Thursday, July 31, 2008

News: Surgery

Word seems to be getting around!

On August 7 I will be undergoing open-heart surgery to correct a congenital heart defect. After 40 years of natural compensation, it is time to replace my bicuspid aortic valve with an artificial "ball-and-cage" valve. Due to a side effect of this flaw, a pacemaker will also be installed.

The story...

Where this natural valve typically has 3 flaps to control blood flow from one heart chamber to another, mine has always had 2. This defect allows backwash from the second to the first chamber, causing inefficient pumping. To compensate, the second chamber has significantly expanded, and the valve flaps have stiffened. While a sufficient solution for four decades, this can only work so long before the expansion interferes with itself, most blood simply gets washed back and forth between chambers instead of pumped to the body, and congestive heart failure follows if left uncorrected; that time is looming, and once reached is irreversible. When discovered some 24 years ago, I was told the defective valve would need replacing in about 20 years.

To complicate matters, the stiffening of the valve has diffused thru heart muscle and has caused an electrical blockage. The upper chambers naturally pulse, and this pulse is electrically relayed to the lower chamber for a subsequent delayed pulse. The blockage is preventing the signal from reaching the lower chambers. Demonstrating the human body is wonderfully made, a secondary natural pacemaker has, to the delight of my cardiologists, developed and is functioning well. Unfortunately, the two halves are now operating independently! The upper chambers run about 80 beats per minute, and the lower chambers about 40. While this is keeping me in relatively good health (relative to what is commonly a terminal disconnect), the situation is seriously inefficient and unreliable. Ergo, an artificial pacemaker must be implanted.

Fortunately, God's providence and manipulation of my human fallibility has led to both situations being timely presented to some of the best cardiologists and heart surgeons in the country. I have recently been subjected to EKGs, echocardiograms, MRI, cold stethoscopes, and much poking & prodding. Several more tests are scheduled to assure safe surgery. My boss has assured me that personal health is far more important than project delivery dates. The implanted medical technology involved is designed to outlast a full life.

August 7 I will check in to Emory Crawford Long Hospital in downtown Atlanta at 5:30AM. I don't yet know the exact procedure and duration. Hospital recovery time will be 5-7 days, with another week or two at home. Diagnosis is "bicuspid aortic valve with severe aortic insufficiency" coupled with "complete heart [electrical] block". The corrective actions for both issues are well understood, with recovery rates exceeding 98%.

Let me assure everyone:
- I feel fine. I have long gotten used to my decreased energy levels, and short of vigorous exercise can do what I like. The only concern is that the future drop-off in health will be abrupt and likely terminal if left uncorrected. For now and in the uncorrected near future my health remains normal.
- I am calm and confident of the near future. God has blessed our culture with medical wisdom and the wealth to implement it; I am additionally blessed to be so near such advanced doctors and facilities. Success rates for this operation exceed 98%, improved by my being in relatively excellent health. I find myself spending time calming _others_ about the situation.

- We will need support of friends for about 2 weeks starting August 7. Please coordinate support via Barry Hasenkopf, Carrie Clement, and Cindy McBrayer.
- Karen & Kirsten will especially need companionship at the hospital on the 7th. Carolyn will start things off early, and Cindy & family will pitch in later; subsequent support may need arranging.
- While I will certainly welcome visitors, understand I will also need rest and quiet during the first week. Drop in if you like, but don't feel compelled to battle Atlanta traffic to do so.
- Meals will be appreciated, especially if leftovers can be frozen. Coordinate this with Carrie.
- Stay calm. I realize news of "open-heart surgery" is a shock to most, I assure you little about it is a surprise to me, and all indications are everything will turn out fine.
- Prayer is needed above all else. God has certainly and clearly guided my long path in this issue; this time is the culmination thereof.

Pardon the length of this email; I've tried to cover everything people tend to want to know. I certainly have not managed to include everyone who should get this; if you know someone you think should know, please forward this email.

Thank you for your care in this matter. Thought you might want to know the details.

- Carl, future cyborg

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