Friday, December 19, 2014

Thursday, December 18, 2014

Back In The Groove...For Now

At one of my Starbucks haunts...made my appointments yesterday to see two different surgeons. I have medical appointments tomorrow and next Tuesday but I'm also determined to enjoy what's left of my favorite season. After coffee and lunch there is a free holiday music concert I want to attend at Liberty Place. That will be fun!

Wednesday, December 17, 2014

Getting Re-acclimated

Home at last...trying to get caught up on everything after a week in the hospital. I received excellent care, nevertheless, I'm still in recovery mode. It'll take some time to get back on my feet. Photo shows the view from the 11th floor of HUP looking towards downtown Philadelphia.

Tuesday, December 16, 2014

Day VII: I'm Being Discharged From The Hospital!

Hooray! I'm being discharged this afternoon with a recommendation for surgical aortic valve replacement. My cardiologist, Marty Keane, was formerly at Penn but he is now at Temple. He has recommended a surgeon that Temple just lured away form the Arizona Heart Institute, Gray Wheatley. Marty also gave me another name at Penn, Wilson Szeto, so I'll meet with both of them. I have time because I have to wait for any neurological damage from last week's incident to heal. It looks like my surgery will be around late January/early February, I feel good about everything and I feel good physically so I just have to stay healthy until I can get rid of the bad valve that is causing the problem.

Monday, December 15, 2014

I Made It! No Coronary Artery Disease!

This photo shows the new-style air bladder pressure dressing applied to my wrist at the cardiac catheter entry point just to the left of the green dot. Using the wrist is far better than the old-style groin entry because recovery is so much faster and far more comfortable for the patient.

I had both the TEE and the cardiac cath this afternoon. The staff here at the Hospital of the University of Pennsylvania is so expert that I got through everything easily with no discomfort or pain, contrary to my fears. While I do not have most of the results of the tests, I did find out that I do not have coronary artery disease validating my own prediction. Tomorrow I'll meet with my doctors and hopefully get the full test results as well as find out what the plan is to address my heart valve, and mini-stroke/heart attack issues.

Day VI: Heavy Duty Testing Day

Today will be extremely challenging because I am scheduled for two difficult, highly invasive tests: a trans-esophageal echocardiogram first, followed by a cardiac catheterization. If I can get through these challenges the up side is that I may have answers to what is causing my heart stress and mini-strokes.

Sunday, December 14, 2014

Day V: The Plot Thickens Yet Again

This morning one of my cardiologists, a resident named "Mike" came in early to fill me in on the planned course of action for the coming week. Since the films from last weeks barium esophageal X-Ray series were negative for any TEE contraindications, I will have the TEE first on Monday. If the TEE does not reveal any contraindications for a heart catheterization, then that will happen second, either on Monday or Tuesday. Then there will be a pause of two days to allow contrast media to clear my system. Next, probably on either Thursday or Friday I will have a full chest contrast CT scan. One of the purposes of this is determine what the surgical options are for AVR. It may be possible for me to have a TAVR procedure but this is yet to be determined. HUP does the most TAVR procedures in the Philadelphia area and they are making the procedure available to populations other than the initial limited elderly and ill who are not candidates for OHS.

Update: I am NOT eligible for TAVR...it has not been approved for bicuspid valves, and it is not being done here as widely as the resident led me to believe. Nothing like getting your hopes up and then having them dashed within a few short hours.Also, the chest CT scan is needed to help in the evaluation of my dilated ascending aorta, however, it is uncertain whether or not it will be ordered based upon the results of the cath, etc.

Saturday, December 13, 2014

Room With A View

Looking west from the eleventh floor cardiac intermediate care unit (CICU) University of Pennsylvania hospital.

Day IV: Information Finally!

l had my much anticipated visit by my attending physician Dr. Litwack and his associates. I was prepared with written questions. Here are the answers: My esophagus is normal. The troponin level peaked so there is no longer any need to track it. I experienced a combination heart attack and stroke. This is not uncommon. I will probably need aortic valve replacement. I can inspect my chart. The plan for Monday is to try for both the TEE and the cath, both of which will help with the diagnosis and treatment plan.

Friday, December 12, 2014

Day III: Stuck In The Hospital

Remember when you took your car in for one repair, and they tell you, oh, by the way, this is broken and that doesn't work, etc., etc?

So I wait all day today, Friday for the heart catheterization, they prep me, take me down to the cath lab and....STOP. Because the brain MRI yesterday showed that I have suffered multiple minor strokes (!!!!) to be safe we need take a closer look at your heart valves to make sure there's nothing that can dislodge during the cath and cause a serious stroke. So I need a type of echocardiogram called a "TEE"...a trans-esophageal echocardiogram, where you get high then you swallow (gulp!) the transducer and they look at your heart valves internally. What fun! So if that wasn't bad enough they ask me questions about my esophagus...no problem until the question about swallowing...any problems? Well, I've had swallowing problems for years caused by who knows what, maybe my dilated ascending aorta? Anyway, that put everything on hold. No TEE, No cath...instead I had to go down to radiology and swallow a half gallon of barium while they x-rayed my esophagus! The other tests are on hold until Monday, MONDAY! So I' m stuck here all weekend with the prospect of the nasty TEE to look forward to before I can even get to the cath. Who knows when I'll ever get outta here!

Thanks friends for reading all this and for your love and support.

Jim