[COLD OPEN]

Bob: I was not even 100% sure that people like me survived heart surgery. I didn't know that. I didn't know, I never met anybody. So I was like, no, this is, I wasn't planning for this long life. I was like, when I was young, I was like, oh, I don't know if I'm gonna live much past this heart surgery. I'm not sure if anybody does.

[INTRO]

Drezden: This is the One Percent Heart. Today's guest is Bob Smith, a climber and English teacher with a mechanical aortic valve and ascending aorta. Bob, thank you for taking the time to join me here today. I've been really interested in connecting with you for quite a while.

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[CONVERSATION]

Bob: Good. Yeah, it's good to meet with you finally.

Drezden: So I'm excited to talk about your journey. And I do want to talk about all the mountains you've climbed, literally and figuratively.

Bob: Yeah. I guess just to start with the how-I-got-there story. I was born with aortic stenosis, and basically we knew at birth that I had to have a surgery eventually. And that was, I was born in 1988 and I had a great cardiac team that worked with me. And we actually had to do an angioplasty when I was just a few days old to kind of open up the aortic valve to allow some blood flow out of my heart. And that was pretty much it until 2016. I had restrictions my whole life, but 2016 I had to have the open heart surgery to replace the aortic valve with an On-X valve. And yeah, since then I've kind of gotten back to full activity and actually a little bit even, I would say a bit more active today than I was even before surgery, which is the thing I'm really excited to chat with you about today.

Drezden: So you said an On-X valve. For those of us like me that don't know, can you tell us what that means?

Bob: Yeah, On-X is actually the company that makes the valve. So the standard for a long time, I think, was the St. Jude valve. And actually, the really cool thing about the heart community is right before I had surgery, I actually met my first person that I ever met that had heart surgery, like maybe one week before I had surgery. No, no, no, no, one week before my appointment with my cardiac surgeon. And he told me about the On-X valve, and I was just like, yeah, this sounds perfect. It's basically really similar to the St. Jude, but required a lower INR value for the Warfarin they have to take. Yeah, I heard it was a little bit quieter too. So it was just, this is the type of valve.

Drezden: So you got someone else's review and it led you to get that valve. That's pretty great.

Bob: I never met a person in my life who had had heart surgery until seriously, it was about a week before I went and saw my cardiac surgeon. And yeah, we talked for a couple of minutes and he just told me what his experience was, which was really cool.

Drezden: It's amazing how common it is for people with congenital heart defects, like you know, you had your first surgery almost right after birth. But it's amazing how common it is for people like you and me to not meet others with similar conditions until we're in adulthood, and even then it's by chance.

Bob: Right. It's like, I was listening to your podcast today with a woman who you spoke with first, I believe. And she was just saying that same thing about building a community of people around that, like, you know, people who don't have access to other people that have gone through this.

Drezden: Which is when I was looking at your blog and I saw all the commenters that were anonymous or unknown asking you questions and you're there replying, that is the kind of community we need. Because I mean, that's what we're almost lacking here is the patient voice. And that's a big part of what I'm trying to do with this, just getting the information put together and put out there in a way that someone can sit down, listen, and go, okay, I know what to expect now. That's all that matters is knowing what you're getting into.

Bob: I think one of the big things for me too was, I was not even 100% sure that people like me survived heart surgery. I didn't know that. I didn't know, I never met anybody. So I was like, no, this is, I wasn't planning for this long life. I was like, when I was young, I was like, oh, I don't know if I'm gonna live much past this heart surgery. I'm not sure if anybody does. And of course the doctors tell you, they give you the outlook on the surgery, like how things are gonna go and what your numbers are and all that important information, but they never talk to you about what is life like after this happens, you know?

Drezden: Yeah, they'll say a certain amount of people survive the surgery, but they don't tell you how many survived six months, 12 months, 18 months later. And if you can't find that data, it's terrifying.

