Steve Nawojczyk's Stuff

Doctor's Update-Good Lipids, Low D

2009-11-01T11:02:00.004-06:00

It's been 16 long months since my heart surgery. I'm still alive.

Spent a couple of days the last two weeks at both the cardiologist's office and my primary care guy, Scott Harrington.

Dr. Conley (cardio guy) says my EKG is the same (right bundle branch block that affects many heart bypass patients) but everything else was good. He did resume my Plavix and said that data doesn't preclude one from taking it long long term to assist in lowering your likelihood of stroke or heart attack. The only thing that keeps many from taking it is the expense. Even with my fairly good work health insurance, the co-pay is still 1.00 a dose. I can't imagine what it costs and how anyone without insurance could possibly pay for it.

Dr. Harrington said my lipids are very good and well within the "low risk" category. My HDL needs a little bump so I continute niacin, exercise and halfway decent diet.

My Vitamin D was down and he put me on some 50,000 take one every two weeks kick ass Vitamin D. This vitamin does a lot. Check the wiki entry here.

More soon.

A Lot Has Happened in the Last Year

2009-07-03T06:38:00.005-05:00

(The photo to the left was taken the first week of June when I spoke at Boys State for the 18th time in the last twenty years.)

Hard to believe that one year ago today, almost to the minute, my bypass surgery was beginning. In a way, it seems like yesterday, yet in another way, it is almost surreal.

So much has happened in the last year. There is no way I can chronicle all of the major events, suffice it to say, it has been an interesting ride. Lots of life changes have happened. Some good, some bad, but all in all, it is simply life moving forward.

As always, thanks for looking in on me. Plus, there are no words that can express how grateful I am to the members of my "Levy" family. I love you each one.

This Time Last Year

2009-06-14T15:39:00.004-05:00

Just about a year ago, in June of 08, I was experiencing some very "heavy" feelings and other symptoms that at the time I had no idea were heart related. Well, as you know, they were serious warnings. On July 3, I was flat of my back getting whacked on.

This year has sped by. Lots has happened. I'm still having some minor symptoms that I have to keep an eye on.

Sadly, I've put a little of my weight back on, but dad burn it, it's hard to keep off. Especially with the sciatica stuff still lingering.

But, I'm still breathing and working. I will update more here a little later about some of the things still happening.

Thanks again to all of you who have kept in touch.

Steve

P.S. I still miss my little Candy dog terribly. Not a day goes by that I don't think about her and how much she helped me heal. I'm still sad that no matter how hard I tried, I couldn't keep her with me. About two months ago, I thought I was losing my other dog, Babe. She recovered from whatever it was that nearly killed her. She is nearly 13 now and I know that soon she will be at the Rainbow Bridge with all my other little critter friends. They will wait on me. I am anxious to be with them all again. The unconditional love they give is something that humans should learn.

Cardiology Appointment-First Post Surgery

2008-12-30T11:49:00.003-06:00

Bright and early this morning I was sitting in Dr. Thomas Conley's (photo left) office awaiting my first post-surgical visit to him and his lovely and accommodating staff.

All in all it was a good report. My lipids are good other than my good cholesterol is just a little low so he suggested I get on the Omega-3 Fish Oil routine which I started at lunch.

He also suggested I re-examine the fact that I have been on Neurontin. So, I'm off on a research mission before my next visit to my primary care doctor to discuss its use. It has seemed to help the numbness and tingling but apparently there are some side effects that Dr. Conley would rather I not experience.

So, it appears things are going well. I'm still struggling every day over the loss of my little helper dog Candy but time will make it all well. In the meantime, my big dog, Babe, and I have been spending a lot of time on the hiking trails of Arkansas. You can visit a photo album of sorts by clicking here to go to a photo site I'm involved with. There are some real pretty pictures there you are welcome to use however you wish.

Well, Dang It

2008-11-25T05:33:00.007-06:00

It's been a tough two weeks for me and my extended family here. Remember my caretaker family who so graciously allowed me to recover at their home? Well the nurse helper has had some health problems of her own. A little cancer scare but yesterday she got an EXCELLENT report from her surgeon and it appears it was not cancer after all. That's good so she can go on tormenting her patients at the VA. ~~smiling here~~ Plus, a good friend lost their job for reasons so stupid I don't even want to think about it now.

