By KEN MOSIER

For Health Care Today

(Editor's note: In case you missed the first chapter, Ken Mosier, who writes often for this publication, had surgery Feb. 8 to replace an aortic valve in his heart. Dr. Mohey Saleh at Good Samaritan Hospital removed the old valve and inserted a bovine valve in its place.)

After six days in the hospital, I was discharged and promptly went into congestive heart failure and was back in the emergency room the next day upon the advice of my cardiologist and my family physician.

• Feb. 24. My diuretic prescription ran out and I again began experiencing shortness of breath. I was soon back in the ER again — same thing: congestive heart failure. I got another prescription for the diuretic and was sent home.

This time the symptoms didn't go away and Dr. Saleh, who had called to check up on me, called my cardiologist, Dr. Fishbein, and discussed my situation with him. I went in the next day for an echocardiogram of the heart — which was working properly — and a chest X-ray. The X-ray showed fluid on the lung and the next day I found myself at the offices of Dr. Rajeesh Patel, a pulmonologist at the Dayton Respiratory Center.

• Feb. 28: I had a CT scan of my lungs and then took a breathing test — 40 minutes of breathing exercises. Dr. Patel said the CT scan confirmed diagnoses that I had fluid in my right lung. He scheduled me for an outpatient procedure the next morning at the hospital.

• Feb. 29: At the hospital my INR — the measure of how long it takes the blood to clot — was taken and Dr. Patel was not satisfied with the results. He gave me the option of returning the next week or taking two units of frozen plasma. Not wishing to be at the hospital at 6 a.m. again, I chose the plasma.

By 11:30, the transfusion is complete and Dr. Patel returns. He put a pillow over the ubiquitous trays found in hospital rooms and had me sit on the edge of the bed and lean on the pillow.

I had been apprehensive about the procedure, which involves a long needle inserted through the back into the lung to drain the fluid. But the only discomfort came when he administered the anesthesia — which he warned would feel like a bee sting. I was still waiting for him to insert the needle when the nurse told me that the fluid was draining. I completely filled one 1-liter bottle with what looked like Guinness Stout — without the foam — and had some fluid in a second bottle. Dr. Patel asked me to take a deep breath and immediately I noticed that the process was much easier.

• March 5: I am losing weight. Partially because I want to do so, but mostly because food doesn't taste good. Even my espresso — I would normally extract three to four demitasses every morning — tastes awful and I have no more than one cup in the morning. (Dr. Fishbein explains a few days later that amiodarone — which I have been taking to control atrial fibrillation — affects the taste of food.)

I attribute this to my deepening depression. Even though I have been warned that depression is often a problem after heart surgery, I didn't realize how far I was sinking into the depths.

Although everyone tells me it looks like I am doing well, I am at the point where I am convinced I will never recover and, what is more, I really don't even care anymore.

• March 6: Dr. Patel gives me a six-minute walk test on a treadmill. The longest I can go is four minutes. He tells me I really need to get into shape.

• March 7: Dr. Fishbein examines me and tells me I can now drive — this, of course, is the day of the blizzard. He also tells me I must get into shape. He also discontinues my amiodarone.

Oddly enough, the little bit of exercise I did at Dr. Patel's office has me feeling a little better. I start spending a few minutes on my own exercise bike after programming it to the lowest level.

It seems to be working. My despair and depression are lifting.

• April 3: I have my cardiac rehab evaluation at Samaritan North Health Center. After giving an extensive history to the nurse, I am asked to complete a six-minute walk test. This time, I do it without breathing hard.

I will go three times a week and work out on the treadmills, exercise bikes, stair climbers and other equipment at Samaritan North. Full rehabilitation includes 21 sessions and a weekly class on living with cardiac rehab.

• April 7: I am looking forward to the first full session of exercise. My depression is mostly gone and, best of all, after the amiodarone has left my system, espresso tastes good again.

The road to recovery has been rocky, but I think I am now entering smooth pavement, and the roadway looks good and clear up ahead.

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