Be strong and courageous, for the Lord your God goes with you; he will never leave you nor forsake you.” ~Deuteronomy 31:6
As soon as the heart transplant team nurse practitioner (NP) who manages my care walked into the exam room, we got straight to work. She enthusiastically asked me how I felt. I didn’t give her the glowing report expected of a 3-month post-transplant patient. I told her that I felt weak and wasn’t making much progress.
Lab results from the day before and an echocardiogram (echo) from earlier that day told a different story. The blood tests showed that my body was functioning normally and confirmed no organ rejection, the biggest factor in transplant failure. The echo indicated that Idaho was performing like a Ferrari, just as the Stanford surgeon boasted after surgery.
The echo is an easy non-invasive procedure. While I was undressed from the waist up lying on an exam table, the technician made circular motions over the heart with a wand. The device sends images and sound to a computer that records the results of the exam. The test measures the strength of the heart muscle as it squeezes with each beat.
A darkened room allows a technician to better see the images on the computer. I’ve had countless echo procedures done. Two things always stood out before the transplant. First, the image on the screen showed a lopsided organ because the lower left chamber of my diseased heart was enlarged. Second, I could hear my heart laboring with unsteady beats.
The six-month echo was different. The image on the computer screen showed a heart that was perfectly shaped. With each beat, Idaho danced in a smooth rhythm while the strong and steady swishing sound of the heartbeat provided the background music. The sound was amazing. It was as if the words of Deuteronomy 31:6 were lyrics to a song that God was singing to me.
The lyrics went on to tell me that it was time to start working to overcome the weakness and hopelessness that had infected my mind. Lying on a table in that dark room, I was reminded of St. Paul’s assurance that hope comes from suffering, endurance, and character. The message was clear: I’ve been here before and I can bounce back again with faith and determination..
Back at the transplant team exam room, the NP confirmed that the results of the echo were stellar. Despite the glimmer of hope that washed over me during the exam, I still reported that I didn’t feel good. Sandra asked if depression and anxiety could play a role in how I felt physically. The NP agreed and recommended that I consider speaking with the transplant team psychologist.
The spiritual echo room experience and the knowledge that Idaho was strong and healthy inspired me to take on the mental and physical barriers that prevented me from moving forward in a positive and productive way. Adding a psychologist and physical therapist to the team was the first order of business.
There has been great progress in the public consciousness about mental health, yet people still tend to lock the issue behind closed doors. In the aftermath of my mom’s passing in 2003, I learned that managing the mind is just as important as taking care of the body. Deciding to give my all to the process was a forgone conclusion.
My therapist is a young woman with the skills of a seasoned veteran. She has a casual, caring, and empathetic manner that allows me to be open about what troubles my mind and soul. Working with her helped me identify the cause of the depression and anxiety that swept through me like a hurricane during the first months of recovery.
The issues we identified are related to my academic disqualification from San Jose State University almost 40 years ago and other self-perceived “failures” from that time. Since then, I graduated from SJSU and married an amazing woman. Together we have two wonderful daughters.
Professionally, I worked my way up the corporate ladder to the executive suite, served in public office, and created a nonprofit organization that trains emerging civic leaders. Personally, I survived a massive heart attack and fought through heart failure for 10 years. The fight included a disciplined diet, medication regimen, exercise plan, and an implanted artificial heart pump.
After all that, failure demons still hung over me like an executioner’s axe looming over the neck of a guilty convict. The events of the early 1980s made me believe that I was a failure. I met every accomplishment with a yawn and a stronger determination to do more. Each professional setback, however minor, further confirmed my core belief that I would never succeed.
Before starting therapy, I spent every day in bed feeling alone and curled up in a loose fetal position. My stomach churned and my mind swirled day after day believing that I failed Sandra and the girls by no longer providing for our family the way I had for so many years. I felt unworthy of the new heart and the donor that selflessly gave it to me.
The therapist not only helped pinpoint the cause of my seemingly hopeless emotional condition, she provided me with mental exercises and a plan to fight the failure demons. Our work and my faith journey, brought back into focus by the spiritual encounter in the echo exam room, put me on the path to be mentally healthy for a successful transplant recovery.
During the early days of recovery, I benefited from physical therapist (PT) home visits. The role of the PT was to work on the twin goals of strengthening the new heart muscle and developing a plan to recondition my body after the traumatic surgery. After three months, I was able to go on short walks a few times per week. Idaho performed well, but the rest of my body lagged behind.
I wanted to walk to the top of Montgomery Hill, a hike I did a few times in the years before the transplant. It’s a 3 mile round trip from my house. To get there, I have to walk through the neighborhood to a bridge that crosses a creek onto a trail that meanders up to the hill. After 8 weeks with the in-home PT and a month of self-guided walks, I still couldn’t even make it to the bridge.
While working on my mental health, I also had the chance to address and improve my physical condition. Kaiser Redwood City has a specialized cardiac physical therapy department with experience serving heart transplant patients. My physical therapist (PT) is a patient and friendly young man with intimate understanding of physical rehab strategies related to heart failure.
He began by asking me to list a few short-term and long-term goals. I gave him three in this order: (1) walk to the top of Montgomery Hill, (2) shoot hoops, and (3) play a round of golf. He developed an exercise regimen I could do at home. These include leg workouts, and light dumbbell and core exercises. He advised me to work my way up the hill in small doable daily walks, adding distance gradually.
Two days before my 57th birthday, I had gotten within a few hundred yards and one steep incline away from my goal. On the morning of my birthday, which was also the 2nd anniversary of heart pump surgery and almost 7 months post-transplant, I made it to the hilltop and quietly celebrated by myself.
Sitting on a bench marvelling at the view of San Jose lying below, I felt the full weight of gratitude. The grace of God was watching over me. I was grateful for Sandra, Marisa, and Erica enduring with me every good and bad step of the way. I was thankful for my transplant care team, the team’s psychologist, and the Redwood City PT.
I was back on track. Faith, hope, and love again ruled the day. The Buddha and the ancient philosophers returned to being valued advisors on this journey. As I made my way down the hill, I walked with purpose and a little spring in my step.
I can’t wait until my 8-month transplant team appointment. God willing, I’ll be able to report that I’m feeling pretty darn good.
To catch up or re-read Part 1 and Part 2, go to the following links: