So Far So Good!

So Far So Good!

It has been 27 days since my closure. Tomorrow, will mark 4 weeks. In these 4 weeks, life has made a dramatic turn for the better. My throat is 100% healed up and the bruise at the catheter sight has almost completely faded.  

The most noticeable change has been in my energy levels. I sleep amazing (most nights) and wake up rested. Even better yet, I end each day will some energy left in my tank! This is a dramatic change from my tank running on fumes by noon. In fact, last night, I slept 7 straight hours (which was unheard of before the procedure). I woke this morning at 5:15 without an alarm feeling rested! I felt so wonderful, I decided to get up and go swim. Keep in mind, I left a warm bed to go outside in the WINTER and by choice jumped in the cold pool. It is now evening, and I still have energy left to write this after a full day in my fourth grade classroom, coming home with my kiddos, and making dinner. What a total change from the last few years!

My incidents of headaches has also decreased dramatically.  I think I have only had 1 this entire month. My palpitations are not noticeable most of the time, although, sometimes still present. I have also been told, I seem calmer and more relaxed by many people including my family. It is so amazing to not be dragging myself through life.

According to my Movescount account, I have exercised 16 times since February 7, 2015. For those of you who don't like math, that is 16 out of 19 days that I have been able to move! I have burned 2639 calories biking or running (the only time I wear the actual HR monitor). In hours, I have biked 5:05, run 2:17, swam 1:10, and skate skied 0:43. I have also completed 3 CrossFit workouts (modified, don't worry nothing crazy).  

This exercise has definitely had some ups and downs. I do pay very close attention to my HR (heart rate) and RPE (rate of perceived exertion). There have been a couple workouts I have finished where I have thought, "What have I done...."  for a couple hours. When this happened, I used it as a gauge to step back do less the next time. It has been a challenge for me to figure out where to begin with my baseline.  It has been 5 years, since I have had to start completely over from scratch.  Overall, though, I have been feeling great during and after each workout and am delighted to be back in the saddle.  

I am learning to check my ego at the door and listen to my body VERY closely.  As a former personal trainer, I know it takes 2 week to lose an endurance base and 6-8 to gain it back under normal conditions. Therefore, I am only half way there.  The great unknown is how my heart will respond and regulate with increased activity.  Right now, I am happy to report, so far so good.

Lessons Learned

10 Lessons Learned

The road to recovery and a better quality of life lies ahead, as this struggle (discovery of a PFO and 2 ASDs and closure of these holes) comes to an end. As I reach this crossroad, it is important to take the time to reflect on the lessons learned as a result of this health scare, in hopes that moving forward I keep each with me. I will need to read this post often..... 

I strongly believe that each struggle we are handed is to help us grow as individuals.

My 2 week follow-up was Monday, so it seems an appropriate time to reflect upon my journey. I am thrilled to share that my resting heart rate was 58 and my blood pressure was 120/68. Things seem to be settling back to normal levels. Now, I get to progress cautiously as I continue to add exercise back into my daily routine. I am 3 weeks post closure today!

The lessons I learned over the past 2 months.

1.  Priority #1 = Family
Never ever take this for granted. I missed my girls like crazy while I was in Denver for my procedure. Nothing will ever match their beautiful smiles and hugs. I am SO thankful that Dean was there with me. He is my rock. Having him by my side is a gift that I will forever be thankful. 

2.  Live for Today, as Tomorrow is NOT a Guarantee
This was an awakening for me. Anything can happen at anytime. Today is a gift, treat it as a gift. I am so thankful for each morning that I wake up more alert and energetic than ever before. I have been given an amazing gift of a better quality of life for that I am so blessed.

My girls

3.  Show Gratitude Everyday for:

Family

Friends

Health

Nature

Fulfilling career that provides for my family

I am noticing more peace and gratitude in my life as I reflect during my drive to and from work, during my bike rides, runs, and swims. Everything just seems so much better now. This goes with #2; what a gift it is to be able to enjoy all the things I love again. Even front squatting 25# yesterday was such gift!

