My 2-Year Anniversary!
Two years ago today, I had OHS to fix my severely regurgitating mitral valve. I was diagnosed with a heart murmur in 2012, but by ...Read more
My 2-Year Anniversary!
Two years ago today, I had OHS to fix my severely regurgitating mitral valve. I was diagnosed with a heart murmur in 2012, but by 2014 the leak had gone from mild to severe. My cardiologist at the time not only said I didn’t need the valve fixed, he also said I didn’t need to have a TEE because I was asymptomatic. I remained asymptomatic in all the days leading up to my surgery. Had I taken his advice, I may not have had my valve fixed and who knows what would have happened other than the leak would not have gone away and my heart could eventually have been compromised. Instead I’m living my life with a normal heart and a valve with no leak, not even trace. During the time I contemplated surgery, I did my research and found that doctors and surgeons do not agree on when asymptomatic patients should have surgery if at all. I decided surgery was the answer and referred myself to Dr. David Adams at Mount Sinai in Manhattan. After the consult, I knew this was the right person to perform my surgery, and I canceled my consult at the Cleveland Clinic. Dr. Adams told me he was 100% sure he could repair my valve. When I asked him the last time he was wrong and had to replace a valve, he said 2002. I decided those odds were good enough for me. My husband, who distrusts most doctors and surgeons, is the one who said I didn’t need to look any further. He totally trusted this guy to take care of me (which if you knew my husband, you’d be very surprised). The surgery went perfectly and I was discharged after 5 days. The only complication was developing post pericardiotomy syndrome. I ended up back at Mount Sinai on August 13th in the ER, and the next day a chest tube was inserted to drain the fluid. After the first 15 minutes, there was already a liter of fluid drained. That chest tube was more painful that the surgery recovery. But I was discharged after 4 days, and Mount Sinai was finally in my rear-view mirror. I went back to work after 6 weeks, but thankfully I had an amazing supervisor who let me telework full time for the first 4 weeks back. Showering and getting ready for my day was still a lengthy process at that point, so staying home in my pjs really helped as my brain and my fingers were fine. In some ways it’s been a surreal journey. It just doesn’t seem possible that I went through this experience and I’m totally fine.
My advice to those of you who haven’t been scheduled for surgery, do your research and find out as much as you can about your condition and whether early intervention is for you. Don’t necessarily wait until a cardiologist tells you that you need surgery. Know your own body, take charge of your health, but don’t panic either. Get yourself educated so you have the best possible outcome with a surgeon that is an expert at fixing whatever your issue is. A general cardiac surgeon is not good enough in this case. And most of all, if the doctors you are seeing do not make you feel comfortable, see someone else. There are plenty of doctors out there and finding the right one for you is key. If you don’t feel comfortable asking questions, or you feel rushed, then maybe looking elsewhere is the right choice for you.
For everyone with upcoming surgery, try as best as possible to make peace with your condition. You probably won’t sleep the night before, but try to accept the situation so that you are not overcome with fear. Can bad things happen? Of course. But you could get in your car today and not make it to work. Perspective is critical. And being on the other side has just been the best thing in the world. I almost can’t describe how wonderful it is even with the complications and the long recovery. It just feels so good!!
And to those of you on this side with me, we have a great community here even after surgery and recovery. I dropped off the site for a while I admit, but I’ve been back and getting excited about all the wonderful stories of folks who have made it and are now living life better than ever. We have a wonderful support group, and I personally have made two friends from this site. We continue to see each other and to catch up on all the wonderful things going on in our lives. I will never forget the support I myself received here when I was scared and couldn’t begin to comprehend what was happening and why. The community has been a wonderful source of support.
Take care, and I hope you all have a wonderful day!
Susan Lynn What a great testimonial and success story. Thank you for sharing and congratulations on your 2 year ... Read more
Susan Lynn What a great testimonial and success story. Thank you for sharing and congratulations on your 2 year anniversary, Darlene!
Anna Jones Hi Darlene Smith. Happy 2nd Anniversary and best wishes for many happy, healthy, and prosperous year ... Read more
Anna Jones Hi Darlene Smith. Happy 2nd Anniversary and best wishes for many happy, healthy, and prosperous years ahead.
My first Cardiologist also told me that I didn't need the surgery even though I was symptomatic and had severe regurgitation that was eccentric, so they weren't sure exactly how severe it was! It took a while, but I found a surgeon, had the surgery, and I went through a second Cardiologist before I found a Cardiologist whom I like and trust.
I feel a little better knowing I am not alone in having to make the surgery decision against the advise of my Cardiologist.
Civita Fahey Happy Anniversary Darlene.. Great to hear you are doing well!
Diane Capece Happy 2nd anniversary Darlene. Can't believe it has been 2 years. Keep in touch.
LINDA ROBERTS Happy Anniversary! Glad to hear you are doing great and thanks for sharing your feelings about your ... Read more
LINDA ROBERTS Happy Anniversary! Glad to hear you are doing great and thanks for sharing your feelings about your heart journey.
As silly as it may sound, I was shocked to realize this is my one year anniversary post mitral valve repair. At this time last year I was still in surgery, ...Read more
As silly as it may sound, I was shocked to realize this is my one year anniversary post mitral valve repair. At this time last year I was still in surgery, but would be awake by 7pm. What an amazing journey it has been. I could not have more respect for the wonderful surgeons at Mount Sinai who visited me twice a day, and the nurses who were beyond amazing. The care was outstanding. When I reflect on the ups and downs, the ups have by far outweighed the downs. Was recovery hard? Yes. But every day I’m thankful I made the decision to have this elective surgery. I didn’t have any symptoms pre surgery, but it’s clear the valve wouldn’t have fixed itself. And my heart would have eventually suffered. I’m exercising full out these days, I’ve lost another 10 pounds since the surgery (22 pounds before surgery), and am now 10 pounds from my ideal weight. I’ve discovered healthy yet delicious recipes with ingredients I might not have tried in the past. I feel like I’ve made lifestyle changes for the best and I’m feeling very good about my long term prognosis. On the downside, I still have some shortness of breath issues that my cardiologist and surgeon are trying to determine the cause of, but my heart does not appear to be the culprit at this point. I also had 4 days last week of what felt like PVCs. I see my cardiologist tomorrow for a regular checkup, and I will mention the irregular heartbeat. But it came and went and hasn’t been back. Strange, but I won’t be concerned until she tells me I need to be. Thanks to all the folks on this site for helping me get through my surgery and recovery. This is truly an amazing support group. We all understand each other in ways our families and friends cannot. Too all those with upcoming surgeries, you will be amazed at how relieved you will be on the other side, and how much progress you will make each day. Some days will be harder than others, but overall, you will feel so much better.
