You Only Live Four Times!

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My brother David once told me that I was like a cat with 9 lives. He was talking about how I bounced back from failing at my first try at college and rebounded from devastating election defeats. I went on to finish college with honors and ultimately served in public office. Of course he didn’t know at the time that his comment also could have been about my battle with heart failure.

Taking a cue from Drake, I’ve taken on YOLO – You Only Live Once – as my motto for this fight, with a few adjustments along the way. First, I stayed alive after a heart attack in 2010. Second, I survived cardiac arrest when doctors shocked me back to life. Third, I lived to tell the tale of a summer on life support in the ICU due to a rare lung complication from the heart attack.

After that summer, I adopted YOLT – You Only Live Thrice (yes that’s a word) – as my rallying cry. For some reason, God has chosen me to stay around for a while. Not questioning His will, I’m just going with it. Last week, I added another life to my résumé. Now my motto is YOLF – You Only Live Four Times (weirdly, there’s no single word for the fourth time).

Boy do I have a story to tell…

As I mentioned in my last post, I’m a candidate for a heart transplant. This is great news! Getting on an organ transplant list is a rigorous process. The candidate has to have the odd combination of great health and a nearly inoperable heart. It requires a long evaluation period called the heart transplant workup, a comprehensive list of medical and mental health exams.

A key part of the workup is a procedure called the right heart catheterization – otherwise known as a right cath. It’s a procedure that measures lung pressure. This is critical to getting on the transplant list. A previous right cath showed that I had high lung pressure, not a good sign. After taking a new medication for a couple of months, the doctors wanted to check it again.

Heart catheterizations are common – according the U.S. National Library of Medicine, about 1 million are done each year in the United States. To measure lung pressure, a heart surgeon inserts a wire called a Swan-Ganz through a small incision in the neck and into the arteries that connect the lungs and heart.

The procedure is done in a cold and sterile operating room. Lying on a narrow operating table, heated blankets kept me warm as the right cath team prepared for the procedure. To ensure the accuracy of the measurements, patients aren’t sedated.

With my head turned to the right, the team placed a small tarp-like covering over the right side of my head to give the doctor a clear view of my neck. I could see the nurse in front of me and hear the doctor and technicians behind me. The doctor explained the procedure and asked if I had any questions. Once the prep was complete, the doctor numbed my neck with local anesthetic.

Everything was going smoothly like the last time I underwent a right cath. I felt the doctor pushing on my neck as the he threaded the Swan-Ganz into my neck and arteries. Midway through the procedure, I felt a weird tickling sensation in my chest. It was like the wire was poking against the inside of my heart. I didn’t feel that the last time, so I told the doctor about the sensation.

Acknowledging my comment, the doctor described making an adjustment to the insertion and continued. The sensation started intensifying. Before I could relay this to the doctor, he announced to the team that he was pulling the wire out. He asked if I felt better and I responded, “yes.”

Suddenly, my heart started racing! I was taking shallow breaths and felt like I was sprinting. I heard the doctor shout, “Place the pads!” He then asked me, “Are you still with us, Mr. García?” I was scared, but replied, “Yes, I’m still here.” For the first time in the 8 years since the heart attack, I believed that I was going to die.

With my eyes tightly shut, a million thoughts raced through my mind. The old tale that you “see your life flash before your eyes before dying” didn’t happen. I thought about my faith journey and God’s will. I worried that I didn’t get a chance to say goodbye to Sandra and the girls. These thoughts swirled through my mind in a matter of a few seconds.

The doctor calmly said, “We’re going to give you a shock, Mr. García.” Then…POW!

Some have said that the shock of a heart defibrillator is like getting kicked in the chest by a donkey. I think my donkey was driving a car when it hit me. I felt a massive blow to the chest and saw a bright flash of light as my eyes opened. My body jumped off the table and I screamed “Oh, shit” and the F-word about 62 times (or something like that). I could feel the electric current from head to toe.

