The Hour - Bernard DeVoto

"Since time immemorial, when bitchslapped by this bitter epiphany we have reached for strong drink--only to find that it is an exemplary of our contradictory ways rather than an antidote for them."

Home - Week 14 - Working Man

I'm back to work this week. I have been able to do yoga each morning, ride my bike to the office each day (approx 25min each way) and hit the weight room 3 times. I feel good and relaxed. The team did a great job while I was away and I was able to come back to 5 easy days of email cleanup, meetings and catching up on news.

With the return of regular days and regular exercise it seems that a regular sleep pattern has returned as well. I have gone to bed no later than 11pm each night and for the most part slept right through to 6am the next morning.

Although I missed a few weeks I have enjoyed my entries in this blog. The exercise of documenting the recovery has helped me in many ways, but I will probably stop talking about the recovery and return to my original purpose which is to muse about the little things and experiences that make me pause and say to my self "I should write this down".

Away - Week 13 - Road Trip

This was my last week before my return to work and as planned I went on a road trip: Vancouver and Seattle to be exact. My plan was to hang out with friends, walk around the respective cities, sample the local cuisine and maybe do a little shopping.

I left Ottawa last Friday afternoon. I had a couple of glasses of wine in the lounge prior to departing with every intent to fall asleep immediately in my seat on the airplane. Once on the plane, I sat down, placed my book in front of me, arranged my bag of candy (in flight necessity) for quick access and put a little Jack Johnson on the iPod. Without fail it was lights out. I woke somewhere over Alberta with my habitual smacking of the lips and a slow revolving look for someone to bring me something to drink. With my drink in hand I reached for the candy and started a rapid fire insertion of sweet morsels into my mouth with little chewing or swallowing. Pure bliss.

It was at that point that I noticed a significant pain in my left upper rib cage. The best way to describe it is a stitch (you know the kind you get when you run too hard). The problem is the stitch didn't go away. I was a little worried because it was making deep breaths somewhat painful. I wasn't too worried because of the explanation the rehab doctor gave me about the fact that they had cracked my chest open and I would experience all kinds of weird sensations for the next 6 months as my muscles and bones moved back into place. The candy probably didn't help either--we're talking a movie theatre size pack of Sour Patch Kids consumed in about 30 minutes.

Unfortunately the stitch didn't go away until Monday and it then graduated into my shoulders. I started on the Advil and Tylenols so that I could enjoy my trip. In Vancouver I visited with my sister and family and I stayed with my friend D. D. lives downtown and walking distance to everything. With D. the first order of business is always food. When I got off the plane we went straight to an all-you-can-eat sushi place. The following day we went to a place called the Banana Leaf. If you go to Vancouver you need to go to this restaurant (http://bananaleaf-vancouver.com/). You will not be disappointed. D. and I also did a little donut comparison: Lee's bakery on Granville Island vs. Honey's in Deep Cove. Each has their distinct style. Lee's is melt in your mouth, light, I could eat 3 dozen in a single sitting style donuts. Honey's is a caky, freshly dipped in honey, sinfully good 2000 calorie pastry, where if you can eat more than one you may end up writing you're own blog about heart surgery. Personally, I decided that Lee's was my favourite.

I was hoping to take some cool boat or hovercraft from Vancouver to Seattle, but poor planning and schedule convenience swayed me towards taking the bus. I had a good book and a pile of music I had ripped at D's. Four hours later I was in Seattle. I hadn't seen my friends F. and M. for almost 2 years and it was great to be at their place just hanging out. While we were having dinner the first night M. mentioned to me that she had not had a poutine in 2 years. I decided then and there that I was going to make poutine in Seattle. All I needed was proper cheese curd. It ain't a poutine without cheese curd. On Thursday I took the bus into downtown Seattle and walked up to Pike Place Market (picture above). If you like food, you this place is a must visit.

