TheBanyanTree: Finally an Update

Tue Apr 29 20:08:18 PDT 2008

Dear Banyan Tree Friends,

On May 21, it will be four years since I entered the hospital to either
receive a heart transplant or die. I was close to death when I received a
new heart on July 28, 2004. This is an overview update of my life since
then.

I wrote you about my experience the day I was moved to the Acute Cardiac
Care floor from ICU. I left the hospital and went home two days later. I
undertook vigorous physical therapy for the first couple of months, and
experienced good recovery and significant improvement. Within two weeks, I
was put on a treadmill and was told to keep going until I was exhausted as
resistance was gradually increased. It was an incredible experience to feel
sweat on the back of my neck for the first time in nearly nine years. The
first month involved biopsy, X-ray, Labs and clinic twice a week, so I saw a
lot more of the hospital than I wanted. Biopsies finally tapered off until I
had the 16th one at 9 months. Now I have follow up clinic including blood
tests with the transplant team every two to three months, and intensive day
long tests yearly. My heart functions perfectly; as well as any man in his
thirties other than the most fit of athlete. FYI, for those to whom it means
something, my ejection fraction is now over 70%. I promise one of my
transplant docs that I'll do better next year and he tells me to give up,
because it doesn't get any better than that. 

In the last couple of years I've completely remodeled and finished a home
that we moved into; I've built decks, fences, garden sheds and done
landscaping. It's not necessarily my choice of favorite activities, but I do
them to prove that I can. For years I hired lawns mowed on our rentals. A
couple of years ago I had a tenant ask why I was moving the lawn and I told
her it was because I can. My only challenge is all this ambition in a 64
year old body. It's not falling apart, but I notice normal aches sooner.

The primary reason for maintenance medications now is for immune system
suppression to prevent rejection. I'm now much more cautious about people
I'm around, and I'd never believe that I'd wash my hands this much, but I
haven't experienced any colds or infections more than normal. I seem to heal
just as fast as I did before the surgery. I've only had a couple of colds,
and they seem to run their course just like everyone else's. Because the
immune system is suppressed, I'm more susceptible to rogue viruses and
cancer. Most of us have cancer cells in our body, which remain in check by
the immune system. A year ago last December I noticed a lump on the side of
my neck. I talked to the transplant people and watched it for a couple of
weeks. When nothing changed I went to an ENT who suggested that it was
probably cancer. After a surgical biopsy we found that I had a Squamous cell
cancer with tumors on several lymph nodes on the right side of my neck. When
the doctor called me, he insisted that to ignore it would result in death.
Surgery was scheduled within a couple of weeks. The surgeon performed a
radical right neck dissection which involved removal of all lymph nodes on
the right side, the main muscle running vertical below the ear and several
nerves. When the doctor saw me in my room post surgery, he was pleased that
I could talk and move my right arm. I hadn't thought about it up to that
point, but then I was pleased to. I knew that the shoulder might be an
issue, but I hadn't thought about not being able to use my tongue. An
addition biopsy during surgery found more cancer in the right tonsillar area
of my throat. Squamous cell cancer cannot be treated by chemotherapy; only
surgery and radiation. I had seven weeks of radiation to my neck and throat
beginning 6 weeks after surgery. I've always been a tough; you can't knock
me down type of guy, but the radiation nearly did it. Because of the damage
to the throat, I lost my sense of taste and my throat nearly swelled closed.
I was threatened with a feeding tube if I lost more than 10-15 pounds of
weight. It was painful but I managed to maintain enough weight during the
radiation treatments. Everything is healed now, and I've gotten most of my
taste back. Unfortunately, proteins don't taste quite the same, and a good
steak is completely wasted on me. That was a bit disappointing. It's been a
year since my surgery. I had a PET scan three weeks ago and all cancer is
gone. When I think about it, it's hard not to be a little paranoid
occasionally, but I don't spend any time on it. I've now lived nearly four
years longer than I was supposed to and I'm sure that I've got a lot more
ahead. Then there is that undeniable truth; we all die sometime. I've been
ready for a long time now, but there is way too much to do to quit now.
Since the transplant, I've witnessed the birth of another granddaughter and
am expecting the fourth one mid June. I am truly blessed. I suppose the down
side is that Linda has had to put up with me for 45 years now, but she isn't
complaining.

OK, it would take a book to tell you what all has gone on in my life the
last 4 years, so I won't start. Suffice it to say that life has been great.
I'm doing my best to make every aspect of it count and be meaningful. I've
worked hard at developing and maintaining a terrific relationship with my
boys. I think that we're making progress. My youngest son Mike wants to
write a book with me about our stock market trading experiences. I think
that we're going to start that within the next few months.

After my transplant; while I was still in the hospital, my brother said that
we would have to do the Grand Canyon when I got on my feet. We made a
tentative date for March 2008. When I called him last fall to ask if he had
a specific date in mind, he seemed a lot less sure than he had been three
years before. Being brothers, and having a normal competitive rivalry, I
assured him that I was going even if he didn't. By the  time we worked out
schedules, we arranged to meet in Phoenix on April 8. Mike went with me,
which made his mother feel much better and we hit the south rim of the Grand
Canyon at 5:30 am the next morning. MY transplant doc said that going down
and up in the same day was too difficult and so he made me prove that I was
ready by hiking 30 miles the week before. I should have listened to him.
While we didn't make it in a leisurely 10-11 hours, I did walk out on my own
two legs at about 10:20 pm after 16 hours. I kept looking for mules, but
alas none came by. I don't think my pride would have let me hitch a ride
anyway. I don't think that I'll be doing it again anytime soon.

Now if you doubt that this old man did it, I offer proof at the photo album
link below. I'm sorry that I've been away so long, but I notice that many of
you early Spoon friends don't post that much anymore. Thank you to the few
who are so faithful. I know how busy life can be.

http://picasaweb.google.com/2ndheart/GrandCanyon40908

Best Wishes, Jim Miller