PVCs

What is a PVC you ask... well let me tell you a bit about them. A PVC is a premature ventricular contraction. Its an abnormal heartbeat that begins in the heart's lower ventricles. These extra beats occur before your regular heartbeat and disrupt your rhythm. The PVCs feel like a skipped beat or a flip-flop in your chest.

Some people can have several PVCs in a row...that is called a non-sustained ventricular tachycardia (NVST) and can become a dangerous rapid heartbeat. Sam started getting these the past few years as his heart enlarged. He would get maybe one in a day or multiple. We usually noticed them more often when he was over-tired, stressed or over extending himself. They also made sleeping a little tricky... he feels them more when he is sleeping on his left side [I think because his left side faces my side of the bed ;)]. Usually they tend to go away or become less bothersome when Sam was active.

This week Sam had a NVST episode. It started on Tuesday and he progressively got more as the day progressed. He called U of M and left a message for Marguerite to call him back. She requested he get some bloodwork done to see if his electrolytes were low. Wednesday Sam went and got bloodwork done at Beaumont and a ECG at his doctors office. His bloodwork came back good and his ECG showed a few PVCs.

We were told by both Diane (Dr. Deeb's nurse) and Marguerite (Dr. Bolling's nurse) that these happen to EVERYONE after heart surgery. His heart is still working on getting smaller and adjusting to the trauma its gone through. He needs to relax (easier said than done) and just focus on getting better. Sam is more relaxed now knowing that these happen to people post-surgery.

1 Month Post-Op Appointment

We drove to Ann Arbor today to meet with Dr. Bolling for Sam's 1 month post-op appointment. It was our first time back in Ann Arbor since surgery and the ride their seemed to trigger all sorts of emotions and memories for both of us. Its crazy to think its been 4 weeks already! At the same time Sam is more than ready to start doing things again. The past four weeks he has been restricted to not lift anything over a gallon of milk, no pushing/pulling, driving etc.

Once we got checked in Sam got a chest x-ray, EKG and INR reading for his coumadin level. Naturally his coumadin level was finally within the range they have been striving for the past four weeks (2.8) and he was taken off of this today. His chest x-ray shows his sternum is healing nicely and his EKG looked very good.

Dr. Bolling was running over an hour late today so we had time to hang out or in Sam's case take a cat nap on the couch in the waiting room. We were greeted by Marguerite and she took Sam's EKG and INR results to show Dr. Bolling. A few minutes later the man himself walked in and greeted us with a large grin (I love seeing these grins)!

Dr. Bolling shook Sam's hand and said he looks great! He listened to his heart, checked his incision site/chest tube holes, and looked over his EKG. He was very pleased with how everything looks and sounds. We went over a few questions Sam had and discussed his medications and the new regimen. Dr. Bolling said he should walk until he feels winded...the more walking the more his heart will go back down in size and faster. He also told Sam his sternum will let him know how much he can do and to listen to his body. It will take 10 weeks for the bone to fully heal.

Marguerite came back in to remove a stitch at the top of Sam's incision that was poking out. She is putting him on an antibiotic for a week to ensure no infection gets under his incision since its still draining some days. She also gave us a print out of his medication changes so I can keep track of them and went over a few more concerns/questions. She is working on his paperwork for Cardiac Rehab and we should get a call on that to set everything up within the week. Sam will need to do at least 6 weeks of cardiac rehab three times a week.

It was a good appointment and its all progress in the right direction. We are very happy and blessed! Thank you all for your continued support, well wishes and visits... we appreciate it all so much!!!

Now Sam just needs to rest and mend...

Don't be Shy - Stop on By!

In case any of you were waiting for the green light to come by for a visit or just scared... we wanted to make sure you knew we do accept visitors. We have enjoyed the great laughs and meals with friends the last few weeks....its been nice to have friends and family over since Sam doesn't get out much. If your in the area and want to pop in for a visit or you want a walking buddy at the mall (he still can't lift more than a gallon of milk so don't expect him to hold your holiday bags) or maybe you want to go for a walk around the block... Sam is open to both. And I may leave and run a few errands if you come over too!

The only catch...if you are sick or think you are getting sick you will have to facetime Sam on the iPad or call him. His immune system is still down so we can't take any chances. We wash hands a lot and use hand sanitizer.

Hope to see you soon :)

3 Weeks Post-Op

Today marks 3 weeks since Sam's surgery....some days it feels like time has flown by and other days I wondered why time stood still. Each day is something different... Sam finds new things that cause him pain, some days he has energy and wants to walk/do steps and other days he wants to take a nap and feels winded to do much.

Sam is down to one night sweat....the washing machine and I thank him for this :) I am now a pro at changing sheets at 3am as well, having fresh clothes on stand-by and still able to get back to sleep. When we have children one day it will be a breeze with the training I have now. Sam has been sleeping in bed more and last night made it all night in bed - HUGE!! I am starting to inch the thermostat down a bit... Consumer's Energy called to see why its going down... kidding but I think they freaked out with it being so high lately.

I know some of you are curious about his incision... Dr. Hanzel and nurses at U of M think his incision is one of the best they have ever seen. The two "bullet holes" underneath are from the chest tubes. Although Sam thought now would be a good time to come up with a story about being shot twice and then having to have emergency open heart surgery...

We have had a very trying week in the Kalef house... anyone in Michigan knows that on Tuesday we got a lot of rain and with that rain came water in our basement. This time it chose to come in on a different wall that was finished. I can't thank our friends, family and family of Fire Station 2 that came over to help me tear down the wall, vacuum up water, move furniture away etc. Sam took this hard because he wasn't able to do anything and went up/down the steps one too many times on Wednesday to check the damage. It was frustrating to sit upstairs for him and hear the drilling, hammering and all sorts of noise we could create in the basement.

[Basement leak discovered....we tried to patch it but water was coming in too much]

[The dyke we created so I could sleep that night and keep the water out of the basement. The water drained into the shop vac and ran from the garden hose to the sump pump]

[After the rod holes were filled and the crack was sealed. Note the sun that we discovered upon removing the wall/insulation]

For me its a bit different... I now know how to accomplish a lot on my own. I can attach a garden hose to a shop vac and route it to the sump pump and clear kinked hose lines if needed. I learned all about rod holes in our foundation walls thanks to Adam at Smith's Waterproofing. I can assist in patching walls and much more!