While I was walking around I noticed Beechers Handmade Cheese (http://www.beechershandmadecheese.com/). Hmmm... I wonder if they make curd. I didn't any curd on display so I asked. "Do you have plain cheese curd?" The woman behind the counter said "sure do". "Would you mind if I test it?" She looked at me funny. "Taste it, I mean." She handed over a nice piece of curd. It was solid and cool to the touch. So far so good. I put it in my mouth: salt (but not too salty) and squeaky. "Perfect!" I said. She set me up with container and it took all my self control not to mow through the cheese on the bus and make up some story about how the yanks don't make curd cheese. I made the poutine that night along with some pan fried haddock. I think it was a success.

On Friday I made a quick visit with F. to the Seattle Space Needle and then hopped on the bus back to Vancouver. Saturday morning I was back on the plane and headed for home. Sunday I woke to no pain in my shoulders or chest. Funny.

This trip was a great way to transition back to my regular life.

As I re-read the above paragraph's I realize I don't sound too much like a guy that just had heart surgery: donuts, bags of candy and poutine. Aside from some of the pains I feel, being winded when I climb a hill or stairs and remembering to take the medication I don't really feel any different than before. I have to say seeing the scar in the mirror kind of freaks me out occasionally.

Home - Week 10 - Bike rides and downward dogs

This week started with meeting the rehab doctor, Dr. P. The appointment is part of the overall rehabilitation plan and it consists of a complete physical examination with a thorough medical review of my current cardiovascular status including blood work. According to Dr. P. I have "the blood pressure of a teenager", my heart and lungs sound great and I should be able to return to the shape I was in the past.

The highlight for me was the blood work. Two numbers are real important: LDL and HDL. These numbers indicate the cholesterol levels in my bloodstream. In December last year my LDL (bad cholesterol) was 4.09 and my HDL(good cholesterol) was 1.36 . For someone without a valve problem and blocked arteries, these are not terrible numbers, but for someone that was in my condition the LDL needed to be 2.0 and HDL 0.9. I'm happy to say my LDL is 1.1 and HDL is 0.79. The HDL is a little low so I will be adding Salmon Oil to my supplements and my increased activity should help get that number up. The good LDL number is probably a result of the Lipitor which means I'll have to continue taking that pill for a while. I hope that in my meeting with the cardiologist in June we will be able to reduce the dosage.

Although there is no change to the Lipitor dose, we were able to reduce the Metoprolol from 100mg to 50mg a day. Metoprolol is a Beta Blocker and it helps reduce blood pressure, angina and risks of having a heart attack. It's other affect is that it keeps my heart rate (HR) down. I figure with my overhauled pumper and a good exercise plan I'll get this one off the list in June. Currently I exercise at an HR of 120 with little perceived exertion. I'd like to start taking that number up as my fitness returns however the Metoprolol will affect the effort. After talking about this with Dr. P. he recommended a reduction in the Metoprolol and said that my cardiologist will need to make the call on cutting it off completely.

At the end of our meeting I got some other things confirmed: (1) I could get back on the bike; (2) I could go back into the gym and start resistance training; (3) I can go back to Yoga without issue; and (4) there would be no problems with sports like paddling. I mention this because of my continuous paranoia about my chest bone. The Dr. explained to me the healing process and also said that the bone actually heals stronger than the original bone. I don't know if I buy that 100%, but it still makes me feel good.

That was Monday. Needless to say I walked out of the OHI with a significant bounce to my step. I have been on the bike twice this week and aside from a little muscle pain, an embarrassing cadence and harry legs, I'd say I did OK. I have also started my yoga sessions again. So far I'm getting my downward dogs in every second day. Let's just say that my flexibility needs work. The breathing was smooth, the transitions between positions was smooth, but the positions were not stellar, including the downward dog. I have learned, especially with yoga, that with practice everything gets smooth.

I finished the week off on Friday with buying a sea kayak. Remember that paddling question above, there was a reason. For a long time I have wanted a sea kayak and today I finally picked it up. I won't actually start paddling until mid June, but I'm pretty pumped about the whole thing.

