Keep Your Eye on the Real Prize

By , SparkPeople Blogger
Expectations are powerful things. They can turn relatively easy challenges into incomprehensible failures or transform the most difficult situations into interesting and rewarding opportunities. What you get out of your own efforts depends almost entirely on what you expect to achieve in any given situation.

The foundation for getting the most out of yourself and your own efforts in any situation is continually choosing and adjusting your expectations so that your strategies and actions match up well with what you can realistically achieve in that situation. Otherwise, you'll end up spinning your wheels trying to achieve the impossible, or settling for a lot less than you could accomplish, or never bothering to find out what really matters to you.

My recent experience with some medical problems and a pretty long hospital stay might provide a good, concrete example of this principle in action. If not, this blog will at least give you the opportunity to introduce yourself to my Inner Pig, who will likely be appearing here in future blogs.

When I went into the hospital a couple of weeks ago for open heart surgery to replace a defective heart valve, I expected that, aside from coping with my phobia of needles and my extreme reluctance to be seen in a Size 6 hospital gown, the most difficult part of this experience for me would be finding the patience to give myself time to recover gradually, and avoid the desire to do too much, too soon. I knew I was in pretty good shape physically and mentally, and I expected that the surgery would go smoothly and Iíd be back home pretty quickly, fighting the urge to test out my new heart valve on a nice hard bike ride before my incisions had even healed.

And in fact thatís exactly how things wentófor the first week. I was out of the Intensive Care Unit on the first day, out of the step-down unit in two more days, and ready and eager to give back my hospital gown and go home on day 6. Thatís not to say that everything was a piece of cake-- there were a few challenges that were a little harder than I imagined they would be. Like breathing. And moving. And finding a position to sleep in that didn't make me hurt everywhere.

Donít believe anyone who tells you that waking up with a breathing tube still in your throat is ďno big deal.Ē If possible, make sure no family or friends see you until this has been removed--this will only scare them and make you feel worse. And donít imagine for even a minute that youíre such a nice person that you would never seriously consider strangling that sadistic respiratory therapist who comes around every two hours, all night long to wake you up and make you breathe into that stupid little tube for 10 minutes. By Day 2 youíll be looking for places you can stash the body where it wonít be found until youíre safely back at home, and by day 4 it will just be a question of whether you get discharged before you snap and do the deed. Just keep in mind that none of this makes you a bad person, as long as you donít actually act on these fantasies.

Other than these and a few other challenges (did I mention that you have a very grumpy roommate for most of your stay?), week one went well enough, and I arrived back home sure that the worst was over. But after my first day at home things started going downhill quickly.

First, my right leg started swelling up fast, and I began having these incredibly intense and painful burning sensations running down my thigh every time I moved. Then I woke up in the middle of the night with my chest and my back aching very badly, and not from the incisions or sore muscles. So, it was back to the hospital for me, by ambulance.

After a long and somewhat terrifying night of being shuffled back and forth between basement rooms filled with large, noisy MRI, CT, X-Ray , echocardiograph, and nuclear perfusion machines, it was finally determined that no one really knew what had gone wrong. There was no sign of blood clots in my legs or lungs, or deep vein thrombosis; but there was some crackling in my lungs, so maybe I was coming down with pneumonia. There was a small hematoma (basically, a bruise) in my upper thigh near where one of the incisions had been for my surgery, but it didnít look significant enough to explain all the swelling in that leg, much less the extreme nerve pain. And the cardiac enzyme thatís often used to tell when chest pain is coming from a heart attack instead of some other kind of problem was elevated, but that apparently doesnít mean much so soon after major heart surgery. The doctor said "I wouldn't call this a heart attack, exactly, but I can't say it wasn't, either." In either case, the chest and back pain was gone by now. And the groin incision might have irritated a leg nerve and caused some swellingóor not. There was no fever or other sign of infection. But the swelling and nerve pain was definitely still there, so the decision was to admit me back into the hospital for observation, and see if anything became more clear the next day.

