I’m not sad about any of my life. It’s so unconventional. It doesn’t look anything like I thought it would. ~ Edie Falco
Moments of Happiness
In the last couple of years in the media there have been a lot of articles taking a different tack on happiness. It’s this idea that in fact pursuing happiness is making you unhappy. It’s the idea that people get so obsessed about being happy, that when they don’t achieve what they perceive as “happiness” then in fact they end up depressed. I really don’t like these articles, I think they miss some really obvious things.
The first thing they missed is that any obsession is almost certainly going to lead to unhappiness. Obsession by definition is going overboard, pushing further than you should, being overly concerned with something. Whether it’s obsessively, gambling, shopping or even obsessive romantic feelings these types of obsessions lead people to doing things that harm themselves. So an obsession with happiness is also very likely to be a bad thing.
The other issue that they fail to discuss in these articles is a discussion about how to define happiness. Part of the problem with searching for happiness, is most people don’t take the time to define what happiness will be for them. Society provides a definition, I call it “the script.” Society says that happiness is married, owning a house, having some kids, working till retirement then fishing a few years before you die. Honestly that has never seemed all that satisfying to me. And of course, happiness is a very individual thing. So for some people, “the script” might be the epitome of joy and happiness but my life and desires are much more unconventional.
So the first thing you need to do, if you’re pursuing happiness, is to define what that will look like for you. Because pursuing a goal, without knowing what that goal looks like is bound to lead to disappointment. So you need to know what that end point looks like. For me at this point in my life, it looks like a house, on a good chunk of land, someone to travel with and time with my nieces and nephews. An opportunity and time to do a lot of things I’ve never had time for and/or have wanted to do but not gotten around to doing. So painting, writing more, learning more about foraging and living a simpler, closer to the land life. Oh yeah and playing with some toys, a metal detector and a really good telescope and of course, a doing some Bigfoot expeditions. I’m working on getting there.
The other mistake I think people make, is thinking that happiness is a single destination. Like many of the things we pursue in life, our happiness goal will change as things change in our lives. Hell, at one point in my life happiness simply looked like being sober, at another time being out of debt, at some points just being with a person I loved. So the endpoint/goal will change over time, the pursuit of happiness doesn’t ever end, it morphs and changes over time. This does not make it some Sysiphean task that is a never ending exercise in hell. So what does it mean?
For me it’s two things, we pursue our end goal of happiness at all times, in reasonable ways when possible and hope to be living as close to that endpoint as much as possible. But equally importantly, we must learn to do two things that are related. First, we need to find joy and happiness in smaller and simpler things and we need to take the time to appreciate and enjoy them. Whether that’s something small and wonderful like walking over a hill to an area full of flowers, laying on a picnic table and watching clouds, or just a really good dessert, we need to be thoroughly present and enjoy those moments of happiness. Not all of them will be small, hundreds of them for me are tied to my little brother. His birth was a joyous day, and not just because the ice storm meant school was canceled for the day, I had always wanted a brother and I was getting one. We were inseparable when he was little, we wrestled and talked and listened to music together. We ran around outside and played like little kids, which he was, I was fifteen years older. But those early years of his life were filled with insane levels of happiness with him. We need to recognize when we’re in those times and truly understand and realize the joy we’re experiencing.
So my friends, define happiness, chase it, but not obsessively. And along the way take time to notice the small bits of happiness you experience and be present for them. Do this, and I promise you more happy days my friends. ~ Rev Kane
San Francisco is a mad city – inhabited for the most part by perfectly insane people whose women are of a remarkable beauty. ~ Rudyard Kipling
A Walking Day in San Francisco
Spent a lovely day walking in San Francisco today. It was a full test of being back to normal, a six mile walk, even if I did avoid the biggest hills in the city. I also rewarded the longest walk since my surgery eleven weeks ago with two pizza stops.
It was a nice walk up from the Civic Center/UN Plaza, up through Hayes Valley, over Russian Hill via Polk to Ghirardelli Square where I took some time to just sit by the bay for a time.
Then I rolled up to Pier 39 and hit Amici’s for my second pizza stop of the day. And finally walked back up the Embarcadero and hit back to the BART Station and home. I love walking in the city, you never know what you’ll see, today I watch a golden retriever go nuts because it encountered a robot dog. Here’s a little set of photos from the walk today.
The knack of flying is learning how to throw yourself at the ground and miss. ~ Douglas Adams
A Taste of Normality
Today I started week eleven since my surgery, my initial healing period and end of medical leave is the beginning of week thirteen, so we’re getting near the end of my initial healing period. By this point I’m supposed to be fully mobile, walking a couple of miles a day, driving and basically doing everything except doing any lifting over ten pounds and very little with my arms outside the core of my body. I’m doing a bit better than that, I’ve achieved all of that and I’m walking four to five miles a day.
