The weather has been stormy and unsettled all week. But this morning, I had planned on sleeping in a bit from what was a really difficult week for me; work pressures, cardiologists, etc.

But, I woke up to birds singing outside and a nice sunrise. A gentle breeze here and there and 60 degrees. It looks to be a nice day.

I'm going to get my hair cut today. Maybe highlighted a bit. One does want to look the best he can when going into bypass surgery. I mean, if it all goes bad, it's less for the funeral home to worry about, right? That's a crude joke, but I'm finding the need to lighten it up a bit. I have my moments of doom and gloom but I try not to let them rule me. And today, with things so beautiful out, it makes me want to get out and garden, do yard work, plant flowers, etc. All of which are off limits to me.

So, I'll go get my hair cut, go to the mall and pick up some new towels and a few odds and ends for the house, maybe stop by the theater and watch a movie, pick up a bite to eat on the way home, and come home and relax the rest of the evening. This weekend is all just for me; the last time I will be alone for quite awhile. I want to take in the peace of it all.

Next week, I work Monday, and a half day on Tuesday. Those are "winding down" days for me and should be slow. I've worked hard to see that they have all the tools they need while I'm out. That way, I won't worry about them a bit. That's not to say that they aren't worried, but, like me, they will just have to figure it out without me. That's not my job now.

My job is to put myself right at the center of the stage and make everything about me and my family. This weekend with all it's beauty is a good start to that.

I met with my cardiologist today. It's the final time I see him before the surgery one week from today. There were some final questions I wanted to clear up for him. I printed out this article, and highlighted the following points to go over with him:

• In 5-10% of coronary artery bypass graft surgeries, the bypass graft stops supplying blood to the bypassed artery within one year.
• Long term, symptoms recur in only about 3-4% of patients per year. Five years after coronary artery bypass graft surgery, survival expectancy is 90%, at 10 years it is about 80%, at 15 years it is about 55%, and at 20 years it is about 40%.
• In patients who have had vein grafts, 40% of the grafts are severely obstructed 10 years after the procedure. Repeat coronary artery bypass graft surgery may be necessary, and is usually less successful than the first surgery.

He listened carefully to each item. To me, they seem like pretty dismal results. He said on the first point that it's true that in a small percentage of patients, the graft stops working, but he emphasized that the percentage is very small.

He also stated concerning "survival expectancy", that it probably will be true that I will have to repeat this sometime in the future. But that's not clear. He said he has had patients where the graft will last five years. And in some other patients, where the life expectancy of the graft is five years, they have gone twenty years on the same graft.

He further stated that in my case he really believes this is less about diet and more about heredity. He said, "Your father dying at the age of 47 of a heart attack is extraordinary. I believe this to be the overriding factor. We will restrict the diet and take all the precautions, such as medications, but this will be something that can not be treated with simple diet. You will have to have stress tests in the future and the grafts will have to be closely monitored."

I guess I'm ok with that. I was looking for one last chance to maybe not do the operation, and he sensed that. So he said, "If you do not do this, your life will be shortened. One artery is completely blocked. One is 70% blocked. They will be bypassed. Another one is 30% blocked and is at this time not a candidate for bypass, but it will have to be monitored. You are very lucky to be alive and you wouldn't be if your heart hadn't made it's own temporary bypass. But that won't last."

I resigned myself to do it. He assured me that I would be just fine, and feels that recovery will be somewhere in the two month time period. I may be able to work at home before that time.

It's just incredible to me how this happened so fast. It's like I'm on a path in a bad dream, and I can't get off that path. I want things to be different, but it seems like this is my future now. I'm so depressed. I'm just going to go to bed and watch TV.

Yesterday, I was thinking of canceling the operation on June 4th. When I was in the hospital I was so out of it because I was on Fentanyl, Valium, and Verset. So when the surgeon came by to explain things, I couldn't understand what he was saying. So yesterday, I called him.

I told him I was having second thoughts about doing the surgery. I did some research online about what it involves. It's gruesome. They will put a 4-6 inch incision in my chest, break through my sternum to expose my heart, stop my heart and put me on a machine that will warm, oxygenate, and circulate my blood while my heart is stopped. They will then run two graphs to my heart with arteries from other parts of my body. I will be in the ICU for 5-6 days, and home from the hospital for 4-5 weeks for recovery. And of course, a LOT of pain.

