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Heart Surgery to Himalayan Heights: A Mountaineer's Inspirational Journey
Episode 6817th September 2024 • Open Heart Surgery with Boots • Boots Knighton
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#67 Inspired by Warren Zevon’s philosophy to "enjoy every sandwich," Billy Haas walked on the treadmill for hours, eating sandwiches post open-heart surgery in order to cope with depression and the reality that his world had changed in an instant. In this episode, Billy shares about how drinking too much coffee on Denali led to a dual diagnosis of Septal Defect and Partial Anomalous Pulmonary Venous Return resulting in open-heart surgery instead of a trip to Pakistan. A year later, he began to experience Severe Vena Cava Occlusion leading to the placement of a stent. Billy walks us through how this major health challenge offered him a fresh lens to view success and failure. Ultimately, Billy successfully navigated his path to physical and emotional wellness and got to go on that trip to Pakistan. Bravo Billy.

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**I am not a doctor and this is not medical advice. Be sure to check in with your care team about all the next right steps for you and your heart.**

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Email: Boots@theheartchamberpodcast.com

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Transcripts

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The septal defect is almost like you have those crack in a straw. The

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straw doesn't suck properly. And then the vetus return is just

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incorrect plumbing. So one of my four tubes was just

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going into the wrong spot, and it was at that point where, you know,

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it takes the sensor out and they go away and they come back.

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And at the time, I had been planning a trip with a friend to

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go on a ski expedition to Pakistan, and I told the doctor all

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about it. He's like, oh, yeah, you know, we'll probably get this figured out for

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you by then. This is, like, six months from now. And the cardiologist comes

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back, and he goes, looks at me, and I say to him, before he says

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anything, I'm like, I'm probably not going to Pakistan this year, am I? And he

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kind of looks at me and laughs. He's like, I'm sorry, bud. You're not going

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to Pakistan this year. We're going to get you scheduled for open heart surgery in

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the next month.

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Welcome to open heart surgery with Boots, a

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podcast for heart patients by me, a heart

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patient. Join me as I take you on a journey through the

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intricacies of the human heart, revealing the

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triumphs and challenges of those who

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undergo the life changing event of heart

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surgery. We're not just exploring medical procedures.

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We're delving into the human experience.

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Be sure you hit subscribe and also

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leave a review. That means the world to

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me, and I read every single one. Also, if you

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have a story to share or want to hear something that I haven't

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covered on this program, you can send me an email, which is

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linked in the show notes. But without further delay, let's

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get to this week's episode. Welcome

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back to another episode of Open Heart Surgery with Boots. I am Boots

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Knighton, your host, and today is such

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a special treat. I feel like I say that

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every week with every heart patient I have the honor of

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interviewing, but this week feels extra special, and I'll tell you

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why. I want to bring you my new friend

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and heart buddy, Billy Haas, who is a

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mountain guide. And he had open heart

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surgery, and he is totally back out in the

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world. Like, climbing new peaks, putting in new

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routes. He's a mountain guide. He is an

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instructor for the American Avalanche Institute, and

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it's like he hasn't missed a beat. And I cannot

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wait to dive in with Billy and get

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to the heart of the matter, pun totally intended,

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to figure out how the heck he is

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thriving despite his heart

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challenge. And he just seems to have risen to the

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challenge and succeeded and has totally

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reached new heights. Also, pun intended, the pun opportunities

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are endless with him. So, Billy, thank you for coming

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to this podcast to share your knowledge,

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your inspiration. I am grateful to you. You are a

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busy dude. You are constantly going new places. So

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thank you for taking the time to sit down with me today and share

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your story. Yeah, thank you, Boots. Good morning. I know this

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has been a little bit of time in the works, but I'm glad I kind

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of found time. And this, yeah, should be really fun. So

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you're out climbing peaks anyway, despite everything you've been

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through. And I talked to so many heart

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patients who have wanted to get back

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to their life, and life is just so

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radically different after heart surgery for all of us.

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I know for myself, I continue to try to get

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back to, you know what I the reason why I moved to the

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tetons for those just finding me. I live in Victor,

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Idaho. Billy lives down in Utah,

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and he also comes up to the tetons to

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guide up here for exim mountain guides. And

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you and I love to play in the mountains. That's why we live here.

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And I continue to struggle to get back to the

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mountains. And so this is a bit of a selfish

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episode for me because I need that

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inspiration. I need that hope that, like, maybe one day I

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can get back to what I used to do. And so I'm just

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so excited to unpack all of that with you today.

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Tell us first, like, set the scene of

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what happened. Just give us your heart

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story as it unfolded.

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Yeah, it was kind of a surprise,

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like, for many, but for me, it started, this is going to sound

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like kind of silly, but this is how it happened. Working as a mountain guide.

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I was up in Alaska guiding Denali,

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and I'm not a big, or wasn't at the time a big coffee drinker.

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Still. I'm not. And, you know, you get stuck in a

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camp, you're there for days, there's a storm.

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And I just kind of sat around with a bunch of guides and

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drank a bunch of coffee. What that did is it gave me a lot of

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basically pvcs or, you know, these kind of

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extra, extra heartbeats. And I thought I was, you know, at one point I look

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at one of the other guys, I'm like, man, I think I'm having a heart

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attack. And they're like, you're probably fine. You probably just drank too much

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coffee. Which ended up being true. But I got back and I had been like,

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kind of complaining about that and stuff. And I've got a little bit of family

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history with heart disease, but we ended up finding out that I

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was more like, it wasn't something that would be genetic. Like, my

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grandpa had rheumatic fever, which damaged his heart and things like that.

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So I kept complaining, kept complaining. Eventually, my wife, who, she works as

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an ICU nurse, she was like, you know what? I'm sick and tired of your

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complaining that you had something happen on Denali. I'm just going to make you a

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cardiologist appointment, and then I don't have to listen to you

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complain anymore. So I kind of go in there to the cardiologist, and I'm like,

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hey. So I had this thing happen. Like, I don't know what it was, but

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I'm telling you, there's something wrong. He's like, do you have any other symptoms? Anything

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else? I'm like, no, not really. I'm just, I'm telling you, it was weird.

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And I almost felt embarrassed being there, almost as I'm

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like, I'm like a healthy 30 at the time I was there. I'm like

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a healthy 30 year old endurance athlete. Like, what the heck am I doing at

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a cardiologist appointment? And sure enough, I thought he was

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actually pretty cool that he did this. He's like, well, you know what? You're here.

