Paul's Heart

Life As A Dad, And A Survivor

Archive for the category “Inspired By…”

Science And Numbers Have Not Lied


First, looking at this picture, do not be distracted by what I am listening to. I actually do like Nickelback. Don’t judge me. LOL.

Obviously, it was that time again for me to get bloodwork done. And for one of the few times, this was a blood test that I was looking forward to. For one, I keep getting the same phlebotomist who performs the draw flawlessly, painless, and quick. The other reason, the test would provide information in regard to my vaccine status and overall Covid exposure.

But before I go any further, I will save anyone time. If you do not believe in science, and/or allow that it can be flawed at times, skip this post. I am not going to get into anything political about this.

From the beginning of the pandemic, science, at least the CDC, NIH, and FDA, had been concentrating on the more susceptible with their studies. The Leukemia Lymphoma Society, recognizing that it was not likely, that studies would be done on those of us who are immuno-compromised, decided to organize their own study, using patients how have or had dealt with blood cancers, such as leukemia and my cancer, Hodgkin’s Lymphoma.

I am not going to get lost in the weeds with all kinds of details, but here is the summary. In my particular case, I made a conscious decision to hold off on being vaccinated, until I knew that a 3rd dose would be approved. I had more than a strong hunch, that two doses would not be enough to protect me based on prior vaccines. For me to have gotten the vaccines when they became available, would not have allowed me the full benefit I needed from a third dose. Here is my proof.

Following my first dose, my blood showed no traces of antibodies, either from the vaccine, or from a Covid exposure. This was done two weeks after my dose.

My second dose was given 28 days after the first dose, with bloodwork following two weeks again. This time, there was a slight appearance of antibodies from the vaccine, nowhere near what I needed for protection. But the good news was, I also was not exposed to Covid.

Because of the choice I made, unlike others who got their vaccines as they were originally available, and their 3rd vaccine, 5-6 months after their 2nd, I received my 3rd dose, just 28 days after my 2nd dose. As I expected, the 3rd dose was a homerun, producing a robust amount of antibodies, and confirmed, still no exposure.

All I had to do was wait. I knew that I would have more bloodwork, to see if I still had coverage, but I was already anticipating a 4th dose being necessary. The lead doctor of the study, had already hinted at the likelihood. But now, as the fourth dose had not been approved yet, I am now in the position, where I needed to wait five months, to get that fourth jab. But before that, yep, more bloodwork.

This bloodwork would confirm what my levels were like after five months from the 3rd dose. The 4th dose had already been expected in my mind. I anticipated a drop in my antibodies, but not as badly as they had, an 82% decline over the five months. I am as close to no longer being protected again as I was back in the beginning of this. The 4th dose is now scheduled. More bloodwork to come. But will there be a 5th dose or some other plan? Clearly, Covid will be a lifetime risk for me.

There was some good news with this latest blood test. To be clear, I have followed every recommendation from the CDC, regardless of the “keystone cop” approach with communications, the message did not change, “use the caution we recommend”. Masks. Wash hands (really cannot believe people needed to be told that). Avoid indoor crowds. For well over two years, I have done it willingly, without the false trope of “losing freedom” or any of the other false claims that these precautions actually did do. I have faced several exposure risks, from having to be in the hospital for three surgeries during Covid times, people around me discovered to have had Covid and remained silent instead of being concerned for my vulnerabilities, and as shown in the photo below, a crowded airport as I waited to check my daughters bag for their flight home (the mask mandate was still in place, yet 75% of the people were unmasked, and the wait was well over an hour and a half, packed together, indoors). The blood test confirmed, as with the others, “no infection.” Yes, I was still following all those recommendations from the CDC that so many complained about as flawed. The fact is, they work. Need proof?

Of my sibling and I, it is me that has all the vulnerabilities. My sibling was (spoiler alert, I did write “was”) younger, and given all of my complicated survivorship issues, expected to easily outlive me. But there was a problem. My sibling followed the chain of false information and reasoning, from “Covid is a hoax” to “Covid is an attack on Trump,” to “I don’t trust the vaccines,” to “I put my faith in God to protect me,” to “I put my faith in God to cure me.” As I said, “spoiler alert”. I am the one writing this post, not my sibling. My younger sibling died because of all of the anti this and anti that.

