This is typically a football column, but this particular piece has nothing to do with football. I hope you read it anyway because it’s important to me.
One year ago, at 6:20 AM on June 2nd, 2015 to be precise, I had open heart surgery at the Cleveland Clinic. Over the past year, my life has transformed as I adjust to all sorts of changes. Some are subtle, others are unexpected, and still more have profoundly altered who I am.
First, the details behind the surgery: I was born with a defective aortic valve. Most people have three flaps that open and close seamlessly when the blood pumps out of the heart. Mine didn’t do that. My valve was not quite tricuspid; two flaps were fully formed and operational but the third never really formed, and it didn’t always open and close in perfect concert with the others.
As a result, I suffered from aortic valve regurgitation. Blood pumped out of my heart just fine, but a percentage leaked back in.
I first found out about the defective valve in 1999 when I was 27. Though I lived with the condition since birth, a bad reaction to a fitness supplement sent me to the cardiologist with pretty intense pain and an irregularly racing heartbeat. The barrage of tests--EKG, stress test, ultrasounds--soon became an annual rite of passage. Every year the doctors would compare my results to the prior year, seeing if the regurgitation rate was getting higher or my heart was getting larger.
For years everything was pretty stable. I continued to live perfectly normal, other than avoiding any muscle growth supplements (your heart is a muscle too). I continued playing volleyball at a high level. I ran 5Ks, even a couple of adventure races. Heck, I even bested Jarvis Jones’ NFL Combine numbers in all but the bench press not long after turning 40.
At my annual checkup in 2014, my cardiologist noted an increased regurg rate. It wasn’t a surprise, either. I had started to feel the impact here and there. My resting heart rate kept dropping, and by that point it was regularly in the upper 40s. My blood pressure, which had always been low, was “normal” at 95/50. I was getting lightheaded more often, and the endurance in activities like basketball and swimming dropped pretty quickly.
I kept telling myself it was my age and not my heart, but my heart knew I was wrong. The follow-up stress test just before Christmas 2014 revealed a regurg rate that would be lethal for people who weren’t in my (relatively) good physical condition. Also, the upper chambers of my heart had enlarged quite a bit. That’s what happens when the blood that is supposed to be flowing out keeps pooling. The heart creates more room for the blood by expanding. That is irreversible and only leads to further issues, complications and impacts I’m extremely uncomfortable thinking about even now.
It was time for surgery. I had delayed the inevitable as long as I could. Little did I know that I nearly waited too long.
Shopping for surgeons is an odd phenomenon. My wife and I interviewed three prospective heart surgeons. It was stunning how divergent their methods and attitudes were, and also the range of options I had to choose from. The primary choice was opting between a mechanical or biological replacement valve. A mechanical valve would last the rest of my life, a one-time procedure. That’s the upside.
The downsides to getting it permanently fixed starkly scared the hell out of me. The surgery itself was more intense, sawing my entire chest cavity open. I would be on blood thinners for the rest of my life. Having a grandparent on each side of my family die from strokes caused in no small part by blood thinners, that proposition was about as appealing as not having anesthetic for the surgery.
So biological it was, and the Cleveland Clinic was the place to go. That became obvious within the first of three scheduled meetings with various cardiologists, surgeons and support staff at the Clinic. Even the billing and insurance was completely set up and all pre-authorized so I wouldn’t have to worry about anything but the procedure.
And worry I did. I’ve never had surgery before. I still have my tonsils, and while I’ve broken 16 bones none have required surgical repair. I fretted about how my body would react to anesthesia, even though one of the tests had required it. That test, a TEE procedure, turned out to be nothing. Having a camera shoved down your throat leaves you with a minor sore throat and a funny taste in your mouth for a day.
A week before the scheduled surgery, I had a catheterization. For the uninitiated, a catheterization involves inserting a tube through your groin and snaking it all the way through to your heart. I was sedated but conscious throughout, as I was for a 70-minute MRI earlier that same day. My right side was purple from the middle of my thigh to my navel from that, one of the side effects of being a bleeder. My fear in blood thinners is deep-rooted in reality.
Cleveland is a five-hour drive from my home in West Michigan. My wife had to drive, and we left the kids at home with her mother. When we pulled out of the driveway and I waved to my anxious children is when the starkness of the moment hit me.
I might never see them again.
All the confidence I had in my world-class surgeon, in a facility where the richest of the rich travel from around the world to get heart surgery, collapsed when seeing the eyes of my son and daughter as we drove away. I knew it was a remote chance, but still a chance. Hospital infections happen, as does MRSA. My mind wandered to all of the great moments I’ve had as a dad. The radio was on but I never heard any music. I was replaying all the happy moments in my life and I wasn’t in charge of the remote.
I slept a little that night. My wife did not. Walking from the hotel a few blocks to the hospital, we held hands. She never does that. I probably should have taken that as something foreboding or perhaps even scary, but it completely reassured me. We were going to make this, together.
The day of the surgery is a blur. My parents were thankfully there. I went through about 45 minutes of final prep, much of it basically blind as I couldn’t wear my glasses or contacts. I do recall it was freezing cold as I lay outside the surgery room, wearing nothing but a loosely tied hospital gown. I prayed and made peace with all the loose ends frayed in my mind.
