Because 26.3 would be crazy!

This weekend I ran my 10th or 11th marathon, the third since my open heart surgery last year.  (If you don't know how I came to be on the operating table you can see the story here.)  

The distance you run in a marathon is 26.2 miles, or around 42 kilometers.  That's once around the Twin Cities from the Metrodome to the Cathedral via Nokomis and the Mississippi.

(For my Australian friends, that's the equivalent of from Flinders St to Frankston)

It's a long way! 

Running has helped me with my health and fitness, and I think it keeps me sane.  It also helps me with my clients.  When I start the run I know that, barring unforeseen or extreme circumstances, I'm going to finish strong.  That's how I work with my clients:  when we start together they know that, all things being equal, we're going to get over the finish line and it's going to be good.

It's called being "consciously competent". 

When I started running I was all over the place.  Sometimes I would put on the wrong socks and get a blister.  Sometimes I would have the wrong shoes.  Sometimes I would have a great run but because I didn't know what made it great I would be surprised when my next run was terrible.

Over time I became better.  As I became better I started to understand how I was becoming better.  I started "incompetent", I became "unconsciously competent" and eventually I've ended up "consciously competent".

I was quite deliberate above when I said I know I'm going to finish barring "unforeseen or extreme circumstances".  I purposefully plan my run so that if I start to dehydrate I know where I can get water, if I run out of energy I know what I can eat, and if I fall and break a finger, (like a friend of mine did), I know how to get medical aid and keep going.

A lot of my clients are really good at what they do but sometimes they're "unconsciously competent".  By getting them to be more self-aware and more planful about what they do they become better able to repeat their successes, better able to handle set backs, and more confident about their ability to take risks…like setting out on a 26.2 mile run and knowing they'll be able to finish well.

Once you're consciously competent you just go out and get it done.  You don't have to prove anything to anyone.  And 26.2 is enough, because 26.3 would be crazy!

My work with clients is like the first run of spring!

If you know anything at all about me you probably know I’m a runner. My parents remember me heading out for a run in my neighborhood from the time I was around eleven. At fifteen I got a part time after school job in a supermarket about three miles away, and I would walk home, change, run to work, pack bags and stock shelves until store closing, then run home again.

I’ve been running for a long time. Today my running broke through to a new level and it reminded me of my client work. Here’s how.

This is me just before my first outdoor run of the spring season. It’s a beautiful change of seasons day in Minnesota. The temperature is a relatively balmy 45F but the lakes are still crisp and white with winter’s ice. The trees are still bare yet the snow cover has melted and the first blades of grass are coming through.

I approach my running the way I approach much of my consulting and coaching work.

First, you had better enjoy what you do.

Every now and again I run into a prospective client or an employee in one of my clients who just doesn’t enjoy their work. When I was fifteen I never imagined being able to run a marathon. Now I’m going to be fifty this year and I can’t imagine the sprints and splits I used to do when I was younger. Nevertheless, at each time in my life I’ve matched my expectations to what’s practical and enjoyed the ride. Life’s too short not to enjoy what you do, so a good starting point for everyone is to make sure you love what you’re doing.

So...I enjoy running. I’m heading outdoors for the first time in three or four months when I’ve been avoiding the depths of winter. While it’s been cold and dark I have been running indoors on a treadmill. Since my operation last year I’ve been slowly building back up, grateful that it was probably my fitness that pulled me through the surgery in the first place.

Over the course of winter I have changed my technique quite dramatically. For those of you who are runners, I’ve moved from being a heel strike/toe liftoff runner to a midsole runner. That means I am no longer landing on my heel and rolling forward through my stride until I push off from my toe. Instead, I’m landing on my midfoot and pulling up on my heel to move forward. That’s a very big difference and not at all intuitive, but it’s the way most long distance runners run.

Learning any fundamentally new skill is hard but there are three stages and they apply equally to running or learning a new management competency. The starting point for me was form. First I had to focus on the new way of moving my legs and feet, and I had to practice it over and over until I was doing it right. In the early stage of developing any skill it’s all about technique. I knew getting the motion right from the beginning would mean I had less to “unlearn” as time went on.