Enjoy your weekend!

Beaumont Post-Op Appointment

Sam is blessed to not only have amazing surgeons and nurses but he also has not one but TWO cardiologists (Dr. Hanzel at Beaumont and Dr. Bach at U of M). Sam had called for a post-op check-up with Dr. Hanzel but he was booked through January. Sam opted to see the nurse practitioner Carla on Monday. Just before we left the house Sam sent a quick email to Dr. Hanzel (Yes they are on emailing terms). Sam told him he wasn't able to get an appointment with him and was 2 weeks post-op and would be seeing Carla in his office that afternoon. In hopes that if Dr. Hanzel was still in the office maybe he could pop his head in and say hi to us.

We met with Carla and Sam has dropped 18 pounds of the fluid weight that was put on from surgery. Great news!! His blood pressure is so good... I am not used to the numbers still. I am so used to it being high on three different blood pressure medications that its always shocking to hear it in the perfect range :) Carla listened to his heart and hardly hears his once very prominent murmur. Sam also used to have what Dr. Deeb called the "bullfrog" - this was when his carotid artery in his neck would bulge due to his heart being so enlarged. This is no more as well :)

We went over the concerns Sam was still having post-op - first up was the ever infamous sweats/chills and difficulty sleeping. Carla suggested he stop taking the pain medicine all together and just take Tylenol as long as he felt comfortable. She also assured us that he will start getting more sleep at night and that it just takes time. We also discussed his current medications (I had to bring a print out since there are so many!).

Just as the appointment was wrapping up there was a knock at the door... Dr. Hanzel came in!! He had office hours in the morning but was doing hospital rounds and had a few seconds to spare and just had to check on his man Sam! Needless to say the smile that spread across Sam's face was amazing! It was so nice Dr. Hanzel stepped away for a few minutes to talk to us and check Sam over. He listened to Sam's heart, did a quick exam and was THRILLED with how great he looked 2 weeks post-op.

Sam felt so much better when we left the doctors office. It was a sense of comfort to hear Dr. Hanzel tell Sam things sounded good and that he looked good...I guess listening to me day in and day out wasn't enough ;)

It truly warmed my heart that we have been lucky to have some really fabulous doctors that are willing to do extra for their patients. Dr. Hanzel has always called us back even if it was 10pm at night or sent Sam an email (what Dr emails patients?! - this guy!). Needless to say there was a little bounce in our step on the way out of the hospital Monday.

Oh what a week....

I can't believe its already Friday and that Thanksgiving has come and gone so soon....We hope you had delicious food, good laughs and great family time. We have so much to be thankful for this year and enjoyed yesterday as much as we could :)

Pre-Thanksgiving.. Sam's beloved fever has made an appearance again....this time its playing hide and seek. Its been low grade staying around 100.5 and below but likes to come out more at night than during the day. Causing the infamous sweats/shivers. To the point that I called Dr. Bolling's office on Wednesday morning after he had to change his pajama's 3x in one night. I talked to Marguerite and she called in an antibiotic to start Sam on. She also ordered blood work so they could check his white blood cell count.

The visiting nurse came over on Wednesday afternoon to check his incision/chest tube site, take blood for the INR (coumadin level)/blood cell count and possibly remove his sutures. The only issue....she couldn't get any blood from Sam. She called her office and asked that a 2nd nurse come over and poke him for blood.... since the blood work was ordered as "STAT" (due to Thanksgiving being the next day and the office would be closed)..the nurse was supposed to be over within a few minutes...An hour and half later the nurse director from the home nursing company came over for blood work. She took a few stabs at Sam before making him bleed. We were told we would get Sam's blood work results sometime Wednesday evening so that he had piece of mind for the holiday.

Marguerite called Wednesday evening and had called the lab to get an update on Sam's blood work but they weren't able to locate his samples that were dropped off. Of course this put Sam into a tizzy and flashbacks of all the poking stirred.... He called the nurse to see if his blood work was in fact dropped off at the lab and asked her to call Marguerite back. We were told the lab was still processing the blood work and can you believe it ... they had results for us 15 minutes later! His white blood cell count was around 10.6 and normal is 10...it is lower than it was in the hospital so that is good. They want him to continue taking the antibiotic for the full 14 day course just in case.

Needless to say Sam wasn't a happy camper after the second nurse left...Good thing Roxy came to stay with us on Wednesday afternoon until Monday...We have been watching her since she was just a little pup of 8 weeks old...Sam LOVES her!! It was good to get a positive loving puppy in the house to break up all the medications, pain and annoyance's Sam faces daily. We are relaxing with Roxy for the weekend :) 

[Sam & Roxy watching the Red Wings]

stay tuned for more updates soon.....

Weekend Update

I feel like the title of this blog post reminds me of Saturday Night Live's Weekend update with Seth Meyers. Well in this case its with Jessica. 

We spent the weekend trying to get a routine down around the house...not really an easy task when we are used to the hospital waking Sam up all night. It took some time to see what furniture in the house was comfortable for him and for how long. Sam didn't like the recliner that was brought over to the house from his parents until....he accidentally moved one way in the middle of the night and it reclines to a nice bedlike chair. Go figure...so that is now deemed his napping location during the day and he occasionally sleeps in it at night. 

Sam did have a low grade fever all weekend and only at night...however, it wasn't over the 100.5 that the doctors warned me about. So I just monitored him and it seemed to work its way out and leave him alone. The fever mixed with some night sweats made for very little sleep...we are still trying to catch up on that around here.. I think Sam gets more than I do and yet says he doesn't sleep. ha! I am listening to him snore right now as I type this. 

We have also discovered the 'night sweats' and they didn't stop at the hospital. He had these in the hospital but of course the nurses chalked it up to the pain medicine he was on at the time. Now that we have switched to a different medication they still happen and he can have 1 a night to quiet a few. I talked with Marguerite (Dr. Bolling's nurse) and she said these happen for multiple reasons but its nothing to be concerned about. As you can imagine Sam is VERY concerned about them and wants them to vacate our home immediately. They usually disappear in a few weeks so until then I am doing laundry daily :) 

Feeling COLD...Sam's feet and hands feel cold a lot... to the point that if I bake something he is right there waiting to put his hands over the heat coming from the oven...this used to be my spot in the house! This is just another one of the "this should disappear in a few weeks" after surgery...I hope it does sooner than later cause he hates being cold and never has this problem. 

