Wandering Thoughts

June 22, 2008

She’ll be Right

Filed under: Aortic Valves,Reactive Arthritis — terence @ 12:27 pm
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They call him the Professor, although he’s not an academic as far as I’m aware. In the world of Wellington surfing even something as simple as the ability to read a weather map can garner you a reputation for bookishness and a moniker to match.

He’s a slightly portly, balding middle aged man who rides a boogie board and the first time we met we didn’t get off to a great start. We were surfing my regular spot when a wave came through. In all fairness it was probably his, but I hadn’t had a wave for a while so I tried to nab it off him. I was the regular, I figured it was mine. He figured it was his. And quite some grumpiness and nasty stares ensued.

Did I ever tell you that I can be a dork in the surf?

It could have been the beginning of an ongoing enmity – the sort that spoils numerous surfs – but the ocean had other plans for us. A few days later the two of us ended up surfing alone in very good waves at another nearby spot. Now I’m a dork but I’m not that much of one. Neither was he and, rather than wreck the best surf we were both going to have in a while pretending not to notice each other, to our credit we both did the sensible thing. We smiled and talked.

And since then, we’ve done our best to be cordial in and amongst the desperately scare resource that is good Wellington waves.

Sometime last year I was driving to my favourite local spot, when I saw him walking along the road. The last section of that drive is on private property and he took the “No Driving Beyond This Point” signs seriously. No one else did. I stopped and offered him a lift.

“Sure. Thanks”
“Looks like that wind’s swung round to the north”
“Yeah, real clean. I think it was westerly earlier so we’ve got lucky”
“Swells a bit small though.”
“But hey”
“There’s waves.”

By that stage we’d parked the car and were walking to the beach. And I thought I’d broaden the discussion. “So, how’s things been otherwise”, I asked.

“Oh, not so good, I’ve been diagnosed with cancer. I start chemo next week”
“Sh#t. That’s not good. What’s the prognosis?”
“There’s about an 80% survival rate.”

In my defense, it wasn’t the sort of conversation I was planning on having that afternoon. And, really, I’m much wiser if I have a chance to jot down a few speech notes ahead of time. So my reply was pretty much stock standard.

“Oh well. 80 percent’s pretty good. She be fine I’m sure mate.”

At 80% the odds are in your favour. They’re even better at 95%. And better still at 99%.

And it’s these latter two numbers that are following me round at present. For someone young and fit like myself the risk of dieing in a simple aortic valve-replacement operation is probably under one in one hundred. If my aortic root needs to be replaced it’s more like 5 in 100. The risk of a stroke or some sort of brain damage, or other unpleasant complications, is somewhat higher but the numbers are still on my side.

Which is good. But not good enough to stop me from feeling frightened. When it’s you contemplating lying on the operating table, even a small risk of disaster starts to feel uncomfortably large.

Hhhhmmm…so what was my point? Oh, yeah, I figured I wanted to blog about open heart surgery honestly. And being honest – I have to admit I worry. And I suspect that, over the coming weeks, my ongoing battle with this worry will be unavoidable. Something I need to get on top of. And I imagine this is the case for most people in my situation.

And my other point: being on the other end of those stats now, I’m pretty sure that my “she’ll be right mate” response to the Professor wasn’t the right one.” I’ve had people say the same to me, and I really appreciate them trying to be reassuring, but I think if I were in the same situation again I’d say something like “oh, how do you feel about that?”

And maybe I would have, that afternoon, with the Professor, if given more time. But right at that moment a particularly good wave came through. And we were both racing to get into our wetsuits and out into the water before the sun started to set behind the Kaikouras.

June 15, 2008

The Butterfly Effect

Filed under: Aortic Valves,Reactive Arthritis — terence @ 12:29 pm
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If a butterfly hadn’t flapped its wings on a warm autumn morning somewhere in New South Wales, then that small low pressure system floating in the Tasman might have never picked up extra water.

And if it hadn’t picked up the water, maybe it wouldn’t have rained so hard as it crossed the lower North Island.

And if it hadn’t rained so hard. I mightn’t have driven my car slushing over the melted gravel roads to a river mouth in southern Wairarapa hoping to catch waves at a spot that never breaks.

And if I hadn’t found those waves, I might never have surfed in the gritty water around the bar as the storm run off mixed into the sea.

And if I hadn’t surfed in that water I might have never picked up that ear infection.

And if I hadn’t got the infection maybe my arthritis wouldn’t have come back so bad.

And if it hadn’t, maybe it wouldn’t have damaged my aorta.

And if my valve wasn’t damaged then I wouldn’t be worrying about open heart surgery.

And if I ever find that butterfly, trust me, there are going to be some strong words.

June 5, 2008

MRI, where am I

Filed under: Aortic Valves,Reactive Arthritis — terence @ 12:33 pm
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[Note: some of the info. in this post is out of date; I misunderstood – see here]

Last week I had an MRI scan. Nothing near as dramatic as an angiogram, but claustrophobic enough to make me glad I’m not a vampire and don’t sleep in a coffin.

Anyhow, the purpose of the MRI was to determine whether my aortic root was stretched sufficiently to warrant having it replaced as well as my aortic valve. It was, and this means I’m in for more complicated surgery although, according to the cardiologist, it shouldn’t make for a worse prognosis or longer recovery time.

The other thing the MRI picked up though was the fact that the walls of my aorta are thickened. Which probably means that there is still active inflammation there.

Now this is a problem, as inflamed tissue is harder to perform surgery on. So we need to find some way of reducing the inflammation before surgery. The trouble is that the three top candidates for doing this – steroids, methotrexate and TNF inhibitors – all have side effects that aren’t particularly desirable if recovering from open heart surgery is your thing.

So it’s a bit of a worry. Although – and this I need to bear in mind – not too much of a worry. People on steroids, for example, are subjected to major surgery all the time and do just fine.

Summary: a bit less ok, but still ok. Sigh.

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