Saturday, December 25, 2010

Merry Christmas every one!

Seven weeks and one day since surgery.  The past 10 days have been ones of noticeable healing and decrease of pain.  Each day I notice some significant occurrence or movement that hurts far less than those grueling three weeks after surgery.

For those of us from the west or who derive from a western Christian experience, Christmas is a holiday of celebration, giving and family.  Certainly, the giving aspect has become dominate outside of faith circles, but I am not exploring the area of crass mercantilism.  Among people who hold onto remnants of tradition, the history Christmas lies in the birth of Jesus of Nazareth some two thousand years ago.  Yet the heart of Christmas lies in something far more transcendent.  The spirit of Christmas lies in the hope for eternal healing.  This hope transcends western experience.

Since starting this blog, its been visited several thousand times, with nearly thirty percent of visits from outside the U.S.  So, many of the visitors have lived outside a western experience.  I offer to all of us that when I search out the heart of this holiday, it remains something far more significant, more ethereal, more transcendent than gifting, receiving, and family gatherings.  Christmas represents our search for meaning; a meaning that includes rising above the depravity of pain and suffering.

The pain in my back and upper chest reminds me of the surgery and the days of suffering afterward.  As the scar begins to fade and the pain abates, my suffering from the events seven weeks ago will become a fading memory.  Throughout this experience, I have reflected on people I know who suffer far more than me due to man's depravity.  Boys who have been forcibly conscripted into horrible wars before puberty, girls raped due to ethnic violence, children born into an environment of dirty water and dysentery, and starvation only to name a few.

Christmas represents the eternal hope that this experience is a comedy; that in spite of all man's depravity, this thing we call life all ends well; that Shakespeare and Dickens got it right.  "God bless us every one! said Tiny Tim, last of all."

Sunday, December 19, 2010

Yawn

Six weeks and one day (November 5) after open heart surgery, I yawned relatively pain free for the first time.  I haven't blogged in the last several weeks working to catch up.  This evening while watching a Fleetwood Mac concert on TV and talking with Tucker about the holiday dance he attended, I yawned deeply and realized that the chest pain has begun to lessen significantly.

Anne and I traveled to New York for business, to visit family and to attend the Charity Water Ball (www.charitywater.org) last Monday.  Anne, a group of friends, and I gave a well for my 50th birthday.  The well will soon be dug in a community of the greatest need in one of the poorest areas of our world.  We moved slowly through the airports and Anne did the heavy lifting.  Though most of my energy has returned and all of the wounds are healing well, the movement of travel left me quite sore each evening.   Yawning, coughing and even laughing deeply were all quite painful.  So, to yawn this evening and feel little to no pain was quite nice.

Tuesday, November 30, 2010

Week three

Last Friday was the three week anniversary of my surgery.  I was and am very thankful for the good result from surgery, but didn't want to write a nostalgic reflection.  As a French friend emphasized, I am lucky to have both good healthcare and insurance.

Technically, week three has ushered in significant improvement.  I have begun exercising, walking at least thirty minutes a day.  Yesterday, I climbed back onto a stationary bike for an easy fifty minute ride that felt great.  The pain has decreased sufficiently that I am now sleeping five to seven hours a night.

The interesting physiological effect was a noticeable lack of confidence for the the first two and a half weeks.  A deep sense of mortality and simple pain were the catalyst of this effect.  Week three seems to be significantly different.  Possibly the depletion of drugs from my body, plus the decrease of pain, plus a sense of overcoming has lead a feeling of tepid confidence.  You know folks, death is near; either you face it or fear it.  Fearing it inappropriately will not extend your life.  I write this because of hearing too many stories about people who put off seeing a cardiologist, resulting in a fatal heart attack.  A heart attack isn't the recommended metric for measuring your heart health.

Sunday, November 21, 2010

Now

Its now two weeks and two days since my sternum was cut and three heart arteries were bypassed utilizing a vein from my right leg and a mammary artery.  I walked with my good friend, Hugh Jones, for over 30 minutes today in the beauty of a cool autumn evening.  Though I feel tinges of pain in my rib area and my right leg, I am recovering rapidly and, at moments today, felt better than before the surgery.  Would you give two weeks of pain in exchange for twenty years or more of a healthy heart?

I have had several friends ask for a description of the symptoms that lead me to talking with Dr. Swords (my general physician) about having a stress test.  On review, the key symptomatic correlation was that I felt the symptoms while exercising actively: at first, tingling in my right thumb, later some tingling in my right arm, and also the feeling or need to burp.  But, these symptoms were not "strong".

Don't become paranoid, but if you clearly have symptoms that cause you some concern, talk to a physician, now.  Don't wait.  Talk with someone who has heart damage, and he or she will tell you, don't wait for a heart attack to learn that you need medicine, a stint, or a bypass.

In my pre-operation meeting with Dr. Gerhardt (surgeon), he indicated that if all goes reasonable well, I should be snow skiing, maybe even racing by early February.  Right now, at my current pace of recovery, I am feeling more confident, each day, that this may become a reality.  So, don't wait to face your reality, whatever it is, act now.