Bob: I didn't even, until after, I was like, after surgery, I didn't even think to ask, wait, like, how long, what's my life expectancy now? And the doctor's like, yeah, like you can live a full life now. And that was like a really, that even was like a bit of an epiphany where I was like, I didn't, I wasn't, I didn't know.

Drezden: Yeah, you had said something that I wanted to tie back to you about full activity. You're back to full activity after the surgery, maybe even a little more. I actually spoke to someone last year who had a congenital heart defect his entire life, had to have a heart transplant. And then afterwards his exercise tolerance went through the roof. He was talking about the flights of stairs he could climb went from like two to 20 or something absurd like that. When you said you're back to full activity, do you feel, it's been what, almost 10, it's been eight years since your replacement, but do you feel like right after the replacement, was there a big difference or were you getting back to a normal that you were missing?

Bob: So it was interesting. I said that most of my life I didn't have very many restrictions and even up until a couple months before surgery, I knew that I had to have surgery, but my activity level was pretty high and I never had any symptoms. I could run and I could swim as much as I want and I was rock climbing all the time. But I kind of had this idea in the back of my mind that at some point I'm going to have symptoms or something's going to happen. So it was kind of, I think you described it one episode as like this ticking time bomb in your chest and you're like, I don't know what is going to happen. I think it's fine. The doctor tells me I'm fine. But I kind of just had this lagging thing in the back of my mind where I was like, at some point I'll need surgery. But I never really had any issues, a flight of stairs is not, you know, I was just living a normal life. And then in 2015, I think, or maybe early 2016, I was running with a backpack on and I was going up to climb, to solo this thing in Boulder, Colorado, just something I'd done a bunch of times. And I was just running up and as I was running I just couldn't catch my breath. And I was like, this is really weird, but maybe I'm just out of shape a little bit. And I kept running and I was like, no, my heart is working really hard right now. And that was actually, a couple months before surgery was the first time I ever felt any issue at all.

Drezden: Is that what led to the surgery or was it just coincidental?

Bob: No, no. So I called, I still went and climbed that day. I sat down on the side of the trail for a while and I was just huffing and puffing. I was by myself and I was like, I don't know what's going on. And I was like, well, I'll figure it out this afternoon. And I still climbed and came back down and called on the way back down. I remember specifically, I still hike this trail every once in a while, so I pass this spot. I'm like, yeah, this is where I called the nurse. I called my cardiologist and got on the phone right away with a nurse that works with him. And the nurse listened to my symptoms and was like, yeah, you need to come in for a cardiac checkup as soon as possible. Because she's like, it could be anything, you could be sick or you could have any type of infection or something. So just come in right away. And when I got there, that's when they kind of figured, we saw, he was looking at the amount of pressure in my heart and he realized that that pressure had more than doubled in a year. So that's when we decided it was time for surgery. And there was no direct cause, it was just with time, it was about that time for it to happen.

Drezden: Yeah.

Bob: And they kind of, we always knew. That time bomb thing where you're kind of just waiting for things to get worse. And I guess we didn't know exactly what that would look like. They were never like, "when we get to this spot, we'll go." It was just more like we kept checking in and checking in and he said, you know, "we'll know when we're there." And that day came in, it's like, "we're definitively here now." I just, "we're gonna run your case through a board of other cardiac surgeons and see what they say. But I think we're here."

Drezden: I saw your blog, you've got an article about getting ready for surgery and that anticipation. Do you want to talk about your thoughts before and then coming out of it? And maybe immediately after the surgery, but then as you've gotten used to this new cyborg life with a robotic heart?