Sam is walking about +/- 1 mile a day on top of doing exercises and steps! We are about to become "mall walkers" at Somerset Mall next week. Can you believe that I went on their website tonight to see if they listed how many miles the mall was etc and they have a club you can join! It meets every 3rd Wednesday... I guess I should keep my laughing to myself as Sam may be a proud member soon enough. 

We are taking everything day-by-day....

1 Week

A week ago today we got up early to head to Ann Arbor for Sam's heart surgery...it was an emotional and tiring day. The day was filled with thoughts and prayers from our friends and loved ones. Up at the hospital I was surrounded by my family and close friends....there was coloring, talking, movies, computers among phone calls/texts to fill the day while we waited to hear from the surgeon...this is how this chapter started.

Today we are at home with the heat turned up (my favorite part of surgery is Sam is cold a lot and this is the highest we have EVER had the heat at- if you know Sam you know he is ALWAYS hot and I am always cold), taking walks up and down the block a few times a day, watching him snooze for a nap and I am starting to get the house in decent shape by unpacking our hospital bags and getting some laundry done. I also have my eyes opened wider...I don't take for granted running to Target for something or taking a simple shower. I wait for Sam's mom or dad to come over before I leave to run out for something. Things are different and we have adapted. We get up 3-4 times during the night and if he isn't up then I am waking him up to take medicine. He can't bend so when he drops something he can't just bend over to pick it up. But in time he will rest, heal and make great progress.

The physical therapist came over today to evaluate Sam, go over some more at home exercises and most importantly work with us on how to get him in/out of bed without so much pain. We got a wedge for our bed from Sam's friend Jeff and the therapist thinks will really help out. We are supposed to try and get him in bed this weekend and do the exercises and follow-up with him to see if he needs to come out again.

We are so blessed to have friends stopping by with dinner during the week. We were able to visit with E'lisa & Chris and talk for a bit about their upcoming baby on the way and Sam's surgery. After our company left and Amy & Mike stopped by to check-in my patient took a nap... he didn't really nap too much today. I need to start sleeping when he sleeps so I can catch up on my sleep too! We can't thank everyone enough for their love, support, cards, meals and offerings.  I am off to catch some zzzz's myself. :)

Day 6: Home Sweet Home

Despite Sam playing musical chairs between the couch, recliner, and bed last night he got more rest at home than the hospital (and I think so did I).

We had a good laugh this morning watching Ellen ...Robin Williams was on and he has a cow valve as well...this episode could not be more fitting...he talked about his heart surgery...Sam laughed (holding the heart pillow) as laughing causes great pain. Since it was a such a good clip we wanted to share it with you...see below.



We are still adjusting to being home and don't have a routine just yet. He has been keeping up with his spirometer, exercises, pharmacy, walking and even went for a walk outside with Fred today. The weather today was a high of 35 degrees....the cold air was a bit much for him and he napped afterwards. That was the first time he has walked outside of the hospital and in something other than his hot hospital gown :)

The visiting nurse came by today around 3pm and checked Sam's coumadin level, looked at his incision and changed his bandage from where his chest tubes were. She will be back on Monday to check his bloodwork and will remove his sutchers next Friday.

Pretty chillaxed day today...lots of naps and just adjusting and trying to keep him comfortable.

Day 5: Post-Op Update

When I left a little after midnight the other night, I had helped Sam into bed...this is the first time since surgery he has wanted to be in the hospital bed...a HUGE step. He also had a fabulous night nurse Betsy - I really think the nurses make a big difference.

When I came downstairs in the morning he looked better...with the tubes and wires removed it made a big difference. We were able to see Dr. Bolling and his touring detail again. As he walked into the room Sam was finishing some cereal and actually had one of his legs crossed on his knee...Dr Bolling said "GO HOME....if you can sit like this you can do this at home" :) Sam asked him if he should use a treadmill or what he should do when its cold outside to walk....Dr. Bolling's response "Wear a coat". HA!

Next the physical therapist came in to go over getting in and out of bed with Sam and I .... this was exhausting for both of us. It kinda turned into Clue at the end...Sam has to be sitting on a certain angle, on my side of the bed (since his neck is still sore from the neck tube area), I need to swing his legs up as he goes down on his shoulder and then we can position him better... like I said it was like clue or it didn't work. So after that Sam took his medications and took a nice nap.

Bonnie & I took turns going to pack up our rooms, load our cars and check out of our home away from home - The Med Inn. Discharge services called Sam's room to get some information and set-up a visiting nurse who will draw blood for the coumadin (he only has to be on this 4 weeks), check his incision and drain tube location. We also will have a physical therapist visiting the house to assess how he can really get in and out of our bed comfortably, if he can do our basement steps etc.

I went downstairs to get 6 prescriptions filled only to find out that they didn't send all of them downstairs so that required a separate trip to CVS once we got home. We got another tree branch of paperwork and instructions to go home with. I got Sam washed up and dressed. There was so much going on during this whole process...It was about 3pm when we were finally wheeling him downstairs to head home.

Bonnie followed close behind us on the way home since I was driving an unusual slow speed....to the point a semi truck honked at me and passed me in the right lane. Needless to say I will think twice about honking at someone driving slow...Sam was clenching his heart pillow since he could feel every bump in the road, was nauseated from both the pain meds and being in the car. The hour drive felt like forever for us since I was driving so slow and so worried about pot holes etc. We got home around 4:30p greeted by Sam's dad Fred. He had come to open up the house for us and turn the heat up.

It felt really weird for Sam to be home... he walked around looking at everything and just trying to get comfortable. I slept on the couch so I could watch my patient...I didn't want him to get up thinking he was ok and doing something. We moved to bed around 2am and he slept in our bed for the first time for 3 hours!!! Despite the up and down he got rest and I didn't bug him with any vitals ;)

Day 4: Post-Op Update

I would like to preface this post...I think I only know the day we are on due to the blog at this point. I haven't left the hospital since Friday and things have really started to blur together...which elevator am I in and which floor do I need to go to...

Since Sam's roommate was discharged yesterday afternoon he was lucky enough to have the room to himself all night and finally get some sleep in his new room chair :) (thanks to his boisterous wife). He got about 4+ hours which is great!