And my little dog Candy died (see post below) which really hit me hard since she was so loved and helped me recover from my bypass surgery. My house has a little less love in it no

w but she was a sick baby and I'd done all I could for her.

About 10 days ago, I started getting some of the same signals from my body that came prior to surgery. Like the numbness and tingling in my face, neck and arm. Crazily enough,

even in my ear lobes. In the last few days, the numbness and tingling and aching has moved into my left arm. It all sounds like classic symptoms of another blockage to me.

Yesterday I talked with Tami at Dr. Conley's (the cardiologist) and she doesn't seem too overly concerned since I've continued riding my bike and on Sunday took a very aggressive hour long hike over at Lake Ouachita State Park's Crawdad Island Road with no side affects such as shortness of breath or chest pain.

Lake Ouachita State Park is a beautiful State Park about an hour and 15 minutes from my house. My big dog Babe loves it. Since it is deer season here, we have to stay out of the National Forest so no one mistakes me for a big ass bear and shoots my old tired bones.

Back to my heart-- Everyone that talks to me and all the reading I've done indicates you may continue with some symptoms for up to a year after surgery, especially if they harvested your mammary artery (they did). Tami said it may be nerves healing. I've noticed the area in my leg that was so infected back in July is also aching a little lately so it might be the nerve healing thing. I hope. I did have my lipids done and all of my readings are excellent! That alone however, does not mean you could not have problems. Remember, LISTEN TO YOUR BODY AND WHAT IT IS SAYING. YOU KNOW IT BEST.

I'd hate to have to go through this again although one book written by a couple of cardiologists says that up to 15% of bypass patients require further tweaking. You know with my luck, I'll probably fall into that percentile group... I had a follow-up appointment scheduled with Dr. Conley on December 30, but Tami said if the symptoms continue or get worse, to call and they'd move the appointment up.

Other than the loss of my dog and the new little things happening inside of me, things are good. I'm staying busy at the job being part of a huge shift in the responsibilites of the agency I work for. Times are challenging for all of us.

Thanks again for checking in on me, and thanks for the kind comments about the loss of my companion Candy.

UPDATE:
Went to my primary care physician and they did an EKG and prescribed Neurontin to deal with some of the numbness. At least to try and deal with it if it is neurological rather than cardiac.

Also, click here for an interesting CBS report about how having a bad boss can increase your heart attack risk by over 50%.

Been there, done that. My original stent surgeon in 2005 told me there was no doubt my work environment contributed to my issues.

RIP My Little Helper Dog Candy

2008-11-15T17:36:00.010-06:00

CANDY 1997-2008

On November 15, 2008 at 5:15, my little helper dog Candy passed away. She had been very sick for about ten days and her kidneys finally gave out. She died at the home of her most wonderful vet, Dr. Richard Allen of North Little Rock. Even though it was to have been a long week-end away for Dr. Allen, he returned early and met me and Candy at his office. She had had a horrible day. He started fluids and was taking her to his house for him to monitor. I carried her from the clinic to his car and I knew in my heart I would probably never see her again.

Ten minutes later, when I got home, Dr. Allen called me and told me that as he arrived at his house and opened the car door to get Candy out to take her in, she took her last breath. Dr. Allen had gone above and beyond in trying to bring Candy back from this sad time.

You might remember that Candy was one of three dogs who helped me during my recovery from the bypass surgery. Candy had so many issues, that she is all I focused on while in the hospital recovering as well as while I was home. She had developed diabetes in 2005 and required daily insulin and monitoring. Then she developed a seizure disorder. She was prone to bladder stones, and, she had more personality than any other five dogs (and most people) that I know.

Here's a post about her guarding us while we slept. Some said she was "mean". No, she just knew what she wanted, knew when she wanted it and pursued whatever it was with great zeal. She fought her way through every illness she had with her great tenacity. She just couldn't beat this last attack on her health, all of the different issues had taken a huge toll on her kidneys.