The doctor confirmed that my heart was back in rhythm. I was going to be okay. He repeatedly apologized for shocking me without sedation, but my heart rate was rising too fast. His action prevented me from going into potentially fatal cardiac arrest. Lying on the table, I was shaking like a scared Chihuahua and my teeth were chattering uncontrollably. The nurses that rushed to the room covered me with heated blankets, held my hands, and comforted me.

When I calmed down, I too apologized for yelling out the F-word so many times. The team smiled and assured me that I just went through a traumatic experience. I asked for Sandra and Erica who were in the waiting room. The doctor went out to talk to Sandra and they came into see me shortly thereafter. I met them with a big smile to assure them.

The doctor sent me to the ICU so my cardiologist could determine if there was any damage to my heart. All tests came back negative. My heart just got annoyed with the intrusion at that moment and decided to send a strong message. I guess my heart is so moody sometimes.

God once again decided that it wasn’t my time. Seven hours after the shock, I agreed to go back in and finish the right cath procedure. I wasn’t nervous and I was no longer scared.

As St. Paul might say, I went back into that cold room with “faith, hope, and love.” The procedure was smooth, just like the other million or so that will be done this year. The result was another mini-miracle. My lung pressure decreased significantly with the new medication. My cardiologist was happily shocked (pun intended) with the results.

I checked off another part of the workup. I feel good. With the fourth life God has given, I will continue to do the things that I love: spending time with Sandra and supporting Marisa and Erica as they pursue their dreams, working to help east side kids and emerging community leaders, and taking daily walks to music that makes me smile.

For a few days after the shock, I was haunted by the words, “Are you still with us, Mr. García?” At the time, I didn’t know if he was asking me if I was still alive or if I was still conscious. I kept hearing the question in my mind. Eventually I turned to my faith and realized that it didn’t matter what he meant. Faith gave me the courage to write this post.

The experience highlighted another lesson I have learned from this long journey. There’s a silver lining to every cloud. There are so many people enduring what I’m going through or suffering from cancer, depression, anxiety, a job loss, a broken marriage, and countless other life challenges.

For those who are going through tough times of your own, I encourage you to put your trust in faith, hope, and love.  Look for the silver linings. They’re there. They’ll help you carry on through the challenges. Trust me on this one.

By the way, if my brother is right, I still have 5 lives to go. Stay tuned!

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Life is for Living!

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The García family this weekend at the Bay Bridge Series in Oakland

For the past four years, I’ve been taking you on a journey about a life-changing health crisis. The left side of my heart started failing 8 years ago after an artery called the widow-maker was 100% clogged. The result was a heart attack that inflicted massive damage to that side of the heart.

For 8 years, the healthy right side of my heart was compensating for the nearly inoperable left side. Now, the right side of my heart is starting to get tired. This was completely expected. Thankfully, it’s taken longer than doctors predicted. Nevertheless, we’re here now.

Three measurements tell the story of how my heart is working:

The first is the Ejection Fraction (EF), which calculates how efficiently the muscle over the left side of the heart pumps oxygenated blood to feed your other organs. Standard EF is 55-65%. My EF is 10%.

The second is called Cardiac Index. It’s a complicated formula that measures how well (or poorly) the blood flows from the left side of the heart to the body. Normal blood flow is 2.6 to 3.7 liters per minute. My Cardiac Index is 1.6.

The third is Pulmonary Hypertension (PH). This is blood pressure in the arteries that connect the right side of the heart to the lungs. The indicator is called Mean PH. A healthy Mean PH is 25-35. My Mean PH is 42.

To make a long story short, I’m getting sicker.

The right side of my heart is starting to fail. At the same time, God and I are getting tighter. I’m so grateful that my 8-year long spiritual journey has led me to this moment. He has taught me about hope, faith, and love. I’ve learned to fully acknowledge my circumstances and accept what He has given. I’m ready to take on the next phase of my life.

It was therapeutic to jot down my thoughts about the heart attack, the complications that left me in a medically-induced coma, and long rehab. As I wrote, my mind and soul opened to receive the gift of faith. I debated about writing about what’s next. Sharing my faith journey as it happens is inspiring, but I’m not so sure about writing about my ongoing health in the same way.

