How much trouble can Hap get into in a hospital with a cell phone and the BBC

I continue to convalesce at home. No pain except if I move the wrong way or cough or the like.

I thought I would share one of the incidents at Morristown Memorial which showed how easy it was for a geek like me to get into even when more or less bed-ridden.

I was taken down to the lab to have an echocardiogram on Monday. (This particular echo because I have agreed to be part of a study that will track recipients of my kind of valve for 8 years.)

While the technician was sticking probes to my chest, she pointed to my right shoulder and said "What is that!? Does your nurse know about THAT!?"

"THAT" turned out to be a blister about the size of a silver dollar on my shoulder…right about at the top.

Flashback to the night before: As I prepared for sleep on Sunday night, I set my Palm Pixi Smartphone to stream the BBC World Service. Since the speaker on the phone is not very loud and since the headphones I brought with me were in the closet and since I was popping in and out of bed on my own yet and since I felt silly calling out to people who were otherwise busy keeping others alive to get a piece of my geeky stuff, I decided to balance the Smartphone on my shoulder (yes, my RIGHT shoulder) and listened to the voices from London.

Why was I listening to the BBC?

Flashback about 5 decades to a stormy July 3 at my maternal grandfather's house in Little Rocky Hill New Jersey, a little North from Princeton on the Lincoln Highway.

At that point my Grandpop Kuderka was living alone in a house that used to accommodate a family with 7 kids. I don't remember the exact details, but I was detailed to spend this particular July 3 night in the house with him. Whatever the arrangements, I am sure I was not told that a midsummer thunderstorm was also fixing to join in the fun.

The thing hit sometime around 10 PM when I was already alone in the North Front Bedroom when the storm hit.

I grew up in the city, Perth Amboy, NJ. I had visited this country house often, but I do not remember being cognizant of being there during a violent nighttime storm.

In the city (except for the one time that lightening struck my father's 27-meter vertical ham antenna and blew out the Blitz Bug…but that's another story), lightening would flash and sometime later thunder would sound. Sometimes it was a BRIGHT flash and a GREAT cracking and roll, but always like that: Flash…silence…crash.

Not out in the country on that night. The lightening and the thunder arrived TOGETHER. Not just once but persistently.

The phenomena produced an effect most appropriate for Independence Day. You would see a bright light in the windows and hear an accompanying SWISHHHHHHHHHHHH followed by a BOOOOOOOOM.

The downstairs phone (a 20 party line, I think) would rind. The few lights in the house would go out. And one city boy would be wide-eyed and unnerved.

I had one consolation. I had bought one of the first Lafayette Electronics six-transistor radios. I turned it on and tuned. Amid all the crackle, I found WOR, a 60kW Class A Clear Channel station with a transmitter in Carteret. (I knew it well because in Perth Amboy you could pick up WOR on a bad filling.)

That was the night I discovered Jean Shepherd. Jean got me through that night and many others.

And since then I have not been able to get to sleep without the sound of someone talking on the radio.

Flashback to last Sunday night.

So I am in this hospital bed with a magic air filled mattress regulated by a robot somewhere in a way that is supposed to protect your skin but has the effect of cause your body to slide constantly downward toward the footboard. I can only lay on my back, have a CPAP mask on my face, and catch quite see or reach the bed adjustment buttons. (BTW, the robot bed also weighs you.)

And I have the Palm Pixi perched on my right shoulder like a pirate's parrot.

Here's what I am doing with the Palm Pixi: I am charging the battery through an outlet in the wall behind me which I have never actually sign but whose existence I take as a matter of faith. I am streaming the BBC World Service through the 3G data network. I amplifying the sound of the BBC stream through the little amplifier in the phone to drive the teensy speaker, AND I am using the phone as a wifi hotspot for my iPad.

The greatest problem designers of portable electronics deal with is heat. Everything you do on an electronic device produces heat. For some examples consider: Charging a battery. Stream Internet audio. Amplifying a signal. Processing data.

And, consequently, my little Pixi heats up. I have noticed it before. Not the OUCH kind of hot but certainly at the "is that thing working right" level, which is just slightly below "hand me the marshmallows."