I woke up about 16 hours later in the post-op ICU. Thus ensued a truly miserable 24 hours.
I was unprepared for a couple of things. There was a tube sticking out of the base of my neck, just above where my right clavicle met the sternum. They put that in so they could “medically detach” my head in case something happened with the heart, or something like that. I had a tube sticking out of my midsection too, and it was extremely uncomfortable. So was the bed, which was just six feet long. I’m 6’5”, and given the fact I barely had enough physical strength to hit the button that shot some strong pain killer directly into my body, staying in the angled bed as I kept sliding off was both arduous and painful.
My move to the post-surgery care wing was delayed an extra few hours because they gave my extra-long bed to someone else. ICU is hell on earth. The guy on the other side of the curtain to my left was dying of COPD and spoke no English. When they finally wheeled me out, I saw some of the other patients and it terrified me. Did I look that close to imminent death? Apparently I was, at least pre-surgery. My surgeon and an attending cardiologist both told me my old valve had maybe six months left. That was a tough fact to digest. Still is.
My room had a nice view of Cleveland. I got to know it quite well because I couldn’t sleep, especially that first night in the room. I got a coughing spell that hurt unlike anything you can possibly imagine. My sternum was held together with wires, the incision still quite fresh and incredibly sensitive. No matter how hard I coughed I could not clear my lungs or my throat. I couldn’t swallow any water. One of my goals going in was to try and avoid as much medication as possible, but that night I gobbled whatever opiates they could give me and the pain was still almost unbearable.
The remaining three days in the Clinic are still a blur to me. I remember eating my first real meal (a cheeseburger and fries!) and drinking gallons of ginger ale to fight nausea. I learned I’m allergic to Heparin shots and let me tell you, dry heaving with a hole in the top of your abdomen and your ribs still barely together from the bone saw a couple days earlier is a nightmare. Watching my beloved Cavs lose a couple of games in the NBA Finals didn’t help.
I do remember a few things. My wife Julie was unbelievably awesome. She was patient and supportive, handling all the questions and answers with the cardio team, the nurses, calling friends and family. My mom brought me a coughing penguin, one which still sits near my bed one year later. A fraternity brother’s father happened to have surgery the day after me, and seeing an old friend (hi Greg!) brought back a strange feeling of normalcy. I made it through.
They won’t discharge you until you have a bowel movement, and that proved to be an issue. All those ads for opioid-induced constipation remedies are legit, but I couldn’t take any. I finally--and painfully--passed that test. One last walk around the cardiac wing and I was on my way home.
You take a lot of things for granted when you’re healthy. Being able to get in and out of a car is one. So is rolling over in bed. Doing those for the first few days at home was excruciating. I couldn’t move my chest and my shoulders had no strength. I could walk about 100 steps at a time and then I needed an hour of rest at minimum.
The stamina started to come back before the strength did. I could walk the 3-mile loop around our neighborhood after three weeks, but I couldn’t lift a full gallon of milk. As the sternum healed, I finally got to where I could get up from the couch without needing a spotter and could do some light cooking.
Having the surgery in the summer meant not being able to frolic in the pool with my kids. I sat out a beach volleyball season for the first time in almost 20 years. I was finally cleared to drive but getting out of the car and especially buckling the seatbelt remained real tough tasks. I had to keep a shirt on to protect the scar from the sun. That was okay because I had a small green wire protruding about two centimeters out of the bottom of my sternum and nobody wanted to see that.
The ability to stay focused on a work task proved difficult. I spend the summers writing season previews and breaking down game tape on the coming season’s draft prospects, but it was very hard to get through either at anywhere close to the rate I normally do. Between the pain meds, the doctor visits, the physical inability to stay in one position very long and the physical fatigue, the summer was a real slog.
Getting back to normal was very important for me. So was hitting a rehab goal, and that was a 5K in early October. I finished that and collapsed in a tearful ball, thrilled beyond words I made it even though I had to walk frequently and came in dead last in my age group. I went to some college football games and appreciated getting back to work, and the scouting and media friends were all genuine in welcoming me back to the press box.
The wire eventually fell out of my chest. I got back to playing pickup basketball at the gym by Halloween. I finally got enough strength, not to mention confidence in my healing, to lift my 7-year-old daughter over my head around that time too. I still do that every night at bedtime.
One year later, some things have definitely changed. While the heart is technically better than it’s ever been, fixing it has altered some other things in my body. I am now subject to random and quite debilitating cramps and spasms in my upper back. I have developed occasional vertigo; about twice a day the world starts to spin like I just drank a bottle of vodka. It passes quickly but it’s not getting any better and my doctors have no explanation. I lost about 10% of my lung capacity, which is really noticeable when working out hard. My overall physical strength is down about 10% as well, and no matter how much I work at weight training it doesn’t appear to be coming back. Nor is the extra 15 pounds I’ve added going away anytime soon, unfortunately.
Still, it’s great to be alive. I am now more aware of enjoying each day and trying to make the most of it. Having a normal heart rate and blood pressure gives me so much more energy. My relatively minor scar is the envy of the cardiology patient world. Most days I’m not all that cognizant of my surgery, quickly losing the “patient” or “survivor” mindset and just being normal. It never felt so good.