Saturday, June 14, 2014

My Dissected Aorta Loves A Dollar

A most wonderful dollar bill exchanged its existence in my wallet for a pill case.  Greater love for me hath no other dollar.
Medication Organizers are inexpensive but so helpful!
 Finally, I purchased a weekly pill organizer from the Dollar Tree for, yes you guessed it, for that folded one dollar greenback.

And it has so helped with my stress levels and panic episodes.  I should have listened to others and bought one sooner.  But I usually have to learn the hard way.  Sometimes I wonder just what I could have accomplished in life if I had really listened to others, learning from their similar experiences.

But no, I have never much listened.  I have been destined to repeat that which I could have avoided.  Perhaps though learning by experience is part of the human curricula. I know learning the hard way is the path I usually take.  Yes, I kinda enjoy experiencing the challenges for myself.

I can't begin to tell you how many times I have wondered and worried, before I spent this dollar.  Did I take my medicines?  Oh oh, I can not remember if I did but it looks like there are fewer pills in my pill bottles.  Frequent episodes like these always sent adrenaline surging through my cardiovascular system.  Not a good thing for those of us living with a dissected aorta.  Especially when there are so many, so very many pills to swallow.

Medication Memory Issues Resolved! #Marfan Syndrome
Hallelujah! Now with my one dollar pill organizer I feel like all the things falling apart from my connective tissue disorder issues might just start slowly become put back together.  No, the plastic box won't heal my root to foot dissected aorta but it might mitigate heart seizing surges from wondering if I've swallowed the colorful tabs or not, and that might prevent a stress-related cardiovascular incident.

That spent George Washington grew so big in size, and in my mind is now more like a security blanket rather than a small folded piece of paper now in a who knows where cash register drawer, purse or wallet.

I should have listened and bought one several years ago.

Maybe I was waiting for just the right dollar bill to spend.  They say we shouldn't love money.  Where ever you are George, I love you….

Tuesday, June 10, 2014

Salinity Tolerance of Plants (Reference Link)

Here is a link for a very useful plant salinity tolerance chart I find useful in coastal green roof design, published by The WateReuse Foundation.
The WateReuse Foundation's helpful Salinity Tolerance Chart for Plants.

Sunday, June 8, 2014

Kevin's Primal Pineapple & Nut & Chocolate, Almond & Coconut Flour Cookies - Cardiovascular Healthy!

OMG!  These primal treats are so delicious and healthy.  And I don't mind the two remaining teens eating as many as they want.
Kevin's Primal Pineapple, Almond & Coconut Flour, Dark Cocao & Nut Cookies
But unlike those junky industrially fabricated cookies you get in packages at the store, these are so filling that you really only can eat one, maybe two.

And there is no sugar crash afterwards - only fat burning and muscle building (look out Atlas!). Lol.
Low carb, good protein and high quality fats.  Eating primal can be fun!
I know because I am typing this blog post after having baked a dozen and eaten one.  I actually feel energized.  Feeling energized while on high doses of beta-blockers and a myriad of other meds is unusual.  Sometimes I actually wait and wait and wait for my heart to go ahead and beat again.  But these treats kick my pulse up and are good for my liver and kidneys.

My kidneys are about shot because of all the contrast dye from multiple CT scans.  In fact I went into serious renal failure after my second open heart surgery.  Ugh.  So I do not handle sugars or high glycemic carbs very well.  However today, I wanted a quick and easy treat - but not one that would hurt me.
Publix has an excellent selection of 'alternative meal', including coconut and almond meal
Lately I have been removing most all processed foods from my diet, and instead eating good proteins and high quality natural fats - you know, trying to eat healthier.

I feel so much better from doing so.  Post second open heart I weighed almost 245 pounds or so.  Today I am down to the mid 170s.  My goal is a BMI of between 20 and 21 and I am almost there.
Yummy, 'almost totally' Primal-Paleo dark cocao
Hey today is Sunday and the two grand teens have returned to Tallahassee to live with their mother and next weekend Jincy is headed off to college orientation.  Me and the fam need a healthy treat today.

Earlier I rode my bicycle up to the market, selected a few 'primal'-'pale' ingredients and came home to whip up a batch of good-for-you cookies. OMG, they are so delicious!
Eating Primal has helped me remove inflammatory substances from my diet - Good for my Heart!!!
Here is the recipe:

Kevin's Primal Pineapple & Nut & Chocolate, Almond & Coconut Flour Cookies

Preheat oven to 350F

Mix 1 cup organic almond flour and 1 cup organic coconut flour in a mixing bowl.
Add 1/2 teaspoon baking soda & 1/2 teaspoon sea salt.
Stir in three brown eggs and 1 teaspoon organic vanilla extract.
Drain and mix in 10 oz organic crushed pineapple with no sugar added.
Add 1/3 cup organic coconut oil.

