Its now 3 months since my surgery, it doesn’t feel like that long. 

Everything seems to be going well, but the one thing that is driving me crazy is the pounding noise I can hear and feel now. 

Its like there is a midget boxer punching the back of my sternum when my heart beats. If I breath deeply it is incredibly loud and the feeling is somewhat uncomfortable. The pulse in my neck is so strong its concerning.

All of this is normal, I have had all the tissue inside my sternum cut out, so there is no insulation. When I take a big breath in, my lungs push my heart forward and it beats against my sternum. This happens from ~50% inflation onwards. ITS SO LOUD! And its constant! Unless I take small, shallow breaths, its there all the time. When I take smaller breaths, I just hear the ticking of my valve, which I can bear. 

If you’ve ever had palpitations, or worked out enough to physically feel your heart against your chest, you are getting a glimpse of what this is like. 

Its strange, its loud, its uncomfortable and its a little eery. I would have thought after 3 months I’d either be used to it, or it would have settled. Neither has happened. It takes a long time for the sternum to heal properly, so fingers crossed it shuts the hell up when that happens.

For as long as I can remember, I have been given stick for being lazy. And I felt lazy.

This laziness would affect me in so many ways. I couldn’t leap off the couch quickly to see to the kids. I found standing for long periods difficult. I didn’t want to walk around asking people what they wanted to drink when entertaining. I just couldn’t be stuffed doing things (going out for example would feel like a big deal.) All the things I felt (and was called) lazy about were low-energy activities. I didn’t feel the reluctance to move when I was performing high-energy activities like cycling, running, etc, I would simply not be able to sustain them. I sometimes needed to properly psych myself up before I was able to do the most simple things.

The thing is, I still feel lazy. Although I am now able to leap to the aid of my nearly decapitated two year old (after she walked into the dining table,) I still feel lazy. Years and years of being made fun of and accepting that I was simply lazy has instilled a deep level of acceptance in me; I am a lazy person. This is not something new, this is my entire adult life. If my aneurysm had been growing for 10 years as they suggested, that’s since I was 22. It doesn’t take long for an Ascending Aorta Aneurysm to be large enough to cause the aortic valve to regurgitate your blood (rather than pump it around your body) and towards the end of my aneurysm, my valve was entirely useless.

[Aortic Valve Regurgitation - Courtesy of WebMD]

What I am trying to get at is, and this is a little more philosophical than the post appears, you never know enough about other people, or indeed yourself, to be able to make a fully qualified judgement. In hindsight we can see that I had a fairly serious issue with my heart that was affecting my ability to leap into action, I no longer have this reluctance to leap into action, but I have 10 years of psychological affirmation of laziness, both from myself and others that was simply not true.

The thing is, I am now able and willing, to leap up at any opportunity, albeit slowly (I get dizzy a lot) for any kind of activity. Get the girls ready to go out, put the dogs out, unstack the dishwasher. No problems. And it feels good to be able to help my wife in ways that used to cause me issues.

We need to be kind to ourselves and equally kind to others. 99% of the time you will not know enough about a person, including yourself, to allow you judgement. And, this judgement can cause more harm than you might be aware of.

For 32 years I’ve been me. While I adopt the Buddhist principles surrounding impermanence and the fact that nothing stays the same, I do feel I’ve been relatively similar for at least the past ten years or so.

I’ve struggled with exercise, I get out of breath and tired quite quickly and easily. I’m very fearful of death. I have felt, at least for the last few years that I’m not quite right (physically.) And many more.

Physically, I haven’t been quite right, I’ve been breaking. My body was telling me, in its way, that something was wrong and was getting worse. Now I feel not quite right in a different way, I feel strange about the man made creations in my chest, like, they kinda don’t belong there… Its a low level, subconscious type feeling that is hard to explain. Its my body telling me that while I’m no longer breaking, there are foreign objects in me.

I am already noticing that I recover more quickly from exercising now, its strange that within minutes of doing any sort of exerting walking (the limit of my exercise at the moment) I am already recovering well. My heart rate has slowed, my breathing is returning and I am feeling less exhausted. Whereas before my heart surgery, my physical exertion recovery was far more delayed.

