My open-heart surgery

I stand naked in front of the bathroom mirror. A rumpled pile of clothes, stuffed into a clear plastic bag, lies at my feet. A bluish hospital gown, neatly folded, sits on the corner of the sink. In the mirror, my face, scrubbed clean, is pale and washed out.

I run a hand slowly along the smooth, unmarred skin between my breasts.

I am 39 years old, and I am about to have open-heart surgery.

I needed valve replacement surgery, and I needed it now
Eight weeks earlier, my husband and I sat in a cramped but ornately furnished office on the fifth floor of the McMaster Clinic at Hamilton General Hospital in Ontario. The surgeon - a tall man with a calm, authoritative manner - sat behind his mahogany desk and delivered the most unsettling news of my life: I needed valve replacement surgery, and I needed it now. I had known for some time this day would come. I just didn't expect it would come so soon.

When I was 14, my parents rushed me to an emergency room with stabbing pains in my abdomen - a ruptured appendix. I underwent emergency surgery, and during my hospital stay, an attending doctor came to my bedside and listened to my heart. A slight frown flitted across his face. He turned to my mother and said, "She has a heart murmur, a loud one. Might be nothing, but you should get it checked by a cardiologist."

We consulted a specialist, and I had an echocardiogram. When my mom and I returned to the doctor's office for the results, the cardiologist sat us down and explained that I was born with a bicuspid aortic valve. Using a plastic model of a human heart and a ballpoint pen, he pointed to the valve - buried deep among blue and red plastic tubes - and traced the route of blood as the valve pushes it into the aorta, which then sends it out into the body.

A normal aortic valve has three pie-shaped leaflets that open and close to regulate blood flow. Mine had only two, and they didn't work well. The abnormality of the leaflets meant the valve had to work harder, putting stress on the heart and causing deterioration of the valve. Over time, two things can happen: The interior walls of the valve thicken (stenosis) and restrict blood flow, and because the leaflets don't close properly, blood may flow back into the heart (regurgitation).

Watch for symptoms - but wait to be "old"
Over the years, I've had several more echocardiograms and seen a few cardiologists. The doctors told me to watch for symptoms, such as dizziness and fainting, but they also reassured me I wouldn't need surgery until I was "old."

Consequently, I didn't think about my heart very often. I started running half-marathons in my early thirties with no problems. Over the years, I lengthened the time between cardiologist visits; instead of every two or three years, I got my heart checked every five or six.

Next page: But in the summer of 2010...