The day started off with seeing Dr. Bolling and his touring squad. This was the first time Sam has seen him since discussing surgery a couple months ago. He is a man of few words but gets the details across. He said he needs to walk, walk, walk, walk and when he is tired of walking I need to get him to walk more. Basically Sam gets to determine if the surgery was a success or not by exercising his heart and that will get it to decrease in size. He told Sam what he had done and told him he would be getting his chest tubes taken out, heart wires removed and one of his IVs today. As you can imagine after he left it was a busy and tiring morning getting all of these removed.

His PA Aya came in first to remove his heart wires...I guess those were hiding under a large dressing on Sam's chest so I didn't really know about them. He described them coming out as "dental floss wrapped around my heart and fishing line pulled through my ribs". Needless to say it was painful and he had to be still for an hour afterwards.

Shortly after that hour they came back in to remove the chest tubes. There were two tubes that ran 12 inches inside of his chest cavity. I stayed in the room for this one to lend some breathing techniques and hand clenching. (Its crazy how scared I get for a flu shot and yet I have been able to watch every step of Sam's stuff without flinching). When they remove the chest tubes they need to hold pressure on the area so that oxygen doesn't get inside of Sam's lungs and cause an air pocket - this process requires 2 people. As they remove the suture around the tube they quickly tie the hole closed and then dress it with antibacterial ointment pads and gauze.

Sam asked to see the tubes they pulled out and quickly realized why he was in so much pain...

 This is the machine the tubes drained into and they had to track his drainage hourly/daily to ensure everything was on course.

He had a chest x-ray to ensure the lungs don't have fluid and all was clear. After a little rest and lunch he has done a lot of walking and spirometer use. We even did a 1/4 mile loop tonight :) He thinks today has been the worst in regards to pain as after everything was removed he now feels all of the movement that was done in his chest.

Here is to a better tomorrow :)

All about the cow....

I know some of you have been wondering where Sam's cow valve came from. Was it from a male/female cow....was it grass fed....was it just raised for valves...and so on. I did some research and talked to Dr. Bolling about it today.

First off, the valve isn't taken from the cows actual heart valve. It is manufactured from the pericardial sack (the tough tissue sac that surrounds the heart of a cow) and then processed into the proper shape.

They are chemically treated for transplantation from animal to human. Humans respond very well to this procedure since there are similarities in the tissue composition. Research shows cow valves are used more in younger patients as they tend to last longer than pig valves and can last up to 20+ years. Dr. Bolling thinks Sam's valve will last 17+ years and we are hoping by then the replacement surgery will be less invasive.

For now Sam is unsure about eating beef ;)

Day 3: Post-Op Update

Took a few steps back today... After Sam being up most of last night with the low grade fever and the issues with the chair he was worn out today. We fought with this chair most of today trying to get him comfortable. That on top of a nurse that doesn't seem to like her job really made things difficult around here.

Sam worked with the physical therapist today and did a couple stair case steps...they were sloooow steps but went ok. I told them not to worry as we have a ranch and the only real steps are to the basement and that is where I do the laundry...note the 'I'...so he will be fine on the main level :) He feels good after the stretches and went walking quiet a few times.

They had him kick up his spirometer game today and use it every hour and luckily the low grade fever has left (for now). They said that your lungs can help determine your bodies temperature and since he used it less yesterday his lungs need more exercise. The nurses and PA told him that unless he wants to get pneumonia and stay here longer to use it more often. Now we have check marks going on his dry erase board to track how many times he uses it.

After a bit of a battle with the nurses late this afternoon and calling in our surgeon's nurse I was able to get Sam a different chair in his room. They took a chair from the patients lounge on our floor and moved it into Sam's room. It doesn't recline but its much easier for him to get in and out of. He prefers to be in the chair rather the bed and has napped in it this evening so I think it will work out just fine.

This evening has been a bit better with the new chair and we have the same nurse (Erin) we had last night and she is really nice. His roommate was discharged today so he has the room to himself and finally some peace and quiet. I am going to take this opportunity to sleep in my room tonight and know I am leaving him in good hands :)

We are meeting with his surgeon in the morning and hopefully getting his drain tubes out - they say this causes the most pain right now in his chest.

stay tuned.

Day 2: Post-op Update

Yesterday was a long day....Sam started the day off up very early..something about he can't sleep in the hospital ...who has that problem? He even compared it to being worse than midnights ...I didn't think I would ever hear those words.

Here are some photos from his ICU stay - This is some of the machines he was on...this was after they took him off of some. So whenever he had to walk you can imagine the ordeal or cords and what had to come with us.

He loved this chair and the ICU was redone recently so these are new chairs we have come to find out. 

He met with a physical therapist and started to do some light exercises. They said your body naturally wants to heal in a caved in position so he needs to do shoulder shrugs, circles, chest stretches, arm circles, and coughing/breathing exercises.

They gave him the boot from the ICU around a little after 4...he was upset since the Lions game was just starting and he was starting to get comfortable there with his private room and chair. They had him walk from ICU to his new room and that counted for at least 3 walks so he got plenty of walking in.

We moved to the University Hospital for the rest of his stay. He wasn't too happy about having to share a room and hates the chair they have in here. It's too deep and harder for him to get in and out of. He felt frustrated like he took a few steps back. I can understand since in ICU they made him work on getting in and out of the chair on his own without using any of his upper body. Then we come here and this chair is deep and tilted funny and he can't do it on his own.

A thought did cross my mind to go to ICU and then run out rolling a chair but I could just see the breaking news now "Woman trying to steal ICU Chair at U of M" or something like that... and then he would have missed out on his slumber party buddy last night.

He had started to develop a low grade fever yesterday right before getting moved so I stayed with him last night. I got the better end of this deal as I got the bed but we were up every 1.5-2 hours since he was either sweating/shivering, uncomfortable or they were taking vitals.

I think he is starting to feel a bit better cause he is complaining more :) I mean he had to go BIG on this one...the guy that has NEVER had a surgery or taken anything above Tylenol in his life. I am the problem one that's had 4 surgeries (two ankle, gallbladder and appendix/twisted cyst). Should have guessed he wanted to trump me with a big one ;)

Sorry for the late post...After Sam's mom Bonnie came down this morning I went to sleep for a few hours in my room...it was only 3 but it felt like a weeks worth so I feel much better now and a bit recharged for our day 3.