Feel free to write me if you have questions.  My private email is belboro@mac.com

Friday, November 19, 2010

Sonogram this morning

I'm off to have heart sonogram.  This is normal follow up to verify that no fluid is collecting around the heart.  Surgery was two weeks ago today.  I am feeling good.  Will walk for 30 minutes to an hour today.  Sleep is still a problem, but feeling less pain at night so as I exercise more, I am hoping my body will call for more sleep.

Thursday, November 18, 2010

Letter to Sarah Palin

Dear Sarah,
I've heard that you've been read'n my blog.  Wow, Alaska looks like a wonderful place.  With my improved arteries, I should be able to get there someday.  Anne and I hope to see you when we visit.  As you probably know, Anne and I lived in the Washington DC area after we were graduated from university.  You'd be happy to know that I worked for the Republican Congressional Committee.

I really don't recommend the place for a gal like you from Alaska.  For one, you can't shoot in the backyard.  This is really frustrating since there is an over population of raccoons and other rodents.  Washington is full of democrats and you can't shoot them either.  They are everywhere and vote for all kinds of silly things: roads, bridges, national parks, and so on.  You wouldn't believe it.  Oh, and Congress, they are constantly disagreeing with the president, but you would like the veto thing.  Overall, I don't recommend it.

On a more personal note, lately it's been rumored that you might run'n for president in two years.  Though me and a bunch of the boys down here in the south think you'd win, we really don't think its the right job for a refined woman like you.  Heck, you know how to dress out a bear.  That would be a darn waste of talent inside the beltway where there ain't no bears.  No, you can see Russia from your area, so we really hope you'll keep our border protected way up there where the sun don't shine (or does it shine all the time?).  I am also concerned for your appearance.  We just love watching you on TV, but did you see what happened to Bill Clinton?  Look at his pictures in 1992 and then in 2000, he looks, like, fifty years older.  That would be a sad shame if you became president.  Anyhow, I don't want to bust your balloon, but you and me, we've always been straight shooters, and frankly, I think the President of the United States should know a bit more.  Don't get me wrong, you know a lot about a lot of important stuff, like hunt'n, fish'n, sex'n, all that, but what 'bout the EU (whatever that is) and places like Serbia, and Kazakhstan, and Tajikistan and a bunch of other places we can't spell.  I'm sure you can balance your checking account, but do you have any idea how to balance a government budget with all those earmarks and social securities?  And, CDSs; everybody says they caused the credit crisis, but do you know how to stop them in the future, whatever they are?  Is QE2 a boat or what?  I ain't say'n you ain't smart or anything, I'm just hoping that the Republicans can find a President who knows a lot about small business job stimulation, Chinese-Indian business and political affair developments, a deeper sense of the financial markets and long term fiscal policy implications, and so on.

I ain't prejudice or sexist but maybe a mother of five who resigned from her job as governor should keep on do'n what you're do'n in Alaska.
Yours truly,
Byron


CC: Harriette Knox, Democrat

A few lessons I've learned

The most important lesson I have learned is be proactive with health.  Don't wait for a heart attack to warn you.  If I had waited, I might have had a fatal heart attack.  Listen / feel the signals your body is sending.

Several doctors, nurses, and friends have commented that too few of us are proactive about heart conditions and health.  Over 1.2m people in the U.S. experience a heart attack each year.  Of the 1.2m, approximately 425k die as a result.  Also, approximately 625k bypass surgeries are performed annually.

Should you get checked?  YES, particularly if: 1) if you experience chest pain, strange arm pain or numbness; 2) heart issues are in your family; 3) you possess other risk factors: overweight, smoke, high cholesterol.

What are the various forms of a heart check up?
From simplest (and least invasive) to most complex
1. EKG - Electrocardiography - electrical activity of heart over time captured non-invasively.
2. EKG plus a stress test (walking on a treadmill).
3. Nuclear stress test - one is injected with a lightly radioactive substance plus an xray is taken before and after stress (walking on treadmill).
4. Cardiac Catheterization (CC) - a catheter is inserted into an artery in groin (old) or wrist (new).  Mine was performed through wrist.

I imagine that a new technology will soon emerge utilizing something like a sonogram or MRI, plus software that digitally reproduces the hearts activity, i.e. a virtual heart and surrounding vessels on screen.

Should I skip straight to the CC?  CC has its own risks.  Seek the advise of good doctors, and trust their advice.  But, we are in an era of significant technical advancement in healthcare.  I strongly encourage a diverse and well rounded health education, particularly respective to one's genetic ancestry.   My family has no prostate cancer history, but does have heart (artery) issues.

