Finding My Nemo - Part III

As the treadmill steadily ramped up in intensity, I felt more overwhelmed by what might be discovered from my CT results than how the stress test would turn out. My cardiologist entered the room with a minute left to go and while reading my EKG, concluded that my heart was functioning well. He added that my CT showed reasons for concern. I would soon come to realize how fortunate I was to have my wife join me at the appointment on this unconventional Valentine’s Day.

What the doctor revealed hit me hard. I had developed an aneurysm at the base of my aorta as a result of my defective valve. In simple terms, Nemo caused my aortic root to balloon. It was currently dilated at 4.5cm. The threshold for surgery is 5cm. When John Ritter died, dilation in his aorta reached 6cm. The big question was how long did it take for my aorta to expand? The bigger question was not if, but how soon will it have to be surgically replaced?

Considering the recent, significant change that I felt within my body and the possibility that the aneurysm could rupture, “better safe than sorry” blurred into “now or never”. This was going to happen…and soon.

Sitting in the car in the parking lot after the doctor visit, my wife and I held hands…stunned and speechless. The sound of rain on the windshield peppered the silence. I was struck with images of both of my parents in their hospital beds, battling their incurable illnesses – stung by the stiff jabs of reality. This thirty-something was going to have open heart surgery.

Weeks later, at my consultation with the surgeon, the courage came to me. As we discussed the procedure in detail, I realized that the fear and pain of recovering from the operation was nothing compared to that of uncertainty and the unknown. Remembering that I had strength in my family, my friends, and my amazing wife washed away my doubts: I was determined to survive this!

After May 26th, a mechanical valve like this will be my life.

Finding My Nemo - Part II

While my wife and I waited to meet the cardiologist, the technician there wanted to take some images of my heart using the echocardiogram. Also known as a cardiac echo, the technology is identical to that of a prenatal ultrasound. To see my heart beating on a computer screen was a surreal experience and it gave me a greater appreciation for the organ’s work in keeping me alive. It was also a moment of amusement since my wife and I recently caught a case of baby fever; we couldn’t help but laugh at the fact that I was one getting the ultrasound!

When the doctor joined us to view the images of my heart, he pointed out something peculiar: I was born with a bicuspid aortic valve – a congenital heart defect which affects 2% of the population. Because my valve only has two leaflets – not the normal three – it doesn’t completely close, resulting in the backflow of blood in my heart. Although not an immediate concern, it was revealed that I would definitely need to undergo valve replacement surgery in my late 40’s or early 50’s. Together, we discussed a plan to monitor the defective valve until then. After this revelation, we postponed the stress test, scheduled a CT scan to rule out any other potential issues, and marked Valentine’s Day on our calendar. It was the day that we’d review my CT results.

In the ensuing days, I struggled with the findings and wondered if I – like my parents before me – would reach my end before my time.

I’d close my eyes and picture the ultrasound that displayed my valve resembling a fish mouth, opening and closing. It seemed like it was trying to communicate and, therefore, naming it seemed appropriate. I thought of the fish mouth and of my small defect. I thought of the clownfish with the abnormally small fin who escaped captivity to rejoin his father in the Great Barrier Reef. It seemed a perfect fit; my valve became "Nemo".

To be continued...

Image of my bicuspid valve from Cardiac Echo.

Finding My Nemo - Part I

It all began early last year. My family was still trying to pickup the pieces from my mother’s death three years before. Things were emotionally difficult for me. But physically, something else was amiss.

My heart was sending me messages - in the form of flutters. Without warning or indication, it would beat rapidly for 2-3 seconds and was jarring to the point of breathlessness. It was infrequent enough to not panic, but concerned me enough to mention it to my physician. He declared them to be palpitations and after an EKG proved to be normal, said I was fine and sent me on my way.

Over the next six months, I was beginning to notice that often times when I got out of bed, my heart would pound intensely. I felt like I was exerting myself more when standing up than doing more strenuous things like going to the gym or playing basketball. The symptoms were perplexing and prompted me to bring it up at my next doctor visit. He ordered an EKG to ease my mind. Again, the results were normal. I was nearing the point of frustration; my body and my doctor were giving me mixed signals. Making the choice to speak up for my body, I inquired about getting a stress test to get a better understanding of how my well heart functions when not at rest. Doc’s response: “it’s not really necessary. Patients don’t usually get those done until they reach their 50’s.” I reluctantly accepted his expert advice and left his office…for the last time.

Roughly three months later, my father passed away at the young age of 59 due to complications from diabetes and heart disease. This prompted a sense of urgency to identify what could be going on with me. With the astute advice of my brilliant wife, I left my primary care physician. I would now be consulting with someone familiar with my family’s health history – my dad’s doctor.

Immediately, my new doctor recognized the risk of ignoring the signs and she granted me the stress test I asked about before. The appointment was made to see a cardiologist on January 10^th – what would have been my mother’s 60^th birthday. I can’t help but think that she was looking out for me that day.

To be continued...

Dad, Mom, and Baby Derek

About "Replacing Nemo"

The date is set: May 26^th

Others in my boat call it the “Waiting Room”, a figurative place where we wait to undergo our surgeries. I have a few months here with which to worry about what could go wrong on the big day. Conversely, I can focus on the great things I’ll accomplish in my post-op life.

The likelihood is that I’ll end up doing a little of both; sharing my experience on this blog would no doubt be therapeutic for me. Yet, my ultimate goal is to chronicle my journey with the hope of helping those that may have similar, undiagnosed heart problems and to provide a forum for others that are waiting with me.