11 Months of Something

 Tomorrow will be 11 months since my CABG surgery.  

A year ago I was in a bit of denial, having found out I needed surgery and not quite ready to fathom how I could have no symptoms and yet need open heart surgery. It was preposterous.

And it was an elective surgery. That sounds ridiculous.

In my head I was thinking "well, they let me go home from the hospital, it can't be THAT bad." 

I was trying to manage the new health condition I found out I had (HHT) that led to them finding the issue with my heart. That was enough to manage. It has been first hospital stay and it had been a scary and emotional couple of weeks. 

A year ago I was making deals with myself, and with God. "Make this all better, Lord. Maybe they made a mistake."

I began researching alternatives to CABG. Robotic surgery, minimally invasive CABG. I reached out to Cleveland Clinic, Mayo and others. Clearly the doctors who looked at me were being alarmist. Or maybe they just didn't have the latest equipment. 

A year ago I was in a very dark and scary place.

Today - I am on the other side. I am 11 years since my CABG, which I learned was the 'gold standard in treating heart blockages. I feel strong, and healthy and happy. 

10 Months - Another Scar Post

I just saw the dermatologist because I am hoping he can help me with my scar. They really don't prepare you for the scar healing. 

So if you have been reading my other posts, you know that I am concerned that the scar seems to be widening. I have been told that this does happen with women because the breasts pull on the skin. They make you wear a bra 24/7 for the first 2-3 months to prevent the incision itself from being pulled.

While this was a pain, I did have a special bra I wore and I got used to it. I wish I knew about the scar wideing issue because I would have worn the bra for a few more months. (YMMV.)

So here is a photo of my scar at 10 months after surgery. My dermatologist looked at it and said "Marvelous! It looks great!" When I told him I was concerned it was too red and looked wider he said a couple of things I wanted to share with everyone:

1.) He said he gives my scar a B+ (this one you see here)
2.) He said the scar will contract in time
3.) The visiting doctor who happened to be with him that day said scars remodel for 1-2 years and suggested I do light massage on the scar tissue to help.
4.) He said in a few months if it is still red, we can do an easy laser treatment to take care of it.
5.) He said silicone gel or strips, or moisturizer on the scare every day helps too.

So there you have it. I still had hoped it would be a tiny white line by now.

Changes I've Made Since CABG

208 days since my surgery (Almost 7 months)

I have one month left of my virtual Cardiac Rehab, and I want to celebrate some of the positive changes I've made with the help of my doctors, my husband, my physical therapists, and my nutritionist. 

I'm eating more fish.

This is a very positive change for me, and Jim and I are now eating tilapia and grouper at least once a week, and some tuna as well. I'm actually shocked at how fast and easy it is to cook fish, and this past week my nutritionist changed my life when she told me I can actually just cook it from frozen. So in 15 minutes we can have dinner on the table. She said fish has omega-3s that are great for your heart health and we should eat 2 servings a week. She said fatty fish like salmon and tuna are especially good for you.

Salmon has never been a favorite of mine, so she recommended we try swordfish.  I'll let you know how that goes.

I'm doing my cardiac rehab.

This involves exercise, yes, but also meeting with my nutritionist and also watching a lot of content about behavior, how to think differently, stress management, etc. I am nor perfect, and I give myself maybe a C+ on this, but I am also a very hard grader.  

I really like the VHPGO virtual cardiac rehab that RUSH booked me up with, and the live physical therapist and nutritionist appointments I do via the computer. I talked about this before, it is a great platform. I also found Cardiac Rehab videos online and subscribed to their content. I like getting their videos and content in my inbox because they have great content and it reminds me to stay on track. I will probably keep connecting with their content when my virtual rehab ends in a month.

I am drinking more water.

Yes, we know we need to do this. But I am actually doing it. I have planned my day to ensure that I have a water bottle where I need it, when I need it. Talking with my nutritonist, I admitted that I am a pro at using work as an excuse for why I don't do what I need to do. So she gave me some accountability tricks and now I am a hydrating pro.

I am doing Pilates, yoga and cardio.

I was already doing some cardio with my Meta Quest 2 (Oculus) and the Supernatural and Beat Saber apps. And in November I upgraded to an Amazfit Balance smart watch to better monitor my heart rate, HRV, etc. (Yes, I love tech and VR and all of that stuff.) But thanks to my cardiac rehab I have a plan with heart rate goals, I understand why and when I want to increase my heart rate, where to aim on the BORG scale and so much more. So now the tech I love is a lot more useful to me. 

