Paul's Heart

Life As A Dad, And A Survivor

Archive for the month “January, 2022”

20 Jan 2022

Yet Another Anniversary To Remember


No, I did not become a king of some small island country. This is not a crown.

This, is an artificial heart valve. To be exact, this is a replica of a “bovine” (cow) artificial valve, placed inside of my aortic valve, one of three impacted by long term side effects from radiation and chemo damage decades ago.

If you have followed my blog, you have then also witnessed the progress and improvement of technology of diagnostic and treatment of diseases, especially over the last thirteen year, and from decades ago.

But when I had my first (of three) heart surgery in April of 2008, it was known, that there were potential other issues with my heart. And what may not seem like a logical decision, to not fix everything while in there, it turns out that there is good reason not to.

The original diagnosis, was a major blockage of the LAD (left anterior descending artery, a main artery of the heart), and a considerable blockage of the RCA (right coronary artery). It also seemed that there were valve issues as well. The original plan was to leave the valve issues alone, because at the time, the surgeon, unaware of my radiation history (at that point I did not realize the correlation), the surgeon felt that the valve situation, as well as the RCA, would resolve themselves following a double bypass of my LAD.

I would later learn, that there was another school of thought to “letting things go”, basically until the time that they needed to be repaired.

Open heart surgery carries with it, many risks. And for Hodgkin’s Lymphoma survivors like me, from decades ago, treated with high dose radiation and ultra toxic chemotherapy, the surgery is not the only risk, but so is recovery. Bleeding and healing are two higher risks.

When I tried to pin down my doctor, not worried about the RCA or the valves, focusing only on the bypass, I asked, “so how long will this last?” A reasonable question, but one the doctor would not give a straight answer to, not even a ball park guess. So, after some research, looking up the method that was used to do the bypass (there are different arteries that can be used), using my mammary artery, the consensus I saw, was between 10-15 years. Which meant, at the age of 42 at the time, I would be looking at having an issue again around the time… oh SHIT! THAT WOULD MAKE THE MAXIMUM TIME NEXT YEAR!!! Not to worry, I know a secret that I will get to shortly.

So, long story short, I did recover (obviously), went through cardiac rehab, and then would discover all of the other issues created by my treatments. However, they do not apply to this post.

Just before the Covid19 pandemic hit, I was undergoing a routine follow up for my heart, and up to this point, everything had been routine. Comments were noted about my valves slowly getting worse over time, but I had been prepared to “watch and wait,” only doing something when needed to be done, something I call “the ticking time bomb” approach.

But this appointment had a familiar feeling to it. Following my treadmill test, I was being told I needed to see the cardiologist. There was another urgent situation. I was questioned why I had not said something sooner. My answer, “I didn’t feel anything wrong.” When I had my original heart surgery, I definitely did not feel well. I could feel something was wrong back then. But this time…

Well, remember the surgeon let that RCA go, thinking it would resolve on its own? Well, in a normally healthy person with just donuts and cheesesteaks as their problem, sure, it could. But for someone with cumulative and progressive radiation damage, the RCA would only get worse. And once again, I found myself at “defcon 5” and a blockage that could have had major consequences.

This time however, the surgery would be different. Scared at the prospect of a second open heart surgery, one that had increasing chances of not surviving, this repair would take place going up through my leg, trans catheter. To my knowledge, this was not something just years earlier, people with my history would not qualify for because of the complications.

And yet, that was exactly the plan, to open up the artery using a stent. Amazingly, I was sent home from the hospital the next day. Once again, went through cardiac rehab again. And of course, started playing the “how long do I have” knowing that stents only last about 10 years, never giving attention to my bypass which had now entered the 10-15 year window for my bypass. There would come a day, that I would need this stent replaced.

Again, follow up cardiology appointments continued. All appeared to be well, with the exception of the valves seemingly to worsen at a slightly faster clip. My doctor felt, at least one valve would require attention soon, as in 3-5 years.

Then Covid19 hit. The warning to me was simple with this unknown, and deadly virus. “If you get it, it will kill you.” My cardiologist was referring to one of the two major events of this unknown disease. Covid pneumonia, which with my lungs majorly compromised would certainly result in my demise, but blood clots that resulted, and with the condition of my heart, definitely lethal.

I still needed my follow up care, all the while, being cautious. Which is not to be confused with the political trope of “living in fear.”