Mix well with a fork and press into small cookies on a cooking sheet prepped with organic EVOO.

Decorate with organic 85% Dark Cocao and your favorite nuts (I like pecans, cashews and macadamia nuts).

Bake for 12 minutes or until golden.

OMG.  What an awesome, filling treat full of protein, good fats and a few low glycemic carbs.

I love eating primal.  Natural foods make me want to stand out back and beat my chest like Tarzan.  But I don't do this chest beating because it might aggregate my existing dissected aorta challenges.  Instead I smile and lick my lips and growl like Tarzan.  And lick my lips again!

Friday, June 6, 2014

My Near Death Experience During Aorta Replacement Surgery

Near death experiences are usually referred to as 'NDE's and there are a number of references across the internet.  According to Wikipedia, NDE's are not rare, isolated events but rather quite widespread, with at least eight million Americans reportedly having experienced some type of NDE or other.

Mine occurred while I was having my first open heart surgery in the emergency room at Jacksonville's Memorial Hospital.

After driving myself to Memorial Hospital in Jacksonville (I know, I should have called 911 but I did not) and stumbling into the ER, the young surgeon on call determined my aorta was dissected root to foot.  He told me that he wanted to go in and replace the aortic valve and install a Dacron graft up to the aortic arch.

To do so I'd have to have my body cooled (hypothermia) and my body's heart put on bypass while they repaired the critically damaged cardiovascular system.

The entire  operation took about ten or so hours.  Recovery was difficult to say the least and I even had to go back through additional open heart surgery to mitigate subsequent heart infections.  Wearing the wound vac over my heart was tough, as was enduring the three months of 24/7 IV antibiotics and anti fungal medications.

This week I happened to catch a clip out of a Netflix series the teens were watching where the main character had been killed and his consciousness was wandering around the halls of a hospital.  He was shouting and calling out to all the humans walking around him but none of them heard him, nor did the humans pay any attention to the 'dead' main character.

What struck me was the empty, hollow feeling he was obviously experiencing, walking around calling out to all those other humans that could not see or hear him.  Obviously he was all alone.  Being alone can be extremely disconcerting and hopeless.

"That sucks",  I told myself.  But that was nowhere like my NDE.

While I was lying on the operating table during my aortic root and arch replacement my self awareness began to take a life of its own, separate from my body.

I can clearly remember what was happening, even to this day.  Unlike a dream that seems real at the time but fades from memory after a few short days, the NDE experience I had that day is as ever clear now as two and one half years ago.

I was so very aware of myself and knew exactly who I was.  My body however was on the operating table below with the doctors and nurses hovering over, cutting sewing and doing whatever thoracic surgeons and their teams do when installing mechanical heart valves and Dacron aorta grafts.

I did not call out to anyone like the main character in the teen's television program, but then again I did not feel like I needed to call out to anyone.  I was quite content, safe feeling and happy where I was, 'hovering' above the operating table.

Looking around I could see many people praying for me and sending me good thoughts.  This was interesting I thought, but I honestly was more interested in what I could see not in the operating room but in another part of my self-awareness.  There was an amazing place of really cool colors and sound I was witnessings.  I could fly, soar and felt very, very at home.

After the entire experience I felt somewhat guilty at not worrying about those people left behind on the earth while I was partying in the afterlife.  I knew my wife and kids and family would be OK.  I did not worry about them what-so-ever in my NDE state.  

I did not even think of calling out to the doctors and nurses.  There was no doubt my body was on the operating table and I could see much of what was going on.  

During my NDE I  was a self aware 'spirit', yet I had form too.  My form was not so much a preoccupying factor though as I 'hovered' in the air above the table.  I know my self awareness had form because I was bumping against the ceiling as I floated upwards.  When I'd bump the ceiling my form would float back down towards the other side of the room.  The floating up, bumping the ceiling and floating back down repeated itself over and over until I began taking notice of this occurrence.

The whole bumping into the ceiling thing really pissed me off.  Not because bumping hurt or anything, but because I was aware of an amazing array of new sounds and senses I was catching a glimpse of and I wanted to explore more.  There were so many beautiful colors I'd never seen before and sounds and scents and hues and textures and stuff I can not even describe.  There was a new existence out there that I was tasting and I wanted more of it, a place where I felt immense love and acceptance and belonging.