You always think nothing can replace a loyal friend like Candy, and that is true. Something will come along that will assuage some of my grief however and then I will remember only the happiest of times with Candy and the rest of my critters like Babe seen in the photo to the right with Candy. (This was taken on October 30 and was the last day Candy felt really well. I could always tell if she was feeling good because she would curl up her tail. It hadn't been up since November 3, not even for a second.)

Luckily, in this age of digital photography, I have many many photos of Candy that I will cherish and remember.

She will be waiting for me at the Rainbow Bridge along with all of everyone else's pets.

From The RainbowsBridge.com :

Just this side of heaven is a place called Rainbow Bridge.

When an animal dies that has been especially close to someone here, that pet goes to Rainbow Bridge. There are meadows and hills for all of our special friends so they can run and play together. There is plenty of food, water and sunshine, and our friends are warm and comfortable.

All the animals who had been ill and old are restored to health and vigor. Those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by. The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent. His eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.

You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

Then you cross Rainbow Bridge together....

Author unknown...

I love you Candy. Be happy and warm, we'll all be together again soon.

Middle October Update

2008-10-16T05:17:00.003-05:00

If you are not familiar with blogs and want to read about the surgery chapter of my life, go all the way to the bottom of the blog, that is where the oldest entry is.

All is well with me still. Thanks for looking in on me. It's hard to believe the surgery was nearly four months ago. Steve

UPDATE

2008-09-03T18:30:00.002-05:00

Hello again. All is still going very well. Back to work and life.

Both of my legs are still a little numb. I can't understand why my left leg is numb since they removed no veins from it. In the book I spoke of earlier it said that the numbness in the harvest leg may never go away but that your brain just logs it away and you soon don't even notice it. My left one is more numb than the harvest leg!

Dr. Rayburn was funny on my last visit when he responded to my query about why the leg was numb by saying, "you're just the lucky one." How appropriate for the way things had gone.

And--now I think I've got carpal tunnel or some kind of tendonitis. When I extend my left hand and arm a sharp knife like pain occurs on the inside of my forearm between my elbow and wrist. Holy cow it hurts! But I'll be damned if I go to the doctor for it. Any suggestions? I'm told I shouldn't take too much ibuprofen since I'm on heart meds.

Message from a great chest cracker!

2008-08-20T06:26:00.003-05:00

I found that Dr. Rayburn took the time to comment on the blog- might I say without his skill it wouldn't have been possible... Here's his message:

Steve:

I've had occasion to see your blog through the process - many of the nurses would have it up in the ICU at various times.

Great recovery and good heart health in the future. You've been an excellent patient - much better than many (or dare I say MOST). Let me know if you need anything in the future.

Tom Rayburn

Released from Surgeon!

2008-08-19T15:48:00.004-05:00

Got a great report today from Dr. Rayburn and his nurse Lynn. My leg is nearly well and there is no evidence on x-ray of any more fluid build up in my chest.

He gave me the routine, "stay on a diet to manage cholesterol, keep a close check on your blood pressure, stay on statin drugs, get regular moderate exercise and keep on truckin' " speech all doctors are required to deliver.

While I can tell I'm not back to 100 percent yet, I have been riding my stationery bike between 20 and 30 minutes a day and have lost over 30 pounds since this started. My blood pressure is under control and I am on Zocor (statin). So all in all, everything appears to be in good shape.

Thanks for all of your support and riding with me through this trip. I will leave the blog up and will post as anything pertinent happens.

Rayburn released me back to the care of my regular cardiologist, Dr. Tom Conley.

Today's tip- after the surgery be prepared for several weeks of the weirdest dreams you've ever had. Some of them that I had were quite entertaining, others were quite disturbing. Several people I've talked to that have had the bypass surgery all experienced these so it must be a fairly common thing.

Again, thanks for your interest and kind words and thoughts.

Headed Back for More X-Rays This Tuesday

2008-08-16T13:45:00.004-05:00

This coming Tuesday I am going back for another chest X-Ray and a visit with Dr. Rayburn to see how things are progressing.

