. Time for stitches and observation. After another hour I was brought back to the critical care unit where I found Mark hooked up to multiple monitors. He had a tube going in (down his mouth and trachea from the ventilator), and tubes coming out (ya don't wanna know).  Of all the liquids and gadgets hanging from his pole, he's actually hooked up to only three or four. The others are there "just in case." This is, after all, the Critical Care Unit. Two nurses had arrived to do a chest x-ray, and looking over his charts, the young one said, "Hey, we have the same birthday!" I told her it's also Mickey Mouse's birthday, which she didn't know. The other nurse was surprised to see Mark nodding slightly. He was coming around already. He went in and out, still groggy from the sedation and unable to speak because of the tube and ventilator. His wrists were strapped to the edges of the bed, too, so he wouldn't yank anything out in confusion. During wakeful periods, he communicated by Morse code squeezes of the hand, though I wasn't a very adept receiver of his transmissions. Still, I caught the words "amazing" and "itch right ear." They switched the ventilator to on-demand mode (not the technical term). Once he was able to breathe fairly well and not trigger alarms, the respiratory nurse came to extubate (is the technical term). She had four students with her, who got some hands-on experience. They removed the tube, a great relief to Mark. 3:45pm status: His voice is very hoarse. His back hurts. He's nauseated. His lower chest hurts where two drainage tubes emerge (to be removed tomorrow morning). But he's alive, and all his vital signs are good. He has three tasks now:
7:30pm: Mark's vital signs continue to show a good recovery. He needs a lot of rest to help his body as it labors to mend. He's able to speak a little better than earlier. He's looking forward to feeling better once this shock stage wears off and the mending progresses. The Critical Care Unit looks to be well-staffed by capable nurses. They'll take good care of him (while I go home to sleep in my own bed). ~joyce the non-nurse Friday Oct 10th, 2014No phone calls in the night... No news is good news, at this point.Here's my blog entry about yesterday: Yesterday my wandering was through the labyrinth of Overlake Hospital in Bellevue, Washington. Instead of wondering at the marvels and miracles of nature, I wondered at the life-saving techniques and gadgets of modern medicine. 11:25am Mark says about last night: "That was the best-worst night of my life!" As in: he got little sleep, what with the noises of Critical Care floor activities and pain resurging and great discomfort... which he wouldn't be experiencing at all if the operation hadn't been a success. Early this morning the staff girded him with a sturdy belt, got him out of bed, and had him walk fifty feet or so. They kept firm grasp on the belt to steady and support him. When I arrived, I found him sitting in his room's recliner. He's off the morphine now, taking oxycodone for the pain. He had his glasses on (would have contributed to nausea yesterday) and looked much more like his old self. Smile crinkles at his eyes and all. (Of course, the oxycodone is helping a lot in that department!) He had jello for breakfast, and now is waiting for his turkey-sandwich lunch. He's still hooked up to tubes and monitors. He has physical therapy exercises to do already, jiggling legs and feet. He says he's ready to get back into bed now, which will require a couple staff members to manage. Just getting out of bed this morning had exhausted him. 1:15pm The surgeon stopped in a short time ago. He mentioned that the valve had looked like a normal 3-flap configuration in the echocardiogram taken a while back, so it was a bit of a surprise to find out, in the midst of surgery, that it was only 2-flapped. Closer inspection of the echocardiogram shows subtle indication of it being bicuspid. He said that a bicuspid aortic valve typically lasts until a person's fifth or sixth decade, in contrast to a normal valve usually functioning well until a person's 80's or 90's. Mark has had two tubes draining the surgery site in his chest-- a large one and a small one. They are now taking out the large one. He is scheduled to have three walks a day. After he takes a nap, he'll get the second excursion of the day. 6:15pm Mark had a good, loooong nap. Dinner included salmon and green beans, though he doesn't have much of an appetite. He just got another pain pill, did his inhalation therapy, and now is taking a walk down the hall, accompanied by two nurses hanging onto his belt. He's got training wheels, too (a contraption remotely related to a walker).  How's this for a walker? It's mostly to help him feel stable and keep his balance, not for support. That's the nurses' job. If there was a bed for him in Telemetry, the next level of care down from Critical Care, they'd move him out tonight, he's doing so well. But they're overcrowded in Telemetry. From his room I can see I-405, the freeway I need to take home, and it's been backed up for hours. The sun is about to set. I'm taking off before darkness descends upon the rush hour mess. Saturday Oct 11th, 2014Today Mark is walking on his own, feeding himself, talking up a storm. (Second childhood? :D )
His temporary pacemaker has been removed. Using his incentive spirometer, he manages to inhale 1250 milliliters at a time, good therapy for his lungs. His goal for today is to take it to 1500 milliliters. His brother Mike has come to visit him today. They're keeping the humor light. No big guffaws. Ah, at last... In midafternoon, Mark got transferred out of Critical Care, up a floor to Intensive Care, otherwise called Telemetry. Now they're keeping an eye on his vital signs via telemetry rather than having a nurse posted right at his door. His good friend Tim Swift, and daughter Alina, came to visit as well, managing to track him down to his new suite. Mark's afternoon walk took him on the full loop of his floor. Wow, what improvement from his first day! 