Daniel Kung Congratulation, Darlene, for reaching your one year anniversary! You are a courageous lady with a ki ... Read more
Daniel Kung Congratulation, Darlene, for reaching your one year anniversary! You are a courageous lady with a kind heart! You are an inspiration for many of us!
Phyllis Petersen It's great to hear how well you're doing. You go!
Civita Fahey Congratulations Darlene.. Here's to many more good years!
Laura Jacobs Wow Darlene, you are an inspiration. May we all do as well as you have done. Congratulations!!!!
Jill Krajnovich Darlene, Congratulations on the progress you have made in the last year and thank you for your words ... Read more
Jill Krajnovich Darlene, Congratulations on the progress you have made in the last year and thank you for your words of encouragement for those of us who have not yet had surgery!
Darlene Smith Thank you everyone! This has been an amazing journey with an amazing group of folks on this site!!
Wow, its hard to believe its been 9 months since my surgery to repair my mitral valve, and about 2 and a half months since my last post. I decided to take ...Read more
Wow, its hard to believe its been 9 months since my surgery to repair my mitral valve, and about 2 and a half months since my last post. I decided to take a (short) break from my doctors and the fact that they all disagree with each other! It all started with some shortness of breath that started about two months ago and hasn't gone away. I'll skip the part about all the conflicting theories and just say that my cardiologist eventually did a stress test and compared it to the one I had done a year ago before my surgery. I was 30 pounds heavier then and had my bad valve, yet I was able to exercise longer. My cardiologist noticed the shortness of breath right away, but she said its definitely not my heart. She thinks it could be permanent lung damage from the post pericardiotomy syndrome I had after the surgery. So now she wants me to have a lung function test, which I am having on Thursday. Other than the breathing issues, I really do feel completely recovered. I can do everything I did pre surgery, and have been for about 3 months now. I'm so glad I made the choice to have "elective" surgery. The road is definitely bumpy and sometimes very discouraging, but overall, I'd do it again in a heartbeat!!
Civita Fahey I think Darlene that even though the physicians are trained, they all have different opinions and we ... Read more
Civita Fahey I think Darlene that even though the physicians are trained, they all have different opinions and we as the patient need to make sure we understand what is going on. As patients we have to advocate for ourselves .. I'm glad all the rest is going well. .
It's been a while since I last posted. It's weird, nothing has been going on! I feel great and my life is back to normal. I'm back on my eating plan (I lost ...Read more
It's been a while since I last posted. It's weird, nothing has been going on! I feel great and my life is back to normal. I'm back on my eating plan (I lost 22 pounds pre surgery and 8 pounds post surgery, not really for my heart, but just for overall health), working out with no limitations including using weights, and working full time, which I've been doing since the six week mark. I'm so thankful I only had one complication and that it has resolved. I'm also thankful for finding this site and meeting people who have become new friends. I feel truly blessed!!
I'm 15 weeks post op and still feeling great, which makes me very happy. What doesn't make me happy is finding out that the co-surgeon that Mount Sinai used ...Read more
I'm 15 weeks post op and still feeling great, which makes me very happy. What doesn't make me happy is finding out that the co-surgeon that Mount Sinai used is out of network for my insurance. Mount Sinai asked me to ensure the surgeon that I had the consult with was in network along with Mount Sinai itself. Both were preferred providers. I had no idea Dr. Adams would use a co-surgeon or that he would be out of network, and now I have a bill for $14,228.80. Very very unhappy with this news. How am I supposed to know that other surgeons would be participating in my surgery unless someone from the office indicated so? And why would the other surgeons on the same team accept a fraction of the insurance companies accepted by the primary surgeon?
Diane Capece Hi Darlene. The same thing is happening to me. I just sent you a message on your email. I am shocked ... Read more
Diane Capece Hi Darlene. The same thing is happening to me. I just sent you a message on your email. I am shocked also.
Catie B Oh no! That is soooo unfair and wrong, wrong, wrong!
Cynthia H. Years ago, I was charged for being seen by an ER md who was out of network, even though the hospital ... Read more
Cynthia H. Years ago, I was charged for being seen by an ER md who was out of network, even though the hospital was. When I called (can't recall if it was the insurance or the hospital,) a rep said I would not have to pay it because I had no I choice in who I saw. I asked why I got a bill in the first place and learned they do not waive it unless you call and ask for it to be waived.
Phyllis Petersen Definitely contact the hospital about this and see what they can do first. This should have been deal ... Read more
Phyllis Petersen Definitely contact the hospital about this and see what they can do first. This should have been dealt with by them before your surgery, so they need to get on this for you. You may eventually have to file with your insurance company, but often the hospital has dealt with this before and knows how to handle it.
Lilly Black Similar to my experience but there were 2 bills, anesthesia and surgeon assistant. $30k in total. Wha ... Read more
Lilly Black Similar to my experience but there were 2 bills, anesthesia and surgeon assistant. $30k in total. What's horrible is you are recovering from a major procedure but faced with humongous bills! This is so unfair. My issue was all about balanced billing. I found out thru my Human Resources at work to request mediation between Insurance company and providers. I ended up only owing $3k. I was so thrilled! $5k for hospital copay also ....$8k in total. But the stress of the ordeal was insurmountable! My husband & I were devastated and angry. Don't let them get away with this! There is hope if you can handle it during this difficult time....because it is another fight you will have to endure! Good luck...so sorry to hear about your bad experience!
Civita Fahey Diane I work I healthcare compliance and have worked with billing before in my past jobs. The co-surg ... Read more
Civita Fahey Diane I work I healthcare compliance and have worked with billing before in my past jobs. The co-surgeon normally charges half of what the surgeon charges for the surgery as the assistant. Now, normally they are part of the network and accept the "allowable" from the insurance and only bill the patient the balance, if any ,that the insurance leaves, ex, copayments etc. If your surgeon and hospital were in network , then I would call the office and let them know that you weren't notified that he would be using a non network surgeon as an assistant. You shouldn't be responsible for that bill if you weren't notified so that you could get the correct referrals in place. Make some phone calls and ask questions. You did everything right by getting your primary surgeon in order, you should have been notified and signed a waiver if the other surgeon was not in network.