The second stage in my transition was range. I started off barely able to maintain my form for more than a few hundred meters. I slowly extended my limit, being able to maintain form for longer and longer. Once I could do that I worked on the other part of my range, the ability to move uphill and down, to maintain my form when I was fresh and when I was tired, and finally, to maintain my form through the whole running repertoire of sprints, jogs and fast walks. All the while I was gradually growing my abilities while still focusing on my technique.

Finally, I could pull it all together and see the effect on my enjoyment, endurance and speed. Speed is the last thing a runner should concentrate on. All things being equal I know I can maintain my form over any distance or type of terrain in front of me. The only thing that varies is the speed and how long it will take. Once I’m thinking about speed I start to see how everything relates together, how little changes here and there improve performance, the fun I get out of my running and how my new technique works successfully across all environments.

Working with businesses and senior executives is exactly the same. First, focus on technique and the few things with the most impact. Second, grow skills and range, developing capacity and confidence. Finally, look at how everything relates and how to maximize results. Focus, Grow, Relate.

I cruised around the lake today at my fastest speed for a couple of years. Excellent. And yes, I really enjoy my work too.

My final (?) comment on my surgery

Last week I ventured out into public professionally for the first time since my operation. It’s been about three and a half months since the diagnosis and operation to repair the faulty valve in my heart. Everyone I met was wonderfully supportive.

It’s good to be among colleagues who are also friends and to have a work environment that is also a positive social environment. It got me thinking about how important friendship is, even at work.

In my work with clients I emphasize the importance of a supportive network of positive relationships. My surgery and the experience afterwards was a reminder that it’s not only at work that supportive networks are important. A Wall Street Journal Article this weekend quoted an Australian university study of more than fifteen hundred women over fourteen years. It found that that the women with the most friends lived an average of 22% longer than the women with the fewest friends. That’s an enormous difference, and it’s repeated over and over with very little variation in the scientific literature.

Sometimes I hear people at work say “I’m not here to make friends”. Well sure, that’s not why you’re coming to work. However, it’s foolish to forgo the opportunity to build a supportive network in your work environment. We know that having fewer friends will make your personal life much more difficult, not to mention the professional effect of missing out on the support of your colleagues .

I’m extremely grateful for all the support I received from all our friends, clients and colleagues. Genevieve and I spent the last month of my recovery “getting away from it all” in Europe, (that’s us in the picture at Versaille in Paris). We traveled around, exercised every day and caught up with family and friends, even staying with some of our old clients who crossed that line and became our good friends as well. When I left Minneapolis I still couldn’t lift my carry-on into the overhead locker. Now I feel brand new after a month of fresh air, lots of exercise and constant contact with people who care.

This is an open thank you to everyone who was so wonderful. Speaking professionally, it’s given me encouragement to keep doing what I do. Speaking personally, it’s given me a sense of humility and gratitude for the great people I’m surrounded by.

This will probably be the last posting specifically covering my operation and afterwards. Now it's time to get back to a full focus on work. One thing I do know...over the next period of my life it's time to pay this forward with everyone I can.

You can email me here with comments or leave a question or reaction below.

The end of Week Five Post-Op

This photo of me was taken by my ever patient photographer wife at the end of my first run, exactly five weeks after my surgery. I didn’t run far, maybe two miles in the sub-zero temperature…it’s a start.

This had been a bad week for me, but it’s all relative. It began with a bloody nose on Tuesday morning after a particularly violent sneeze. It turned out that I had burst a capillary in my nose, and with the blood thinners I am taking it just wouldn’t stop. I had to cancel meetings I had set up, and then put up with hanging around the house feeling useless while my nose dripped.