That last tube is draining the chest cavity operation site. It will probably come out tomorrow. (I've added a couple of photos above.) Sunday Oct 12th, 20141:00pmFrom what they tell me, I walked 1/3 mile. Two laps! Totally unbelievable. I'm now drawing 2.25 liters on an incentive spirometer. Another huge step forward. I just have to keep this pace up and I'll be out of here quite soon. Just had the last tube taken out. (felt like an alien, from the movie) I'm finally able to take that deep satisfying chest-expanding breath that feels so good. My appetite is getting better. I've almost exhausted the menu. Guess it's time to leave. That's the current condition. 
A t-shirt made by Rachel. (Are you of the generation to remember this Timex ad?) 
By day's end, Mark had walked enough laps to total one mile. No more tubes a-dangling, no hand at his elbow, nurse walking at his side. 
His nurse said that if she had gold stars to give out, she'd have stuck them all over his forehead by now. He had visits from his brother Mike, his buddy Tim Swift and his family, and from three good friends from church. 
A Sunday portrait (top few inches of his chest incision visible here): Enjoying the company, hugging his pillow whenever he laughs. Okay guys, enough with the jokes! What do you get when you cross Frankenstein's monster and Santa Claus? Ho ho ho... Ouch! (Must think of a good punch line...) Looks like Dracula was here, too, by those puncture marks on the jugular... Monday Oct 13th, 2014Isaac's 5th birthday! On Wednesday evening in family prayer, the night before surgery, Isaac prayed that Grampa would be brave.Will Grampa get to go home today? It depends on his blood clotting factor. Everything else points to a big green GO! 4:00pm Discharge papers coming through... 
6:00pm Mark's home, with a grin and a paper bag full of prescription bottles. Details to be posted later. We're exhausted! Tuesday Oct 14th, 2014Last entry in this blog:Yesterday, since I had walked a full mile around the corridor on the floor I was on, I was classified sufficiently stable on my feet to start my recovery at home. I was discharged from Overlake Hospital Intensive Care Unit at 4pm, October 13th. I felt a little apprehensive about leaving the hospital- all the new adaptations I would need to make as I begin the next 8 weeks of recovery. I told several nurses and nurse technicians that it felt hard to leave because I was having too much fun! It's a matter of perspective and which day you are on as far as 'fun' is concerned. I was treated with such respect and felt that I had received the utmost in professional care from all that attended to me. I could feel their genuine concern for my well being and how I was feeling. The highest mountain of recovery is behind me, or the immediate stabilization after the surgery. Now, it needs to be that slow steady pace of keeping other things from hindering the full recovery that can often cause setbacks. Just this morning it was difficult to get my lungs moving air. Once I got them cleared out I felt so much better. It is so easy to just sit back and not exert yourself and fall into pneumonia this way. Doing the proper exercises, I can now draw two and a half liters of air in one inhalation. Considering the fact that two days after surgery, I couldn't even draw half that! The short distance walk was even easier. We were told that for some the regimen of these slow steps can be overwhelming because of the frequency they need to occur and the temporary life style changes needed to accommodate these changes. Oh how we all need to do the little things to keep our lives in balance. I didn't necessarily need something of this magnitude to make me realize the importance of the little things that need to be consistently exercised. I was shocked when the cardiac surgeon explained his version of what this type of surgery could be compared to. "It's like getting hit by a bus and he backs up over you again." He also indicated to me that the size of my heart has decreased just a small amount due to not having to push against such a small opening and such high pressure. I would feel like it is "stepping on the gas while rolling down hill." I can definitely feel it doing the "Happy Dance" because until it gets all settled into its normal 'pocket' I will feel the thumping it's doing. If I sit very still you can see it rocking my upper body with its movement. I know there were many converging health changes that made this the prime time to have this surgery. It is just miraculous to live in a time where I get another opportunity at life. Most of all, thank you to all those well wishes and silent and spoken prayers on my behalf. What an adventure to go through knowing all the risks and advantages. In my case, the risks were small enough that the choice to take the advantages was "good enough." I agree with a friend of mine that had a very similar operation: "This is a transcendent experience when you consider the alternative." Another funny sort of perspective: "I guess I had the warranty work done before the warranty expired." Thank you all. Mark Holt (Rev 2.0) PS: The On-X valve we elected has a life-time guarantee. PPS: This is not the end. This is just the beginning! 
Now on a regimen of four walks a day, with this back-up plan for rainy weather. Here I am, ready to ride, holding my pillow, with my breathing gauge at hand. |
You know Mark. Besides being a piano tuner and a ham radio operator,
Action needed: Open-heart surgery to replace the aortic valve, which has decided to close down to one-fourth the normal aperture. Location: Overlake Hospital in Bellevue, Washington. aortic valve stenosis according to Wikipedia bicuspid aortic valve |