Tiny Bubbles.....

Wednesday, 27 May was my one month follow-up appointment to see how the PFO closure was healing, to make sure the device is working as it should and to find out whats next. I was hoping for good news, what I got was so much more.

I showed up to the fifth floor of the south tower at Cedars Sinai about an hour and a half early. I guess that I was feeling excited and apprehensive at the same time. Before seeing the Doctor I was having an echocardiogram with bubble study. Basically, it is a normal echocardiogram (ultrasound of the heart) but at one point they inject a bunch of saline bubbles into a vein and watch them flood into the right atrium. If the surgery worked as it was supposed to, all of the bubbles would stay in the right atrium and not shoot across into the left thru the newly closed PFO.

I have become somewhat used to having echos done now. I know what images they are going to grab and typically in what order. I even know how to stay comfortable in the awkward positions. So I knew when it was over and time for the bubbles. A nurse had already come in before the test and installed an IV line in my arm but for the actual injection of the bubbles the technician called the Fellow who was on duty.

The tech had a pretty picture of my left and right atria on the screen (the right one appears on the left of the screen.....go figure). And in coordination with the fellow, the bubbles were injected rapidly. On the screen the right atrium started to show up bright white as the bubbles rushed in. The left atrium was remarkably empty. Neither myself, the tech nor the Fellow could see any bubbles pass thru the PFO. The surgery worked as it should have.

With a new sense of relief I left the echo lab and made my way to the Doctor's office. I felt like a kid running home to see a parent with a good report card (not that I have ever known THAT feeling). I couldn't wait to hear what Dr. Kar would say. Most of my apprehensiveness had now been replaced with pure excitement.

At Dr. Kar's office the wait felt intolerable. It wasn't very long but I was dying to get in to see him. Asma came and took me to the room and went over how I was doing. She asked if I had received her reply to my email that told me basically no increased physical activity until at least a month after surgery. I said I did receive it and we laughed that I knew the answer to the question before I had asked it....guilty.

Dr. Kar came in and was as excited as he is every time I have seen him. He asked how I was feeling and I told him that I was fantastic. He read the echo report and told me that the doctor who read the results had seen a couple of tiny bubbles make it into the left atrium. Dr. Kar told me not to worry about that because first off I had, in his words, "a Huge PFO"; and secondly at the end of six months enough scar tissue should grow over the device so that no bubbles would come thru. But for now, the size and relative amount that passed thru were nothing at all to be concerned about.

Then when the appointment was drawing to a close I asked about my activity level; about what I could or could not do. In one of those moments where one's words were not specifically chosen but they are exactly right he said "you can do anything". How inspiring is that? That's right, I have NO LIMITATIONS now. I committed that upon my return to the mats (probably Tuesday, 2 June) I would take it slowly and not roll for a month or so. The Doctor told me to come see him again at the six month mark and sent me on my way.

I cant begin to describe my appreciation for Dr. Kar, Asma, and the entire team who got me thru this. When one hears that they have a hole in their heart the level of fear is paralyzing. They made it so easy to deal with and as I saw with my own eyes, they fixed it.

When I return to the mats next week, it will have been after about five months off. I last trained on Saturday, 10, January. 2009 will go down as a year where I lost half of it to a couple of strokes, the discovery of a hole in my heart, surgery and finally a mid-year triumphant return.

Stay posted, the return of Jiu Jitsu content is imminent!!!