4. Accept Help; It is OK to be Human

Dirty Bird Liftoff Thanksgiving 2014 Pre-Closure

This was probably the hardest lesson for me to learn. In fact, I am fairly certain that I will be working on this one my whole life. I have always prided myself on being able to take care of myself. "Little Miss Me Do It", my mom has said this more than once in reference to me. Being the oldest child and a natural care giver, it has never been in my nature to let others help me. However, I got to a point where I was so exhausted pre-procedure and felt so crappy for a several days after, that I realized it takes a village. I am so grateful for all those who stepped up to help. I couldn't have done it without all of you! I also learned how helping others in their time of need or allowing others to help you, can bring friendships closer together. I am forever grateful for this lesson.

5.  Listen to Your Body 

If you think something is wrong, trust your judgement and keep seeking out answers, you are probably right. After several years of frustration, we finally found answers. I was unwilling to accept the quality of life I was experiencing. Knowing your body, paying attention to changes, and not stopping until you find answers can save your life. Had I not kept searching, these holes may not have been found for a long time, and irreversible damage could have been done. I am so lucky these were found BEFORE experiencing a stroke or heart attack.

6. Find a Great Healthcare Team and Advocate for Yourself
I am so impressed with how fast I was able to have my procedure completed. From diagnosis to closure was less than 2 months. Once we figured out the root of my problem, things seemed to move quickly. Although, while in it, it felt like snail pace. My heart goes out to those in my PFO Facebook group who have been waiting for many years due to insurance or other issues. 

7.  Technology is Amazing

44 years ago, my mom had an ASD repaired via open heart surgery. The recovery time in the hospital was 10 days followed by several weeks at home.  My closure was done via my femural vein with a catheter while cameras were sent down my esophagus.  Instead of sutures, a Gore Helix and a Amplatzer Occluder patched my PFO and 2 ASDs.  This involved 1 night in the hospital and 1 week of recovery.  Enough said.

8. Embracing New Hobbies is FUN!

Having my exercise limited to brisk walks forced me out of my normal routine. Because I am a busy body and not one to willingly spend time holding down the couch, I was left no other choice than to explore new hobbies. In the past 2 months, I have taught myself to crochet.  This is something I would have never done had I not been forced to sit still. My girls are thrilled! I also started blogging which has been a great motivation to have a purpose for writing and an outlet to work through my struggle. Last, I returned to yoga more regularly so that my body wouldn't turn to stone sitting on the couch. All three of these new hobbies are things I am planning to make time for even when I am back to my normal routine.

9.  A New Exercise Mindset  
This is definitely one of the harder transitions with which I have struggled. I have always been an athlete and have the mindset of an athlete. Let's face it, I want to be the best at whatever sport I am participating in and will often rearrange my world for a goal. To say I am competitive, might be an understatement. Now that I have been cleared to continue a "normal" exercise routine, I am working on changing my outlook from that of an athlete to that of an exerciser. What is the difference?  (Read this article Are You an Athlete or an Exerciser?; really it is enlightening.) Right now, I am learning to take my ego and competitiveness out of my workouts. I really don't have a choice. In fact, yesterday, I did front squats with 25 lbs and a WOD with power cleans at 35 lbs. I also faced away from the clock. This was very hard for me to do in a gym filled with other people. My runs and road rides are slow and shorter than they have been in years. However, I am so grateful to be off the couch and moving.  Will I train for a competitive goal again?  Yes, I hope to....soon.  First thing is first, RECOVER!

10. What Doesn't Kill You Makes You Stronger
I am confident that I am a much stronger woman as a result of this experience due to all of the above reasons. Even though, I would have rather not gone through this, I am convinced that it is something I needed to experience in order to move forward with my next 40 years in a more enlightened fashion. Life has a whole new meaning now.

Oxygen - What a Difference

Oxygen - What a Difference

Views from my first bike ride back.  Squaw/Baldwin Loop

Exactly two weeks ago, on the eve of my procedure, Dean and I were enjoying dinner at Chili's, as we discussed the changes that were to come. At this time, we could only speculate that I would feel better, but we had no idea what lay ahead. There have been several ups and downs, but overall I am thrilled with the results I have experienced to date.  

Immediately following the procedure, as I was coming out of the anesthesia, I noticed  that my hands were warm. It was a weird sensation as it came from the inside. However, the next day, Dean commented that he felt like he was holding someone else's hand, because my hands were so warm.