I've not been suffering from any shortness of breath (aka dyspnea) or other symptoms I was told to watch out for concerning the pleural effusion. Hopefully that means they won't have to cram a needle in my back again...although it was sort of cool seeing all that stuff draining out of me.

Also, I bought a great book yesterday called:

"Your Heart: An Owner's Guide" by John A Elefteriades, MD and Lawrence S Cohen, MD

It's a great guide for those about to have any sort of heart surgery as well as for those of us who've already paid our dues on the surgery slab.

One thing I learned is the "bounding" heart I feel when I'm still or am in bed is a normal thing. Of course my worry-wart self was thinking the worst, you know, I was about to break back into atrial fib or something even worse. According to the book, lots of people go through it. There's lots of other tidbits in it too. It's really a must read for patients and their families.

Ok, shameless commercial plug over with.

Back to Work and Happy as a Pig in Slop

2008-08-12T14:15:00.004-05:00

Started back to work Monday and all is going very well. It is nice to be back in the swing of things and doing what I do best...sitting around issuing all sorts of wisdom. Plus, I've lost 30 pounds since all of this started and I'm determined not to put it back on. Energy level is great and I'm taking it easy.

Drain Day

2008-08-08T14:49:00.009-05:00

So today I report to Springhill for the doppler (top photo) to see if there was fluid on my chest as Dr. Rayburn suspected a pleural effusion Boy was there.

The second photo from the top shows the drain actually in my back. The next photo shows radiographer Jennifer after she removed the tube.

Finally, Radiology Techs Wendy (l) and Jennifer display the liter and half (about 50 ounces) of fluid that was removed today. They stopped at that amount even though it was still draining. This is standard since they don't want too much to drain which could cause complications with the lung. The procedure was only slightly painful, but it was an odd feeling as the Doctor fished the tube around and there is some residual uncomfortable feelings a couple of hours post-procedure. The leg drain (see below posts) was actually more painful.

I learned today that this is a fairly common event when you have chest surgery and chances are, unless my body can deal with any more fluids, that I will have to go back for another thoracentesis. A second one is also a fairly common occurrence according to Wendy and Jennifer and about every nurse I spoke to.

Dr. Conley, my cardiologist, dropped in to see me and told me the same things. So, if you are preparing for a CABG, be prepared for these speed-bumps in your recovery.

But, on a positive note, I get to go back to work Monday!

Thursday Surgeon Visit

2008-08-07T15:01:00.005-05:00

Today Dr. Rayburn, the heart surgeon, found a possible pocket of fluid on the chest x-ray they took. He said this is a common occurrence (and if it can happen it will happen to me) after heart surgery. He did say my leg and my chest are looking very good however.

I go in tomorrow for another ultrasound, this time of my chest. If it determined there is fluid then they will perform a thoracentesis, which should be an outpatient procedure. It will be an ultrasound guided procedure which according to this article is a little safer.

He did clear me to return to work on a limited basis Monday so at least it appears he is not real concerned about this new glitch in my git-along. It's a little disheartening because I've been being very good and following orders. Oh well, such is life. I will keep you posted.

Tuesday Update

2008-08-05T08:31:00.003-05:00

My follow-up surgeon's appointment had to be moved to Thursday due to an emergency surgery Dr. Rayburn is having to perform.

The antibiotic I'm on has some side effects I don't like. It dries out your mouth and effects the taste of food. I'm not sure if it is causing my blood pressure to spike or not, but the BP is becoming somewhat of a concern to me. I'm monitoring it very closely and working with Dr. Conley, my cardiologist, on tweaking my meds. I've heard that after bypass surgery it sometimes takes a while to get the BP leveled back out. I only have a couple more days on the Zyvox (antibiotic).

Blood pressure is something that everyone should monitor very closely.

A Little Sunday Leg

2008-08-03T14:43:00.001-05:00

Here's a shot of the leg on Sunday afternoon. It's looking, feeling and doing a lot better. You can scan down a few posts to see how it looked last week. I'm happy with the progress and I hope Dr. Rayburn will be as well. Again, thanks to all of you for your support and thoughts. This has been quite an adventure.