One thing that happened as a result…I finally got it fixed on Saturday. I’d gone to Urgent Care as recommended by my physician if it wouldn’t stop, and after a really bad downpour that ruined a shirt I’d had enough. I was ready to get my nose cauterized. My blood pressure was up, and my blood clotting ability was down, so they’ve changed my meds and then looked at what they could do to fix the bleeding in the meantime. “Have you tried Afrin?” asked the physician.

I’m thinking it will be a $95,000 experimental drug I’ll need to get special permission to take, and it turns out to be a $3.50 over the counter spray that most people would already have used. I guess he could have recommended a more significant medical intervention, but he did for me what I hope my advice does for my clients: regardless of what he gets out of it he presented the most effective solution in my best interest.

The second thing reinforced for me this week was the kindness of the people I know, both personally and professionally. I have four projects on currently, and I’ve had to contact each client, explain my situation, and talk with them about how we can handle their project in the best way for them. The very positive thing is that each one has gone out of their way to accommodate me, juggling calendars, doing work virtually and by email, and generally being as helpful as possible. I’ve had flowers sent to my home, books and meals left for me by friends and colleagues, and even a bag of chocolate covered licorice, (my favorite), deposited anonymously on my doorstep.

In the past I’ve visited my friends in hospital, dropped by and offered help when they’ve been sick and tried to go out of my way to cover for absent colleagues. I don’t think I’ve been particularly good at it, and I’ve never been sure how my efforts have been received. Now I’m on the other side of the operating table let me say, it feels really good to have people make an effort for you. It has helped my recovery enormously and given me a world of motivation to get well. I’m sure it wasn’t done in the spirit of payback, but nevertheless, I feel fortunate to be the recipient of the largess, and an obligation to do more for others in the future.

If the golden rule of “do unto others as you would they do to you” has any meaning it is as a basis for everyone building a kinder, more generous society where we think about how our actions affect others and try to maximize their well-being. My take-away from this week is that I should try to do that more, and ask for help when I don’t know how to deal with a nose-bleed.

One small run for me, one giant thought for society.

Week five is the week of hubris

There’s no word in the English language for hubris. The ancient Greeks and Romans wrote about it often. Oedipus in his pride refused to step aside for another on his path and unknowingly killed his father. As a result he goes on in his ignorance to marry his mother, a sort of ironic come-uppance from fate. The word means a lack of humility coupled with overconfident presumption, and usually precedes a suitable downfall.

Wikipedia has a great modern example:

“During the 2006 Winter Olympic Games, American snowboarder Lindsey Jacobellis had attained a seemingly insurmountable lead in the Snowboard Cross event final until she attempted a celebratory method grab as she neared completion of the course. The unnecessary move caused her to fall, allowing Tanja Frieden of Switzerland to pass her and win the gold medal. The media has cited this incident as an example of modern-day athletic hubris.”

So…my hubris was assuming my recovery was going so well that I thought I could start back at work three weeks early, and I told people I was “as fit as a lion”. I’m still very well, and there’s no big problem to my health, but starting Tuesday morning I got a nose bleed that wouldn’t stop. I’m on blood thinners so essentially I had a bright red dripping nose from about 11am until bedtime. A trip to the anti-coagulation clinic and some advice has kept the drip somewhat manageable, but still not something you want to inflict on other people.

When you presume too much and get overconfident you leave yourself open to problems! Now I have to eat humble pie and get ready for next week’s challenges. It's a sobering lesson in hubris.

The end of week four

Genevieve took this portrait of me this morning, exactly four weeks after my surgery. I'm sitting at my computer and finally catching up on all my work and correspondence.

Yesterday we met with my surgeon for the first time since my discharge from the hospital. I'm doing well, as was indicated when the nurses asked if I would like a wheelchair to get to the X-ray department. I haven't used a wheelchair since the second day after the operation, and even walked out of the hospital under my own steam on the day of my discharge.

So yesterday I had a lot of blood samples taken, looked at a lot of charts and figures, and spent a lot of time contemplating my recovery.

