Open Heart Surgery and Me

Wow, where do I begin? I'm sitting here in my recliner a mere week after open heart surgery, starting down the road to recovery, and trying to pull together the events of the last couple weeks here for posterity.

I had first noticed some chest pain and discomfort when I went walking for any extended period of time... out for a walk on my lunch break, walking into church carrying Nathan in his carseat, and walking around the neighborhood while Beth pushed Nathan in his stroller. I felt pressure at the base of my neck, which tended to radiate out over my collarbones and sometimes up into the back of my head. At first I thought it was some strange new muscle pain since I had just started being active once the weather warmed up outside. After a few days though it didn't take much to bring on the pain. Just walking from my car into my desk at work brought on a mild headache. The final straw was on a Tuesday trip to WalMart on my lunch break. I barely made it into the store before feeling chest pain and barely made it back to my car to sit down and call the doctor. I took the afternoon off work, went home, and had Beth bring me to the clinic for a mid-afternoon appointment.

Despite my young age (29) and lack of normal heart disease risk factors, my doctor took it seriously (which I'm told doesn't always happen). He ordered an EKG, a chest x-ray, and some blood work. All of these tests came up normal, so a stress echocardiogram (stress test) was ordered. We called the hospital and set it up for the following afternoon.

I went into work Wednesday morning and felt pretty good overall since much of my time there is spent sitting down with my body at rest. My boss was very understanding and helpful having dealt with his wife's heart issues in the past. We brought one of my coworkers up to speed on my big projects so they could move forward while I was out yet another afternoon. Little did I know I wouldn't be back for quite awhile.

The stress test was pretty straight forward. Record some ultrasound video of my heart at rest, walk on a treadmill until I hit 162 beats per minute, and record more video of my heart beating at that point. Getting to that point was a painful process, but I could appreciate the usefulness of the test... being able to re-create the problem for the medical staff who would be investigating. Like I had experienced before, chest pain set in fairly soon and got worse the longer I went. I kept telling the technicians about what I was feeling, pain level, etc. It was really tough. Once we hit the target heart rate I got back on the exam table and they took more video of my heart. After a few minutes of rest I was back to normal again. At that point I had my own cardiologist.

The cardiologist came in and described what they saw in the test. They could see in the video that some portions of my heart valves weren't opening and closing properly. This is usually caused by a blockage in one of the arteries of the heart. In my case, they were 90% certain there was a blockage in the Left Anterior Descending Artery. Needless to say Beth and I were shocked to be hearing this, and yet took some comfort knowing what was causing me so much pain and what could be done about it. The plan was to go in on Friday for an angiogram (test to locate the blockage) and possible angioplasty (implanting a stent).

After Friday's angiogram the terms "incredibly rare" and "incredibly lucky" were thrown around a lot. The blockage I had was not normal. It was called a Spontaneous Coronary Artery Dissection, meaning that the inner lining of the artery had torn and blocked the flow. This is very rare and there isn't any specific cause. Had the blockage happened only a quarter-inch "upstream" it would have most likely given me a heart attack and/or killed me. Because of the location of the blockage, a stent was not recommended. I would need open heart surgery to perform a bypass using an artery in my chest to bring blood flow below the blockage. The surgery would be a bigger ordeal and would require a longer recovery but in the long run would be better for me than dealing with the issues associated with stents. I stayed in the hospital Friday and Saturday waiting for my surgery on Sunday. My family set up my CaringBridge site to spread the news and keep everyone informed on how I was doing.

Thanks to my mother in law, our son was being taken care of, and I got to spend much of my time with my wife which made all the difference. She was my partner and friend throughout my hospital stay, and my second set of eyes and ears since I wasn't always able to focus on what was going on. Saturday night and Sunday morning were busy with surgical preparations. The last thing I remember before surgery was being wheeled down to an anesthesiology prep area with my family.

My first memory post-surgery was a half-conscious haze with a breathing tube in my throat. I was listening to my family talk to me and managed to talk back by writing messages in the air with my hands. I spent the rest of Sunday and part of Monday in the Intensive Care Unit, and moved up into my room on the 4th floor. Somehow I managed to get the best view of the downtown skyline from the corner room. Recovery in the hospital was rough, but it was the best place for me to be. Having Beth there much of the days really helped. My nurses and nurse assistants were very good to me, helping me when I needed it, and keeping an eye on my vitals. Sleep was ok, but never great. They also taught me some basic exercises I could start doing until I got my strength back. Progressively I got my various lines removed, and finally had my drainage tubes removed from my chest on Wednesday morning.