So many were there with me too.  This place where my self awareness was, was a very good city or town or wherever- whatever it was.  I did not want to leave.  As soon as a beautiful new form would pass by and I felt drawn to it, the bumping would start again.  That damned ceiling!  

The bumping meant I was not going to die.  I knew this as I continued to bump, and it disappointed me. I wanted to stay and explore this new place full of wonder and beauty.  As I floated up, bumped and floated back down I kew that if I were going to die I'd float straight through the ceiling, out into this place of wonder.  The bumping meant I was going to stay.  My earthly body was keeping me in the room.

During my long recovery period I revisited this plane of self awareness several times.  Two and a half years later I do not see this land so much anymore, except for those once-in-a-while nights where deep sleep takes me there.

Having my heart disconnected from my body and being cooled to hypothermia levels gave me a chance to see different things.

I do believe I almost died.  I also believe I caught a glimpse of what happens beyond our present self-awareness.  I am really glad I am here today to see my teens raised and spend days with my wife, friends and family.  Looking forward to many more years here before I drop dead.

But get ready for a cool adventure when it is your time to go.  Been there, done that and it is amazing.

Tuesday, June 3, 2014

Warfarin Bleeding Episodes, Marfan Syndrome and Mechanical Heart Valves Medications

Today I learned that I need to keep sterile gauze pads in my 'tote with me wherever I go' Marfan first aid kit.  It is impossible to keep a bandaid on a tongue.
Life with warfarin, get used to bleeding. Marfan Syndrome normals.
Living a life framed by daily Warfarin doses is a challenge, we all know that.  But warfarin life is manageable when the bleeding occurs somewhere a bandaid will stick.  I really did try.  But a bandaid did not stick to my tongue.

I have been used to the persistent bruising and hard to stop bleeding cuts and scrapes.  But most of these bloody events occurred somewhere on the outside of my body where I could apply the reliable bandaid.  And I keep many in my go everywhere first aid kit.

This afternoon I was brushing my teeth after eating a dried fig.  Unfortunately one of the figs had a little stem left on it.  A sharp little stem.  A little stem so sharp that I said ouch when I bit into the fig.  But the fig tasted so good so I ignored the ouch part.  Until I went to brush my teeth.

Wetting my toothbrush I applied the Crest to the bristles and opened my mouth to clean the choppers.

Holy cow!  I looked like one of those vampires on the TV shows the teens watch, blood everywhere.  First question; Where was I bleeding?  Gums?  Tooth?  Once in a while I have a little blood from flossing but not the amount I was seeing flow down my tongue.
Mechanical aortic valves require anti-clotting drugs like warfarin (Coumadin)
Ugh.  The sharp stem.  I remembered.

Panic started swelling in my chest.  What am I going to do?  What if my tongue continues to gush blood?  I can never go swimming in the ocean again till I get this bleeding stopped!

OK.  I told myself that I had to calm down.  How do you stop a bleeding tongue from gushing blood?   I couldn't run ask Judy or the teens because if I opened my mouth they'd probably scream 'Vampire!'

The bandaid did not work, that was instantly obvious.  Then my problem solving expertise kicked in.  I thought 'sterile gauze bandaid'.  Grabbing a couple gauze packets from the closet I sat down on the floor and wedged the gauze between my tongue and the top of my mouth.  Gag! Blah! But that approach worked after about twenty minutes of gagging on a piece of gauze in my mouth.  Ugh.
Gauze is now a staple in my portable first aid kit.  Stopping a bleeding tongue is a challenge!
Thank god this happened here at the house.

Obviously it is time to go have my INR checked.

But I was going to make sure the vampire look did not return tonight - I made a broccoli smoothie.
Green vegetables high in vitamin K can quickly slow bleeding issues.  Just be careful you do not clot up your valve!
Quickly gulping the vitamin K rich liquid green I could feel my tongue bleed slowly throttle downwards in velocity.
Gulping the broccoli smoothie.  Post-dissection repair life is a challenge with daily warfarin doses.
Tonight, four hours later I can still taste blood.  I'll be sleeping with a packet of gauze nearby tonight in case the vamp symptoms return.
Finally, the bleeding slowed.  Yep, I need to scrape my tongue.  But not tonight!
Aortic dissection, mechanical valves and warfarin, the new normal.  No one to call, no where to turn to.  Figure this stuff out on the fly.  The new Marfan normal.

