Roni Posner

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My Aortic Valve Replacement Story

May 15, 2002

 I was incredulous.  I looked and felt fine, with absolutely no symptoms.  Had gone to see my GP, in early March, about a pain in my chest, which was diagnosed as a torn muscle (probably from hauling firewood at our beach house in Delaware during the winter).  But she did detect a heart murmur (about a 2-3 on a scale of 6) and suggested that I see a cardiologist (which I got around to doing a month later).

 As an active and relatively fit 53-year-old, I was stunned to discover on April 1, 2002 (was it a joke?) that I had been born with a bicuspid (2 vs. 3 flaps) aortic valve that was deteriorating/not closing completely and allowing, at that point, 75% “regurgitation” of my blood, flowing back into my heart on each beat.  After the echocardiogram that afternoon, I was told that the valve had to be replaced – and soon.  I needed to schedule, over the next couple of weeks: blood tests, a heart catheterization and the surgery.  (Why hadn’t any doctor ever heard the murmur?  It had to have been developing over many years.)

 In retrospect, I think that the hardest part of all of this was telling my partner, Jeri, my three sisters, my friends and staff.   (I run a national, professional association of management consultants to nonprofits.) Starting with Jeri, the words seemed impossible to find: I needed to have open heart surgery, and the recovery period would be 4-6-8 weeks.

 But abounding love and support enveloped me, and we dealt with the major questions: Where to get a second opinion?  Who should do the surgery and where?  Synthetic or pig tissue valve?  Answers: second opinion:  from Al Phister, at Washington Hospital Center; Bryan Steinberg (at only 37 years old, already a pioneer in “minimally invasive valve replacement”), of Cardiology Associates in DC, at the Washington Hospital Center, to do the surgery; and pig valve – could not imagine living on coumadin for the rest of my life and, besides, in another 12-15-20 years the technology will be so advanced that getting another valve, if necessary, will likely be “a piece of…bacon.”

 I showed up at the hospital on Wednesday April 17 and proceeded with my check list of to-do items:  have surgery that morning; come out of anesthesia that afternoon; keep my hands away from the tubes in my mouth; sit up and dangle my feet over the side of the bed that night; be released from the ICU the next afternoon (Thursday); be released from the step-down cardiac unit/hospital four days later (Sunday).  DONE.

 Nobody had told me, though, about “reaction formation” – the delayed emotional reaction with which I am still, now four weeks later, dealing (especially prominent among check-list types!).   My first “breakdown” or “episode” occurred in the hospital, on the third night, when the pacing wires were removed from my chest.  No one had told me about this procedure, and I flipped out.  Got hysterical.  (They had to get Steinberg in there to talk with me and get me to refocus on “control” and my long-range goals.)  I had realized, for the first time, what had actually happened to me.  Have had about one of these emotional reactions each week, and am told that they are “perfectly normal.”  I’ll be happy when “normal” is over.  Mostly, though, at this point, I just can’t believe that I even showed up for the surgery that morning.

 Jeri deserves a “purple (lavender?) heart”, so to speak.  No question, the caretaker has the hardest job of all, and often that reality is grossly overlooked.  Fortunately, though, my friends and family have focused very closely on Jeri, as have my various docs throughout this process.  (One huge achievement of the Clinton administration was the passage of the Family Medical Leave Act, enabling federal workers like Jeri to apply her eight weeks of accumulated sick leave to my recovery – and be on “sabbatical”, at home with me.)

 Have reached the dangerous point wherein I am now feeling strong and energetic; the trick, now, is to not be stupid.  A costly setback could occur in a “heartbeat.”  Am walking 2-3 miles a day now.  Started very slowly, though, that first day after returning from the hospital.  Took me about 2 hours to get myself up and showered and dressed in the morning, and I was out of breath after walking about two blocks!  Made it a point, though, not to be bedridden.  My strength has been building each day and week.  The incision is healing beautifully; am putting vitamin E oil on it twice a day.  The tricky part, of course, is the reweaving of the sternum, ribs and chest muscles.  I can tell, still, that I only about 80-90% “there.”  Am still fearful (somewhat irrationally), when out of the house, of getting bumped into or tripping and falling. 

 Plan to spend one more (fifth) week here in Delaware, working via email and phone.  Will return to DC and the office, at least part time, after Memorial Day.  Then, I plan to be very healthy for our annual national conference in San Diego on June 13-16.  (Won’t be lifting my own luggage, though.)

 But, the best part, especially for this Jewish American Princess, is all the pig cards and gifts and jokes and snorts.   Actually, I consider myself a lucky, lucky duck.  I have a new lease on life, and, with each beat, my heart sings.