Roseline Rosario I'm with Phyllis and Civita. Call till your fingers hurt and document every call!. How about a patien ... Read more
Roseline Rosario I'm with Phyllis and Civita. Call till your fingers hurt and document every call!. How about a patient advocate?
Darlene Smith Good advice, thank you all!!! The hospital initiated the discussion by asking me to get a reconsider ... Read more
Darlene Smith Good advice, thank you all!!! The hospital initiated the discussion by asking me to get a reconsideration of the reimbursement amount from my insurance company. The hospital said they could not ask for a re-review, I had to do it as the patient. I'm waiting for that to come back from the insurance. Assuming they will say no (insurance has already told me in advance the answer will likely be no as the surgeon was paid in accordance with the plan allowance for out of network providers), then I will start pushing back with the hospital. Mount Sinai has patient advocates so I will contact them as well as the person who called me initially and asked me to talk to my insurance. Bottom line, I'm not paying this bill. Oh and one more interesting fact, the co-surgeon charged the same price as the primary surgeon!!
Vincent Racaniello There is a form called a surprise medical bill form that you may be able to file to cover this. It is ... Read more
Vincent Racaniello There is a form called a surprise medical bill form that you may be able to file to cover this. It is for a situation like this when you have no control over who comes into your surgery. Check with your insurance company about it I'm in New York but New Jersey may have the same rules.
Steven A Husted i agree with Vincent and Roseline and Phyllis and Civita sometimes they will write it off or include ... Read more
Steven A Husted i agree with Vincent and Roseline and Phyllis and Civita sometimes they will write it off or include it in the main surgeon's bill so you do not have to pay or they will word it so the insurance co will pay under the main doctors bill i think with mine all the doctors and hospitals were in network this was one of the questions i made sure my doctor understood before starting anything that i had very limited funds and would not be able to pay they were very helpful
Lilly Black Darlene, my $12K Surgeon assistant bill was waived completely! I wish you the best of luck.....looks ... Read more
Lilly Black Darlene, my $12K Surgeon assistant bill was waived completely! I wish you the best of luck.....looks like some very helpful feedback has been provided to you. :o)
Civita Fahey As another issue, insurance companies normally pay 1/16 of the allowable for assistant surgeons, so, ... Read more
Civita Fahey As another issue, insurance companies normally pay 1/16 of the allowable for assistant surgeons, so, if it has to be that you have to pay a balance I would let them know that they would normally have received 1/16 of the "allowable" which is what they contracted with that insurance payor.. and we wonder why our health care is so expensive. !
Hello to all my heart sisters and brothers! During the last three weeks since my previous post I have felt great. I'm not only working full time but I only ...Read more
Hello to all my heart sisters and brothers! During the last three weeks since my previous post I have felt great. I'm not only working full time but I only took 6 weeks off, which really shocks me in hindsight. I'm back to how I felt pre-surgery, i.e. I do not feel like I had heart surgery at all. The fluid around my lungs continues to hang around (I'm on week 12 of that nonsense), but I'm happy that there has been no pain since Sept 21st. My cardiologist is continuing to watch the fluid to make sure it doesn't build up again, and I have a follow up with her on Oct 31. Maybe it will actually be gone by then. If not, hopefully it will be like it is now, and not causing me any distress. To those of you who have followed my story, I hope all is well with those of you in recovery, and for those who have upcoming surgeries, just remember that there will be challenges during recovery. Its hard! But you will get through it, and you will feel better! In fact, you will feel amazing! But recovery is like a bumpy road, with many ups and downs. And we are here to support you!!!
Jim Whipple you sound great. Hope I can mimic your progress after I have surgery.
Amy Steele Darlene - Thanks for your update. I'm almost on week three of my recovery and hope to be doing as we ... Read more
Amy Steele Darlene - Thanks for your update. I'm almost on week three of my recovery and hope to be doing as well as you by week 14.
Ben Hyman You give me hope that I'll have a similar outcome when I get my Mitral Valve repaired
Susan Lyons I needed to read this! Been a bit discouraged day 9 since surgery. Still can't walk far without stop ... Read more
Susan Lyons I needed to read this! Been a bit discouraged day 9 since surgery. Still can't walk far without stopping to breath.So exhausted all the time.
Steven A Husted I AGREE THERE ARE UP AND DOWN DAYS GOOD AND BAD DAYS BUT IT DOES GET BETTER ONE DAY AT A TIME SLOW AN ... Read more
Steven A Husted I AGREE THERE ARE UP AND DOWN DAYS GOOD AND BAD DAYS BUT IT DOES GET BETTER ONE DAY AT A TIME SLOW AND EASY IT WILL GET BETTER AND DONT FORGET CARDIO REHAB PHASE 2 AND MAYBE PHASE 3 IF YOU WANT I KNOW THEY HAVE BEEN A GREAT HELP TO ME
Catie B Great to hear how well you are faring, Darlene!
Darlene Smith I definitely had my down days. In fact I had a few days after ER visit #3 where I will admit I could ... Read more
Darlene Smith I definitely had my down days. In fact I had a few days after ER visit #3 where I will admit I couldn't stop crying!! It was so hard. But now that I can see clearly, this was the best thing I could have done for myself and my heart! You all are the best, so supportive, and I couldn't have done it without you!
I haven't posted in a while. I am now 11 weeks post op and hoping the pain from this post pericardiotomy syndrome is finally over. Pain has been quite erratic ...Read more
I haven't posted in a while. I am now 11 weeks post op and hoping the pain from this post pericardiotomy syndrome is finally over. Pain has been quite erratic over the last several weeks with the worst of it lasting a full 9 days of continuous pain that the narcotic barely touched. Surgeon thinks I will be over this soon, but its so hard to be patient. I've had this fluid around my lungs for 9 of the 11 weeks!!! They started me on a new drug cocktail and now I've been pain free since Sept 21st. Fingers crossed that this complication is the last and I'm finally home free. Thankful to be able to get back to my walking. I leave later this week for a prior planned trip to CO to see my sister, and I want to feel good while I'm there.
Darlene, awesome I am hoping you will remain pain free so you can spend time with your family and enj ... Read more
Darlene, awesome I am hoping you will remain pain free so you can spend time with your family and enjoy your life!
