Home - Week 4 - Air Guitar

Several months ago I started putting together a playlist called "Air Guitar". It was going to be a collection of music that regardless of my mood I would bound to that infamous semi-stride pose, one hand plucking away at my thigh, the other hand stretched out from my shoulder with a slight bend at the elbow, fingers in arthritic positions, and all the while imagining I have wild hair as I bounce my head emphatically to the beat of the music.

With time on my hands I decided to go back to the list and see where it would take me. The first part of the list looked pretty good as it stood: Fat Bottomed Girls, Queen; Voodoo Chile (Slight Return0, Stevie Ray Vaughan; All Along the Watchtower, Jimi Hendrix; Over the Hills and Far Away, Led Zeppelin; and, Baba O'Riley, The Who. After some thought, I was missing some more recent tracks. So I added Alive by Pearl Jam. If you can keep your body still during this song, I know some good heart doctors you should talk to.

Recovering from surgery (and perhaps recovering from anything) is odd because you spend quite a bit of time just sitting there. For me it's sitting on my couch beside the fireplace. M. set me up with a pillow to put behind my back so that my feet touch the ground and I can maintain as best a posture as possible while I just sit there. I catch myself often just staring straight ahead. I give myself one of those head shakes that flaps the cheeks and jiggles the eyes back to focus. I pull my work table close to me and start looking at the playlist again.

I added something not so classic, but a great tune for playing it loud: Doesn't Remind Me, Audioslave. Again, if you can make it through this song without a foot tap or a little chin bounce, you need to give yourself one of the above head shakes. I liked where I was heading so I added Resurrection by Moist. Nowhere near a classic, but a great digression. I'm not going for a mixed tape history; this is an air guitar playlist. Every song is a whole new personal rock out session.

One of my favourite personal characteristics is that I digress in mid conversation. It must be annoying as hell for everyone else, but I'm fascinated how I can completely get off track often unable to return to the original thought. That's how I was starting to feel about this playlist and I embraced the digression and added What's the Frequency Kenneth by REM. I then thought Green Day. I had no GD. Whether you like them or not, the simple 3 chord nature of almost every song makes it impossible to not want to start plucking. Not in that classic way either. This is more of a bounce up and down pausing occasionally when you land to go from knee to waist in rapid succession with one hand while the other maintains the chord. Then back to the bounce. It was a hard choice, but I went with Welcome to Paradise.

Digression well in place I decided to brings things back with a few gems that don't get the recognition they deserve: Rockin' in the Free World, Neil Young; No Sugar Tonight, The Guess Who; Tom Sawyer, Rush (although I would describe this track more of an air drum than air guitar); and finally Detroit Rock City, Kiss.

I pushed the table back, adjusted my headphones, jacked the volume, moved my cursor up to track one and hit play. Then I just sat there... It didn't take long for fingers, hands and feet to start moving. With my mom in the room I wasn't prepared to start windmilling, jumping off the couch or kicking over furniture, but in my head I was in full air guitar mode.

The days are getting better. We're up to 2 full 40 minute walks a day. The pace is still slow, but there is progress. Sleep seems to be more difficult now, but I trying different tactics. My chest is still pretty numb; we met with the surgeon on March 26 and he was pleased with the x-rays and what he was hearing. My next big step is Rehab.

Home - Day 15 - Thresholds

I've always liked the word "threshold" because it seems to defeat the word "barrier" so well. Crossing the threshold and enter a new space, leaving behind that barrier that loomed. My daily walks are all about thresholds at the moment. Some would say I'm confusing threshold with milestone, but threshold is truly what I experience.

The first threshold is a literal one. It's actually getting my outdoor clothes on and getting out the door of the house. For me right now the effort is more mental than physical. Once out the door (and over the threshold) the walk has started. I push the button on my watch and we start walking.

The second threshold is a sensation I get in my chest when I am standing straight and walking. The sensation has two components. The first is a sensation of contracting skin into my scars. The second is sensation of muscles in by abdomen and thoracic regions being incredibly tense and unable to release. After about 10 minutes of walking (first set of lights in our current route) the sensation goes away.

While passing over the second threshold, the third begins. It is a seizing of the muscles around the upper spine. Some days the pain has been too much and I have not been able to cross the threshold. We just turn around and head for home--it's very discouraging. Other days I can get through it and then its just heads down walking.

The fourth threshold is the turn-around point. It means I'm halfway there and heading for home. It's a big one for me because I know I going to get the full time in. My watch beeps and we finish our stride, do a 180 and head back. It doesn't mean the trip back is any easier physically, but mentally it just seems easier. The distance to home is diminishing.

The last threshold is the same as the first. I walk into the house and I'm happy to be home and content with my walk. It's all pretty small in the grand scheme of physical accomplishments, but that's how my walking feels. My mom and I walk every day, once in the morning and once in the afternoon. By Monday next week we'll have hit the 40 minute limit. After that we go for a while until the walk is comfortable and then we start pushing the distance within the 40 minute envelope.

Today is an important day because it's the 15th day I have been home and marks for me a threshold in my recovery. It means I have been home from the hospital for 2 whole weeks and I am starting to feel physically human again. I walk around the house more freely, I sleep entire nights, I can stay focused on a task for longer than 30mins and my appetite is returning.

As of today I will also start posting only one entry a week so that I can put some time into some other projects I hoped to explore while recovering from surgery. I still have some catching up on a couple of days after the surgery as well.

Home - Day 14 - Easter Sunday

Today was another tough day mentally and emotionally. We got a full morning walk in, but the evening walk was tough on my back and we had to cut it short. I simply wasn't able walk and breath at the same time. We figure part of it is due to the cold and part of it is that we're going too late in the day after I've eaten. It's like all the muscles around my upper spine seize at once. We're going to try walking early and before meals which is the way we had started. With a couple of my down days we had slid into walking whenever I could muster the will. Time to throw that away. Although my mom doesn't mean it in a bad way she says "I don't want to push you... but, I pushing you."

Easter was pretty tame for us, my mom and I had a quiet easter dinner (Ham and yams) and watched a movie.