I got the go-ahead to start driving, and because I'm pretty flexible now and pain-free, I even got approval to begin some light running if I want. I still can't lift much until the bones knit, but I can get around OK, and I have much of my old stamina back. (My old stamina, as in before 2008 since I suspect that much of what I thought was old age and laziness last year was really the result of the poor heart circulation).

All things being equal, this will probably be the last entry here that specifically relates to how I'm recovering. I still have some insights that have come as a result of the experience, and I'll continue to put those here where I feel they can benefit others.

I also have to say, thinking and writing about things has benefited me enormously, particularly in so far as it has helped me get a sense of humility and the role of good fortune in my recovery.

Everyone has been wonderful and positive, and if I haven't said it directly, (which I hope I have often enough), then at least you know I have been continuously thankful and pleasantly surprised by just how supportive everyone has been.

Sincerely,

David

You can email me with comments by clicking here, or leave a comment for others to see by clicking on "COMMENTS" below.

End of week three

This is me exactly three weeks after my operation. I’m still at home, but I’ve started seeing a few clients and getting back into my regular routine. I still can’t drive, but that will come soon.

Last week at my second physiotherapy session I lifted my arms over my head for the first time: painful but worth it. I can’t lift anything heavier than a gallon of milk, but I can put on my own shirt and tie, lift my books and generally get around the house. I still have to sleep entirely on my back, but I can get into and out of bed easily enough, and make myself comfortable in most chairs around the house.

Everything is relative.

I have been very lucky, both in the friends and clients who have been so supportive, and in the good healthcare outcomes that are putting me on the road to a great recovery.

A lot depends on whether you focus on how good things are, and work at the few things that are not going so well, or whether you focus on how bad things are and spend all your time looking for something to feel good about. I try to do the former.

Connections, Connections, Connections

During my recent hospitalization I made many connections with the nurses, technicians, physicians and support staff on my ward. Hospital rooms are a bit like Times Square or in my home town, Flinders Street Railway Station: many people constantly coming and going whose purpose and motivations you don't understand.

A concept I discuss with my students and clients is Peter Singer’s “circle of ethics”. Drawing on a long history Singer talks about how most of us start with a fairly narrow circle of care: the people whose interests we try to assist and whose positive outcomes we support. It begins with parents and family, extends to neighbors and play-mates at school, and over time comes to include “first a class, then a nation, then a coalition of nations, then all humanity.” As the circle of care expands, so too does the circle of influence. Once we begin to care about suffering in other countries, we start to find ways to positively influence overseas welfare. Our circle of care runs a little ahead of our circle of influence, and directs where we spend our time and emotional energy.

In the hospital I made a point of introducing myself to everyone who came into my room. When Genevieve was allowed to stay with me I introduced both of us, and I made a point of trying to remember everyone’s names so I could greet them again when they came back. This is just part of my nature, but I imagine it’s also something I have learned to do because I am positively rewarded for it. The staff made little allowances for us, and generally made our stay as pleasant as possible. We were pulled into their “circle of care” because we had created a personal connection with each other.

As an example, it seemed like every six hours or so someone would come to change my IV site, take a blood sample or do something else that involved tubes and poking me with sharp needles. One day, two gentlemen came in together and I went through the usual introductions: “Hello, I’m David, and this is my wife Genevieve.” Almost anyone will then tell you who they are by name, and these two introduced themselves and told me they were the new phlebotomist and his trainee. We made a little small talk, and I was interested to hear how the trainee's job was going because my Little Brother from the BigBrotherBigSister scheme has just started working as a trainee at the Red Cross.

So then the time came to stick me. “Ah,” I said. “And which of you will be drawing my blood today?”

Now you have to remember that my arms already have two IV lines in them, and they are blue and bruised all over from the many blood draws I already have. A trainee will be hard pressed to find a spare vein, and will find it even more difficult than usual to take the blood sample painlessly.

“Well…I guess I can do your draw today” said the trainer, and the trainee handed over his needles.

