TheBanyanTree: Heart Chronicles - Been a little busy

[Jim Miller]

Hello leafing friends,

Today I write again.

By now, many of you know that I received a heart transplant in the early
morning hours of July 28, 2004. As discussed previously, I spend most of
the day on the 27th in preparation for an entirely different surgery
Wednesday morning. Let me recap that day for you before proceeding.

I started the day with an early breakfast since I had a procedure
scheduled for 2-3PM and couldn't have any food or liquid orally for 6
hours. The scheduled procedure was a Trans Esophageal Echocardiography
(TEE).  This is a heart echo through the soft tissue of the esophagus.
The ability to map the heart is improved by this method and Dr. Icenogle
wanted a good map to work from. The TEE was to be performed by my
cardiology group.

Through the Rhapsody Music Service, I have available to me any type and
style of music that I could wish for. Through my stay here at the
hospital I varied it considerably, frequently homing in on 60s pop as
that is my era. I apparently raised a staff person's ire one day when I
played Elvis continuously. Have you counted the number of Elvis Presley
albums available? It seems that all the guitar base went rumbling across
the floor and out the door. I was asked to close my door by a much too
cordial chaplain. Sorry, I have trouble with phonies in any religion,
and boy was this guy a phony. On Tuesday I decided that I wanted comfort
music. I have always held a strong affinity for Southern Gospel and
anything by Bill Gaither. I spend the entire day listing to Southern
Gospel Quartets and Bill Gaither Homecoming albums. 

At 9:30AM Dr. Icenogle and VAD tech Dave Sato came in to explain the
surgery again, show me the backup VAD, give tentative approval to a
video and get all the releases signed.

Around 1PM, my nurse Brian came in and said the TEE was delayed until
4PM. Shortly after that the lab showed up to draw, what seemed like a
gallon of blood for all the surgery work up.

Linda came around 3 and we were waiting to be taken for the TEE. At 3:20
Dr.Icenogle walked in and immediately stated that "tomorrow's surgery is
off" walked over to a chair, sat down and said, "We have a donor". After
a few stunned moments, Linda said "You've got to be kidding". He, as a
matter of fact, continued that a donor was available and after being
rejected, for cause, for several other possible recipients arrived at
me. He gave us approximate timelines, had me sign a new release and
left. Next the lab techs returned to draw another gallon of blood. It
seems that the previous workup wouldn't support the new surgery. This
was right at the time of shift change and the entire floor staff, coming
and going had been informed. They stared filing in with hugs, prayers
and well wishes. 

As the lab techs were starting IVs and drawing blood, I lay wondering
with what I could associate this special day. Then it dawned on me that
I had spoken with my brother, who is located in Phoenix, twice that day;
first to discuss the pending surgery, and then to tell him about the
transplant update. In the entire day, I had completely forgotten that it
was his birthday. I called him once more to wish him a happy birthday. I
hope that he doesn't mind celebrating his birthday with my rebirth.

Next came the task of notifying everyone of the change of events, and
then the wait to find out if the heart was acceptable to my surgeon. I
got out my email list and really covered the bases. We called those
people who would want to know regardless of the hour. To a person, they
were nearly all in as great a shock as us. Youngest son Mike lives here
in Spokane and was planning to be in early with Mom for Wednesday's
surgery. Oldest son Dave had just completed a project and was on his way
from Kirkland when we updated him in route. We then tried to notify
everyone else who might have more than a passing interest.

I then called Deacon Dan, the transplant chaplain, and a person with
whom I've grown very close. I asked if he had been called yet. He said
no, but would be here by 6:30. Dan later visited me quickly in ICU and
jokingly asked if I was ready to convert yet. Dan being Catholic and me
not being Catholic. This comment has enjoyed regular running status for
several weeks now. We prayed later that evening as a family with Dan.
This was after finding out that the heart was acceptable to Dr.
Icenogle. I accused him of practicing with the Baptists.

The waiting pretty much ended at 9:15PM when the evening charge nurse
announce that one of the transplant coordinators, Paula, had called to
tell us that baring unusual circumstance, the heart was a go.

I had received the long awaited full body shave earlier and around
11:30PM returned to my room for a neck to knee betadine paint job. It
was requested that I be transported to pre-op at midnight. I was greeted
in pre-op by Dr. Sandler with a full load of gum and an obvious
adrenalin high.

I was given some last minute encouragement, said goodbye to Linda and
the boys. Mike took a few more pictures and I was wheeled off to the OR.
Once I crawled onto the operating table, I don't remember anything from
that point on.