Phyllis Petersen I'm sorry to hear that you've been struggling with this so long. I hope that you're past the worst of ... Read more
Phyllis Petersen I'm sorry to hear that you've been struggling with this so long. I hope that you're past the worst of it and on your way to full recovery.
Ellen Leng Here's hoping you're through a long rough patch and into a better place!
Darlene Smith Not only has the pain stayed away, but I can finally say I feel great!! This last week has been so g ... Read more
Darlene Smith Not only has the pain stayed away, but I can finally say I feel great!! This last week has been so good, I actually feel totally normal!!! Thanks all, I think I may be finally over this fluid.
I am just shy of 6 weeks post op. I decided to start working part time from home. Logged 16 hours last week, and boy did that make me tired! How can it be ...Read more
I am just shy of 6 weeks post op. I decided to start working part time from home. Logged 16 hours last week, and boy did that make me tired! How can it be so tiring to think??? I have an office job and I didn't expect to have to take a nap each day after putting in 3-4 hours. I guess I need to work on my patience.
Conrad Skowronski Me too. I think I'm a lot better off than I really am. I must be careful not to push it and have a ... Read more
Conrad Skowronski Me too. I think I'm a lot better off than I really am. I must be careful not to push it and have a set back.
Darlene Smith Conrad, good to hear from you. Other than trying to be patient, how are you feeling? Sounds like yo ... Read more
Darlene Smith Conrad, good to hear from you. Other than trying to be patient, how are you feeling? Sounds like you are doing well.
Diane Zeigler I am almost 9 weeks post op and still get tired. I need to take a nap almost everyday and cant wait ... Read more
Diane Zeigler I am almost 9 weeks post op and still get tired. I need to take a nap almost everyday and cant wait till bedtime. My appetite is back and I am hoping that means I am progressing.
Rita Savelis Going back to even light office work is exhausting!! It is still very early for you, Darlene. Take it ... Read more
Rita Savelis Going back to even light office work is exhausting!! It is still very early for you, Darlene. Take it easy, don't push yourself.
Meredith Bray Wow! back to work after 6 week! I was still taking naps after lunch then. Take it easy!
David C Darlene, I just had a few meetings last week [6 weeks] and I was super faded after. It's easy to forg ... Read more
David C Darlene, I just had a few meetings last week [6 weeks] and I was super faded after. It's easy to forget that even when we are feeling more like a human, the body is still putting itself back together/finding a new normal. My biggest thing is actually the fact that I haven't slept really well since surgery. I can get a nice run of hours asleep, but it's hard to fall asleep and get deep restful sleep. Either way, 16 hours is a lot. I did about 3 last week, and was grateful to one have a handful this week.
Lilly Black I took 3 months off and I am so glad I did. Hats off to you for going back to work after 6 weeks. Tak ... Read more
Lilly Black I took 3 months off and I am so glad I did. Hats off to you for going back to work after 6 weeks. Take it easy....one day at a time. Good thing its part time! take care
Conrad Skowronski I'm doing okay. A little A-Fib here and there, a little numbness in my right chest -- but otherwise ... Read more
Conrad Skowronski I'm doing okay. A little A-Fib here and there, a little numbness in my right chest -- but otherwise very good (knock on wood). I start cardiac rehab this Thursday. My planned first week back to work is the 1st week in October -- fly to MN for a meeting!!
Darlene Smith The most amazing thing about this community is we all understand each other and can relate. Thank yo ... Read more
Darlene Smith The most amazing thing about this community is we all understand each other and can relate. Thank you all for the support. I knew you would help me realize it is still early. I am very thankful I can sleep and glad that hasn't been an issue for me. My PT wants me out of my recliner and back in my bed, and I refuse to go. If I'm sleeping so well where I am, why change? Plenty of time to do that later.
David C @ Darlene. I think we get to go sleep where ever we can, and do what ever is needed to recover. There ... Read more
David C @ Darlene. I think we get to go sleep where ever we can, and do what ever is needed to recover. There will be plenty of time to get in a bed. I have been "sleeping" in my bed for weeks, but I am not having great sleep since I cut out any of the strong pharmaceuticals.
I start full time work the end of this week. I am hoping I can make it 8 hours. Luckily I can make my own hours as needed...we'll see.
Darlene Smith David, I'm supposed to start full time the day after labor day. Not sure that will work, but we will ... Read more
Darlene Smith David, I'm supposed to start full time the day after labor day. Not sure that will work, but we will see. Good for you on making your own hours. I can't really do that, but I do have an amazing supervisor who has supported me fully in whatever I need to do.
David C I will be thinking of you next week! This has been quite the journey. Not exactly how I planned on my ... Read more
David C I will be thinking of you next week! This has been quite the journey. Not exactly how I planned on my summer going...at all.... :)
Steve Wykstra Just "Thinking" is hard work! The brain--like a muscle--uses up a lot of calories doing it!
Steve Wykstra Just "Thinking" is hard work! The brain--like a muscle--uses up a lot of calories doing it!
THere are also often lots of little (or big) inevitable stresses that come with working with others, which trigger the body to release it's various fight-or-flight hormones, which affect heart-rate, blood pressure, and all that stuff. From our humble primate beginnings God gave us all we need to cope with saber-tooth tigers, winters without enough nuts and berries, marauders with clubs looking to sow wild oats whereever, as well as jerks spreading lies or being pigs at the water cooler.
Our hearts are marvelously made to handle all such crap, but we gotta give them time to learn to use their new valves and let the valves grow into the job!
Anyway, in the immoral words of some country singer whose name I forget: that's my story (and I'm sticking to it).
My first two weeks post op were amazing. I don't think my recovery could have gone better. Since August 2nd, I have been in the ER three times. The first ...Read more
My first two weeks post op were amazing. I don't think my recovery could have gone better. Since August 2nd, I have been in the ER three times. The first ER visit was to my local hospital and they gave me the diagnosis of pleural effusion. I was admitted to the hospital and they got my pain under control. I was discharged two days later and told the effusion would resolve on its own. On August 12th, I went back to the same ER as the pain had come back along with a fever. They said the effusion was worse and I might have pneumonia, but they discharged me anyway. I called Mt. Sinai on Sat and they told me to get up there if I could. Went to their ER and was admitted immediately. Diagnosis was post pericardiotomy syndrome. They inserted a pigtail catheter on Sunday, and drained over a liter of fluid in under 15 minutes. They left the catheter in for 24 hours. The pain of that catheter insertion almost put me over the edge. My pain level was off the chart and the pain meds only took the edge off, it never removed the pain. By Monday morning I honestly wanted to die (I know that is a terrible thing to say). The catheter was removed later that morning, and for the first time in two weeks I could breathe!!! Most of the pain left with the catheter, and my ability to take a deep breath has improved tremendously. I didn't realize how compromised by breathing had become. That liter of fluid was slowly crushing my left lung. So glad I went back to my surgeon and stopped going to my local ER. Because my immune system is overreacting to the surgery, I am now on steroids to ensure the fluid does not accumulate again. I was discharged on Weds and will need weekly chest xrays to monitor the fluid. I hope I am finally over the hump as these last two weeks have been more than challenging. Its rocked my confidence and taken a toll mentally.