Connecting with people draws you into their circle of care, and if they have the ability to influence your well-being it makes people positively inclined to go out of their way for you. It’s why waiting staff introduce themselves to you at your table, and why it pays to get to know your auto mechanic. Done with sincerity and genuine care it expands the circle of people around you who will put out their hand to help you.

Recovery is a marathon

I’m up and about, and yesterday I even met with a client as I slowly resumed my normal work pattern. Not such a good idea.

I think that if you wanted to make a broad generalization about people you could say that they are either temperamentally suited to be sprinters or marathoners. The sprinter types see challenges and obstacles as something to be tackled right here, right now. They throw their all at a situation, and depending on talent, motivation and opportunity, they either succeed or fail, right here, right now.

Marathoners are a little different. Today wasn’t such a good day for me. Just as a hill looks different at mile six, or sixteen or twenty-six, a few simple tasks today completely tuckered me out. I hadn’t realized how much being out and about had taken out of me. I slept in front of the TV for three hours yesterday, and this morning I was still sleeping on the sofa at 11am.

However, I don’t succeed or fail based on how I feel today. Recovery is about keeping your eye on the finishing line and keeping on being the best you can. I want to give my clients my full attention when I'm with them, and I want to be on top of my game. Recovery is a marathon, and sometimes you have to slow down to go fast. I’m taking it easy for a couple of days and then I’ll try again…and I’m going to make that finish line faster than you might expect.

Self identity and effectiveness

This is me two weeks exactly after my surgery. You can tell from the beard...I'm not planning to keep it but it's been growing since the operation. It gives me a Ernest Hemingway look that goes with the fact I have been doing a lot of writing and reflecting lately.

Two things happened today that made me think again about how my recovery process has progressed. Firstly, I received my monthly copy of the Journal of Applied Psychology today. This month's special edition is on social identity and well-being. (I'm an applied psychologist...that means I did six years full time university study after my undergraduate business degree, and my focus is psychology applied to real world issues. In my case my expertise is psychology applied to business, ethics and organizations. The International Association of Applied Psychologists is the world's oldest professional psychology association.)

Secondly, someone I don't know was reading this blog and commented "...I did find it interesting. He sure is a type A. I could not agree with him more on how his outlook affects how he recovered!!!"

I don't think of myself as a type A, or super competitive, or very driven. I've had feedback before that I come across this way, but, like most people I just think I'm "normal". However, I know that how you identify yourself makes a huge difference to your effectiveness when faced with stresses and challenges.

You've possibly heard the saying "whether you think you can or think you can't, you're always right". A lot of people mistake "positive outlook" for some kind of new-age ability to affect the world around you because of how you think. It's much more complicated than that. My IAAP journal featured articles that show that if you identify with a group that gives you a sense of meaning, purpose and belonging, it's likely that your positive self-image will spill over into your ability to handle challenges, particularly health related challenges.

Type A outlook? Sort of, but not quite.

You can see in the picture that I'm wearing my last marathon finisher's t-shirt. Today was my first day of physiotherapy, and I wore it to the physio session. I wasn't trying to be smart, but I think of myself as a marathoner. I identify with that determination to finish, stamina, and positive mental attitude. I didn't think about why I wore it today until I came home, read my email comments and opened my journal. Yep...that's one of the ways that I identify myself, and that attitude carries over into my ability to deal with this surgery and everything else in my life.

Social and self identity are extremely important. How you see yourself is reflected in how others treat you, and plays a key role in determining the mental resources you can muster. I once coached a Finance Director who felt that every day on the job was a fraud...another day he got by until people found out he wasn't very good. The thing is he really was good, running financial operations for a multi-billion dollar operation spread across dozens of countries, but with that attitude he could never muster the self-confidence to be a really effective leader in his organization.

It's better to find a more effective self-identity...like great parent, generous parishioner, faithful friend or whatever. All of us have complex self identities, part of mine is being a marathoner.

How do you identify your self?

You can email me here, or leave comments for others to see by clicking "comments" below.