Monday, November 15, 2010

Scar II as of 11-15-10

More than 25% of the visits (total visits in last 14 days have been 1,886) to this blog have been visitors viewing the scar.  Humans like the Macabre, so here's Scar II

Sleep

During recovery, a nights sleep has been the most difficult conflict.  I write conflict because as the night approaches, I am almost apprehensive about facing insomnia resulting from the inability to achieve a comfortable sleeping position.  Like many of the simple, routine activities of daily life, sleep is desired, yet night is dreaded.  Sleep was often one of those activities I take for granted.  Others, like shaving (painful to lift arms and I can't lean on the sink edge), walking (I must pay closer attention so as to not slip or become too winded), phone conversation (enjoyable, but many times, I am tired and it contributes to a stiff neck), work (I love to work, particularly right now, with great people who are driven by vision and purpose), I appreciate much more.

I guess my point is that sleep contributes overall to health and its something many of us take for granted.  I returned to see my cardiologist, Dr. Nishan today.  My recovery is going well.  Next, I will have a sonogram of my heart this Friday to verify no fluid collection around my heart.

This sleep difficulty reminds me that I want to acknowledge the small blessings of life as well as the specific blessings that have saved my life: Dr. Nishan moving aggressively and working with his partner Dr. Cooper to identify my condition and get me scheduled for surgery; my friend and neighbor Dr. Gerhardt who really seems to have surgically fixed me in, at least to me, an amazing way; Nurse Portia Payne, who I will forever envision as an angel carrying me from the hell of pain, fear, and misery while in ICU.

So, I am writing this both for that person who is or has or will encountered this and for myself.  After two weeks of near insomnia, this too will pass. Someday soon, I will, once again, be back in a comfy bed for a full 7 or 8 hours of sleep.

Because I love U2's Unforgettable Fire disk, I'll leave you with a great lyric:


MLK

Sleep, sleep tonight
And may your dreams be realised
If the thundercloud passes rain
So let it rain - rain down on him
So let it be - so let it be

Sleep, sleep tonight
And may your dreams be realised
If the thundercloud passes rain
So let it rain
Let it rain - rain on him
--Bono and U2

Saturday, November 13, 2010

Mornings

Mornings are difficult.  The pain is worsens after being stationary during the night for 4-5 hours.  Typically, awakening at 4:45am, I shuffle around the house to get my body moving in search of pain reduction, usually light a cup of tea.  Its a terrifyingly fantastic moment of the day.  Its nice to add music to my tea.  This morning, I listened to this several times:
http://www.youtube.com/watch?v=Eo-UKCxCglg
Vedder at his best

Friday, November 12, 2010

Passing Time

Bright Star
Bright star, would I were steadfast as thou art -
Not in lone splendour hung aloft the night
And watching, with eternal lids apart,
Like Nature's patient, sleepless Eremite,
The moving waters at their priestlike task
Of pure ablution round earth's human shores,
Or gazing on the new soft-fallen mask
Of snow upon the mountains and the moors -
No - yet still stedfast, still unchangeable,
Pillow'd upon my fair love's ripening breast,
To feel for ever its soft fall and swell,
Awake for ever in a sweet unrest,
Still, still to hear her tender-taken breath,
And so live ever - or else swoon to death.
-- John Keats 1819

Wednesday, November 10, 2010

Still too tired to write a lengthy description, but here are a few important points

1.  Get checked early!  Don't wait.
2. Verify that your doctors are working together well.  Generalist with Cardiologist with Surgeon (if necessary).
3. Stay ahead of the pain.
4. People who care make the difference in life.  My heros are two nurses I haven't even met yet because I was so drugged, Samantha, and Portia Payne, my ICU nurses.  The first two nurses gently brought me out of anesthesia, held my hand, brought me back to life.  I'll find them and tell their story later.  Samantha (Sam) worked the 7PM to 7AM shift.  That shift in ICU is a little hades on earth.  Heart and lung alarms going off all night long.  Its a little like trying to sleep in Times Square after a beating.  Unfortunately, Sam was so busy, I didn't really get to know her.

My hero is Portia Payne.  She was incredible.  At each stage, she nursed me with health care, knowledge, and confidence.  For example, gently walking me through the extraction of two 1/2 tubes out of my abdomen (used to drain any blood that might collect around heart and lungs).  Saturday was, physically, the most miserable day I can imagine.  But, please, if you know a critical cancer patient, that is worse and they need our care and support much more than me.  Portia kept me positive and forward thinking spiritually, emotionally, and physically.  A few more Portia Payne's in the world and we would solve most of humanity's ridiculous problems.

Also, here are my two sweet at home nurses:
Sister Lynn and Anne


Tuesday morning!!  Only four days after open heart surgery.  At home in front yard for my 100yard exhausting walk. Wonderful walk!  Only 27 days of recuperation to go.

Tuesday, November 9, 2010

The scar

Behind this scar is an improved heart.  This probably isn't my only scar, but it's one that has taught me a profound and hopeful lesson.  A lesson of hope and of commitment;  a better friend; a better leader; a person committed to truth.  Veritas!  Thank you for the support.  I will write a more lengthy detail of the surgery and aftermath as I regain energy.

