Sept 10, Sunday: yup, more surgery

Hi all! Continuing to imrpove, holes continuing to close, feeling better on stairs. Chest still hurts, but I can do a little more. Driving somewhat painful, especially with turning, so restricting to just local driving for now. But, as those of you who have been reading regularly suspected, the hernia has to go. As I mentioned, it is ridiculously large and painful. I'm also afraid that one of these times when it comes out that the ribs or muscles will close around the lung, which, outside of the excrutiating pain, would also be bad for the lung. This can happen with regular abdominal hernias.

While having another surgery so soon after the heart will probably set me back in my recovery, it just can't wait. Also, it's better to get it taken care of now and only have to extend my return to work by a couple more weeks rather than doing it in six months or a year and taking off 4-6 weeks again. Besides, one of these years I would like to take a long vacation to someplace that does not involve my getting stuck with big needles and large tubes in strange places. The CT was interesting (and I didn't do anything embarassing!). With the bearing down manuver the hernia really showed up, to the point that the radiologist actually came out to talk to me and ask "Did they remove any of your ribs during your other surgery?" Now, outside of the fact that this indicates that he can't count :), it gives an indication of how much spread there is. I passed on the opportunity to say that I had given a rib back to Adam and explained the first surgery when they went between the 4th & 5th ribs and kept them spread for 10 hours, thus starting the problem. The sternotomy then cut a third side, so that's what made it worse. What it will take to repair is unknown, but the large and dense amount of scar tissue around my heart would indicate that there is just as much to cope with around the hernia.

I got the OR report last Monday (yes, my OR report!) and didn't know until then that the scar tissue had been so dense that they couldn't get into my left atrium to get to the mitral valve, and instead had to go through the right atrium and then cut open the septal wall to get to the left side. (No, nothing is ever easy with me!) And, since these lung hernias are so rare (Temple has only seen 4-5, and they do lung transplants), I would rather be at the hospital where they have a whole thoracic surgery department. Especially with as wonderful (relatively speaking) as my heart surgery experience was, my decision is to return to Brigham. I had already met with the Chief of that department, Dr. Bueno, so it wasn't a problem scheduling. Dr. Cohn wanted to wait six weeks, so on the six week anniversary, Sept 21, I will be in surgery up in Boston. There is a good chance of a thoracotomy, which is when they have to make a large incision between the lower ribs to get into an undamaged part, then go up the inside wall to free up the lung and "unstick" it from the chest wall, put in mesh and sew the ribs together with wire. Additionally they will probably go in another way to get to the outside of the rib cage for mesh there. While it doesn't involve my heart stopping again (unless there is a REAL problem!), it is still a pretty big surgery.

 I have spoken with my boss, Dr. Gladstone, and they remain incredibly supportive (although anxious for my return!) for another round. I had pointed out to him before that since I was never having children that these "leaves" could be considered kind of equal time wise!

While I am staying very positive about this, it is still nerve-racking.  I will have lost almost three years of my life by the time my recuperation is done, and I want to get on with living. So this way I can start 2007 with the idea of building my strength up as much as I can, and not having anything else hanging over me. More details later.

Again, thanks for the support and we will have a review of the happy healing thoughts on 9/21!

Laurie P.S. to Deneen: I didn't really kill an ant, it was just "dramatic license"!