Yea they don't tell you all these things when you are ramping up for the surgery. Right now I might h ... Read more
Yea they don't tell you all these things when you are ramping up for the surgery. Right now I might have a infection in my incision where they bypassed me in my leg. Going today to have them look.
Corey Sines Doctors are just practicing medicine. You did the right thing, if anything in your recovery isn't ad ... Read more
Corey Sines Doctors are just practicing medicine. You did the right thing, if anything in your recovery isn't adding up, seek another, or as many consultations as you need, to get to what seems the right answer. Usually, the expert centers we seek out for surgery, also know best all possible complications and how to deal with them as effectively as possible. Keep your chin up, The first few months of recovery after heart surgery can go pretty smooth, or be a roller coaster. Just don't stop advocating for yourself, you will get to the other side eventually.
Lily He Sorry for that. But at least you survived the surgery. Pray for your healing. I'm now still on pre-o ... Read more
Lily He Sorry for that. But at least you survived the surgery. Pray for your healing. I'm now still on pre-op panic: looking at the risk rate of heart surgery stats. Scaring.
Amy Dorsey Oh man! I am dealing with that same situation. I'm 4 weeks post and had 2 trips to ER within days aft ... Read more
Amy Dorsey Oh man! I am dealing with that same situation. I'm 4 weeks post and had 2 trips to ER within days after discharge. Everyone acknowledged the pleural effusion but no one has done a thing. I finally saw my PCP who was the first doctor to justify my pain levels and difficulty breathing. He's sending me to a pulmonologist tomorrow. I hope to finally have some relief because I really think this is hindering my recovery!!! So glad you finally have some relief! 💗
Catie B Darlene, I'm so sorry. That sounds like an awful--and a terribly painful--ordeal! I hope your recove ... Read more
Catie B Darlene, I'm so sorry. That sounds like an awful--and a terribly painful--ordeal! I hope your recovery is much smoother from here out.
Darlene Smith Amy, I saw your post from earlier and thought the same thing, you might have this recurring fluid as ... Read more
Darlene Smith Amy, I saw your post from earlier and thought the same thing, you might have this recurring fluid as well. The pulmonologist will set you straight. The pain you describe sounds just like what I went through. Lily, if you go to a valve repair center, the success rates are much higher than with general heart surgeons. Corey, yup practicing is what they do! Too many variables with each patient for them to really know until they do several tests. Dan, good thing you are going back. Infections are serious business. Glad I didn't have that too. Catie, thank you! I feel better today than yesterday, so back to optimism!!!
Steven Dean Sorry about the setback but glad to hear you got it figured out and are back on the road to recovery. ... Read more
Steven Dean Sorry about the setback but glad to hear you got it figured out and are back on the road to recovery.
Barbara Laurie Darlene, so sorry this happened! I know the pain of the pig tail chest tube! Everyone was so helpful ... Read more
Barbara Laurie Darlene, so sorry this happened! I know the pain of the pig tail chest tube! Everyone was so helpful to me, even as I was begging for more pain meds! After 10 days I got that sucker removed! I hope you'll get your confidence back Darlene, OHS is a big deal and your situation is somewhat common, even though it's pretty scarey! You're back on the road to full recovery. Keep deep breathing, or use the spirometer often, it does help. God Bless❤️
Darlene Smith Thank you Conrad, Steven, and Barbara! I have felt great over these last few days! I think the wors ... Read more
Darlene Smith Thank you Conrad, Steven, and Barbara! I have felt great over these last few days! I think the worst is over.
David C Any updates? Hope things have been going more easily, and you have been able to do the work of recove ... Read more
David C Any updates? Hope things have been going more easily, and you have been able to do the work of recovery since this post!
Today is day 21 post op. Had a little setback, and ended up in the ER last week with a diagnosis of both pleural and pericardial effusion. The pain was actually ...Read more
Today is day 21 post op. Had a little setback, and ended up in the ER last week with a diagnosis of both pleural and pericardial effusion. The pain was actually worse than the valve surgery itself (seriously). I was discharged after 3 days and am mostly pain free as of today. So I'm back on track with my walking and exercising. I know there will be ups and downs, but ending up in the ER was actually surprising to me. I felt things were going so well, nothing could stop me. So onward and upward!!!!
Kate Watson Sorry to hear of your setback but glad you are back on the recovery track!
Catie B Goodness! Sorry to hear of the effusion and severe pain. Hope everything keeps rolling forward now.
Diane Capece Sorry to hear you had a problem. Did they say what could have happened? Did you go back to Mt Sinai ... Read more
Diane Capece Sorry to hear you had a problem. Did they say what could have happened? Did you go back to Mt Sinai? Hope you are feeling better....
Darlene Smith Diane, I went to the ER of my local hospital, but I was on the phone with Allison on the drive over. ... Read more
Darlene Smith Diane, I went to the ER of my local hospital, but I was on the phone with Allison on the drive over. Really was no way I could get to Mt. Sinai in my condition. The paid was so sudden and so severe! But Allison was great! And my local hospital, as soon as I said I was two weeks out from having OHS, they took me immediately and were very attentive. I received great care there. They even tested me for a heart attack just to be sure!
Thanks all! I feel like I'm totally back on track this week.
Diane Capece Glad to hear you are doing better. Keep it up. It is a bumpy road but the worst is over. I did pos ... Read more
Diane Capece Glad to hear you are doing better. Keep it up. It is a bumpy road but the worst is over. I did post something yesterday but I don't know where it went???????????????
