ARTS & FARCES internet

At 4AM on Thursday, 10 February I went into the emergency department at United Hospital in Saint Paul, unable to breathe adequately. My breathing difficulties have been worsening for several weeks. I had attributed this to the severe anemia associated with my kidney failure. Dozens of times in the past this has happened, and, as soon as my hemoglobin level was raised with increased doses of erythropoietin (EPO), I felt better. This time it was something else. I had a pretty severe heart murmur that no one had heard before.

I was admitted to the hospital and later in the day was diagnosed with mitral regurgitation after an echocardiogram. The mitral valve in my heart is not closing all the way, thereby allowing blood to flow backward into my heart. The valve has leaflets that open and close, controlling the flow of blood through my heart. Small muscular cords are attached to the leaflets that work the opening and closing of the leaflets.

These cords that attach the valve leaflets to the wall of my heart have somehow become torn or otherwise damaged and the leaflets no longer close properly.

As with my kidney failure, the cause of the cord damage is unknown.

As a result of the valve not being able to close properly, approximately 80 percent of the blood flows back, and my heart has to work harder, pumping the blood nearly twice. As a result, my heart has grown larger as it tries to pump more blood with each heartbeat.

The good news is that there doesn’t appear to be any damage to the rest of my heart and the muscle itself is still sound.

On Friday, 11 February, the initial diagnosis was confirmed with a transesophageal echocardiogram (TEE). A tube with an echo transducer was passed down my esophagus and positioned next to my heart. Because the heart rests on the esophagus, the ultrasound signal is stronger because it only has to pass through a few millimeters of tissue.

My initial reaction was, of course, to ask Karen to call Bear and ask for a vial of his best and to ask the cardiologist for a couple handfuls of pain pills and muscle relaxants so I could go home and cash in. For some reason this made Karen pretty hysterical but my better angels intervened and I’ve decided to move forward through this latest bump in my Great Adventure. Remarkable woman that she is, Karen has handled all of this with a hell of a lot more grace than I have. I am blessed to have her in my life, her love, and never forget that it’s totally undeserved.

Treatment for my condition requires open heart surgery to repair the damaged mitral valve in my heart. The surgeon will make an incision through my chest and separate my breastbone to expose my heart. My heart will be stopped and I’ll be placed on a heart-lung machine that will handle my breathing and blood circulation. The valve will be repaired by sewing a ring around the valve. If the valve can’t be repaired, it will be replaced with a mechanical one. The breastbone will be wired back together and the incision sealed. The surgery will take 4-6 hours.

I’ll remain in the hospital for 5-8 days post surgery and the recovery time is 6-8 weeks.

I was discharged the evening of Friday, 11 February for about a week to get my affairs in order.

I’ve got to have a dental checkup and x-rays to prevent bacteria from entering my bloodstream infecting the repaired/new valve.

I’ve also got to have a coronary angiogram where a catheter is inserted in an artery in my groin and passed up to my heart. A contrast dye is passed through the catheter so the arteries display well on the x-ray and any coronary artery problems become apparent.

Then, I believe the surgery will be scheduled and I’ll be readmitted into the hospital.

If you want updates, consider following my Twitter account. This is the easiest and quickest way to find out what’s going on. I know some of you will resist. It’s the 21st century; deal with it. Twitter’s the easiest way for me to provide quick updates and status reports because I can do it from my laptop, the iPad, or the mobile phone.

The Twitter updates will also carry links to longer updates published on Hasten down the wire on our website, ARTS & FARCES internet. All of my health related information will be in the ESRD section, so you don’t need to subject your sensitive selves to my other rants. Twitter will carry direct links to all of the updates.

In the alternative, here are additional coordinates:

Home/office landline: +1 651-698-0741
Michael’s mobile (with SMS and MMS support): +1 612-562-7466
Karen’s mobile (with SMS and MMS support): +1 612-562-7471
Michael’s email: .(JavaScript must be enabled to view this email address)
Karen’s email: .(JavaScript must be enabled to view this email address)

I will be in United Hospital, Saint Paul for the duration.

The surgery has not yet been scheduled—there will be at least a tweet and hopefully a longer article when that happens.

I’ve been scheduled for a dental checkup and coronary angiogram tomorrow (Tue. 25 Feb) and the coronary angiogram on Thu. 17 Feb.

Thank you in advance for your kind thoughts and, please, keep me in your heart for awhile.

Am I frightened? My pants would be on fire if I said I wasn’t horrified. What will the recovery be like? What impact will my kidney failure have? What about dialysis? Will I even make it through the procedure? What about my immune system that’s virtually non-existant because of my kidney failure? What did I not learn with my kidney failure that’s causing me to get whacked again?

I’ll get through this. Karen and I have fifth-row center tickets to see Rickie Lee Jones perform her first two albums—Rickie Lee Jones and Pirates—in their entirety and original running order with a full band, including horns, to recreate the sound of those first two remarkable releases. The show’s on Saturday 30 July at the Lake Superior Big Top Chautauqua and I will absolutely be there, beaming. And we expect to see those of you in the Twin Cities at least a few times at Sue McLean’s Music in the Zoo series this summer.