Home - Day 13 - The All Nighter

I stopped counting the number of all nighters I have done for work in the last couple of years because it's kind of scary. I seem to be able to handle all nighters better than most and sometimes one all nighter has extended into two. I'm not beating my chest about this I just want to make the point that when comes to sleep deficit I figure I have some serious debt. The benefit, if there is any, of being in sleep dept, is that falling asleep is not a problem. Those who know me, know that I can pretty much sleep anywhere anytime. As a passenger in moving vehicles (plains, trains, automobiles) seem to be a favourite. Even with this ability to cat nap anywhere, I figure the debt is still pretty big.

My first couple of nights at home were not great from a sleep perspective. I had back pains and chest pains, I could feel the beating of my heart in my head, I was too warm, I was too cold or some other reason that disturbed my sleep. In this second week of recovery I find myself sleeping quite a bit. Afternoon nap, after dinner nap, pre-bedtime nap and full night time sleep. Sometimes I sneak in a mid-morning nap. I lie down I put the headphones on, close my eyes and I'm asleep. I'm sure some of it is related to my actual recovery, but I'll bet the majority of the sleep requirement is coming from past sins. I think my mind is saying to my body each day "dude, are you serious, we don't have to work tomorrow?". Followed quickly by, "dibs on the couch" and then "how about we listen to that Jack Johnson guy"; "hey he's got a new album you know". The banter ends when I've slipped my headset on. "Moby! 'da hell?". "Alright, let's give it a try". "Nice, I like it". "Hey grab that blanket." ...zzzzzzz. At a subconscious level this how I figure it's happening.

For those of you who don't think your mind and body talk, go on an epic hike, bike ride or adventure race. It has to be at least 12 hours, harsh conditions and some discomfort. The words emerge. "This is nuts". "Lets just stop right now." "Come on! Not more bushwacking. I hate bushwacking." "You got to be kidding me, is that another f___ing hill?". None of this is spoken. They are words that seem to occur in the back of the head, but resonate in the ears as if someone were beside you yelling. Then the other part of the conversation kicks in, its a calm rational voice, originating more from the heart and gut. "One step at time." "Just keep walking." "Comfort gear, smooth pedalling, just 5% grade, look at the hill not up the hill." "Stay focused."

I have to say the conversations about sleep are much more entertaining and of course lying down on a couch is a little easier than a 12 hour hike with 60lbs on your back. I figure by the time I'm fully recovered from surgery I just may have eliminated my sleep dept for the last 5 years. I'm probably averaging 3 hours of daytime sleep and 9 hours of night time sleep. That's a lot of sleep where I come from. I'll know it when that inner voice says "dude, I think we're good with the naps, how about you grab that bike of yours so that I can start some real complaining again?."

Today's another cold day. Cold days are really hard on me when we walk outside. We substituted the morning's walk with a trip to Bob's (as in Bob Loblaw). I figure with all the zig zagging and back and forth I easily got my 28 minutes of walking in. The afternoon walk was more like an 8pm walk. We went outside and it went reasonably well. I'm still feeling some back pains, but a couple of tylenol prior to the walk knocked the sharp edges off the pain.

Home - Day 12 - Case of the Blues

Sadly today's blog is not a story involving a case a of beer. It was a pretty blue day for me emotionally and I just don't have the energy for a story.

We got a slow start to the day. Both walks were cold and tonight I couldn't finish the walk due to back pain and cold. I hope to be in better spirits tomorrow.

Home - Day 11 - Walking in "la sluch"

In English we describe semi-melted snow as "slush". In Quebec colloquial French its "la sluch". Personally I feel the word better describe the physical nature of the semi-solid, unstable, snow-water-dirt-garbage mixture that makes up la sluch. To say it correctly all the emphasis is on the "ch" at the end.

This morning's walk was all about la sluch. Yesterday was such a bust due to the weather that no matter what my mom and I were getting out and walking today. It's hard to describe the way I feel from a fitness perspective. I'd say my energy is about 55% of what it usually is, my lung capacity is maybe 65% and my muscles are simply on vacation. So a 24min walk in la sluch is pretty epic. It didn't seem so bad when we started. After about 8 minutes I was in death march mode. One foot in front of the other to get it done. No matter how much I slowed down or stopped I didn't seem to be able to get to a relaxed breathing. I wasn't panting or anything, I just wasn't comfortable. The footing was crazy and there really wasn't an option once we started.

Along with the experience of la sluch comes and entire vernacular of Quebecois curse words, expressions and the like. I figure my last 12 minutes of walking this morning covered a good 70% of the gamut. You know, its the kind of cursing that can only be portrayed verbally because of the value associated with the emphasis, pauses and general drawl used. I used my inside voice of course, but I was into full conversational cursing. Had the walk been longer plots and themes would have developed. La sluch around my house looks like it's going to stay a while and so to avoid too much exertion and curse combinations that would impress a Quebec city theme park roadie, my mom and I looked for new terrain.

This afternoon we decided to go indoors. I got in the car for the first time since I came home from the hospital and we headed towards Billings Bridge Mall, commonly know as the "Blue Hair Mall". I figured the traffic pace would be just about my speed. My mom and I did 4 lengths of the mall in 24 minutes. We got passed by a couple of buggies and a lady on O2. Aside from that we held our own.

The day itself has been alright. My mom has eased the trash talking in crib after a couple of come behind wins on my part. Every day I feel my lung capacity get better, some days it's tangible, other days I just convince myself that the breath I took was deeper. We got both of our walks in along with the exercises. Today was a good day.

Home - Day 10 - Cousin in Kandahar

One of the interests I wanted to explore during my recovery are some "new" things on the web that I understand technically, but not socially, i.e. blogs, Facebook, Flickr, etc. The biggest mystery to me is Facebook. I don't understand the appeal--it just doesn't seem productive. Yet, Facebook's value is in the billions. I created and account in Facebook because my friend F. sent me a request. I checked out his profile and thought it was cool, but I was still confused as to why this is better than email, Blog or the telephone. I plan to try and understand the value both from a business and personal perspective.

My sister sent me a note today saying my cousin Mu. has a Facebook account. Mu. is a member of the 12e RBC in Valcartier, Quebec. Since the day I can remember he was always fascinated with the army. He signed up in his mid-20s and has been one of the happiest men I know. At the end of January Mu. shipped out to Afghanistan. Mu. has been in combat situations before in Bosnia and he likes the nature of a real operation. Afghanistan some how seems to be different in that the severity of the mission is more tangible. We were all be shocked at the pictures that come from Bosnia and Somalia, but nothing hits home when the pictures are of Canadian soldiers coming home in coffins. I don't want to debate the mission or the politics--to me personally, it's simple, our guys are there and we support all of them. Period.