Today, also marks day 1 of week 2 being back to work. There has been a noticeable difference in the energy I now have to keep up with my fourth graders. I am not dragging myself through the week like I did prior to the closure. It is amazing to experience the improvement in my energy level at the end of a Wednesday despite spending a large portion of last night coughing, missing out on precious sleep. 

During the day, I also feel much more alert.  Getting out of bed in the morning has become much easier as well. It is amazing the difference oxygen can make!

In my opinion, the best part is coming home and having enough energy to be present and enjoy my girls after a long day at school. I look forward to seeing them so much more, because I am not so exhausted. My patience with them has also increased which just allows me to be a better mom. 

Before my first workout post procedure.

Now that my resting heart rate is in the 60s and palpitations are rarely noticeable, I have also been able to return to exercise.  This has been both exciting and humbling.  I am thrilled to be outside in the beautiful 50 degree weather feeling the blood pumping though my body again. After 2 months off, I am definitely out of shape and am starting completely over....I am trying to be patient with the process, but am struggling with starting from ground 0.  I worked so hard to be where I was, it is frustrating that those gains can disappear so quickly. I have put in a total of 4 days of exercise and am really focusing on keeping my effort levels and heart rate at zone 1.  This is my plan for the next month.  After that, I am really excited to see where this improved heart can take me!  I am in awe of what a difference some oxygenated blood can make.

Next, I need to kick the sore throat that I have had ever since the procedure......but continue to be eternally grateful for all the improvements in my life. It is amazing to wake up each morning and accept each day as a gift, even on the hardest days. 

Becoming Bionic

Becoming Bionic

On January 29, 2015, the alarm woke Dean and I up at 6 AM sharp in order to begin the preparations for my 8 AM procedure to fix the 3 holes in the wall of my atrial septum; 2 ASDs and a PFO that had been there since birth.  The early morning preparation and emotions felt very similar to those I commonly feel on race morning.  There was much anxiety, excitement, and anticipation in the air. Dean and I even dressed for the day in our team shirts.  We chose these particular shirts, because growing up in a Finnish family with a mother who is 100% Finnish, I had heard this spoken about often. Dean and I recognized and brought this part of my heritage back into the forefront of our lives, as we started CrossFit last fall.  These are actually Rogue t-shirts.

According to Wikepedia: Sisu is a Finnish word generally meaning stoic determination, bravery, resilience,^[1][2] perseverance and hardiness,^[3][4] supposedly expressing a peculiarily Finnish national character.

At 6:30 that morning, I checked in at the front desk of the University of Denver Hospital. Shortly after, I was taken back to a room. I was given a hospital gown in which to change.  I was bummed to have to trade my team shirt for the drabby gown, but what can you do?  

After that, several nurses entered the room.  One began asking me questions as the other nurse started an IV in each arm.  Then, 2 anesthesiologists explained to me what they would be doing to put me to sleep.  I was not entirely prepared for this portion of the journey.  I knew I was going to be put to sleep, but I had yet to realize that this was the scary part upon waking.  

After I got the 411 on anesthesia, I was visited by the main cardiologist's assistant.  It turns out he had just moved to Denver from Minnesota where he was working at the Mayo Clinic.  For some reason, the connection to Minnesota helped to put me at ease. Not sure why, since he was actually Ethiopian, but he seemed like a great guy!  Of course, once he left the room, Dean had to comment that he was probably a good runner, since he was small and from Ethiopia.  He did kind of look like a runner.....

Sorry for the random thought...... after at least 3 trips to the restroom, apparently I get nervous bladder before surgery just like I do for athletic competitions.... the Dr. from the cath lab finally came.  I my goodbyes and I love yous to Dean and was wheeled away.

Once, I was in the cath lab,  I met the main anesthesiologist.  The only thing I remember about this portion was talking about my new mountain bike with 2 of the anesthesiologists.  Apparently, one of them has a daughter who just bought a new tri bike.  However, before I was able to ask about the bike, I was asleep. Some nights, I wish I could fall asleep that quickly.

Upon awakening, I felt horrible.  I had no idea how awful it can feel to come out of anesthesia.  It was not a fun experience.  Luckily, it did not make me vomit, because my throat was extremely raw.

