Sunday, April 26, 2009

That Part of my Life is Over!!! The PFO is Closed!!!

Friday was the big day. PFO closure surgery at Cedars Sinai. My wife and I got to Cedars before 0500 in the morning. They told us to be there by 0600 but we did not want to risk being late given the fact that we had to travel south on the 405 freeway on a weekday. Upon our arrival we knew that this experience would be dramatically different than any other medical procedure either of us had ever had.

The staff working the front desk of the south tower that early Friday morning were as welcoming and accommodating as you would expect to find professional concierges in high end hotels. I signed in and upon their urging took a seat in the well appointed waiting room. We waited for about ten minutes until one of the ladies from the front desk called my name along with the name of another guest. As I rose to my feet she came to me instead of me going to the desk. I was assuming that I needed to fill out some of the requisite paperwork; instead she proceeded to walk my wife and I along with the other party to the elevators and all the way to our destination, the 6th floor.

My wait in the 6th floor lobby was not very long. The registration agent at the desk told me that they would probably be calling me back at about 0615; guess what time they called me back....0615. I cannot begin to describe how much I appreciate punctuality and respect for the patients time when in a hospital setting. Having that one thing to count on makes all the difference when one is facing stressful situations.

When they took me back to the prep area, the professionalism continued. This is a well-oiled machine that does not compromise. I will spare everyone all of the details of the prep work they performed with two exceptions: First, there are no clothes under that gown; and Second, the part of you they prepare for the Catheter to be inserted so they can get up to the heart is not in the "leg" like they say....think a bit higher...that's all I will say. If you want any deeper insights please just use the link to the right and email me.

The procedure was simply amazing. I was AWAKE the entire time. After a few minutes the nurses mildly sedated me to take the edge off but I never became less lucid. My thoughts might have been a bit slower but I was still able to be conversant with the surgical team as well as watch the four monitors that showed the surgery progressing. Dr. Kar showed me the Starflex device before he sent it up and into my heart. Simply amazing, and big. He exclaimed upon seeing my PFO on the screen that I had a "Huge" PFO. I replied back that size matters and the surgical team had a bit of a chuckle.

While they were testing atrial chamber pressure using did begin getting a migraine. Dr. Kar told me that this was a relatively common occurrence, that the bubbles traveling thru the PFO and into the brain can cause migraine. They were able to give me medicine intravenously that aborted the migraine as the aura faded. The only downside to me was not being able to see the end of the procedure. There was never a point during the procedure that I felt any discomfort. When Dr. Kar was injecting the contrast dye and anaesthetic into my leg, I felt the needle and the bit of pain from that but nothing else.

I must give a great deal of thanks to everyone who was in the room. All of the doctors and nurses who worked on me during the procedure were so professional, caring and accommodating. Of course I have already raved about Dr. Kar in my previous post. This time I had the pleasure of meeting Dr. Broder as well. Dr. Broder was very friendly and took the time to make sure I understood what was going on. He also acted as my discharge doctor and helped me clear up an issue with my incompetent local pharmacy. Big thanks to Dr. Broder for that. I also met a Dr. Dublin (I hope the spelling is correct), he was in his words "low on the totem pole" with the team but I could tell that given time he will be an outstanding choice for this procedure. Dr. Dublin came into the pre-op room and spent some time with my wife and I explaining how things would go and then after the procedure he went out to the waiting room to tell her that everything went well and brought her back to see me.

They wheeled me back into an ICU / Cardiac Step-Down center where I got my own private room. I had to lie pretty much flat on my back for 6 hours before I was allowed to sit up. Then after a couple more hours a doctor came to remove the sutures from my "leg". They put on a compression bandage and that was it. The only pain was a bit of stinging when the doctor wiped alcohol on the sutures. I had a gaping hole in my leg and a foreign object in my heart, but I was feeling good and in no pain. How cool is that?

I camped out in the room until morning when they did an echocardiogram to make sure the device was in place and holding tight. Then Dr. Broder came in at 10:00 when he said he would, and released me. We headed for home, stopping off to get some real food outside the confines of the hospital.

It's been a couple of days now and I still feel fantastic. I am moving around like I always have. Today I took off the bandages and though the bruising looks bad, the actual incision is pretty minor and I don't think there will be much of a scar. I am on Plavix for three months and asprin for at least six. I am allowed to begin moderate exercise again within the next week or two. I will be allowed to resume BJJ after the three month mark. Sooner if they determine that scar tissue is growing over the device fast enough.

A big bit of thanks to everyone for your support and well wishes. This has been a very long three years of two strokes and three TIA's, heart problems and not having any answers. I am so happy that it seems all of that should be behind me now.

Thursday, April 16, 2009

The First Day of the Rest of...Cedar Sinai Rocks!!!