Sunday, June 1, 2014

A Florida Green Roof that Failed Over and Over Again - Missed Opportunity

Green roofs in Florida must be designed for a very unique set of rooftop variables.  Time and time again I see marvelous, well designed growing systems that work most everywhere else in the U.S. fail in Florida.
The first failure.  Check out the sprinkler erosion patterns in the green roof soil media.
Beware.  A successful Florida green roof is usually based not on the growing system.  Successful Florida Green Roofs are all about the rooftop plant design.  Other than hurricane resiliency and wind uplift issues, the green roof growing system could be a simple vertical coquina stone wall and with the right plants, be green and beautiful year around.

Remnants of the sedum plants that once covered the roof.  More irrigation erosions visible in the soil media.
I do not understand why this concept is so hard to understand by some.  But hopefully we can all learn from these 'hard' lessons.

Sedums work great north of Atlanta generally speaking.  The black death fungus commonly known as Southern Blight, Sclerotium rolfsii, that is pervasively present here in the Sunshine State, apparently wiped out the entire rooftop planting in a matter of weeks.

During hot, wet summer months, Southern Blight will turn many succulents to mush.  Want to learn more about this 'ScleROTium'?  Read more here.

Here in Florida there are a few 'constants' in green roofing design.  The underlying roofing assembly should keep the building water tight.  The entire roofing assembly and green roof system should be fire rated.  Additionally, the roof and green roof growing system should be wind uplift and tropical storm resilient.

A coquina rock wall can satisfy most of these requirements.  What I am trying to say is that here in Florida green roof plants can grow in any growing system installed on a roof.

What matters most is the type of plants chosen and how they interact with primary and secondary design variables.

The 10,000 square foot, green roof system shown here was a installed on the Aloft Hotel in Jacksonville, Florida by a well known national roofing company with a marvelous green roof line of products.

It has failed and failed and failed and was finally removed.

After the first attempt, perennial peanut, Arachis glabrata, was tried as a rooftop cover.  This design too was a failure. 
Such a waste of a beautiful green roof system.

Note the perimeter dead zone on the roof soon after the second round of plants were installed on the roof.  Within a short time the perennial peanut took off, but so did the Bidens app, Goldenrod, Dog-fennel, Ragweed, Pokeberry and extremely tall 'weeds'.

Hoses were draped over the edge of the roof to supply lots of water to plants destined to failure from day one.

Whirly bird sprinklers were set up on the roof but in the end did not save the plants, rather they contributed to washing out the soil media and atomizing-spraying what smelled like reclaimed irrigation water all over the swimming pool and garden patio area below.
Florida has the deadly seven H's.  Plants must be designed around each of them.

Hot summer, relentless photoactive radiation and no matter how much irrigation was applied the chosen plants dried up and turned brown.
This roof not only failed multiple times but also presented a serious liability and safety issue.  With rooftop temperatures approaching 150 degrees F, an afternoon breeze laden with a single cigar ash could have turned the entire structure into a great big torch.
Sometimes a green roof designer will mistake 50 inch annual rainfall amounts for being spread evenly over  four seasons.  Here in Florida it is not uncommon to see ten, twelve or sixteen week droughts without a single drop of rain.  
Again, the roof and growing system here are first class.  But in Florida, a successful green roof is designed around the plants.

I recommend talking to a nursery specializing in green roof plants.  Most nurseries know what drought tolerant plants to install on the ground, and the peanut might have worked well at the hotel site on the ground.

Yet, rooftop ecology needs are nowhere near the same as ground level landscape requirements.  Leaf surface temperature differences can be as high as 80-90 degree F greater on the roof than on the ground.  Find a green roof nursery specializing in green roof plants that has worked for years in your area.

Dead green roofs are fire hazards

Wind too can have so much more impact on the roof than on ground level.  Perennial peanut's success on the ground is due to a hyper-fast photosynthesis rate and biomass creation.  The plant grows fast and covers the ground quickly.  However because the plant does not possess significant spatial or time based separation and protection of the Calvin Cycle processes, roof level heat and wind can pull the water out of the plant faster than the vascular system can resupply.

Maybe as soon as rains started the plant may have 'greened' up (possibly), yet during the dry periods an unacceptable and serious fire hazard existed.

The landscaper had previous success with peanut on the ground.  But a Florida roof is unlike the ground.

Florida green roof design is all about the plants and not so much about the system.
Note too that because there is no handrail system, personal fall protection device attachments would have to be installed to protect maintenance workers.