I vaguely remember the cardiologist's sweet nurse coming to visit me as well as a few other medical people to poke and prod.  Dean had already been briefed by Dr. Carroll and learned that all went well with the procedure.  

The procedure had taken roughly 3 hours to complete.  I now have a 30 mm Gore Helix Occluder and a smaller Amplatzer Occluder housed in the wall of my septum.  A 30 mm Gore Helix device was used to repair my 1 inch PFO and a 3-4 mm ASD.  An Amplatzer device is now filling the space of a second 3-4 mm ASD.   In all, I had 3 holes patched.  

Gore Helix Occluder being placed over holes in the septal wall.

These devices were inserted into place via a transcatheter procedure through my femoral vein. The cardiologists monitored the procedure via cameras in my esophagus. 

After the procedure was complete, I had to lay in bed flat on my back for 3 hours.  This was to allow the blood to clot in my femoral vein.  This part was not real pleasant either.  I am not a back sleeper.  I was so excited when these 3 hours where over!

I was able to leave the hospital the following day around 11:30 AM after having a magnesium IV, 4 huge potassium supplements (they had found these levels were low in my labs done that morning), and a (transthoracic echocardiogram) TTE.  This showed that the holes where repaired correctly. Thank goodness!  There were almost no bubbles crossing the wall at rest and very few when performing the valsalva maneuver.  (For notes on what a bubble test involves see Faith Under Stress post.)  The doctor said the holes are 90-95% repaired and within 6-12 months, tissue will grow over them and the will be 100% repaired.  This TTE will be repeated at 1 month, 6 months, and 1 year.

The procedure to close these holes was approximately 5 days ago. Since then, I have had many ups and downs physically and emotionally.  The scariest part for me is that my RHR (resting heart rate) has been 80-90 bpm.  This is 30 or more beats above my normal RHR.  I have also had periods of time where my PVCs (palpitations: skipping heart beats) has been up to 7 in a minute. This makes me feel incredibly nauseous. 

I went in for an EKG and labs yesterday afternoon.  Things look good, so far.  My throat is 95% better and my groin area is only slightly tender.  I still need to take it easy for a little bit longer, but Dr. Carroll did say that I am allowed to begin light exercise 1-2 weeks following the procedure and competition like training after 1 month if all is going well.  I am looking forward to this process very much.  

Yesterday, and today, I enjoyed the beautiful weather and went for light walks.  Yesterday, my walk was 15 min HR was mostly in the 105-120 range.... Today, I was able to get in two walks 20 min and 15 min.  Heart rate was similar.  Seems weird to have such a high heart rate while walking.  I am hoping that things will calm down soon.  As I sit here typing my RHR is 75-85.  If I can continue to make progress like this in the days to come, I will be thrilled!

A card I received from a friend in MN.  Thanks Matt.  You always did believe in me.

I am pretty excited to test out my new bionic heart (slowly, I promise). It just sounds pretty darn cool to say.  Girl of Steel, otherwise know as Supergirl; I am looking forward to feeling more like this version of myself. Thanks again for reading and continuing to be with me on this journey.  I am excited to author future posts continuing to update progress.  Til next time!

Amazing

Amazing

Amazing is the most fitting word I could think of to describe the friends and family I am so thankful to have in my life. The word doesn't even seem an adequate description of those who have surrounded me with love, support, and encouragement over the past 2 months.  


I feel so fortunate to have had this challenge thrown my way, because it has taught me so very many things already. The most important lesson has been that of friendship.  More specifically, how to be there for someone during both the good and bad times. I have learned the meaning of true friendship from being on the receiving end of such an outpouring of support. 

A single day has not passed since I found out about the holes in my heart where a friend or family member has not reached out to me simply to ask how I am doing in the form of a phone call, e-mail, or text message. Most days, I am the receiver of several of these messages.  Everywhere I go in this small, little mountain town whether it is to the grocery story, local coffee shop, or even Mass, I am flooded with well wishes and hugs. A few weeks ago, it brought me to tears after Mass.  Thank you to all the friends who have come to visit, brought food or cards, or sent messages since I returned home.  


I am so thankful to live here, and the opportunity to be surrounded by such amazing people. I have made such wonderful friends over the past 10 years.  I could not imagine living anywhere else. This has become home and friends have become family.  