Yes, I found minimally invasive a way, while stuck in a hospital bed after aortic valve replacement surgery, in an environment just nuts about controlling injuries and infections, to give myself a second degree burn with a Smartphone.

Hap

Going home today.

Sunday A Day to Start Walking

I am up sitting in a chair waiting for breakfast after being hosed down by thie very pleasant medical tech. (I have given up all notions of modesty. The tech says the same. She has seen them all she says.)

I had one weird and frightening thing happen in the Cardiac Anesthesiology Recovery Unit (don't call it the ICU.) I was there a for a few hours and felt a bit of nausea and, as any Bojsza would, suppressed it. Then I fell asleep although not in a good way. My pulse dropped and, apparently, I would not respond to the staff. I finally came to with eight people yelling my name and my field of vision filled with that visual white noise you used to see on a television that wasn't tuned to a station.

That freaked me out. I was afraid to fall asleep for a bit after that.

My attending cardiologist says that the wiring that keeps the heart pumping runs passed the site of the aortic valve and that could cause such a reaction. Since the valve is slightly swollen at first it can mess with the wiring.

Today I will walk walk walk, I am told. I M looking forward to it. I am on track for going home on Thursday.

Hap

In my rroom

Well, I am in my hotel like room in the Gagnon Cardiovascular institude at Morristown Memorial. It is room 332. The policy of the Gagnon is no flowers please. Edible arrangements I don't know.

I am sitting upright in a chair waiting for regular food for dinner.

Cardiologist says I may be able to leave On Thursday. Perhapd I already said that walking starts tomorrow.

Hap

Ok in recovery. In a regular room this afternoon. -hap

Hap is awake and talking and does not remember anything after joking with the o are staff. All is well.

Hap is talking and does not remember anything after joking with the o are st

Breathing tube out. Now driving nurses crazy with snoring. -Kate

Just saw Hap. Quiet for first time ever. Breathing tube to be removed in a few hours.

Dr Brown from Morristown just reported surgery over & everything went well. Beth says "that's a good looking surgeon" -kate

(4 of 4) he won't mistakenly think he has checked out. -beth

(3 of 4) wheeled him down! Evidently there will be harp music in the recovery room. Someone had to warn him about this so that as he is coming out of anesthesia

(2 of 4) surgery and aunt agnes and I are playing tag team. Dad seems really relaxed- perhaps due to the shot of morphine he got in his rear right before they

(1 of 4) The receptionist in the family surgical waiting room is so nice she even pronounced our name correctly. Mom is going to stay in with dad until the

Dad is prepped for surgery. -beth

It's just starting to get light out and we are giggling in the hallway as

I am awake and ready to go.

Ten Hours

I am about to turn in.

I have been prmised that no more pokers and measurers will bother me tonight.

Lesson learned for anyone finding themselves in a similar position: Bring a bath brush. I was instructed earlier to take a shower using surgical soap from head to foot. Easy enough task except Nurse Peggy rapped my right arm in a plastic bag to keep the IV line from getting wet.

Don't try that at home kids.

To make matters worse, surgical soap does not create any foam so it is awfully hard to figure out where you have been and where you have to go.

Tomorrow I expect to be awakened at 4 am for prep. That will include shaving my body. This was a problem this morning when I was made ready for the heart cat. I am ticklish. Always have been. So I was writhing in giggles as they tried to do the shaving.

Let,s not even talk about the swapping with iodine or whatever it was. Nothing like being speed out there mostly naked giggle and jiggling.

I hope I do not wake the rest of the floor.

A man from the ICU came in to explain some things to me and have me suck on that crazy plastic thing to see what my lung capacity is (he promises it will be less this time tomorrow).

He also had the courtesy to inform me that I will be awakened by the sound of a harp. He implied a live harpist playing on the PA. He said some people hear it and think that things didn't work out and they are in heaven.

He was a gum chewing person with a gold american eagle on a chain around his neck. He didn't care much for the idea of the harp.

The operation is at 8:30 and will probably take 3 hours. The anastesia will have me out for about six. I have to prove to them that I can breathe on my own before they remove the ventilator (I hate the ventilator idea).

Well, off to sleep and then to the great adventure.