Bob: Yeah. I mean, preparing for surgery, I just remember I was kind of complacent. I was just like, we have a, I have a great cardiac surgeon. I know he's wonderful. The team seemed amazing. He walked me through the procedure. I felt really comfortable with surgery. And once I had that conversation with the cardiac surgeon, I was like, excited to do it. I was like, let's just do it. I'm going to be done with surgery now. This is going to be a huge thing to have off my plate. And so right after surgery though, I kind of felt, I think I had done a good job of setting myself up to recover from that surgery. I had moved my bed upstairs and I had set up my bathroom so that I could access the shower really easily. I'd put little strips on the bottom of the shower so I wouldn't slip. I'd done all these things to prepare my house, which was really nice. But I think the more important thing is I'd done a lot of work to prepare mentally. I'd figured out what books do I want to read. And I realized that reading books was actually really hard after surgery. Holding a book is really hard. And just the concentration level to focus on that for a couple weeks is kind of hard. You get tired really easily, was my experience at least. So for the first couple weeks, I just watched a lot of movies. And I knew coming out of surgery that the easiest way for me to get through this was to just 100% commit and just say, I'm not a rock climber right now. I'm not doing anything athletic. Instead, I am recovering from surgery. That's my 100% job. That's all I'm doing. I'm going to eat. I'm recovering from surgery. And I'm going to rest. I'm recovering from surgery. I hear a lot of people send me messages, and they're like, "I'm going to try and run my first marathon three months after surgery" or something like that. They just have this goal. And I'm like, don't do that. Don't, because then you're going to be disappointed. Instead just be like, these are the cool things, I usually, whenever I've had surgeries, I spend a lot of time practicing my Spanish and I watch movies and I do all the things that normally I'm not doing throughout my day. But I just really fully committed to at least the first five weeks after surgery, 100% just recovering, that's it.

Drezden: A lot of people don't realize that there's a mental aspect to it. You need to be able to, your heart and your mind are very connected. You're going to have to give your brain a break when you're recovering from these surgeries. But you also have to, if you say I'm going to run a marathon in three months, that means you got to start prepping a month after surgery. You're not giving your body the chance to recover. And I've been guilty of it too. After my last heart surgery, I went in for a checkup, maybe a week after, actually, because I was still bleeding. And the doctor made some offhand comment about how "your numbers are good, just never expect to keep up with your peers." And I got pissed and I put on, because I had gone in, it was a cardiac catheterization through the leg, so I put on like three pairs of compression shorts and ran on the stair stepper for an hour. And I didn't rip a stitch, thank God. But I mean, I've been guilty of it too, making those big leaps when your body's not ready. And that could have seriously impacted my healing time and the quality of the repair.

Bob: I think that that comparison is really dangerous. When I was young, my doctor was like, "Well, you'll never be like full size, you're gonna be smaller, you're gonna be", almost made it sound like I would be frail for my whole life. And I'm like six feet, 180 pounds. And I was like, why did the doctor tell me that I was going to be smaller than other kids? Because my heart was, I think that was their thinking, that because of the blood circulation or something. I don't know why they said that. But these weird comparison things that are said, it's an interesting idea. And then the goal setting, I think it's just so strange for a person who's never been through a heart surgery. I think if a person's been through it already, they'll know that it's not good to maybe do that. But a person who's not been through it, I think we want to face it like we face everything else, like, I'm gonna do this thing by this date and I'm gonna keep building, I'm gonna see progress. But really what I always say is that my goal after surgery was to recover really, really well. And that meant that, if you set a goal like that, like, I'm going to listen to what my body is telling me to do. I'm gonna sleep when I need to sleep. I'm going to read books as much as I can, but I'm not gonna be like, "I'm gonna read three books a week." Just be like, I'm gonna read until I get tired every day. I'm gonna read until I'm done.

Bob: I would say, you know what's funny, these goals I would set. I had this sidewalk out front of my house. So I would just walk to, I was like, okay, I think I'm starting to get tired. And then I would come back and I would sit down and take a nap. And then I'd wake up from the nap and maybe a couple hours later, I think I was allowed to do like three or four of those walks a day. And those were my goals. I'd be like, well, I got to this part of the sidewalk yesterday. And I think I feel fine, I'm going to go a little bit further, but not much, and then I'm going to come back again. And so these were the goals I was setting. It wasn't like I'm going to force myself to do whatever. It's like I'm going to go to where I'm still comfortable but stay within that realm of comfort.