I wanted to call Mu. before he departed, but I was hip deep in my own ordeal preparation and all of a sudden he had left. Then the note from my sister came. I don't know if I could have been more excited. I jumped on Facebook and immediately found Mu. and sent him a Friend request. I hope to get a response from him soon. I can't wait to see his updates and send him my own updates. It could be any other technology, but the bottom line is there is now a medium for me to talk with my cousin in Kandahar.

The interaction with my cousin should be interesting because Facebook is not just messaging and photos. There are a bunch of other components (quizs, memberships, likes and dislikes) that describe people in a method that isn't words and has the potential to present whatever image you want. Here comes the deep part: maybe Facebook lets you live a fantasy. During the day I'm vince, but on Facebook I'm the "Spoonman". Hmm... Like I said I don't get it, but it will make for some interesting reflection.

14 days since the operation! I wish I could say today was a great day, but I woke up pretty tired and my energy level has been low all day. We were unable to go for our walk today due to the weather--rain, snow and ice. Downright shitty. I have to be exceptionally careful about falling so I made the call that we weren't going walking today. If the weather continues tomorrow, we'll hit a mall and do our walks there.

Home - Day 9 - Pills, pills, pills...

I have never been big on medication. The root of it is probably the same reason I have never been a big drinker or smoker. Anything that puts my head in a fog makes me nervous. I'm not an idiot though, if something is going to get me better or kill severe pain, I'm at the front of the line with my hand out. I just like to have a specific reason for taking medication.

My fast and furious introduction into heart disease has been a bit of a shock for me when it comes to medication. Upon discovery of the heart disease I went from taking 5 pills a year to 5 pills a day (Lipitor for cholesterol, Metoprolol for blood pressure and Aspirin). Apparently I will be taking these pills for the rest of my life. Because I wasn't used to taking medication the first thing I did was go out and buy one of those plastic containers with 14 slots, 2 for each day (AM and PM). I fill the container up every Sunday night when I finish up my week. The container sits front and center in my house so that I never forget it (I have forgotten once since the beginning of January).

I wouldn't describe myself as someone who is careful with his health care. I'm pretty good from a diet and exercise perspective. I don't drink much, I've never taken drugs and for a long time I have been pretty strict about what I eat. I do however have a vice that is not exactly stellar. It would be innocent, if it didn't border on gluttony. I love candy. Those who know me know this fact. I have been able to go cold turkey a couple of times, but when it comes down to it, put a bag of Nibs or Sourpatch Kids in front of me and that bag is gone. Forget about being polite, forget about pacing myself, the bag is gone. Some of it is a nervous thing, when I'm thinking or under stress I need to chew something. The other part is a comfort thing, I just like candy--it just makes me feel good.

The other part of my health care that I have have been negligent is checkups and regular testing. When I visited Dr. V. for my chest pains it was the first time I had been to a doctor for a checkup in 10 years. The way I see it, I was just lucky that we caught this thing when we did. Had I continued to say "I'm too busy" or "it's really not that bad, it'll pass", I could have found myself facing the sky after a heart attack and then the lucky part would be if someone found me to get me to a hospital.

My apprehension with doctors has been that they always give me bad news and out of no sense of rationality what so ever I had decided a long time ago that I didn't want to hear it. Fortunately for me, rationality kicked into high gear along with a significant dose of M. logic. I was having chest pains, they weren't normal, both my father and my uncle recently had bypass surgery and there is history of heart disease in my family. M. like most women is very responsible with health care and for her it's not an option. You don't feel right, you go to a doctor. I suppose you could say I can see the light now.

That brings us back to medication. Similar to visiting doctors, I saw taking medication as something superfluous to health. You take medication, if your sick. I figured if my cholesterol is too high, I'll change my diet. If my red blood cell count is to low, I'll eat more iron. If I'm too heavy, I'll exercise. What I have learned from my experience is that things just don't work that way. No matter what I eat my cholesterol will be high--genetic predisposition. No matter what I eat or how much I exercise my blood pressure will always be a little low--genetic again. That doesn't mean that I'm going to become KFC's number one client because I packing 40mg of Lipitor every day. I still have to do the diet thing. It just means that the diet thing isn't enough. My body needs the drug.

I take a lot of pills now. I still take the big 3 (Lipitor, Metoprolol and Aspirin), but added to that cocktail is a diuretic, potassium pills (to replenish the potassium release caused by the diuretic), antacid (all the pills I take are hard on the stomach), extra-strength Tylenol and Dilaudid (serious painkiller). After breakfast I pull out my purple container, open up the AM compartment, grab a glass of water and start popping. Same routine after dinner, except its the PM compartment. To me, it's now just part of the routine, same as the exercises and same as the walks. I count myself lucky that I haven't needed too much pain medication, that my heart valve was fixed so I don't need blood thinner and that none of the drugs seem to be causing any issues.

Perspective is an interesting word because in essence it means from where you are looking. I figure perspective can be changed in 3 ways: incident, reflection and observation. My perspective on my personal healthcare has changed through incident and reflection. It probably should have changed through observation a long time ago, but it didn't seem to happen. It's too bad because observation is the easiest, and least painful, way to learn anything.

I was a little groggy today. I got up a little late and it took me a while to get the engine firing. The walks were good and I got a win in at the cribbage board. My mom and I watched "A River Runs Through It"--what a great story.

Home - Day 8 - The Game of Cribbage

I bought a cribbage board several months ago hoping that M. and I could get into playing. With all the preparation leading up to the surgery we just didn't get around to it. I can remember cribbage for as long as I can remember. My parents used to play it with their friends and still play a game or two every day.

The night my parents arrived from Quebec I decided to break the game out after dinner. We played a couple of games and it was great. For me, cribbage is an ideal game: there is strategy, calculation, luck and this wonderful board that allows you to visually watch the progress of points. There is one other part that of the game that comes when my mom is playing and that's trash talking. She does it in an innocent kind of way but it is what it is.