Thursday, November 4, 2010

In Search of Rhythm

In Search of Rhythm 
Loose rhythm and you loose life.
Tomorrow’s coming
Forty years or so search’n for rhythm
Tomorrow’s coming
One of those days that change us
Like the death of a newborn
In a far away place
Tomorrow’s coming
There was a day, I didn’t know
Now, don’t forget
Tomorrow’s coming
My heart’s a’beaten
I need your love
Like a rhythm unbroken
They need your love

Dear Friends,
Thank you from the bottom of my heart.  In these brief ten days, I have experienced fear, confusion, compassion, grace, exhilaration, love and much more.  More than once, my eyes have swelled tears - not only for fear - for the thought of those who don’t have this support.  I can’t imagine the fear and loneliness of facing any serious physical condition alone.  Anne, Michael, Megan, Katherine, and Tucker have felt so very close.  You, friends have have boosted my resolve, confidence and sense of humanity, a humanity that can effect magnificent change.  
I don’t understand the equations Green’s “String” nor the sequences of genetic code, but this process, deciding the fate of my heart, receiving encouragement from you, confirms more than ever to me that we are all, all of humanity connected by a force far far beyond my - our nascent understanding.  I marvel at the surgeons skill, but so much “risk” remains, so much we don’t understand.  There is so much we don’t know.  I can only hope and pray and ask for prayer that the surgeon’s skill is adequate.
A few years ago, a few friends, David Gentile, Anthony and Cathy Cordle visited us from Africa.  David described that in the bush, far away from the skill of an experienced physician, one isn’t endowed with the option to believe in the “almighty pill”, that person only possesses mere option to believe in God.  Does God use pills, apparently so, but I’m no expert; is love apart of the healing process, yes, and part of the death process also.  Folks, the world seems to be torn asunder by religion today, but this isn’t a new battle.  I have experienced a personal battle, and I have been armed by love to face the enemy.  My heart is strong, my will is strong, the rest is in God’s hands.... and His nurses and doctors.
With great love and fondness,
Byron

Wednesday, November 3, 2010

Albania

I've had a large number of hits on this blog from Albania.

Michael (my son) with Medi and Donika in Tirana

Albania is a small but proud country that holds a special place in my heart.  If you like to travel, put Albania on your bucket list.
Parker and I in Berat with Dorian

Pre-operation preparation - two days before heart surgery

More info for those interested in the technical process of preparing for heart bypass.

Today, two days before surgery, the doctors ordered a series of tests.  These tests provide the surgical team with current patient information.

First, blood was drawn from an artery (not vein) in my left wrist.  This was a fascinating experience mostly because of the high technical proficiency and personality of the flobotomist.  I admit, he just didn't look like a flobotomist.   He was a wily young man with 12 years experience drawing blood.  When I asked him of his prior experience.  He exclaimed that he had hung and finished sheetrock,  adding that he often helps some the nurses in little remodeling projects.  So, I had to ask if he found that the sheetrock experience benefited flobotomy.  "Come to think of it", he reflected in a pleasant rural North Carolina accent, "you know when your trying to screw an inside sheetrock corner?"  Yes, I said.  "Well" he went on, "if you don't drive that screw in straight, it'll twist and damage the sheetrock."  What a great explanation.  Ryan did a great job.

Next, I was ushered to a cardiac sonogram room.  The purpose of cardiac sonograms is two fold.  One help identify the possibility of stroke; and, identify blood flow in arm and leg arteries.  These procedures are conducted with my cloths on, buy the way.  The technician, who unfortunately I didn't get a name, squirted a gel on my neck, then used a sonogram device to record the flow of blood in my right and left carotid artery.  Basically, she was searching for plaque on the walls of these arteries.  Fortunately, she found clear arteries in my neck.

Two, she used a sound recorder and sonogram device to record and film the flow of blood through the arteries in my ankles, feet, wrists, and hands, my extremities.  Of particular interest was the two arteries in the wrist and hand, named palmar arch.  This site provides a good diagram: http://home.comcast.net/~wnor/lesson5artofhand.htm

These tests help the surgeon's knowledge of the patient and provide them with risk indicators.  They both indicated that I was in good shape according to their experience.  These processes required about two hours.

Tuesday, November 2, 2010

This Friday - details of surgery and recovery prognosis

This evening's blog is about the science of my heart surgery.  I hope that this helps others who either have personal concerns about their health or know of others who are experiencing heart health concerns.

We (Anne, Megan, Michael, and I) met with Dr. Ed Gerhardt, my cardiovascular surgeon,  today.  He explained that my Left Anterior Descending (LAD) artery is 100% blocked (very bad).  This probably occurred several years ago.  My Right Coronary Artery (RCA) is 60% blocked (bad).  This is most likely a more recent occurrence.  Interestingly, collateral arteries have grown from the RCA over to the lower section of the LAD supplying blood to that area of my heart.  This is probably why I have not experienced a heart attack.  If I don't go ahead with surgery, and if the RCA blockage increases, I could die of a heart attack.  Conversely, a successful surgery will give me a very high likelihood of many healthy years, and more ski racing!!