Maintenance on a green roof should only be done by staff trained for working on a roof with personal fall protection equipment.  Never allow a landscaper on a roof unless they are properly trained and equipped with safety gear, including a hardhat, safety glasses, high visibility vest and personal fall protection gear for starters.

But even with the proper maintenance procedures and awesome green roof planting bed, someone never figured out that  it is 'all about the plants'.

Nice green roof system plus wrong plants equals dead green roof planting.

The fort in St. Augustine, Castillo de San Marcos, is built with solid coquina rock walls, continually buffeted by strong salt laden winds and exposed to intense sunlight.  But the walls support over fifty species of plants.  No soil media and no added irrigation.  Over time populations of native plants have made their self at home.

Castillo de San Marcos plant's teach us that here in Florida it is not so much about the rooftop growing system.  It is not so much about the soil media, although the wrong soil media will not support long term growth.  It is all about Right Plant Right Place on the green roof.

So if you want to design a Florida Green Roof you can learn via trial and failure over the years, or work with a plant person who understands rooftop ecology.

We are presenting a series of design articles covering the basics of rooftop plant design.

So follow our green roof modeling discussion on the website under their Tropical Green Roofs Section.  Part one of the discussion was published a couple months ago.  Part two of the design discussion is coming soon.

The green roof has been removed.  What an amazing opportunity missed.
And for a quick revisit of the seven H's check out some of the other posts about designing Florida Green Roofs.

Once more, Green roofs in Florida are harsh places – remember the 7 (or more) H’s:
  • High Humidity
  • Hot, hot heat
  • High desiccating winds (killer)
  • Hurricanes (not the football team)
  • Hard Freezes
  • Horrible temperature swings
  • Hurtful droughts
  • Harmful floods
The green roof planting system installed above was really amazing.  But forcing those plants though they may grow great elsewhere in the states, that are not suited for the 7H's, on a Florida green roof was not the right approach.

Then hiring a landscaper without a rooftop background to try and remedy the problem only magnified the issues leading to failure.

Thank goodness the landscapers did not fall off the roof.  Thank goodness a cigarette ash did not land on the dead vegetation.

It is not really about the system.  On a green roof, it is all about the plants.

A green roof is all about the plants.

Ditching Most Processed Foods From My Marfan and Post-Dissection Life

Recently I have embarked on a Paleo Diet adventure.

Yummy ice cold watermelon!  Ditching processed foods forever!
It is June 1st today.  I have fallen love in with the Paleo Diet, finding more satisfaction and fullness in this approach to eating than in ANY other food pattern I have encountered.  First, let me say my definition of Paleo may be different than others.  From what I understand, the Paleo Diet mimics what our nomadic ancestors would have eaten.  Though this sounds complicated it is not.  Just eat non-processed food.  Today I have eliminated any food that for the most part does not look like its original form.  I have seen my energy levels soar, my blood pressure drop and my weight peel off.

Of course I have my cheats, such as when company arrives and we go out to eat.  Even then though I stay away from highly processed substances, especially sugars, wheats, corn, beans and dairy.

I am eating more now; lots and lots of healthy foods.

Here is my typical Paleo food day.  I am not a purist Paleo, just trying to stay away from most processed foods.
  1. Breakfast - 2 cups coffee & green tea, 2 eggs (boiled, scrambled in butter or over medium), 4 slices of bacon, and a piece of fruit
  2. Lunch - one avocado, one tomato, handful or almonds or several small sardines
  3. Dinner - grilled salmon with garlic, kale, onions, rosemary, turmeric, and green peppers
  4. Water - 2 liters
  5. Snacks - couple handful of almonds, cashews or walnuts
Compare this to my old eating approach typically represented by a day such as;
  1. Breakfast - 2 dried dates, small bowl of black eye peas and small piece of baked chicken breast
  2. Lunch - 2 veggie burger patties & small bowl sauteed garden veggies in EVOO
  3. Dinner - 2 small bowls black eye peas
  4. Snack - couple handfuls of salty Lays potato chips (I know....) & 1/4 cup walnuts, couple of Nori wrapped garlic clove
Do you see the big difference?

I am staying away from high carb, processed corn and wheat products.  I am eating ocean fresh fish, grass fed beef and high quality fruits and vegetables.

Today I checked in at 175 lbs on the bathroom scale.  That is down 11 pounds in two months and 65 pound since my second open heart surgery.  And I am not hungry anymore.

Remember, always check with your doctor before changing your diet!