When I was recovering in the hospital we broke the game out a couple of times. To me the game indicated that my brain was back and functional. While I'm at home my mom and I play after lunch and dinner. If M. or my dad are around they join in, but for the most part it's me and my mom. I get a couple of wins in here and there, but the woman seems to be taking a significant portion of the games. We'll be close and then all of sudden she'll get 16 points in her hand and then turnover her crib and score an additional 12. Meanwhile I'll get 4 points. The frustrating part is she'll have a mediocre hand until the cut and whatever card is turned seems to be exactly the one needed. Now imagine what happens when you take someone who trash talks with a 4 point lead and you give them a 24 point lead. She'll start with "Oh my that's quite a gap"; then when she gets her hand "another great set of cards, what two should I give to my crib"; finally it will end with "look at that, I have skunked you again".

I however skunked my mom today, but that was my 1 to her 3 games. We'll see how the rest of the week goes.

Today was another good day. My sleep was regular and the body pillow gives me that little respite I need for my back and neck to recover. We hit the 20 minute mark on our walks and I'm starting to feel better during the walk. My chest is still pretty tight and deep breaths are about 2/3 of what they should be. The melting snow is making things tricking, but M. set my mom and I up with these Yak-Traks that you slip onto your boot and the grip on ice is amazing.

Home - Day 7 - Comparitively Speaking

When I first decided that I wanted to try bike racing, I knew I was going to have to get a little more disciplined about my riding and training. I did a little reading and discovered some key elements: goals, structure, periodization and discipline.

First, I needed an ultimate goal, some race or training objective. I picked a local race called the "Gatineau Grand Prix" and decided that I would set next year's race as the objective. I looked up the results of the category I was going to race in and I picked the lap time I felt was achievable.

Second, I put a training plan together based on what I had read. That included nutrition, weight loss, weight training, on bike training, off bike training and mental preparation. The plan was roughly eight months long and required me to loose close to 15 lbs and gain a significant amount of fitness.

Because I had eight months the 3rd element of periodization was pretty easy. I started off with keeping a training log (diet, body weight, resting heart rate, training objective, results), getting regular workouts in the weight room and building base in the legs with long easy rides. As each month progressed, the plan changed and got harder. I started riding different patterns: intervals, isolated leg, sprints, etc. I started pushing more weight in the gym and more focus on the cycling muscles. I kept adjusting my diet to match the training requirements.

I have a small piece of paper in my study that has two words written: Focus and Discipline. I added a third, Integrity, a while ago, but the first two, I believe, are the lowest common denominator to achieving anything. For eight months I needed to be disciplined about training. I had a demanding job for a company that we were trying to get off the ground and it took everything I had to maintain focus and discipline on that personal goal I had set for myself.

Race day was approaching fast. The training was going well, but I still wasn't getting the lap times I wanted. I just couldn't seem to get up the hills fast enough. Relatively speaking I was doing great. I had never been as fit, nor had I ever felt as good, I simply needed to take 3 minutes off my current lap time to stay in the pack during the race. I rehearsed the race day a couple of times because I had never been to a race before and the day of the race I arrived well rested and as I ready as I could be. At the end of the race my lap times ended up being a little faster that my last training laps, but not enough to stay with the pack. It's funny I wasn't discouraged at all. I showed up to the race as prepared as I could be and I did the best I could. In that race and the process leading up to it I discovered something I really liked doing (cycling) and I discovered just how hard competitive cycling is.

Today I sit in front of a different plan. This one is about healing a valve that has been fixed, two arteries that have been repaired, two lungs that were completely deflated and partially inflated and a split chest bone. Funny though, the principles and tools that have been laid out by the OHI are identical to those I used to prepare for the race. Goal: Heal (get back to work and back on the bike). Structure: Log (sleep, weight, temperature, exercise record, medication, food intake) Rest, heart healthy diet, exercise program, walking program, medications and follow-up visits. Periodization: We started with 2-10 minute walks and exercises consisting of 10 calf raises while holding on to a chair. Discipline: knowing that the OHI has done this before and at 37 there is still a whole lot more living to do. Maybe even a bike race.

Today was a good day. I slept well. M. bought me this body pillow that allows me to sleep on my side without collapsing my shoulders. The ability to make small shifts during the night alleviates quite a bit of the back pain. My mom continues to beat me at crib--today my ass was handed to me three times. It wouldn't be so bad if she wasn't trash-talking the whole time. We had two great walks with the sun shining and snow melting.

Home - Day 6 - The Afternoon Nap

I wonder what it is about taking a nap that seems so satisfying. I have been a napper my entire life: as a child I took naps because I had to; as a teenager I took naps because adolescence seemed to require an inordinate amount of sleep; and, as an adult I take naps just because. A quick (45 min) on a Sunday afternoon with a little music in the background, maybe a fire in the fireplace and a little blanket--pure luxury.

The routine for my current recovery days is well set. I get up early (probably because I go to bed early). I read, work on the blog or just putter with the computer. At about 9am we have breakfast. I then take my variety of medication and my mom and I go through the exercise routine provided by the OHI. I take a shower, shave every second day, get dressed and my mom and I head out for the morning walk. When we get back from the walk we putter until lunch and then eat lunch (usually a turkey sandwich). After lunch, we play a little game of cribbage. The afternoon consists of some little project (like consolidating the remotes or figuring out my shelving design for the basement), an afternoon walk and a maybe a movie. Then, its dinner, another game of crib and a movie or some more of a little project. Bed time comes early and sleep is welcome.

Today my mom and I deviated a bit. After lunch and the game of crib we both sat down to reading a bit. My mom was first to go. She slowly set her book down, grabbed a blanket and curled up. 2 minutes later I could here that comfortable breathing that is synonymous with someone sleeping. I took a different approach. I put on my headphones, selected a long playlist of instrumental guitar from the iPod and stretched out. About an hour later we both woke feeling very satisfied with our collective nap. What a great feeling to just drift away and wake up when it's the right time to wake.

The exercises and walks are going well. I felt a little winded today on the morning walk, but I think it had more to do with the temperature of the air than the pace or distance.