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Let's check some things out. Probably nothing. And

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echo, you know, ecgdeh, uh,

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they did a calcium score test,

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and in the, a few days later, in the echo, he calls me up. He's

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like, hey, so you actually have a little bit of right side

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enlargement. Really, really minor, really minor. But generally, when we see

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that, we want to follow up with a CT or, sorry, um,

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MRI. And it was in the MRI that they ended up

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seeing some right to left shunting. And at that point, they

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kind of said to me like, hey, you actually probably do have something. It's got

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nothing to do with a coffee and those skip heartbeats, but you actually do have

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something. It's probably something called a septal defect. Generally, they're

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pretty easy to fix, but we need to get some more

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imaging to see how big and how we're going to fix it.

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So that's when they did a trans esophageal echocardiogram.

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And that was actually kind of a funny story because

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the sedation, because, you know, they give you some lidocaine to

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numb the throat, and then they put you under mild sedation. I was, I felt,

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like, fully awake for it, and I was kind of, like, gagging on the

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probe the entire time. They're like, look, if we sedate you

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anymore, if we sedate you anymore, we're going to put you to sleep, and then

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you're going to be here for a long time. You don't want that. So either

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just kind of take it right now, or this is

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going to be a much bigger thing than you want. So it's like, all right,

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just do it. And I could hear the

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cardiologist kind of, like, explaining some things

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to the resident he was with. And at that point, I'd

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done enough research to kind of understand some things and what they were talking about

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a little bit. And it kind of went from like, okay, okay. Mmm,

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mmm, mmm. You know,

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and it was after the te that they learned that I had a pretty

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large septal defect, but I also had an

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anomalous pulmonary vein, so they call it partially

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anomalous venous return. So one of my pulmonary veins

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that's bringing oxygenated blood back from my lungs

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was kind of going into my superior vena

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cava, essentially just recirculating a quarter of

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my. Of the blood, the oxygenated blood returning from my

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lungs. So it was like they give you all these

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analogies to try and help lay people understand, but it was like, you know,

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the. The septal defect is almost like you have those crack in a straw.

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The straw doesn't suck properly. And then the Venus returned. It's just

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incorrect plumbing. So one of my four tubes was just going

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into the wrong spot, and it was at that point where, you know,

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it takes the sensor out and they go away and they come back.

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And at the time, I had been planning a trip with a

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friend to go on a ski expedition to Pakistan. And I told the

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doctor all about it and stuff. He's like, oh, yeah, you know, we'll probably get

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this figured out for you by then. This is like six months from now. And

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the cardiologist comes back and he goes, looks at me, and I.

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And I say to him before he says anything, I'm like, I'm probably not going

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to Pakistan this year, am I? And he kind of looks at me and laughs.

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He's like, I'm sorry, bud. You're not going to Pakistan this year. We're going to

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get you scheduled for open heart surgery in the next month. Wow.

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Wow. So that was kind of the

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diagnosis. I'm just thinking about you and

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Denali having. I mean, my husband Jason has also

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been on Denali. And, yeah, you do sit there

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for some days. For many days sometimes. And

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I'm just thinking about how that started for you, that is

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so intense. I'm

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just glad that, like, you actually didn't have a heart attack on Denali, because that

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would not have necessarily gone very well. Yeah,

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well, it is something that happens, people, because you do put a lot of

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stress on your heart.

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Cardiac events at high altitude are not uncommon.

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We weren't terribly high. We were at 11,000ft, which

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is particularly for where we're coming from,

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not super high. And it's funny

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because what I was having was just a result of

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me having too much caffeine. And I

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just am really sensitive to caffeine. I still am. So it

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was like totally separate. It wasn't actually anything to do

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with what I had, but it was what led me to go to see a

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doctor. So there's like a subtle joke I have with my

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wife. That coffee saved my life in a way.

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Hey, whatever it takes, because we need you here

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you are dealt this news. Walk us

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through. Like, how did that land? Like, here you had. It

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was such a 180, right? Yeah. And it

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was something that I think, you know, I've had

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orthopedic injuries before, ACL repairs, things like that.

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Like, you know, you get those kind of. That kind of news and it's like,

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okay, this is like what you expect. I'm a skier or stuff like that. You

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know, I have to have this kind of surgery. That kind of surgery. I smashed

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my face once and had to have that fixed, you know, and

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that's something where you're like, okay, this makes sense. This is

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like, I'm like a human machine and we need to fix, like,

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this arm of it or something like that. But with this one, it was

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like a little different. Like, I wasn't thinking about, am I going to be able

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to do this skiing this year or that climbing this year? I was more

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like, did I just lower my life expectancy? Like, you know, like,

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am I going to live like. Like how, you know, am I going to have

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a weak heart for the rest of my life? And so I think it hits

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quite a bit more than some other styles of

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injuries or things like that. I remember coming

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home that afternoon, and maybe it was just the sedative

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wearing off or whatever they had me on, but I was less. Like, I felt

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cold and clammy. I kind of felt nauseous for the whole day. I was like.

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I was. Yeah, I was really upset. And

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I think the good thing was, and I'll probably say this 500

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times, but, you know, my wife Diana, through the whole thing,

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was about as important as anyone in

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one explaining things to me, but also being

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optimistic. And, I mean, that's many partners and

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many friends and, you know, that's kind of their. I don't want to say their

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role, but that's the role they end up assuming. But it's. It is really

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important to have that. Yeah. Oh, yeah.

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And you're lucky because she's, like a medical professional, too, so

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she really better than anyone could. She

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could be your advocate, your educator, like, all the

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things. Exactly. Yeah. Yeah. You were. So then

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you were scheduled within the month at University of

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Utah. Yep. Yep. So it was. Yeah, it was early

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winter when I had that te. And

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I think, yeah, then I was scheduled for. It was a little over a month,

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but it was like, February 1 was when I had my surgery.

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And I remember prior to that, I worked quite a bit

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just to get as much work in before the surgery. But I also skied as

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much as humanly possible. I put in, like, some of my biggest days ever.

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A lot of big solo days. Like, I did have some of these, like,

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vision quest style solo skis.

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And then right the day before my surgery. Oh,

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go ahead. I was just gonna say I want to set the

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scene for our listeners. Cause I have

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listeners all over the country and

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59 other countries. And

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when you have a big day, I want

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people to understand what that means. Cause it's really

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incredible what you do with your machine

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that, you know, is your body tell people, because, like, it's hard for

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people to understand. Like, I know what your big day is. I

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used to have them myself. But, like, brag about yourself. Like, it's

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amazing what you were still able to do despite

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being born differently. Yeah. And it's. It's

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funny because having no symptoms, like, I played a. I played college lacrosse.

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I, you know, fell into this career as a yemenite

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ski athlete and endurance athlete and never had a symptom. And it's

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amazing how your body can compensate throughout all of that. My understanding

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is, with my two problems in combination,

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there's a few common diagnosis points.