Day 1: Post-Op PM Update

Sam was able to get out his catheter, neck tubes and be taken off oxygen fully yesterday. It was a busy morning working with the nurses to get him off all of these devises and he was happy when the poking and prodding was done to just take a nap. In the midst of this we were able to meet with Dr. Deeb and you may want to refer to the earlier post on him.  I left him to get something to eat shortly after noon and he was just getting some warm blankets and about to nap.


They try to keep cardiac patients very active and up and at 'em pretty quickly. He has a chart in his room where it marks how many times he is up in the chair, goes for walks, and uses his spirometer. The goals he has for these are as follows: 


Chair - 3 times a day
Walks - 4 times a day
Spirometer - 10 times a day

Day 1 Post Op Summary:

• He loves the CHAIR! So he is in it more than bed and certainly more than the 3x a day required. 
• He completed 3 walks and each time went further than the last. 
• He used his spirometer 5x. Today we are kicking it up a notch since that helps with keeping fluid out of his lungs and gets them stronger from being put on the ventilator. 

He did cough up some blood in the afternoon and naturally if you know Sam he thinks he is dying. Thank goodness I haven't let him have any electronic devices or he would have been on webmd so fast! I talked to the nurse and just as I thought, it is natural given the amount of tubes down his throat. It only took about 4 coughs and it was all over. 


He loves his heart pillow and has been using it any time he needs to cough, they lower his bed, he has to get up sometimes etc. I got this two years ago when I thought we were at "go" time so its been waiting at home in a closet.

The hospital provided Sam a heart hugger...Its like a harness that goes around his arms/shoulders and meets at the center of his chest. It has two padded handles that he can use to squeeze together to help him with pressure to get up etc. 

stay tuned....

Seeing the man who did part of the Deeb....

We were able to talk to Dr. Deeb yesterday (he was SO kind enough to stop in on his way home) and ask a few questions in regards to Friday's Surgery.  You may remember Dr. Deeb is the surgeon that focused on the aortic valve and was brought into the operation room to determine if he could repair Sam's valve or if needed a replacement. He was so kind enough to stop in Sam's room for a few minutes and meet with us. Sam's face lit up when he saw him and he is part arabic so we are automatically related somehow ;)  This was the first time that Sam was able to talk to one of the surgeons about the surgery.

He was able to briefly tell him about the mitral valve repair that Dr. Bolling did. We found out that this was the 2nd congenital defect in this nature that Dr. Bolling has operated on in his career. He has done over 2,500 mitral valve operations. This was all new news to me as well as Dr. Bolling seemed to leave this out during our initial post surgery recap.

Dr. Deeb went onto say his aortic valve was so destroyed that he couldn't and wouldn't try to repair it for fear he would need another operation too soon. He looked at Sam and told him "If you were my son I would have made sure you had a replacement with a bovine valve and that's what I did because I know it lasts a lot longer." Sam smiled and was thankful. He doesn't always believe what I say to him so at least he can see we are all on the same page!

Needless to say I already have some thank you cards drafted for each doctor to be left on their desks...I can now see why they say maize and blue....cause its amazing at the U.

PS. We haven't been able to see Dr. Bolling since the surgery since he is in Orlando for a conference however, he did promise me some mickey mouse ears when he hugged me goodbye on Friday and told me Sam was looking great.

Perspective

Since its late I will post the afternoon details of Day 1 tomorrow morning (well it already is morning so later today).

Sam's obstacle today was the fact that after they took out his catheter he hasn't been able to pee on his own. This is very common after being fully cathed as your sphincter can swell up and cause you to feel like you want to relieve yourself but you can never actually do it. Or your sphincter can become "lazy" and need a little nudges to get going on its own. In the meantime if its been 6 hours without urination you are forced to get a straight catheter. This has upset Sam quiet a bit today since unfortunately it happened twice.

While Sam was getting all upset over this SMALL hurdle in his life right now... i decided to give him a little perspective from what I have seen lately. I told him to turn and look at the clock in his room and tell me the time. It was about 10pm. I told him at this time yesterday you had just gotten your chest tubes out and were able to say your first words after surgery.....You have walked 3 times today and been upright in a chair most of today....there is a man down the hall who is having an emergency procedure in his room.....there is a family in the lobby whom I met tonight whose husband/father was air lifted from Petosky, MI for a heart transplant tonight...and not to forget we witnessed a family last night receive some tragic news....so if this peeing issue is his BIGGEST problem right now then I am THRILLED....it could be a lot worse. I wasn't all badass mean and said of course its easier for me to say this to you but despite the pain to please think about all of the other things happening in the ICU of the Cardiac Center and then tell me if this is really a terrible issue to have right now...

needless to say it sucked to do it again for him but i know a week from now this won't be what he remembers from being here...I will continue to show him the positive things and make sure he stays grounded. It has been a real eye opener what you see in an ICU let alone a cardiac one...I am very thankful for everything we have in life and cherish everything just a bit more tonight and will continue to.....

goodnight!

Day 1: Post - Op AM Update

I came downstairs after 4.5 hours of sleep to see my love sitting up in a chair!!! He is having some pain today from the 2 chest tubes that they have running along side his incision area. They run up inside his chest along the incision a few inches and drain out the access fluid into a measuring container. This way they can monitor if there are any issues by the way the fluid looks. Currently its in just the plain old blood phase. We are hoping for more of a red kool aid look today...progress! 

He started out with some dry cheerios (which was the first thing he has eaten since midnight on Thursday). He wanted to stand up since his butt is falling asleep in the chair/bed. :) That went well and the nurse and I helped him up so he was able to move his legs a bit. 

They brought him a nice cardiac breakfast this morning and he had some of an egg omelet, piece of banana bread, decaf coffee (he thought it tasted so good and for a hospital), milk and more cheerios. They didn't want him to eat too much or too little..kinda hard to gauge that but all he has had recently is meds so this is the first thing to hit his stomach. 

After all of this the cattle has started to move into the pasture ....he went for a walk down the hallway. I did get two quick shots that he may get back at me for but I said it was for the blog ;)

Sam and his brother Jimmy walking

We had to add an extra cape to him so that his little booty was being shown off :)

stay tuned for an afternoon update. 