Faith Under Stress

Faith Under Stress

To say yesterday afternoon was stressful is an understatement. Dean and I were looking forward to my much anticipated consultation appointment with the cardiologist Dr. Carroll at the University of Denver Hospital.  Traveling from Cheyenne, we made a list of the questions I had regarding the procedure and recovery. We stopped for lunch at Chipotle, even eating outside as it was 70 degrees!

Once we found a parking spot on the gigantic hospital campus, we walked to the Anshutz Inpatient Pavilion.  After winding our way through many long hallways, we finally found the cardiology and vascular wing on the 3rd floor.  Here we checked in and waited.

Once all the basics including vitals were taken care of, I was finally put into a room and was able to meet Dr. Carroll's nurse and nurse practitioner.  Finally, he arrived.  

Needless to say, the appointment didn't go as I had envisioned.

First, the disc that I picked up from Sage West the day before, did not contain the content that the team needed.  We had requested my transthoracic echocardiogram (TTE).  The disk instead contained a CT scan.  This was not even of me. Second, I learned that Dr. Carroll had not even received nor was aware that I had had shunt study completed in Casper in early December.  Third and most shocking, Dr. Carroll explained that as of then, he did not have the objective information needed to justify the closure of my holes.

"WHAT?"  I though.  I had a pretty hard time hiding my surprise.  All I could think was, "Why are we here then?  What is the alternative? AND How can I continue to feel like this the rest of my life?"  I couldn't even fathom being limited to brisk walks for the rest of my life.  I am 35 years old!  Am I just going to wait for a stroke or heart attack to occur?  I should not be feeling this crappy. I should not breathe hard during a brisk walk.  Needless to say, I am pretty proud of myself for not bursting into to tears that minute.

So, the plan was to have another TTE and bubble study and repeat all lab work.  Also, the nurses were to take me for a walk and measure my oxygen levels to check if there was a change from sitting to light exercise.  Dr. Carroll needed an objective measure that the holes in my heart where not an incidental finding and are actually causing problems in the function of the heart.  He stated, if the right ventricle is enlarged, it will mean extra stress is being placed on the heart and this will warrant closure.  

I had been told by the cardiologist in Casper the right atrium is enlarged, but nothing about the right ventricle.  I got very nervous that we wouldn't find what we needed to find in order to keep the procedure scheduled.  Most of all I was worried that I would not be feeling better any time soon.

"Ok," I said, "but what if we can't find a reason to need to close these holes?  What then?"  Dr. Carroll said that then we will need to continue to investigate what is causing my symptoms.

So I began praying.  Almost the entire time I lay on the bed during the TTE, I prayed.  I asked God to reveal what they needed to see in order to help me become well again.  I asked him to only do this if the closure was truly what would help me to feel better soon.  (I do not want to have a procedure that will not help with my current symptoms.)  I kept repeating, "Please let everything turn out ok," as I wiped tears from the corners of my eyes several times.

Thank goodness my rock Dean was right there with me the entire time.  It is amazing how long 45 min-1 hour can feel when you are stressed.

Soon after we returned to the room, Dr. Carroll returned.  He came back shut the door with authority and said, "We will absolutely move ahead with closure on Thursday morning."  

"Thank God!"  I said my shoulders dropping several inches.

He explained that the TTE showed that my right ventricle is enlarged and also that I have bilateral shunting.  This would explain why I feel so terrible.  He said my oxygenated blood and deoxygenated blood are mixing together. He used the words aneurysmal and fenestrated.

Later Dean explained to me in normal people language that basically my septum is like a thin piece of swiss cheese.  It has several holes and is a thin flap. (The exact number of holes will be determined on Thursday.  The Dr. thinks at least 3.)  He described it as plastic blowing in the wind.....  

Seriously, I still can't believe it.  But I did see it flapping around on the screen with my own eyes.  I also saw the bubbles go right through right to left instead of left to right like they are supposed to do.  

Editor's Note (Written by Dean):  A bubble study is where bubbles are injected into the veins which are delivered to the right atrium where they are supposed to go to the right ventricle and then the lungs.  In a normal system, the bubbles are filtered by the lungs and do not return to the heart.  If there are bubbles on the left side of the heart, it means something is wrong.  