How trust helped me through

I’m writing this in the second week after my open-heart surgery. I’m home and feeling well, and getting ready for my first physiotherapy sessions. I am reflecting on my experience and the notes I took and I have decided to start with the big one: Trust. Trust is the basis of all human interactions. That’s a huge statement, and one I repeat frequently with my clients and in my presentations. Trust helped pull me though my recent surgery.

I shopped around for my surgeon. I called on my network and checked out a few of the different places and people who could do my operation. When I sat with my surgeon for the first time it was Genevieve and I having a three-way discussion about my options and prognosis.

What would have happened if we hadn’t trusted each other? Without trust it’s difficult to have a relationship of mutual and positive outcomes. If you don’t have trust you’d better at least have, in declining order of effectiveness:

1. Respect
2. Compelling Mutual Goal/Context
3. Continual and Intense Communication
4. Power and Competition
5. The ability to “live with it”

Sound familiar? Many patients complain they don’t understand their surgery, or they feel powerless to get what they want. Eventually, many patients have to “live with it”, feeling pushed around by their medical staff and not a part of the process.

I wanted to trust my surgeon, and just as importantly, I wanted my surgeon and my medical team to trust me. What is trust? Here’s how I define trust as an outcome of four different aspects of the relationship:

• Capable: Can do what you say
• Reliable: Will do what you say
• Open: Will say what you do
• Principled: Will do what you should

When it comes to trust, like a crop, you reap what you sow. So of course, we asked many questions such as how many of these procedures the surgeon had done before, what the success rate was, what the options were and so on. One question in particular stood out for me. I wasn’t afraid of much with regard to the operation, but I did have a morbid dread of being one of those patients who “wake up” under anesthesia and experience the pain of the operation without being able to do anything about it. The surgeon’s response? “Yes, that would be terrible, and it does happen. That’s why we do X, Y and Z to minimize the chance of it happening during your operation.”

I liked that. He was clearly competent and didn’t try to sugar coat the risks for me. He empathized with my fears. He outlined what might happen, and the steps taken to minimize the risk. He was principled…he was open and frank with me and I trusted him as a result. But how did I come across to him?

Trust is a two way street. By doing my homework before our meeting I hoped he would see I was competent and reliable as well. I was open about what I knew I could do post-surgery, and what I felt was beyond me…and in our discussions I believe I came across as principled: someone who would do the right thing when needed.

And as it turned out, I believe my surgeon’s trust in me helped my recovery just as much as my trust in him. Certainly, when it came to my peace of mind it was much easier to be relaxed and focused believing I was in the best hands. When the medical team discussed my pain medications and my options for getting up and moving around they let me try to move forward at my own pace. They trusted that even if I wasn’t as pain medicated as many patients, and was trying to get up and walking quickly compared to others, I would be open with them about my limits and take responsibility for the outcomes. They let me try walking on the first day, and I was able to gently push myself to getting out of the ward on the fourth day post-op.

Our mutual trust worked well for both of us, and set the basis for our interactions together.

A psychologist's experience of open heart surgery

So this is me six days after surgery: at home, out of pain and well on the road to a complete recovery and resumption of my healthy pre-op life.

I've done well, but more importantly, I had a network of really powerful relationships supporting me through all this. Let me take a quick moment to express my thanks to my beautiful wife Genevieve, her mother and my parents, the surgical and post-operative teams at Park Nicollet Cardiology, my friends, my clients and everyone who has been in touch and provided comfort and support.

My recovery has been really good. I know that because I saw others on my ward and heard the experiences recounted to me by the medical teams. This is the biggest thing that has ever happened to me...more life changing than I could have imagined originally. I took notes throughout, and with hind sight I can pull apart my experiences and explain them with the benefit of my training. I am going to put what I have learned into a series of posts here.

• The importance of trust
• Self-awareness
  
• Self-efficacy and the belief you can do well
• Emotional support
• Managing your emotional state
• Building relationships
• Appreciating others

The soft stuff is the hard stuff. Everything I knew and applied helped me come through this as strong and well as I did.