Drezden: Yeah, that's almost like your goal. And I've actually, this ties to a lot of the conversations I've had about how CHD patients seem to have a bit more of a drive and a bit more of an awareness of having to push themselves. So sounds like you had to make your goal to not push yourself, if that makes sense. You had to make your goal to not force yourself to go around the block right away.

Bob: Yeah. And the goal is more like, I'm going to stick to what my recovery plan is. That's the goal. And not like, it doesn't have to be a marathon or this many books or whatever. It's like, I'm going to just recover really, really well. And that's, I think that was my mentality at least.

Drezden: And how quickly did you go from that to free climbing huge mountains?

Bob: Well, yeah. So five weeks, the sternum is broken for surgery and it takes five weeks for that to recover. For me, it did. That's what the doctor told me, he said at five weeks, usually the sternum can't refracture itself. Like it won't just get fractured from movements or from driving a car or anything like that. And at five weeks, I was also taken off of beta blockers. So I kind of got my energy back a little bit. And I think that was a big mark of like, okay, I've gone through surgery. I'm not frail anymore. My heart has been behaving now for five weeks, my sternum is solid, I'm off beta blockers. Let's start, let's see what happens. And that's when I got into the gym. And I started, I was so weak. I'd accumulated a little bit more fat than I usually have, and cardio-wise I was just out of shape. So I started getting on the pull-up machine, the one that takes weight off of your body. So basically you stand on the platform and you pull up however much weight you didn't take off. So I probably weighed like 185 pounds at the time. So I'd take off like 170 pounds and just do 15-pound pull-ups and just get into the motion of starting to use my muscles again. Like waking them back up.

Drezden: That range of motion must have been a little scary with the recency of, yeah.

Bob: It was tough. And I remember having a lot of pain in the outside of my pecs, basically. Maybe it was from not being used, or maybe it was from, I also kind of took on this posture for a couple of months where I was curled forward and really stiff because I didn't want to even move my shoulders back. So just starting to do exercises that were opening my chest a little bit was something really challenging. And that's why I took off so much weight and basically just did such tiny baby steps as I was waking back up, getting my muscles back in order.

Drezden: I do wonder sometimes, I had open heart really young and my chest is a bit concave. I do wonder, and I'm sure there's research out there I just haven't seen, the effect on your physiology if you're in the gym often, if having open heart, if the muscles start to move differently, if maybe that's why different areas are being activated. And I've always been curious as to how my physiology might be different, my build might be different, if I didn't have these massive surgeries during my formative years.

Bob: Wow, yeah. Because if you even spent a couple weeks or months not using your muscles as, like, you were 16 when you had this? Or younger?

Drezden: Six months. Through the leg. But my whole life I've had a, it's kind of like Iron Man, just almost a concave little hole in my chest no matter how, like, I got to the point where I was benching well over 225 and it grew everywhere but right here where the open heart scar is. Maybe that's something they need to research once they fix most of the other heart problems we still got.

Bob: Yeah, then they'll be on the more cosmetic and musculature ones.

Drezden: So as someone that's had these surgeries and has these changes to your heart, the structure of your heart, there's a mechanical piece in there. What are you thinking when you're, I mean, you mentioned you climbed El Cap, Mount Rainier, and other, for lack of a better term, holy shit, those are big mountains.

Bob: Yeah, they're really cool.

Drezden: The mindset, I guess, is what I'm going for there.

