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

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

incorrect plumbing. So one of my four tubes was just

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

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

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

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

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

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

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

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

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

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

the next month.

Welcome to open heart surgery with Boots, a

podcast for heart patients by me, a heart

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

intricacies of the human heart, revealing the

triumphs and challenges of those who

undergo the life changing event of heart

surgery. We're not just exploring medical procedures.

We're delving into the human experience.

Be sure you hit subscribe and also

leave a review. That means the world to

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

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

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

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

get to this week's episode. Welcome

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

Knighton, your host, and today is such

a special treat. I feel like I say that

every week with every heart patient I have the honor of

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

why. I want to bring you my new friend

and heart buddy, Billy Haas, who is a

mountain guide. And he had open heart

surgery, and he is totally back out in the

world. Like, climbing new peaks, putting in new

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

instructor for the American Avalanche Institute, and

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

wait to dive in with Billy and get

to the heart of the matter, pun totally intended,

to figure out how the heck he is

thriving despite his heart

challenge. And he just seems to have risen to the

challenge and succeeded and has totally

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

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

to this podcast to share your knowledge,

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

busy dude. You are constantly going new places. So

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

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

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

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

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

through. And I talked to so many heart

patients who have wanted to get back

to their life, and life is just so

radically different after heart surgery for all of us.

I know for myself, I continue to try to get

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

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

Idaho. Billy lives down in Utah,

and he also comes up to the tetons to

guide up here for exim mountain guides. And

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

And I continue to struggle to get back to the

mountains. And so this is a bit of a selfish

episode for me because I need that

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

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

so excited to unpack all of that with you today.

Tell us first, like, set the scene of

what happened. Just give us your heart

story as it unfolded.

Yeah, it was kind of a surprise,

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

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

I was up in Alaska guiding Denali,

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

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

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

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

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

basically pvcs or, you know, these kind of

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

echo, you know, ecgdeh, uh,

they did a calcium score test,

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

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

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

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

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

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

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

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

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

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

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

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

And that was actually kind of a funny story because

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

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

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

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

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

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

just kind of take it right now, or this is

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

just do it. And I could hear the

cardiologist kind of, like, explaining some things

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

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

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

mmm, mmm. You know,

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

large septal defect, but I also had an

anomalous pulmonary vein, so they call it partially

anomalous venous return. So one of my pulmonary veins

that's bringing oxygenated blood back from my lungs

was kind of going into my superior vena

cava, essentially just recirculating a quarter of

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

lungs. So it was like they give you all these

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Wow. So that was kind of the

diagnosis. I'm just thinking about you and

Denali having. I mean, my husband Jason has also

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

for some days. For many days sometimes. And

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

so intense. I'm

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

would not have necessarily gone very well. Yeah,

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

stress on your heart.

Cardiac events at high altitude are not uncommon.

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

is particularly for where we're coming from,

not super high. And it's funny

because what I was having was just a result of

me having too much caffeine. And I

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

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

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

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

wife. That coffee saved my life in a way.

Hey, whatever it takes, because we need you here

you are dealt this news. Walk us

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

was such a 180, right? Yeah. And it

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

orthopedic injuries before, ACL repairs, things like that.

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

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

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

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

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

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

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

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

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

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

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

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

quite a bit more than some other styles of

injuries or things like that. I remember coming

home that afternoon, and maybe it was just the sedative

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

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

I was. Yeah, I was really upset. And

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

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

was about as important as anyone in

one explaining things to me, but also being

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

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

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

important to have that. Yeah. Oh, yeah.

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

she really better than anyone could. She

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

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

you were scheduled within the month at University of

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

winter when I had that te. And

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

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

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

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

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

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

vision quest style solo skis.

And then right the day before my surgery. Oh,

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

scene for our listeners. Cause I have

listeners all over the country and

59 other countries. And

when you have a big day, I want

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

incredible what you do with your machine

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

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

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

amazing what you were still able to do despite

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

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

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

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

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

is, with my two problems in combination,

there's a few common diagnosis points.

One is at birth. The other is generally in your

teenage years because. Or as you know, kids

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

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

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

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

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

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

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

But that compensation does damage to your heart. And

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

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

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

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

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

vertical feet and kind of linked up some technical

lines in one of our larger alpine zones. And the

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

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

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

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

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

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

lift service skiing. You were climbing

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

And it takes an incredible amount of endurance to

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

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

careful about how I word things. Cause

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

word congenital heart defect because I just like to

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

it has an emotional impact when I think of defect

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

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

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

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

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

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

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

we heart patients throw the best pity parties.