The inspiration for my story, Summer in the Waiting Room, has been to bring hope to individuals and families facing seemingly discouraging circumstances. With faith, family, and friends, I was able to overcome long odds and continue living a meaningful life. I hope sharing the next phase of my health journey in real time will encourage others confronting life-changing decisions.

Taking medications as prescribed, regular exercise, sticking to a healthy low-fat and low-salt diet, and great medical care has kept me alive and kicking since 2010. Sometime in the future, that regimen won’t work anymore. My heart has been a workhorse and it’s running out of steam. To address this reality, my cardiologist has laid out a few options.

The choices include a heart transplant, a mechanical pumping device, and continued adjustments to medications. Each alternative has its pros and cons. The first is wrought with potential complications, including rejection. The second is less invasive, but may require a dramatic change in lifestyle. The third is the least complicated and the least effective.

In the not so far future, I’ll have another set of life-changing decisions looking at me in the face. Spiritual soul-searching, doing homework on the options, and praying and consulting with Sandra, Marisa, and Erica is the game plan going forward. This is where faith steps in. With this in mind, I recently paid a visit to a parish monsignor who has become a dear friend.

The monsignor has always been available to guide me through my faith journey. He’s been along for the whole ride. He visited the hospital during that challenging summer 8 years ago to provide comfort, prayer, and guidance to Sandra, and the girls. As I outlined the decisions I’m soon to confront, he thoughtfully suggested a path for reflection.

We ended our visit with the Prayer for Discernment:

God our Father,
You have a plan for each one of us,
You hold out to us a future full of hope.

Give us the wisdom of your Spirit
so that we can see the shape
of your plan in the gifts
you have given us,
and in the circumstances
of our daily lives.

With a clear mind and a faithful heart, I’ve spent many hours reflecting on my circumstances and consulting with my family. Of the three choices that will define my future, I like one, I’m reluctant about another, and I’ve dismissed a third. The deliberations will continue with faith, family, and friends by my side.

The good news is that I have time. The decision isn’t imminent. My doctors had the foresight to begin the process early. I’ve taken a multitude of tests to determine my eligibility for a transplant or implantation of a mechanical device and I have a few more months of tests to go. Conditions have to be just right to get a positive recommendation from a committee of specialists and doctors.

In the meantime, I’ll continue to live the life that I love. As time goes by, fatigue will play a bigger role in how I do that, so I’ve learned how to better manage my energy. Mastering that has allowed me to carry on working my passion of advising Latino emerging community leaders and supporting east side high school kids. I still walk and exercise every day.

If I’ve learned anything from the past 8 years, dwelling on what went wrong is not the way to go. Life is for living. This past weekend, Sandra, Marisa, Erica, and I were together laughing, telling stories, and enjoying each other and extended family. I even got in a few dances as a DJ spun tunes at the Giants vs. A’s tailgate. It was a whirlwind weekend.

This morning my world is back to normal. I have lots to think about and more to be grateful for. There are serious decisions for me to make down the road. I want to do what’s best for me and my family. With their support and God’s guidance, I know it will all work out.

On another note, thank you for allowing me to share my story with you for the past four years. Sharing my thoughts has been a blessing to me. I hope it helps others facing similar life-changing decisions. Stay tuned. God willing, there’s a bunch more to come.

Finding True Happiness

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Kicking back on a summer day – 2018

I don’t think I’m a selfish person. Part of this assessment comes from my personality and part is my upbringing. Whether I offered to carry groceries into the house for my mom as kid or pulled the wagon of milk cartons to kindergarten class, I was always the boy that made himself available to lend a helping hand.

Growing up, the concept of needing something overshadowed wanting something. My parents provided everything I needed: unconditional love and support, food, shelter, clothing, and an occasional jelly donut from Peter’s Bakery. Unlike other kids, I didn’t have a Lite Bright set or electric race car track. That was okay by me.

I think I’ve been pretty unselfish as a man too. Nonetheless, I’ve done many selfish things in my life. I first started realizing this when I made the 6th grade basketball team. The kids who lived in the big houses “up the hill” wore red suede Nike high tops to match our uniforms. I wanted those shoes too.