Bob: Yeah, yeah. I guess when I, before surgery, I had that same thought you had, that ticking time bomb. Like, I wonder if I can squeeze so hard on it. Because when you're rock climbing, sometimes you're just squeezing so hard that you're screaming and you're trying to lift your foot above your head and just screaming and pulling as hard as you can. And I always had this thing in the back of my mind, like, I wonder if I can break my heart doing that. Like, I wonder if I can mess up whatever's going on and have an issue. After I had this surgery, I kind of was like, okay, I don't have that excuse anymore. Like, I know that it's good. The valve is replaced. I was having a big issue with regurgitation, when my valve would close, it wasn't closing correctly. And it was a bicuspid valve. So there was a huge amount of regurgitation. I wasn't allowed to put too much pressure on my heart, the doctor didn't want that regurgitation to get worse and make my left ventricle get kind of enlarged. So I think after surgery, my mentality changed a little bit. And I wasn't tired, I'd gotten tired a little bit before surgery and was nervous running and stuff like that. But after I was fully recovered, I would say maybe after almost a year, it took a long time to fully recover, but once I was fully recovered, I was like, okay, I don't have any excuses anymore. Up until this point of my life, I could always have said, "Well, I can't do that because I have a heart condition." And then a year after surgery, I was like, I can't say that anymore. The only reason that I have for not doing something is because I didn't prepare for it or I wasn't good enough. I couldn't use the heart thing anymore. So then it became like an interesting experiment to see what I was capable of doing, trying bigger and bigger things.

Drezden: So pushing the envelope now that you've cut the excuse.

Bob: Mm-hmm. And I'd climbed a little bit. I had climbed Half Dome in Yosemite Valley a few years before surgery, I think it was in 2015. I'd climbed Half Dome, which is a 2,300-foot wall. And there's a thing that most people do when they climb Half Dome, which is to go up the backside, the rounded part of Half Dome in Yosemite Valley. But I went up the northwest face of Half Dome, which is this old-school route that was put up in the '60s or something. And the cool thing about that climb, and this was pre-surgery, but that climb had taken us 23 hours to do. And I'm saying that's not a good time. That's not something to brag about at all. We'd started climbing at 4 a.m. one day and we climbed straight through the night till about 3 a.m. the following day when we topped out. And I felt fine doing that. This was definitely before surgery. But that was my biggest adventure I'd ever had. And the really cool thing I learned there was that I could kind of push it. So that taught me that I can do big walls. I can do big adventures. And then after surgery, I had that mentality already, I know I can do big stuff. I know I can go on day-long adventures. I can survive these big things. And then I started figuring out what other things I wanted to do. So yeah, I did El Cap in 2019. I did that in three days with two friends of mine. And three days is the pretty standard, anybody who climbs El Cap probably does it in about three days. So it's a 3,000-foot wall. You climb the first thousand feet on day one, then you sleep about a thousand feet up. Day two you climb another thousand feet. And the end of day three we slept on the top of El Cap. And that was a big thing where I was like, okay, one interesting question I had during that was, I wonder if I'm the first person to do this with a mechanical heart valve. And then I kept thinking, well, what else could I do and be the first? Because now I have this qualifier where I'm like, I'm not the first person to do something because I'm not that good or that cool or whatever, but I could be the first person with a mechanical heart valve to do this thing. And so I started playing with that. I went up El Cap and then I've climbed a bunch of other walls that are actually probably harder than what we did on El Cap, not because they're longer, but because the climbing is more challenging. And I've also summited Mount Rainier outside of Seattle. I've summited Mount Rainier three times. I've done it once pre-op and twice after. And up until that time, have you ever been to Seattle and seen Mount Rainier?

Drezden: Long time.

Bob: Yeah, well, Mount Rainier is just the biggest thing I've ever seen in my life. Because in Colorado, we have 14,000-foot mountains, but they're on average, they'll probably start at 10,000 feet and there'll be 4,000 feet of gain. Mount Rainier is actually 14,000 feet tall, you can see it from sea level. So it's just the biggest thing I've ever seen. And my buddy and I had very little skill when we first did it. But we had a friend that was a mountain guide and he kind of walked us through it. I remember he wrote on the back of a napkin, he drew the things we should worry about along the trail. The trail's already in place from other people. You just basically walk along where everyone else has gone. But he drew on a napkin one night when we were sitting at a bar and he's like, "This is what you need to do. You need to go to this spot and walk fast here and then take off your rope here and walk this section and then put your rope back on." And he drew it on a napkin. And I remember I had that napkin on me on Mount Rainier and I'm looking at the napkin and I'm like, this is, yeah, but he was a mountain guide. He had walked it maybe 20 or 30 times that year. He has summited over 80 times. So I'm saying, compared to a lot of people, the things I'm doing aren't earth-shattering things. It's just, I'm not a mountain guy. I'm a high school English teacher. Going up there is like, you're definitely in this other world with very athletic people, which is really cool.