So, I thought, maybe I can live with this. This is the question I posed to Dr. Surendra Chawla, my cardiologist. He is very kind and patient. His answer to me was pretty much word for word, this...

Me: Doctor, I'm having second thoughts on doing this procedure. If I don't do it, what are my chances of survival?

Dr. Chawla: If you don't do the procedure, life will go on. You are in no immediate danger of a heart attack because your heart has already done the bypass for us (see diagram below). So, if we do not do the procedure, all that will happen is that you will have diminished capacity that will be a chronic condition. You will have to live with being limited to what you can do. You have a decreased blood flow of 30%, and you can expect that blood flow to become somewhat worse over time, making it more difficult to do even what you can do today. You have the blood flow of the general 75 year old man. The heart itself is healthy and the bypass that it created is plenty for the heart, but not enough to feed other organs for increased activities. If you are ok with that, there's no problem. The only danger is that everything depends on the health of the arteries that did the bypass. If they become compromised in any way with an obstruction, it will be extremely serious and the heart would most likely suffer damage. Our options at that point become limited.

Me: So, if I think I can live with this, I won't have to go through the recovery and putting my family through this?

Dr. Chawla: Correct. And I won't lie to you. The recovery is difficult and painful. You will be in the hospital in ICU for 5-6 days. We will then release you and you will have a one month home stay. After that, you can start to build up your stamina and build your life again. And there is a risk of pneumonia.

Me: It's so much to take in.

Dr. Chawla: Yes it is. But what if I told you that a man your age should not have to be in this condition? Right now, you go to your mailbox, and when you get back, you have to rest for 10 minutes to get your breath back. What if I was to tell you that after this is over, you will fell like you are 20 years old again? Over a long period of time, your body has done extraordinary steps to protect you. And because it has been such a gradual progression to this point, you have become used to it. After the operation, you will realize blood flow that you haven't had in years. So, the real question you have to answer is this: Is one month of recovery worth getting that back? How much do you want it, and are you willing to risk a compromise of the blood vessels that are keeping you alive? Only you can answer that.

Me: Well, you've clarified this very well. Thank you.

Dr. Chawla: So, should I cancel the scheduled operation on June 4th?

Me: No. I'm going forward with it. I want back what I once had, and now that you've explained it, I don't think one month of what I have to go through is too much to ask.

Dr. Chawla: Good! I'll see you bright and early on June 4th then, and we will do this together.

In a more technical explanation, this is what is happening with me:

What is collateral circulation?

This is a process in which small (normally closed) arteries open up and connect two larger arteries or different parts of the same artery. They can serve as alternate routes of blood supply.

Everyone has collateral vessels, at least in microscopic form. These vessels normally aren't open. However, they grow and enlarge in some people with coronary heart disease or other blood vessel disease (such as in the case of stroke). While everyone has collateral vessels, they don't open in all people.

How does collateral circulation help people with heart disease?

When a collateral vessel on the heart enlarges, it lets blood flow from an open coronary artery to an adjacent one or further downstream on the same artery. In this way, collateral vessels grow and form a kind of "detour" around a blockage. This collateral circulation provides alternate routes of blood flow to the heart in cases when the heart isn't getting the blood supply it needs (myocardial ischemia) (mi"o-KAR'dede-al iKE'meme-ah). (source: American Heart Association)

This shows a bit what is going on.

Image source: Cleveland Clinic

The Left Anterior Descending Artery (LAD) has a blockage. Collateral vessels have opened up and grown around the area from the Right coronary artery (RCA) to form a bypass of the blockage to protect the heart. I'm one of the lucky people that this has happened to. It doesn't happen in all people.

So that's where I'm at today. I have to make some arrangements the best I can and go from there. I want to say what is most important to me now:

I have an amazing family. My folks are flying out to be with us during this time. Kent is cutting his trip short to South Africa to be here when this happens. My friend Austin and his wife Carole have spent many days with me getting me to the hospital and bringing me home. Austin stayed with me in the hospital the first time. I don't know how I can ever repay that.