Post-Op Update

Since I am tardy you get a 2 for 1 special on posts tonight... Sam became more alert around 8pm and they called me back to see him. He was still on the lung machine that was doing most of his breathing but he was becoming more alert. I was more at ease when I told him I loved him and he was able to do 143 with his fingers to me...tears were streaming!

The nurse started to take him off the lung machine more - forcing him to breathe on his own and he was able to do so. They conduct three tests to determine if you are really ready to come off the machine as they don't want to have to try and put you back on it.

1. They decrease the lung machine and ask you to take very deep breaths (uncomfortable) so they can get a reading.
2. They disconnected him entirely from the lung machine and had him breathe out as hard as he could so they could get a reading on what looked like it could be an old metal stop watch.
3. They draw some blood (don't worry from a pre-poked IV) and run some tests

He passed the first two and they were very pleased with the results. We had to wait another 20 minutes for his bloodwork to come back and it was all clear too. Jen (His nurse for the night and so nice) went to show the results to the ICU Dr to ensure it was ok to take him off of the machine. Then it was go time! I held his hand as Jen and another nurse carefully took out his mouth tubes. He was thrilled to take a breath on his own and not gag on a tube anymore. I believe some of his first words are along the lines of "holy shit" and "Am I alive?". Which I beamed with telling him how great everything went.

Since he doesn't remember much or talked to the doctor; after some ice chips he wanted to know what they did. I thought it wasn't the best time to MOOOO at him so I explained they did need to replace the aortic valve with a cow valve but assured him it was all great and the surgeon's could not have been more pleased with how everything went. He was more concerned about if there were any complications or if they had to use his groin - and all thankfully didn't happen.

I kissed him goodnight around 10:20pm and he was getting some meds and sleeping the night away.

I can't thank everyone enough for all of the love and support today...especially my amazing hospital support group that made me actually eat and had kleenex handy when I needed it :)

much love. I will update you all tomorrow after we see the doctor.

Surgery Details

[sorry this is tardy...every time I went to finish I was called back to talk to a nurse, doctor or able to see my honey]

Thank you all for patience and well wishes...We have really appreciated all of them and they have helped out tremendously.... Surgery was very successful!!!

We met with Dr. Bolling around 4pm and he greeted us with a huge grin... which I LOVED. He explained to us that the mitral valve was repaired. They put a ring around it and trimmed up the flaps of the valve so that there is no longer blood regurgitation back flowing. This will assist in decreasing the size of his heart.

Dr. Deeb came in for the aortic valve consult and after looking at his valve determined if they were to repair his valve he would need another surgery in 1-2 years. The valve was shattered and transparent. So instead of repairing the valve they decided to replace the valve with a bovine valve (cow...mooo). See valve photo below.

Dr. Bolling said Sam's heart was the size of a cow's heart which is much larger than a human heart. However, with the repair/replacement valves in time his heart will decrease in size. He claims 1 year from today Sam will feel amazing and will see how much his heart has been adapting to his body. Mr. A-symtomatic will love this new found energy!

We have certainly been counting our blessings today... as it has been a very emotionally draining and trying day at the hospital. You just never know what can happen... We were given great news on Sam and I was able to see him a couple hours after surgery. His color looked good and he doesn't look very swollen. He was still on the lung machine and they are trying to fast track him off of that and plan to have him off tonight.

 In the midst of our happiness and relief we witnessed a family given the worst news of their loved one not making it. It was devastating and I cried for them... well really I have done a lot of that today but I am counting my blessings more than ever.. I soaked up every minute I could with Sam tonight whether he knew i was there or not...

The Deeb is done!

He's done! He's out or surgery 2 hours ahead of time. Surgery went really well. Once they started the surgery and were able to actually see what the were dealing with they had to change up the plan a little bit, but it all worked out beautifully. He's in recovery observation now and will move to Cardiovascular ICU in 2-3 hours where we can finally see him. Thank you EVERYONE for your thoughts and prayers, they are obviously working. Keep them up!

In Surgery...

I was able to go back and see Sam for about an hour before they took him into surgery. It took longer than an hour to prep him due to his infamous Arabic hair coat covering most of his body and they had to put in a tube in his neck that had 3 tubes coming out of it...one of them is in case he needs a blood transfusion and I don't remember the needs of the other two. I do know that out of all the machines he was hooked up to that was the most annoying.

His mom and dad went in first to see him. Then I was able to go back and try and distract him a bit. I think I need to suggest to UofM that they put in flat screen tv's in that area... i mean that always help when you are being poked/prodded and need to wait.

I met two of the many nurses that will be in the operating room with him and a anesthesiology team. They all assured Sam and I that he will be fine... of course that is easier for them to say than for us to digest right now. I gave him a big smooch and told him everything will be fine  ....They took him into the operating room at noon and now we wait another 5-6 hours until he is out of surgery and we can talk to the drs and hear how everything went.

stay tuned....

All Checked In...

We got as much sleep as you could expect for having a big surgery today... less than 4 hours... but that was enough to charge my battery and be up bright and early trying to get things together for us to leave.

Sam's parents followed us up to U of M and we were lucky enough not to hit any traffic or construction.

We arrived at the hospital at 8am and were given more paperwork...i have a growing pile at this point. They took Sam back to the pre-op area to get him shaved, IV started and to talk to the anesthesiologst. They said we can come back and see him once he is prepped two at a time for a few minutes...so now we wait to see him.... stay tuned!

All Checked In

We got as much sleep as you could expect for having a big surgery today... less than 4 hours... but that was enough to charge my battery and be up bright and early trying to get things together for us to leave.

Sam's parents followed us up to U of M and we were lucky enough not to hit any traffic or construction.

We arrived at the hospital at 8am and were given more paperwork...i have a growing pile at this point. They took Sam back to the pre-op area to get him shaved, IV started and to talk to the anesthesiologst. They said we can come back and see him once he is prepped two at a time for a few minutes...so now we wait to see him.... stay tuned!

Counting Down.....

In less than 12 hours we will be at U of M Hospital and Sam will be in the operating room....I feel like time has flown by today and that it was just this morning when I looked at my watch and we went to breakfast and Costco.

Today was filled with tying up loose ends like running errands, laundry, packing and getting an oil change on Sam's car. We went to dinner at Sam's sister Kara's house tonight so that he could see his niece and nephew (who will not be at the hospital) and to take our mind off looking at our packed bags at home.

