Surgery is on

Zora is having heart surgery tomorrow (Tuesday), scheduled for 7:30AM. I had long talks today with Dr. Gumprecht (I.D. at Mt. Sinai, the "Good Doctor") and Dr. Adams (surgeon at Mt. Sinai). We feel comfortable and happy with Dr. Merrick. Cardiologists feel there is risk of flying back to New York. Not the actual flight, but the idea of another embolus say causing a stroke when a hospital is hours away.

Dr Merrick believes the chance of mitral valve repair (as opposed to replacement) for Zora is 90%. If it has to be replaced, she’s decided (and I concur) to go with the “pig” valve. We were a little disappointed to learn that a “pig” valve doesn’t actually come from a pig anymore. It comes from a cow. And it’s not the actual cow’s valve, but simply made from parts of the cow. I heard someone compare it to leather. So it’s basically a processed meat product. Animal lovers be damned. If she gets that, it means she will have to have surgery again in about 20 or so years. But we think surgery will be better then. Maybe less invasive. And a lifetime on blood thinner doesn’t sound like a good option. If the valve is successfully repaired, then she’ll be good as new. Or at least the heart will be.

Zora is amazingly strong through all this. Her good spirits are a good sign and they certainly help me.

She could (very barely) make out faint bits of motion and light in her blind eye. And I really mean very barely. No chance at how many fingers am I holding up. Simply (and barely) the difference between bright flashlight shining in eye versus not shining in eye. Minimal function is better than no function. That does give some hope, but it’s all too safe to say she will not be seeing out of her left eye again.

Jim and Katie and I did an amazing job last night of uploading Zora’s old 460 MB TEE CD from my home computer to the web, and then downloading it to Jim’s computer and reassembling it and burning a CD. It was quite a bit of tech savvyness on our part that involved Jim “hijacking” my computer at home and using my website as a data storage site (I’m also glad I got a website last week). Jim brought that CD to the doctors this morning who were very happy to have it so they could compare the before and after pictures (it’s amazing in this day and age that this sort of stuff can’t be sent from one hospital to another, but that’s another story).

The quality of the old TEE image was outstanding, by the way. Better than the new one. They were very impressed here. So thank you again, wonderful doctor in Manhasset.

Anyway, I saw the new imagines. Flappy looks a bit bigger and a fair amount meaner now. And prolapses (goes) into the valve a bit. And there doesn’t seem to be any sign of the growth on the anterior side of the other leaflet.

Hopefully the surgery will go well. Certainly, this hospital is better for post-operative recovery than any hospital we’ve been to in New York. The rooms are nicer. The nurses are better. Much better. Communication is very good (we even got a CD of the new TEE). Zora says the California attitude we normally find so annoying isn’t so bad in a medical context. If Forest Hills was a Days Inn. Maybe Manhasset was a Holiday Inn. Mt. Sinai could be a Ramada Inn. UCSF is a Hilton.

There is one young doctor we’re not too fond of. He always comes in and touches Zora, not like it’s natural. But like he learned in some lecture in medical school on good bedside manner. Then he repeats what has already been said. Still, compared to the other hospitals, it’s better to get too much information rather than too little. And this doctor isn’t doing the heavy lifting. Perhaps they could transfer him to Forest Hills or Manhasset where they could use him productively.

So the surgery should take a few hours. Then Zora will return to her room with arm restraints and a catheter, a ventilator, and tubes sticking coming from her heart and lungs. The ventilator comes out soon after she wakes up. And all the tubes should be out a few days. She will be in a lot of pain.

If all goes well, and it’s about time something did, she will be in the hospital for maybe 5 days. Then she will probably go to her father’s in Santa Cruz to recover. It helps that his girlfriend is a nurse. Unfortunately for me, they have cats so I can’t come along. She might be somewhat functional and able to fly in 2 weeks (on the near end). And perhaps we’ll be Waltzing Maltida in 4 to 6 months.

I imagine the pain of this surgery is somewhat similar to having a cracked rib (which I’ve had twice). No doubt worse. But I remember I couldn’t sit up without Zora’s help and almost fainted in pain walking to the bathroom. Coughing, sneezing, breathing deeply, and laughing make the world go billy billy.

It’s not a constant pain. But an excruciating pain if you move the wrong way. And then you start protecting your motions to prevent the pain, which isn’t good for the body’s natural gentle jangle. I can’t imagine choosing to do anything in the first month after something like that.

Zora’s mom arrives tomorrow. Jim is going to pick her up at the airport.

Here are some useful links I just found:
http://www.heartsurgeons.com/pr3.html
http://www.heartsurgeons.com/ed4.html
http://www.heartsurgeons.com/ed5.html
And even videos at http://www.clevelandclinic.org/heartcenter/pub/guide/disease/valve/valve_videos.htm
More video (much longer, but better, I think) is at http://www.or-live.com/umm/1151/

Neither video is exactly what will happen to Zora. But they're still very informative (and much less “disturbing” to watch than you'd think).