So this week I decided to run a bit of normalcy test as well as take a minor vacation. So I’ve come to Reno for a few days apparently to lose money gambling and eat good food. This was a good test, a four hour drive in the car, sleeping flat in a bed and generally living normally. It’s gone well, the car ride went well, I’ve slept ok and generally it feels like a normal trip to Reno. I also got to lay all of my NFL season bets.
I got some good news today, I will be going off of my blood thinners on August seventh, that also means I get to come off another medication that I’ve been taking in conjunction with the Warfarin. So, six less pills to take every day. I also got my blood test results back and all of my blood metrics have come back to normal. I had my last blood draw as well so normal life is coming at me at high speed. This is something that brings mixed feelings, first, very happy to be getting back to normal and unfortunately it means going back to work soon.
I’d hoped to get in a little vacation but there still are some appointments coming up and it just hasn’t worked out timing wise so I’ll have to settle for some great seats, row one, right on the field, for the Giants and Pirates next week with a couple of friends.
The last big thing for me is that I have my first physical therapy appointment on August fourth so I can start working on getting my upper body strength back. Then I work on flying. Have a happy day my friends. ~ Rev Kane
Lately I’ve been thinking a lot about expectations. I’ve come to realize that a lot of the unhappiness that I’ve experienced in my life has been related to my own expectations. You see, I’m someone who has always believed that you should give what you get. If someone is giving of their time for you, then you should we willing to give the same for them. I’ve always expected that if you care about someone, take care of them, give them physical and emotional support, you can expect the same. It’s that thinking that I have come to realize is wrong. Now, this is not a new intellectual realization to me, I have many times had what I call “the levels” discussions with friends about romantic relationships.
The levels conversation is a pretty simple and logical idea, in almost any romantic relationship one person is more invested than the other. There typically is someone who feels incredibly fortunate that the other person is willing to be with them. I think the relationships that work the best, are those times when both partners feel this way. When a person feels that they are lucky to have, and maybe even undeserving of the other person’s attention and affection, they will work harder to make the relationship work. They will also likely be more willing to forgive a lack of attention, affection or time out of fear that if they don’t, the other person might move on. When you’re on the other side of that, you come to realize, perhaps even subconsciously, that you don’t have to be as giving, as the other person will not move on. This can lead to a pattern of one person being more and more, and the other person being less and less invested in making an effort in the relationship. The partners are at different levels of commitment and desire to work in the relationship.
So, knowing this, you would think that I would have easily made the logical leap to understanding that non-romantic, friendships and family relationships would work the same way. Somehow, I believed that non-romantic relationships would be more equal. This is the realization that has really hit me during the last couple of months as I work through my recovery.
The expectation that others would return what I gave, often not being met, is something that has led to a lot of unhappiness for me in my life. So, there’s an easy solution right, just don’t expect anything from anyone and you’ll never be disappointed. This is a meme you’ll see on social media, and a discussion you’ll see in articles. If you have no expectations, you’ll have no disappointments, so have no expectations is their advice. The problem with this idea is that other people are trained by your actions. If you give of yourself, have no expectations, and nothing comes back in return and you’re not upset about this and there are no consequences to the other person, you’ve taught them how to treat you. They will learn that they can expect from you, but don’t need to give the same, or anything for that matter in return and they’ll still have the connection and relationship. And while having no expectations might remove your disappointment, it could also quickly make you a doormat, which is not ideal.
I’ll give a really tangible example of this. I had a person I was friends with in college, we’d spent a lot of time together and were pretty good friends. Once we graduated we stayed in touch, even saw each other from time to time. Mostly though, this was pre-email days, it was phone calls. So, every few months I’d call her up and we’d catch up and they were great conversations. But I started to notice a pattern, I was always the one who called. Finally I brought this up to her on a call and her attitude was, yeah, I’m terrible, I never call anyone but it’s ok because everybody calls me. We had all taught her exactly how to treat us. I was really offended by this attitude, and in fact, stopped calling her, and because I was the only one making the effort, we never spoke again. Not at all what I wanted, but if only one person is making the effort, is there actually a relationship?
So what’s the answer?