Hap

Flat until two

They send the catheter up through the groin. When they finish, they put some sort of plug in the artery ando it takes a while to set apparently. I'm not allowed to lift my right leg or my head (puts pressure om the groin muscles, especially one as big as my head) until 2pm. Hard to eat Rice Krispies this way.

In room after heart cath. Doc say my arteries are beautiful. No bypass. Room like a hotel.

Doc just came. Looks like we are ready to go. Takes about an hour.

After two tries the iv is in. Now the wait.

Just had my groins shaved. It tickled.

Here we go...off to Morristown and phase one.

Memorial from West Orange. Got to be there 6am tomorrow.

Making a dry run to Morristown M

(2 of 2) daughters will post here when I cannot. Hap

(1 of 2) I will be admitted to Morristown Memorial around 6 am on Thursday, 7/15. I will have a heart cath that day and then surgery on friday. One of my

Heartfelt Story

It looks like I will be having heart surgery sometime in July.

Perhaps I should stop there...it is a pretty dramatic statement isn't it.

Perhaps you want to stop here, as you wonder why I feel compelled to tell you this. It's OK if you do.

For those of you still with me, I need an aortic valve replacement. The one I got (at a very good price at the time) is leaking. I asked about the guarantee, but it is up.

I consult my GP, the thorough Scott Orenberg in Maplewood, twice a year just for fun. Late last year he mentioned that, since there is heart disease in my family and since I am getting to be an old f...let's just say old...I should see a cardiologist, just to be sure which is what Dr. Orenberg likes to be.

I went to Dr. Levy in Florham Park, and I had a nuclear stress test (run on treadmill, inject dye, take MRI pics) and an echocardiogram.

I received a call from Levy's office that the stress test was good, but I needed to make an appointment to see the doctor to discuss the echo.

OK, I can't make phone calls. OK, I get distracted.

I made an appointment in March (by fax I think).

At the appointment, Dr. Levy said everything looked pretty good...hmm...but...say, has anyone in your family ever had an aneurism?

Only my maternal grandfather...does that count.

Dr. Levy told me to come back in for some more echo pics.

One these, he felt there was a significant change since the December pictures. Change or not, my aorta was enlarged and my left ventricle was also fattening up.

But, he said, the situation did not quite meet the guidelines for a valve replacement...I guess he was afraid that some insurance company would think that it was elective surgery that I had done for cosmetic reasons...confusing my heart with my nose which so many people often do.

Levy sent me for another test which he said was "like HDTV" which is definitely the only thing he had to say to me.

In the cardiac biz we call it a TEE test for Trans-esophageal echocardiogram. Yes, those of you with quick minds, it means stick a transducer down your through until it is in proximity of the heart and taking picture with a receiver on the outside.

The report said moderate to severe regurgitation. That has nothing to do with gagging (oh, another sweet high like the one at a colonoscopy). We cardiac experts call the leaking of blood back through the valve regurgitation. (Stick around, you'll learn more).

The test also showed that I had a tri-cuspid valve with two of the leaves fused together with calcium. This ruined a fantasy for me because I hoped it would show that I was born with a bi-cuspid valve, thereby giving me an excuse for never excelling at anything that involved physical exertion.

(I should also point out that, in my artistic way, I had Joan take me to the wrong facility in the morning and my having to beg a ride from the security detail there...they let me sit in front but did not let me turn on the blinking lights. I also had to redirect good friend and default John O'Reilly when he picked me up.)

Still, Dr. Levy did not think this result was conclusive enough to say I should have surgery.

I had accidentally given Dr. Levy the impression that I was asymptomatic. As family members may attest, I come from a line of loud stoics. It's an odd combination. Always a lot of noise but a downplaying of anything may be remotely important. When asked if I felt any pain I would say (loudly), oh, just a little tightness. I withheld the detail of gasping for breath halfway up the stairway of the Whitehall subway station.

Also not sharing that I nearly died when son-in-law Nic and I carried the family heirloom wooden swing up the backyard slope.

So he sent me for another test. I forget the name of this one but in it they use a drug to cause your heart to beat faster. The deal is that all the other test look at the heart after stress, but at a time when it is at rest.

