Jim On Open Heart Surgery

On October 23, 2017, I’m going to be having open heart surgery.  I’m 39 years old.

There are a lot of things in the world that are pretty surreal to have said to you — that first “I love you,” getting recognized for something you busted your ass on, the phone call that someone has died, breakup discussions…  you know, surreal stuff.  I got some zingers lately!  “You have developed a large aneurysm in your ascending aorta,” my primary care doc said over the phone while I was driving home one day.  Then, the platinum best seller from my cardiologist a few days ago, “Don’t plan anything after the 23rd, we’re going to schedule open heart surgery.”

"Dude, WTF!" --Roxy

Well, what we know is that this started with me having serious shortness of breath, dizziness, and just a real lack of the ability to just feel well.  Anybody feel like this, constantly?  Go see your doctor.  I went to see my primary care doc around the middle of July — the weeks right after the middle of June 2017 were an insanely stressful time for my family and I, and during that time I started feeling like my system stopped getting fuel — my legs started getting exhausted after no work, then my arms too.  Imagine having exercise fatigue after a few minutes of walking, then having haul ass through ATL on a gig, or worse, MSP!  Tests upon tests upon tests later, my doc sees that some real crazy stuff has happened — my ascending aorta has blown up like a bubble in a bicycle tire.

Let me tell you:
you can quickly become motivated to learn a lot about medicine when you hear someone say “You have developed a large aneurysm in your ascending aorta.”

Have you ever seen what an aneurysm looks like?  It’s a weak spot in an artery, ostensibly, caused by factors like increased blood pressure.  Technically, the circulatory system isn’t wholly different than a hydraulic system — a pump, hydraulic fluid under pressure, and hoses everywhere.  The problem with an aneurysm is that it’s basically a weak spot in a hose — and when a hose under pressure with a weak spot caused by higher than normal stress on the system, you get a hose blowout, you lose pressure in the system, and you have to shut down the system in order to replace the hose.  Right?  So, now imagine that blowout not being hydraulic fluid, but blood — and that aneurysm, were it to tear, I would bleed into my chest, the heart would shut down in a few minutes.  In typical JimOnLight loud-and-large fashion, I’ve developed the worst kind of aortic aneurysm, the ascending aortic aneurysm.  Living the dream.

ascending aorta, normal and with aortic aneurysm

From Healthline:

The aorta is the largest blood vessel in the body. It leaves the heart and forms an arch.

The arch’s downward portion, called the descending aorta, is connected to a network of arteries that supplies most of the body with oxygen-rich blood. The upward part of the arch, which is the section closest to the heart, is called the ascending aorta.

The part of the aorta in the chest is called the thoracic aorta. The portion further down in your trunk is called the abdominal aorta.

An aneurysm is a bulge that forms in the wall of an artery. It happens when the artery wall weakens. Aneurysms anywhere in the body are dangerous because they can rupture and cause massive internal bleeding. An ascending aortic aneurysm is especially serious. A rupture in this part of the body can be life-threatening.

Obviously, we’d really like to avoid my major heart artery blowing in half, which is where I am right now.  I’ve not been able to fly because of this, I’ve been on restrictions for carrying stuff, and honestly life has been hell.  Since about mid-to-late June, I’ve been experiencing some crazy shit — my blood “regurgitates” back into the system, which essentially is causing deoxygenated blood to leak back into my bloodstream, and that really screws things up.  I’m dizzy pretty much 24/7, worse when I push myself, and sometimes I get these crazy flush feelings in my chest, like when you kink a garden hose and then suddenly unkink the hose.  It’s f**king scary!  When that particular sensation stops, I’m always pretty glad for my life.

This has moved very, very fast.  Honestly, I feel like this entire situation is completely out of my hands.  I have an amazing primary care doctor and nurse that really need to be given a gold bag with gold bars in it for catching this before it killed me, which it would have done according to the cardio team.  If I were not having open heart surgery, if my genius doctor hadn’t have caught this, there is a major realistic chance I would have dropped dead at a trade show from aortic dissection sooner than later.

Team JimOnLight now has a samurai cardiologist that has given my heart the old “how’s your father,” and I meet with my surgeons in a few days.  I had a transesophageal echocardiogram last week, and not five minutes after it was over, the surgeon’s team was in my room telling me about the open heart surgery we’re gonna be doing.  Take jumping out of a plane — that feeling of falling — except be sitting in a hospital bed getting handed a bag of surgical soap saying “you’re gonna have about 6-8 weeks of recovery while your sternum grows back together, you’ll be wired shut.”  What now?  Sorry about that, I MUST have had something f**king insane in my ear.  You said you’re sawing through my chest?  Y’all know I’m 39, right?