Surgery is scheduled for first thing Friday.  I will enter the hospital around 6am.  Ed explained that surgery will begin around 8am and last 4-5 hours.  By 2pm I should be in a Cardiac ICU room and awake by 3pm.  They would like me to walk with support by early evening Friday.  I will remain in ICU mildly sedated for one or two days.  Next I will step down to a intermediate ICU for two or so days.  During this time, I should be walking steadily.  He explained that the more I move, generally, the faster I will heal and recover, with the help of pain medicine.

If all goes very well, I will be home in three to five days.  The fact that I have not experienced a heart attack and am in pretty good physical shape, offers me a very high probability of relatively speedy recovery.  At home, he wants me to exercise (walk) as much as possible.  I should be back to bench pressing 150 lbs. by next Thursday - just joking - testing whether anyone is reading at this point.  Seriously, Ed said There will be walls that you didn't know existed in your home;  "suddenly you will be walking and hit that wall and you will need to rest".

The at home initial recovery is one to two weeks, then progress will be dictated by my resolve and ability to fight against laziness and my fight to recover.  The mean probability of success for this surgery and recovery is 98.5%.  This mean number includes all heart bypass patients in all age categories, so my probability number is closer to 99.9%, being that I am 50 years old and in good health.   During the next several weeks, if you read this and have questions, particularly questions about your emotional, physical or spiritual health, email me at belboro@mac.com.  I'll try to answer as best I can.

Monday, November 1, 2010

Schedule Upadate

Doctor called this morning.  He reviewed my charts and prognosis looks fine.  Anne, Megan, Michael, and I meet with him tomorrow at 4pm for preparation consultation.  Right now, surgery is scheduled for this Friday morning.

Poverty money and love from TED

Jessica is a very bright beautiful Stanford MBA grad with a big heart.  She and I pulled weeds at an inner city Washington DC half way house two years ago.  She told me this story.  I fell in love with Jessica's vision.  She now runs the world's most unusual $150m investment bank.  Take a few minutes to watch this.  If you're a HBS fellow, this is a good case.  Hope you enjoy this talk from Jessica at TED last year in Oxford, UK:

http://www.ted.com/talks/lang/eng/jessica_jackley_poverty_money_and_love.html

www.kiva.org

Sunday, October 31, 2010

The heart of an orphan

I have a friend who loves children, but particularly, he has a heart for orphans.  He's the kind of person who breaks the mold.  Now, I know, I know, lots of people "break the mold".  There's a lot I don't know.  Sadly, a lot of places I haven't visited, nor will I.  But, I've got a pretty good grasp on people and molds.  I'm a life long student, even entering an intensive program at Harvard in 2002 and have been studying there off and on for the last eight years.  Trust me for a moment, this guy breaks the mold.

He has been educated at three of the most prestigious schools in the world.  He has covetable job at one of the most prestigious investment houses in the world.  He is considerate, but he doesn't give a flying flip about any of the prestige.  He loves orphans.  He desperately loves his wife.  She is an orphan.

I met this friend in a London kitchen.  He didn't know at the time, but I had a sense our relationship would be profound.

Five years ago, Anne and I began dedicating our lives to what we call life changing things.  Similar to what John Replogle said at the Harvard Club panel last monday (read blog below), Anne and I have purposed to help others live better lives.   At the time, five years ago, I was embroiled in a miserable business situation; the type of situation in which there are winners and losers. Having written this, its actually like war, there are no winners.  Frankly, the notion of life changing things has been of interest to Anne and me since we married.  But, I wasn't very good at it then.  It's just that several situations in the last ten years have effected commitment within us at a higher level, initiatives at both personal and professional levels.

Back to the mold breaker.  I learned a very important lesson from this young friend; that we all feel orphaned at one moment or another.  Our hearts yearn for something more than money, fame, power, prestige.  Its at this point, that some, who have insatiable egos, begin to back up and say, whoa, this guy's a little touchy feely for me.  Sad part is, the most proscribed drug in the rich world are anti-depressants.  And, the rich down the pills at faster rates than the poor.  We rich are too often overfed, hooked on something, whether its power, sex or money.  But, more importantly, there is an inverse relationship between power, money and happiness.  So, my friend decided to break the mold.  He;s attempting to give away 90%, personally living on 10%.  If I were his boss, I would realize this is fantastic.  The guy'll have to work his butt off to live on the 10%!  But, this is how much my friend loves orphan kids.

Have you ever been to an orphanage?  Orphans are happy.  They want the most important things in life. They want to be loved.  They want to be fed.  They want a family.

When Lee Atwater was dying of cancer, he didn't want to help the Republicans get elected, he wanted to love and be loved, and forgiven.  One of the greatest CEOs in American business history, Colman Mockler, left a legacy of love, care, well, and great razor blades.  Do you think you'll want to turn another "deal" or win another election with your last day.  I'm sad if you do.  The self aware person will want to love another and be loved, like the orphan.

Reading this blog

The first blog is at the bottom.  It makes the most sense reading it from the bottom up.  Byron

Saturday, October 30, 2010

The last two weeks

Hi Folks,
This is for those curious about how I arrived at the point of needing open heart surgery, at 50 darn-it!