I also understand the importance of strength training and mobility training. The VHPGO has a range of online classes on demand, and I have done some pilates and yoga classes on the mat, and I can absolutely feel the difference in my body. 

I'm being more purposeful.

It is so easy to give in to the urgent and immediate needs of work, friends and family every day. But it is far more important to ensure that I am doing what I need to do to recover and become a stronger, healthier human. That means making purposeful changes, and purposeful decisions every day. I am nowhere near perfect, but I am planning small things into every day that purposefully get me closer to my goals, From planning trips to the kitchen for a water refill (which at my work involves a several minute walk to get my bones moving) to forcing tilapia onto my dinner menu rotation. It also means saying "no" to things if I already have a workout planned that afternoon, or know I need to spend time doing something else that moves me closer to my goals. 

This week will mark 7 months since my surgery, and about 8 months since I found out I even needed surgery. I am better now than I was then. But I want to keep getting better. For me, better means stronger.

Scar update 6 months later

205 days since my surgery (6.5 months)

Well, I saw the dermatologist today to have him look at my scar.  He said "it's looking great!" Which I was so glad to hear, because I look at it and think that it looks too red and that it is 'widening' over time. When I got a little emotional telling him I had to get all new clothes and can't wear any of my pretty things anymore, he assured me that I will be wearing them again! 

Before he came into the room his assistant told me that anywhere on the body where there is tension a scar can stretch and widen. Certainly the sternum is an area -- for women -- that has tension on it. Men don't typically have breasts that can pull on the skin.  When lying on your back (they make you sleep on your back for 2-3 months after surgery) the weight of your breasts, especially if you have larger breasts like me, pulls the skin on the center of your sternum quite a bit.  This is never a problem until you have a 6-8" scar between the middle of your breasts.

I wore a bra 24 hours a day for the first 3 months, and I was so glad to not have to wear it anymore, but I am now thinking maybe I should have worn it longer because I DO have larger breasts. So you may want to discuss that with your doctor ahead of time if you have large breasts. 

The surgeon's office was pretty non-chalant about it before surgery, and the NP there told me that with "my skin" I would probably barely notice any scar there in a year or two. We shall see if she is right.

My dermatologist happens to be the best derm in the world. Maybe everyone thinks theirs is the best, but mine really is. :-D  He told me that the silicone scar tape is great and I can wear it all the time if I want, and it should help.  He also said I can use the tape or the gel, and that some people find silicone gel easier to use. I might look into that. The tape package said to wear it 12-22 hours, but he said just take it off before bathing and then put it back on. 

I secretly believe that wearing the tape to bed might help the scar widen less, but that is complete fantasy on my part to be sure. 

It is also next to impossible to find photos of a sternotomy scar healing over time. I have Googled everywhere and you can see new scars and old scars. So I am going to keep sharing my scar over time so anyone else out there who needs to know can hopefully see this and get some helpful info. Hopefully my pain can be your gain! :-D 


**WARNING - SCAR PHOTO BELOW. STOP HERE IF YOU DO NOT WANT TO SEE A SCAR.**

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You can see what I mean by it looks like it "widened" and there is a little lumpiness at the top, which the dermatologist said we can "fix" if it is still there in a year. That is where the suture knot was, and he told me sometimes they have to remove those suture knots a year after surgery. He even mentioned having to "dig in to find them" or something, which sounded gross. So I am glad mine came out, even though at the time it freaked me out a bit.

He thought it looked great -- which was surprising to me. I really thought it looked awful. But that is why we have dermatologists.

You can see at the bottom my two drain scars. And the impressions on my skin there are from my bra. The bra band hits right where the drain scars are so you can see why it was such an issue when they were healing. Ugh, what a memory that triggered. LOL!

I wonder if silicone scar tape would make those drain scars go away? Hmm I might try that.

Here is a pic of three stages of scar progression for reference: (Please note the middle photo was taken at a different distance which is why you don't see the drain scars at the bottom.)

At 4 months the top of the incision still had a little hump there, which absolutely went away like they said it would.  But now I do (sometimes) have that little lump of skin at the top.  It seems to go away after wearing the silicone scar tape overnight, but then appears again by the end of the day. I am guessing it is related to laying in bed versus being upright all day. Who knows.

Cardiologist Appointment -- woohoo!

185 days since my surgery (6 months)

I had my second "3 month" check in with my cardiologist. He gave me an A+ and said I don't have to come back until next January. My echocardiogram showed sustained EF around 54% so everything is going great (it was 35% back in December, and 55% is the bottom of 'normal.)

