My symptoms crept up slowly, perhaps over five or more years. I was coming up on 50 and thought my lack of energy and stamina was the result of time and insufficient exercise. My first shortness of breath episodes were as infrequent as my participating in physically demanding activities. My response was to try to limit my activities to match my diminished physical ability. I did not choose to recognize that these episodes were symptoms of physical problems. In my mind I had "successfully" avoided shortness of breath. "Out of sight, out of mind" is the operative concept. Avoidance became automatic and my other symptom, lack of energy, grew so slowly that it also went un-noticed until it took every bit of my energy for my career. My personal life had degraded to couch potato with frequent naps. At this point, I was convinced that age was catching up with me and there was nothing I could do about it. However, I was determined that feeling old of body, when I was in the prime of my Silicon Valley professional career, was not going to prevent my success. I worked harder and crashed harder at night and on the weekends. Now I transferred the cause from old age to excessive work. This was psychologically more acceptable. Many would call this classic male denial. In hindsight they were right. Writing this reminds me what my wife Rachel had to put up with, and how very lucky I am to be married to her.
Ultimately the symptom I had avoided for some time came at a time when it could not be ignored. While laying on the couch during a regular worknight crash, I experienced shortness of breath. This could not be rationalized to old age; I realized I had a serious problem. It would be a lie to say this didn't scare me. In that terrible moment of truth, time stood still while fear fought an all out battle for control. Fear lost the battle but waited in the shadows for another opportunity. However, basic fear is a great motivator. Despite years of denial, I was not going to let this beat me and I called my doctor at Kaiser. In today's vernacular, I had decided to "get a life".
One gets used to trading personal convenience and time for affordable health care. I have to say that Kaiser is a different place when you have real problems. At my initial doctor visit I learned that when your heart efficiency goes down your lungs fill with liquid, ergo the shortness of breath. An echo cardiogram (a specialized ultra sound) helped identify a poorly functioning heart valve. Determining how poorly would take a cardiac catheterization. That scary term, "Open Heart Surgery," was becoming a real possibility. Even though I approached this new challenge with a positive attitude, I still had moments of paranoia that I didn't want to share with anyone. I feared I would not be able to maintain my mantle of artificial courage if anyone displayed fear or pity. Men don't cry, unless no one is watching.
Then the expected verdict arrived; a failing Aortic heart valve needed replacement, and in less than two weeks I would be on the table. Since ignorance is the mother of fear, I did what any technoid would do, I surfed the web. This was very valuable because it allowed me to focus my education on issues that were important to me. I discovered that the survival rate for open heart surgery was in the high 90 percentile. I started to psyche myself that the only possible outcome was recovery. As it turns out, there are choices to be made, and the Internet was a big help. It felt good to have choices; I felt more in control of the situation. The major choice was what kind of replacement heart valve - pig, human, or artificial. This was a decision that the surgeon wanted me to make, perhaps because of the impact it would have on my life. Artificial valves will outlive you but the natural ones may only last six to ten years. There is a price to pay for longevity, however. An artificial valve would require me to take blood thinners for the rest of my life. Proper control of the dosage requires a monthly blood test. I chose the artificial. My surgeon has not had to replace one in the 17 years he has been "installing" them. There are people that compete in the ironman triathlons with the same valve I have. A triathlon is a little past my own physical plans, but the potential is nonetheless reassuring.
Now the time had come. Surgery was tomorrow and Rachel and I would be spending the night in San Francisco. We went out to dinner at one of our favorite restaurants and had a wonderful meal and a very nice bottle of Merlot. During dinner fear poked its nose out of the shadows. This was the defining moment of realization. This could be my last moments of life as we know it. There was nothing more I could do to prepare other than to win this last battle with fear. I won! Despite a 4:30 AM wake up I sent my last E-mail at 2:00 AM before retiring for the evening. Those that know me, would recognize this behavior as normal fare.
This may sound strange, but the surgery itself was not part of my personal experience. I arrived at the hospital the morning of the surgery and after changing into one of those wind-up-the-back uniforms was given a shot to help relax me. There ends my firsthand experience. The next thing I remember was coming to with a nurse telling me that everything had gone well. There is little to say about the in-hospital experience other than I had tubes or wires coming out of every God given (and a few man-made,) orifice of my body. Everyone I interfaced with at the hospital seemed genuinely interested in both my comfort and recovery. I asked for what I needed or wanted and always got it. I was up and walking, albeit slowly, in a day, and my third day I climbed stairs. I already saw the improvement in my breathing and although weak, I felt better than I had in a long time. I did everything they told me to and I felt stronger every day. I was home in five days, and within three weeks I started visiting work weekly and worked part time at home. Four weeks after the operation I started driving, sparingly. Driving was a major milestone; I felt free and very normal. Within six weeks of the surgery I was at work full time working 10-plus-hour days. My recovery was faster than most but that related to my general good health, positive attitude, and focus on getting well. It is important to take the time you need. My weekly visits to work, about four hours each, were very helpful in gauging when I was ready to return. If this experience taught me nothing else, it was to listen to your body and most importantly, take action when it tells you to.
My personal view ends as my healing is almost complete. The other day I started up a two story escalator and found myself running up the steps. When I reached the upper landing I asked myself, "why?" and the answer came quickly, "because I can".