Drezden: Now, it's interesting, you're a high school English teacher. Do you tell your students about, I've had a few English teachers, some have been very loose in their course content, they didn't really teach books, they taught how to think. And I've had others that just teach straight out of a book. Do you tell your students about your heart? Do you tell your students about your mountain climbing? How do you approach that kind of dynamic?

Bob: Yeah, I tell them all the time. Actually, specifically, I don't like to talk about myself too much. I try to spend most of my time focused on the students and talking about what they're up to. But when I do talk about myself or when I'm introducing myself, I usually say one of the coolest things about me is that I've had a heart surgery. And I do tell them because you can hear my heart ticking in class if it's quiet enough. So maybe this is my way of asking them to quiet down, but I'll tell them, if we're ever really quiet and if I've had too much coffee that morning, then you all might hear my heart ticking as well. So it's kind of the introduction I do in class sometimes. I work at a school for Career and Technical Education in Denver. And I have some nursing students and some pre-med students as well. So I'll go into their classes sometimes and I have a little slide presentation that I show them what my surgery was like. And I do have videos of my specifics, of the surgeon doing my valve. So I've shown that to the nursing students and the pre-med students. But in general, I just introduce it like I would any other part of a person's life, where they're from, what their hobbies are. I kind of throw it into that type of introduction.

Drezden: And that's good. Have you ever had a student that you know of that had a CHD? That maybe that made them talk about it more, maybe more comfortable?

Bob: I haven't, but I would love, I do think that's valuable. I think, I know when I was young, I didn't know what the life expectancy was of a person with a heart defect. And so I would love if that happens, and if I ever have a student who has that, I would love to talk to them about it. But again, it's like, I don't know if I would have wanted to talk about it much when I was young.

Drezden: Right. And just being open with it, someone might have it and then it might just compel them to talk later on, even if they don't bring it to you directly. So I think you're doing good work by being open and honest, the power of vulnerability.

Bob: Yeah, and I think it's, I don't really love social media that much. I don't like to use it too much. Or like, I don't like to talk about myself in my usual life. I don't want to talk about myself all the time. But I think that sharing those stories on social media has really been a cool thing as well because so many people reach out and say, "Hey, I have this same condition and this is what I'm going through and I'm scared of this." I had a guy that I was communicating with over the last couple weeks who lives in Greece and he's like, "I'm scared right now." And he's, I don't know what time in the morning it was, but he's like, "I'm trembling. I'm not ready for surgery. What happens to my family if something goes wrong? What happens to this?" And I would just chat with him through Instagram. Having those conversations, I think they're really important. And yeah, it would be the same thing if I had a student or anybody else who was interested in talking about this stuff. It's one of the things that I love doing so much. Because I think it's important. I almost, if I describe my ideal job, I think it would be working, doing this somehow, where you're talking, working with the cardiac, or no, I wouldn't want to be on a stage. But instead, talk to, like, you're going to get surgery. I had surgery too. And I'm not a doctor, but let's talk about what was it like. What did it feel like? Like having, I couldn't laugh for four weeks because my chest hurt so bad. And the doctor never told me about that. And it's not medical advice. It's just this thing that you just don't learn until you start laughing the first time. Or if you have to sneeze, you just learn, it's like, those are the things you can't Google and you can't, or like, to have somebody that can talk, like, this is what pre and post op looks like.

Drezden: I have an episode that I recorded with two of the Adult Congenital Heart Association's peer mentors. And what their peer mentor program is, is people that have gone through it telling other people who are going through it now what to expect. You should really consider signing up. I'll put a sales pitch in here for anyone listening who has gone through this kind of event and wants to do exactly what you're talking about and give back by telling people what to expect and telling people the things you wish they told you beforehand, that's a great way to do it.

