Tomorrow is the visit with the surgeon and I am of mixed emotions; I am excited and anxious. I hope and pray that I am healing properly and correctly and fully; that he will not find something unusual or abnormal or “not right”. I also hope and pray that he gives me the 100% good “thumbs up” and says I can drive and hike and mow the lawn and turns me over to my cardiologist. I’ll know in about 28 hours!
I did not walk yesterday, after a long string of daily increases in distance. I had read you should take a rest so I did so. I walked today, but far less than I had been – only 2 miles compared with 4- and 5-miles days previous. There is a chance I will go for a second walk later today so we’ll see. I remain frustrated with my health metrics. For example my cardio health as estimated by something called VO2max has plummeted daily since I began walking, down from 23.8 to 17.9. And I have no idea why! My distances are improving, my pace is improving… I just don’t know what the algorithm is looking at that is declining causing my score to go down.
I suspect my meds may need adjustment. My resting heartrate remains far lower than I believe it should be – currently right around 40bpm. That is better than a week or two ago when it was in the mid-30’s though! And my walking heartrate is higher than it should be, often getting up to around 105-110bpm, which is something I would not expect to see unless I was hiking a long tough hike and was actively climbing a steep hill. And I wonder if those wide variances are impacting my VO2max score and falsely indicating poor and declining cardio health. Not sure I will get those answers from my surgeon; may need to either go see my GP or wait for October to see the cardiologist.
While walking today, my mind drifted to how lucky I really am. Not that this thought has not occurred to me hundreds of times before, but I am SO lucky that the thought deserves to resonate in my mind as much as it wants. I was apparently in such a precarious position with the coronary artery blockages that despite driving myself to the hospital only several days after hiking 14-miles, once there they would not let me go home, despite the fact that there was no procedure scheduled for me. And they kept me on 24/7 EKG monitoring. And when it came time to move to Boston, it had to be in a special cardiac ambulance with EKG monitoring and attendant surveillance the entire trip. I seem to have had one foot on the edge of the cliff and the other on a banana peel.
And as I reflect on the intensity of those two weeks beginning with the stress test on 6/18, to the failed catheterization on 6/21, to the move to Boston on 6/23, to the surgery on 6/26, and finally coming home on 7/2, I am acutely aware of what could have been. I had over 250 trail miles logged in this year to date. Granted, not hikes up mountains since there are none here, but still rugged and strenuous hikes, each averaging 11 miles per hike. Any single step on any of those hikes could well have been my last given the severity of my blockages. Almost every one of the cardiologists I dealt with (and I met dozens of them over those two weeks) commented on how lucky I am that I was still standing given the quantity and severity of my blockages, particularly in the LAD artery which when blocked, often produces a near instantaneous fatal heart attack, often termed the widow-maker. And several of the cardiologists were actually in genuine disbelief that I had hiked so many miles just weeks before the surgery without dropping dead; never mind being able to hike at all. So, lucky just seems to ring weak with me as a reflect – perhaps blessed begins to approach the thought!
I was doing some research in preparation of tomorrow’s visit with the surgeon and I stumbled on some data of which I was not previously aware. I had assumed I was good for another 25 years or so which would put me in the early to mid-90’s. But apparently, statistically, I picked up 17 to 18 years. Now that’s mid-80’s and is quite a bit less than I had assumed. Of course, that us the average – I could well hit my 25 years I hoped for, especially since I am healthy and reasonably fit. And 17 years is still far more than what I’d have had if this had not been caught in time.
I will update this tomorrow post visit! Fingers crossed for a good one!
So…a fully, completely, and totally underwhelming surgeon’s visit. They told me to arrive for the 1:30 appt. a half hour early so as to get a chest X-ray done beforehand. I arrived at 12:52 and checked in at 12:55; they sent me right up to the 2nd floor cardiac area where I was told to wait. Over an hour later (after asking twice if I had been forgotten or lost in the system) I was called in. By this time, my patient portal status had gone from “Scheduled visit Appt. with Surgeon” to “Completed visit with Surgeon”!!