Unfortunately, it didnít. The docs kept me in the hospital for three more days, until everyone was pretty sure my condition was stable, but we never did figure out what exactly had happened, why my leg was still swollen and painful, or where things should go from here. I came home again last Monday. At this point, I still canít stand or walk without a lot of pain. Sitting in a chair or lying in bed doesnít bother me, and I can ride a bike for short distances at very moderate speeds without trouble. Iím up to about 4 miles per day at this point, with more to come, and Iíll be back at work full-time on Monday as originally planned.

The fluid retention in my leg does seem to be going down slowly. Iím still about 8 pounds heavier than I was before surgery, but thatís down from 34 pounds at the high point (that was a shocker when I saw the nurse write that number down in my chart, lol), and itís all located in my right leg, as far as I can tell, which looks more like a tree trunk than a leg right now. The pain hasnít changed significantly, and no one is making predictions about if or when it will. The hope is that itís just a simple paresthesia that will clear up on its own soon, and not a permanent nerve injury, but itís just too early to tell.

The good news is that I seem to be handling this pretty well emotionally, so far at least.

Iím not happy about the prospect of being in pain for potentially quite a bit longer than I expected, or having to live with an "exercise lite" approach for quite a while, but it doesnít feel like the end of the world either. There are some things I can do right now, for both exercise and pleasure, as long as I donít get caught in the trap of putting everything on hold until my leg problem gets sorted out. And if the leg problem doesnít heal on its own, there are some things the doctors can try. Thereís no reason for me to make assumptions about how thatís going to turn out at this point, and especially not to spin out a bunch of worst-case scenarios, so Iím doing my best not to do any of that.

All in all, I think Iím doing a pretty good job of keeping my eye on the real prize, which is doing the best I can with what Iíve got to work with each day, one day and one choice at a time. That's where real satisfaction comes from, and it doesnít really matter whether what I can actually do is more or less than what I expected.

Does it?

The one concern I havenít quite come to terms with is how to describe my post-surgery self. I used to be about 85% Irish and 15% mutt. Now Iím 85% Irish, 14% mutt, and 1% pig. My new heart valve was provided by some pig who gave his all so I could live, and I certainly feel like itís important to acknowledge his contribution in some way. I stopped eating pigs a while ago, so Iím thinking that maybe I should give my new heart valve an appropriate name, but Iím having trouble coming up with one I like. My Piggily just doesnít do it, you know?

Do you have any suggestions?

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So glad that you did well with your surgery - okay, at least you are around enough to write a blog about it! You will continue to motivate and inspire many people! Report
Glad to read an update on your status - missed you! Report
Thank you so much for sharing your experience with us. Many people will benenfit from your sharing so honestly. Nice reminder to pay attention to our bodies and be patient with ourselves. Report
Dear Coach Dean, I am glad to hear from you. A name for your heart, I can't think of, but I do have a comment.
You said: Iím not happy about the prospect of being in pain for potentially quite a bit longer than I expected, or having to live with an "exercise lite" approach for quite a while.
I completely understand being in excrutiating pain...constantly. I have 5 or 6 pain disorders, one being a continual back spasm, now into week 13. It is no fun and it does limit a lot of what you can do and how you are mentally, psychologically etc. And regarding the exercise lite you mentioned, I live that way. I can't go hard at it like most people here and that frustrates me to no end. If you have good health, do not take it for granted...that's usually the time you get a dose of what others go through. God bless on your recovery, but as you would tell us, listen to your body. :) Report
Yep! I like Harley! Report
Well, I've heard of men being "Pig-headed" but you are the first one I've thought of as "Pig-hearted." Coach Dean, I'm call you BLESSED. Report
Wanderingdoc, I wonder, was the valve kosher? Report
Sorry you have had to go through (& are still going through) this painful experience! It looks as if you've already gotten lots of good ideas for naming the valve, so I'll just say I really hope the swelling goes away & you're back to normal very soon. Report
as someone who has to wake you up every two hours to breathe into the little tube, we don't like it any more than you do. and now that i know you fantasize about killing nursing/respiratory staff and telling people it's ok, I like it even less. Report
Hi again Coach Dean,
I forgot to tell you a little story about pig valves. My father in law who will be 99 in May had surgery to replace his aortic valve in August of 2006. Yes , he was 96! Anyway he is Jewish. Being a physician, I asked him if his surgeon had mentioned to him that they may replace his valve with a pig valve. He had to think about it for a minute, but then told me he thought God would forgive him for saving his life! We didn't need to worry about it, they used cow valve instead!