Two weeks ago today I felt fine attending a national conference named the National Association of Corporate Directors (NACD) with my colleague Phil Johnston.  The NACD is an association of mostly forward thinking corporate directors interested in best practices in corporate governance.  It's three days of lectures and interactive discussions from 6am through 9pm.  I felt fine.  Returning home Tuesday, Anne and I enjoyed a pleasant ride through Charlottesville and the rolling Virginia Countryside bursting with autumn color.

The next two days were filled with follow up work from the conference, plus new business and ongoing development of V2 of our website.  Feeling fine.

Thursday (9 days ago), I went in for a scheduled physical with Dr. Bruce Swords.  We've know each other for years so the conversation is quickly and easily to the point.  I mentioned to Bruce that I should probably get some further testing as I've felt a strange feeling while exercising; part of the feeling was a very slight burning like sensation in my chest but it felt more like my esophagus, so we thought it might be an upper GI issue.  The other feeling was a very strange, very slight nerve pain or even numbness feeling in my right thumb.  Usually these sensations occurred with my heart rate above 150, considered a fairly high rate for a 50 year old.  Anne and I attend a "spin" class one to three times a week.  Beyond spin, I try to get to the gym, plus I walk, some weeks, considerably.  Beyond scheduled exercise, I also play golf three to five times a month, often walking.  In winter, I ski race on the local ski team.  You get the picture, I'm not sedentary and I can maintain a high heart rate.  Bruce scheduled a stress test for the following Tuesday.

Friday, was a normal somewhat long work day.  That evening I had the nice surprise of an old friend Carey Redd in town on business but with a free evening so he and I dined at the Proximity Hotel's Print Works Bistro.  Aside, Proximity is the world's first LEED Platinum hotel, a big deal in the sustainability business world, and Dennis Quaintance, an outstanding local business leader, proclaims that the benefits are economic, not merely environmental.

Last Saturday, spin class in the morning, then work around the yard.  While working in the yard, I noticed Ed and Lori practicing dance steps in their back yard, for their wedding reception that evening.  Ed's my heart surgeon neighbor.

That evening, we put on our evening dress and went to dance the night away with Ed and Lori, Barrett and Kristin and others on the rooftop terrace of the art deco Kress building .  It was one of those dreamy, beautiful cool autumn evenings when the atmospheric conditions cause the distant lights to sparkle like signals from afar. The city was buzzing with activity and nightlife.  While dancing I felt just the faintest tingle in my right thumb again, but the beauty of my lovely wife dispelled any concern.

Sunday was routine, enjoying the morning with Anne and friends at an inner city church that rocks with great music from my friend Steve Lynam, who I knew long before moving to Greensboro.  What a voice.  Then Bill Goans delivered a message about grace over sin.  Bill is another faithful friend, dear man, loving husband, paragon of a community leadership and pastor.  Bill is also a heart patient.

Monday was a heavy work day from early then ending with a very interesting Harvard Club of RTP panel discussion with: John Replogle (CEO Burt's Bees), Michael Jacobs (Professor of Corporate Governance at UNC, Kenen Flagler), Tony Frazier (VP Cisco), and Jim Whitehurst (CEO Red Hat).  The big takeaways were; "My purpose in life is to help others live better lives" - John Replogle; then overwhelmingly, these four aren't in "it" for the money.  Sure, they want to pay their bills.  But, Whitehurst proclaimed CEOs make too much money; they represent a growing ethos where the players are pursuant of a business model that first improves the world, does no harm, performs profitably, the triple bottom line.

Tuesday - D day.  No food, no coffee before the stress test.  This is the real stress test with lots of wires, sticky tabs all over the chest, nuclear dye squirted up through IVs.  Its a three hour adventure, really culminating in an inclined run on a treadmill; this is the "stress" part.  My blood pressure started with a typical 115/68 and rest heart rate of 56-60bpm.  Then, we started the test.  The kind technician (whose room is clearly "owned by her" posted with supportive prayer verses on the walls) took me up to a heart rate of 150bpm over the next twenty minutes.  Spin class is 45-50 minutes at 140-160 so this was easy.  When she said told me I could stop, I thought I passed with flying colors.  No, heart pain.  I felt good.  I felt I could have gone at least another 50 minutes to hour without trouble.  My blood pressure was ranging up to 130/80, still in the excellent range.

During a nuclear stress test, you lie under a radiological device twice, before and after the stress portion.  In total, the devices take hundreds of pictures of our heart and arteries.  I returned to the waiting area with my iPad working away, even lost in the pressing matters of that afternoon.  At one point, a technician walked out and a told a similar, but older patient that he could leave.  I began to think this "funny feeling" was probably only indigestion.  I have always had a sensitive stomach.