"Keep doing what you're doing!" he said.  I told him about an incident I had at an after-work event when I felt a little light-headed and had to sit down. I also told him that my blood pressure readings have been in the 90-100 over 60s. So he discontinued one of my medications (spirinolactone.) 

I am still checking my blood pressure a couple times a week, and my watch checks my heart rate regularly. All things are looking good!

I'll get another echocardiogram in January before my next visit with him. Echocardiograms are very painless, so I have no issue there. 

6 month check in

183 days since my surgery (6 months)

Well it has been 6 months since I had my surgery. I wondered back then what I would be like 6 months later. I would say I am doing pretty darn well!

Virtual rehab is going great -- and I am actually doing yoga and able to get up and down off the floor pretty easily. Kinda easily. Knee still a little iffy, but that is not heart related.

I'm proud of myself that I am still going strong, but I feel like I need to do even better. Right now I am trying to eat 20 different fruits and vegetables a week.  It is harder than you think.

So far this week: blueberries, cucumbers, carrots, clementines, onion, edamame. 

14 more to go.

How's the home rehab going? Pretty good..

166 days since my surgery (5.5 months)

I really wish I had gotten this virtual rehab program a couple of months after surgery - it's pretty good. I am realizing how bad my balance is when I try some of the exercises, and I am working on that. There is a range of workouts I can choose from — including strength training, cardio, yoga, meditation and more. 

I am also trying to map out some weekly goals for myself and stick with it. Which is hard because I regularly use work as an excuse to be lax. (At least I am becoming more self-aware!) 

Today I am watching a video called "Staying Motivated with Lifestyle Change" and the doctor in the video just said this:

"If you are persistent, you will get it. If you are consistent, you will keep it."

This hit home with me, and since today is Sunday I am thinking ahead and trying to plan my week, set some goals and stick with them. She recommends scheduling workouts so you PLAN to fit them into your day, versus wait and see if you do them or not. 

She also recommended we have a "Promise of 3 Things" we PROMISE to do every day so that even when the day is not going well, or we have a curveball in our day, we can still get 3 things done.  

The intention is for the 3 things to be easy and doable -- like having an extra vegetable, going for a 10 minute walk, lifting hand weights - anything you KNOW you can do every day. 

So  today I am going to determine my 'Promise of 3 Things' and see how that goes for me.  

Virtual Cardiac Rehab

137 days since my surgery (4.5 months)

Today they finally called me to tell me they have an opening for cardiac rehab. Huzzah!

Unfortunately, with work and travel, it's not going to be convenient for me to head out to the suburbs at the time available and then get back downtown for work. So when they finally do have an opening, it sure isn't convenient if you work.

So instead they are connecting me with Virtual Cardiac Rehab through an app and/or website. I have an intake appointment next week. The platform and app are called VHPGO. 

This isn't ideal, but I also think it might be better for me to start charting my own course here and put together a plan that will work for me and my schedule. The therapist assigned to me is going to work with me over the next three months to talk about nutrition, exercise. mental health etc. I also get one-on-one nutritional counseling, live classes online and more.

Away we go. 

Having a pity party over here

125 days since my surgery (4 months)

It is four months and three days since my surgery. I’m doing great. But today I am going through all of my pretty blouses and work clothes that I love. Because most of them are V-neck my scar is now the first thing you see if I wear any of these. 

I know this scar will get better, and in a year or two from now I might even be able to wear a v-neckline without worrying about it. But today I just feel sad. 

Maybe only the women will understand, but I love so many of my things. I felt so confident and pretty in so many of my outfits. I know people say “don’t worry about it, who cares if your scars shows.” But I’m an executive and a professional, and I don’t want the scar to be the first thing someone sees when they look at me. 

Anyway. I guess I’m having a little bit of a pity party over here. And I should probably be grateful that I can afford to buy new clothes. But today, I’m just sad.

4 months after surgery

122 days since my surgery (4 months)

Four months ago today I went into the hospital and had open heart surgery. It seems like a distant memory and also feels like it never even happened. Unless I look at my incision scar.

My scar is actually getting much better - I have been using sicilone strips to help it heal flatter and smoother.

My niece is a cardiac surgical nurse at a children's hospital, and also has had some hip surgery in her past. She recommended these, and she showed me her scars --which you can barely see - that she used these on.  So I am hopeful they will help my scar get flatter.  Really the only part not flat is the top where the suture knot was.  Sometimes it is a little raised and then if I wear the silicone strips it goes down flatter. 

