Jim On Open Heart Surgery


On October 23, 2017, I’m going to be having open heart surgery.  I’m 39 years old.

There are a lot of things in the world that are pretty surreal to have said to you — that first “I love you,” getting recognized for something you busted your ass on, the phone call that someone has died, breakup discussions…  you know, surreal stuff.  I got some zingers lately!  “You have developed a large aneurysm in your ascending aorta,” my primary care doc said over the phone while I was driving home one day.  Then, the platinum best seller from my cardiologist a few days ago, “Don’t plan anything after the 23rd, we’re going to schedule open heart surgery.”

"Dude, WTF!" --Roxy

Well, what we know is that this started with me having serious shortness of breath, dizziness, and just a real lack of the ability to just feel well.  Anybody feel like this, constantly?  Go see your doctor.  I went to see my primary care doc around the middle of July — the weeks right after the middle of June 2017 were an insanely stressful time for my family and I, and during that time I started feeling like my system stopped getting fuel — my legs started getting exhausted after no work, then my arms too.  Imagine having exercise fatigue after a few minutes of walking, then having haul ass through ATL on a gig, or worse, MSP!  Tests upon tests upon tests later, my doc sees that some real crazy stuff has happened — my ascending aorta has blown up like a bubble in a bicycle tire.

Let me tell you:
you can quickly become motivated to learn a lot about medicine when you hear someone say “You have developed a large aneurysm in your ascending aorta.”

Have you ever seen what an aneurysm looks like?  It’s a weak spot in an artery, ostensibly, caused by factors like increased blood pressure.  Technically, the circulatory system isn’t wholly different than a hydraulic system — a pump, hydraulic fluid under pressure, and hoses everywhere.  The problem with an aneurysm is that it’s basically a weak spot in a hose — and when a hose under pressure with a weak spot caused by higher than normal stress on the system, you get a hose blowout, you lose pressure in the system, and you have to shut down the system in order to replace the hose.  Right?  So, now imagine that blowout not being hydraulic fluid, but blood — and that aneurysm, were it to tear, I would bleed into my chest, the heart would shut down in a few minutes.  In typical JimOnLight loud-and-large fashion, I’ve developed the worst kind of aortic aneurysm, the ascending aortic aneurysm.  Living the dream.

ascending aorta, normal and with aortic aneurysm

From Healthline:

The aorta is the largest blood vessel in the body. It leaves the heart and forms an arch.

The arch’s downward portion, called the descending aorta, is connected to a network of arteries that supplies most of the body with oxygen-rich blood. The upward part of the arch, which is the section closest to the heart, is called the ascending aorta.

The part of the aorta in the chest is called the thoracic aorta. The portion further down in your trunk is called the abdominal aorta.

An aneurysm is a bulge that forms in the wall of an artery. It happens when the artery wall weakens. Aneurysms anywhere in the body are dangerous because they can rupture and cause massive internal bleeding. An ascending aortic aneurysm is especially serious. A rupture in this part of the body can be life-threatening.

Obviously, we’d really like to avoid my major heart artery blowing in half, which is where I am right now.  I’ve not been able to fly because of this, I’ve been on restrictions for carrying stuff, and honestly life has been hell.  Since about mid-to-late June, I’ve been experiencing some crazy shit — my blood “regurgitates” back into the system, which essentially is causing deoxygenated blood to leak back into my bloodstream, and that really screws things up.  I’m dizzy pretty much 24/7, worse when I push myself, and sometimes I get these crazy flush feelings in my chest, like when you kink a garden hose and then suddenly unkink the hose.  It’s f**king scary!  When that particular sensation stops, I’m always pretty glad for my life.

This has moved very, very fast.  Honestly, I feel like this entire situation is completely out of my hands.  I have an amazing primary care doctor and nurse that really need to be given a gold bag with gold bars in it for catching this before it killed me, which it would have done according to the cardio team.  If I were not having open heart surgery, if my genius doctor hadn’t have caught this, there is a major realistic chance I would have dropped dead at a trade show from aortic dissection sooner than later.