Mr. Loflin, "I want you to walk with me this way to see the doctor".  That wasn't what they told the other guy.  I immediately thought something was up.  "Something showed up on your pictures after the stress test that the doctor needs to review with you".  I was ushered into a private waiting room where the door was cracked open.  Its while sitting there, I overheard: "We'd like to schedule the Cath lab for 9:30am tomorrow morning"... "Yes, the patient's name is Loflin, Byron Loflin".  Next the doctor entered.  "Hi my name is Dr. Nishan, tell me why you are here today".  I told him my little story.  "Where are you from?" he asked.  I told him this part of the story.  Then, he said,  "I grew up outside of Boston, and was fortunate enough to receive a scholarship to Harvard Medical and then did my residency at Mayo".  Somehow, he seemed to know that I would understand the meanings of all this.  We talked about having Harvard in common.  I was at HBS in July studying "Making Corporate Boards Better".  Then he turned more serious, "Well, Mr. Loflin, your stress test revealed significant blockage in a main artery.  The fact that your in good shape, no apparent heart damage, your prognosis is very good.  We've scheduled you for a catheterization process tomorrow morning."  He explained many of the details, including, "there's a likelihood you will require bypass surgery".  At that moment, I went into a minor state of shock.  This is the moment where the pictures of life raced like a movie theatre screen within my mind.  I could understand most of what Dr. Nishan said, but, over the next few minutes I saw hundreds of people and places important to me: my family, friends, acquaintances...from Greensboro to Australia, London to Dehli to Cape Town, it was a amazing collage of people, places and things that matter, friend's their homes, their friends that I hope to yet visit and their culture yet to engage.  Was it over?

The next morning, the catheterization procedure was foreign, so I engaged with a bit of trepidation, but since it was performed though my wrist, it felt like a donating blood.  Its during this procedure, as mentioned in my "Doctors" blog, Doctor Cooper concluded that bypass surgery offers the "best long term prognosis."  I envisioned pain.

Friday, October 29, 2010

The PM's heart

One of my more memorable heart related events occurred in the Balkans.  I was there on a trip visiting some very dear friends, encouraging the ongoing peace effort.  Its an exciting place of change and reconciliation.  A few days after arriving, AC, a close friend and man whom I admire greatly was invited to visit the PM.  He requested that I join him.  The two of us were ushered into a small private room off the PMs office.  A few minutes later the PM entered and we went through all the formalities and introductions, settling into overstuffed leather chairs.  After a few minutes of chit chat, AC asked the PM, "how's your heart?"  Apparently, the PM had undergone surgery several years before.  Like a typical Balkan leader, the PM puffed his chest and answered forcefully, "Its strong".  "No, how's your heart?"  retorted AC.  The tall, broad chested, national leader hesitated, drew a long slow breath and sighed, "its hard".  "We have many problems, conflicts."  Time seemed to slow.  The PM revealed the challenges and stress of leadership.

Rich or poor, powerful or weak, globally, we share more, than less in common.  All of humanity share heart; some pour it out, others change it.  I felt connected to the PM,  a man of power willing to reveal his heart.  Heart - fascinating that we use this word to describe the muscle that pumps the blood through us; its also a word to describe feeling, emotion, and affection; one can pour out his heart; another can lose heart; then it can also be the center of a matter or even city.

While in the fog of the catheterization lab, as a catheter was directed though my wrist and to my my heart, all viewed on monitors above, doctor Cooper identified the blockage details, then turned to me: "you are fortunate, your heart is very strong, no damage, but we can't do anything of benefit for you here.  You'll need bypass surgery"

The Balkans have been on a twenty year bypass surgery journey.  Centuries of heartless conflict eroded into one of the worst wars of the late twentieth century.  Catholics, Muslims, Orthodox, behaving like barbarians, each claiming ancestral rights to land, unable to live together.  Visit the Balkans today and you will meet beautiful people, diverse cultures, and countries struggling to find their way into the developed union of Europe; people with beautiful hearts.

Sam Poole's heart

This picture is from Tucker's football game Anne and I attended (with Megan and Joe) in New York a few weeks ago.  Unfortunately, the doctors don't want me to travel this weekend; its parent's weekend at his school.  When I attended Kent, just a few years ago, a teammate, Sam Poole, fell ill from a heart disease necessitating a  heart transplant.  During the next three years, I distinctly remember his heart changing two ways....

Sam and I became friends and kept in touch now and then until he died 7 years after we were graduated from Kent.  When I first met Sam my forth form year, he was a touch hard edged.  I remember experiencing some amount of hazing and ridicule from him, mostly in the good spirit of prep school upper to lower form discipline.   Sam became very sick, so sick that he required a new heart.  While he was away, we weekly remembered him in many ways, but particularly within the incense fragranced walls of St. Joseph's.  A few years later, Sam returned with a new heart.  An aside, I was shocked that he played on the football team-new heart and all!  With the new heart, he was tender, compassionate, thirsty for life, even spiritually awakened.  One day in the locker room, he took the time to show and explain the scares.  I distinctly remember his big smile.  Sam had a big heart.  I learned from Sam.