THE STERNUM SAW!!!!!

It’s not mine, but below is what they can see with a transesophageal echocardiogram (TEE) — this is amazing stuff.  You get one of these for more detail of the heart, valves, arteries; with the normal outside-the-chest echocardiograms there isn’t as much detail.  It makes total sense, with a normal echo the scanner has to reach down through bone, skin, fat — the trans-esophageal echo only has to see through the tissue of the esophagus.  Pretty cool, no?  The kinds of stuff you get to do when they’re tracking something like this…  well, let’s just say they’re cool because it’s high science, and they suck because you end up having to do stuff like gargle a few tablespoons of AstroGlide-consistency liquid with Lidocaine in it so they can very gently and lovingly feed a probe down your throat.

I’m sorry I’ll miss everyone in Vegas this year.  I have 5-7 days of hospital nights after the open heart surgery, and then 6-8 weeks of recovery.  This is the first LDI I’ll have missed in forever — I was going to be there manning our offsite Avolites suite.  Believe me, I’d rather be there paying way too much for a beer than recovering from open heart surgery.  But, this is going to literally save my life.  And, 2018 is going to be one outstanding year, I am already looking forward to it.  My entire life is going to change drastically, positively.  I’ll blog as much of this process and its details as I can, and I love turning medical images into art, so let’s hope for some beautiful radiology imagery soon!


Editor’s note:

Folks, I am currently living proof that external stress in high doses can literally inflate your arteries and screw up your heart valves and nearly f**king kill you.  Please take care of all aspects of your life.  I am fortunate that I had an amazing doctor who found something wrong and jumped on it.  Manage your own care, advocate for yourself, find a good doctor you trust, and listen when they talk.

Some open heart surgery reading/watching material:

Symptoms and Causes of Aortic Aneurysm

Questions about Aortic Aneurysms

Severe Physical and Emotional Stress May Cause Catastrophic Tear in Aorta — the Yale Center for Thoracic Aortic Disease

Acute Aortic Dissection and Emotion/Exertion — Elsevier link to the scholarly paper

Aortic Aneurysms, and Aortic Dissection (where the thing rips in half and kills you)

Neurohumoral Features of Myocardial Stunning Due to Sudden Emotional Stress — the New England Journal of Medicine

Anxiety and Risk of Incident Coronary Heart Disease, A Meta-Analysis — Science Direct

Aortic Aneurysm in the Differential

the Transesophageal Ecocardiogram video playlist…  yes, it exists

Surgery for Aortic Aneurysms

Who’s at risk for Aneurysm?  (Hint, it’s men higher over women, because women are superior beings when dealing with stress) – National Heart, Blood, and Lung Institute

Repair of Thoracic Aortic Aneurysms — Society for Vascular Surgery

Thoracic Aortic Aneurysm Surgery — The Cleveland Clinic

An excellent page from Johns Hopkins University on Abdominal and Thoracic Aortic Aneurysm Treatments with Open Surgery — and a quite interesting 4-minute video:

Thoracic Aortic Aneurysms at the Mayo Clinic

KHAN ACADEMY!!!  Thoracic Aortic Aneurysms by the great Khan Academy!

This video right here is too creaking cool — Dr. Arie Blitz performing a repair of an ascending aortic aneurysm at Case Western Reserve University Hospital and then giving a post-op debrief.  Heads up, it’s a cracked chest, but this is amazing.  He walks you through his entire procedure.

Sniper Kills 50+, Wounds 400+ in Vegas Concert Shooting

“He opened fire on a crowd of more than 22,000 concert goers.”  Guess what, America?  This guy is a terrorist.

UPDATES, at the bottom of the post…

Quick editorial note right up front:
I spent this entire day from the time of posting arguing with people about my use of the word sniper in this article.  You’re right, he’s not a sniper, never was a sniper, and was not trained as a sniper.  Because of this decision I made to use that word, which I was using to describe a person firing from an elevated position, some were severely offended.  That wasn’t my intention, apologies all around.  Thank you.

I keep wanting to write ‘this is unreal,’ but we’re kind of way beyond that here in modern America.  A 64-year old coward named Stephen Paddock from Mesquite, NV opened fire from the 32nd floor of the Mandalay Bay with automatic fire.  The video sounds like he was just emptying a magazine into the crowd, taking cover, reloading, and doing it again.  He killed at least 50 people, more than any time in US history.  I said a sniper shot in the title; this guy wasn’t a sniper, ever, he was never trained as such, I chose that word as a description of a person firing from an elevated position, thinking that people would equate that better than other choices that may have been more militarily appropriate.  I’m not military.