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One is at birth. The other is generally in your

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teenage years because. Or as you know, kids

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start to mature because they can't really do activity,

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and they have trouble with activity. And then the other point is that death,

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because it's usually the cause of death. And I think, like, the life expect is,

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like, mid fifties or something. Untreated was what I was told.

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But by the way, it is amazing because, like,

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to know I didn't do anything to help this because I didn't know about

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it, but my body, for whatever it was, was just able to compensate well.

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But that compensation does damage to your heart. And

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that's why I had that right side enlargement. So while I did compensate well, it

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still needed to be fixed. And, I mean, for me, like, you know,

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I go out there and I'm doing some of these big days right before. Right

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before my surgery. And I think one of them was this solo day in the

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Wasatch range here. And I think I skied like, 14 or 15,000

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vertical feet and kind of linked up some technical

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lines in one of our larger alpine zones. And the

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whole time I just had, like, a huge smile on my face. I remember, like,

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every peak, every line I skied, I was just, like, beaming,

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and I was, like, kind of scared about what was going to happen.

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But that was a really good day. Like, I'll never forget that day for the

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rest of my life. And luckily, I can sort of picture where that is,

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and it's beautiful. And I want to tell the listeners, this isn't

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lift service skiing. You were climbing

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the mountain and skiing down. It's called ski mountaineering.

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And it takes an incredible amount of endurance to

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be able to do that. Even with a good heart. I mean, your heart is

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still good. I don't want to imply that it was bad. I'm really

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careful about how I word things. Cause

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words really matter. And I even don't like saying the

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word congenital heart defect because I just like to

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think of it as born differently because I know for me,

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it has an emotional impact when I think of defect

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versus be, just being born differently. But that's my own

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journey. No, and I feel the same. Like, I remember

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I would have these mopey moments where I'm just like, well, I guess I'm just

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not, you know, a normal person. Like, I guess I'm a

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broken person. Yeah, no, I agree with that, though. Like. Cause I had

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those. I had those moments of, like, feeling sorry for myself. And a lot of

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it was just because of that. Yeah, I have a feeling

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we heart patients throw the best pity parties.

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Probably the woe is me,

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but I. And I think it's necessary. I mean, there's. I just

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aired an episode yesterday with a really great

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emergency room nurse up in Canada, and

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it was amazing. She's like, I just want to. She said, I want to give

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you and your listeners permission to grieve.

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And I. I really grieved when I

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was diagnosed in 2020, and I did

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grieve that year. But then I had to get on with things. I had to

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get on with saving my life. And my mom died

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and, you know, like, all these things were happening. Plus it was Covid

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dumpster fire, and I

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think I still have a little more grieving to do. And it just

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comes in waves. So, yeah,

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it's like, be in the pity party and then let it pass.

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So then what? That way, it doesn't get stuck in you and, like. Cause, you

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know, like, emotions can get stuck if we don't allow them to, like,

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express themselves. And then. But then it is time to climb the

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peak and smile and get on with living and be in

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today and what we have, what we've been given today.

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Yeah, that's something I tell myself all the time. Like, it's okay to feel

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like crap right now, so just. That's how it is, you know? And

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I think that's totally fine. Yeah. Okay, so you had a

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kick ass day before surgery. Good for you.

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Bravo. And then it was surgery day, and it was. Yep. And I,

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you know, again, it was kind of nice because having my wife,

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you're not like, an insider in a sense, but you get prepped

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with what's going to happen. All these things. Everything's kind of explained to you, not

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just from a healthcare provider, but by someone you really, really

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trust. And I remember

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they must pump you up on valium or something right before you go into

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the. To the operating room. But I was like. I was riding a high.

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I was like, thumbs up. Let's do this. I remember very adamantly that

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I would not let them pick me up from the bed that they

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wheeled me in on. I think I kind of pissed some people off because of

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this. I was like, I would like to sit onto my own bed, not get,

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like, wheeled in here and then, like, lifted. And

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I was a bad patient sometimes, but, yeah,

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I could go into that a little bit. I definitely was, like, not a good

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standard patient in some ways, but, yeah. And then you

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wake up and you're like. You wake up and. From open heart surgeon, as

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I'm sure you probably remember, boots, like, you're supremely messed up.

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There's tubes coming out of you left and right,

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you know, like, you're really messed up. And

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I remember being incredibly nauseous, and I was

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so scared that if I threw up, I would, like, ruin something.

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Like, I would, like, throw up on my wound or I'd, like, break my

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chest open or something, even though that somewhat irrational and just

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being so nauseous and so nauseous like, I don't

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remember the pain. I remember the nausea and just trying to, like, fight

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that off. I ended up spending seven days in

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the hospital. I had a small

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complication. I mean, realistically small complication. One of my lungs collapsed

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post surgery. Just meant I got another tube and.

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But, yeah, I was, you know, after seven days, discharged from the University

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of Utah, and surgery seemingly went well. And those

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were really crappy seven days, though, I will say that. Yeah.

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What was. What was crappy about it? I mean, yeah, you had the collapse lung.

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That doesn't help the nausea. Oh, my God. Like, I threw

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up 25 times after my open heart surgery.

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Yeah. Like, I broke record.

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Yeah. And so for listeners who haven't heard my story,

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I had my surgery right down the street at Intermountain hospital

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down in Utah. And, yeah, at the time, the ICU nurses told

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me I broke the record for a number of times. Vomited in, like, a

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24 hours period. Yeah, don't

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recommend that. So she rubbed

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me for good luck. See, these are the kind of stories my wife.

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My wife comes home with. So I like to

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expect. I'm sure people were talking about me,

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certain. But, yeah,

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that's. So seven days. I mean, I got out

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lightning quick despite my time with the puke

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bucket. But how old were you when you had your

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surgery? I was 30. Yeah. Okay,

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so I was 30 years old. And, you know when you're in there,

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and here's the thing they say to you, and to be totally honest, when you're

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in there, they're like, oh, we don't get patients like you all the time. Like,

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oh, what are you doing here? You know? Or like, stuff like that. That doesn't

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make you feel better. It's like, okay, well, yeah, what am I doing

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here? Yeah, my surgeon said he only operates on fat

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people, and so he didn't know what to do with me. Yeah,

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yeah, no, I. That's, you know, and I was pretty mobile on my own, and

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I think that was something that they were like, oh, here, let me help. I

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was like, no, like, don't touch me. Like, I'm going to get myself up right

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now. And like I said, I was a bad patient. Like, a

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few things, they make you walk, right? You know, and they make you stand up

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and do these, like, short walks once or twice a day. And

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I was. I was pretty depressed, like, not that I couldn't walk, I just didn't

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want to walk. And I was just laying in the bed, basically, just staring at

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the ceiling tiles. And I didn't watch tv once.