Home - Day 5 - Turkey Sandwiches

When I was 17 I had Hodgkins disease and part of the treatment was chemotherapy ("chemo"). Chemo isn't so fun and one of the big side effects is some pretty intense vomiting. When my mom would bring me home from the hospital she'd put me down to bed so that I could try to rest. The first couple of hours were rough, but then things would settle down and I'd actually get hungry. My first food after chemo was melba toast and lemon tea. Sounds pretty simple I know but after a day of retching my guts so hard that I was breaking blood vessels in my head, the fact that I was able to eat something was miraculous and melba toast and lemon tea became a comfort that indicated things were getting better.

Fortunately the recovery from heart surgery does not include anything like chemo and there's no nausea or retching. But similar to my chemo time, I found something that brings comfort to my entire soul as soon as I take a bite.

My angiogram procedure was a full day procedure. I was scheduled first thing in the morning, but the recovery went into late afternoon. During that recovery the nurses begin with giving you water, then juice, then fruit and then a full blown sandwich. The sandwich that was given to me was a turkey sandwich. Nothing special: very fresh whole wheat bread, real sliced roasted turkey and probably some margarine. Comfort is all I can say when I took a bite of that sandwich. It couldn't be more simple, but if that wasn't the best feeling I had all day.

Since I got home my mom has been making me turkey sandwiches with fresh whole wheat bread, real sliced roasted turkey, a little lettuce, a little relish and a little margarine. Every day I sink my teeth into those sandwiches either for lunch or a snack in the afternoon or both and the feeling of comfort is overwhelming.

We added another couple of minutes to my walks today and things are going well. I actually had a couple of good sleep periods last night too. And of course we had turkey sandwiches.

Home - Day 4 - Restless Sleep

One problem I never thought I would have is sleep. Prior to my surgery and pretty much my entire life I have been able to lie down anywhere and go to sleep. It typically takes me about a minute to clear my thoughts and then it's lights out.

I have been home now for 3 nights and sleep has been all but the paradise it once knew. Due to my movement restrictions I can't do my ritual flipping around to find just the right spot prior to falling asleep and it also means that I can't do the 2 to 4 position shifts I typically make during the night. Last night I benefited from a back rub by M. and couple of extra strength Tylenols yet I still had a broken sleep, waking several times and ending with a sore neck and shoulders. Don't get me wrong, if this is the worst of it, I'll take it and shut my mouth. It just amazes me how my comfort sleeping has disappeared and now I would almost rather not sleep.

I keep thinking its the pillow configuration, but I have been through about 5 different pillows now and none are better than the other. I'm even trying a little drink of milk before bed. I figure I'll keep with the tylenol, milk and stick with the last pillow and see where it goes.

The daily walks are going well and I'm feeling more and more energy return to my system.

Home - Day 3 - Beauty of the Band-Aid

My friend D. wrote me a message today asking for a picture. It was funny because I hadn't ever really taken a good look at my stitches. It just didn't seem important. D. was asking and I figured, better get a record of what was done.

It's pretty impressive when you think about that 8 inch slit right down my sternum. During my hospital stay all the nurses commented on what a good job it was and Dr. M. did quality work. Having seen my dad's scars and heard about 100 plus staples used to suture up the cut, I looked at this clean vertical line and 3 horizontal cuts and sighed in relief. As far as I was concerned Dr. M. was "da man".

There is something significant that you can't see in the photo, but it is about midway up the sternum cut and to the left. It's a small green dot tatoo that the radiologists used to line up there devices during my radiotherapy for my Hodgkins. The irony is thick. The last remnant of the process that caused this surgery sits right next to the scar of the surgery. Cause and effect, side by each.

In looking at the picture I also started to reflect on what was actually done. The original plan was a triple by-pass with a valve replacement. In my pre-op meeting the surgeon had said "no matter how good the data is from the Ecography, MRI and Angiogram, we'll only know for sure when we get in there". Normally this would worry me when someone talks like this because it's about as definitive as a Yogi Berra prediction. The difference is there was a plan based on the data. If the data was correct the plan would be executed as planned. If the data was incorrect, then adaptations would be made.

I'm simplifying this substantially, but imagine the surgeon once he "gets in there". First order of business is the valve. He takes a close look at the valve: how it opens and closes and the level and distribution of plaque. Then he says to himself, "I reckon I can jig that so it'll work". Now I can guaranty this guy doesn't talk this way because he has more letters after his name than I thought were possible. But that's the way I like to see it. The guy knows his shit and he proceeds with fixing the valve. He shaves the plaque, reshapes the valve opening and then tests it operation. Done. Then he proceeds to the by-pass. Determines that the blockage for two of the arteries are close enough that he can cover it with single by-pass. That brings the total number down to two instead of three.

The results of are amazing to me. No valve replacement means potentially no future surgery. It means no blood thinner. It's HUGE. There are no guarantees, things may degenerate and I may have go back in the end, but I got a fighting chance and in most cases that all anybody needs.

Although it's not necessary I'd like to ponder the beauty of the band-aid in the above picture because it too carries some irony. Here is an 8 in scar that represents to me the mastery of a surgeon able to analyse the condition of a living heart and make on the spot decisions that will impact the life of the individual. Below the scar is a standard band-aid that is the representation of a temporary fix where no mastery is involved. Peal the ends and stick the band-aid on. Hope for the best. I love it.

Today was the first day of walking. My mom and I did the prescribed exercises and then headed out of a 10min walk. I was surprised how winded I was after only 10mins. We did another walk in the afternoon. It's also today where I decided to write this the blog.

Home - Day 2 - My Stuff

I woke very early this morning (05:30) after a pretty crappy night of sleeping. My neck hurt, my back hurt and I was still pretty groggy. The big difference was that I was home. I put on my pyjamas, my hoody and my housecoat and went down to my living room.

For those who have had the pleasure of being around me in the morning, I'm a morning person. Well not this morning. I knew I couldn't sleep any more, but I had a significant grog going on. I grabbed my MacBook, through in a BSG DVD and proceeded to watch episode after episode in a haze. After a while everyone started to get up and I was starting to get revived a little.

With breakfast under my belt, we did exercises and then I went up for a shave and a shower. What a difference a real shower makes. After that I reacquainted myself with my stuff. My MacBook, my iPod, my books, my moleskin idea books, the TV and the movies. In the grand scheme of things all this stuff is pretty insignificant, but for today it represented not being in the hospital.