My follow up appointment in 2020 resulted in a decision from my doctor, it was time to replace the aortic valve. Great, right in the middle of this pandemic. Not only having to deal with the virus, but then be in a building where the virus is populated with patients. A short detour however, as another scan pointed out another pressing issue, which resulted in something needing a higher priority than my valve, my carotid artery, also followed for years, was now at a stage that needed to be fixed. Though not what I want to discuss on this post, it was fixed. But then the attention needed to turn to my heart valve.

Just as my “widow maker” situation back in 2008, my symptoms had grown so much worse with my valve. Most notably, SOB (shortness of breath), a major sign of heart failure. I could barely make it from one room of the house to another and this symptom was rapidly getting worse.

The surgery would be the same process almost, going through my leg, and then into the heart itself, to place this crown-looking device, inside of my damaged aortic valve. When I came to hours later, the results were immediate relief. And again, sent home from the hospital the next day. I am currently wrapping up my 3rd round of cardiac rehab. I do still have issues with two other valves, but they are not near the level to require attention, and I have two other anomolies with my heart which I have only begun to learn about, as it is a condition that right now, does not require attention.

Today marks 3 months to the day, that this device, gave me heart relief like I had not felt in years. Sure, I am still dealing with my other health issues, but believe me, if your heart is not feeling right, your quality of life is not really what it should be. Gives new meaning about “putting your heart into things.” (Mick Jagger of the Rolling Stones went through a similar procedure back in 2019)

These devices are meant to last 7-10 years, and for someone my age, 56, that would mean likely, another surgery for the valve would be a guarantee for someone with a normal health history. And honestly, it is quite cool how they would do it, if able. You see, there are multiple sizes of this artificial valve.

Just like a child’s toy, as long as you did not start off with the smallest of the valves, doctors in theory will be able to insert yet another valve if needed, directly inside the replacement valve, which was seated inside the original valve you were born with (hence the children’s toy reference).

I am one of the lucky ones because I do have a valve the size that will allow another replacement if needed.

But here is my dilemma, math. And with the precision of a scientist tracking a meteor careening towards earth, there is a collision course likely in my future.

While my bypass has now passed the 15 year mark, and had not needed repair, it is continuing to fail again, with its current status at 40% blocked. I would estimate it is likely, to need attention, not waiting for it to reach “widow maker” status to repair, in approximately 7-10 years. Combine that with my RCA stent, and now my valve, there is the potential, if necessary, that all three things would need to be addressed at the same time, no easy fete, filled with all kinds of risks.

And if you read yesterday’s post, you will see I have another factor creeping up on my, the curse of my paternal longevity.

But I have one thing in my favor, a major goal. One that has me trying to do all the right things health wise that I can, most importantly, believing that I can get there.

Back when I first became aware of all of the late developing side effects from my treatments, there was only one thing I wanted, to live long enough to see my daughters grow. Never a doubt, my doctors share my desire, and with careful and diligent follow ups, each year becomes one milestone closer.

An 18th birthday so far. A high school graduation coming this year. Another 18th birthday next year. One in college in the Fall. Another high school graduation the following year. Another in college. Two college graduates. Two marriages. Hopefully grandchildren (at least one daughter has promised me many). These are all goals within my reach, I can feel it. Fourteen years ago, my doctor told me I was lucky to be here, it was “not a question if” I “was going to die, but when.” And that has been all I have thought about, every year, every health event I have had to deal with, and for the last two years, dealing with Covid19 all around me.

But I am doing it. And I am getting closer to my goals, one at a time.

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19 Jan 2022

What Would Be?


I always have mixed feelings about “birthday” posts recognizing “what would have been,” someone’s birthday, if they would be alive today. I can understand why it is done, that desire to think about what it would be like, if they were still here today. Or perhaps to recognize how long it has been since the loved one had passed.

These two photos are the first known, and last photos of me with my father. Today is his birthday. Oddly, it was not until about a decade ago, that I could remember what day of January it was and then it hit me, one month after mine. I have not forgotten it since.

Sadly, all I get to do on my father’s birthday anymore, is just remember it, remember him, and remember what we had gone through with each other over the first half of my life.

There are not a lot of stories from my childhood of my father, or photographs (something that I have more than made up for when it came to his granddaughters). My parents were divorced when I was three, and without going into details, not relevant to this post, I hardly saw my Dad.

It was not until the second quarter of my life, that we reconnected, and made amends. There was a lot to talk about and a lot to deal with. Long story short, my Dad took advantage of that second chance with me.