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Like, I thought I was going to, like, read a book or, like, listen to

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music. I didn't do any of that. I sat every single day staring

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at a wall or staring at the ceiling. Sometimes I'd have them, like,

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sit the chair, because they had a chair in the room, and they'd face me,

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like, out towards the mountains, and I could, like, see the

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helipad and, like, just, like, watch the helicopters come in and go out.

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And that's all I did. I didn't even, like, look on my phone much.

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And, yeah, they'd have you walk, and they'd be like, oh, don't you want to

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walk? Like you're, you know, a mountain person? You love walking, all this stuff, yada,

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yada. I'm like, I don't want to walk, you know? And they're like, well, you

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have to. I'm like, but, yeah. And that was where I think having my wife

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really helped, because I'd be like, I'm not going to walk until my wife gets

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here and she can walk with me. And they'd be like, well,

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you know, we usually don't let family members do this. We usually. And

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the charge nurse there and my nurse kind of knew my wife, and I was

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like, just go talk to the charge nurse. Just. And, you know, and then the

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physical therapist would come back and be like, okay, okay. Yeah, well, when your wife

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gets here, she can help bathe you or help this or that

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or stuff. And so that was

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nice because I can see if you don't have someone who

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works in the healthcare system who's maybe even friends with some of the people there,

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it's like you have strangers doing all this to you. And that was something that

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was frustrating to me. Like, all I wanted was to have my

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wife there helping me do these things. And the nurse that primarily took

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care of me, he was on for. Luckily, I got him for a full round

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of shifts for three days because I was in the Cvicu for

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two days, and then I was in the floor unit,

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the cardiac floor unit for five days, and he was with me

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when I got to the floor. And that was great. He was super

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nice, kind of friend of a friend, things like that. Like, knew

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Diana, so that was, that was really helpful. And

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I think having gone through that, like, I have a lot of empathy and

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for people who don't have that. And, like, if I was in there on their

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own, even if I had family come and visit, oh, hey, you know, like, that's

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fine, but really having someone walk you through stuff and help

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you with things that. That made a huge difference, or at least seemingly made a

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huge difference for me. She's your. And Diana's your person, you know? I

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get it. Like, it's. Yeah, it's. It's such a

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hard, scary moment in life, and we need

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our security blankets, which are our partners or close

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friends or family members. Yeah. And you're right. Not everyone

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has that. That gift of

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having a person. And that's one of the reasons for

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this podcast. It's like, I want to. This episode and all the

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other episodes, it's like, I want it to feel like a hug for

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those who don't have someone close

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to them. Like, we heart patients don't have to do life

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alone, and it's even better if we do have a

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partner. Totally. Not that any of the other care providers at the University

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of Utah were bad. It's just. It's really nice when you have someone who you

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know well to help you with some stuff. Like,

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the example is at one point, they're like, okay, we're gonna. We're gonna give you,

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like, a sponge bath and kind of clean you here. And

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very nice young medical assistant. And I just looked at how I was like,

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hey, man, can we just wait till my wife gets here and she can do

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it? And he's like, again, well, we usually don't let family members, you know, yada,

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yada. And I was like, just go talk to Mike. He was my nurse. I

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was like, just go talk to Mike. He comes back in, like, a minute later.

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He's like, oh, okay. Yeah, yeah, I know when your wife gets here, she can

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help you. And I'm just like, that kind of stuff was helpful.

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Yeah, yeah. Well, I mean, with heart

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surgery, I can't speak to other surgeries, but, I mean, it's

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such a vulnerable act of

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going through heart surgery. And, I mean, our hearts have

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actually been touched by other humans, and that in and

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of itself is so much to process and then to continue to be

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poked and prodded with all the tubes for the next however

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many days. And, I mean, it is all

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dignity goes out the window. And so it's like, whatever

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dignity we can hold onto is so

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important and necessary for our self

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respect. I mean, I remember I got so violently ill a

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couple of times, and I was so embarrassed to ask for

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help, and I just wanted Jason, my husband, to help because

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I was like, I'm so embarrassed. Like, it was so. I

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was so sick, and it is such a vulnerable

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few days in the hospital. And even though these people do it as a living

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and they want to help and they signed up to help, it is still so

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weird to have. Yeah. A stranger you don't know at three in the

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morning coming in to clean you up. It is. It is

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tough and I just want to normalize

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that for listeners. And I'm sure there are people right now listening to this

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going, yep. It is as part of heart

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surgery that we aren't prepared for ahead of time.

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And I hadn't, I'd had things happen in my life, like orthopedic injuries, other

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things like that, where I'd been in the hospital, things like that. But this is

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on a whole other level in it. And it is, it's, it is a

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little demoralizing, but you get through it and that's the nice thing.

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Yep. And so let's talk about that. So, okay, sure. You

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were in the hospital for seven days. None of us are going to judge you

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that you weren't a great patient. I have a feeling you weren't nearly as bad

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as you're making yourself sound.

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You're thriving. Walk us through your recovery

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and how you got back

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to climbing 8000 meters peaks. Well, I did have

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a hiccup and I'll get there in a second because it wasn't all like smooth

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sailing. I had a pretty major hiccup. But

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one of the things that's interesting with heart surgery is, again, I'm used

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to other styles of injury on my friend. It's like you get hurt,

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you get a surgery, you do rehab. For me, I was like, well, what

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do I do now? You know, like they, they have you on the sternal precautions

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and they're like, right now you just, you chill. And then after

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like two. And I, when I walked like that year to that

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February 2019 was one of the biggest February's of snowfall on record in

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the wasatch. So that was also a little hard.

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And, yeah, my house here is kind of like

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a road stop for a lot of my friends going up and down the Cottonwood

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canyons to go skiing. So I have my friends over all the time. They're all

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like, dude, it was the best day ever. You know, like I, and, uh, which

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I was psyched on and I was, I was genuinely psyched on that. And that's

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another thing I'll, I'll get to in a second of kind of how I've changed.