Today is day 10 and I can't believe how fantastic I feel! I received outstanding care at Mt. Sinai. It may not be the prettiest facility around, but the doctors, ...Read more
Today is day 10 and I can't believe how fantastic I feel! I received outstanding care at Mt. Sinai. It may not be the prettiest facility around, but the doctors, nurses, nurse practitioners, and patient care assistants were top notch each and every one of them! Even the food workers were professional and just all around good folks. I was treated with the utmost respect. I also think it helped that I've been hospitalized before, so I knew exactly what to expect with round the clock care and continuous interrupted sleep. Luckily I'm an excellent napper, so I was able to get all the rest I needed. I've been recovering at home since July 23, and except for a little shortness of breath and fatigue, I have no complaints. My BP is 100/66, my resting heart rate has gone up from pre op of 66 to post op of 80, but I expect that to continue to come down as I get stronger. My new cardiologist said I look great although she has nothing to compare too since I just met her yesterday. Met with a PT today who gave me a walking program since I am nervous about how much to use my heart. But overall, I could not be happier with my progress post op. For those with upcoming surgeries, I have you all in my thoughts, and keep a positive outlook. I came to acceptance, and was not terrified, and my outcome has been fantastic. I hope you all follow in my footsteps!!
Catie B That is sooooo great, Darlene! Sounds like you are doing most excellently! :)
Diane Capece I am so glad to hear you are doing so well. I hope I follow in your footsteps. So glad to hear your ... Read more
Diane Capece I am so glad to hear you are doing so well. I hope I follow in your footsteps. So glad to hear your care was so good. 4 more days until my turn. Getting anxious!!!!!!
David C Congrats! Glad to hear recovery is going well. Agreed 100% on the role of a positive attitude. All th ... Read more
David C Congrats! Glad to hear recovery is going well. Agreed 100% on the role of a positive attitude. All the best!
Darlene Smith Thanks Catie and David. Diane, wishing you as uneventful of a recovery as me. You will still feel lik ... Read more
Darlene Smith Thanks Catie and David. Diane, wishing you as uneventful of a recovery as me. You will still feel like you got hit by a truck afterwards, but they did a great job of pain management. Any questions you have, shoot me an email at drsmith3657@hotmail.com.
Conrad Skowronski Great to hear you are doing well. I do believe your positive outlook helped me get through my surgery ... Read more
Conrad Skowronski Great to hear you are doing well. I do believe your positive outlook helped me get through my surgery!!
Lilly Black Darlene, I'm so happy for you! that is great news! I totally agree with keeping a positive attitude. ... Read more
Lilly Black Darlene, I'm so happy for you! that is great news! I totally agree with keeping a positive attitude. As a matter of fact, recovery is so much quicker when keeping positive, a known fact. Good for you!
Darlene Smith Conrad, good to hear from you!!! Hope you are recovering well. Lilly, couldn't agree more!!!
Someone I met on this site just stopped by as she was doing her pre surgery testing today. It was sooo nice to meet you Diane!!! I will be thinking of you!!! ...Read more
Someone I met on this site just stopped by as she was doing her pre surgery testing today. It was sooo nice to meet you Diane!!! I will be thinking of you!!!
Darlene Smith Diane, the big man on campus stopped by yesterday!!! It was great to see Dr Adams again. I told him h ... Read more
Darlene Smith Diane, the big man on campus stopped by yesterday!!! It was great to see Dr Adams again. I told him he needs to work on chest tubes now. He said they've been trying to figure that out for 25 years, lol.
Had surgery on Mon at Mt Sinai with Dr Adams and his outstanding team. Doing well and will go home Sat. Breathing tube, no big deal. Chest tubes, probably the ...Read more
Had surgery on Mon at Mt Sinai with Dr Adams and his outstanding team. Doing well and will go home Sat. Breathing tube, no big deal. Chest tubes, probably the most pain I've ever experienced when they ripped those puppies out. Luckily I now feel great and can walk without the PT. Getting there!!!
Steven Dean Congrats! Sounds like your recovery is going great.
Conrad Skowronski Great to hear Darlene. I wish you well on your recovery. You give me hope for my surgery.
Me to.
Richard Puckett Sounds like you are doing great! It's good to be on the other side. Getting free from all of the ha ... Read more
Richard Puckett Sounds like you are doing great! It's good to be on the other side. Getting free from all of the hardware makes a big difference!
Ron Broadhead That's really good Darlene. Sounds like you are having a good recovery. Things will only get better f ... Read more
Ron Broadhead That's really good Darlene. Sounds like you are having a good recovery. Things will only get better from here.
Cheryl Ventimiglia Great news. The breathing tube was rough for me. Keep up the good work.
Alexa Aveta I was in the Mt. Sinai cardiac ward 2 weeks ago! I adored the staff, everyone was so nice and caring! ... Read more
Alexa Aveta I was in the Mt. Sinai cardiac ward 2 weeks ago! I adored the staff, everyone was so nice and caring!
Sharon Turner Darlene so good to hear you are doing well. Look forward to hearing about your recovery. I leave Ca ... Read more
Sharon Turner Darlene so good to hear you are doing well. Look forward to hearing about your recovery. I leave California for New York on Sunday. Surgery with Dr. Adams on Friday 7/29/16. Prayers are with you
Diane Capece It was very nice to meet you also. You looked great considering what you just had done!! Keep up th ... Read more
Diane Capece It was very nice to meet you also. You looked great considering what you just had done!! Keep up the good work.
Darlene Smith Thanks again for all the well wishes! Alexa, I loved the staff at Mt Sinai. I had heard such great ... Read more
Darlene Smith Thanks again for all the well wishes! Alexa, I loved the staff at Mt Sinai. I had heard such great things about them that I actually made gifts in advance. Sharon, good luck to you on Fri. I can not give more praise for Dr Adams and his staff. Truly amazing folks who never seem to stop working. Diane, I will be thinking of you next week. Aug 2nd is my 25th wedding anniversary, and I'm hoping your recovery is like mine!!! If you have either Kevin or Jasmin in ICU, tell them I say Hi! For nurses, if you have Abel, Katie, Alexis, Freshta, Jean, Daniel, or Susan, please pass along my greetings as well! Amazing folks who I will forever be grateful to for their outstanding care.
Diane Capece Hi Darlene. You are my idol. Every time I start to panic; I think about how well you are doing and h ... Read more
Diane Capece Hi Darlene. You are my idol. Every time I start to panic; I think about how well you are doing and hope I can do the same. Keep me posted on your recovery. Happy Anniversary and enjoy your day!!!! By the way, do you have to do cardiac rehab?