I saw Dr. Kar at Cedars on Wednesday, 15 April. What a different experience than I had at UCLA. First off, I cannot say enough about how welcoming and accommodating Dr. Kar and his staff were.

My wife and I were first greeted by Dr. Kar's P.A. Asma because he had scrubbed into a procedure earlier in the day and was still assisting. Asma sat down with us and listened as we recounted my journey of the last three years. We detailed each stroke that I have had from the first one in 2006 all the way up to the two in one day that I just suffered back on 9 March.

We told her about the PFO that they had found while I was in the hospital and that while we were terrified to learn that I had a hole in my heart, we were exhilarated to learn that there might be a permanent solution. Then the story shifted to detailing my experience at UCLA and how the esteemed doctor there had only offered me entrance into a trial, and how self serving that seemed. A "miss-trial" she asked, and with that remark, we decided just how much we liked her already.

She told us that with my mix of symptoms and history, that doctors certainly should recommend closure. She told us that Dr. Kar would more than likely want the same thing, just as soon as he finishes up with the procedure. Asma told us to go downstairs, have some coffee or something to eat and come back up at our leisure and the doctor should be back by then. So we did.

Upon our return to the offices, Asma took us into the exam room again and right behind her Dr. Kar entered. My nerves were already a mess. I had been anticipating this appointment for weeks now, and after the glimmer of good news Asma had given us just an hour before this meeting, I was extraordinarily nervous. What if we were this far and he decided not to do it, what if for whatever reason I am not a good candidate, what if....its just another trial.

After just a few moments with Dr. Kar, filling him in on my history, all of my fears were laid to rest. He was amazing. Finally someone understood. He listened to our concerns and addressed each one. He then described the procedure in detail, told me how perfect my case is for trials, and then told me that he was not going to twist my arm to join his because as he jokingly put it I "had earned it".

He is going to perform my surgery using the Starflex device which is getting FDA approval next week. I will be one of the first people to receive this device without having to be in a trial. He has used it in a great many procedures already, for clinical trials of the device. This is the newest and the best device and is perfect for my PFO. Once this device is implanted it will start to become a part of me. Scar tissue and heart muscle will grow around it, making it invisible in months.

My surgery is going to take place on Friday, 24 April at Cedars Sinai. That is right, basically one week from now. I will go in Friday and be home on Saturday. I will be back at work on Monday and back to full activity within weeks. Back to the mats within........NOT TOO MUCH LONGER!!!

Saturday, April 4, 2009

A Moment of Gratitude

I know its true for myself, and I'd venture to say its true for many out there, that we all tend to get wrapped up in ourselves from time to time. Bloggers especially can fall into this trap. Lets face it, we talk about ourselves a lot. I try to make it a point to let people know that I appreciate them regularly, but as I said its hard sometimes.

When I was in the hospital a couple of weeks ago, everyone knew I wasn't dying or anything. For all intents and purposes it was routine...for me. I had suffered yet another TIA (mini-stroke) and though this was the first hospitalization, it certainly was not my first rodeo. What was amazing to me was the fact that even though I was fine, and everyone knew that...people showed up. I get a little choked up just putting that on paper. It blows me away that someone would willingly go into a hospital when they don't have to, in order to see someone who is doing well and ready to get the heck out of there.

As you can see by reading my past few posts, I learned some pretty shocking and difficult news about my heart while I was in the hospital, and with the love and support of my wife plus the support of everyone who came to see me or called or texted me, I knew I had a deep bench to call upon during difficult times.

I am eternally grateful to Caleb from The Fightworks Podcast. Without him, well there would be no Fightworks Podcast first off. Secondly, he is the reason I started this silly little blog to begin with. Last year when he posted his list of blogs he reads and the instructions on how to view them in google reader I followed his advice. That introduced me to this wonderful community we have. Before then I never knew just how many others shared my passion. I came to love checking reader daily, to see what was going on in the lives of Gringa, 365, Slidey, Steve, Valerie, Farts and countless others. This was the perfect outlet for someone like me.

Caleb was kind enough to include me in his listing late last year and now that he has posted his revised "Blogs I read" list / file, I find myself on there again. I really am grateful for that. Because anyone who has read my blog lately has found pretty much zero Jiu Jitsu content as I have been off the mats since mid to late January. So, a big THANK YOU Caleb. I'm so glad you are out there. Below is the link to Caleb's post which has the OPML file and instructions to upload and use Google Reader.

Or if you are more tech savvy than I, here is the OMPL file itself:

Download the OPML File of BJJ Blogs Here

Also, I am so thankful to everyone who reads this blog. Those of you who left me comments after my first post out of the hospital, I want you to know I truly appreciate it. You guys are the reason I love this sport so much. From the outside it can look so imposing and even hostile, but once you are inside it, the only word to describe it Thank you all for being a part of mine.