From the Heart, One Year Later

It’s been a year since I had my open surgery to remove an aortic aneurysm. It’s been a l-o-n-g emotional and physical journey, with some ups and downs. I'm happy to report that the scar is fading. It's almost gone. I am healing and overall, I am thankful .

The top photo is of me now. I gained some color (and a little weight.) The second photo was taken a few days after surgery last year. I looked pretty pale and felt awful from the chest pain and limited mobility. I tried to recreate the shot. It’s the same Old Navy shirt and wall background.

Here is my New York Times article that I wrote about the journey that led to the surgery and my immediate recovery.

And here are my previous blog entries in order (From the Heart, More From the Heart and From the Heart, Part 3.)

From the Heart Part 3

It's been almost three months since I had open heart surgery to remove an aortic aneurysm. I can finally say that the chest soreness and breastbone pain are gone. I can sneeze or cough freely without having to quickly grab a pillow and press it up to my chest so that my sutures don't pop out.

The zipper-like scar that lines the center of my chest is fading. I have gotten used to it. Six weeks after my surgery, my surgeon and his physician assistant lifted the physical restrictions they had me following. Now I can drive, lift light weights, swim, and more importantly, run, one of my favorite things to do.

I returned to running last month.  I began modestly, running half a mile. I did not want to overdo it, knowing that I have new piping in my heart. A side affect from the surgery is that I sometimes feel and hear my heart pumping. It's strange and unnerving. Who wants to hear their heartbeat in their ears? It's weird but I was told that would eventually go away. 

Although my doctors cleared me to exercise,  they strongly suggested that I do not over do it with the running and weights even though I was feeling good.

"Don't go lifting 200 pounds now, Johnny,'' my surgeon said. "Start at 10 pounds. Take it easy. Progress slowly. Listen to your body." 

Like a blinking yellow traffic light, caution ran through my head as I began to hit the pavement. Instead of running like a colt, I slowly jogged, which felt like I was running in place and not going anywhere but I was moving and that was the goal.

Other runners, mostly University of Miami students, whooshed by me but that didn't matter. I was going to run on my own terms. This was not a race. This was me literally getting back on my feet. When I reached my half mile goal, I smiled. A great sense of accomplishment washed over me. I did it!  

I couldn't believe that just a few weeks before, my chest had been cut open. I was in the hospital for five days attached to a tangle of IVs. I could barely move around without feeling searing pangs of pain in my torso. I finally recovered, cured of the aneurysm, untethered from the paranoia and fear of it suddenly bursting. Running was my way of celebrating that feat.

It felt so good to run again, the freedom that it brings. The breezes tickled my face, the sweat beaded on the back of my neck and my shadow accompanied me each way as if watching out for me. Knowing that I could get around on my own boosted my confidence. 

I enjoyed running to the tropical rhythms of Jimmy Buffet such as “Brown Eyed Girl” and The Beach Boys including "Sloop John B." These songs always put me in a good mood. I imagined I was back in the Keys and gazing at the various shades of blue in the water. I also ran to a medley of Pussy Cat Dolls hits because their infectious pop-dance songs make me want to run faster and their lyrics are fun to bounce along to.  "Tip top, drip drop, Bottles drop, lips lock..."

My confidence continued to blossom. I began running a mile which is what I am doing lately. Again, I do not want to over do it.  My doctors told me that my heart was stopped for about 2.5 hours during the 5 hour surgery so they could cut out the aneurysm. The heart was kept cool with a special fluid while I was hooked up to a bypass machine which did the work of my heart and lungs. I do not want my heart to suddenly stop because I overexerted myself with the running and weights.

My goal is to eventually return to 2 and 3 mile runs, my previous routine. But I am in no rush. I know it will happen. I am already half way there.

 

From the Heart

A soft cloth graft sits inside my aortic artery, helping blood flow throughout my body. The graft, almost like a 32mm sleeve or about 1.2 inches, replaced an unruptured aneurysm (bulging of the artery) that was silently and dangerously growing inside my aortic root. The aneurysm was recently removed and replaced at Mt. Sinai Medical Center in Miami Beach. The name of the procedure is a mouthful: valve sparing aortic root repair.

It's weird to think that my heart has a new part or an artificial section (featured in light blue in the above illustration along with my messy notes.) I discovered the aneurysm by accident. Before a colonoscopy in Boston, my heart wouldn't stop racing. It was as if I was running even though I was lying down waiting for the happy drugs. The gastroenterologist halted the procedure and strongly suggested I see a cardiologist which I did a few months later in Miami.

That led to an appointment with cardiologist Dr. Todd Heimowitz followed by a series of follow ups and tests (EKG, echocardiogram, CT scans) that eventually revealed the aneurysm or "slightly enlarged aortic root." It was being monitored and managed with blood pressure medicine (and I was okay with that.) Before I moved to New York last fall, Dr. Heimowitz had strongly suggested that at some point whenever I visited Miami again, that I seek a second opinion from Mt. Sina's chief cardiologist Dr. Steve Xydas who specializes in aortic repairs and aneurysms. Aortic aneurysms affect about 15,000 Americans each year and they are most common in men and people over the age of 60, according to Columbia Surgery.

After meeting him in January of this year, he strongly suggested I have the surgery done and not to put it off. The news struck a huge fear in me. Open heart surgery? I thought I was too young for that. I wasn't 60 as the statistics show and I am not a smoker. More importantly, I didn't want my chest carved open like a Thanksgiving dinner.

I had thought I could just live with this for the rest of my life (knowing in the back of my mind that I had a grenade in my heart) but that would not be the case. While I was in Miami, Dr. Xydas quickly ordered another CT scan which showed that the aneurysm had grown to 5 cm (or a total of two-inches.) I was right at the line, near the danger zone of bursting. He said it's better to do this as a choice than during an emergency. He and his staff were also confident that I would be a strong candidate for the surgery and come through well given my "young" age and my overall good health.

My family history played a role into the decision for surgery. I had two uncles (RIP Josito and Bartolo) who died from aneurysms in their heart and abdomen in their 60s and 70s so that added to the urgency of having surgery sooner than later. I held off as long as I could with the chaos of the Covid-19 pandemic. But when summer rolled around, I knew it was time. An inner voice kept getting louder and nagging at me: You have to get this done! Don't wait any longer!

I had the surgery in mid-August (I had no idea that the nurses would shave EVERY THING even though I keep explaining that my heart was in my chest and not below my waist but that's another story.) The photo below is the second day after my surgery when I got my own private room after being in the ICU. If I look a little out of it, it was from the painkillers. After five days at the hospital (no visitors were allowed) and now several days recovering at home, so far so good, although my chest is really sore (they had to cut through my breastbone to reach the heart.)

My chest feels like someone took a hammer and struck me in the middle of my torso. It hurts when I laugh and when I cough (I have to hold a pillow to my chest for the latter.) I am somewhat limited in my movements; I am doing my best and feeling a little like old myself every day.

I am walking a few blocks a day. No running (which I miss,) no driving and no lifting weights...for now. And I definitely can't play Twister, not that I would. I went back to work a few days ago, eager to write news articles once again. In the meantime, I am thankful this is behind me. I'm also kinda getting used to my badass battle heart scar which you can see below. Maybe I can turn it into an awesome tattoo at some point.