Update--Friday

2008-08-01T12:14:00.003-05:00

Been home from the leg debacle for a few days now. Dr. Delap put me on the antibiotic Zyvox for a ten day run. This drug for twenty pills cost $1700.00 at Walmart. I am one of the lucky Americans who has a fairly good health policy and my co-pay was only sixty bucks. I just can't imagine someone without insurance having to make these purchases of life-saving drugs.

I'm having to keep my leg wrapped in an ACE bandage and that really is uncomfortable but I was told it is important to keep the fluid from coming back.

I'm also having a little trouble getting back into a regular sleep cycle. After all, being in the hospital for a total of about 3 weeks gets you sort of messed up because as you all know, you do not get to rest in hospitals. They are in every other hour for something or the other and that sticks with you.

Hopefully, I'll be back on track soon. I go to my chest surgeon's office on Tuesday for my follow-up visit and I think I will be released on that day to go back to work at least on a part-time basis and I can hardly wait for that. Being off work without pay isn't too good of a feeling.

HOME

2008-07-29T17:21:00.001-05:00

Got home about 2 PM. More to follow.

More Monday

2008-07-28T13:57:00.003-05:00

I went and had the leg wound drained. They got out a bunch of goo and left this drain in place and said it would be in a week having to be flushed 3 times a day with strict instructions not to get it damp in the slightest way because if it got wet it was almost a sure thing that more infection would set up shop.

Then Dr. Rayburn came in to see me and he said, "I'll be taking that drain out tomorrow, you don't need it." To which I said, YAY! Then Dr. Delap came in and said that she would be examining the fluid they removed to see what sort of oral antibiotic I should be placed on upon discharge which in all probability will be tomorrow after she and Dr. Rayburn confer one more time once they review all the lab results. The good news from both of them is that I should be able to return to work next Monday! Which is great news for me--and my creditors.

Now, if Dr. Delap finds some bacteria or infection she doesn't like, Dr. Rayburn will have to open up my leg which will have to be left open to allow it to heal from within. I'm hoping against that, but the way my luck runs...Anyway, keep thinking positive thoughts for me. I want out of here in the worst way.

Oh yea, the best thing that happened today? I talked Dr. Rayburn into ordering me a regular diet rather than the horrible low-fat low cholesterol thing I have been on! Not that the "regular" diet is much better. I do have a friend bringing me a chocolate Elvis from Planet Smoothie this afternoon and I can't hardly wait.

Quick Monday Update

2008-07-28T08:59:00.006-05:00

Photo taken Sunday of RN Safonda flushing my PIC line after they finished with a round of Vancomyicin

Dr. Rayburn's nurse Lynn came in this morning early and has ordered another doppler scan of my leg. If fluid is present they will try a needle aspiration. Then, knock of wood, I'll be going home with orders to wear a leg stocking and will be placed on a strong oral antibiotic. This is the best case scenario and it is what I KNOW will happen. I'm so ready to be out of here. I've been in nearly as long for this leg business as I was for the actual bypass, which several folks up here tell me happens a lot. You'd think they could figure out how to prevent it.

I'm also waiting on Dr. Susan Delap to come in and give her final thoughts about all of this as I had a very good feeling about her abilities and I respect her knowledge and forthrightness. I'd hate to get out of here without her looking at all my latest lab work and chart from over the week-end.

More later as it develops.

10:30 AM update- The ultrasound shows I do need to have some fluid drained so I am back in my room awaiting the call to come to the "specials" room in radiology to have this procedure done. I'm also still waiting on Dr. Delap's visit and don't know if it will be before or after the procedure, which I also don't know the timing on. Hospitals seem to be "hurry up and wait" in nature.

Sunday and Nothing New

2008-07-27T13:59:00.005-05:00

Well, it's Sunday, my fourth day in the hospital with this leg infection business. I have had so much antibiotic that if a flea bit me I'm sure death would be in short order for the little critter.