The mandates are gone and as expected, all those who were “forced” to protect themselves have now made their choices to throw all precautions to the wind. Many have been infected multiple times, emboldened that they have survived each time, and therefore, will not go to any lengths to protect themselves or anyone else. As one of my friends mistakenly offered his opinion, “herd immunity is what is needed. Which I have always said, herd immunity would come at such a high cost, millions of lives, to which this person responded, “all for the cause. It is the patriotic thing to do.” I was speechless at the thought that someone claimed to have strong religious faith, was okay with sacrificing lives for the cause of the country, as opposed to following simple recommendations. And this sentiment still continues over two years later.

My goal as a long term cancer survivor, as a parent, was to see my daughters grow, become adults, start their lives. As hard as it is, and the odds that are against me doing that, Covid was not something I needed thrown in front of me, making these wishes even more challenging. Yet here I am. I need to avoid Covid so that I can be there for my daughter’s graduation just next month, fortunately, will be an outside event.

So, I must continue to mask. I always wash my hands. I avoid crowds (in full transparency, have always hated crowds anyway). I do go places, but at “lighter” times of day when not as busy. I have just begun eating out, but only if outdoor seating available, or just do take out as I have during the whole pandemic. I have no interest in overpriced boring movies in theaters or concerts. I am pretty much doing all the things I want to do, with all the precautions. I am still free. I am still alive. That is science. Those are the facts.

A Super Hero Effort


Continuing on with my post from yesterday, on the 14th anniversary of my emergency double bypass, the fog had worn off from the prior anesthesia, and all I could do was look at the clock. It was now after 8pm, I had just gotten a slight appetite, but now not allowed to eat because of the need to fast prior to the surgery.

With the pre surgery testing complete, not being able to eat, all I could do is wait. I could not sleep as my nerves definitely were getting the best of me. How could this be? I was only forty-two years old, and in fairly good shape. I had been exercising regularly. I was active. I did not smoke.

Per my request, an orderly came into my room around 3am, I was not able to sleep. I had asked to be taken down to the hospital chapel for a few words. I do not believe in organized religion, but I do believe in a higher power and that is as far as I will go with that. Upon my return back to my room, a large figure, I could only compare to the actor Michael Clarke Duncan, feeling specifically like I was in my own movie of “Green Mile.”

He was there to prep me for surgery, as well as take me there. Why did I get the feeling there was a need to have someone so much larger than me and more powerful than me, as if necessary to make me comply? In reality, one of the few people in my care during any procedure, never a word spoke between us, hence, never knowing his name. And for as big as he was, he was a gentle giant of a man.

I was placed on a gurney to go down to the operating room. It was 4:30am. Other than the pre testing, I was completely unaware of what was about to happen, other than the simplistically put, “having open heart surgery,” which I clearly understood. Unlike other patients who would have days, weeks, or even a couple of months to dwell and think about what they needed to go through, I had no time to worry or obsess, or stress.

The actual operating room that I was delivered to, was twice this size, and filled with so many television screens, multiple pieces of equipment, and of course, the operating table, which I was transferred to upon my arrival. I could see piles of materials and surgical tools, I knew all of them meant for me. I was scared, but I was also amazed by the clear effort that was about to take place.

Of in the distance, I heard one of the nurses make the comment, “he’s too young for this.” I normally do not respond to conversations I was not meant to hear, but this time I did. “I am young. Quite young. And I want to get through this. I need to get through this. My daughters need me.” Still, they were my focus on this, even more than the surgery.

As they continued to position me, and organize everything, the last thing I remember, was them removing my hospital gown. Yep. Just laying on the table, all sprawled out, in my glory, also now being restrained. Nowhere near ready to begin yet, my anxiety must have been registering, as I remember nothing after that moment.

But clearly, a lot was about to happen. And it was only by reading the operative report, that I could not only see, but appreciate the extraordinary efforts that went into saving my life.

This was my super hero. He did not wear a cape or mask. But he did have the most steady hands, nerves of steel, and the best skills necessary. Reading through the operative report is an amazing story, and quite surreal. This stuff was actually done to me. I won’t post the entire report, but some of the highlights:

  • a median sternotomy incision was made, exposing the sternum. Simultaneously, a vein was being removed from my left leg to be used for the bypass
  • a decision was made to use a different artery, the mammary artery for the bypass

This next part is what still shakes me to this day. It is extraordinary.

  • “The patient was placed on bypass, cooled, and emptied.”