No, I didn't have a heart attack

But, I really feel deeply for someone who has had a heart attack.  During the past three days, I've had a crash course on the mechanics of the heart.  Did I tell you that I like doctors?  I love science.  I know this amazing scientist... but that's another story I'll tell you later... Paul, doesn't Coldplay have a song about The Scientist or maybe you wrote one... I digress.   As I described in my last blog, Ed, the heart surgeon, lives on one side.  And, David, the cardiologist lives on the other.  David came over yesterday and spent two hours helping me understand the mechanics of the heart.  For one, David educated me on the success rate of bypass surgery; among the highest of all surgery.   So, if I don't make it, I take this moment to broadcast one reason, if not the reason, I started this blog: love your neighbor!  David detailed the various arteries and ventricles, you know, the stuff we memorized and forgot years ago.  Knowledge helps us on the way to confidence.  Check out DIKW - data, information, knowledge, wisdom.  Ignorance breeds fear.

Oh, and for those who heard a rumor: no, I didn't have a heart attack.  I felt what one might describe as slight burning sensation in my esophagus and a strange feeling in my right thumb.  Something coaxed me to tell Bruce (Dr. Swords) during my physical.  He ordered a stress test and, well you know some of the story.  Throughout this period and for the recent several months, I have felt pretty good.  Doctor Cooper said my heart if very strong, no sign of any damage.  Just bum luck arteries.

I met Bruce and Diane through coaching their son Clayton in soccer some many moons ago.  A lovely couple, plus Lauren and Clayton.  To this day, Clayton's first smile warms my heart.

The doctor

I love doctors.   Like all of us, I've been poked and prodded, jabbed and questioned.  I live in an area where doctors are ever present, particularly the local Starbucks.  Doctors are some of the hardest working humblest people on the planet.  They've gotten a bad rap all about money.  They don't own their schedule, they've given it to us.  My neighbor, Ed, is a consummate public servant.  His car comes and goes at all hours.  I have often awaken in the middle of the night to his headlights.  Ed's a cardiac surgeon.  He saves people's lives.  But, folks, we own Ed's schedule.  If he's doing the bypass surgery on me next week, I sure hope he is sufficiently incentivized to do it well.  Ed serves hearts.   Anne and I happen to have been with Ed and Lori on the dance floor late last Saturday.  Ed has a big heart.  I might tell you more of this story later.  Back to doctors.

Anne and I have had some great times with doctors.  There's the anesthesiologist, a sweet lady who cooks like the iron chef.  Come to think of it, most of the doctors I know are good cooks.  Kinda scary, if one of them decided to contradict the oath and go the other way.  Seriously, Vito, Joe and Bobby are three of the finest people I know.  Boy, can they cook.  Maybe we should blame them for my clogged arteries.... no, just bum genetics and lack of disciple by me.   They love their wives.  I'm gonna stop for a second.  We all have problems - all our wives have problems.  Vito, Joe and Bobby - if something happens to me, I'll haunt you the rest of your lives if you don't stop and take the time to realize and really love your wives.  They are precious and they love you.  These three are examples -  that goes for all of us - love your wife and family.  Joe, thanks for stopping by to check on me in the Cath Lab Tuesday!

The point about doctors is that regardless of the money, the prestige, they first and foremost gotta have chosen the profession because they love to help people.  Being on call, the doctor is a slave to the patient.  Ponder what a doctor really does.  A doctor is a public servant.   Sure, like anyone some loose their way.  But, that's part of my motivation for this blog.  We all loose our way, from time to time, but where are we going?  What is my - your purpose?  Who do I serve?

Doctors are also willing to face some of the hard questions of life; life and death.  It must be difficult to live a life of helping people, yet facing the fact that we all die.  This thing we call body, dies and turns to dust.  Architects can design things that last thousands of years.  Doctors constantly fix something that will break again.  It will be dust within a hundred years.

Thursday, October 28, 2010

The stress test

I have started this blog for friends and for someone in their 40s-50s confronting heart disease. While having a routine physical recently, I told my doctor (and friend) that I had felt a few funny or different feelings in my chest while exercising.  I also mentioned that I felt a slight tingling sensation in my thumb(s).  We discussed the possibility of a gastrointestinal problem or cardiology issue.  His office scheduled a stress test.

Three days later, after what I thought was a very successful "passed" stress test, a nice lady said that I should see the doctor because something of caution showed up on my nuclear test.  I was directed to a waiting room where I overheard someone schedule a procedure in the cath lab for the next morning.  The person scheduling then said the patients name; it was mine.  Suddenly, I became a heart patient.  50 years old, a loving husband and father of 4, a successful ski racer, avid athlete, golfer, tennis player, hiker, now a cardiac patient.  A rush of emotion swelled inside.  In the next few minutes, pictures of people entered my imagination.  All my family- walking with Megan to work on 54th, talking with Michael in a cozy corner of manhattan, eating indian food with Katherine, throwing a football with Tucker on the lawn this weekend, faster and faster the pictures flashed, golfing with Tom, playing chess in Mark's office, George and Tita in Portugal looking down on the Porto River, Dorian in his office, Neil and Lesego's little one, Sam and his siblings playing in the yard, Murry and Liz with the girls on the Great Ocean Road, faster and faster the pictures cycled, hundreds per second.  If you are reading this and know me, an image, experience together, a memory appeared.  I remained cogent but overwhelmed by the rush of feeling that I really loved these people.

Enter the doctor