Dr. Martino was in this morning but no decision has been made. My blood work will be done later today to see how my white blood cell count is and so forth. The leg appears about the same. Dr. Rayburn should be back tomorrow. I know this though, I'm ready to get out of here but must abide by what those much smarter than me think and say. I just know I miss my dogs...and my friends.

Afternoon Update: Dr. Delap's partner, Dr. Hammack was in this afternoon to take a look at things. He said it looks as though it is progressing and explained the process a little more about the antibiotic therapy. Dr. Delap and Dr. Rayburn will be in tomorrow morning and will be making the final decision about what is going to happen.

The IV

2008-07-26T14:21:00.003-05:00

RN Steve prepares to start another dose of "Zosyn" antibiotic which I get three times a day and probably will through at least Monday. I learned this afternoon that Dr. Martino had come in this morning fully planning on cutting my leg open and draining the wound creating a whole new scenario, but after examining me, he opted to continue with the current line of treatment. I am glad for this and hope all continues to go well.

He's got legs and he knows how to use them--sort of

2008-07-26T10:59:00.013-05:00

Here's a photo of the reason I developed a high fever on Wednesday. Apparently there was a high powered infection cooking in my leg where the veins were harvested. It had probably been cooking for a while and finally boiled over on Wednesday requiring hospitalization.

In photo to the right RN Safonda cleans up the leg in preparation for examination by the surgeon (photo left), Dr. Martino who was taking call for Dr. Rayburn who was out of town. A lab tech also prepares to draw a blood sample.

In the photo below, Safonda continues her clean-up of the draining wound.

I was then taken to surgery where an indwelling PIC line was placed so I could be zapped with heavy antibiotics which is going to be the course of treatment. I will probably be in the hospital until at least Monday to be sure the infection is nipped in the bud. The surgeon called in the infection doctors who are consulting closely about the cause of this little speed-bump.

Dr. Delap (infectious disease doctor photo right) said this just happens in some cases, and of course, I drew the short straw, but it does give me more stories to tell. Her advice was just as the surgeon's, we will just keep taking on antibiotics by IV before a decision is made to surgically intervene.

Day 20 post surgery

2008-07-23T09:58:00.004-05:00

All is apparently still good. My blood pressure is getting a little high mid-morning and they may make some adjustments in my meds. Also, my leg where the veins were removed is a little more sore and stiff this morning than it has been. Probably just healing. It's less than a week to my first follow-up appointment with Dr. Rayburn. I suspect I will learn much more about timelines and such on that day.

UPDATE: Well, things weren't so good. About 11 AM on Wednesday I developed a fever of 102.5 and by 9 Wednesday night I was once again staring at the ceiling in Springhill Baptist Hospital's Clinical Decision Unit. The photo taken by a friend shows my unhappiness at being banished to the hospital again. But, wadda ya gonna do you know?

Sleep and Thoughts and Thanks and Hugs

2008-07-22T09:10:00.004-05:00

I actually got a pretty good night's sleep last night and it was the first night in a bed since the surgery (19 days ago now). I didn't have to put my feet up, but still had to sleep on my back. The only drawback was the Cyclops dog, Candy, she wanted up about every two hours to go on "bug patrol". She is quite the bug chaser and I guess the heat has driven some bugs from the outside to the inside. So, up and down and up and down. It was sort of like being back in the hospital with one of the nurses coming in every two hours for either blood, vital signs or just generally to be sure you weren't getting any rest!

Anyway, it was the beginning of some good nights I hope.

On another note, if this surgery is looming for you or someone you love, fear of the unknown is going to be natural. You will worry yourself sick over things you really can't control. You will read about all the bad things that can happen and so forth. My advice is to take them into consideration and brush them off because the outcomes now-a-days are so much better than before. This surgery is almost like an assembly line. Each person does have their own risk factors though, such as diabetes and smoking and a completely sedentary lifestyle, but those are in your hands generally. Maybe one day we will eliminate the need for any sort of heart surgery. The younger your age when you start doing the right thing in your life, the better off you will be as you get older.

Thanks again to all those following me through this and I know your prayers and positive thoughts have been instrumental in making my progress so speedy. And don't forget, tell those you love that you love them every single time you see them. Hugs help too. People need hugs.