Team JimOnLight now has a samurai cardiologist that has given my heart the old “how’s your father,” and I meet with my surgeons in a few days.  I had a transesophageal echocardiogram last week, and not five minutes after it was over, the surgeon’s team was in my room telling me about the open heart surgery we’re gonna be doing.  Take jumping out of a plane — that feeling of falling — except be sitting in a hospital bed getting handed a bag of surgical soap saying “you’re gonna have about 6-8 weeks of recovery while your sternum grows back together, you’ll be wired shut.”  What now?  Sorry about that, I MUST have had something f**king insane in my ear.  You said you’re sawing through my chest?  Y’all know I’m 39, right?

It’s not mine, but below is what they can see with a transesophageal echocardiogram (TEE) — this is amazing stuff.  You get one of these for more detail of the heart, valves, arteries; with the normal outside-the-chest echocardiograms there isn’t as much detail.  It makes total sense, with a normal echo the scanner has to reach down through bone, skin, fat — the trans-esophageal echo only has to see through the tissue of the esophagus.  Pretty cool, no?  The kinds of stuff you get to do when they’re tracking something like this…  well, let’s just say they’re cool because it’s high science, and they suck because you end up having to do stuff like gargle a few tablespoons of AstroGlide-consistency liquid with Lidocaine in it so they can very gently and lovingly feed a probe down your throat.

I’m sorry I’ll miss everyone in Vegas this year.  I have 5-7 days of hospital nights after the open heart surgery, and then 6-8 weeks of recovery.  This is the first LDI I’ll have missed in forever — I was going to be there manning our offsite Avolites suite.  Believe me, I’d rather be there paying way too much for a beer than recovering from open heart surgery.  But, this is going to literally save my life.  And, 2018 is going to be one outstanding year, I am already looking forward to it.  My entire life is going to change drastically, positively.  I’ll blog as much of this process and its details as I can, and I love turning medical images into art, so let’s hope for some beautiful radiology imagery soon!

Editor’s note:

Folks, I am currently living proof that external stress in high doses can literally inflate your arteries and screw up your heart valves and nearly f**king kill you.  Please take care of all aspects of your life.  I am fortunate that I had an amazing doctor who found something wrong and jumped on it.  Manage your own care, advocate for yourself, find a good doctor you trust, and listen when they talk.

Some open heart surgery reading/watching material:

Symptoms and Causes of Aortic Aneurysm

Questions about Aortic Aneurysms

Severe Physical and Emotional Stress May Cause Catastrophic Tear in Aorta — the Yale Center for Thoracic Aortic Disease

Acute Aortic Dissection and Emotion/Exertion — Elsevier link to the scholarly paper

Aortic Aneurysms, and Aortic Dissection (where the thing rips in half and kills you)

Neurohumoral Features of Myocardial Stunning Due to Sudden Emotional Stress — the New England Journal of Medicine

Anxiety and Risk of Incident Coronary Heart Disease, A Meta-Analysis — Science Direct

Aortic Aneurysm in the Differential

the Transesophageal Ecocardiogram video playlist…  yes, it exists

Surgery for Aortic Aneurysms

Who’s at risk for Aneurysm?  (Hint, it’s men higher over women, because women are superior beings when dealing with stress) – National Heart, Blood, and Lung Institute

Repair of Thoracic Aortic Aneurysms — Society for Vascular Surgery

Thoracic Aortic Aneurysm Surgery — The Cleveland Clinic

An excellent page from Johns Hopkins University on Abdominal and Thoracic Aortic Aneurysm Treatments with Open Surgery — and a quite interesting 4-minute video:

Thoracic Aortic Aneurysms at the Mayo Clinic

KHAN ACADEMY!!!  Thoracic Aortic Aneurysms by the great Khan Academy!

This video right here is too creaking cool — Dr. Arie Blitz performing a repair of an ascending aortic aneurysm at Case Western Reserve University Hospital and then giving a post-op debrief.  Heads up, it’s a cracked chest, but this is amazing.  He walks you through his entire procedure.

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