Get well soon and don't push yourself too hard.

Kathie Report
I'm liking the "Harley" name :)

Theres nothing like a HOG


Thanks for checking-in. We've been praying for you (and see all the good that did - LOL. Can you imagine that it could have been WORSE?)

Expectation is everything. I've always been a bit of a pessimist. It allows me to spend most of my life being pleasantly surprised!

Hang in there.

P.S. I think if I had a new pig heart valve I might call it my "Ham Flap." Report
Welcome back.
I have been praying for your recovery. Sounds like you have had "fun".
Name that body part: Sir Spark-ham, or Wilbur (from Charlotte's Web) -
' cause he was teerriiffiic - like you.
Mind the doctors, okay? Report
Welcome back - and Get well soon -
Celebrate the new life you have this Easter! Report
Great to hear you are back and doing well. I like Babe also, great name! Happy Easter. Report
My friend went through some similar leg swelling after surgery. She went through the same ordeal at the ER and they couldn't find anything. Finally one of the nurses asked her if she had been keeping her legs elevated above her heart??? Evidently they neglected to tell her that in the hospital.

I've been wondering how you've been progressing. Good to see you back "almost". Take it easy. We'll still be here when you're ready to give it 100%.

Having recently "survived" a TKR, I completely understand every word. Not being where WE expect to be at OUR OWN prescribed time is probably the worst thing we can do to ourself. Be thankful all is well, do the best you can to follow the doctor's advise and be kind to yourself! Glad to have you back!! Report
Welcome back! Sounds like you've been through quite an ordeal. I think your idea of naming the heart valve is a fitting tribute to the one who gave its all. My suggestion is "Babe." Your could refer to your sweet babe ... and inasmuch as it's in your heart ... it's truly fitting since that's where your babe should be!! Whatever your choose, I'm sure it'll be perfect! Take care!! Report
I read your article, thanks for sharing.
It's good to know you are up and about on your bike, but please take it easy and may GOD continue to Bless you on your journey what ever it may be.
For you new valve, if you do not have a new name yet I like Hamlet, Piglet fror Winnie The Pooh, and SPARKY for the people who are always there for you, these are a GREAT Bunch of SPARKS, but what ever name you choose I know it will always be a reminder that a little piglet saved your life.
HUGS and GOD Bless you always. Report
Having had my first open heart surgery at 33 (yeah 33) with four bypasses and remembering the recovery part like it was still yesterday (29 years later), I was wondering if what I experienced when they took the drainage tube out really was only "slightly Uncomfortable"? It took me long enough to recover from the drainage pull that the surgeon was able to make it off the floor.

While I've never had a valve replaced, I've had another OHS - this one with 5 bypasses, a stent inserted another time, and yet again - a defibrillator (completely on-board, connects to the computer through a special telephone line and it has a 10 year - replaceable, battery).

Back to YOUR surgery.

I doubt they would be able to tell you wither the pig valve came from a boar or a sow - we just know it came from a pig.

Everyone knows that the PIG is the number one selling motorcycle of all time in the United States. It's known for it's ability to put on the miles and shrug off life's little dings and scratches.

PIG, thy name should be HARLEY!

Agape, my friend.

PS: With my first surgery, I had a swelling problem that required I wear those ugly looking compression hose for about six weeks. Really looked strange there in Houston, guy walking in shorts with one leg covered with that white stocking. It made me very aggressive working up to my 5 miles/day walk. Report
Thank you for sharing your journey. You are such an amazing example!! We will hold you close in prayer during the days to come.

How 'bout Arnold from green acres....