I think it’s a combination of two things, lowering your expectations to a lower level, but if that level isn’t met, then move on from the relationship. This has both benefits and problems. First, there is a benefit, having lower expectations you’re less often going to be disappointed and this should help prevent a negative impact to your happiness. Secondly however, humans have a tendency to want fairness, so when you lower your expectations, often like the example of my friend, you get less in return from people as there are fewer consequences to them. So you get less from them and are then often less willing to give to them, because it feels unfair. So while giving less satisfies your sense of fairness, it creates distance in the relationship and this can increase your feelings of loneliness and isolation. What I recommend is that you pay close attention to that cycle. If people aren’t willing to give you what is fair, what you need from the relationship, then you have a choice. Confront them with this information and see if you can build a better relationship or move on. But there’s a corollary to this in that there are people that do give back what they get from you. Dig deeper in and invest more in those relationships, as those are the deeper truer relationships in your life and the relationships likely to bring you greater satisfaction and happiness and are most worthy of your time.
A note on relationship contact frequency. Friendships can take on many forms, I have equally good friends who I hear from in radically different levels of frequency. Some I talk to weekly, others monthly, some only a couple of times a year. The way I gauge the depth of these relationships is by a simple question, if I really needed them, would they be here for me? This may mean either emotionally or physically. The reality is people have complicated lives, for me, most are at a large geographic distance away. So what you give and get, will look very different across different relationships.
One last thought on this topic, humans are by nature self-centered creatures. So while reading this you are naturally thinking about the relationships you have and how people respond to you, you’re thinking about who gives back what you give them and likely focusing on the relationships where you feel like you are giving more than what you give back. But we are all on both sides of this equation in our various relationships. So it’s important to think about those relationships where you’re the person who is not giving back what you get, the relationships where you are making someone else feel less valued. I think it’s important to be honest with yourself about these relationships. It’s important to make a decision, should you extricate from the relationship because it’s not important to you, or should you make a greater effort to bring those relationships into a more just balance?
So my friends, may your relationships be satisfying, balanced and bring you happier days. ~ Rev Kane
So there is one thing we have no control over and that is the march of time. We are all getting older all of the time and eventually we will all get old. It’s also coming faster than most of us are willing to admit. There is a meme on the net lately that I really like:
This meme explains a simple truth that I have always known. One of the reasons that I started my process of quitting every three years and traveling from six months to two years before working for another three years and then doing it again, was that I understood this and I wanted to do things that I wasn’t sure that I would be physically able to do if I waited until I retired, which at the point I started was looking like 65 or 70 at the earliest.
Recently, due to my open-heart surgery, I got a taste of what it’s like to be much older. For a couple of months, I wasn’t able to physically do, what I normally could do. Initially, I could only walk short distances, I couldn’t bend over, I could only sleep on my back, I had absolutely no upper body strength. It meant that I needed help with almost everything, couldn’t drive, couldn’t grocery shop or move anything around in my apartment. It was an incredibly humbling experience and it’s not over. The main injury from the surgery is that they cut my breastbone in half and so effectively I have a broken sternum. This means it will take six months before I’ll be fully back to speed. This has really made me think about getting old. And at sixty I’m not far off from being at an age where my limitations will start to add up.
We’ve all seen “old people” at the grocery store. Walking slowly and seeming fragile, having a hard time concentrating and paying at the register, asking that they only include an item or two in each bag. You know that they have no one at home to help them bring in the groceries, you feel sad for them. But that will be most of us eventually.
So there are two lessons in this my friends for your happiest life.
First, do the things that you want to do, don’t wait, there is a time coming where you might not be able to physically do them. Don’t fall prey to the idea that your fifties are middle age, they’re not, so don’t put things off until your fifties or sixties.
Second, move, exercise, strength train, don’t let your body get weak. While you can’t permanently put off aging and decline, you can definitely slow it down by being in better physical shape. And it’s never too late to get started, you can always get stronger and more flexible, can always improve your cardiovascular health. You can start small, any exercise, any training will make you better. I want you all to get to follow your dreams and be physically ready enough to do them. It will help you have happier days my friends. ~ Rev Kane
San Francisco has always been a haven for misfits and weirdos. I’m both of those, which is why I came here. ~ Michael Franti
A Walking Day in San Francisco
Prior to my surgery, I often walked San Francisco at least one day every weekend. It’s such an amazing city with so many different neighborhoods, tons of parks, lots of museums and of course amazing food everywhere. Also, it’s a place where you never know what you might see.
Since my surgery I’ve been a bit limited, initially to the distance I could walk, then and continuing, the healing process for my breastbone and the inability to wear a backpack. Finally, I am up to walking significant distances, my breastbone is still healing but is at least fused together and I can handle a backpack as long as it only has a jacket and a hat in it.
So today I went for a small walk along the Embarcadero, took BART down, and walked from the Ferry Building over to Pier 39 in order to get a pizza.