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But, but, yeah, I walked a lot. I walked around the neighborhood and it was

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funny because I walk around these blocks and there's all this snow on the ground,

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and usually I'm a professional mountain guide, and there's, like, a patch

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of ice on a sidewalk, and I'm like, whoo. Got to be careful. Like, let's

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get around this carefully. You know, like, I could, it was kind of

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funny how my mindset shifted there, but, yeah, they didn't have me on any kind

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of, I mean, they're like, yeah, this is a standard cardiac rehab, but, like, you

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don't, this is going to seem silly for you. So I walked. I walked a

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lot. Like, I got obsessive with my walking. And then as I

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was able to walk more and more and they lowered my sternal precautions, I started

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to go to the climbing gym where I'd walk on an inclined

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treadmill. I still wasn't allowed to, like, hold on to the

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treadmill because of the sternal precautions, but I put the

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incline treadmill as steep as it would go, and I would walk

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for hours, literally hours. I'd be there for, like, five, 6

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hours just walking. I mean, I had jokes like, I ain't got nothing else

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going on. I might as well just do this. And you can only walk, like,

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you know, 1 mile an hour. I did 10,000 foot vertical days on the

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treadmill. You know, like, that's pretty messed up, uh, in

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terms of the monotony of just, like, that's what I did.

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And honestly, until they took me off the sternal precautions, that is what I did.

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I walked like a crazy person, and I walked on that incline

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treadmill. That thing became, like, my best friend. Like, I would bring, like,

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sandwiches and food onto the, like, no one does that, you know, no

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one, like, is on a treadmill, like, eating a sandwich.

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People would, like, look at me weird, and I think one of the problems with

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heart surgery is you put a shirt on and you don't look like you

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just had an accident or something. You know, you don't look like you just

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had a surgery, so you look relatively normal. And there's, at the climbing gym,

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there's even these big, heavy doors that, like, I couldn't open,

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particularly when, when I was on the sternal precautions. And I'd have to sometimes

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wait outside the climbing gym for someone to open the door for me. So then

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I could, like, scoot in and then, like, the common courtesy would be to hold

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the door for the next person. I'd be like, hey, sorry, I can't. Gotta go.

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You know, like, kind of look like a, a jerk not holding the dog for

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someone, but, yeah, you don't have, like, a shirt on that says, like, on

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sternal precautions, you know, watch out. But that's, honestly, that's what I

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did. I walked as much as I could, and I walked on that incline

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treadmill at, like, one, one and a half miles an hour, uphill all

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day. That's, like, what that, like, was the only thing at that point in time

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that was making me happy. So were you. Would you say you were battling

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depression? Oh, definitely. I've been pretty fortunate with my mental

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health through most of my life. And other than that period,

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I mean, that was, like, by far the only time that I can say I

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felt, like, truly depressed. And, like, again,

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I had all these plans. I'm like, during my recovery, I'm gonna, like, do this

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writing. I'm gonna do that writing. I'm gonna help with this project. I'm in that

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pride. I did nothing. Like, I did absolutely nothing.

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Honestly, the biggest thing I did at one point, I think because my

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parents came and visited for a bit, and, like, my mom got me, like, a

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Lego set. I made a little Statue of Liberty out of

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Legos. That's what the Lego set was. That's the only thing I did,

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because I just couldn't focus on anything.

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But I have a lot of great friends, and I've got good family, and this

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is my wife. Like, my friends coming over and hearing about their ski day and

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things like that, that actually was. That was awesome, you know, and that really

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helps. And even the texts, the cards, things like that,

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I used to probably would have been like that. Whatever, don't worry about it. But

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that stuff actually does make a difference. It does. And it makes you

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feel better, and I feel bad because a lot of them, you know, I didn't

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even respond to. I was kind of so not out of it,

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but I was so, like, disconnected that, like, I. I feel bad now

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that I didn't respond to half of them, you know, or I responded to a

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lot of them, like, a month later. And, yeah,

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I wasn't prepared for that because, again, I'd been prepped on. Okay, you'll feel a

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little post surgery depression. That's pretty common, things like that. But

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I wasn't prepared for that level of it. It's real,

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and I think it's something that's maybe was the part of

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my treatment or recovery that I felt like I was least supported in or

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at least prepped for. Yeah. And a lot of

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heart patients would nod. There had some agreement with you

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and me included. It's. I was warned about it, but I

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wasn't warned about how intense it would be and how dark

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it would get. Yeah. Yeah. And I think.

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I don't know what it would have done if I was. If I had known

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to the extent. But it was definitely. That's something that I'll.

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Yeah. Never forget from that experience as well.

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How long did that last for you? Honestly, this is gonna

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sound really cliche, but probably till I could start skiing again. And I.

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And I remember. So February 1,

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March. So around April 1, I know this

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sounds crazy, but April 1, they said, hey, you could start doing some light activity.

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Some three months post surgery, they said, some light activity. And

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me being the dummy that I am, I was like, okay, well, light

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activity to me is light different than light activity to that person. Yeah. But I.

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So I started skiing April 1, and at this point, I felt

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pretty good. Like, you know, my walking, I think, actually helped. Like, I think it

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really helped. And I felt pretty good. And I remember ski touring up to some

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of these runs right above the town of Alta called the Emma's. And I did

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some Emma laps, and, you know, it was great. And had some friends there. My

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wife. And then the next day, I decided to go ski off Mount

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Superior, which is an even bigger peak above town, and. But we skied off

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superior, went back up, did another lap, and then skied this semi

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technical line called the heart of darkness, and then

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went up and skied this other semi technical line called the rampage.

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And I was with my friend Colby, and I just remember the whole time, my

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friend Colby's just like, you better just not. Something better not happen, or else I'm

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going to get in trouble here. Like, you sure this is okay? The whole time?

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You sure this is okay? I'm not taking the heat for this if something happens.

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And. But realistically, at that point, I just started skiing as

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much as I could, and I actually. I felt pretty good. Like, yeah, my. My

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chest kind of creaked and ached and stuff, but I felt

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pretty good. And as my doctor and my surgeon

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had said, like, just kind of let pain and stuff be your guide. And, you

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know, he said, everything's healed. Well, like, we like what we see. But because

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I would be like, hey, I just did this. Is that okay? They'd be like,

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okay. I think they didn't really understand what it was when I tell them, oh,

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I skied this run or that run, but they seemed okay with it to

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the point where I felt good enough that my friend Adam

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and Noah and our friend Ben asked me to go to

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Alaska in May. And I was like,

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yeah, I mean, I don't see why I can't. And we were going to. We

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kind of started planning a trip to Alaska that may to the point where

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mid May, I don't have the exact date, but by mid May, I

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skied a run called the Archangel ridge on Mount Forker in like a

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big alpine push with, with those guys. And we put

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in a first descent on a peak called Weske Hilton, a peak. And the trip

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kind of culminated in us all skiing the Mesmer cooler on Denali. And, you

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know, I'm like four and a half months or whatever, four and a half

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months post surgery at that point, which is amazing. Like, to

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me, that's still amazing. Almost like it didn't happen to me. Almost

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like it was someone else that that happened to or did that.