You can send me an email by clicking here, or you can share a comment for others to see by clicking on the word "comments" below.

Sincerely,

David

Getting strong again

This is me on the afternoon of the first day after surgery. I'm sitting up out of bed, I've asked for my book and some glasses, and I've put on my own "luxury" robe.

Why?

I can't speak highly enough about the surgical and post-operative teams. While I was in the hospital I saw my one job was to work at feeling as well as I could. I didn't emphasize "getting better" because that might be out of my hands, but I did know that I could be fully responsible for making the best of every opportunity I had to be as well as I could. It's a subtle difference but an important one.

Shortly after this photo was taken I went for my first "walk". Probably not really a walk. The ward I was on was in the shape of a cross, with a central nurses' station, and rooms coming off each of the arms. My best guess is that the arms were about twenty metres/twenty five yards long. On the first day I went from my room to the nurses' station, up one corridor and back...maybe sixty or seventy yards round trip. It took a good twenty minutes and left me totally exhausted.

I had a tag on my arm saying "fall risk" and a nurse on one side with Genevieve on the other.

On the second day I made the trip eight times...it took me eight hours.

By the third day every nurse or procedure technician coming in would say "oh, you're that marathon guy aren't you?". I was off pain medication for more than twenty-four hours, and off the blood pressure medication as well, which none of the nurses could believe. I had a slight set back in that I put on eight kilos/twenty pounds in water weight on Saturday, and needed to be stabilized again. On Sunday I was asking to go home. I was disappointed when they wouldn't let me out on Monday, although they removed all the drainage tubes, catheters and pacemaker wires. By then I was cruising the halls of the hospital taking walks every hour or so, and covering my floor and the public floors below.

They made the decision to let me go home before lunch on Tuesday.

For more click here.

You can send me an email by clicking here, or you can share a comment for others to see by clicking on the word "comments" below.

My operation

This is an illustration of the operation I had done, beginning with the incision made in my chest. Basically the surgeons needed to get access to my heart, and the way we chose to do it was by the frontal incision you see here. There is a neat scar from just below where my throat ends to just underneath my sternum. Once the chest is opened the sternum is cracked, (sawn?), and the ribs spread. The internal organs are moved around, and the heart is exposed for the operation.

I say "we" chose this because we had discussions with the surgeons before the operation about how it could be done. There is an alternative method that involves "keyhole" type surgery from the side. Post-operatively the results are much better as there is less trauma to the body. However, the surgical outcomes in terms of repair and complications may not be so good. We figured I was young and fit enough that I would prefer the better chance of a full repair and I'd fight my way through the recovery after.

I believe a major factor in my recovery is that I felt engaged and fully trusted the surgical team. I'll come back to this in a later post because this is a major learning for me and my clients in terms of self-efficacy. We do well because we believe we can do well, and there are clear paths to improving what we believe about our abilities.

The day before the major operation I had a angiograph...one of the procedures where they knock you out and put a catheter into your heart from the artery in your leg. Then they flood the heart with dye and check out the health of the blood vessels. Bingo! I have the heart of an ox, and despite the occassional beer, wine and plate of fish and chips everything was clean and healthy.


This is an illustration of the work done in the heart. It was cut open to reveal the mitral valve between the two left heart chambers. In my condition the valve wasn't closing properly, so if I understand correctly about 40% of each pump went back up the heart instead of into the body. This was causing my upper atrium to expand, and limiting the oxygen my muscles were getting.

The damage to the upper atrium isn't permanent, but would have become permanent if this had gone on.

After the repair I was moved to ICU where I was on ventilation and a heart pacemaker. For the next two days I had IV drips in my arms, two drainage tubes from my chest attached to a portable "suction" machine, and the electrical lines for the pacemaker still buried into my heart "just in case".

For more on my recovery click here.

On the mend

As you can probably tell from the photo, I'm up and about and enjoying the taste of real food. This picture was taken on the morning after my surgery while I was still in the Intensive Care Unit. I'm doing well and the recovery has been good.