This week was a good week.

Home - Week 8 - Flying Solo

First week on my own. The feeling I had on Saturday morning when I woke was the same I used to get when I was a teenager and my folks had gone somewhere for the weekend. There is a stillness that seems amplified by the fact that you are the only one in the house. Every disturbance is concentrated: house cracks are louder, clocks have thunderous ticks and even the fridge compressor wines to its high pitch and then stops with an echo.

My chest is feeling much better these days so I can actually sit straight up without the protective tuck or roll I was required to do for the first month. As I sat up in bed, bug eyed and disoriented, the cobwebs started to dissipate and all my plans for the day, the week and the month started to flood my brain. I started to itemize all the errands I would do (with the truck), I figured out when I would do my walks, I started meal planning for the week and for about an hour I sat their thinking about doing stuff. When I finally got out of bed, I did the walk around. You know, you walk around your house almost like you want to make sure everyone is gone and you're alone. I used to do this every time my folks left me alone.

With my action plan ruminating in my brains I took care of the first order of business: Latte. During my recovery, for some reason or another, I decided I wasn't going to hit the espresso maker. I fired up the Rancilio, grabbed a bowl from the cupboard and proceeded with my coffee morning ritual. Things are getting back to normal.

This week was more Rehab sessions. The sessions themselves are designed for people who are 50+ in age and unfamiliar with exercise and healthy living. That means that I don't fit in very well, but the way I look at it, I'll see how adaptive they are with their program for a 37 year old that knows about training plans, diet logs and periodization. So far the physiotherapist have been pretty conservative, but I'm still technically in my eight week healing period. I have Rehab every Monday and Wednesday. The sessions consist of a consultation (5min) with the Physio, an aerobic workout (40 min), a set of cool down exercises consisting of weights and stretching and then a "talk" about some healthy exercise topic (i.e. hydration). During the exercises portion of my sessions this week I had to use 1lb weights (thats right one (1) pound) because I'm still in the healing period. Fortunately I have checked my ego permanently at the door of the OHI.

Home - Week 7 - One final game

From my first day of recovery I have been terrified of the possibility that my chest bone (sternum) doesn't heal properly. The healthcare team has warned me with every movement that I must be careful not to disturb the healing of my chest. The consequences are painful and repair is unlikely. I can't lift anything greater than 5 pounds. I have to be careful when twisting in bed. When I sneeze, laugh, cough or yawn I need to cross my arms in front of my chest. At the beginning the amount of pain I was felt any time I moved my chest was reinforcement enough. After a while though, the pain wasn't so bad, but by then I was fully brainwashed to protect my chest at all costs.

The healing schedule for my chest, as described by the physiotherapist, is the following: after 4 weeks the bone begins to mend, after 6 weeks the bone can withstand movement, and after 8 weeks the bone is healed. When I met with the surgeon 2 weeks ago he said the x-rays showed the bone was healing and everything was good. I was still pretty worried because I was still having pains in my chest and occasionally I'd get a popping of bones around the sternum. It was nothing too significant, more like a knuckle crack. This week I decided to call the nursing coordinator (NC) at the OHI to confirm that I could start driving and to ask some questions about my chest.

Once I was on line with the NC I gave her my name and surgery date. She said, "oh ya you're a young fella aren't ya".

I acknowledged that I was young from a certain perspective and then proceeded to ask about the driving. She answered, "how do you feel and how are your walks going?"

To which I replied "I feel good, I still have some numbness and soreness in the chest. I'm doing 2-40min walks a day".

She then says "OK you can drive".

"That simple?", I say.

She says, "yup".

Feeling good about the driving I then started telling her about my worries that my chest may not be healing correctly. She replied "when you look down at your chest and breath in, does one side come up before the other?"

"That simple?", I say.

She says, "yup".

I say good bye and hang up. Of course the first thing I do is look down at my chest and breath in. Both sides came up at the same time. All is well and I am ready to drive.