The important things that I wasn't thinking about today but remain always with me are that M. and my folks and my friends are around with as much support as I will/can accept. I'm a lucky man.

Hospital/Home - Day 5/Day 1 - Goin' Home

I woke up this morning knowing exactly what day it was. It's Discharge Day! That's right I'm going home today. There are still a couple of things left to do, but the plan is to be out the door by mid morning.

I woke up in the similar fashion, on my back, slightly elevated and staring at the clock. My parents arrived pretty early (7:30am) so that they could get a good parking spot. Parking at the OHI is brutal beyond 8:45am and the current snow conditions make it that much worse.

Breakfast arrived as usual at 8:15 and it was my last chance to try and get a rise out of the Food Lady. "Good Morning!." It's almost like I was talking to some one else. Blank stair, drop the food off and move on to the next room. It's weird because it doesn't feel impolite. Just absent.

After breakfast, M. arrived smiling the chiclet smile because she knows what day it is too. Going home is progress. Going home means there's no complications.

Due to all the weather in the past couple of days the nurse teams in our ward have been short handed. It was hardly noticeable for me because I didn't demand to much attention, but I could hear snippets of conversations from the hallway. With that in mind, it took a while for the nurse to come in and do my vitals check. I also told her that I needed the heart monitor wire removed and the sutures checked. She left the room and returned in about 20 minutes with some gear.

First was the heart monitor wire. It was the last dangling remnant of my surgery. It's a wire that is connected straight to the heart that can link to a pacemaker or another device to monitor my heart activity. Now that I was going home it was no longer needed. So, I'm lying down, she tells me its going to feel weird, grabs hold of the dangling part and gives a soft yank. I can't say I felt the wire detach, but I sure as hell felt the wire as it meandered it way to the surface. Done. It was probably about an 6 inch length that had been in my body. The nurse showed it to me, guessing correctly that I wanted to see what it looked like. It was just a wire. Nothing special. She put a band-aid over the wire hole, checked my chest and leg sutures and then went off to find the doctor for my prescriptions.

The list of prescriptions was substantial but all had a purpose. I met with the resident for one last discussion and he gave the nod that I could go home. I pealed off my well appreciated pyjamas and put on some regular clothes. M. and my folks collected my various fruit baskets, flowers and other stuff. I walked over to the nurses station to say "thankyou very much and goodbye" and then we got out of Dodge.

I was still pretty stiff, so getting in and out of the truck was tricky. Once home I sat down on my couch, took a deep breath (as deep as I could manage) and just sat there. The rest of the day consisted of a marathon session of Battlestar Gallactica episodes, an early dinner and then early to bed. My own bed with M. by my side. Things were starting to feel right again.

Hospital - Day 4 - The New Brunswick Connection

The pattern of my hospital stay continued today except my back wasn't so good this morning. My night nurse Mc. set me up so I could sleep on my side and he kept the Dilaudid coming at regular intervals. I slept well, but about an hour after I woke I started feeling pain and then after our morning walk in the ward I was in serious pain. It hurt every time I breathed in and out. It just plain hurt. For the first time I was truly uncomfortable and in a significant amount of pain. We started with Tylenol, but the request for Dilaudid came pretty fast. I laid down to rest and fell asleep. When I woke my back was significantly better.

The order of the day was the physio briefing. M., my mom and me walked into room and around us were men and women ranging from late 30s to late 70s. The patients are easy to spot, we're the ones in pyjamas and housecoats clutching our teddys (pillow used to brace your chest when you cough). When the physiotherapist started her spiel I couldn't help but feel like I was at a self-help meeting. The intro was like AA (or at lease how I have perceived it on television), "Hi my name is Vince and I had a valve repair and double bypass". The group then responds in unison, "Hi Vince", in a long drone. ...The group didn't really respond that way, but it would have been funny. In reality we gave each other the understand nod that goes with being in the same situation.

My day nurse, H., had been in and out a couple of times in the morning, but I was feeling some serious pain and didn't notice the University of New Brunswick pin she was wearing. A night nurse I had earlier in the week, Mt., was from NB and my night nurse last night, Mc., was from NB. I figured what the hell, I'm going to ask. Indeed all three nurses knew each other and all three came from the small town of New Maryland close to Fredericton. I now had lots to chat about because I had been a quasi-resident of Fredericton for almost 2 years during a project with the DND.

That night my nurse was again Mc. Mc. had lots of work to do on me, changing dressings and the like. While he was working I figured, I'll ask him, "hey how well do you know Mt.". Mc. responded with I smile, "I've know Mt. since the second grade". I thought that was cool. How many of us are still in touch with a friend we've know since we were 7 years old. I didn't dig to much and whether they are buddies or not, that's none of my business. I just thought it was cool. 3 people that know each other from the same small town, working in the same city and in the same hospital ward. The best part is they were all awesome nurses.

I didn't mess around tonight. Mc. gave me the Dilaudid and I was out for the count. Tomorrow is discharge day.

Hospital - Day 3 - Race Car Pyjamas

The best part about my third day in the hospital was that I got to put on my pyjamas. No more bloody hospital gown, I transitioned to my race car pyjamas. Flannel, custom made, race car pyjamas. Oh yeah!

Dignity is a funny word because I think it gets confused with vanity, or at least that's how most people see it. When you're in the hospital a lot of people say you need to park your dignity at the door. I think they're wrong, I think it's your vanity you need to part at the door. Your dignity is how you treat people and how they treat you. Regardless of whether my ass was hanging out of the back of my gown or having a nurse come in and shave my chest and other areas I never lost my dignity and I never felt the healthcare people threatening my dignity. Vanity, possibly. Having the big white stripe down my chest was pretty funny looking.

Imagine, someone in the healthcare industry has to treat every person the same. How many of us can say we can do that? Regardless of whether the person is 90, 20, hard of hearing, faking pain, or terminal; they show up to work and do what has to be done. If a chest has to shaved, a catheter removed, thoracic tubes pulled or the washroom cleaned up after an accident; they do it. Was my dignity threatened when the pulled the cather? Hell no. How else was it going to come out?