I am still waiting for my spot in the cardiac rehab program.  My friends on the AHA support group highly recommend I do it, so I want to. But it's been FOUR MONTHS! I can't believe how backed up they are!

Cardiac Rehab intake - finally!

99 days since my surgery (3 months)

Today I finally had my intake appointment at the Cardiac Rehab Center. They had me do a 6 minute walk test, and they said I did great.  The minimum requirement is 500 yards and I blew that away. They basically had me walk back and forth between two cones for 6 minutes

She also had me do sit-to-stand tests where they ask you to sit and then stand up a number of times and checked my balance. They had me turn around after standing a few other things. They also checked all of my vitals.

While I was there I saw a group of people sitting in a group doing basic exercises like knee raises, etc in chairs. People were also on treadmills and recumbent bikes. 

I asked if this was what the cardiac rehab program would be like, and they told me this was a pulmonary rehab group but that it would be similar. 

I have to admit it was underwhelming.  Most of these people seemed to have low fitness levels and were mid 60s to late 70s and I don't know if that is the level of rehab I need. I am already quite active, and I am thinking I need more strength training etc. When I asked this of the intake nurse, she told me to try it for a few sessions and then if I want, I can do it on my own.

I'm now on the next waiting list.

The bad news is that the intake is just the next road bump to actually get TO cardiac rehab. I am now on the waiting list to get an actual spot. And that will take a couple more weeks. So now I wait some more.

A word about attitude and positivity.

95 days since my surgery (3 months)

They do warn you before surgery that depression is a very common result of having open heart surgery. I mean - this is a very serious and scary thing. I was scared, anxious, nervous. 

One thing that I think helped me is that I am a pretty positive and optimistic person, and I believe that God has His hand on my life and all will be well.

I did have nurses and others comment on my positive attitude, and contrast it with other patients in my same situation.  But I also had an elective CABG - so I did not come in through the emergency room after a cardiac event, and I was relatively healthy heading into surgery. That is certainly going to make a difference. 

I also had a Dad who - despite many of his own hardships and significant health issues - always stayed positive, maintained a great sense of humor, and would point out that someone else always has it worse. We need to stay strong, positive and thankful.  I channeled a LOT of my Dad's positivity during all of this. I could feel his and my Mom's spirit with me, for sure. 

But I am also someone who is a bit "lit from within" and I believe in letting my light shine in the world. So I do try to stay optimistic and see the good side of things. I have seen people who are more 'negatively-wired' have a hard time with even small disruptions in their life, so if you are indeed that way, this will probably be a harder journey for you.  I do believe attitude, resilience and grit play a key role. But the good news is that we can all work on those things and get better at them.

I will also say that I did have a couple of episodes of sadness -- like a ton of bricks, it suddenly hit me one night that I had just had open heart surgery. I started to cry and was scared and anxious. I started praying to my parents and to God and it was really a bit of a 'stream of consciousness' of all the things I was feeling and afraid of while I cried. It felt good to let it all out, to be honest. But it surprised me because I thought I was doing pretty good mentally and emotionally and wasn't sure what that came from.

I am also a person of faith.  When I pray I do believe my prayers are heard. I also believe my parents, friends and loved ones who have died are all still connected to me and that they are praying for me and supporting me as well. As a Catholic, we call this the 'community of saints.' We are all connected, and remain connected. My ability to talk with God, and my family, and the saints, and just know in my soul that I was not alone was a great comfort to me. 

I spent a lot of time praying for everybody else.

I don't know how atheism works, or how someone would cope if they felt they were all alone. But I spent most of my time in the hospital praying for other people who were also in the hospital. I prayed for the surgeons and the nurses, the hospital staff, the patients and their families. 

I prayed for anyone who was in the emergency room that night, and anyone who had surgery. I prayed for the people who had surgery right after me, and everyone who had been in my room before me. I also prayed for the people who would be in my room next, and the people who didn't know they would be in my same position soon. I prayed for the people who were going to die that day, and their families. I prayed for the chaplains who would counsel them.

I prayed for my husband and my brothers and my family and asked God to keep them strong through all of this. And I prayed for all the people who felt alone, and sad, and frightened and asked God to wrap them in his love and mercy. And I prayed for the atheists - anyone who didn't know God and didn't know just how loved they were by Him. From saying rosaries to just random conversations with God, I felt better when I was praying for everyone else and asking Him to care for them. 

So if you're facing sadness or depression, maybe start praying for everyone else in the world who has it worse than you and ask God to help them through. Seems like it helps.