We both had our health issues, I had already gone through my battle with Hodgkin’s Lymphoma, and he would have a major heart attack in his late 50’s, leading to major lifestyle changes. Following that heart attack, I found myself paying even closer attention to my Dad and our relationship. If he needed something physically done, I would take care of it for him, such as chopping firewood for the winter.

That would change when I would begin to develop health issues myself, related to the treatments I had received for my cancer, now 32 years ago. The two of us, with our heart conditions, would actually become an issue, as, even though we saw different cardiologists, it was in the same health network computer-wise. We have the same first and last name, and yes, the same day of the month. Had anyone paid attention to the year of birth, there would be no mistaking who was who. But on at least two occasions, I had to correct the nurse, that I was not the “Paul” with the heart attack and a smoker. Our charts were definitely different inside.

But there is one thing in common that we do have, actually seems to run in my family on my father’s side. We are not known for our longevity. My father, one of five children, is only the second child to live past 55 years of age. His younger sister died at 48, his mother at 49.

My father and I had never really given family longevity a thought, especially since he survived his heart attack. Admittedly, given all the health issues I deal with, I have passed 55 myself, but I do not take every day for granted with all the cards against me.

At the age of 65, and a smoker for at least fifty years of those, my father had been diagnosed with emphasema. But it was a mild enough case, that they told him, if he were to quit smoking, he could actually reverse the progression. Unfortunately, he could not quit, and not for lack of trying. But two years later, he would face his most difficult challenge ever, a diagnosis of lung cancer.

Again, I won’t go into the details here (I have written about it in “My Dad Was Just Like Me”), as by now you know the ending.

But it was a comment that my father had made, which stands out, every birthday just before his birthday, the year that he died. “I just want to make it to 70.” He would be one of the few, to make it that far. He would pass away four months later, and I do not know if he realized that he had done just that, made it to 70. The cancer had spread enough, that it was not causing memory and other cognitive issues. He had his clear moments, and then, there were those that we could not recognize him.

As humble as any man could be, I am glad that he lived long enough to be a part of his granddaughters’ lives. And I know he was glad to have that time.

I miss him dearly. And I remember him often. And though my health challenges are just as if not more serious than my father’s, I do hope to live long enough to see things that I have set as goals.

Happy Birthday Dad.

Posted in Cancer, Education, Family and Friends, Inspired By... | Leave a comment
08 Jan 2022
2 Comments

“You Talkin’ To Me?”


I am going to use several movie references for this post.

In the movie “Taxi Driver,” actor Robert DeNiro is rehearsing some sort of dialogue he intends to have during a pending conflict. I am paraphrasing the lines, as he is looking in a mirror, repeating, “you talkin’ to me? You talkin’ to me? (He looks around himself) I don’t see nobody else here, so you must be talkin’ to me. I’m standing here. You talkin’ to me?”

One of my favorite comedy movies, with clearly the greatest one-liners, is Airplane. Throughout the entire movie, an air traffic controller played by the late great Lloyd Bridges, states the many vices he had given up, but during the crisis currently involved in, has relapsed with all of them from smoking to “sniffing glue.” The meme I have posted is my own, and will explain shortly.

As it turns out, my grandmother had actually prepared me for this particular day, more than forty-five years later. A smaller than average kid, I was an easy target for bigger kids looking to make an image or reputation known, for being tough, a bully. Not only was I small, but I was also shy, and then the worst of it, clothing I wore, bought by my grandmother, definitely was not cool or trendy. I had all the trademarks of an easy mark.

My grandmother had an interesting way to deal with the various efforts of bullying and taunting. “Just turn the other cheek, and walk away.” While clearly my size was against me, this strategy failed miserably, as I just got attacked from behind.

As an adult, I understand why she said what she did. It clearly did not help the situation though. In conversations with my daughters I have used my own philosophy, “a fire will only burn if you keep putting wood on the fire.”

Indeed, very “Mr. Miagi”-sounding, of course referencing the original “Karate Kid.” Yes, Gen Z-ers and millenials, there was a movie series prior to Cobra Kai. Focus Paul-son.

Getting back to my meme with Bridges, and the Coke reference, I found myself referencing all three movies the other night. And while I am sure I will hear from fellow cancer survivors and friends, all with their recommendations of the many other uses for Coca-Cola besides ingestion, none the less, that is what has triggered this post.