I went in to surgery at 7am on Friday 30th January, and I came out into ICU around 2pm. They had me stabilized and on IV and heart monitoring, and Genevieve was able to see me around 5pm, which is roughly when I became conscious. I was on ventilation for an hour or so, and on a heart pacemaker overnight.

I'll not share with you my experiences of recovering consciousness and the ability to breathe. It's enough to say that it took me a good twenty minutes to remember how to speak again even after the ventilation came away. I remember holding Genevieve's hand while I learned the shallow in and out breathing that kept the machine off me, and how thankful I was for having her there and the care of the nursing staff.

The first thing I asked for when I could speak...a sprite! I never drink sprite so I've no idea what was going through my mind, but I can tell you it seriously tasted so good I have no words to describe it. It was like I had to regain the ability to taste, and the sugary liquid set off every pleasure center in my head I have ever known. Genevieve and the nurses said I couldn't stop laughing.

The following morning I could sit up with support, and I asked for solid food. From then on the hospital has told me the recovery has been one of the best they have ever seen.

I'm writing this about one week after it all happened, so you know things have just kept going uphill from here. I'm very thankful for all the kind support and good wishes that have been sent to me.

I am going to keep this short, and I will post the rest of the recovery in some short messages that follow. You can send me an email by clicking here, or you can share a comment for others to see by clicking on the word "comments" below.

For more on my recovery click here.

Once again, thank you to everyone for all the support.

David

A stitch in time!

I know news travels fast, so I thought I should get in touch and let you know I’m OK, and I’m going to be OK. Even with modern technology it's difficult to get to everyone, and I'm sure there is someone I haven't been able to get to. So if you’ve already heard something on how I am, here’s the full story, and if you haven’t…here’s the full story.

For Christmas I gave Genevieve a trip to Paris. I decided I could enroll in the Paris marathon in April, and combine it with some work and leisure while Gen spent time with her family. The French marathon authorities, being French and very thorough, required me to get a physician’s sign-off that I was fit to compete. Now…I’m OK but…

The physician takes my weight and blood pressure, and wants to listen to my heart before signing the form, (“Come on Doc, I’ve done seven of these marathons and last September’s was my best ever”). “So,” he says, “you have a pretty strong heart murmur. How long have you had that?”

To which I reply, “What murmur?”

Thunk.

Turns out the mitral valve in my heart has "broken" since I last ran in September, and I’m currently only pumping about 60% of the blood I should be. I’ve had lots of tests and pictures of my heart in the last week or so. Apparently I’m as fit as a horse and I have a really strong heart, which is why I hadn’t noticed any symptoms except a sort of growing lethargy and a little shortness of breath.

After a few more tests and things I'm scheduled to go in for coronary angiography on Thursday 29th January, and heart surgery on Friday the 30th. The angiogram is because "we're going to go in anyway, so we may as well look around to see if there's anything else we should be doing". They don't expect to find anything. I was offered keyhole surgery, but the results are more problematic with my issue, so we opted for the more traditional approach. Basically, the doctors open up my chest, open the heart, put in a couple of stitches to tighten the valve and off you go. The doctors say I will be out of hospital in 4-5 days, and back running in 4-6 weeks. These are the sorts of things that just get worse and used to kill people of our grandparents’ generation. So, wow…sometimes we don’t know how lucky we are.

The France trip was actually a present for April, which is when I would have done the marathon there. We still plan on France, but now it will be more sedate with plenty of red wine and cafés. I’ve also got a trip I’m leading to China in May so I’d better be good for that as well!

I’ll be back on deck in a week or so. If I didn't manage to get to you personally with my news I'm sorry, and I hope you'll recognize it's because we have a few things on our mind. I'd love to connect with you after I'm better, so please get in touch...Genevieve will update this and let everyone know how I am.

All the best to you all,

David

Click here to email me with any questions or thoughts, or click on the "COMMENTS" link below to leave a comment.

Late news! I'm better now and at home. For the rest of the story click here.