I am wearing my heart on my chest as I ready, and steady myself, for a heart valve replacement. It was first scheduled for January 31st, but for reasons in the story below, was changed to February 14. This, in my mind, made it cool . . . they would be doing it on the BIG HEART day and if something happened to me that day my family could tell the story that I died on Valentine’s Day of a broken heart [literally]. Well that no longer is true since they moved the procedure to February 21.

They will use a pig or a cow valve and I’m not curious about what it might be. Not sure whether my heart will drive my appetite when it comes to sausage and steak in the future.

I was diagnosed with stenosis of my aorta about 25 years ago but I kept watch and had an echo cardiogram most years. The results were always the same: “moderately severe.” That is medical terminology and they indicated nothing needed to be done until it was “severe.” As the years passed I thought it might stay “moderately severe” forever–but alas it did not.

I was also diagnosed with Afib in summer of 2022. The Afib is much more annoying than the stenosis which I don’t feel. Every time I go to the office I get all the questions: “Are you out of breath when walking, talking or doing anything”. I answer no. “How about when you go up stairs.” Again, I answer no. “How about dizziness?” And once again, I answer a loud no clarifying that I have no symptoms of a tired heart. I feel really good.

The Afib is quite a different story. I feel it every time it happens. While wearing a heart monitor a year back, my doctor was surprised that I recognized the Afib every time it happened. For those of you never monitored, it is a small plastic device on your chest and a cell phone. When you feel uncomfortable for any reason, you input the event into the phone. So when doctor checks the print out at the end of the month and your responses, they can tell whether you feel it or not [I am not sure that even matters] but I am told that there are people in Afib all the time who never feel anything. I only wish that was the case. I have become accustomed to the feeling and although I get distracted when it happens; I don’t panic. Unfortunately fixing the stenosis with the valve will not cure the Afib.

Pre-op procedures began in December. There were breathing tests to see whether there was any pulmonary deficits and a cat scan with dye to see whether the procedure for the valve replacement could be done through the groin rather than open heart surgery. After a week or so while I was having a martini with friends at Del Frisco Steak House in Battery Park City, I got a call from the physician assistant whose name is Blerta. I need to say right now, I depend on her for information. She knows her stuff and is responsive. She said the tests went well but they discovered that I am bicuspid and not tricuspid. Most folks have three valves going into their aorta–I have two. Blerta indicated that I would need to go through an extra test since the original cat scan did not show enough information for the doctors to go through the groin and not through the chest cavity as in open heart surgery. I absorbed the information as I sipped on my gin martini and said “thank you so much for calling Blerta.”

I have a Medicare Advantage* plan and so far it has worked well for me. My doctors are all connected at Staten Island University Hospital and all seem to be on the same page. New testing was set up for angioplasty where they insert a thin catheter through the vein in your wrist and some dye to see if you have blockages in your valves. It was a procedure that needed very little pre-op and promised to be a minor procedure with no overnight stay.

So on January 9 I showed up at 8:30 am and, as anyone would be, I was anxious. By this time I was a pro about checking in for test and procedures. I was checked in and headed to the unit where they do the test. The hospital is very efficient in these matters. You are taken on time and people explain what is happening at every moment. At least 10 nurses and physicians asked me questions and gave me information about what was next. After being wheeled into the room where the procedure would take place, I was chatting to the large crew of people in the room and asked whether I would be asleep. They said I would be awake but sedated. Okay. WTF is that–I should have asked before. Once they injected me and I realized they had put a needle in my right wrist, I realized I was awake but didn’t really give a shit what was going on–probably because I didn’t feel anything. When the procedure was over my doctor immediately indicated everything was good and I had no blockages in my arteries other than the original stenosis and the procedure of replacing the valve could be done through my groin rather than open heart surgery. Indeed, very good news for me.

I had a follow up appointment with one of the doctors who would do the next procedure. He threw a wrench in the conversation when he started explaining both open heart surgery and going through the groin for the valve replacement. After hearing the pros and cons of both procedures, the doctor mentioned that if he did open heart surgery [let me explain–sawing through your chest plate to get to your heart] he might be able to give me an ablation and fix my afib, as well as replacing the valve. He asked what I wanted to do. WOW! YIKES! I had to make a decision. It only took about 30 seconds . . . there was no way I wanted anyone to hacksaw through my chest bone to get to my heart; I indicated I would take the TVAR procedure through the groin. Let me say: I hate my afib, but I hate someone sawing through my chest more.