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And I didn't. Again, like, I didn't do any crazy rehab other

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than just I walked a lot. And when I could start doing activity

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again, I did do some weight training, as you know, to kind

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of help get myself back into shape a bit and get some

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more power and stuff. But the endurance, I never felt as if I really lost.

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And I don't know if that would have been different if I didn't do the

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walking. But from the endurance standpoint, I actually felt

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pretty good. It was more strength and power that I lost during the

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surgery, not as much endurance. And it'd be

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interesting to have more of like a technical conversation with a

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cardiologist or a trainer, you know, maybe both, and stuff

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like that. But, but that was my experience there. But the, here's the

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hitch. On that trip, I started to notice something that became

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pretty significant over the next year was on that trip,

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I noticed I had a lot of JVD. Like my jugular vein was

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kind of constantly swollen. And I felt like I had this tightness in my

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neck. And I get back from the trip and I go

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to my cardiologist, I said, hey, this thing, I'm getting like, this tightness

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in my neck. And they said, oh, that's probably just your, you know,

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your muscles figuring everything out from, you know, we did slice

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your, crack your rib, you know, your rib cage apart and spread it.

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And so it's probably just something like that. After that trip

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that brought me into my summer guiding season at examined. And what I'd start to

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notice through that summer was not only did I have this JVD,

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I start to feel tingliness in my hands, and I would feel

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lightheadedness if I bent over things like that that

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progressed into the fall, it just kept getting worse and worse and worse. The point

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where I'd be, like, I'd be rock climbing, and I'd have to, like, find these

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weird positions to stop so I could, like, let the tingliness go away and. And

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stuff. And somewhat long story short, they ended up finding I had this

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thing called SVC syndrome, which a

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result of my initial surgery. The scarring in my superior vena

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cava caused clotting. Kind of get that

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turbulent flow and caused clotting. And my

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superior vena cava was essentially almost fully occluded, like, it was

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almost fully blocked. And what that does is that

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prevents the proper return, blood return, from everything,

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from your head, neck, shoulders, and arms. And the layman's

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analogy they like to give you on this one is the highway analogy, where

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imagine you have a six lane highway, and that highway is now closed, and

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you have to deviate around on side streets. And

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fortunately, yeah, fortunately, you have

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these collateral veins that can bypass the SVC, and

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you have your azygos vein, which can bypass the SVC. So you still have return.

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It's just poor. It got to the point where my face started

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swelling up so bad that I was, like, almost

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unrecognizable. Like, my face was swollen. It looked like the

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rest of my body looked normal, and then it looked like I had gained, like,

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100 pounds. And this was actually a much more

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complicated thing to deal with. I saw thrombosis

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and kind of surgical teams at the University of Utah

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intermountain Healthcare. I consulted with physicians back

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east in New York, and a lot of them were like, hey, this is kind

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of a weird thing. The more common way people get SVC

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syndrome is from a chest tumor pushing up against their superior

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vena cava and causing that clotting. And a lot of the solutions

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and the stenting procedures for that are often just palliative, because

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those people with the chest tumors, it's probably so bad at that point that they

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only have so long to live anyways. So it was kind of a weird

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thing. And it wasn't until I was kind of

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recommended to a interventional cardiologist at

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the primary children's Hospital, a pediatric

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interventionalist. Her name is doctor Martin. She's great. Like,

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she was probably the best healthcare provider I had the

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entire time. And she said, I've done this stenting

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procedure for people with your

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condition and have. Who have had the same style of

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surgery. The first surgery I had was called a warden procedure, and she

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said, the only difference is, I think the oldest person I've done it on is

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15 or something. You're 30. Or at this point, I was probably

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31. And just to give you an idea, though, the timeline here is,

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I started to realize that stuff in May of

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2019. I didn't get it fixed until

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May of 2020. So it was

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almost a whole year of me trying to figure that out. And

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that was also the height of COVID Uh, so for

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that, I. I was able to just have a catheter procedure and

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the stenting just all done through a cath procedure, which was awesome.

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But that was an interesting experience, having to do that and go through all

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that during COVID which I'm sure you're a little familiar with. Like, it was not

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as easy, and there was a lot more unknowns. Like, she. She was very honest

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with me. She's like, we don't know if we'll be able to get in and

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fix this with the cath. If that doesn't work, we may have to do another

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open heart surgery, or we may just have to figure something else

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out. But luckily, she, uh. She did

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great. We got in there. We got it done. And, um,

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I now have a few different stents in my spiramina cava, but

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I'm, like, back to normal at this point. From then on, I haven't had any

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other issues since that. Since 2020. That feels more

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intense to me than the open heart surgery. That's a lot.

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Yeah, it was. It was definitely more. It was more anxiety, because while the

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procedure, in the end, was more simple, I was on blood thinners at that point.

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I was on eliquis, and, you know, and again, maybe don't tell them, but I

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kept skiing, and I just wore a helmet. That was my. That was my

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mitigating factor there. I just wore a helmet. And,

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I mean, but I had. I had people saying, like, hey, we, this. You know,

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you might have to kind of stop guiding, like. And they'd ask you these quality.

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They'd be like, well, what if I. I mean, are you okay with the situation

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as it is? I'm like, no, no. They're like, oh, okay, so

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you want us to do something? I'm like, yeah. Like, I can't live like

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this. And that was when I found out you really have

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to advocate for yourself, and you really have to let them know who you are

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and what your life is, because sometimes, you know, their care plans

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are often determined by quality of life outcomes,

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and quality of life for everyone's kind of different, and that's okay. And I

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really had to push for a solution for that that was going to allow me

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to get back to the quality of life that I

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knew and wanted. Now, that said, I was also. There was a part of me

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that was preparing for a different quality of life. Like, I had

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enough physicians tell me, like, hey, this. Even if we do get in there,

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like, you might not be able to, like, be back to where you were because

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you might not have the same returning blood flow and things like that.

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Yeah, I started, like, I started looking at jobs, I started to think

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about different careers. I started to, like, think about different hobbies

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and stuff, and, like, those things started happening for me. And

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luckily, we didn't have to go to plan b. We stuck with plan a.

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But, yeah, that was 100% happening in my mind.

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You were coping ahead, which is a skill that we

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heart patients have to do. Yeah, we have to cope ahead for

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all the possibilities. It's a way to prep your nervous

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system, which, I mean, I've. Do you have

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a therapist? You know, I've never seen

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a counselor. Like I said, I've been pretty fortunate with my mental health,

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but I would not hesitate in a heartbeat,

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pun intended, to do that. I've had many friends have good success with

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it. Yeah, it's something I talk a lot about on this

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podcast, and, I mean, it's

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obviously such a personal choice. And the

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grief road that we all have to travel when we're

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diagnosed with heart conditions is so personal.