I’m sitting here listening to interviews of survivors behind me on the news — this happened last night at the Route 91 Harvest Festival, 3-day country music thing going on in Las Vegas next to the Mandalay Bay.  I just saw a video this morning of automatic gunfire.  I have fired an automatic weapon several times (like many of us have), and that sound is indistinguishable:

Police in Henderson have commented that they found 10 long rifles in his room; he had automatic weapons.  If you have an FFL in America, get ready for that yearly visit I’m guessing.  The FBI is going to be looking for this automatic weapon/weapons’ history, because this guy had nothing on him legally, the police say he had a traffic ticket.  He had a female companion; they’ve questioned her, but details of that are sparse and conflicting.

This dude did this during Jason Aldean‘s slot — all crew and Jason Aldean are accounted for.

This guy shot a lot of rounds a long f**king way.  Seriously, look at this:

Most of the news we’ll learn will be today — LVPD is going to be searching this nutbag’s property this morning, I’ll update as I see.

Listen to this video — the video is very grainy, but the sound is unmistakeable, it sounds like clapping.  I wouldn’t be a bit surprised if they discover drum mags in his room:

What is known right now about this mass killing in Las Vegas:

  • Shooter is dead; self-inflicted gunshot wound before the police could get in.
  • No motive yet.
  • The shooter had a pilot’s license.
  • 2 off-duty LVPD at the show were killed; two on-duty were wounded.
  • This guy was a local — from Mesquite, Nevada (80 miles or so away)
  • He had at least 8 firearms in his room, on the 32nd floor of the Mandalay Bay.  He checked in on the 28th of September.

Photos of this new nightmare:

An ABC News report that happened live:

More as I see it.  I’m sorry, everyone.

UPDATES

UPDATE, 10:47am Central:
Killed number has been updated to 58 and possibly 59 depending on one patient who isn’t expected to survive.
Wounded number has been updated to 518.

UPDATE, 15:52pm Central:

Some details on the shooter:

  • His father was a bank robber, Eric Paddock said. The FBI lists the late Benjamin Hoskins Paddock as being on the FBI’s most-wanted list from June 10, 1969 until May 5, 1977.
  • The father escaped from prison in 1969 and lived on the run until 1978, when he was arrested in Oregon, the Eugene Register reported at the time.
  • He has a brother — Eric Paddock — Eric Paddock said his father died a few years ago and that “he was never with my mom.” Eric said he was born while his father was on the run.
  • “He was a wealthy guy playing video poker … on cruises,” his brother said, adding that Stephen could afford anything he wanted and played $100-a-hand poker.
  • Authorities believe Paddock had a device similar to a hammer to smash the hotel windows prior to the shooting, Lombardo said. Officials think Paddock brought the weapons into the hotel by himself but did not provide specifics.
  • No military records so far for Stephen Paddock.

This guy is a terrorist — now he is a dead terrorist, having cowardly gone out the way he cowardly killed all of those people.

People jumping to get over the barricade away from the incoming rounds

The busted out windows of Stephen Paddock’s hotel room where he was firing at the crowd

Dude had Daytime aftermathUPDATE, 19:39pm:
Killed has risen to 59; wounded is now at 527.

On several occasions, Stephen Paddock gambled more than $10,000 per day — and in some cases more than than $20,000 and $30,000 a day — at Las Vegas casinos, according to an NBC News source who read the suspect’s Multiple Currency Transaction Reports (CTR) and a casino gaming executive.

This guy had more than 16 rifles in the Mandalay Bay room, plus a pistol; the search of his home turned up more firearms and thousands of rounds of ammunition.

 

Some hat tips/research list:
http://www.cnn.com/2017/10/02/us/las-vegas-concert-shooting-scene/index.html
http://www.cnn.com/2017/10/02/us/las-vegas-attack-stephen-paddock-trnd/index.html
http://www.reuters.com/article/us-usa-lasvegas-shooting/lone-gunman-kills-59-injures-hundreds-in-las-vegas-concert-attack-idUSKCN1C70FU
http://www.foxnews.com/us/2017/10/02/las-vegas-police-feds-race-to-uncover-what-drove-aggressively-unfriendly-gunman-with-weapons-arsenal-to-kill.html
http://abcnews.go.com/US/50-dead-200-injured-las-vegas-deadliest-shooting/story?id=50223240
https://www.nytimes.com/interactive/2017/10/02/us/mandalay-bay-vegas-shooting.html





https://www.nbcnews.com/storyline/las-vegas-shooting/las-vegas-police-investigating-shooting-mandalay-bay-n806461

http://www.cnn.com/2017/10/02/us/las-vegas-attack-stephen-paddock-trnd/index.html
http://www.aljazeera.com/news/2017/10/las-vegas-shooting-20-killed-scores-wounded-171002092103925.html
http://www.syracuse.com/us-news/index.ssf/2017/10/las_vegas_gunman_stephen_paddocks_father_was_bank_robber_wanted_by_the_fbi.html
http://www.latimes.com/nation/la-las-vegas-shooting-live-updates-carnage-concert-leaves-50-dead-100-injured-20171002-htmlstory.html