Thursday I got to go home from the hospital. A volunteer brought me down in a wheelchair while Beth brought the car around. It was a beautiful day and good day to go home. Each day since has been difficult in it's own way, and great in it's own way. Each day gets a little better. My muscle soreness has been getting better, my breathing has gotten better, sleep has improved, etc. My chest incision has been looking better, as have my drainage tube incisions. The recovery process has its own regimen to it. Right now I need to make sure I take all my medication, do my exercises, and take three 10-minute quarter-mile walks each day. As time goes on I'll e taking longer walks but right now that is about as much as I can handle. Everything happens slowly and I tire easily, but I can feel that getting better. Next week I start regular outpatient rehabilitation 3 days a week at the hospital.

It's going to be strange being home for 2 months without being able to lift or move anything over 10 pounds, but in the end, besides having a healed breastbone I think I'll come out of this a much stronger person.

Ciabatta Bread

Once in awhile I come across something that catches my interest, particularly because it's something new I can try & learn. Lately it's homemade bread.

In my blog reading, I came across this "one minute Bread" posting over at Lifehack.org. The recipe seemed simple enough, so I took it a step further and looked into some more authentic recipes at allrecipes.com to see if they were any different. While true ciabatta bread seems to be a very lengthy process, I found one of the most popular recipes on the site was also quite simple. You can see the Allrecipes.com Ciabatta Bread recipe here.

Since this recipe calls for a bread machine, I took what I had learned elsewhere online and in the AllRecipes comments, and did without the machine. I also invested $1.25 in a water spray bottle which helps (more on that later). After a few loaves, here is what I ended up with:

1 1/2 cups water
1 1/2 teaspoons salt
1 teaspoon white sugar
1 tablespoon olive oil
1 tablespoon rosemary
3 1/4 cups bread flour (I used all-purpose flour)
1 1/2 teaspoons bread machine yeast
Seasoning for topping the bread (rosemary/basil/oregano)

- Mix all ingredients in a bowl except the flour and mix well
- Add the flour and mix with a spoon until it turns into a stiff, sticky ball of dough
- Cover the bowl with plastic wrap and let the dough rise for 2-3 hours at room temperature or higher until it doubles in size (see photo at right)
- Preheat the oven to 425 degrees F
- Transfer the dough to a baking stone or heavily floured pan. The dough is very sticky, so using a spoon or spatula will do you more good than your hands. Shape the dough to the desired shape, usually a longer wide loaf
- Let the dough rise at least 45 minutes after putting it on the stone/pan. I didn't have a good way to cover it, so I misted it with water to prevent it from drying out while on the stone.
- Top the bread with any seasoning you like. I usually sprinkled on some more rosemary and some basil.
- Place into a 425 degree oven for 25 minutes or until golden brown. For the first 15 minutes, spray the bread with water every few minutes. This keeps the outside soft enough to allow it to expand more in the oven, and supposedly gives you a better crispier crust.
- Allow bread to cool, and you'll have a delicious soft bread... that was relatively simple to make!

I personally like it warm with butter.

Happy 29th Birthday To Me

Today marks another year of my life... 29 to be exact. While a lot has happened in the last year, the highlight was the birth of our son. Best part of today? Nathan was EXTRA excited to see me when I got home. A lot more cooing, laughing, and wiggling with excitement for daddy! so much fun. Needless to say I love my family and being a new dad.

Last night we had my side of the family over for dinner. We served up a taco bar, homemade guacamole, and I enjoyed making a really rich chocolate cake topped with chocolate ganache. Next Friday we get another birthday celebration with Beth's family.

Happy Birthday to me!

A little joint-replacement surgery for my Laptop

In hindsight, the display hinges on my Dell D600 laptop have been a little flimsy for awhile. We really noticed a problem a couple weeks ago when one of the hinges was bulging up under the plastic cover. After a closer look and a little research, I determined the hinges were partially broken, and weren't far from totally breaking and letting the screen flop open.

I wasn't too happy that my hinges had broken, but I have to remember it's lasted almost 6 years now without any major issues. As it turns out, this is a fairly common problem, and replacement hinges were easy to find on eBay for less than $10 with free shipping. Since I used to repair laptops in college, I wasn't afraid to open up mine to do the repair myself, and Dell has a nice service manual available online. Overall it wasn't too difficult, just a lot of small screws to keep track of and some rubber bumpers to remove. My new precision screwdriver set came in very handy for the job.

Here's a photo of the damage to the left hinge, broken in two places, as shown next to the new hinge. The right hinge was only broken in one place, but still broken. The new hinges are installed and are working great. I like fixing things :-)

Building my magnetic stir plate

Back in November I went out to learn more about brewing beer. Among the demonstrations, one guy showed us a magnetic stirrer he made using a computer fan and a magnet. He was using it to stir up a yeast culture. In theory, this helps the yeast grow and thrive more than just letting them sit. Since starting a healthy yeast culture is an important step in making wine and mead, I thought I could use something like this for myself. Plus, I love a good workbench project.