The bubble study wasn't just "positive", it was shocking.  When you can impress the cardiologist (who has done 600+ of these procedures) you know that there's something really wrong. 

Most shunting (blood flow through the leaky heart wall) will go from left to right as the left side of the heart is higher pressure than the right side.  This causes the right side of the heart to have to process some blood twice, effectively increasing its workload and causing the heart muscle to get bigger and stronger due to the stress. Ann's shunting is the opposite of what is expected, her deoxygenated blood has been passing through the holes in the atrial septum and then being pumped directly out to the body, effectively skipping the lungs and their required oxygen.  Even though the majority of the flow is right to left, there was still enough left to right shunting to cause increase in the size of the right side chambers of the heart.  Whether or not blood is going right to left or left to right is dependent upon what Ann happens to be doing and the position that she's in at any given time. (end Dean) All of this apparently makes for me feeling pretty cruddy.

Needless to say, I am relieved that we are going to go ahead with the procedure.  Dr. Carroll did say there is a 5% chance that when he gets in, he won't be able to close the holes percutaneously.  In that case, I would need open heart surgery. 

 I have continued to pray all day today that all goes well, and I will not be that 5%.  Either way, I know with faith, all things will be okay.  Thank you all for your continued love and support.  

Isn't It Ironic

Isn't It Ironic?

Irony: On September 11, 2011, I finished Harvest Moon Half Ironman Triathlon in Aurora, CO.  I am sure that I had a view of the University of Colorado Hospital from my hotel room and didn't even give it a second thought.  Fast forward; a little over 3 years later, I will be visiting that very same hospital this week to have my ASD and PFO repaired via a cardiac catheter procedure in which two patches will be placed over the holes.  I have been told this procedure will take anywhere from 4-6 hours.  I finished the Half Ironan in 5:36:05.  Irony.

Taking the irony one step further, I listened to the book, Unbroken, during my 6+ hour drive to the race as was recommended by a friend and neighbor.  What an inspirational story.  The movie came out last month.  Dean and I have been putting off seeing it in hopes of catching it while in Denver. This to be a "restful" outing on the day between my appointment and procedure. I don't even think I need to explain the irony in the title.

It amazes me how so many things in life end up coming full circle. Past experiences prepare you for future battles.

I admit it. I have been struggling to face the unknown.  However, this morning while sitting in Mass a sudden realization hit me. Going into this week, I have felt exactly how I feel one week before a big race.  Nervous; Excited; Scared; Unsettled; I think I have even noticed some adrenaline..... Sound familiar?  Then, a wise, little voice whispered,  "Use what you know.  You have faced so many physical challenges successfully.  You can do this, too. Be strong." SO TRUE!  I can do this. I will come out of this experience a stronger person.

In many ways, the challenge I am facing at 8 AM on Thursday morning is not much different than what I face at any start line in any race.  Most of life's challenges come down to what is between our ears; MENTAL.  Our bodies are capable of so much if we just let go and trust that they will carry us through.  When racing, I am putting trust in all the hard work and training that I have done in the months prior knowing my body is strong and can handle it. Although this is a different challenge, my body is still strong and can handle the task at hand.  In fact, it will very likely come out stronger in the end.  

Now, I know what I must do.  This week, I have to put trust in the training of my cardiologist.  This part is much harder for me, because I do not have control over this aspect.  Once I am put under anesthesia, most of the outcome is in the control of the doctor and his team.  I HATE NOT BEING IN CONTROL. Everyone who knows me knows this.  

Therefore, today, I am choosing to control the things I can and try to trust in the things I can't.  I will trust that I have chosen a fantastic doctor at a good hospital.  Someone (I wish I remember who) told me a few weeks ago, "Remember these doctors do these procedures like moms change diapers."  That has stuck with me and comforts me. So, I will make my lists. Grandma Brenda, will then know my girls schedule and important phone numbers, while she is here taking care of them.  I will leave good lesson plans for my substitute teacher, to ensure that my classroom runs smoothly in my absence.  I will pack my bags with all the items I will need this week.  

Tomorrow at 4:30 PM, I will give my girls the biggest hugs and kisses ever. I will bravely get in the car with Dean and leave everything here in good hands.  I can do this.  One step at a time. One foot in front of the other. I CAN DO THIS.