Bob: No, and that's another thing. That's the whole reason I have the blog too. I write on the blog very inconsistently now, but I almost find these themes of questions that I've been receiving. And then I'll be like, okay, four people have asked me about this, so I'm gonna write this thing really quickly. Or like, when I do something, I traveled, I lived in Colombia for a while and I didn't know if you could get a blood draw down there. So after I did, I was like, well, it took me three days to get my first blood draw down there. But doing those type of things is like, can you travel after you've had heart surgery? Don't you need to be near an American hospital where they can do these tests? All these questions, I was like, I don't know. And I went to Colombia and I was like, I'm going to figure this out because I can't ask anybody.

Drezden: Shouldn't you have figured it out before you went to Colombia?

Bob: Well, I thought I could always fly back. I thought it would just be expensive. But I was like, I can't fail 100%. I'm not going to have a cardiac issue down there. I just don't know if I can get a blood draw. And I don't know if they do blood draws or how the healthcare system works. But who do you ask? I was like, the cardiac surgeon won't know that, "how do you get a blood draw in Colombia?" So I was just like, the only way to figure that answer out is to go. And so I've gotten blood draws now in Colombia and Mexico, and they're easy. They're so chill. So many people are on Warfarin and Coumadin, so many people need blood draws, that I just had to learn the vocabulary for that in Spanish. And now it's easy to say and ask for.

Drezden: That's awesome. That's great. And you're exactly right. We all need people that have done it before to show us how to do it. That takes me back to what you're saying about being the first person with this condition to summit this mountain.

Bob: And yeah, well, maybe. Anyone can dispute that, I've got my dates. So I would love to know if somebody else has done it too.

Drezden: But now someone like you five, ten years ago is gonna be listening to this or reading your blog or looking on social media or talking to their friend and they're gonna be like, "Oh, I really want to hike that mountain or climb that mountain but I don't know if I can with my heart. Here's something you gotta check out. Someone's done it and it's that." Breaking that kind of mental barrier for someone else.

Bob: And I think the interesting thing too is, Mount Rainier is not the epitome of mountaineering or whatever. But I guess the question is, can you go to altitude? What happens if you go to altitude? Another thing, when you walk up a big mountain like that, you have a lot of sharp pointy things. On your boots, you have metal spikes attached to them. And you have an ice axe in your hand and all this stuff that could cut you and you're at high altitude. And I was like, well, what will happen if I take one of these crampons, the spikes in my boots, what if I kick my leg and now I'm bleeding everywhere? It's like, well, I've done that now. One time I specifically did it really bad and I was just bleeding all over the side of a mountain. I was like, no, this is not good, but I'll figure this out. And so I think it's just interesting to see, can you do this step? And then people, if they try it with their own situation, if they have a different heart issue than I did, or if their cardiologist tells them they shouldn't do these things, they shouldn't. My cardiologist was just like, "Yeah, you're fine. You don't have a heart problem anymore." So now you can start going to do these things.

Drezden: That's a big sentence.

Bob: Yeah, that was really cool. And that's where I was like, oh my gosh, I don't have an excuse anymore. Because I remember, my cardiac surgeon was one of the coolest people I've ever spent time with. And we spent a couple hours together before surgery, which was, I've never heard of a doctor just letting you into their office. We sat down and we just talked for an hour. He's like, "Yeah, you got a bunch of questions." And here's what I'll be implanting, and he gave me all this information. And then after that, he said, when I was in the hospital, he's like, "Yeah, we don't need to hang out anymore. You don't have a heart problem anymore." He's like, "But you can always use me as a resource." He was actually in this, the heart valve company that makes the valve, they came out and filmed me rock climbing one day. And they went and saw him too. And they got a little B-roll of him talking about the condition and stuff. So he's a really cool guy. But he's just like, "Yeah, you don't need a cardiac surgeon anymore. You're done with this."