We received our confirmation call from the hospital this afternoon and there are no changes. We have to arrive at the hospital at 8:30am and surgery is scheduled between 11-11:30am. Pretty lucky on 11.11.11 and for a surgery time to be 11am....just sayin'. Its approximated to take 5-7 hours with two surgeons in the operating room. Sam needs to shower tomorrow morning with an antiseptic wash that is supposed to sterilize and reduce bacteria on his chest. This is needed so that they can shave him in the morning in preparation of surgery. Anyone that knows my Arabic man knows he has some hair...he asked them if they would have a hedger on hand ;)

I will keep everyone updated via the blog tomorrow so feel free to check it often (sometimes the email updates have a lag) and I will update as soon as I talk to the doctors and nurses.

We appreciate everyone's thoughts, prayers, vibes and messages....it means so much to us.

SURGERY DATE MOVED

We received a call from the cardiac nurse at U of M stating that Sam's surgery needed to be moved as the hospital is at full capacity. They were told to move all surgeries with patients that need an extended stay. With that said our new date is 11/11/11. Easy to remember right?! So please re-highlight or circle your planners for Friday, November 11th.

We are grateful that we are lucky enough to live only an hour from the hospital and don't need to change flight reservations etc. He will be the 2nd surgery of the day with surgery starting around 11:30am.

As you can imagine it was hard for us to swallow this news as we were mentally and physically prepared (thanks to my check lists). So now we are looking at this in positive light and going to make the best of our next couple weeks getting to the Cider Mill and a few other things we didn't have time to squeeze in. :)

We feel bad that many of your rearranged your schedules around this important day for us...this has been one heck of a whirl wind. Thanks for all of your thoughts, prayers and understanding.

1 Week....

It feels like just the other day we were in the waiting room at Dr. Bach's office in Ann Arbor waiting for Sam's check-up. When you expect the same old response every time it can really throw you for a tail spin when the doctors change it up on you... I can remember Dr. Bach's hesitation to tell us it was time for surgery and the tears streaming down my face. Of course I had other plans for us and surgery wasn't one of them.

But now that we have hit the 1 week mark we are soaking up every minute together - even if it means I hit snooze for another 10 minutes in the morning (its a good thing I don't have 9am meetings for awhile), going out with family/friends, getting things buttoned up at work and getting stuff done around the house. As some of you have said I started "nesting" and deep cleaning the house and Sam has done some fall clean-up outside. Aside from that I am in full planning mode. I have a list for everything: what to bring to the hospital for Sam, what to bring for me, playlists to create, questions for the doctors after, What needs to be done at our house etc.

For all of you that know me well you know that I am a true planner at heart and even my best friend Amy has been on the receiving end of the 'Planning Jessica'. A couple years ago Amy had to undergo surgery and I did a ton of research before and during surgery. I showed up after surgery to the hospital - told the nurses I was her sister and walked in the room with my list of questions for the Doctor. The Doctor came in and went over a few things and asked if there was any questions. Amy laughed and pointed to me and said she has all the questions and he answered every one of them.

I am sure the time will fly by between now and then.....thanks for all of your support, thoughts and prayers!!

Meals

Some of you have asked how you can help out and our amazing best friend Amy has started a page for us at Take Them A Meal. Don't feel like you have to sign up but I wanted to keep you in the loop on the opportunity. 


When Sam returns home he will be on a low sodium diet which is common for cardiac patients. The American Heart Association (AHA) recommends that those on a cardiac diet consume meals that are low in sodium and low to moderate in fat. The AHA says that it is important to get enough protein to heal after the operation. The sense of taste and smell are impaired for a few weeks post-op. The use of fresh herbs and spices will enhance the flavor of the meal and is suggested by the AHA. 


If you are having a hard time coming up with low sodium recipes I have found a few links that may help:


Keep The Beat Recipes

Mayo Clinic Low Sodium Recipes

Better Homes & Gardens Low Sodium Meals

Taste of Home Low Sodium

Low Sodium Cooking

We can't thank you enough for your support and assistance during this stressful time. 

Pre-Opness

Today we went up to UofM for a slew of pre-op stuff which included blood work, EKG, a physical, meeting with the Surgeon's Physician Assistant and the surgical nurse. I am tired thinking about all of the stuff we did today.

The tests were easy...well I guess I can say that since it wasn't me having them done :) We met with the physician assistant Michael Guerra. He did a physical exam on Sam. They swabbed his nose for staph and will call us on Monday with the results. This is standard before having any operation at U of M. If for some reason there is any trace of it we were given a prescription to get filled for a nose spray to take 5 days prior to surgery.

PA Guerra was kind enough to answer more of my questions and confirm that both Dr. Deeb and Dr. Bolling would both be in the operating room. That was a great relief since once the surgery was bumped up a day we were concerned Dr. Deeb wouldn't be available to be in the operating room. Sam also had to sign his consent for surgery and give his valve choice (tissue).

After PA Guerra left the room the surgical nurse Sherry came in to talk to us. She covered everything from when Sam needs to stop taking vitamins/blood pressure meds, getting a copy of his durable power of attorney,  loading us up with more paperwork, giving us his incentive spirometer to practice with and directions for the week of surgery.

On the day of surgery we have to arrive at the cardiac center at 6am for an 8am surgery start time. I will keep you updated as we get closer.

We appreciate all of your thoughts and prayers today!

PS. Don't forget to leave us a comment :)

Breaking News: Surgery Date Change

Breaking News alert... not like a severe weather alert but a surgery update one.... Sam's surgery date has been moved to Thursday, October 27th. Same time, same place, same doctors.

We think this is a good move so that we have all of the doctors around on Friday for his recheck as opposed to a Saturday where the residents are usually in. So please highlight and circle your calendars with the new date... i already had it highlighted in pink on mine so not sure what I am going to do to move it a day... We will keep you updated after his pre-op appointment on Wednesday.

U of M Hospital

I would say they are the mecca of hospitals and honestly we couldn't be happier with the staff, surgeons and everything it has to offer! Every time I see a "Michigan Difference" commercial I get goosebumps and my eyes well with tears... i think this hospital is truly amazing.... 

Their cafeteria has so many choices and amazing food - that is important - a girl's gotta eat! Plus my father-in-law LOVES hospital food... although this is more upscale than what he is used to at Beaumont. They have all sorts of stations and grab 'n go's...it can be overwhelming really.

