I'm Back

Wednesday morning I had to report to Baylor St. Luke's Hospital in Houston as surgery began sharply at 8AM.  We spent the night at a hotel in the medical center the night before.  That morning, they had me do a thorough cleaning and then they shaved me shoulder blades to knees.  I had to put a cap on and a gown.  

The last thing I remembered was being rolled into a large operating room with a gallery with viewing windows up top.  There were lots of lights and lots of equipment and a full team of people getting ready to work.  It was very cold in there.  Then I don't remember anything.  The surgery lasted for 6 hours and then I was pulled into ICU.  Tricia and my Dad and Mom came and visited me, but I don't remember any of this.  I was still knocked out from the anesthesia and still intubated.

The surgery went well, they said.  They were able to repair, versus replace, the mitral valve.  They didn't need to give me any blood.  That was important to me.  I didn't want a transfusion.  The surgery was called Minimally Invasive Robotic Mitral Valve Repair.  They went into my femoral artery and I went on the bypass machine.  I assume they oxygenate the blood and pump it through my body by the machine, while the heart is arrested for about 90 minutes while they fixed it.  

In the surgery, they break no bones.  No sternotomy as is normally the case in open heart surgery. There are several incisions for the instruments, but they are relatively small (the biggest being about 4 inches between my ribs on the right side) and no human fingers went inside my body.

The photo on the top left below shows what they did inside my heart, robotically.  I think you can click on it and enlarge it.  The brightly lit area shows my mitral valve inside the heart chamber looking down.  The mitral valve was prolapsed, with a severe regurgitation.  What that means is that approximately 25% of my blood was flowing in the opposite direction.  It had caused the upper chamber of my heart to expand and had to be dealt with to avoid further damage.  The heart was very inefficient, but I felt no symptom.  Of course, when they told me what was going on, my mind told me that this is why I was getting tired.

They cut a triangle-shaped piece from the mitral valve, pulled it together and stitched it up. You can see the black stiches in the center of the photo.  Then, to re-shape the foundation of the valve, they used mesh to fashion what they call "the smile" to form up the foundation.  This was riveted into the muscle.  You can see the tubes in the photo that the robotic arms worked in.

Then they pressured up the heart valve with saline, and it was pressured up at 2 times the normal pressure of the chamber.  When it showed that the leaflets/valve held the blood securely without allowing the backflow, they knew that the repair was successful.  At this point, if it was not successful, they would have cut all of that out and put in a pig or cow valve.  I could have also chosen a mechanical valve, but would have been on blood thinners for the rest of my life, so I opted for the biological valve, if needed.  Fortunately, they were able to repair it, so a happy pig rests somewhere tonight with his valve still intact?

I was moved after one day out of ICU and into a regular room.  In this photo, you can see the extent of the scarring.  Really not too bad.

The doctor, on rounds, came to remove my chest tube which was draining.  That thing was very uncomfortable.

They had me up and walking very quickly.  I felt good.  Honestly, the pain meds make you feel like you're okay, but if you get behind on your meds, you quickly realize that you're not okay.  The care from the surgeons, to nurses and all medical staff at the hospital was simply amazing.  As the doctor was pulling out my chest tube, he told me that the surgical team had a heart transplant scheduled for that evening.  They do about 40 heart transplants each year and about 100 lung transplants.  What an amazing thing!  To be able to make an impact on people's lives like that!  I told him when I went home, my goal was to plant some cabbage, cauliflower, and broccoli.  His plans were to take a diseased heart out of someone and replace it with a donor heart that would extend his or her time with family and friends.  The intricacies of the human body and the wisdom God blesses people with to be able to work on them astounds me.

The doctor also clipped the wires on the pacemaker and let it fall back into my chest.  I also had an 'epidural-like' injection into my spine area which was deadening my whole right side where they had cut through the muscles to get to my chest cavity to gain access to the heart.  That was removed as well.  I don't have any sensation on my right side.  I assume that I have some nerve damage from where the incision was made to get to my heart.  Nerve damage heals slowly, but I'll bring that up with them.

By Sunday afternoon at 5PM, I was released from the hospital and Tricia drove me the 3 hour trip home.  Unbelievable!  Wednesday at 8AM open heart surgery commenced and in less than 5 whole days I'm back at home.

I have several checkups I have to go to and I can't drive for two weeks.  I just have to take it slow and allow my body to recover.  I'll say this:  God is good!  He saw fit to give me extra time on my clock and gave me excellent service from some very skilled medical doctors that are on the cutting edge of technology.  He also gave me a wonderful family who cares for me and close friends who have concern for me.  Many prayers went up and God answered them.

Montgomery Gentry sang a country song called "Lucky Man" that I always liked.  I don't believe in luck.  I believe in blessing, so I've changed the words of the chorus, but I think they are appropriate:

I know I'm a blessed man, God's given me a pretty fair hand,
I've got a house and a piece of land, a few dollars in a coffee can,
My old truck's still runnin' good, my ticker's tickin' like they say it should,
I got supper in the oven, a good woman's lovin' and one more day to be my little kids' dad,
Lord knows I'm a blessed man.