Drezden: That's interesting. That's great. Well, and I think that ties in perfectly. You know, we're coming up on time here, but something I always want to end with and ask all my guests is, with everything that's happened now, with this adventure you go on, what does CHD mean to you now? Not the technical definition, not the malformations and the structure of the heart. Given all that you've personally seen and accomplished, what does CHD mean to you?

Bob: You know, I know what I think about it, because I think about it a lot. When I was young, I thought I had a limited amount of time. So I moved to Colorado and I learned to rock climb and I kayaked and I just did a lot of stuff. I was like, I think I might have a limited amount of time and I think my life might be shorter. So I can't be like, I'm going to move to Colorado in 10 years, or I'm going to move there in 15 years, because I don't know that 10 or 15 years, I didn't think at the time, and this was a misconception, I just didn't know, I didn't think that that was guaranteed. So the thing that CHD, congenital heart disease, means to me is: I'm lucky at this point with everything taken care of. I think I'm lucky because it forced me to act and to do what I wanted to do when I was young. And that mentality I still have now, I'm like, well, if I'm gonna live to be 70 or 80, I've got to change the way I've been thinking about things. But up until now, I still have that same mindset of, oh, I don't have a bucket list. I don't believe in bucket lists because of CHD, where I'm like, if I want to go to Guatemala, I'm going. And if I don't buy the ticket in the next couple months or half year, then I'm gonna stop saying that I'm gonna go there, because I haven't, I'm not doing it. So it's more like this desire to not become one of those people that say, "in a little while, I'm going to do this thing eventually." It just took that away. Which was really nice. When I was young, I was scared. But now I'm just like, oh, I can see, that's why I moved to Colorado. Because I was like, I don't have time to say that I'm going to. So yeah, for now, I think it's been, it started that mindset of doing what you want to do.

Drezden: That is a wonderful answer, and I'm not just saying that because I've answered the question the same way. When it comes back to me, I always say it gave me a perception of the world that most people didn't have where, like you said, the ticking time bomb in the chest, I didn't know what was gonna happen when. And it made it so whenever I wanted to get something done, I might not be the smartest person or the most talented person or the most gifted person in the room, but no one's gonna outwork me, because I know I have a limiting factor to get past if I want to get something done. So I'm right there with you. It's amazing how optimistic and joyful everyone I've asked that question to is, because at this point, the passion, the drive, the consistency in the motivation, I see how the CHD patient community continues to blow my mind.

Bob: Yeah, I also think the real skill that I have now is that I know I can go through heart surgery and I can recover from heart surgery. I don't know if there's anything harder, there are harder things than that to go through, but I also know that it's just a very calming thing where little things don't bother me. I'm like, I've thought I was going to die for a long time. I got through heart surgery. If somebody cuts me off in traffic, I don't care. I just wave at them and I'm like, I hope you get where you're going. And that's all.

Drezden: I've been told this a long time ago, but someone asked me how I always managed to keep so calm under these high-pressure situations. And it came back to just what you said, this isn't high pressure. You and I, we've seen high pressure. This is just another Tuesday, guys.

Bob: Yeah. And you know, you can outwork people too. So you're like, well, the option is we can either not do this thing, or we can work really hard. And both of those are fine. Let's do one of them. And then let's just, I spend so little time worried about little things. I kind of cut right to the chase. Usually, I try to be as efficient as I can. And I'm just like, yeah, let's just do this thing or not do it. And I think that that's a mindset that comes from having a heart condition when I was younger.

Drezden: "Do the thing or not do it." I think there's nothing that's gonna be more beautiful to end on. All right, that was, thank you for taking the time to talk to me today. I do think this is gonna help people.

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[OUTRO]

Drezden: That was Bob Smith of My Aortic Adventure. You can learn more about Bob by visiting his website, myaorticadventure.blogspot.com. Or you can follow him on Instagram at aortic_adventure. As always, if you have questions or comments on this episode, you can reach out through our website. You can email support@onepercentheart.com or you can message us on Instagram at the CHD podcast. Talk to you soon.