Then after my pizza I did a walk back up along the Embarcadero but detoured just a bit to hang out in Levi Plaza, a lovely little park outside the headquarters of the Levi corporation. While there, I got to see some really happy bees working the flowers in the park.
As always, there were interesting sights all around.
It was a lovely day and a nice little test walk. I have to admit a bit of anxiety as I ended up in a huge crowd for Bastille Day, but I came through without getting bumped or jostled in any way and felt pretty good about the experience. As with all of my walks I got a few pictures of flowers and that’s how I will leave you tonight, have a happy day my friends. ~ Rev Kane
To travel, to experience and learn: that is to live. – Tenzing Norgay
My New Hiking Audiobook is Live
Ten years ago I hiked a thousand miles on the Appalachian Trail, after coming off of the trail I spent three months living in Pensacola, Florida working on this book. I put the book out as both a physical copy and an E-book and it actually did ok and is well reviewed on Amazon.
I wanted to do an audiobook but the time and set up needed to do that was just something I couldn’t find the time or the energy needed to do. So the idea languished and then it became too far after the original publication to really do anything about it.
Enter technology, the advances made by AI have now allowed for the possibility that AI can narrate from text. Amazon is running a beta test on their new AI narration system and gave me the opportunity to use it to create an audiobook for Appalachian Trail Happiness.
The process was a bit complicated, but once I got the hang of the system the editing process only took me about three days to complete. It even allowed me, once I figured things out, to cover over some editing errors in the text version.
So, if you, or someone you know is into hiking and want to listen to a fun and interesting book about a wonderful hiking adventure, grab a copy and give it a listen and reviews are always welcome.
If you carry joy in your heart, you can heal any moment. ~ Carlos Santana
Rev Kane’s Wild Ride: Heart Surgery Tips
First, the general disclaimer. I’m not a doctor, this post is not medical advice in any way. These are just suggestions from my own experience that may or may not work for you. If you are about to, or have just had open heart surgery, ALWAYS, clear any plans you have with your care team.
Recently I had open heart surgery to replace a bicuspid aortic valve and two aneurysms, an ascending aortic as well as a root aneurysm. When I was in the hospital, one of my doctors said to me, that I was the most prepared and mobile heart patient she’d ever had and asked me what I had done. That, with some pointers about making recovery easier, is what I’ll be answering with this post. I’ve done a previous post where I laid out exactly what procedure I had, and what the experience was like.
Another little disclaimer, I’m 60, which is pretty young for this type of surgery. As you bang around on the net looking at information about preparing and recovering from heart surgery, and you’re in decent health like I was, the information seems a little off. It took me some time to realize, that the average patient getting this surgery is typically in their 70’s and have symptoms and are not likely very mobile or in great physical condition. If you’re reading this, my biggest recommendation is to tailor the advice to your own current level of fitness and ability.
The biggest thing I did prior to the surgery was to make sure I was in the best possible cardio-vascular health I could reasonably be in given I work and have a life. So no, I wasn’t out running five miles a day (I actually hate running) or doing ridiculous workouts in the gym. What I started doing was walking a minimum of two miles a day. My goal was every day to do between two and four miles with the occasional weekend walk of six or eight miles. For me, that meant a long day walking around San Francisco and eating good food. So effectively, the minimum was forty minutes to an hour of walking each day and I didn’t always do it in one walk, my busy life and job didn’t always allow for that. So sometimes it was one forty minute walk, and other days it was four ten minute walks in between meetings. Also remember rest is important, I did minimal walking or exercising every Monday, you need to give your body time to rest and recover. The big thing is consistency, you don’t have to walk fast, but doing this every day will absolutely improve your cardiovascular fitness, and you don’t need a gym, special equipment or anything else, you can walk anywhere. Seriously, your neighborhood, your apartment complex, parking lots, the mall, it doesn’t matter where, just that your walking. Now, the longer the continuous walk the higher the impact, but if you’re consistent, you’ll see benefits. There are lots of articles on the benefits of walking, here’s a link to one that also includes a 12-week walking plan.
So that’s my first and maybe my most important recommendation. Walking will both get you in better cardiovascular shape and strengthen your legs and core. This will be important in recovery as you begin walking after surgery. Which leads to my second recommendation, core exercises. Again, do these at whatever level you are comfortable working at but they are important. You see, post open heart surgery, you will not only be recovering from a damaged heart, but you will also be recovering from a broken (cut in half) sternum (breastbone) the sternum injury, of the two, takes the absolute longest to heal for most people. Your breastbone will fuse in six to eight weeks, but won’t be functionally healed for twelve weeks, this is why most people get twelve weeks of medical leave. It’s at that point, I’ve been told I can start resistance training (weight lifting) again. However, last week I talked to an EMT who broke his sternum and he said it was a full six months before he really felt like he was near normal and could start training again. The sternum injury recovery is a long process requiring patience, but it also means that a lot of things you normally do with your arms, will not be available to you, particular pushing and pulling with any force. I learned this shortly after returning home, the details don’t matter but I had a shotgun I needed to unload, I quickly realized I did not have the strength to rack a shotgun. Something I’d been doing since I was fourteen years-old.
