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How I almost left my heart in San Francisco – Part 1
First of a series of articles about Timo's heart surgery and its aftermath.

By Timo

A very short preface: food has always been my life. This story begins after I had been chef-owner of my San Francisco restaurant for about ten years and had been working as a cook for 30 years.

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During a little chat with my dermatologist, on an office visit for some small problems, I described to her some recent episodes of weird feelings and tightness in my chest. I had attributed these symptoms, which I had been experiencing for a couple of months, to digestive problems, never thinking it could be anything serious. I was very surprised when she said "those are chest pains, you probably have heart problems and should get examined right away. If you can't get an appointment by tomorrow, get your butt over to the ER and tell them what you just told me".

This came as a complete surprise, as nobody in my family had ever had heart problems. At the time, I was a member of Kaiser Permanente, so two-three days later I walked into the Kaiser Hospital ER for what I thought would be a quick visit. I answered a few questions, including: Q- "Date of birth?" A- "8/22/41… er, 1941". I was used to this because normally, when I answered that question, they looked at me like "1841?".

In short order, I was lying on a bed with patches all over my torso and wires sticking out everywhere – I didn't even know I was undergoing an EKG. After the exam, when I demanded my clothes back so I could go home and get ready for a planned evening celebration, I was told "you are not going anywhere …"  What???

Long story short, the following morning – the morning of my 60th. birthday, 8/22/2001, I woke up in a room for two, with a whole lot of needles in my left wrist and oxygen tubes sticking out of my nose. I thought "well, your birthday is as good a day as any to kick the bucket".

I remained in the hospital for two more days, during which I became acquainted with my wonderful new cardiologist, Dr. Sheryl Garrett, and underwent several more tests, the one that got tattoed in my brain being the angiogram. Whatever drug they give you before starting makes you not care what is going on: I was actually getting a kick out of watching this little snake go up the artery from my groin to the heart, not feeling anything, just watching TV. What got my attention was the conversation between the people conducting the procedure; I heard things like "wow, look at this guy's heart, it's all messed up, is he still breathing? blah, blah, blah".

When I was discharged, I was asked to go to Dr. Garrett's office – in another building in the Kaiser complex – two days later, to discuss the planned course of my treatment. Not exactly auspiciously, the interview began with something like "I don't yet know exactly what is going on, but there is a possibility I may arrange an appointment for you with the transplant folks at Stanford". We then spent a couple of hours discussing my whole life history – I answered, honestly, what seemed like hundreds of questions and went home expecting to hear from Dr. Garrett by the following day as to what the next step would be.

I did hear from her: the "good news" was that I wouldn't have to go to Stanford; I just needed bypass surgery ASAP, which we scheduled for three-four days later. Fine and dandy. But two days later, I learned that no surgeon was willing to touch my case: my heart was too weak, a big factor being my previous use of non-FDA approved drugs, facts that came out upon a thorough review of my history. We devised a regimen designed to strengthen my body overall, my heart especially, until such time as the surgeon decided to proceed. For the next 6+ months, I went to bed every night not knowing if I was going to wake up the following morning.

I lost count of how many cardiologist appointments I went to in those six months - constant monitoring of what I was doing and not doing, what I was and was not eating and drinking. One time, Dr. Garrett said "I think I want to go in there myself and see what is going on": another angiogram, which she performed herself; it didn't change anything. But the new strength regimen was working: I gradually showed consistent improvement.

I can categorically state that this six month period was no picnic: I was dealing with angina, atherosclerosis, high cholesterol and gout. I was on Warfarin (Coumadin), statins, gout meds, blood pressure meds, nitrates for the chest pains, all kinds of FDA-approved crap, probably as hard on my system as the non-approved drugs I had used in the past. To add insult to injury, 9/11 came and went, and then, on November 12, my 43 year old wife passed away, due to a relapse of ovarian cancer that had first manifested itself about four years earlier.

Yet, in some ways, it was a picnic – literally: I was back running my restaurant, although trying to take it easy. But I had to get stronger, so I was allowed to eat fish and even the occasional steak or rack of lamb (my favorite meat). And – I am pretty sure this was not approved by Dr. Garrett – a glass of wine here and there. Nobody will ever convince me that one can digest a piece of meat properly without at least a touch of red wine.

Finally, the surgeon said OK, and we scheduled the bypass surgery for March 7, 2002 – a Friday: my youngest of four sons and his then soon-to-be wife drove me to the hospital at 6:30 AM. By 8:00, I had checked in, had visited with Dr. Garret for a little while, then somebody gave me an injection, and the last thing I remember is being wheeled on my way to the operating room. Next, I came to at about 5 PM, in the recovery room, my body connected to what seemed like 100 things: machines, tubes, hoses, needles. My son, his fiancée and Dr. Garrett were there and greeted me; I could not talk to them because I had a pipe sticking out of my mouth, which did not even allow me to turn my head. Before too long, I passed out.

Saturday: I woke up in another room for two, nurses hovering around; I talked to them and to a few visitors, including Dr. Garrett, from whom I learned they had performed a quadruple bypass; also Dr. Malikian, the surgeon came by to check up on me. I had some juice and maybe something very light to eat, but don't remember much about that whole day, except for the acute pain in the middle of my chest and on my left leg, from above the knee all the way to the ankle, the wounds of the surgery. With some assistance, I got on my feet and took a few steps, and even visited with a little man from another room who had undergone the same procedure two days before me, and who gave me a lot of pointers and encouragement. I also received various instructions from nurses, including how to use a weird plastic toy into which you blow and try to raise a little plastic ball to a certain height. I would have to do this every two hours or so for several weeks, to regain normal lung function.

Sunday and Monday: that's when the real picnic (more like a banquet) began. So, in between having a catheter and other things removed, receiving more instructions, planning for a three month recovery at my son's home in the Peninsula (the doctors did not want me to go to my own flat so I wouldn't have to deal with a double flight of stairs) and walking around the ward, I enjoyed visiting with several friends; Joanne, the only person to touch my hair in the previous 20 years, came by with her tools and fixed up my hair – and I ate like a pig. Anybody who knew me would have been aware of how I would feel about hospital food, and I had made sure to let all my friends and colleagues know that I would need to do some healthy eating to speed up my recovery. They responded: Delfina, Suppenküche and Palio (these are San Francisco restaurant names any foodie would know) all sent me fantastic meals, enough to share with visitors. Dr. Garret walked in when I had a glass of my favorite Sangiovese in my hand – she agreed that it was excellent.

Tuesday: the day I was discharged from the hospital. My son showed up shortly after noon, intending to take me straight home, but that is not what happened: I insisted on a little detour; after all, it was lunch time. We ended up at Zuni Café, to this day my favorite San Francisco eatery. I got my favorite table, close to the wood-fired oven. That extraordinary meal was on the house.

Afterwards: the next three months were nothing to write home about. The expected house calls from a Kaiser nurse, an occasional visit to Dr. Garret's and to my restaurant, lots of walking and cooking great meals. Then, back to my own home and to running the restaurant. After the smoke cleared, I ended up on several medications, supposedly forever:

  • Aspirin;
  • Lipitor (cholesterol control);
  • Coreg (blood pressure, beta blocker);
  • Colchicine as needed (in case of gout flare-up);
  • Omeprazole as needed (in case of heartburn - GERD);
  • Isordil as needed (nitrates for chest pain).

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In Part 2 of this story, I will tell you how, when and why I replaced all the above drugs with good nutrition and high quality food supplements and what the results of that have been so far.

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