I walked into the convenience store, not like the Sac-O-Suds in “My Cousin Vinny”, though I have to wonder, was it much different given the mentality of the store clerk I was dealing with?

I needed to purchase some gas for my Camry, not a 1964 Buick Skylark, and while doing so, grabbed a bottle of Coke. I really should not be drinking it for several reasons, and have quit many times before, but at this point, was off the wagon.

Between me and the clerk, were sheets of plexiglass suspended over the counter, the purposes of protecting both clerk and customer during the Covid19 pandemic. In full disclosure, my hearing is often questioned, whether selective or actually failing. But in this particular moment, I am pretty sure my hearing was spot on.

I put my bottle of Coke on the counter and explained that I would like to put $20 of gas into my car. That was it. No other small talk, clearly neither of us were interested in that.

How is this for a reference? From “Dude, Where’s My Car?”… “and then?”

“Bah-ah-ah-ah-ah-ah”

And odd thing for the clerk to utter, and honestly, I thought like many other clerks, who work with ear buds in the ears, he was likely listening to something and simply reciting along with it. But as I said, with my hearing, I was not sure what I was hearing, though it sounded like a sheep sound. And then he did it again.

“Bah-ah-ah-ah-ah-ah”

Now, I could probably post a snapshot from the movie Clerks for this, but that movie was funny. What was happening right at this moment, was not.

As I looked around me, like DeNiro in “Taxi Driver”, there were four other people in the store besides the clerk and I. They all shared one thing in common, and different from me.

I was wearing a mask. They were not. I was 95% certain, this clerk was trying to provoke me. I was not sure what I had heard the first time, I was 100% certain after the second sound. And then… as if more confirmation was needed, Floriduh man behind the counter started putting words together, the first word I heard being “Covid.”

At that point, I knew what was happening, and unlike the lesson my grandmother had taught me, which never worked, I replied very DeNiro-like, “excuse me?” At that point, the clerk now looked up, had stopped mumbling his crap. I repeated myself, “are you talking to me?”, making him clearly aware that I had heard his provocation.

This jackass was making a reference that I was a “sheep” or “sheeple”, because I was wearing a mask, recommended in helping to prevent getting infected by Covid19, and from spreading it to others. Clearly, he was one that did not believe in wearing a mask, and the fact that the remainder of people in the store did not have masks, made him more brave to take a shot at me.

In fairness, this dope had no idea that I wear a mask, as one of the more vulnerable people to Covid19, having a compromised immune system, as well as other co-morbidities related to my cancer survivorship. And that is none of his business, just as my decision to wear a mask or not, just as it is none of my business whether he wore one or not.

He did not respond to me after I called him out. I grabbed my soda, and went out of the door to pump my gas. And then I steamed. I did exactly as my grandmother once taught me. As I child, I never understood the benefit to walking away other than I was not going to get my ass kicked. But, as an adult, I was getting more mad. I do not like leaving things unresolved. I was provoked. I wanted closure.

This situation is different than just a conversation between two people sitting in a bar, or passing by on the street. The was during a business transaction between customer and employee. And while I understand that employees can have cranky days, and end up reflecting that on the customers, this was not the situation.

Representing his employer, this putz decided to exercise his free speech, and acknowledge the division in our country over whether the wearing a mask is appropriate or control. I have long given up on this debate, especially after two years. After two years, we are where we are because of the decisions both sides have made, and hopefully not worse. But it is unlikely that any large percentage of people will change their minds as to their stance. If science is correct, which I believe in science, like the other viruses I have faced in my life during my survivorship, I will get through the pandemic. Sadly, too many still will not, yet to come. And then… for those who made the claim that Covid19 was “just like the flu,” will finally be able to make that claim, because like the flu, Covid19 will not be going anywhere. One major difference, is the number of people Covid19 has killed, and did not have to be that way.

We are divided, there is no doubt. And an employee like this does not help. And while I risk a “Karen” reference, which will not be allowed because I am only using movie references in this post, I did speak to the owner, who agreed that he did not want this issue having an impact on his business.

And with that, my final movie reference.

Wear a mask, don’t wear a mask. We know the difference masks make. We know the political inference by those opposed to wearing them. We are who we are. And just like Mr. Vernon in “The Breakfast Club” had to do, we have to just accept we are who were are in the world of Covid19.

Posted in Bullying, Education, Family and Friends, Inspired By..., Politics

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