I received my pyjamas as a going away gift from the folks at the office. The pyjamas came with a housecoat with the IM-Ontrack logo (the company I work for) and a bucket of bubble gum. I thought cool, these PJs are going to look great! The pyjamas couldn't have been more perfect: they are unique, they're cool and they're practical (warm). I can strut around knowing that nobody else in the OHI ward looks like me.

Strut may be too strong of a word to describe my walk, but today M. and I walked the ward hand in hand. M. and I did the full loop twice, once in the morning and once in the evening. The walks themselves aren't so bad, but my back was starting to hurt, right behind the shoulder blade and around the spine. So to rephrase I hobbled (because walk might even be a stretch) holding M.'s hand, only now I was sporting my race car pyjamas. Dignity never gone, vanity returned.

By now a routine is starting to form. I wake up several times during the night, look at the clock and go back to sleep. This in and out of sleep goes on until about 7:30 am, then I just stair at the clock. When I wake my back and neck ache something fierce, so I get up and wait for breakfast to be delivered by the Food People. After breakfast its the nurse shift change and someone new shows up to check my temperature, breathing, blood pressure and give me my pills for the day. Then after the nurse someone comes in to take blood and another comes in to record an ECG. I then head to bed where I stair at the clock and fade in and out of sleep. M. and my folks arrive around 10am. Between 10am and 7pm we talk and I fade in and out of sleep. My folks head home around 7pm and M. and I talk for a while. She has been sending updates to everyone via email and she reads the responses to me. A nurse shows up around 8pm to give me more medication and do a final check before I fade into sleep. It takes a bit of time for the medication to kick in and at about 9pm M. packs up reluctantly and heads back home. I go to sleep staring at the clock...in my race car pyjamas.

Hospital - Day 2 - Food!

The day started early with the removal of the catheter. Mt., my first male nurse explained to me how it was going to work, one guy to another. "The women nurses don't understand, they think you got to be all slow and careful. It just lengthens the pain. Trust me, it has to be done fast." What am I going to do about it; it's 4am, I've got painkillers in the system and very limited movement. "Ready". "OK" I say wearily bracing for the worst feeling of my life. "Done". "Well that wasn't so bad", I say and it wasn't, not painful anyways. Like quickly taking off a band-aid. There's an initial feeling, but after that it goes away fast. "Now imagine if I had done it slowly" said Mt. with a dumbfounded question mark towards his colleagues of the opposite sex. "I'll take your word for it" I say and put my head down to rest.

At about 8am, breakfast showed up. It wasn't much, cream of wheat (or the like) and a single whole wheat toast. I hadn't eaten in two days, but I wasn't ravenous. I just knew that eating something was a good idea. Since I was in chemotherapy I have always associated the sensation of hunger and the capacity to eat with feeling better. If I'm not feeling good and I'm not hungry, I still have a ways to go. As soon as that first thought of eating or that little gurgle develops in the abdomen, things are getting better. I ate the breakfast and immediately started to feel better.

With breakfast down the hatch, mobility returned (sans catheter) and somewhat of a clear head I went back to the bed. M. and my parents arrived soon thereafter. When all you do is lie in bed, drop in and out of sleep, have small conversations and submit to the hourly nurse attention (blood, pressure, temperature, medication, etc.) time goes slow. Real slow. My bed faces a clock and every time I would wake from a dose I would see that the clock had only moved ahead ever so slowly.

Lunch was soup. Some kind of soup that had the gelatinous consistency of porridge. I just hunkered down and ate it. The "Food Lady", as she became in my nomenclature, came by and picked it up. She wasn't very conversational and as I learned during my stay, the "Food People" are a quiet people. Again, I wasn't ravenous, but eating made me feel like I was recovering. I was still in that ridiculous hospital gown, I still was drugged on pain killers, I still had all kinds of IVs, my blood pressure was still really low, I was still swollen all over and my chest still hurt; but, I was getting up under my own steam and I was sitting at a chair and table and eating. Eating "real" food.

The Food Lady dropped dinner off around 5pm. Not a word, not a smile; just a forced walk into the room, a sigh at the fact that my table had stuff on it, a small grunt as the tray slid onto the table and a laboured walk back to the corridor to deliver the next tray. "Thank you!" I say... Nothing. Not unfriendly though, just absent. Dinner was soup and pasta. I ate the soup, but could not eat the pasta. I had some fruit and more apple juice. All in all not a big calorie day, but 3 meals down and the satisfaction that my body was back to creating its own energy.

Hospital - Day 1 - The Good Stuff

The nurse shift change occurs at 7am. The new nurse, R., was a guy. I was still under the influence of medication, but like any person hammered (drugged) and conscious I felt it necessary to prove how lucid I was. Whether I was making sense or not, R. seemed to respond to the questions without too much pausing. The order of business this morning was some tube removal and transfer to the hospital room.

At this point I had been in ICU for 12 hours. The tube down my throat had been removed, but the tube in my nose (drainage to my stomach), the 3 tubes in my abdomen (drainage), the catheter, the main line (IV to the jugular), pacemaker wire, and arm IV remained. I had other IV lines in me during the operation, but they had been removed earlier in the night.

I was on some general pain medicine, but for the tube removal R. administered some morphine. It didn't take long before I was flying pretty high. It's funny I was awake, but just barely. First, it was the nose tube. Imagine these two little tubes that go up your nose and then all the way down to your stomach. Then imagine the sensation of the ends of the tube dangling their way up your digestive track and out through your nose as it is being pulled out. You can feel the whole thing, but no pain.

The second set of tubes to go are the 3 drainage tubes used during surgery to clear mucus and other liquids that collect in the thoracic cavity. This time R. administered a little extra stuff. I can't remember the name, but he said it was short acting. Again, a good numb feeling overwhelmed by body. I was still awake and then R. started removing the tubes. Same odd feeling of the ends dangling their way to the opening. At that point R. must have stitched up the openings but I couldn't remember. From that point on the pain killer for which I can't remember the name became the "Good Stuff".

With the tubes out and me flying high on painkillers R. settled into some paperwork and I was drifting in and out of sleep. Then all of a sudden I caught a slight sensation in my nose indicating the proximity of coffee. Out of the corner of my eye I could see a tray with red cardboard cups and brown lids heading towards R. Out of my field of vision I heard "thanks, double-double right?". I figured I would see if I could get R. to share his coffee with me. I was still doped up, still had tubes coming out of my body and the only thing I could keep down was ice, but there was coffee in the house and it was morning.