The principle is very simple: place a magnetic stir bar (a small plastic coated magnet) in a container, and then place a spinning magnet underneath the container. This will spin the stir bar, and thus stir the mixture. I started researching, and ordered some small stir bars. I tried using some salvaged hard drive magnets, but I didn't like the results after my initial testing. After that I bought some smaller stir bars from eBay, and it turns out the seller of those stir bars runs the website stirstarters.com, whom I must give much of the credit for the design and my inspiration. While he sells his own stir plates, he also understands the DIY culture, and provides details about his design including a schematic for the speed control. With this information, I set out to make my own with one major difference: I didn't want to have to keep track of another AC adapter. I just wanted to run AC wall current right into the device for simplicity.

To get power to my stir plate, I would need an AC adapter to convert 120V AC to 12V DC, and it needed to be small enough to fit inside my project. What I found was a wall adapter that converted to a cigarette lighter plug like the one in your car. These are often sold as cell phone accessories, and with some searching I was able to find them very cheap online. I removed the "car plug" and the prongs that go into the wall, and replaced them with wires to connect into my project. This gave me 12 volts DC for powering the stir plate.

To actually get the AC power into the box, I salvaged an AC inlet plug and power cord from an old computer power supply. The plug mounted nicely onto the project box, and looks pretty nice I think. I also used a molex plug and wires to carry the 12 volts DC out of the AC adapter.

The speed control circuit was fairly simple to build, with the exception of the voltage regulator which I put on backwards the first time due to a poor diagram on the package. Thankfully it didn't cause any damage, just a confused engineer. I was able to find all the parts I needed at the local Radio Shack, except for the potentiometer, which had an uncommon resistance value, so I ordered that and the project box from Jameco. Had I not already bought my parts from Radio Shack, I would have gotten everything at Jameco. They have good selection and good prices. I mounted all of it on a proto circuit board to keep things relatively tidy, and added a power indicator LED to the circuit because I had some laying around... and LEDs are just fun.

The stirrer itself is made up of an old computer fan I pulled from an old project, a plumbing adapter from Home Depot which happened to be the perfect height, and some super strong button magnets from Ax-Man Surplus. This whole assembly is held together with epoxy, and thanks to some careful planning and assembly, is pretty well balanced when it spins.

The completed stir plate works quite well. I can just plug it in, turn on the power switch, and adjust the speed. I haven't tried it out yet on a yeast culture, dissolving some bentonite, or anything else yet... but it can stir water like a champ! I tested it out on a 1-gallon jug and got a little vortex, so this looks like it will be a useful tool to have on hand.

Happy Birthday to my new Nephew Toby James

Happy Birthday to my new Nephew, Toby James. He was born January 19th, 2010 and weighed 7lbs 11oz. We were able to visit him later that evening. He was very alert and very cute! My sister and her husband and their new son Toby (and big brother Sammy) all seem to be doing well.

Welcome to the family!

Kitchen Creative: My First Fondant Cake

This past Sunday was our son's baptism, and we needed a cake. Being that I enjoy opportunities to be creative, and enjoy making fancy deserts, I wanted to make & decorate the cake. Years ago, I worked for a joint franchise of Subway and TCBY. When we added the TCBY counter, I wanted to learn a bit about cake decorating since we would be selling custom cakes. He paid for me to take classes at Michael's, which was fun. So... this was a chance to try it again.

As I researched and thought of ideas, I started to read up on Fondant, and found lots of how-to videos online with tips on technique. Fondant is basically a cake frosting with a dough-like consistency. It's typically rolled out flat, and then draped over a cake to give it a smooth texture, and is often used on high-end "3D" sculpted cakes. I found a recipe on AllRecipes.com that seemed simple, so I decided I would give it a try.

I decided to make a two-layer 9 by 13 cake (although in hindsight one layer would have sufficed). I cut some cake off of the top layer and used it to sculpt a small turtle, like the ones his nursery is decorated with. I then used canned frosting to stick everything together, and frosted the outside so the fondant would stick.

I made up a batch of about 3 lbs of fondant. This particular recipe seemed a bit greasy to me due to the use of shortening and corn syrup, so if I try this again I might try another recipe. I did add more powdered sugar to try to compensate though. The hardest part was doing the base of the cake, but perhaps if I had the proper supplies it would have been easier. Rolling out a sheet of fondant big enough to cover a 2-layer 9x13 cake and then transferring it to the cake was tough. A smaller round cake would have been easier to manage, but I was able to do it without too many tears or cracks.

I took the fondant that wasn't used on the cake and colored it with some food coloring gel to make blue and brown for the turtle. This worked rather well. I rolled out small sheets and draped them over the turtle and trimmed off the excess. I like how it turned out.

The final piece was lettering. I had plenty of blue fondant left over, so I rolled out a sheet and used a pizza cutter and knife to cut out lettering for the cake. It was very time consuming but it turned out well. To make sure they stayed in place I used some fondant thinned out with water as a kind of glue. The final result was put out on Sunday and everyone was impressed. Best of all it tasted good. I enjoyed a piece of turtle shell myself :-)