Linda, Dave and Mike were kept advised throughout the procedure. Around
2AM, it was announce that Dr. Icenogle was in close proximity and Dr.
Sandler opened in preparation for the new heart. Dr. Sandler later told
Linda that my heart was the size of a football and barely squeezing.  He
said of the new heart, "it's a real squeezer.  Surgery was completed,
and I was transported to CICU at 7AM. I woke up at 11PM Wednesday night.
Jackie my night nurse woke me by gently talking to me. I still had
inhalator tubes inserted and wouldn't be extibated until 7AM, so I
mostly spoke by pointing at an imaginary watch, pretending to remove the
tubes and raising my hands in a questioning motion. The next eight hours
went by painfully slow. It was as much misery as I've experienced this
entire time. On schedule, Jackie had me cough and pulled the tubes in
the morning. She asked what my last name was and announced that, "we
have vocal cords". I knew she was going to ask the question, only I
thought that it was a test of my alertness. Obviously, I was wrong. A
few hours later, the Foley catheter was removed. I've had them before,
but forgot that it feels like you have to constantly urinate.

Dr Icenogle came in early Thursday morning and went in to the numbers of
higher priority rejects, the success ratios, and what sounded to me like
the exponential improbability of the new heart ever getting to me. He
assured me that it was a miracle and said that it was God telling him
not to do the MAZE on Jim Miller. It almost certainly would not have
been successful and would have ended on a VAD.

CICU is a most boring of places to stay. I was harnessed by 6 foot cords
to and an oxygen tube to a central monitoring console. Nurses worked 12
hour shifts and typically don't have more than two patients. I was
immediately put on anti-rejection pills, steroid pills, anti-biotic
pills, anti-virus pills, raise the heart rate pills, control the blood
pressure pills, lasix pills, antacid pills, swish & spit anti-bacterial
juice, swish & swallow anti-fungal juice and various intravenous
anti-something-or-the-other. Today, I'm down to 34 pills, five swishes
and a couple of short term intravenous bags.  This load should taper
30-40% over the next two months. That leaves television. Being a
Catholic institution, the basic cable channels are slightly censored.
Most of the public channels have been removed. Of course this leaves
room for in-house educational faire, nothing of which I needed educated.
24 hour news is repetitious, kidnappings/disappearances or politics. I
didn't watch new channels. The meds have completely whacked my
metabolism and biorhythms. The bed was very uncomfortable; leaving back
aches, headaches and neck aches. Since Wednesday night, I've slept in
1-2 hour fits, usually sitting in a chair, for around four hours sleep a
day. I hope that improves in a new bed tonight.

By Friday morning, I had spent several hours out of bed sitting in a
chair. Dr. Icenogle authorized walking, which we started that night with
250 feet. By Friday noon, I was off straight liquids and on regular food
again; the first meal since Tuesday's breakfast. The nurse was trying to
run down someone who would remove the chest drain tubes. Everyone was in
surgery on Friday. Finally, Dr. Sandler came in at 12:10AM. He said that
he though I would like to have them removed before tomorrow morning. I
suggested that he may have missed the objective, but I would certainly
welcome the relief. Tubes removed in about three minutes. Saturday I
walked 500 ft and Sunday, I walked 750 feet. As the swelling has gone
down, my breathing has improves substantially. It started out good, so
improvement is significant. Dr Icenogle was in surgery all day Sunday
and allowed me two minutes late Sunday afternoon. I told him that I
wanted to leave CICU, and he told me that weekends weren't a good time
to transfer out. I learned at 8PM Sunday that they also had another
heart working. Transfer orders were written to move me to floor six,
where they have isolated transplant rooms for care until release. I was
moved to floor six at 8AM this morning.

I also learned that the other transplant, my friend Steve was to be in
surgery this morning at 6AM. Linda visited his wife in the waiting room
before leaving the hospital after my transfer. I also learned that
Steve's miracle was that this was a second heart in 12 hours. The first
wasn't acceptable, and the second came up 2 hours later. He is doing
well and is awaiting his gentle awakening in CICU as I write. The good
Dr. Icenogle finally made it to bed after about 36 hours straight.

Today I've walked about 1,500 feet. I've been told that when I can walk
800 feet twice in a day, know my med and ask, I can go home. Tomorrow,
I'll walk 1,600 feet straight, recite my meds and ask to go home. It may
be too soon for their observation period. I'll promise them anything;
offer to walk it with someone and ask again. Just send me home. All the
nurses tell me that my progress is advanced substantially over everyone
they have seen come through here. Don't you think I deserve to go home?
I'm sure my insurance company would appreciate that, but what's one more
day to them at this point?

As I write this, a dust storm has blown in from the southwest. Just an
hour ago, it was perfectly clear. Now visibility is only a few hundred
feet. I suspect that the airports are all closed down. No more organs in
today. I've learned not to question God's perfect time, and I've learned
first hand the artistry he practices daily through the hands of these
great surgeons.

Mike took several pictures prior to surgery and in the CICU. Linda
brought my new camera to play with. It arrived Thursday. I'll try to
take more pictures before I leave. I'll get them posted to the gallery
as soon as I get home. Maybe sooner.

A temporary byproduct of all these meds is a hand tremor. My right hand
gets going so fast that I can barely brush my teeth. My typing has
always been slow. Today it has been nearly impossible at times. It is
finally settling down enough that with several breaks, I'll get this
posted this evening.

Thank you for all your prayer, encouragement and well wishes.

Jim Miller
Read my journal and see the photos at:
http://www.maze.cc