Cabbage Soup

Well I had my appointment with the surgeon this morning.  Getting there was really quite an adventure.  Yesterday his office called to advise me his schedule had changed and asked if I could come in an hour earlier which was no problem.  We left in plenty of time to get there early, but just as we pulled into the parking lot my phone rang.  Dr. Brady had been called in for an emergency surgery and my appointment needed to be rescheduled.  They promised to call as soon as possible to get me in so Julie and I decided to go have breakfast at IHOP.  Just as we were finishing up our meal my phone rang and they advised me he could work me in if I could head over to his other office downtown next to St. Joseph's Hospital, so off we went.  I had all my paperwork already filled out and brought along the DVD of my catheterization for him to review.  To my surprise I didn't have to wait long and we were soon escorted back to the consultation room.  I provided the video to the assistant who roomed us and she said she'd upload the images right away so Dr. Brady could review them.  It didn't seem to be more than ten minutes or so before he entered the room and introduced himself.  Being a busy surgeon he pretty much got right to the point.  He was a fast talker and exuded confidence which Julie later pointed out is something you really want in a good surgeon.  I liked him very much.  He didn't beat around the bush and just pretty much laid things out as he saw them.  He agreed with Dr. Aquino that stenting wasn't the best option.  He explained that the stents were basically little chain link fences that would eventually build up plaque and become clogged again and that stents didn't last as long as bypass grafts do.  Given the number of blockages I have and that they involve all three coronary arteries, his recommendation is to proceed with coronary artery bypass grafting (CABG or Cabbage for short).  Ultimately he said it was my decision whether to proceed or not but I know not doing anything would not lead to anything good and my chances of long term survival would be pretty nil.  My best chance at extending my life is to move forward with surgery.

His office will be calling me within the next couple of days to schedule the procedure.  He said he's currently scheduling in August for non-emergent cases so it won't be happening for probably a few weeks.  This gives me lots of time to worry and obsess about it!  It also gives me some time to try my best to quit smoking.  Not surprisingly he'd really like to see me smoke free prior to surgery.  Being a lifelong heavy smoker I'm already at risk for post-operative lung complications like pneumonia.  He was up front and said that many of his patients are like me, overweight and heavy smokers, and that he's seen cases where that deep smoker's cough has split the wired breastbone back open which he's had to go back in and repair.  It takes a minimum of eight weeks for the bone to heal and I'd really rather not experience that setback along the way.  I've got to do my best to kick this damn habit once and for all.  He does the "beating heart" technique which means I would not be put on a heart-lung bypass machine but he did say that because of the number and locations of the blockages he had his work cut out for him and it wouldn't be easy.  I had several other questions for him and he took the time to answer them as best he could.  I asked about harvesting veins from my legs and if this would cause any decrease in circulation to the lower limbs.  I'm concerned about this because I already have some neuropathy from my diabetes.  It was nice to hear that the veins he uses are minor vessels and in no way decrease blood flow.  I also asked about recovery time.  He said the average hospital stay for his patients was five or six days but that it was a very individual thing.  It wouldn't be out of the ordinary for someone with complications to be inpatient for two weeks.  He also confirmed that I would likely be transferred to a skilled nursing/rehabilitation facility for continued healing as I would not be strong enough to be home alone for a while.  I would have to build up my strength first.  Even after I am able to come home I'll still need people to check in on me and help with more taxing activities, though I would not require someone to be with me 24/7.  So there it is; my path is set.  I can now prepare myself for the road ahead.  As scary is it all is and as much as I wish there was another viable and less invasive course of action, I admit I'm somewhat relieved that I know now what's to come.  I look forward to continue documenting my journey and, as always, ongoing thoughts and prayers are certainly appreciated!