Probably the biggest place this kicks in is getting up and down out of bed and chairs. We typically use our arms to push up out of a chair, that is no longer available to you for at least three months. It is one of the reasons, most people sleep in a recliner for the first week or two at home, they don’t have the ability otherwise to get out of bed unassisted. Now, if you have a constant caretaker it’s a bit different they can certainly assist you. For this reason core exercises become really important, it will be by the strength of your core muscles that you will need to get up and down out of chairs and beds. Even when being assisted, you’ll need these muscles to help you up. I was doing core workouts for six months prior to surgery to be in a better mobility position after surgery, I’m really glad I did them. Here’s a link to a set of core exercises for absolute beginners that you can do. Again, you don’t need a gym or equipment, just a little space at home. And here is a link to exercises that are a little more advanced for those of you who are already in good walking shape.
Another part of the preparation that I did, which is just common sense but sometimes escapes people, is that I practiced everything I normally do without using my arms. Or, without using my arms outside the core of my body. You’ll get information on doing things in the core, here’s an image to give you an idea of what keep your moves in the tube means:
So one of the things I did pre-surgery was to practice getting in and out of every seating surface in my apartment and my deck. Additionally, I practiced getting out of bed, which is when I found out, I was not going to be able to sleep in my bed for at least a few weeks after surgery. It’s not unusual for folks to spend a couple of weeks in a recliner after surgery so I wasn’t too upset. I do live alone, so one other factor for me was that I had to be able to do all of this with no support from anyone else. If I couldn’t do that, I was going to either need to go into a rehab facility for a time (not paid for by my insurance) or bring in a nurse at night (also not paid for by insurance). What I found out was that certain chairs were easier than others to get in and out of, my deck chairs needed a cushion on them so that I could easily get in and out. My couch worked well, the recliner was a breeze, like I said however my bed was out.
Sleep is incredibly important to recovery, it helps you heal faster and with less pain. My first couple of nights alternating between the recliner and the couch taught me immediately this was not the right option. I’d get maybe three hours and then wake up with stiff muscles or joints because I could never find a great position to sleep in all night. While this wasn’t terrible, it was about the equivalent to the way they wake you up in the hospital, it also wasn’t great. That’s when I broke down and bought a head adjustable bed frame. I got incredibly lucky, I’d found a good frame and mattress set online for a not insane price about $1700. But that also involved it being shipped, needing help to set it up and having my current bed removed which meant calling the junk guys to come and remove it which was another cost. At the last minute it hit me, local places often advertised installation and removal of your old bed. So I went online and found an adjustable frame that looked like it would support my current mattress. The next morning, a Saturday, I made a call to Bedroom Express. I asked about the frame, it was on the web as $499, I asked about fitting my mattress, and installation and removal of the old bed. Turned out the store was two miles from my home so 50% off the delivery fee, installation was free, the frame was on sale for $399, I had mentioned I was recovering from heart surgery and so he waived the removal fee. Oh, this was 10:30AM, they had it delivered and set up by 2:30. All in all $500 and I had the bed in hours. Having the head up bed was a game changer. It meant I could easily get in and out of bed and most importantly, I was sleeping in my own bed.
It’s important to really analyze your home with the limitations you’ll have in mind. You’ll have no upper body strength, won’t be able to carry but a few pounds. How will you do laundry, what things are on high shelves that should be re-positioned? You may be on heavy pain medications, how is your house set up for movement if you’re unstable? Are there clear paths around your home? Do you need a shower stool? One thing I did was to install some handholds in my shower. They weren’t the same as handicap bars but they gave me something to grab on to and feel more confident the first few days home. I also for the first week, only showered when someone else was in the apartment.
Next is the thing I did that I was most happy about. No, not the bed, the hand holds in the shower, moving food and pots and pans to my kitchen counter, nope, my most genius decision was in response to the inability to be able to bend over after surgery, I bought a grabber.
Then, and Watchmen fans will appreciate this, it hit me, who grabs the grabber if it falls to the ground. So I bought a second one. It’s been so amazingly helpful and is able to pick up far smaller things than I imagines, I have often picked up pills I’ve dropped on the floor. This has been so incredibly useful, I may never bend over again.