In other words, I was put onto a heart/lung machine, that would do everything for me, my body about to be unable to do it on its own. Cooled and emptied? Yep. My heart was drained of all blood. And then came the ultimate moment, planned and necessary of course.

  • “The heart became asystolic.”

My heart no longer had any electrical activity. My heart was no longer beating. My mind is still blown seeing these words. Clearly I am here, as I am writing this post. But technically, on my own, I would have been dead. To keep risks against survival from this process, patients are intended to not be on this machine more than one to three hours if possible. My documented time was forty-five minutes.

  • the bypass process had been completed

And then the really cool parts:

  • “hot shot of warm oxygenated blood solution was given.”
  • “the heart was allowed to fill.”
  • “the heart fibrolated at this time.”

My heart was beating on its own again. How chilling that is to see in writing. And I survived this.

And finally:

  • “I closed the pericardium loosely, rewired the sternum, and closed the wound.”

The surgery had been a success. I was off to recovery.

My doctor was a hero once again.

The “Oh Sh*t!” Moment


Continuing on from yesterday’s “anniversary” post, as promised, I arrived at the Cardiac Cath Lab at six in the morning for what the cardiologist had described as an “in and out” procedure, “a stent or two and would be good as new.”

Without getting too lost in the weeds, a catheterization process involves a thin tube being inserted through an arm or leg, in my case a leg, fed through a blood vessel to the heart with a small camera to look for issues such as blockages or irregular heartbeats. During this process, if the doctor sees something that needs correction, which was already assumed in my case, he fixes it, again, expecting to place a stent to open up what is expected to be a blocked artery. Textbook procedure.

My nurse Heather had prepared me for the procedure. I do not remember why, but a conversation about my surviving Hodgkin’s Lymphoma came up. It might have been, because I was only forty-two years old, way too young for heart surgery, and I had explained that I had already been through a major event, so, age really had nothing to do with it.

My biggest concern, was that I had no spleen, removed as part of the diagnostic and staging procedures for my Hodgkin’s. So, I urged Heather to make sure all involved, knew that I was at an increased risk of infection and to take all necessary precautions. I wanted this to go as simple as possible.

When I came to, in my room, I saw my cardiologist, and a friend/co-worker who had stopped by to see how I was doing. The looks on their faces were serious. Though I remember the conversation, at that moment, it was not sinking in.

These are the actual images from my heart, and a drawing to make sure I could clearly see and understand the moment. A moment that was so extreme, and because of coming out of the anesthesia, I could not grasp how dire the situation was. Perhaps that was a good thing.

It was explained that I had three blockages that were of concern, one to the degree that even as a cancer patient I had not given the prognosis a possibility. The most serious of the blockages was the main artery, blocked between 80-90%. My friend, who also happened to be a paramedic, blurted out, “oh my God, it’s a ‘widow maker.'”

This simplified exclamation from my friend, though accurate, caught my cardiologist by surprise. “Yes, though we don’t like to call it that.” As I mentioned, I was fortunate to still be groggy from the anesthesia. I had no idea, that I could die at any moment, a fact that my cardiologist would tell me at my first follow up appointment a month later.

A blockage like this, nicknamed “a widow maker,” is referred that way, because the result is a major and fatal heart attack and unless it is able to be responded to immediately, the likelihood of survival is zero. The fact that I had symptoms for as long as I did, and did nothing about the situation, even more astounding as to my luck of survival. As my cardiologist phrased it, “it was not a question of ‘if’ you were going to die, but ‘when.'”

Oh shit! But as I was not understanding fully what was going on, my cardiologist was also confronted with his own “oh shit!” moment, clearly not expecting to have run into what he did.

I was scheduled for an emergency triple bypass the next morning, April 18, 2008, which was Friday, as in the anniversary of that day is tomorrow.

I thought the worst I would have ever had to deal with in my life, was going through cancer. My heart said…

As the anesthesia wore of, I discovered I had a busy twelve hours ahead of me in preparation for this surgery. The doctor had to find a vein to be used for the bypass, likely from either of my legs. Chest x-rays would be done, and tons of blood work. All of this had to be done quickly, as I was scheduled for surgery first thing in the morning. But there was one thing that I could not do before then.

See my daughters one more time. Hug my daughters one more time. It was an awful feeling. I could not even tell them I loved them one more time. And as long as the surgery was successful, it would still be days before I could see them.

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