Today (Friday) is my mom's last day here. After suffering through another night of insomnia, I woke late and went in to pick up my truck. It was a little funny to start driving, but not as foreign as I thought it would be. When I returned home, my and I had lunch and then decided to play a game of crib. One final game. As it turned out with the time line my mom set for herself in combination with a couple of interruptions we weren't able to finish the game. As much as I need to move on to the next step of recovery, I'm going to miss having my mom and dad around. Very few of us get to spend 8 solid weeks with our parents anymore. We're all too busy. I'm glad the game was left unfinished. Too me we didn't say "good bye", we just said "until next time".

Home - Week 6 - A flicker of light

When I was 9 years old our family moved into our first house. The biggest and most novel feature of this new house was a fireplace on the main floor and a slow burning stove in the basement. This was a "country" house and my dad's thinking was that the majority of the heating would be done with the stove.

The novelty of the fireplace and stove remained for quite some time. Who gets tired of making and feeding fires with huge pieces wood? As we got settled into the house we also needed to establish a discipline of feeding the stove so that the house stayed warm throughout the day and night. Whether I was the beneficiary of a traditional sexist father (boys do men things and girls do women things) or ultimately the sucker of a more savvy sibling (my sister); I don't want to speculate, but I became the designate for ensuring that the fire in the wood stove remained active throughout the night.

Although the stove could handle some pretty serious pieces of wood, a maximum load with the minimum efficient air intake would last roughly 6 hours. I was 9 and to bed early so my dad would typically get the stove set before heading for bed. That meant that between 4am and 6am the house was out of heat. It was a struggle for me to get up into the freezing house, make my way downstairs and get things heating again. Over time I would simply sleep downstairs and feed the fire constantly through the night. For the first few hours I would leave the doors open and use just the grill so that I could look at the fire. There was something about the flickering light, the smell and the sound.

I wasn't always the perfect fire keeper, but between ages 9 and 16 I spent many nights falling asleep in front of the fire. It didn't hurt that the couch we moved down to the basement was incredibly comfortable. The purpose of sleeping downstairs was simply to avoid getting up early and/or making several trips downstairs to feed the fire. Yet I think over time the fire became a comforting catalyst to slumber.

This will be my fourth entry in this blog where my sleep patterns are central to the theme (Home - Day 4 - Restless Sleep; Home - Day 6 - The Afternoon Nap; Home - Day 13 - The All Nighter). I'm starting to think the hardest part of my recovery has been dealing with a schizophrenic sleep cycle. For the last 3 weeks I have slept miserably. My spirit, energy and mood are all affected by a broken sleep. I decided to return to my childhood to see if I could conjure up an old friend. I grab a big blanket from the bed and head down to the main floor. I flick the switch for the fireplace (gas) and I hunker down on my couch and watch the flames. No sound and no smell, but still a flicker of light that seems to have a hypnotic affect on me.

I wish I could report that this new tactic triggers an unconscious reaction and immediately sleep overcomes me, but it doesn't. Some nights I think the flickering light of the fire actually does help; other nights I think whatever troubles I'm having are beyond childhood comforts, homestead nostalgia and plain old wishful thinking. The sandman runs from me as if I were the embodiment of a mushroom cloud.

At some point a "normal" sleep pattern should return. I hope I won't need to resort to medication. In the mean time I'm plowing through my reading list (4 books last week) and exploring some new concepts around the midnight snack.

My session at the OHI rehab. clinic was a bit of a bust. I think I probably set my expectations a little too high. The 3 hour session ended up being a series of short meetings with various people to schedule various information sessions and visits. I was hoping to actually ask some questions. Apparently my next appointment in a week will be with a real physiotherapist where we set goals and establish limits for physical activity. For the moment I feel pretty good physically. We've had to cancel some walks because I have been brutally tired from a lack of sleep, but when we do get out and walk I feel pretty good.

1 more week and I get to drive!