Finally, and for most people this will be easy, but I’m a loner, who lives alone and is a bit anti-social. Get your support team in place. Make sure you have at least a handful of people you can really count on. I was surprised how many people volunteered to do this without being asked. Especially if you live alone, I recommend two visitors a day the first two weeks and then you can start to tail off. By week six I was only calling people to move stuff around the apartment. At that point I was also cleared to drive so I didn’t need to rely on people for rides.
The final piece of advice really comes from my long-distance hiking experience. I’ve hiked a thousand miles on the Appalachian Trail. I’ve hiked across Scotland three times, part of the Camino in Spain and spent thirty days hiking in the high passes of the Himalayan Mountains including Everest Base Camp. What everyone expects is that the physical exertion will be a test and of course it is. But with these types of hikes, like the surgery, people often fail to prepare for the mental aspects. You’re going through a trauma, there is a lot of fear and anxiety going in and even after. That first week or so, every weird heartbeat feels like imminent death, every crack your sternum falling out of place and every weird blood pressure reading is a problem. I had night sweats one night and was convinced it was a symptom of Afib. It’s really stressful and scary, that’s ok, you’ve had one of the most major surgeries anyone can have, they stopped your damn heart. In doing my own research a lot of people react weirdly, some get a new purpose in life, some get incredibly depressed. So be prepared for this. Avoid boredom, get your Netflix and other streaming ques ready, have a stack of books or a subscription to an audio book service. Do you have hobbies you can still engage? Make sure you have everything you need to do them. Also, remember that you’re healing mentally as well as physically. So do the things that support and lift your spirits. Does watching birds make you happy, buy a bird feeder you can watch. Make contact with the best people in your life, the ones that support and lift your mood. Avoid whenever possible the people who bring you down. Do you love chocolate or a type of candy, make sure to have some in the house. One of the things I did was to make sure I had some of my craving foods available in case I had a craving. Silly things, top ramen, Spaghettios, ice cream and yes, dark chocolate.
Don’t be afraid to ask for help as you go through this. People understand and will be there to help you, but help means mood lifting as well. Need to get out of the house, ask for someone to just take you for a drive. Go to movie mattinees, walk in the park or by the river or the ocean. Most mornings I take a half hour and just sit in the sun on my deck and listen to a podcast. Once I’m back to work, that’s a pleasure I won’t be able to engage in.
So my friends, take care of yourself, be prepared. Get in better shape by walking, do your core exercises, practice the movements you’ll do post surgery, make sure you can get good sleep, take care of your mood and mental health, ask for help, ask your care team lots of questions and of course BUY A GRABBER!
Finally, good luck and I hope your experience turns out to be a good one. ~ Rev Kane
The best and most beautiful things in the world cannot be seen or even touched – they must be felt with the heart. ~ Helen Keller
Rev Kane’s Wild Ride: What Open Heart Surgery is Like
Today I wanted to write about my experience of going through open-heart surgery. The exact surgery I had was a biological replacement valve implanted to replace my aortic valve. I was born with a birth defect, a bicuspid aortic valve. Essentially your aorta should have three leaves, two of mine had fused together leaving me with two instead of three and this narrows the opening and causes problems with the heart. Additionally, this condition, along with my high blood pressure caused additional pressure on my arterial walls leading to both an ascending aortic aneurysm and a smaller root aneurysm on top of the aorta. The video below explains the conditions, details of survivability etc… and the procedure to repair them. The repair I had, will hopefully last ten to fifteen years before I would need another procedure.
I’ll be honest, the procedure is a bit terrifying. The idea that they would be stopping my heart for a couple of hours. The idea of having my chest opened, my breastbone cut in half and being essentially split open like a lobster is not something I was looking forward to having done to me. However, it was a necessary procedure that should give me a better quality of life.
One of the things I didn’t completely expect, I hadn’t had major surgery before, were all of the pre-surgery tests and appointments, and man there are a lot of them. You of course meet with your cardiologist and the surgeon, but you also meet with an anesthesiologist, a surgical scheduler, a surgical nurse and a nurse practitioner. And it seems like just about everyone has a different set of questions and blood tests that need to be done. You also have to have a procedure, a heart catheterization where they feed a small wire up through an artery in your wrist or leg and into your heart to check for any blocked arteries, which determines whether or not you’ll need any bypasses during your procedure. Happily, I had no issues and no bypasses needed to be done.