The negotiation started with a simple request. Then a small plead. Then an appeal to "helping a brother out". Now that I think of it there wasn't much negotiating going on because I had nothing to negotiate with. After that realization, I tried guilt. "Come on R. I just had my chest cracked open. I'm lucky to be alive. You can't deprive a buddy of coffee." R. was nobody's fool. He gave me a spoonful of ice and asked me if I needed more painkiller. Its kind of funny when you think morphine is a second place for coffee.

After some time M. and my parents came in to visit. They shared the news that the surgery did not go as planned. Upon examination the surgeon was able to repair the valve and only 2 grafts were required instead of 3. Those famous words, "we'll only know when we get in there", came back and it was for the better. The big news was the valve. By repairing the valve it gives the possibility of not requiring any future valve surgery as well as no blood thinners. Pretty good news as far as I was concerned.

During the visit with M. and my folks I figured I'd give one last shot for the coffee. Guilt again was my tactic. "M., Mom and Dad, this is R. He's a really good guy. He was just about to share some of his coffee with me." Sadly, R. didn't go for it.

An hour or two later they transfered me to my hospital room. I met my first nurse, S. She set me up with some more crushed ice and some apple juice. I was still quite swollen from the surgery and my blood pressure was low. They started me on a diuretic and gave me some more pain killers. I drifted in and out of sleep. The night promised to be a busy one because I was still being checked every hour and some time early the next morning (4am) the catheter was going to be removed and some of the dressings were going to be changed.

Surgery Day

I was scheduled for afternoon surgery. Each surgeon does 2 procedures per surgery day: AM and PM. The OHI requests that afternoon patients arrive at the hospital by 9am so that all the preparatory work can be done and you can be ready as early as 11:30.

Wednesday, March 5, we woke to a winter storm that was made worse by a layer of ice caused by freeze-thaw earlier in the week. The plan was to leave the house by 8am. Under ordinary circumstances an hour would have been way too much time, but with the storm and the fact that it had occurred over night, the roads were going to be terrible and Ottawa drivers tend to react poorly to bad conditions. The vehicle plan was for my parents and I to take my truck and M. to follow in her car. As soon as we started to move the cars around I knew it was going to be trouble. First my mom's car got stuck, then M.'s and I then just asked everyone to park their respective cars and we would all go the truck. The truck had no problems in the snow and was the perfect vehicle for the day.

The troubles didn't end there. On our way to the exit we encountered a car partially blocking the rode spinning its wheels and clearly going nowhere. My dad and I got out of the truck and started helping out. It's still amazing to me that there are people in Canada that insist on driving in winter without snow tires. This guy actually had summer slicks on his wheels. His driveway was uncleared, the roads were uncleared and here he was trying to drive around on summer slicks. My dad and I were there for a bit when my mom finally got out the truck and said "sorry we got to go, my son is having heart surgery today and we don't we don't have time to help you". As soon as she said it my dad and I realized how futile the effort was and how unimportant it was to help this guy get to Tim Hortons for his morning coffee. We got back in the truck and drove around the guy and off to the hospital.

We got to the hospital on time. I hadn't drank or eaten anything since 9pm the night before so I was starting to feel pretty light headed. We registered at pre-op and started getting ready. First order of business was personal information. Then, it was ECG, blood work and a chest x-ray. Being in pre-op I didn't have to wait in the typical lines, I just show up and they would take me right away. After that, I got changed into the typical hospital gown that covers the front of your body and has to ties in the back. Shortly thereafter a nurse came in for the shaving of my chest and legs. I then took a shower with more of the antibacterial soap/brush used by surgeons. I walked back to my pre-op room and waited. M. and my folks joined me.

About an hour later (roughly 12:30) a nurse came in and said they were ready for me downstairs. She gave me a couple of pills (relaxants) and said they would come by and pick me. Shortly after 1pm a guy in OR clothes with the shower cap showed up. They transferred me to a wheeled gurney, fitted me with an oxygen mask and off we went. Staring at the ceiling I made my way down to the OR, the orderly told my parents we were at the farthest point they could go, a big set of double doors opened and then shut behind me. After that I was placed in a waiting area. I don't remember much, just a bunch of people coming by to talk to me and look at my chart. Lots of checking and double checking of my personal information.

Maybe 20 minutes later an orderly came to pick me up and we entered the operation room. Operating rooms are pretty nifty, if you're a gear fanatic. I don't remember the details, I just remember a really technical room with a bunch of people moving around with purpose. They moved me from the gurney to the operating bed and then people started poking me, inserting IVs and taping stuff to me. At some point I fell asleep...

I woke up to a dark room with a young nurse checking my blood pressure. My mouth tube had already been removed and I was aware of the room. She told me my M. and my parents had just been in to see me. I asked her for some ice and fell asleep again. Throughout the night I would wake when she was either checking my blood pressure or administering medication. I'd get some more ice and then fall asleep again.

The Night Before

I figured the days leading up to, and especially the night before, my surgery would be nervous and the sleep would be restless. As it turned out I was pretty calm. The day before couldn't have been more simple: my parents had arrived the day before and we just hanged out, I then made dinner all of us, I walked through the OHI surgery script, we played a little cribbage, I took a shower using the anti bacterial soap/brush used by surgeons, I wrote a email to my friends, and we all went to bed. I slept like a rock.

I know I have been nervous before, but my nerves left me a long time ago when I discovered 3 things: don't worry about what you have control over because you have control over it; don't worry about what you don't have control over because you don't have control over it; and, anything that has an end it site has an end. I'm not trying to be profound or anything, but this is why I wasn't nervous. The things I had control over I took care of. The things I had no control over had happened the way they were going to happen. And, by 8 pm Wednesday night the surgery would be over and I would wake up a little later that night to whatever result was going to occur.

For those who know me, especially in my business life, I typically don't talk this way. I like to control as much as I can. This was different--maybe I have mellowed. Maybe for the second time in my life I get to look at my mortality and I'm starting to see things I have simply ignored. Then again, maybe some obscure defense mechanism kicked in and I just shut everything out. Whatever way it turns out tomorrow is the day.