I have always had a fear of death, I have spent a lot of time working on this in the past, doing lots of meditation and reading of various Buddhist books. I couldn’t shake the seemingly core-level fear that accompanied my any thought about ‘moving on.’ That was, until I was faced with it, on a hospital bed approaching my surgery. My calmness and relaxed state while coming to a realisation that ‘this was it’ was my bodies way of keeping me under control while things shut down. (A quick search on Google shows that an ‘impending sense of doom’ is one of the more common symptoms accompanying an aortic dissection) The curious thing is that since then, I can’t get myself worked up about death anymore. Even if I try! I focus on it and I think about me dying in the next 5 minutes and there is no fear or concern. Its a very,very strange sensation because this is a core feature of my being, my personality. Something I have lived with for as long as I can remember, and now its different. Changed. Swapped. Opposite. This isn’t just a ‘change of the mind’ type change, this is a fundamental swing in the complete opposite direction.

And this scares me. A lot. What else about me has changed? While my physiology comes to terms with the foreign objects, what has changed about my mind? I’m aware of the change in my approach to death because its been a constant thought for the past 6 weeks, but what else can be changed?

I feel different, I feel like a different person. I am mostly the same person, butsome thingsare different.

I understand impermanence, I understand that everything changes, but I’m not sure it should change this quickly and I think its going to take some time to adjust.

For various reasons, you can have issues with your brain after you have a procedure like mine.

1. The anesthetist uses amnesiacs in your ‘mix’.
2. The oxygen to your brain is cut off for a period of ~20mins.
3. During the same 20 min period, your body temp is lowered to 18C (64F)
4. Not to mention the general trauma of having your sternum sawed open and your heart tampered with.

I have really struggled with my head for the past 6 weeks. Its really been my ‘hold back’ during my recovery. My head has affected me in lots of different ways.

1. Massive anxiety in hospital. Extreme. To the point where I seriously considered just walking out of the ward and getting myself home. Valium fixed this pretty quickly.
2. Super fast mood swings. Likesuperfast. I coined the affliction ‘tri-polar’ because bi-polar didn’t seem to do me much justice. This still affects me a great deal at the moment. My fuse seems much shorter and I am overly emotional a lot of the time.
3. Memory loss. Not long term, but immediate things. I walk into the kitchen because I have something to do, but I dont know what it is. I know a lot of people say ‘Ohhh, I get that all the time’ but you dont understand how ‘all the time’ is simply not ‘all the time’ until it happens to youall the time.Within 30 seconds it comes back to me, but its constant.
4. Being overwhelmed. The kids running around me, or mass crowds in a shopping centre. This is similar to #1, but the anxiety I felt in hospital was of a level I have never known and is very scary. My being overwhelmed, while being fairly awful, is still of a bearable nature. I can walk away from situations where I feel this, I didn’t have that level of rationale in hospital.
5. I get stupidly tired if I use my brain. If I engage in long conversation with somebody, or I try to work out some kind of complex issue, I get seriously drowsy and will usually need a nap during the day.

My psychologist (and the psychiatrist that came to visit me in hospital after one of my ‘episodes’) believe I have some form of Post Traumatic Stress Disorder. For the record, Ihateterms like ‘Post Traumatic Stress Disorder’ or ‘Depression’ or ‘ADHD’ etc because I feel that every person is different. You can’t put people into these categories because they tick a few symptoms. Also, people love having things to blame and for that reason, they love having ‘Depression’ or ‘PTSD’ and will throw the terms around willy nilly. (I’m not a hater, I respect mental illness and have had my fair share of mental illness, but I dont like the way its dealt with.)

A lot of these problems are much better or totally gone (#1 is gone and I am not on Valium anymore) and will continue to get better. Physiologically I will be almost totally better by the three month mark and at 6 weeks post op tomorrow, I am pretty certain that I am at least mentally, almost better.

Its a long road and one that affects so much more than you expected. I never thought that I’d have an issue with my head - that wasn’t what was broken! The fact is that the trauma, the surgery, the drugs I was on and the suddenness of it all just put my brain into a situation it had never been in before and its been the most difficult part to live with. 