UPDATE:  Wednesday, October 4, 08:15am

The girlfriend is going to be questioned, she’s back in the states.  The sister’s story is that she was “surprised with a cheap ticket to the Philippines,” and that it was because she was sent away as to not get in the way of the planning.”  No shit, I just heard her say it.  The coward sent $100,000 to the Philippines a few before.

Murderer had cameras set up all around his room, inside and out; he was monitoring the room and the hallways, and one in the peephole of his door.

The guns inside the hotel room appeared to have bump fire devices attached to his rifles.  When you take them to the range and just have fun with them, they’re great.  This asshole used these currently legal devices and turning them into killing devices.  If you have one, I assume we won’t be able to have them anymore or they will become illegal soon.  He had 47 firearms (that’s the number today) in that room, several with long-range optics (scopes).  He was firing indiscriminately and picking targets.

There’s a picture out there of this jerk dead.  That’s how he deserves to be, for each of the families that he just ruined.

Photos coming, I’m on the road with spotty internet.


UPDATE:  Thursday, October 5, 08:14am

The general sense of the MSM news outlets is that there is more to the girlfriend’s story; at present, the coward killer gave her a “cheap ticket to the Philippines in order for her to visit family.  He also apparently wired her $100,000 for them to purchase a home there.  Then, in an interesting slice of irony, the girlfriend is back in the USA, and her attorney is speaking for her.  I personally find that odd, whether there is more to that is to be seen.

The killer’s girlfriend’s sister’s statement on video:

The girlfriend, Marilou Danley, had her attorney make a statement:

“It’s taken us this long to make a statement because it’s important to respect the investigative process. We wanted the FBI and the Las Vegas Police Department to have the first opportunity to talk to my client, Marilou Danley, about everything that she knew about Stephen. That being said, I have a statement to read from my client Marilou Danley. ‘I am devastated by the deaths and injuries that have occurred and my prayers go out to the victims and their families, and all those who have been hurt by these awful events. I have faith in God and I will continue to pray for everyone who has been harmed or hurt. I am a mother and a grandmother and my heart breaks for all who have lost loved ones. I knew Stephen Paddock as a kind, caring quiet man. I loved him and hoped for a quiet future together with him. He never said anything to me or took any action that I was aware of that I understood in any way to be a warning that something horrible like this was going to happen again. A little more than two weeks ago Stephen told me he found a cheap ticket for me to the Philippines and that he wanted me to take a trip home to see my family. Like all Filipinos abroad, I was excited to go home and see family and friends. While there he wired me money, which he said was for me to buy a house for me and my family. I was grateful but honestly I was worried that first the unexpected trip home and then the money was a way of breaking up with me. It never occurred to me in any way whatsoever that he was planning violence against anyone. I have not made a statement until now because I have been cooperating with the authorities and I voluntarily flew back to America because I know that the FBI and Las Vegas Police Department wanted to talk to me and I wanted to talk with them. I will cooperate fully with their investigation. Anything I can do to help ease suffering and help in any way, I will do. Please respect my privacy and my family’s privacy. Thank you.”

Here’s current numbers and information:

  • 58 people killed plus the gunman, but f**k him.  59 including him.  58 actual humans died in his planned attack.
  • as of right now with this update, there are 172 people still in bed care at area hospitals in the LV metro.

More photos, some of these are f**king terrible.  I have also posted, at the bottom, a protected photo of the aftermath of the coward murderer’s rampage — I protected this image with a click-first image, but I posted this just like I posted the photo at Le Bataclan — this is history, and that photo is a reminder of how little this asshole valued our lives.

A person who just wanted to go see a concert. That’s a body.

Victim of the shooting — she needs four more surgeries on her wounded arm, according to the source.

LVPD reacts and remains behind cover during a pause in one of the bursts of fire

Bystanders attempt to get help for a shot woman at the show

This one haunts me — how many times have we walked those halls???

Another haunting image — she’s in shock. Someone needed to be there with her.

Aftermath of the field at the Rt 91 Harvest Music Festival after the stampede of people getting away from being killed

This image below is of Stephen Paddock, the coward who killed 58 people and wounded over five hundred, dead from what appears to be a self-inflicted GSW.  Click it if you want, if not, do not click.