So the past two days have been a roller coaster. 

Over the past few weeks I have had to make peace with the fact that I would actually need surgery instead of the less invasive transcathater procedure. Monday I went through a battery of tests and then met with the surgeon. In short, he said that if I want to have an active lifestyle (e.g. ride my bike) and NOT take blood thinners for the rest of my life, I should choose a tissue (as opposed to mechanical) valve.  Unfortunately I will probably outlive a tissue valve, which will mean that I will want a transcathater (TAVR) procedure in the future. While the FDA has approved TAVR on TAVR procedures, it is too new and not something that the doctors feel is safe enough to bank on at this time. 

So, the doctor wants to so a mini-thoracotomy which essentially is to cut a whole between my ribs, split them apart two inches and replace my aortic valve. Sounds painful, but less invasive than a sternotomy (open heart surgery). I will be in the hospital 3-5 days followed by about a month to recover partially. I should be “mostly” recovered after 8 weeks, although they don’t want me to do anything that risks falling for 12 weeks. So indoor riding is okay but not shredding the trails. 

On Tuesday the scheduler told me that the first available appointment was on August 8th. I was livid. It isn’t such a huge deal to wait another four weeks, but after everything that has happened up until now felt like the final straw. First, I had to take in that I had a serious illness. Next, not only have I not been able to be active or ride my bike since my diagnosis in June, but I was not able to go to Europe to see family (much of which I had not seen since pre-pandemic). I was no longer able to ride in Switzerland nor see the Tour stage in the city I was born (Lausanne). Plus, I had to wait for weeks before finally seeing the Surgeon, I had to deal with all that I didn’t know and having to become more conversant in heart valve issues which included reading about some pretty horrible sounding possibilities. Finally, I had to say goodbye to plans to race cyclocross this Fall. 

I took all those setbacks in stride: trying to make the most out of a bad situation. Somehow, when they told me I had to wait another four weeks that felt like an eternity. 

My luck changed for the better today when this morning I got a call from the scheduler that a surgery appointment opened up for this Monday. It feels a little quick to get all my affairs in order (cancelling patients, pre-op testing, etc.) , but I didn’t hesitate to take it. So that is the current plan. Get cut open Monday, replace my aortic valve, recover for the next few weeks and then try and go back to resuming a normal life.

By the way, I also got a call from Jeff White who had heard about my situation from Jules. He was generous in talking about his situation and how he dealt with similar surgery while Jill was pregnant with their first child. Now that is crazy.

I appreciate all the messages of support. I look forward to riding with you all in the future

Surgery on Monday (18th) went well.  I don’t remember any of it. Actually I don’t recall any of that day after the anesthesia kicked in. For that, I am thankful. I now have a cow valve for my Aorta. I am calling her Bessie. My surgeon seemed strangely excited about how “good” this valve was. I was too doped up to ask him why.

As cyclists, we pride ourselves on our ability to endure suffering. This was my mentality going into surgery. The recovery would be a kind of suffering that I knew I could get through. Also I assumed that a minimally invasive Thoracotomy would be less painful than traditional Open Heart Surgery (Sternotomy). Maybe its a good thing that I didn’t know this before hand. Recovery “should” still be quicker. 

I was not ready for how much pain I experienced Tuesday. I was on plenty of meds but when I coughed up the bloody phlegm in my lungs it felt as I was being repeatedly stabbed in the ribs. The surgery involved cutting through muscle and tissue as well as moving ribs in ways they were not designed to move. The result? More pain than I ever remember experiencing. 

Wednesday started off feeling better until I started having a Migraine. Something about the surgery was kicking off migraines, but I can only take so much of my Sumatriptan in 24 hours and the hospital was pretty strict about its rules so I ended up with a Migraine so bad that I actually forgot about any other pain I was having. 

Fortunately, the rest of my recovery has been mostly uphill from there. Removing the drain tubes from between my ribs meant that my ribs hurt less often. They moved me out of ICU, which was akin to a 5 star hotel given the amount of attention they gave me. The rest of my stay was more like a Hampton Inn, where if I didn’t ask for pain meds, they were not going to give them to me. 

By Thursday they were ready to send me home, but that got delayed until Saturday when I was finally able to have a BM. That became an ordeal in itself, but the less I say about it the better.

It’s been good to be home. I am sure my wife and son don’t mind having to serve my every whim. LOL. But seriously, they’ve been great. I am staying on top of meds, taking walks, and trying to kill time as I heal. Le Tour Hommes and now Femmes “avec Zwift” have been great distractions. I have been watching some streaming series and made the mistake of watching a comedy the other night. I felt the repercussions of that laugh until the next morning. That night I didn’t get much sleep even with pain medication.

I see my doctors next week, after which time I will have a better idea of how my recovery is going. 

GregHoge said:

@mugwump I can't help with the shoulder break, but glad to hear the head is OK.  Your helmet looked pretty scrapped up when I ran into you this morning.  Hoping the recovery is quick!

Jules said:

 I'm sure the team will scour youtube and instagram for you on the off chance there is some Zapbruder tape out there.