What about Jesse?

So the next most frequent question I get is what will become of Jesse during all of this. Well, Jesse is going to stay with Vince's brother, Doug, his wife, Carol, and their daughters Laura, age 12 and Julia, age 8, in Bixby, OK which is right outside of Tulsa. We have visited Jesse's aunt, uncle and cousins every year since Jesse was a baby and have stayed at their house every time. Jesse loves spending time with his cousins, so truthfully this is as good of a situation as is possible under the circumstances. Jesse is looking forward to a fun, if hot, few weeks in Oklahoma where he can swim, play games and educate his relatives on all of the fine points of Pokemon. Hopefully while he is there he won't insult anyone's politics. Vince and I have been working hard to explain to Jesse that there are different political perspectives held by many if not most there in OK. Well, Doug and Carol can always blame it on the poor values their nephew is learning from his liberal California parents while they all roast from the non-global warming.

Why Mayo?

People keep asking me why I have to travel to the Mayo Clinic in Rochester, MN. to have this surgery when there are plenty of capable doctors right here in Los Angeles. Well, here is the reason....I am going to the place where they have the most experience with this surgery.

There is a dedicated Hypertrophic Cardiomyopathy clinic at Mayo which treats people from around the world. My surgeon, Joe Dearani, has done more of these operations than almost anyone else in the U.S. There are 4 doctors in the country who have done the lion's share of this surgery, Dr. Dearani being among them.

I happened to have the opportunity to meet Dr. Dearani and Dr. Steve Ommen, my Mayo cardiologist, last year at the annual HCMA meeting. I was so impressed with them I decided that when and if this time came, Mayo was where I was headed. So, after much trial and error with different medications, and working closely with my local doctors, we have all come to the conclusion that this is the best way to go.

My local doctors, Dr. Robert Siegel and Dr. David Cannom, are the best that L.A. has to offer, so I will have excellent post-operative care right here at home.

I have a hereditary heart condition known as Hypertrophic Cardiomyopathy or "HCM." The main feature of hypertrophic cardiomyopathy is an excessive thickening of the heart muscle (hypertrophy literally means to thicken). The abnormality of the heart muscle in Hypertrophic Cardiomyopathy causes two problems. First, it can sometimes interfere with the normal electrical signal in the heart and cause sudden cardiac death. That is the reason that I have had an implantable cardiac defibrillator implanted into my chest -- to prevent against a potentially lethal arrythmia. Secondly, and of note in my case, the muscle thickening also narrows the outflow tract where the blood is pumped from my heart out into the rest of the body. During the ejection of the blood flow from the heart, my mitral valve touches my septum (there should normally be a considerable gap between these structures) causing turbulent blood flow and obstruction to flow which produces a loud murmur. In the surgery I am scheduled for, called a septal "myectomy," Dr. Dearani will remove a portion of the thickened muscle from the septum (or the part of the muscle that divides the heart) thereby widening the outflow tract and relieving the obstruction. This should both relieve my symptoms and improve my long term prognosis. If you would like to learn more information about HCM, please visit www.4HCM.org.