-Carol Report
I'm so glad you're back & on the mend! Have been wondering how you were. It's good to see you still have your sense of humor. There are some great pig names here! I like Hamlet myself, because as someone already said, the ham let you live. Take care and keep going (gently and carefully)! Report
No wonder!! I missed your blogs and wondered where you we know!!! Well, glad you are taking one day at a time with minimum expectations for now, although, its only natural to expect to be fit after fixing the problem. Unfortunately, these days when we go under, nobody but the doctors in that OR know what they did ( right or wrong!). Look at me waking up suddenly with " Pulmonary Arterial Hypertension" - symptoms of shortness of breath, fainting, blue lips, unable to carry on my daily functions or even walk 15 steps after my Oophrectomy in 2004. No matter that I was a runner, walker, fit and healthy as a horse prior to that!! Glad you are on the mend. You have an excellent attitude and you do inspire us all very much - Wow! 4 miles biking is awesome!! You will be fine and whatever it is bugging you wil alsol heal as you heal! Sending good thoughts your way Coach Dean. In reference to your Ms. Piggy in the heart - well, she is all yours to select any name you want and I read a few really good ones...I'm not quite as creative! Everyone has a feminine musculine side to them, depending upon their sex, so, I would love to see a female name assigned to your Ms. Piggy!! Take care! Report
Good luck. Hope you get back to your normal routine soon. Report
Good Luck in your recovery... your saving "heart-piece" is to be blessed!
Glad to hear the surgery went well! Amazing that you're riding so soon! Also, way to show restraint by not injuring the respitory therapist! I hope they sort out your leg and everything is better soon. Report
Cheering you on...
Thanks for sharing.
1% indeed. Report
I'm so surprised that you are writing so soon, and so pleased that my favorite sparkling inspiration is back! I'm glad to hear that you are doing fairly well, and blown away with what you are going through with your leg, and yet still already riding your bike 4 miles at a time!!! Hence - the reason for you being so inspirational.
Well...the names ~ Nothing new to suggest, but Pig o' my heart (cracked me up!), and babe ( and the reasoning behind it) get my vote!

Best wishes - thanks for taking the time from your recovery to update us and inspire us, yet again!

a gentle hug,

Mary Report
while working as a unit secretary, I was amazed by the change in the "mummies" in CICU and the new people able to walk the halls within a few days. I thought personally they made them get up too soon, but with wisdom gained from experience I have learned the best way to deal with pain is to keep moving. You are an inspiration and I will be praying for you and "Boss Hogg". Report
Love your open, honest summary of your happy you are doing well.......Good luck with your journey to health....mind, body and soul....

The Queen Report
Coach Dean,
Thanks so much for your honest and open articles as always. I wish you the best with your recovery! Report
Read you article and sending thoughts and prayers your way.......looking forward to hearing all the plusses as you move along!!!!!!! Report
Good to have you back Coach Dean! Thanks for giving us an update on your progress. I love the 1% pig line! You have a great sense of humor and that will carry you a long way. How about Valve-a-pig? Report
I think you are doing really well managing your expectations. Unfortunately my mom was the exact opposite way when she had knee surgery in November. Starting from BEFORE the surgery she was very negative, and it has continued up to the present.

There are certain uncomfortable things that happen when you are embroiled in the health care system (like teeny gowns and yucky roomies), that you just have accept. My mom took those little things like personal affronts and did NOT handle them well.

I applaud your attitude, keep it up. And do keep up the exercise as you can--as you know --it will keep your mood up!

The tail is the cutest part of a pig...may I suggest Curly? People won't get it until you explain! I also admire your sense that you want to honor this pig who gave his life for you. My husband has a donated bone in his neck, and we feel the same way about his donor. Report
glad to read everything went well. going to remember this post for a long while...1% pig is LOL..i'll be thinking of you next time i see a ham :) Report
how about pig o' my heart?? glad you're doing so well. do empathize about size 6 gowns!! size fits all, when pigs fly!! lol jules Report
Glad to hear you are back on the mend...hope from this point on all goes well.