This test showed that the pressure on the valve when my heart was beating at 134 bps was twice as much as when my heart was ticking along at 60 or 70. It should be the same. A valve that doesn't close all the way also doesn't open all the way.

When I saw Dr. Levy after that, we both agreed that there was finally a good enough story to tell an insurance auditor.

Debby, Joan's cousin and a nurse, told us that all of the nurses' fathers with heart problems went to Dr. Brown at Morristown Memorial hospital.

I went to see him today. He has a wall in his office that had to be reinforced because of all the certificates on it.

He does about 400 heart operations a year and about 200 of those are valve jobs.

(I have a second name from Dr. Levy, but I really don't want to go through that second opinion stuff to come up with the same decision. I have had four tests that all say I have a problem. So there is no second opinion about that. I hear the hue and cry from many of you. Dr. Brown took time with me. He is the chief surgeon there. He does 400 operations a year. He designed the cardiac exhibit at the Liberty Science Center. I am going with him.)

We discussed the kind of valve, mechanical or biological. For someone my age (I am speaking of my biological age and not my mental age) a mechanical isn't a bad idea. Biological valves (and let's get things right...it is not a valve from a pig or a cow, it is a valve fashioned from a layer of tissue from a pig's or cow's heart) tend to wear out in 15 or 20 years. A mechanical valve never wears out unless you take it skydiving or something.

Trouble is, with a mechanical valve, you have to take anticoagulants for the rest of your life. I am ok with that. I already have a pretty well-developed aspirin habit. (Hmmm, reminds me of a phase my mother went through where she was having me drink lemon juice because it "thinned the blood," but that has nothing to do with what I am writing about.)

So I went into the office, notwithstanding a strong recommendation from my PLM Joe Brennan that is has got to be bovine or nothing else, thinking that I would like a mechanical valve, please.

Then Dr. Brown lays this on me: You will have to go for a blood test every three weeks. The anticoagulant needs to be adjusted (it sound like he was saying cumin. but that couldn't be it) constantly.

NO THANKS! I can't even remember to change my undies every three weeks...but maybe that's too personal.

So, Joe, it will be a biological valve. Bovine? Not sure. We Poles are quite fond of pork.

Another idea about the bio valve is that by the time it wears out there will probably be new technology that will allow it to be replaced using a catheter through the groin. (If "groin" isn't too personal.)

Since niece Zydico Diane Baas is getting married on 6/19, I don't want to have the procedure before that. Lucky too, because they are now only selling tickets for July performances.

I may also defer the whole thing to after August 5 because our week down on Long Beach Island starts on July 31. If I can make that work, just think of the attention I will get down there (with the only competition being bro'-in-law Jerry Stropnicky's knee replacement).

(The warranties are definitely expiring.)

When the time does come, I will spend the first day in the hospital having a heart cauterization {or however it's spelled). If that shows up any blockages, the surgeon will do a bypass along with the valve replacement. That's SOP because there are just so many time that you want to open the box and fiddle with what's inside. The actual surgery will occur on the second day.

If all I need is the valve, they will make a relatively shot thoracic cut. A bypass will need a longer cut.

For someone in my condition, this is not a particularly risky procedure. Nothing like this is risk free, but I am not afraid of it. I am a little weirded out by it. But not afraid.

I hope some of you don't feel I have imposed too much information on you. Family members, you can pass this info around if you care too...I have fewer email addresses in my contacts than I thought.

Be real,

Hap (or Walter or whatever you want to call me but never Wally or Bojsh)

Starting Up

I am starting this blog five days before I have heart valve replacement surgery. I think the next couple of months here will be mostly about that experience as I keep friends and families appraised about what is going on and if receiving a porcine heart valve does cause one to begin grunting (or, in my case, grunting more than usual).

Re-considering that first paragraph, I wonder if I am living up to my own admonition to BE REAL.

A dear friend down the block from us had the same surgery last year and was decidedly more private than I am being. It does seem to be a good example of buries to this that any of you might care to read about my version of the same experience.

I guess that is part of being me. Shy enough not to make phone calls to me closest friends, but otherwise naked when talking to thousands.

My next post will be a repeat for some of you as I publish some email that I sent out when it became obvious that I would be doing this excursion into medical technology.

Hap