I've had so many emails, posts to my website and my Facebook page from well wishers. I've had flowers delivered to my home from friends afar. I've receive so many cards in the mail that I've lost count. I feel so loved and I've taken so much of this and my friends for granted in the past. That stops now.

Yesterday, I went into the hospital for an angioplasty. I wish I could say it went well, but it didn't. The routine went as scheduled, but after two hours of trying to make it work, they aborted the procedure.

It seems that one of the arteries in my heart is completely closed up. That means that an angioplasty procedure is not an option. Normally, the blockage of this artery would be a coronary heart attack where people would dial 911 or just not make it. It's usually devastating. This has been happening over the course of 8-9 years they think. And gradually, exercise and everyday activities have been getting gradually more difficult for me. The told me that my diet was not so much the problem and that it was mainly hereditary (my Dad died of a heart attach at 47 years old). My blood work shows fine.

But my body did something that has them somewhat puzzled - very unusual they tell me. It protected itself. Over those 8-9 years, the lower arteries of my heart expanded and grew to take up the slack of the big artery. The result was that the heart was protected and continued to receive all the blood it needed. Therefore the heart itself is in great condition and without damage. The problem is, the smaller arteries are not a replacement for the big artery. They are simply too small to supply the needed blood to other parts of my body when those parts demand more blood for oxygen delivery, such as the case with my lungs. So, the lungs don't get the oxygen they need, and I become exhausted.

What has alleviated much of this it seems, is my use of Xanax. Xanax brings everything down. It's calms the body and relieves the stress. So, all those "panic attacks" and shortness of breath it seems were not panic attacks at all as I was lead to believe. It was a failure to deliver oxygen to different organs that needed it. The Xanax merely provided a situation where they no longer needed it because it calmed me down. That's not the purpose of Xanax, but that was the chemical effect it had.

And the danger now is, if one of the smaller arteries fail, I'm in big trouble. So, I have only one option, and it has to happen fast. At 5:30a.m. on Thursday, June 4th, I will be admitted to St. Francis Hospital in Hartford for open heart surgery. They will do a bypass, taking two arteries from somewhere else in my body, and grafting them onto my heart to bypass the large clogged artery. I'm not sure what my chances are. I do know that I have no choice, and I've accepted this. I also know that I will be at one of the premier hospitals in the country for this type of operation.

After the operation, I'll be in ICU for 4-6 days. I can then return home for recovery. I'll be away from work for a month and will not be able to drive during that time either. Fun times! But, I'm going to do what I have to do and just hope that I can get back to my old life.

I just wanted to let you know my situation. I have a lot to work out with my work next week and to prepare for this. I will be in the hospital for 4-6 days in the ICU, and required to not drive or go to work for one month. After that, maybe my life can return to normal.

Well, tomorrow morning, I will be at St. Francis hospital in Hartford to be examined for a blockage to an artery leading to my heart. It's sounds awful when you put it like that. I was fearful at first. Then I went through a period where I was fine with it. Then an hour ago the hospital called for their final prep for the procedure. It sounded awful as she described in painful detail every single thing they are going to do to me. I won't repeat it here. I may be home tomorrow afternoon, or the next day. It all depends on what they do to me, and they won't know that until they go inside.

So now I'm back to being anxious again. I'm waiting for my friend Austin to get here. I want to take him to dinner somewhere. I'll have a very light dinner tonight, and try to get to bed early. God I'm not looking forward to this. What if they go through this and find that it's not the problem and it was all done for nothing? Or what if it's worse than they thought. Jeez, I want this over with already.

I guess the bottom line is this. Knowledge is power. Do I want to just get along day by day not knowing what the problem is? No, I don't. So I know this is the right thing to do.

One thing this has shown me is how many people love me. Do any of you know how much you mean to people? I bet you don't. I didn't. I had no idea the impact I have on people. I've received so many letters from so many people that at times, like last night, I would sit alone in my bedroom and think about it. And before long, I just started crying. I'm just very humbled at how lucky I am to be so loved. People don't have to be here. They have told me and shown me how they feel.

Whatever happens tomorrow, I'm so thankful for that. And if for whatever reason this is the end for me, don't be sad. I'm not. God I've had such an extraordinary life with one extraordinary husband. Kent, I love you so much. I can't find the words to truly express it.

Just love each other and please forget our differences. The one thing that we all have together is love.