In my case, my surgery almost got cancelled because my blood sugar numbers were too high, happily I was able to work with my general practitioner to get them into an acceptable range before surgery. Then, because there were two emergency admissions who needed surgery, my surgery was pushed back three weeks. It’s an odd thing I didn’t expect, they don’t absolutely confirm your surgery until the evening before. Which is crazy considering the night before you have eating restrictions and have to shower with specific surgical soap and wipe down your body with disinfectant wipes.
Happily, the night before they called about 6PM and confirmed me for the next morning. I of course had to arrive at the hospital at 6AM. The morning of surgery flies by pretty fast, you go through admitting and then walk up to the surgical floor waiting room. Once they pull you in they put you in a bed, strip you down to the lovely hospital gown, take your vital signs, ask you a bunch of questions, have you sign away your life (you hope not literally) and then stick an IV into your arm. They pretty quickly roll you down to the operating room staging area, here a person comes in and shaves any areas that need to be shaved. Then a little while later they roll you out into the hall, your doctor and team make a quick appearance and then you’re rolled into the operating room. The anesthesiologist says good morning, drops a mask on you and says take deep breaths, I remember taking two. Then, what feels like ten seconds later you hear the voice of a nurse saying, “Mr. Kane, you had heart surgery, it’s 3:30PM on the day of your surgery, you have a breathing tube in, when you wake up a little more we’ll get it out.”
A couple of quick things, what added to my level of trepidation prior to surgery was the experience some others have had. As a healthy person, survival rates for this surgery are near 99% but there’s always that 1%. I know three people who’ve had this surgery. A friend a couple of years ago who had the surgery and had multiple complications. My closest friend growing up, who had the surgery a year ago and died. And a colleague, who six months ago had the surgery came out and a few days later went into a coma for a time, he’s happily ok now. So I was afraid of dying of course and also of ending up in a coma. So one of the things I did was shave my beard real short, I was planning to touch my face when I woke up. If my beard was gone, or really long, I would know I’d been in a coma. But my magnificent nurse took that anxiety away by saying it was the day of my surgery, I was very grateful for that.
My second fear was the breathing tube. First, I was an asthmatic growing up, so one of my biggest fears is not being able to breathe, I’m also my grandfather’s grandson and at 90 he woke up from being unresponsive and ripped out his breathing tube, IV’s and catheter. I was really afraid of waking up with the breathing tube in my throat and had warned my team I might freak and rip it out. The anesthesiologist I met with pre-surgery had told me not to worry, most people didn’t even remember it coming out, a combination of all of the pain meds and sleep drugs. And in fact, later that night when I started to be a bit clear headed I really didn’t remember it.
Until the next day, you see the next night, in the next room another patient was going through the process, with the nurse I’d had the day before. Hearing her talk that patient through the process brought the full memory screaming back to me. It wasn’t as horrible as I had imagined, but it wasn’t pleasant. When I first woke up and could feel the tube I started to freak, the nurse put me at ease. I really didn’t like having the tube in, I bit down on it a couple of times and a couple of times gagged a little. But I was also still fading in and out of consciousness and they were instructing me to breathe deeply. I was concentrating on doing that and I think it took about a half hour before I heard my nurse say, “I think he’s ready.” They made the call to the respiratory person and then it was a process of breathing deeply then exhaling hard as they pulled it, unpleasant but it made me really happy. I fell in and out of consciousness for the rest of the night. Often listening to everyone but for some reason it was a couple of hours before I opened my eyes for the first time.
While you may anticipate some down time of just laying there recovering, they warn you in advance this will not be the case, they will have you up and walking the next day, and they do. The next morning I woke up with an IV in my arm, an IV in my neck, two drainage tubes coming out of my chest, two wires coming out of my chest hooked up to a portable, external pacemaker and of course the catheter. I actually didn’t mind the catheter, it was nice not to have to get up to go to the bathroom and there are a lot of fluids introduced into the body during surgery so the drainage tubes and catheter initially stay very busy. Then they pump you up with Lasix and the fluids rain out of you like a waterfall. But that first day, they did indeed get me out of bed for a short walk with a walker, while six different sets of tubes and wires hung from my body and we dragged an IV tree and a vital monitor around with us.
The biggest issue those first two days are the chest tubes, they hurt like hell. Every breath is a little pain, every big breath a lot of pain and when you cough it’s like people are stabbing you with serrated knives. I was on a lot of pain meds the first couple of days and it still hurt like hell, not to mention your chest isn’t all that comfortable either, and I have a pretty high pain tolerance. They tell you again and again, it will get better once the chest tubes come out, I would smile and say ok. Inside I was thinking you’re a bunch of lying bastards give me drugs.