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And a lot of what we bring in, like, life

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experience prior to the diagnosis

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day really does impact how you process

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that moment and time. And I. But when you're throwing

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curveballs like this, it's hitting me differently.

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And, you know, where just because I'm your fellow heart

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buddy, you had this open heart surgery. You got on with living your

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life. Heck, he went and skied the messner. Like,

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that's amazing. And then to be thrown this

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curveball when you think that, you know, you've got everything in the

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rear view mirror, and this curveball is really

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consequential. I don't want to belittle that in any way. And I just.

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It is such a 90 degree term. Are you on

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medications now for it? The only thing I'm still taking

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is baby aspirin once a day. And I've even spoke

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because now I'm seeing this congenital team, a really, really good

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team of providers at the University of Utah. We've spoken about whether I actually

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need to be on that or not. I think there's a pretty small

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cost benefit either way. So just out of habit, I

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just take my 1 or 81

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milligrams of aspirin every day, and that's it. My understanding with what

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I've got going on, the long term kind of outcomes

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are pretty good. I think I was pretty fortunate to. What I've

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had was they had good solutions. And really, one of

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the biggest things is maybe some weird heart arrhythmias,

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and they're not super serious heart arrhythmias is my understanding.

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It's just because of the tissue densities and stuff around the sinus node

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were changed from my initial surgery. So my biggest follow ups are more

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checking my rhythms and stuff, and I'll have to wear monitors.

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It's like every two years, I'll do a two week monitor and things like that.

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So pretty easy road in the

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future, hopefully. Okay. And then do you have, like,

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imaging every year? No, not every year.

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Every. At this point now it's going to be every few

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years. I think they want to check both the heart and the stent, but,

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yeah, it's because I think a standard echo wouldn't really look at the

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stent as much, but I think it's always going to be in my order now

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to check both. But it's mostly just an echo, is my understanding. Maybe every other

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year. Okay. Wow. I'm grateful you're here.

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Before we wrap up, what has given you the

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confidence to return to activity in the mountains,

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despite, I mean, yes, you. You walked us through walking on the

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treadmill. I'm hearing a healthy dose

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of determination and

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maybe a little bit of hard headedness that we all need to

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play in the mountains. It

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does serve us well at times. But what ultimately

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gave you the full confidence that you could get into the back into the

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mountains and not worry about dropping dead? Yeah.

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Yeah, right. You know, I've thought about this actually quite a bit. For me,

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I think a lot of it was, like, really understanding what I

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had and what happened to me, you

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know, what. What the surgeries involved entailed, you know,

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and this isn't like the COVID style. Like, yeah, I did my own research

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on the Internet, you know, I tried to speak with as

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many, particularly cardiac health

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professionals or cardiac specific health professionals, and really understanding

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what I had done to me, what could be the

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potential issues there and what to look out

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for. And the more I understood about what I had,

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and as one cardiologist said to me, hes like, youve got a pretty serious

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problem with a pretty good fix. So I got lucky. I think in that

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sense that the style of procedure that was done to me and, you

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know, a lot of it's how they manipulate the heart structurally

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and stuff. Some things are better than others, right? Because the heart's a

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small machine that has different parts and things. And so I

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think really understanding what my condition entailed,

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what my fix was and what that meant

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gave me confidence and I think a good example and just educating

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myself as much as possible on this, you know, and I already did things right.

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Like, I'm not a smoker, you know, I'm, I'm, I

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drink alcohol at a pretty moderate level. I'm

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active and I think, you know, I eat a good diet. Like, I didn't need

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to change anything from a diet standpoint. Like, I already was kind of there, which

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I definitely would have. Side story, my dad had sextuple

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bypass surgery, um, two or three years ago. And he's like

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totally changed every, you know, his, it's like mediterranean diet

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is the Bible basically to him now. That's what we call it. We call his

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mediterranean diet book the Bible. But that's a whole other story.

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I'm not going to go there. So I think for me, yeah. Really understanding what

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I had done, what I could look for and things like that. And I think

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the good example here is I just got back from

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finally I made it to Pakistan and we

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skied. Me and my two friends, Adam and Brendan skied

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gasherbrum one and gasterbrum two. Two 8000 meters peaks

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and going to gastroom one. We did gastroom two

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first and in between. And I, you know, for the first time

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in a while, put a heart monitor back on. I did that. I wore a

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heart monitor quite a bit after my surgery. And then a few years go by,

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I kind of stopped wearing them and stuff and. But I put one back on

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for this trip and was kind of monitoring my vitals and things and really

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paying attention again because we were going to be stressing our bodies and

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ways we hadn't before at those altitudes. And

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when you're climbing these peaks, particularly without oxygen, like we were doing, like, you're

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putting a lot of stress. Like, you're not getting muscle fatigue, but you're getting

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like system fatigue more. And in

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between the two peaks, I noticed I was getting some of those pvcs, like

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they were coming back and I'd feel these quick shortnesses of breath.

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And I remember texting my wife and texting some friends in the knowledge and

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they said no, like, that's probably okay. That's not what you'd

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be more or less. Long story, like, on that. That's just even if I had

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had my heart stuff or not, I'd probably be getting those pvcs anyways, because they're

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often associated with fatigue, lack of rest, potentially

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dehydration, things like that, which I probably was. And really

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understanding that kind of stuff helped me have the confidence to then say, hey, I

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can go do the next peak. We did the gaserobon one about a week later.

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I'm okay to do this. You know, this is just probably

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things that were happening from other issues rather than my

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heart issues. So I wasn't like, I'm going to drop dead on this climb now.

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And that would be one of my biggest pieces of advice to people, is

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it may seem annoying, but, like, educate yourself as much as you

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can, because I think particularly if you want to return to high level activity,

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that's going to help give you the confidence. And. And that definitely helped

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me, amongst other things. Helped me. I mean, like, I can't say enough about how

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much my wife helped and friends and family and stuff, but I. I would say

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that's the one kind of specific thing that helped me. Knowledge is power.

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That's a cliche for a reason. There's a lot of

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research about facing

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head on any medical issue. There's even an app. So

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I broke my leg nine months ago. Now, at the time of

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this recording with you, and I have been using

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an app that is called recognize, and

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it actually has me flashing

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either the right leg or the left leg. And I have to

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choose the discrimination between right and left. How this came

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about was researchers did. They looked into

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people with back pain and those who would not

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look at their backs after open back surgery, like an actual back

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surgery. Those who didn't look at them almost said open heart. But, yeah.