The problem was that they cost $24 ($105 in today’s money). My parents couldn’t afford that, so the answer was “no.” It was the first time I remember feeling deep disappointment about not getting something. After wearing canvas basketball shoes for a couple of seasons, my mom saved enough money to buy the suede Nikes for my 8th grade year.

I had mixed feelings. I felt bad because I knew my mom sacrificed and scrimped to pay for them, yet I was happy because I got what I wanted. In high school, I couldn’t wait to get a part-time job. That way, I could get the things I wanted without having to ask my parents.

My parents’ insistence on working hard made sense. If I wanted something, all I had to do was work for it. There were a couple of hitches that my parents warned about. Getting what you want won’t necessarily make you happy and focusing on your desires can lead to selfishness. In hindsight, I should have paid better attention to those lessons.

After flunking out of college on my first try, I proceeded tirelessly to make amends. What I wanted was redemption from that failure. I knew that if I worked hard enough, I would get what I wished for. With every new career accomplishment or material acquisition, I would soar with happiness. With each setback, I would dwell in self-pity and displeasure.

Not completely heeding my parents’ advice impacted me negatively. When I was happy, I was generous with my spirit and my time. When I was disillusioned, I could be selfish with my mood and attention. I wanted to be the best father, executive, husband, public servant. But, I was a slave to my wishes and justified it with my “successes.”

Most of us are under the impression that getting what we want leads to happiness. That belief drove my quest for redemption from that early failure in college and dominated the first few years of living with heart failure. Exploring faith has enlightened me about the intersection of selfishness and unhappiness.

Finding true happiness has been a result of my faith journey. I’ve become a big fan of St. Paul the Apostle along the way. His lessons on love are inspiring. Paul emphasizes that “love isn’t self-seeking.” He also teaches us that the path to true happiness is accepting that life isn’t about achieving and acquiring.

One could say that just prior to having a massive heart attack, I was a man that “had it all.” My life was full with a beautiful loving wife and two wonderful daughters, a career I couldn’t dream up as a kid, the stereotypical middle-class luxury car and nice house in a desirable neighborhood, lots of friends, and a future seemingly without limits.

I look back and now realize that I wasn’t really happy. I hadn’t been for most of adulthood. I was too busy trying to be successful, too busy looking for that magic bullet that leads to genuine contentment.

That didn’t mean there weren’t joyful times. Being with Sandra and the girls and giving back to the community as a corporate executive and public official made me happy. Unfortunately, those instances were short-term and the professional generosity had strings attached.

Psychologists call this circumstantial happiness. That was me. In fact, that’s most of us. Research published in Psychology Today shows that “happiness is not the result of bouncing from one joy to the next.” The pattern of unhappiness sprinkled with moments of joy started in college and continued well into my battle with heart failure.

Since my life altering illness, I spend most of my time alone. I had never done well by myself. Being around people is a big part of those happy times. Left alone with my thoughts, I sulked over the desire to return to my normal life. I wanted the exciting career back. I wanted to shoot hoops with the kids. I wanted to eat bad food. I wanted to dance with Sandra well into the night.

Then my outlook started changing. The more time I spent alone reflecting on life, the more I got to know myself. Despite my ambition, I wasn’t meant to be an executive that expects something in return for a good deal or a public official doing good works for votes and recognition. I was destined to be the same unselfish little boy that carried groceries for my mom, but in a man’s body.

True happiness is a state of mind. Like good art, you know it when you feel it. For the first time in my adult life, I’m truly happy. I still feel anger, frustration, sadness, and anxiety. But those sensations are no longer the main event. They’re merely brief circumstantial encounters that interrupt my general state of contentment.

My existence and happiness aren’t dependent on getting what I want anymore. I accept all that I have and I’m grateful for everything that’s happened to me, including the probability that my life expectancy isn’t promising. St. Paul helped me understand how I feel. While awaiting a death sentence, he wrote, “Not that I speak from want, for I have learned to be content in whatever circumstances I am.”

Yup, I get it now and I’m happy.