April 5th - 9th

Date:     Sat, 05 Apr 1997 Subject:   Welcome back Peter!! Couldn't sleep tonight (first outdoor 800m tomorrow!!), so I thought I'd play around here a little. I noticed that I haven't given Peter the hearty "Welcome Back" he deserves. "Welcome Back, Peter!" (stated in a hearty manner) I know I speak for all of us when I say get well soon so you can be up and hitting the roads/trails again! I will keep checking your homepage for new updates. Hope your spirits are high, we're all behind you! Ben Maynard New London, Connecticut USA "It is with the heart that one can see rightly; what is essential is invisible to the eye."      -Antoine de Saint-Exupery

There was this phenomenon which the heart surgery literature referred to as cardiac awareness. Sensations relating to secondary functions like breathing, heartbeat, pulse, etc. would be more pronounced for a period of time following OHS. I could certainly attest to this. I still maintain that much of the heightened sensations had a physiological basis - more than just a passing mental state. For example whenever I got up or twisted my torso in a way that translated to a shift in the stress on my rejoined rib cage, I would feel a sort of buckling at the top of my chest. It wasn't at all painful, just strange. It was as though the ribs were flexing, adjusting to a slight change in geometry. It was also strange how my heart rate would quickly elevate whenever I moved at all. While seated or just standing still for some time with my heart in a resting state, my HR seemed close to what it was prior to the surgery. But as soon as I changed positions or walked or became active in the slightest way my HR would surge! And I easily felt every beat as it accelerated ... I didn't need heart monitor to tell me it was climbing! It's understandable that this was a response of a cardiovascular system in the process of healing. When you realize the trauma that OHS introduces to one's system - major blood vessels being cut into, clamped off and then patched into the heart-lung machine, the heart and lungs are bypassed and forced to lie dormant for the duration of the surgery - it's impossible to predict the amount of adjustment needed once everything is reconnected. I have vivid memories of the sensation of my shoulders shaking to the rhythm of my pulse whenever I tried to lay flat. (I learned later that there is a good explanation for the exaggerated heartbeats. Normally the heart is snugly contained by a protective sack called the pericardium. This sack must be cut and peeled back to expose the heart before any corrective surgery can be performed. Following surgery the pericardium is fitted loosley back around the heart but cannot be closed with stitches. During the first weeks of recovery the heart literally bounces around while the pericardium gradually knits together again). And the internal sound of my pulse was loud enough for me to tune any surrounding noises out, enough to pacify me to sleep sometimes. And breathing? Obviously as my lungs labored to keep up with the demands of an overly excitable heart, it's to be expected I would be on slight alert. But even at rest my breathing was difficult to ignore. After my sternum had healed to the point where deep breaths caused no pain, I became tuned in to this simple process taking place second after second. Expansion, contraction ... air in, air out ... chest up, chest down - the perpetual movement of the diaphragm. I began to notice the very depth of my breaths, almost like I knew every last pocket that trapped the air I in haled. It was a most enjoyable sensation at that. ... the crudest evidence I was alive!

Date:     Sat, 05 Apr 1997 Subject:   Very belated... Welcome back, Peter! It's great to hear your surgery went well, and that you are already feeling more energy... how wonderful! :-) I'll be checking out your homepage sometime soon, for perhaps some more stories. Take care, Andrea

After I was rested again, I started doing short walks covering the length Vikki's driveway and back. Vikki was very clever to pose a challenge for me to pick up her mail every afternoon. It was a simple enough task, the least I could do for her while she put me up for the month ... or maybe I should say, put up with me? I had resisted doing anything in the way of exercise early on. I just didn't feel like it. Especially now that my computer was set up and I had a half-dozen books to read and several dozen of my favorite CD's to play. Walking at this stage was extremely tedious compared to the running regimen I was used to - so little distance gained for so much effort. My breathing was embarrassingly difficult as I covered the roughly 600 meter round trip. It depressed me. The struggle was compounded by the fact that more than a week had passed and I still wasn't able to have a bowel movement! Nevertheless, on the 5th of April I managed to push the limit a bit and walk a full mile. Possibly, I did it for no other reason than to write an entry in my log book for the first time since the end of February. And it would have been too odd to enter anything less than a mile. But Vikki knew better than I, that a daily routine of 20 minutes walking was absolutely essential for the healing process. While I chose to ignore the literature they sent home with me, she was reading all the fine print. She was a nurse by trade, after all - there was no stopping her curiosity about the fine art of recovery! By the end of my second week out of the hospital, Vikki would ultimately show me her firm side. It was clear that a kick in the ass was what I really needed!

Date:     Sun, 6 Apr 1997 Subject:   Re: Open-Heart Surgery: A Test Of One's Will Dear Dead Folks, My surgery report is done and very long. It can be viewed from my web page as it is listed below. The link is called: Open-Heart Surgery: A Test Of One's Will . Peter, Thanks for sharing the information. What I enjoyed most of your story was the care and thought with which you picked out your clothing for the trip to the hospital. I will be sending healing thoughts your way. Don't ever underestimate the power of thought and love from other people. It sounds like you had lots of support for this event. Keep us posted on your recovery. Paula from Maine Date:     Mon, 7 Apr 1997 Subject:   Re: Open-Heart Surgery: A Test Of One's Will Wow! Okay, I know it's a stupid comment, but I'm really overwhelmed and don't know what else to say... You have a wonderfully addictive writing style and at the end of part two I wanted to read more...but you still have to live it !! In bocca al lupo, Peter. I'm very excited for you, like starting life over again! Julia Jones Italy Date:     Mon, 7 Apr 1997 Subject:   Re: Heartbeats Shelley Walsh wrote in her reply to Steve Patt: Sure resting heart rates get lower with increased fitness, but that doesn't mean that someone with a resting heart rate of 40 bpm is necessarily any fitter than one with a resting heart rate of 50 bpm I've been just waiting for someone to bring this up! This has a lot of relevance in my opinion. In my best effort to become fit and track the change in my heart rate some years ago the lowest I could get my resting heart rate (RHR) down to was 62 bpm. Of course I was baffled by this because I had reached a fairly high level of fitness that summer by concentrating on speedwork and I secretly wondered what was "wrong" with me. Last summer (about 8 years later) I reached an equally high level of fitness and, though I did not continuously track my heart rate, I did occasionally record my RHR and saw a wild flucuation in that value. While I was still running (prior to my arthroscopy) I got a measurement of between 64 and 79 bpm. Then several weeks after I stopped running I saw an all-time low of 56 bpm while reclining on a table with my feet in the stirrups of a Stress Test bicycle, waiting patiently for the test to begin. It made no sense whatsoever to me. My point is that, not only is it senseless to compare HR values among different individuals, but it is really tricky to get an accurate and/or stable reading from one day to the next ... at least in my own case. ObCardioNote: It is interesting that one of my medications for recovery from OHS is a small dosage of beta-blocker or Lopressor as it is called. This effectively prevents my heartrate from getting too high while it undergoes the healing process. As I pointed out in my surgery report, my RHR hovered around 100 bpm for long periods of time while I was in the hospital - a sign that it is working very hard to mend the LDA graft and PA closure done in my bypass procedure. Peter dellaFemina

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Updated January 15th, 1998