I sat down and the nurse did vitals, which were all fine, and she told me the doctor would be shortly. I mentioned that my portal indicated he had ordered an ECG and an X-ray and she said something about not knowing about that, but then was back with an ECG machine a few minutes later. She did the ECG without comment and removed the leads, took the machine and left.
The surgeon and associate came in a few minutes later. We exchanged pleasantries and he asked how I was feeling. He looked at my chest incision, took my wrist pulse, and asked if I had any questions. I asked about lifting and was told to stay at 10lbs maximum until three months. He said I could begin to drive again, which was great news! He asked a question that I didn’t quite hear and his associate jumped in and related the story about how I had an issue one night in the hospital which ended up making me stay an extra day. She said it wasn’t A-fib but I was throwing PVC’s. He then said something about I should ask my cardiologist about having me wear a heart monitor for a few days, but I am not sure why. And then like the setting sun, was suddenly gone! The nurse came back in and asked if I had to schedule a follow up and I said I had no idea. She said if he didn’t say anything to me I was all set. Then she told me to go back downstairs to get a chest X-Ray (better late than never….)
I went back down and while waiting for the X-ray, saw the surgeon and his associate leaving the building, which meant he certainly wasn’t going to view the X-ray! Got the X-ray done quickly and we were headed back home. The X-ray results turned up on my patient portal and the report read normal and fine to me. The ECG report turned up the next day but without any commentary or report; merely the values of each of the 12 leads. The values seemed pretty normal as I Googled them each, except two that were slightly out of the normal range. Given that it was not even six weeks post-op yet, I am not at all sure that means anything.
So, the short of it is that I had an ECG and an X-ray, was sent home with no follow up, and am allowed to drive. So those are all wins in my opinion!! I drove us out to dinner that same night to celebrate! I will go see my GP in a few days and have bloodwork done for my lipid panel. I guess the next thing in line is to get an ultrasound of my kidney done to begin understanding what they noticed on the X-ray up in Boston. The fun never ends!
I admit to continuing to mildly obsess over each and every miniscule scrap of data my Apple watch offers me – many, many, many time each day. And I am ashamed to admit that I am more than a bit reactive to it all. I Google all of them trying to understand if my heart is doing well or is struggling, if my rehab efforts are succeeding or failing, and whether I am winning or losing. An act of which makes zero sense in reality because it is really just a wrist watch; not a medical device, not calibrated, and not approved for “diagnostic” matters. Yet I do it anyway, often causing myself a fair amount of stress when I find something seemingly amiss.
An example of this would be my heart rate variability, which is a measure of the interval between heart beats. I found the data from my watch and noticed it was changing so I Googled it. The value was a little over 200 and I was concerned because it had been increasing for a few weeks. Well Google reported that higher is better so I was thrilled. I looked at the YTD data and found that up until surgery, my value had been in the mid-30’s, which is basically average. Top athletes can have an HRV of 90-100 or even higher.
So, I was tickled with being above 200; until I read further that while normal can be from 20 to 200, once above 200 is not considered good. A closer look at my data showed that I have often been above 300 and actually had come to within a few ticks of 500 at least twice. I freaked out and began stressing. But likely without reason; this morning my HRV was 86.
My problem is three-fold: I am not a cardiologist and while being of sound mine, I am not capable of interpreting a few datasets and making any sort of an informed or correct analysis; I am using data from a wrist watch with which to analyze and interpret that data; and my heart is still reeling from the highly invasive and violent procedure it endured just six weeks ago. It continues to react, respond, and recover hour by hour, day by day, and week by week. I am not even yet halfway to the amount of time my heart requires to heal and “return to normal”.
All part of the journey… every recovery article I read indicated I will experience a wide range of emotions, feeling sad, depressed, even crying at times. I’ve had none of that. But I have felt disappointed in myself and my recovery progress, especially when reviewing my Apple watch data. But when I put all that aside, my progress and recovery is greatly apparent and highly evident and I have nothing to get discouraged over.
Just finished a four-mile walk. Decent pace and decent heart rate as well. I hit 114bpm at one point but overall, it was a nice gradual increase from a start of 96bpm and ending at 104bpm, all of which are zone 1 rates. I will have to learn about zones 2 through 4 and where (and when) I should be hitting them. In the interim, I will close this out and get it posted. Stay well dear reader!!