They have a hotel located inside the hospital for families called the Med Inn. 

Its a very small hotel with only 30 rooms but its conveniently located inside the hospital and has reduced rates compared to area hotels. They assist about 950 people with their lodging needs each month. We were able to check it out on our last appointment...since there were no photos online I really was interested to see what a hotel inside a hospital could look like. It was converted patient rooms after all... but to our surprise they had just remodeled 2 months ago from their throw back 80's style. The rooms are really nice, clean and have either 1 or 2 queen beds, mini fridge, microwave, flat screen TV and spacious bathroom. They allow families to book up to 2 rooms for the duration your loved one is in the hospital. I already booked one for Sam's parents (Bonnie & Fred) and one for myself. Since surgery will be so early we decided to head up there the night before - that way I already have a room and don't need to worry about checking in and 5:30am will come very quickly.

The Cardiovascular Center is 350,000 square-feet and one of the largest facilities in the heart of the U of M Medical Campus. The Center includes a 24-bed surgical post-procedure ICU, 24 vascular general/moderate care beds, nine cardiac procedure rooms, four cardiac surgery operating rooms, two vascular surgery operating rooms, two general thoracic operating rooms, two endovascular procedure labs and 36 clinic exam rooms.

Surgery Date

With two surgeons we had to wait to get official word on Sam's surgery date....once everyone synced up we were called and told to circle and highlight Friday, October 28th on the calendar. Its a little later than we expected since the doctors were telling us it would be September but at the same time it gives us time to get things in order and have fun with friends and family! Sam is thrilled to hit the links, finish out the Tiger's season, take a trip to Florida, kick it at some Lions games and attend some weddings before surgery. 

Our next appointment is October 12th for some pre-op tests, physical and to answer any other questions I can come up with by then...and trust me I am really making all these doctors and nurses work hard with all of my questions and research findings :)

p.s. Sam loves The Peanuts :)

Dr. Steven Bolling

Do you know how many times your heart beats in a lifetime? Well if you were seeing Dr. Bolling I think that may be his opening question.... and the answer is 3 billion! I don't think I will ever forget that.

On Monday we went to meet the 2nd surgeon - Dr. Steven Bolling. A little insight on Dr. Bolling:

• He performs 350-400 mitral valve repair surgeries a year (other surgeons only do about 4 repairs a year and mostly do replacements). 
• He is 1 of 3 surgeons in the region that perform the large amount of mitral valve repairs.
• The oldest patient he has operated on was 100 years old and the youngest was a newborn.
• He has worked with Dr. Deeb for 26 years - thats longer than some marriages!

He was very impressive!! He was down to earth and one of the first doctors that didn't talk to us using the usual textbook terms or a long list of acronyms we weren't familiar with. He immediately drew a picture of Sam's heart and highlighted the problem valves and explained in depth what was going on and how he was going to fix it.

The week before our appointment with him I got an email from Adam's Heart Valve Surgery Blog (I subscribed to this a few years ago and the articles are great). Dr. Bolling talks about the mitral valve predictably here on Adam's Heart Blog. Its amazing how things happen at just the right time... it landed in my inbox and i happened to catch the name in the headline and immediately got goosebumps watching this small clip of him.

I was so happy that both Dr. Bolling and his physician assistant Dr. Michael Guerra were so patient and answered our long list of questions.

After our appointment we went to find the Med Inn hotel located inside of the hospital. I wanted to see where it was located in relation to the cardiovascular center and get the 411. Lucky for us the rooms were just renovated from the 80's two months ago and look almost like Marriott hotel rooms - not too bad for being hospital rooms transformed!

Surgery has been scheduled for the end of October... more details to come.. 

Welcome to our blog!

Thanks for stopping by. This blog is about Sam and the heart condition that he was diagnosed with nearly 6 years ago. Sam had insisted on keeping this a private family matter but thought now would be a good time to kick things off and be able to keep our extended family and friends informed about what will be going on in the near future.....hence the cute header "from the heart".


So as you may or may not know... Sam was diagnosed with a heart condition back in the summer of 2006.  His heart was enlarged and had two leaking valves (mitral and aortic). The first doctor he saw that summer wanted him to have open heart surgery right away....since that didn't sit well with any of us and especially since Sam felt fine we looked for a 2nd opinion. We met with Dr. William O'Neill at Beaumont and after some tests he felt we should hold off on surgery and try a combination of blood pressure medications to help delay. Dr. O'Neill left for Florida shortly after our initial visit and we started to see the valve specialist in the practice Dr. George Hanzel. He is amazing! We were able to go a few years with some check-ups and tests to monitor the heart. 


We got to the point two years ago when Dr. Hanzel suggested we see a surgeon and that surgery may be around the corner. We met with a Beaumont surgeon - Dr. Francis Shannon in 2009. He was a very educated surgeon but not the one for us. We decided to get a second opinion at the University of Michigan (which was difficult for Sam since he is a Spartan fan) where we met with Dr. Michael Deeb. From the moment we walked into the doors of the U - there was a calming feeling...everyone is so nice and helpful. Sam loved Dr. Deeb on our first appointment (and he is half Lebanese too)! After a TON of testing that Fall, Dr. Deeb decided now wasn't the time for surgery and that he wanted to monitor Sam carefully and have a UofM cardiologist see him regularly - Dr. David Bach. 


We have been seeing Dr. Bach now for the past two years every 6 months for echo-cardiograms and check-ups. To our surprise during our last visit with Dr. Bach (June 2011) he said it was "go time" with the surgery! So needless to say things have been a whirlwind the past 2 months.. we have been in Ann Arbor every 2 weeks for either a test or an appointment. We met with Dr. Deeb  a couple weeks ago and he is going to operate on Sam's aortic valve. He hopes to repair it and give him 10 years on a repair vs a replacement with a pigs valve. He won't know until he gets into the operating room and looks first hand. In addition to Sam's aortic valve being operated on - he is referring us to his partner Dr. Steven Bolling who will be performing the mitral valve surgery on Sam. Due to the complexity of Sam's valve conditions he will be getting the two best surgeons that the region has to offer - all in one surgery! 


Stay tuned for the Dr. Bolling update! 


We appreciate all of your thoughts and prayers.