I like the name "Bacon" Report
Wishing you a speedy recovery! Report
Welcome back and hope you're soon 99% + 1% Coach. Thanks for sharing. Report
Good to see you're on the mend Coach Dean. I assume your swollen leg was the side the graft was taken from for your heart surgery. If that's the case I believe some swelling is normal due to less vascular return. That happened to my dad after his open heart. Report
Welcome back Coach. Sorry you have had some speed bumps but you have the right attitude towards the situation. I think it is wonderful how you share your experiences with everyone. You will continue to be in my thoughts and prayers.

Just take your time!! Report
Coach Dean, Why don't you call your new heart valve Sparky? It will remind you not only of the pig who gave his all, but also of all the folks around here who couldn't have reached their goals without your support and who are wishing you well right now! Report
hey coach!

I was wondering when you were coming back, and I was pleasantly surprised to see your posting. It sounds like you've hit a few speed bumps in your recovery but your sense of humor and perserverance is still with you. Before you know it you'll be back to normal and in the groove...

Keep your chin up and be PATIENT!!!! Report
Thumper Pumper Keep your thumper Pumped and ready to rumble! Report

You have a plethora of comments, but I would like to add mine. You have been so effective in sharing previous struggles with weight and now with this medical procedure. Thank you for your openness and helpfulness to us. I pray that you will mend quickly. We need you back, actively helping others, but you must see to your needs as a priority.

Your articles are usually my favorites on SparkPeople. I know they will be realistic, honest, and helpful.

Gary Duke Report
Coach Dean glad to hear that you are out and on the mend. Hospitals are never any fun! As for naming your new found help. I vote for Arnold. But what ever you decide has to feel right for you. Wishing you all the best & hugs for sharing such an important part of your life. This just gives some of us a gentle reminder that we all need to be vigilant in our daily lives, THANK YOU FOR SHARING YOUR FIRST HAND EXPERIENCE WITH US. xoxoxox Report
I remember going through similar things with my stent implants two years ago. I didn't have leg problems (except for laying absolutely still for five hours after each of five angiograms so my femoral artery didn't tear open and bleed out), but I do remember overdoing it just after I got out of the hospital. When you suddenly feel better it's so tempting to go back to what you were doing; I should have stayed home instead of gone grocery shopping.

I have had chronic chest pain since my heart attack. It's all in the rib cage and shoulders, but until I figured out how to tell that from angina I was always going back to the ER. It really does take around 12 to 18 months to recover from heart surgery.

The swelling in the leg was probably a blocked lymphatic. It's possible the groin incision severed or pinched closed the main lymphatic vessel in your leg, thus preventing the usual uptake of fluids from normal body processes. Your symptoms sound remarkably like a guinea worm infestation, also called elephantiasis (not elephantitis as so many people say). I say that because the guinea worm blocks lymphatics and causes similar symptoms. 'Course, I'm no doctor and I've never met you (much less read your charts), but it seems a logical explanation.

When my father had his two open-heart situations he had symptoms similar to what you described. Bone heals pretty slowly, and if you don't continually work your chest muscles and rib cage there is the danger of the bone healing in such a way as to impede breathing. That's why you had to do those painful exercises. My father had to do ten minutes every hour; early on in his recovery, it hurt me just to watch him.

I'm just commiserating; I have a general idea of what you went through. I'm certain you'll completely recover. Like me, it may be a shock to you how long it really takes, and your physical condition before the surgery helped a great deal (as did mine). I worked for three days during my heart attack, and kept up my walking for the following three days until I went into the hospital. The doctor told me I was lucky to be in such good shape or it would have been much worse; I'm sure they told you that as well.

I wish you well in your recovery. Take care of yourself! Report
What a shock! It's good to read that you still have your sense of humor. That helps so much in the healing process. I hope you have time to continue writing. Not only do we enjoy reading about your experiences because of the humor you inject into the most dire of circumstances, but it can be a great stress reliever for you. I like Miss Piggy. Now you can talk to your feminine side. Report
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