The Day Before Open Heart Surgery

As I mentioned before, here (http://livingwithfh.blogspot.com/2016/01/the-importance-of-connectedness.html), I have joined a forum for heart valve patients (http://www.heart-valve-surgery.com) when I found out that my open heart surgery is imminent, to replace my aortic valve. I have a journal on that site, where I recount the day to day life during this heart disease and heart surgery journey. What follows here is mainly what I posted on that site today.

As FH will have it, my surgery has gotten a bit more complex than just the aortic valve replacement. Due to atherosclerosis, which is a side effect of prolonged high cholesterol in our arteries, there are several other things that will be done during my surgery tomorrow. Just read along. I will explain.

Today was pre-op day. You go to the hospital for several hours and you do a number of things:

- blood tests, urine tests, chest X-ray, EKG, as far as tests go;
- you also meet with a nurse who will go over the pre-surgery instructions with you: when to shower, how to shower, when to shave, when to disinfect, what meds you're allowed to take; what meds you need to skip before the surgery (which is tomorrow)
- then, I also met with my future cardiac rehab counselor. This is the lady who will work with me to build up my stamina, after ICU, so I can eventually be released and go home. She talked to us for almost an hour and she explained EVERYTHING. Very informative meeting.
- then, we also met with the surgeon. He scheduled the surgery for 8 AM tomorrow, and I will be his only case that day. He will also be assisted by two other surgeons in various portions of the surgery.

The "menu", as he once put it, for my surgery is this:

- replacing my aortic valve with an ON-X valve
- replacing my ascending aorta with a Dacron graft
- a double by-pass on my LAD and OMB arteries.
- he fourth item (reconstruction of the aortic arch) is still a "maybe" although he said he wants to walk in the OR thinking it's a definite.
 
So, if that happens, then the circulatory arrest and the hypothermia is back on. I am not a fan of that, but I also want him to open me up just once and not have to do this all over again for the aortic arch in a couple of years. But as of right now, we're not 100% sure if this will be done or not.

Without the rebuilding of the arch, the operation will be about 5-6 hours. With the arch, it will be more like 7-8. Either way, he's planning for a whole day.

I am not allowed to eat any solids till 11 PM tonight, and I am not allowed to even drink anything after that, into the surgery tomorrow. I am on a beta blocker right now (atenolol, been on it for 19 years), but they told me to not take it tonight and tomorrow and just take metoprolol instead.

The surgeon asked me again if I made any plans with my cardiologist about being on the PCSK9 drugs when all this is over. He said he will repair most of what is broken around the heart, to give me a good pumping life ahead, but with the cholesterol still outside normal ranges this disease (atherosclerosis) will continue to progress. I told him that my cardiologist and I did talk about it and we will explore the affordability and the risks for sure when I come out of  the recovery.

Now, back to the surgery tomorrow: I am incredibly at peace with this whole thing. I am looking back at my December self, when I was picking valves and worrying about how coumadin will change my life, and worrying about dying of a stroke during surgery and never seeing my husband or my family ever again; and now, with everything else in the picture, knowing as much as I think I can know about everything, and hearing all sorts of stories from real patients, AND having met my surgeon and having complete faith in him and God, I am ready to do this.

Especially after the surgeon giving me an honest to goodness bear hug today, and telling me several times that I'll be fine. We can do this. We'll be fine. He has always been talking about me and him as a team, in the short time we have known each other. I love him. I am really, really lucky!

I figured: I cannot control this, technically/ mechanically. The ONLY way I can control this is if I train my body that we got this in the bag! We (me and body) are fit and healthy, otherwise (sure, my cholesterol is high, still, and I have atherosclerosis all over my body), but I live a full life, I work a full time job, I eat right, I don't smoke, I feel like physically and mentally I am in the right spot, so we can go through this (my body and I) and we can work beyond tomorrow to get better and recover. 

From my yoga practice, I am way too familiar with the "monkey mind". The mind will always try to take control and make you think of things that are not and will never be even real. But if you train the monkey mind, you can quiet it down, and teach it that all good is still to come, and you can make it work with your body to seek nurture which will lead it to health. Just breathe in and breathe out. And ignore your mind, like you ignore an unruly child. It will eventually stop taunting you and that's where you find your peace.  All else will fall into place.

Anyway, it took me close to two months to get here. But once I got it, I am ready to climb this mountain, and plan the rest of my life!

I will say that a key help in my journey to today, "the day before", has been my family, friends, and co-workers. The encouragement and prayers and "atta girl"s and "you're strong, Alina"s that they have sent me incessantly have motivated me to know that I have SO MUCH to live for. I might come out of this with complications, even long term problems caused by strokes or whatever ... but I know one thing for sure: I am not ready to die yet. Now, God might still have other plans, but if I can help it, and if He allows me, I will come out and fight this to my last blood drop, to get better and live  a full and healthy (whatever "healthy" means to me) life.

And last but absolutely definitely not least: the "heart-valve-surgery.com" site as well as the Bicuspid Aortic Valve Heart Condition site on Facebook  (https://www.facebook.com/groups/BicuspidAorticValveHeartCondition/?fref=nf) , those communities, all the patients recounting all their stories in detail, and all their triumphs have kept building up my mental strength as well.

On the medical, and technical aspect of this journey, THIS was the biggest help for me! Just being able to relate to symptoms and doctor's visits with all the other patients has made this sound and feel more familiar - and this is such a blessing. 

Social media is amazing. And I am grateful for people that take the time and put in the effort to update these sites, so people like me can learn from your experiences. I only hope that one day, I'll do the same for others.

Talk with you all "from the other side of this Rubicon" as my dad put it tonight.
Much health, you all, and may God bless your own journeys!