Kathleen F. I was at Mount Sinai as well, and Jean (Torres) was also one of my nurses. It was my first time being ... Read more
Kathleen F. I was at Mount Sinai as well, and Jean (Torres) was also one of my nurses. It was my first time being hospitalized and the care was outstanding, from the surgeons, nurses, food service, reception - I was so impressed. I'm glad you also had a good experience. I'm sorry to read about your subsequent issues and I hope your recovery goes smoothly over the next few months. Maybe work less if you can? I recall being tired and wanting to take as much time as possible to focus on recovery. Good luck to you!
I can't believe my surgery is only 5 days away. This has certainly been an interesting 4 months. I cannot wait to be done with it. I think if the hospital ...Read more
I can't believe my surgery is only 5 days away. This has certainly been an interesting 4 months. I cannot wait to be done with it. I think if the hospital called me today and said there was an opening tomorrow, I'd take it! Planning a fun weekend, then one last work day on Monday to square away all my projects for others to look after. Thanks to Adam for starting this website and to all the supportive folks here encouraging and helping each other. It really is invaluable to know there is an entire community out there who knows exactly what I'm going through right now.
Steven A Husted amen heart sister i am so thankful to adam also for starting this site it is and has been a life savi ... Read more
Steven A Husted amen heart sister i am so thankful to adam also for starting this site it is and has been a life saving site from before surgery to now and the future i am in cardio rehab phase 3 and almost 2 years out thank you adam and god bless you and your family
Ron Broadhead You are going into surgery with a great attitude! You will do fine.
David C You've got this! Sending positive thoughts for an easy surgery and a quick recovery!
Darlene Smith Thanks all! I just got my wish, my surgery got moved up one day to Monday!
Bridget Sawmiller Good luck, prayers for a successful surgery and great recovery!
Conrad Skowronski Darlene - I'll be thinking about you on your big day. Mine is now a week after yours. You get the h ... Read more
Conrad Skowronski Darlene - I'll be thinking about you on your big day. Mine is now a week after yours. You get the head start on recovery, but I'll try to catch up (under Doctor supervision, of course). All the best for us!!
My surgery is 9 days away. I spent a week at the end of June in the Poconos at a house on a lake, just returned from a 3 day scrapbook retreat, and next weekend ...Read more
My surgery is 9 days away. I spent a week at the end of June in the Poconos at a house on a lake, just returned from a 3 day scrapbook retreat, and next weekend will see Coldplay at MetLife Stadium. Celebrating to the maximum extent possible the wonderful life I've been able to experience up to this point, and the next chapter post op!!
Conrad Skowronski Hi Darlene - thank you for writing in my journal. I too am very close to surgery - July 25 and have ... Read more
Conrad Skowronski Hi Darlene - thank you for writing in my journal. I too am very close to surgery - July 25 and have been given a wonderful outlook toward this whole thing by your comments. I am going to enjoy and live life to the fullest until then, through your advice. I wish you well on your medical journey -- with an attitude like yours, how can it not have a great outcome!! Let me know how you doing post op.
Darlene Smith Conrad, thank you! I wasn't always in this place, but realize now its where we all should be! You t ... Read more
Darlene Smith Conrad, thank you! I wasn't always in this place, but realize now its where we all should be! You take care too and I wish you the best as well. Not sure how much I will post right away, but I will post updates as I am able.
PJ Fugitt Darlene - hi I am a few days behind you- my surgery is scheduled for the 28th in Cleveland. Like you ... Read more
PJ Fugitt Darlene - hi I am a few days behind you- my surgery is scheduled for the 28th in Cleveland. Like you having mitral valve repair hopefully. There is been quite a delay from first sending paperwork in Feb until Jul. a lot to think about and research with a great deal of anxiety. Last week a friend sent me a ticket to Long Island to enjoy the beach for the weekend. Another friend invited me as a guest for front row seats to see Garth Brooks and Trish Yearwood 2 days before I leave!
Certainly feeling blessed and loved throughout this portion of the journey. Also feeling more becalmed by the incredible individuals who are also blessed and are sharing their stories on this site. Amazing miracles - and exceptional teams of doctors and nurses who keep us all going. Blessings to you and all who may be reading this post.
Wanda Mroz I read all your posts Darlene. I had mitral valve repair in August 2015. I had minor complications ... Read more
Wanda Mroz I read all your posts Darlene. I had mitral valve repair in August 2015. I had minor complications and recovered slowly but pretty well. Try not to be nervous and stay positive. You will do great! I had a lot of fears prior to surgery too. It's normal. If you have any questions, ask. Best wishes and prayers for a smooth ride to the other side! 💞
My surgery is coming up on July 19th. I've been looking at the news feed to see what folks are experiencing post op. I have to say its a little depressing. ...Read more
My surgery is coming up on July 19th. I've been looking at the news feed to see what folks are experiencing post op. I have to say its a little depressing. I'm trying to prepare myself mentally for a long road and to not expect too much too fast. But the list of possible complications seems endless. I'm also looking for folks who had their surgery at Mt. Sinai. I see some hospitals allow family to spend the night on the floor and to accompany patients to the pre op area on the day of surgery. Mt. Sinai does not allow this and also states cell phones and e-readers are also not allowed. These last two "rules" seem a little overly restrictive. Any patients out there who had their surgery at Mt. Sinai?
Barbara Laurie Darlene, firstly, have you read Adams book? It's true that everyone is different, but the statistics ... Read more
Barbara Laurie Darlene, firstly, have you read Adams book? It's true that everyone is different, but the statistics of heart valve surgery, if that's what you're doing, are good. Don't be depressed! Also,, when I went to UCSF's web page it read no cells or tablets.. But when we arrived, there was wifi to connect to..while in ICU, I remember talking to my mom on my cell..so obviously the web site was outdated. Maybe Mt Sinai has outdated info as well. Also, people who you may be seeing posting here have had long recoveries or complications, so they write..but think of the thousands of people who have had their surgeries, did well, and after a few posts, move on! Everyone experiences pain differently,and have different abilities, being positive about your surgery will help. Your hospital is very highly rated, in valve replacement and also all around. Are you too far away to make a trip there before hand, or meet your surgeon?