I didn’t have much of an appetite at first, my first breakfast all I could eat was a small yogurt. I would eat about a third of my meals the first couple of days and experienced a really weird thing. I would in an instant get super hungry, but if i didn’t eat within about five minutes, I’d suddenly get nauseous and not want to eat anything. Eventually I learned to save a piece of fruit from each meal, so when my hunger hit, I could eat immediately.
On day three in the ICU they came to take out my chest tubes, it was the weirdest damn sound and feeling when they pulled them out. They pulled them out simultaneously and it made a weird squishy sound. The image I had was them pulling two large squid through a puddle of Vaseline with all the assorted squishiness that would command. But the nurses and doctors had not lied, literally the first breath after the tubes were out was pain free, it was an unbelievable and amazing difference. While it still hurt a bit to cough, I immediately was able to cut back on almost all of the pain drugs save the max dose of Tylenol that I was on. After the chest tubes I actually never took anything other than Tylenol for the next four days, nor since coming home.
The next two days in the ICU were the same routine wake up, eat, walk, nap, eat, walk, nap, eat walk sleep. I would have left the ICU a day sooner, but they didn’t have a bed for me downstairs on the step down floor. We dealt with lots of little things, BP at times too low, discovering I had sleep apnea, I don’t normally sleep on my back. They would as the days progressed pull the catheter and the neck IV and eventually pulling the pacemaker wires which was a really wild sensation. I think the idea that they were literally pulling these off my beating heart added to the exhilaration of the moment. When they do, your heart does this weird fluttery thing, I didn’t like it. I was lucky, they never needed to pace my heart, I didn’t have any complications like Afib, and there were no infections. The one big thing I had to overcome to get out of ICU was making a bowel movement. That happened on day three and when it did, it really did, I’ll spare you the details but it matched the name of a Robert Plant solo album.
While you’re in ICU you get visits from all sorts of specialized folks, social workers, rehab folks and physical therapy who assess your mobility and strength. They teach you out to get out of bed without using your arms and give you tips for recovery. They also take you on walks, happily I did well enough that they cleared me before I left the ICU which was great, but it also meant once I moved floors there was no way for me to walk stairs and I have twelve steps leading up to my apartment.
The step down floor was a very typical hospital stay, I got to take my first shower. Each day is routine which of course means they wake you up two or three times a night and you have a lot less attention than you did in ICU. I was happy to have good nurses, and this time is really all about them making sure there are no complications, you’re mobile and your vital signs are good. I left there in three days and my cardiologist told me I left the hospital faster than any of her other patients had before. I credit that to how much I prepared for the surgery, which I address in another post.
Finally, going home was stressful and exciting, I did the stairs easily. I did well, I expected the first week to be hell. The first couple of nights, sleeping in a recliner and on the couch weren’t great. I broke down and bought an adjustable bed on day 4, being able to sleep in my bed made everything better. Being home is mostly about patience. You need help the first couple of weeks (this assumes you were healthy and fully mobile and independent before surgery) there are just some things you can’t do. By week four it’s a lot better, it’s week nine for me right now and I’m finally feeling close to normal.
So, if you’re about to go through this, I hope this gave you some info and peace of mind, and good luck on your surgery and recovery. ~ Rev Kane
Cooking is a philosophy; not a recipe. ~ Marco Pierre White
Happiness and Making Sauce
So there comes a time in the garden where you don’t have any ripe tomatoes but the basil is still growing like crazy. At that point, you only have two choices, make pesto or make sauce. While I do like pesto, I’m not a massive fan and it’s a bit of work and just doesn’t hit like sauce does. So today, I found myself with one only one ripe tomato and a ton of basil. So I decided to make make sauce today.
I decided to do it right, so while not fully from scratch, I worked pretty close. I love cooking and the whole process, cutting and sauteing the vegetables, frying up the sausage, making the meatballs and cooking down the sauce is all an act of love for me. The smell of a pot of sauce on the stove always takes me back to one place, my Uncle Mikey’s cabin.
That’s Uncle Mikey in the picture above busting through the screen door. His cabin was the center piece of our extended family’s summer. You see Uncle Mikey’s cabin had a pool, a big damn above ground pool and it was the place to be every summer. Every summer you’d find people in the pool, sitting on the deck at the cabin, inside the kitchen eating pasta and always, there was a pot of sauce on the stove. There was always pasta on request and of course, a loaf of Italian bread on counter so you could rip off a piece of bread and dunk it in the sauce.
So sitting here today, smelling the pot of sauce on the stove, on a quiet Sunday afternoon is about as happy as I get, remembering the man I was named at and all the happy times at his cabin. Well, as happy as I get until I make those ravioli’s later and drown them in the sauce.
The Ministry of Happiness 