The prospect of Joe’s open heart surgery was scary.  We went through several stages in getting ready for the heart surgery.  Firstly, we learned nearly three years ago that Joe had a heart murmur, which an echo-cardiogram confirmed that it was due to aortic valve stenosis.  This would eventually require open heart surgery to replace the valve.  Because he did not have symptoms, what was called for was waiting until it got worse, and/or symptoms appeared, and the cardiologists said that was sure to happen.

Aortic valve stenosis is a hardening of the aortic valve, almost always due to calcification, which prevents the valve from opening adequately in response to the blood ejected from the left ventricle to the entire body.  This puts some strain on the left ventricle, and if it gets to be symptomatic or severe or critical, the heart muscle becomes damaged.  So we watchfully waited, and carried on as usual.

Then, about a year ago, a cardiologist recommended surgery, because the newest echo cardiogram showed that the condition had progressed to severe, even though Joe experienced no symptoms.  So we upped our preparation for surgery, telling most of those close to us.

The patient, Joe, decided to lose weight and became a near tea total-er in pursuit of this weight loss.  We looked up everything we could online about how to manage with the condition, and read everything we could get about the surgery timing, and procedures, and he managed every single condition which he could, which seemed to be becoming more and more numerous.    We walked as much as he could, often  20 blocks, to be as healthy as possible.

In this preparation window, he had been diagnosed with possible gout, laryngo-pharyngeal re-flux, aggravations of  osteoarthritis,  asthma, sleep apnea, and tiredness.  He did not, however, have symptoms associated with severe to critical aortic valve stenosis, so he, and we, continued our watchful waiting preparation.

He rationed his energy, because, with the area of this major valve area reduced to about 25% of its normal cross sectional area, he simply did not have a rapid enough turnover of his blood to his organs, and tired more easily.  Even so, he did not obviously experience the aortic valve stenosis symptoms of dizziness, breathlessness, or (chest) pain.

I read Straight From My Heart by Bob Sluys, the  e-book pictured above, and learned something about the experience from Bob Sluys, a four-time open heart surgery patient.

In December 2013, his cardiologist told him to see a surgeon, and so he went to one which ultimately I selected.  The alternative to surgery is continued declining condition ending in death, perhaps sudden.   And we continued to prepare with some relief that “the dye was cast”, as Joe said.

We had a wonderful Christmas, with all the children and grandchildren.   We collected information, good thoughts and intentions from everybody!

We were given the second book pictured above, and which I read, by Marc Wallace, and his wife-caretaker, Jamie Colby.   I did more of the reading than Joe, because he did not want to think about it very much.  We were afraid of many things, including a condition which can afflict open-heart patients called “pump head” which seems to be caused by exposure to the heart-lung machine which is necessary while the heart is stopped for the surgery.

We were afraid of stroke and even death.  We were afraid of a hospital acquired infection, especially because the C-PAP mask had started causing a pressure sore on his nose in the danger area for afflicting the brain, had become infected, and that had just been treated, but had started to deteriorate when he began using his C-PAP again.  We were afraid of antibiotic resistant infection due to his nose treatment with two different antibiotics.   It is not easy to get a C-PAP mask on short notice, but we did.

I began to think about advance protection of his immunological and neurological systems, via nutritional approaches.  So in the last couple of weeks before surgery, he agreed to take a probiotic, zinc, and lysine, advocated by some to support the immune system, in case of hospital or self acquired infection.

We knew that there were several  certain insults to the brain, including even a short interruption of blood supply, the anesthesia, the re-warming of his body after protective chilling.  We suspected he had a predisposition to stroke. problems.  So we gave some nutrients believed to be neuroprotective, including N-acetylcysteine (NAC), phosphatidylserine,  magnesium.

Recommended in the Back to Life book, was that it improves outcomes if one listens to music during and after surgery, so we spent a whole day at Fry’s to search for a DVD player which could be used with earphones during surgery.  Joe tried putting his purchases together, and it did not work as planned.  But at least he had a DVD player he could use in the hospital.

Two days later, armed with the best information, advice, good wishes, health, and logistics we could arrange we drove close to the hospital, and a relative gave us a drive to the hospital.  She handed Joe and me a tote full of helpful of helpful items, and dropped us off.  We were there one hour early, knowing that we were as ready as possible to embark on this personal journey, and that the time was right.