So the procedure called TAVR [Trans Aortic Valve Replacement] was now scheduled for January 31. I was told that I should go to the dentist to assure that everything was alright with my teeth. I have learned that bacteria from your teeth is lethal to your heart. I have two dentists, one a periodontist and one a regular dentist. They wanted sign off from each. I went to my periodontist since I see him more frequently. He thought I should have two teeth extracted because they looked like they had bacteria and might cause an infection. He also thought he needed to cut a root in my front cap. OH MY! THIS WAS A LOT! I am ok with heart surgery but having teeth removed and a root cut–OH NO!

So the dentists are not going to sign the pre-op papers unless I take care of these problems. I am frantic because I only have 9 days before the TAVR procedure is scheduled. I get in touch with Blerta and let her know that I think I have to cancel the next pre-op and the procedure. She checks and says “keep the pre-op” and “I’ll reschedule the TAVR for February 14th.

I have one of the two teeth extracted because my dentist thought the other one was fine. It was not painful, but it was a tooth that was always questionable, and I always told both dentists that I thought I would take that tooth to the grave with me. When he finished the extraction, I was not in pain and the healing went perfectly. He injected something that was like styrofoam in the root holes and the extraction was a success with no pain and no bleeding. I reminded my dentist of my passion to keep that tooth but that I spoke to it this morning and told it–it was time to go. He laughed. I thanked him and left for home. I did have a martini that evening and went to bed happy for one procedure to be done.

The next dental procedure was much more complicated as they cut into my upper gum to cut through a root and tooth. It took about an hour in which I recited a mantra of “Our Lady Queen of Peace, Pray For Us!” Putting my mind on something else helps me stay calm and composed and peace is definitely needed in the world right now. I was injected with many novocaine shots and did not feel the surgery. I was able to have a martini that evening. There was swelling for about 3 days but I am none the worse for the surgery and glad it is taken care of. I am a week and a day away from that surgery and although I eat everything, there are traces of stitches not dissolved yet and my nose hurts as if it was broken.

So onward to the TAVR procedure, or so I thought. I get another call from Blerta who informs me that the event must be put off again for two reasons. She needs to get another sign off from the insurance company since there must be a representative from a firm who makes a device that would need to be used during the procedure in the operating room. THIS IS GETTING TO BE QUITE A LOT! I struggle to keep listening and not put my mind on overload of how many things might go awry. Let me say this call came the same day as the dental surgery, so I was already sedated with novocaine during this conversation. I almost forgot she said there were two reasons. Blerta went on to say that during the pre-op procedure they discovered I had a UTI and it had to be treated before the TAVR procedure. I told Blerta I was already on an antibiotic for the teeth and maybe that would work to cure the UTI. [I basically know that not all antibiotics work for everything, but I really don’t like to take them]. I told Blerta I would call her back in a day or so. I needed to rethink this whole process [it was then I started writing this piece.]

I called Blerta back a few days later to ask some additional questions about this new device. She kindly and patiently explained that since I am bicuspid and not tricuspid, they wanted an additional device in my carotid artery during the TAVR procedure in case any calcification from my stenosis escaped from my heart. This little screen [she described it as a mesh cup you use for tea] would catch any calcium pieces before they went to my brain and caused a stroke. A WHOLE LOT MORE! I breathed deep as she went on to explain, this was a good thing. I did keep my head about me and asked whether they were cutting my neck open for this device and she thankfully said “oh no, all is done through the groin.” I made an appointment for another urine culture to see whether the UTI was gone. I am waiting on those results and hoping I need not take another antibiotic. After all, I have informed my doctors that I only take antibiotics when I eat chicken. They cause me intestinal distress.

Well, at this point I have not gotten the results from the urine culture; but assuming all goes well, the valve will be replaced on February 21.

Instead of the BIG HEART day, the 21st is NATIONAL STICKY BUN DAY! Who knew, but an interesting history to that. https://www.daysoftheyear.com/days/sticky-bun-day/