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Anyway, those who would not look at their backs

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actually had persistent, lifelong pain. Those

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who did look at their backs and, like, face the

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surgery, looked at it in the mirror, their back pain went away.

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So if we choose to face any

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situation head on and not be afraid

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and learn about it, what it actually does is it regulates the

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nervous system, which turns down the pain response. So

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that makes sense. Yeah. And I think I remember reading it. It was like.

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They called it, like, acute cardiac awareness. Like, after heart surgery,

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you're more, like, in tune, and sometimes maybe a little bit of

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in a hypochondriac style way, like, in tune with what's going on in your heart.

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But I don't think that's a bad thing? I think after this,

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like whole experience for me, I'm much more in tune with

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everything going on in my body and I not to like an

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obsessive way, I think in a healthy way, you know, and I really pay attention

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to myself a little bit more when I need rest, when I need sleep, you

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know, when I can kind of push harder, things like that. Like I've become a

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better athlete through this, I think, because I'm much more

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aware of my body and my biometrics and stuff like that.

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And I think that's true for us mountain folks anyway, because

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a way to stay alive, especially you, who's doing these

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really consequential climbs and, you know,

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8000 meters peaks. For those listening who

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don't understand, I mean, you were, you were really

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high up in altitude and you do have to have a different level

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of awareness of your body because it's not an

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easy rescue. It's not like you can just run back to the trailhead and

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drive home. Yeah, no, you definitely can't. So

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you have to have an level of awareness. Yeah, I could

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have just, you know, winged it, but I'm glad I didn't. So,

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Billy, we could talk for hours about this

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is, before we close, is there any

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lingering nuggets of wisdom you want to impart

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on those who are going to come after you and I with heart

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surgery? What is like the nagging piece of advice

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you just want everyone to know to be able to thrive

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post open heart surgery? I guess the first thing is

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every, you know, if you have a sternotomy and

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you have open heart surgery, like there, there's lots of different issues

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and, you know, I'm a good success story in that

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I was able to basically return to my activity at

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the same capacity. And I understand that that's not going to be the

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same for everyone, you know, like these structural issues

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that we have with our hearts, like, they're all different and they all have different

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fixes and solutions and outcomes and stuff and. But

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for me, probably the biggest thing was, I don't want to say I

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had this nice reinvention of myself, but there are

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upsides. Like, I am definitely a different person

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in some ways, you know, and I'm still, you know, kind of, I don't

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want to say intense, but I'm still very focused and dedicated to the things that

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I do. But I definitely, in a good way, see things

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differently, you know, like, it's okay for me now to have to

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be at home dealing with something else while my friends are having a good powder

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day. Like, I used to not do well with that. Like, if I was missing

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out fomo, right? Like, that used to be hard for me, you know, if I

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had a trip that didn't go well, I'd be all bummed, like, ah, it didn't

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go well. Like, I'm definitely okay with

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success and failure more. And I'm much

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happier when I see friends or others doing things

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that are really, really cool. Like, I'm happy for them where maybe back in the

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day, when I was younger, in my twenties, I would have been like, damn, I

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didn't do that whatever and stuff. So call

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it this cathartic experience if you want. And I think focusing

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on things like that is important. And,

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yeah, that's definitely something that I thought quite a bit about. And like I said

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when I had that instance of, oh, you may not be doing this again, like,

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I'm okay now. If something happens to me, say I have a really bad knee

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injury and I can't return to skiing the way that I used to, like,

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I know what I'm going to do. Like, I've got this kind of plan b

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in the back of my head, and I'm okay with that. And I've, like, come

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to peace with it. And, yeah, I guess generally just I'm a little bit more

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relaxed. This sounds, like really

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down, like an emotional rabbit hole. But I listen to a lot of

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music, you know, when I'm on trips and stuff. And I Warren Zevon, someone who

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I really like, and there's a really good Saturday Night Live or not Saturday Night

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Live Letterman interview with him. And he at the

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time, had been diagnosed with cancer and had only so many months to live.

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And he kind of knew that during this interview. And he has this, like,

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line that I think became somewhat well known that says, you know, enjoy

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every sandwich is something like that. And that I

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felt that, like, you know, it was kind of like every trip, every moment. Like,

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you know, this is cool. Where for me it used to be

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I'm very objective oriented, goal based. Like, I need to accomplish this and then move

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on to the next thing. So the advice there, I guess, would be,

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you know, embrace, like, changing yourself through these, because

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oftentimes that change can be. Can be pretty positive and

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just kind of see where it will take you. Because, like, I look at my

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dad's experience, and he's a different person than he was prior. And. And, you know,

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my dad's always been a great person, but I'd say he's a healthier, better person

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than he was prior. So just focus on the things

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that you can control and then, you know, let everything else

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just do its. Do its thing. So that's a great place to

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stop. Enjoy every sandwich. I love it.

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Yeah. I'm grateful for you, Billy. It's a good Warren Zevon quote.

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Yeah. Thank you. Thank you

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so much for this. I'm

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better for it. I needed this today and I

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am just continuously amazed at the power of the

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human spirit to overcome the biggest of

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challenges. And you are. You

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exemplify that today. So where can listeners find

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you? I have a pretty modest Instagram account

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so that I unfortunately don't put enough stuff on,

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but that's one place. And then I'm. I work with a

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website called the high route.com dot. When you type it in, you got to do

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the hi route.com.

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but soon I should have an article on that

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and it's going to come out in print as well. That goes in a little

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more depth to my experience with my heart

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surgery and my return to skiing, as well as other articles. I do a lot

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of stuff on that, just beyond just trip reports and things. That's kind of my

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biggest platform. It's cool. And if you like skiing,

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it's a good thing to take a look at. Great. And I'll have all

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that in the show notes too, so it'll be easily clickable. But

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Billy, thank you so much for your generosity with your time today.

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And I know listeners are going to love this. And for

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those who are wanting to follow along,

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sure that you have subscribed to this podcast and

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there are a couple of things that are so helpful to someone like me

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who is an independent podcaster, believe it or not. Reviews

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on Apple, Spotify, wherever you get your

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podcasts really do matter, as well as

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following the podcast. And I have a

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Patreon community I'm just now launching in 2024,

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September of 2024, and it's going to have

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two options for Zoom meetups every

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month. I am hoping to accommodate those

Speaker:

globally. So there will be one in the morning and one in the evening,

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mountain standard time to catch some of my european

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listeners. I would love it if you'd consider becoming a

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member of Patreon. You can find me at Patreon.

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It's a way to keep this podcast going and I

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so appreciate you coming back every week to listen. Be sure to

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come back next week for another episode of open Heart surgery with boots.

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