No matter what, I hope you get info that puts your mind at ease❤️💕❤️
Best Regards 💕🌹💕
Rita Savelis One can never be really "prepared" mentally, can one? But as Barb says, statistics are in your favor. ... Read more
Rita Savelis One can never be really "prepared" mentally, can one? But as Barb says, statistics are in your favor. OHS is difficult, recovery can be long and hard, but one keeps moving. As far as cell phones go, I didn't have one in ICU (5 days) as they weren't allowed in there. In fact, I didn't go on a cell phone for weeks, and felt there was something very calm about not having to communicate, and instead just heal. Of course my husband and son were coming to visit. But it was mainly about healing and rest. There will be time to communicate in the future.
Clare Auten OHS is a big deal like Barb and Rita said. Mine was 1/9/2014. I remember going to my kids Valentine P ... Read more
Clare Auten OHS is a big deal like Barb and Rita said. Mine was 1/9/2014. I remember going to my kids Valentine Party at school that year, feeling pretty good. OHS is doable. Even with minor complications like a-fib, I consider myself lucky to have had the surgery when I did. nowadays, surgery and hospital stay are kind of a blur....kind of how you eventually forget about the pain of labor and delivery. Good luck to you.
Elinor McCullough Will also be having my OH SAVR surgery in late July 2016 and every time I think about this surgery I ... Read more
Elinor McCullough Will also be having my OH SAVR surgery in late July 2016 and every time I think about this surgery I get depressed and teary eyed. Thank goodness I have Bach Flower Essence Rescue Remedy which I seem to take often which helps tremendously. I'm 74 yo and hoping the recovery will not be too painful as I vividly remember the pain from the two total knee repl (TKR) surgeries in which there was absolutely no pain med that helped me and this keeps me anxious because this surgery will be even more painful than TKR surgery that surgery is absolutely no "walk in the park" with a long recovery (for me anyway....like for the most recent TKR surgery 4-1/2 yrs ago and still in pain from that surgery). I guess I need someone to relieve my fears.
Darlene Smith Thank you everyone for your responses! I'm outwardly calm, but inwardly obsessed with this whole thi ... Read more
Darlene Smith Thank you everyone for your responses! I'm outwardly calm, but inwardly obsessed with this whole thing. I'm fine with disconnecting from the world for a while and not having my phone, but I'm a music nut, and I was hoping to have my iPod to plug in my headphones and tune out the machines and activity while in the hospital. I have my pre op tests this week and will ask those questions of the staff while I am there. Luckily I'm in NJ and only about 45 miles from Mt. Sinai so I have met the surgeon and the team and feel very confident in their ability to repair my valve.
Sophia Ridley The surgery was far less painful than I was expecting (I've given birth twice and had open kidney sur ... Read more
Sophia Ridley The surgery was far less painful than I was expecting (I've given birth twice and had open kidney surgery, they were all much worse), it was the utter exhaustion that was a shock to me which wasn't helped by my low BP. Please keep yourselves well hydrated in the weeks leading to op, I was v dry during surgery and had to have transfusions.
Franklin Wyrick I was pleasantly surprised by the fact that I had very little pain. I had nothing but tylenol for pa ... Read more
Franklin Wyrick I was pleasantly surprised by the fact that I had very little pain. I had nothing but tylenol for pain after the second day post op. The healing is slow but not much pain, at least for me.
Rita Savelis Yes, I would also agree that pain was not a part of OHS for me, while every other operation I had (s ... Read more
Rita Savelis Yes, I would also agree that pain was not a part of OHS for me, while every other operation I had (spleen, thyroid, exploratory abdominal surgery, pacemaker)and of course childbirth, was painful. I really never used the word pain to describe OHS. It was a lot of other things - there was an intense discomfort, suffocation feeling, incredible awful tiredness, inability to sleep or get comfortable and I remember asking for more morphine to forget all that. Not to mention the intensity of the ICU unit and feeling like I just wanted to turn off my brain and thoughts. But pain was not an issue. I had an anesthesiologist confirm that for me before the surgery and it was definitely true for me.
I do understand wanting to listen to music, anything to get your mind off of ICU and the other patients and all those nurses bugging you. I hear you on that one. It was not allowed for me,alas At one point, they did bring in an old funky radio that belonged to the ICU, but I found that listening to that was worse. As soon as I got into my own room and out of ICU, all that stuff (iphones, computers, headphones) was allowed.
Take care. Breathe. You'll be fine.
Darlene Smith These comments have been so helpful!!! I really appreciate all the responses.
Diane Capece Hi Darlene. I met with Dr. Adams and his partner Dr. Eshmawi. Both were very nice and confident and s ... Read more
Diane Capece Hi Darlene. I met with Dr. Adams and his partner Dr. Eshmawi. Both were very nice and confident and seem very knowledgeable. I am scheduled for August 2nd. I am very nervous especially about the breathing tube. They both were being very reassuring but I am still petrified about the tube. Did you also meet his partner?
Rita Savelis The thought of a breathing tube can be really scary, Diane. But many patients ( myself included) bare ... Read more
Rita Savelis The thought of a breathing tube can be really scary, Diane. But many patients ( myself included) barely remember the breathing tube because it is often taken out so quickly that you are still groggy/out of it and don't even realise it is there or is coming out.
Darlene Smith Hi Diane! Yes, I met with both Dr. Adams and Dr. El-Eshmawi. Glad to know someone who is going to th ... Read more
Darlene Smith Hi Diane! Yes, I met with both Dr. Adams and Dr. El-Eshmawi. Glad to know someone who is going to the same hospital and with the same doctors as me. The breathing tube doesn't scare me as much as the heart lung machine. I think I'm fine with my heart stopping for 3 hours, but I can't get my mind around the fact that I won't be breathing either. Its hard to comprehend, but at least I won't remember any of it.
Barbara Laurie Darlene,
I thought the same way..except the tube scared me too.. But the heart lung machine issue dis ... Read more
Barbara Laurie Darlene,
I thought the same way..except the tube scared me too.. But the heart lung machine issue disappeared in pre-op.. The anesthesia guys are there, talking with you, getting your IV inserted in your arm, then all of a sudden you're extubated and feeling really groggy. 🌹 Best Regards kiddo.. You'll do great!
My first Cardiologist also told me that I didn't need the surgery even though I was symptomatic and had severe regurgitation that was eccentric, so they weren't sure exactly how severe it was! It took a while, but I found a surgeon, had the surgery, and I went through a second Cardiologist before I found a Cardiologist whom I like and trust.
I feel a little better knowing I am not alone in having to make the surgery decision against the advise of my Cardiologist.