Don’t be still, my beating heart

I was born with a heart defect. The medicalese is bicuspid aortic valve with aortic stenosis. My aortic valve, which controls the flow of blood out of the heart into the aorta, has two flaps instead on the normal three. This causes it to open less wide than it should. The average diameter should be at least  3 cm, and I’ve held steady for most of my life at 2.7. My pediatric cardiologist once referred to it as “trivial,” but of course something I needed to monitor.

I’ve never been restrained or limited in anything I’ve wanted to do. Growing up, I went on countless hiking, caving, climbing, rappelling, and other high adventure activities in the Boy Scouts. I marched across football fields with 40 lbs. of sousaphone on my shoulder, while blowing every bit of air I had through it. I’ve done consistent 5-10 mile runs. I’ve bicycled 100 miles on numerous occasions. Most recently, this past Feb., I earned a 4th degree black belt.

So, when I tried to take a run a couple of months ago and almost blacked out on the side of the road, I just knew it wasn’t my heart. I shortly afterward noticed that I constantly had this weird, out-of-breath feeling. It had to be my lungs. I waited it out a month, giving it time to clear, but it didn’t. So I went to my primary care physician and he started checking out my lungs, eventually finding that they work great.

At the same time I did that, I also checked in with my cardiologist. I hadn’t been in a couple of years due to another medical issue that had popped up and since resolved. I did what I’ve always done – got an Echo with doppler, and then went to my cardiologist a few days later for my visit. So I could check it off my list and figure what was really going on with me, I just needed him to say what he always said…”Looks great, keep watching it, and come back next year.”

Except, that’s not what he said.

The “trivial” 2.7 cm valve is now at 0.7. It has to be replaced, which means, for me, open-heart surgery. I’ve known all my life that there was a possibility upon hitting early middle-age that the valve could go. It’s been this surreal, out-on-the-horizon idea that I’ve never fully appreciated. That’s probably why now, at age 41 when the timing was right and the symptoms were all there, it still took me by surprise.

Maybe I knew and just didn’t want to admit it. Having worked for years in healthcare, I know that it’s everyone’s natural tendency to immediately jump to the worst possible conclusion, so I equivocated and rationalized everything away:

• Shortness of breath – “Well, I had asthma as a child. It must be coming back.”
• Left shoulder pain – “I’ve pulled it out of socket three times. It’s always hurt.”
• Left arm pain – “I must have hurt it in karate.”
• Chest pain – “Indigestion.”
• Fatigue – “I work long hours, and I’m not sleeping enough.”
• Heart skipping beats – “It runs in my family.”

Of course, reading this list, it’s easy to Monday morning quarterback and ask, “How did he not put it together?” The short answer is that it’s very easy to do when it’s yourself. I’m sure some women reading this are thinking, “That’s just a man for you,” and maybe there’s some validity to that. A hot button issue of mine is that way heart disease in men vs. women is treated, but that’s a separate issue that maybe I’ll get to later, once I’m able to do so. I’ll have about 14 weeks of recovery, so I don’t know what I’ll be able to do, and when. My entire sternum is going to be opened up, as my aorta has to be repaired in addition to the valve. The pressure of the blood coming through the narrowed valve dilated the ascending aorta.

It’s going to be an ordeal, but I’m ready for it. Maybe not so strangely, I’m far more calm and positive about all this than many of my family and friends. There’s a certain serenity that comes with having no other options. Either I do this or I die. Although I haven’t been told expressly, I gather I have probably less than a year, untreated. That doesn’t work for me. I need to be around to assist my son on all those adventures he dreams up, and help him become the man I know he’ll be. I need to be there to support my daughter, scare boys away from her, and eventually walk her down the aisle should one of the little punks actually be worthy of her. I need to grow old with my wife, and to finish out everything we put in motion when I asked her out to my senior Homecoming 24 years ago.

And while I intone that dying is not an option, and it is a very slim possibility, I’m prepared for it nevertheless, and with that also, I am fine. As the hymn goes, “It is well with my soul.” I accept that everything goes according the Lord’s will, and if it’s in His plan that my time here is over, then I know it’s going to be alright. I am not afraid, regardless of the outcome.

I’m timing the release of this blog to coincide with my surgery. As this blog hits, I can’t communicate.  If I need to say anything at this moment, it’s that I’ve been so touched at the outpouring of love and support for me and my family. Sometimes it takes a dark moment for you to see the light all around you. I have complete faith and confidence in my surgeon and the medical staff. I can tell you that I’m doing fine, and there’s nothing to worry about.  Everything’s going according to plan.

 

Photo:
photo credit: <a href=”http://www.flickr.com/photos/41513150@N00/25744479574″>Heart</a&gt; via <a href=”http://photopin.com”>photopin</a&gt; <a href=”https://creativecommons.org/licenses/by-nc/2.0/”>(license)</a&gt;