I hope to talk to you later in the week if all goes well. I'm hoping it does. Keep hope and love alive!

Let me start from the beginning...

A few months ago, I started to notice a shortness of breath while exercising or doing yard work. I attributed it to allergies and generally ignored it. It gradually got worse. When I went in to get my yearly physical a few weeks ago, I mentioned it to my doctor and told him I thought it was allergies. He gave me an inhaler to try out. It did no good. He them sent me for a stress test, thinking that I'd pass with flying colors.

So, I get on the treadmill, all wired up, and start the stress test. Right away I start to feel the tightness in my chest. By the time the treadmill went to it's top setting, the doctor aborted the test. They finished by injecting me with a radioactive isotope. This was for the imaging to take place one hour later.

One hour later, I'm laying in this tube with this huge camera, taking photos of my lungs and heart. It went ok. It's weird (and hard) to lay perfectly still for twenty minutes.

A few days later, I returned for another imaging - this one without the treadmill. They wanted to do a comparison of the two; one showing after stress, and one without stress. It went ok.

I return to work, and two hours later I received an urgent phone call from my physician's office. They told me to get to this cardiac care facility NOW. I said, "Don't you need an appointment to get in?" They said, "We called them. There are three cardiologists who want to see you. You need to get in to you car and go NOW!"

It scared the hell out of me. I kept thinking to myself that if I was half dead, should I really be driving?

I show up and I'm confronted with an office full of 25 people, mostly in their 70's, who are waiting to see the doctor. I think to myself that I'm going go be waiting for the next two hours to get in to see the doctor. I fill out my three pages of paperwork, and less than five minutes later, they call my name. I'm thinking to myself, "WHAT THE HELL?!?"

I go in to this room, the doctor comes in within one minute, and looks at my charts. He turns to me and says, "You have a blockage in one of the arteries that feeds blood to your heart." Just like that. I started blabbing about all kind of irrelevant things by saying, "....but my partner and I aren't married yet.... will they let him in to see me?.... what do you think?" He honestly must have thought that I was on some kind of trip or something. How could he understand my fears? All he said was, "Yes, I think you should marry your partner." But could he even know what I was talking about?

I started to cry. Hell, I went in for the stress test thinking I was being tested for allergies, and within two hours, I was being confronted with this. He came up to me and put his hand on my shoulder and said, "You are going to be fine. Do you trust me? Because I'm very good at what I do. I don't lose people." I said, "Well, I don't have a choice. What do I need to do?" He said, "You need to get the blockage repaired. The reason you are short of breath is because your heart is not providing enough blood to your lungs to deal with the added stress. Your body is, at that point, shutting down."

He was actually quite kind. I asked when I had to do this. He said, "As soon as possible." We scheduled it for May 20th at 9:00 in the morning. It will require a hospital stay. I'm ok with that but what really sucks is that Kent is in South Africa for a month. Thank God for my friend Austin. He's going to take me to the hospital and bring me home. I think I'll be ok after that. Heck, I'm on nitro pills now when I need them. What a kick! Didn't think I would see that until 70 years old. But, life is full of surprises. You just have to go with the flow.

This is what I'm about to have done...

What Are the Risks of Coronary Angioplasty?

Coronary angioplasty is a common medical procedure. Although angioplasty is normally safe, there is a small risk of serious complications, such as:

• Bleeding from the blood vessel where the catheter was placed.


• Damage to blood vessels from the catheter.


• An allergic reaction to the dye given during the angioplasty.


• An arrhythmia (irregular heartbeat).


• The need for emergency coronary artery bypass grafting during the procedure (2-4 percent of people). This may occur when an artery closes down, instead of opening up.


• Damage to the kidneys caused by the dye used.


• Heart attack (3-5 percent of people).


• Stroke (less than 1 percent of people).

As with any procedure involving the heart, complications can sometimes, though rarely, cause death. Less than 2 percent of people die during angioplasty.

Sometimes chest pain can occur during angioplasty because the balloon briefly blocks off the blood supply to the heart.

The risk of complications is higher in:

• People aged 75 and older
• People who have kidney disease or diabetes
• Women
• People who have poor pumping function in their hearts
• People who have extensive heart disease and blockages

(source)