While I dont want to focus on the damage done or the physical negativity of what happened to me, I am still struggling with the gravity of the situation and writing about things always helps me come to terms with things. I know I touched on this briefly before in my last post and I’m sorry for the double up.

So, my Aorta had an aneurysm, the surgeons don’t know how long it had been growing, up to 10 years.

What they found when they opened me up was that my Aorta had dissected. But, the aneurysm was so substantial that my aortic root had swollen from the normal 3.8cm in diameter to over 7cm. This also caused my aortic valve to ‘regurgitate’ blood back into the heart in the opposite direction.

The aorta had actually ruptured and was bleeding into my pericardium.

Because the aortic root was so much bigger, it had actually caused the coronary arteries to start dissecting also.

So, despite almost all these wikipedia articles stating that these conditions are sometimes (to usually) fatal, I’m still here and breathing.

The surgeons told my wife it was the worst damage they had seen caused by an aortic dissection and that I had literally minutes left before it was all over. People with far less damage than me die regularly from aortic dissections.

My sternum was sawed open (with some fracturing also because they were so eager to get in) and my aorta and dodgy valve cut out (after being placed on a pulmonary bypass machine, of course.) The new man-made aorta made of a fabric called dacron, with a mechanical valve, were sewn in place of the normal aorta and valve and the fixed coronary arteries were sewn onto the sides of the new dacron aorta.

Pretty full on stuff. It feels weird to write it all down. But then, due to normal side-effects from the bypass machine, everything is feeling weird at the moment.

I’ll be updating with some issues I have experienced and my feelings about my future shortly.

I wrote this when sitting in hospital a week or two post op, its the best place to start.

Just when i thought there were no more proverbial bombs to land on me in my life, i get the mack daddy.

Wednesday the 18th of april, i am working out before work with my boss Kim. Only 20mins in, not too puffed yet, i get a pain that feels like a pool cue tip being pushed by the worlds strongest man into the back of my sternum. Seriously painful, i dont think a great deal of it but i am unable to continue and sit down outside.

Basically, after 20 mins or so of speaking to the Nurses& Doctors hotline and being convinced by Kim, i let him drive me to the hostpital. Not too concerned though as no radiated pain through my left side. Feeling a bit wuss like.

I spend about 5hrs at mona vale hostpital with my wife, lots of tests done. We find out that i have an Aortic Disection. I am immediately transfered to Royal North Shore Hostpital where i am met on arrival by a full cardio team, this is serious. I get a little scared. My brother in law, Mark, is there. He had been rostered on to run the heart bypass machine.

MY heart bypass machine.

He had to switch with somebody else.

This next part is hard to explain and i am not able to fully articulate what happened, not long after choosing my new valve (mechanical, over biological) i became very settled, very calm, very relaxed. I quietly asked Mark to make sure my girls were looked after. Physically, subconsciously, my body had decided that it was my time. There was no white light, but such an overpowering sense of calm. I was ok with it.

9hrs of emergency heart surgery saw my Aorta partially replaced with a new mechanical valve. My sternum is left open for quite some time and is closed up several hours after my initial surgery, i believe this is dueq to swelling.

I spend 2 pretty average days in ICU on a ventilator before being released to my heart ward which is where i sit, on the 27th of April.

So, what happened? So many thing happened. Essentially, i was potentially dead several times over.

1. I had an Aortic Annurism: this caused blood to split the layers of my Aorta, causing a ‘ballooning’ of the wall of my Aorta. This annurism, they think, has been growing for many years (in hindsight i see several symptoms.)
2. The Aortic Base, with a ‘normal’ diameter of 3.8 cms is now 7+ cms (goneskis) this also means my valve has been letting blood back into my heart from the wrong direction.
3. The annurism has started blocking several big arteries from my Aorta, including the flow to my brain. (Goneskis #2)
4. The Aorta has started to disect, causing the pain i experienced. This is what happens when the layers in the Aortic wall start to tear.
5. My Aorta had started to pop. So, blood was leaking from my aorta into the space between the heart and the membrane. (Goneskis #3)

I find out later that the surgeon gave me 3 mins to live and was so eager to get into my sternum that he fractured it while sawing it open.

I wont yet touch on how i feel about the future because i am in a dark place atm, ill touch on that at a later time.