Probably the woe is me,

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

aired an episode yesterday with a really great

emergency room nurse up in Canada, and

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

you and your listeners permission to grieve.

And I. I really grieved when I

was diagnosed in 2020, and I did

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

get on with saving my life. And my mom died

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

dumpster fire, and I

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

comes in waves. So, yeah,

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

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

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

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

peak and smile and get on with living and be in

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

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

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

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

kick ass day before surgery. Good for you.

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

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

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

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

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

trust. And I remember

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

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

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

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

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

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

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

I was a bad patient sometimes, but, yeah,

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

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

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

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

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

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

I remember being incredibly nauseous, and I was

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

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

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

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

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

that off. I ended up spending seven days in

the hospital. I had a small

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

post surgery. Just meant I got another tube and.

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

of Utah, and surgery seemingly went well. And those

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

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

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

up 25 times after my open heart surgery.

Yeah. Like, I broke record.

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

I had my surgery right down the street at Intermountain hospital

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

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

24 hours period. Yeah, don't

recommend that. So she rubbed

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

My wife comes home with. So I like to

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

certain. But, yeah,

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

lightning quick despite my time with the puke

bucket. But how old were you when you had your

surgery? I was 30. Yeah. Okay,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

or stuff. And so that was

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

hard, scary moment in life, and we need

our security blankets, which are our partners or close

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

has that. That gift of

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

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

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

those who don't have someone close

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

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

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

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

know well to help you with some stuff. Like,

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

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

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

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

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

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

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

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

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

Yeah, yeah. Well, I mean, with heart

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

such a vulnerable act of

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

actually been touched by other humans, and that in and

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

poked and prodded with all the tubes for the next however

many days. And, I mean, it is all

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

dignity we can hold onto is so

important and necessary for our self

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

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

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

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

was so sick, and it is such a vulnerable

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

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

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

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

tough and I just want to normalize

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

going, yep. It is as part of heart

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

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

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

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

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

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

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

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

as you're making yourself sound.

You're thriving. Walk us through your recovery

and how you got back

to climbing 8000 meters peaks. Well, I did have

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

sailing. I had a pretty major hiccup. But

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

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

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

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

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

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

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

the wasatch. So that was also a little hard.

And, yeah, my house here is kind of like

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

treadmill because of the sternal precautions, but I put the

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

because I just couldn't focus on anything.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

at least prepped for. Yeah. And a lot of

heart patients would nod. There had some agreement with you

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

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

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

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

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

Yeah. Never forget from that experience as well.

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

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

And I remember. So February 1,

March. So around April 1, I know this

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

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

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

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

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

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

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

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

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

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

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

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

technical line called the heart of darkness, and then

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

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

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

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

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

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

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

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

pretty good. And as my doctor and my surgeon

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

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

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

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

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

the point where I felt good enough that my friend Adam

and Noah and our friend Ben asked me to go to

Alaska in May. And I was like,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

walking. But from the endurance standpoint, I actually felt

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

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

interesting to have more of like a technical conversation with a

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

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

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

pretty significant over the next year was on that trip,

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

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

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

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

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

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

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

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

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

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

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

lightheadedness if I bent over things like that that

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

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

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

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

thing called SVC syndrome, which a

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

cava caused clotting. Kind of get that

turbulent flow and caused clotting. And my

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

almost fully blocked. And what that does is that

prevents the proper return, blood return, from everything,

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

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

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

you have to deviate around on side streets. And

fortunately, yeah, fortunately, you have

these collateral veins that can bypass the SVC, and

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

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

swelling up so bad that I was, like, almost

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

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

100 pounds. And this was actually a much more

complicated thing to deal with. I saw thrombosis

and kind of surgical teams at the University of Utah

intermountain Healthcare. I consulted with physicians back

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

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

syndrome is from a chest tumor pushing up against their superior

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

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

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

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

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

recommended to a interventional cardiologist at

the primary children's Hospital, a pediatric

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

she was probably the best healthcare provider I had the

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

procedure for people with your

condition and have. Who have had the same style of

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

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

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

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

I started to realize that stuff in May of

2019. I didn't get it fixed until

May of 2020. So it was

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

that was also the height of COVID Uh, so for

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

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

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

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

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

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

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

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

out. But luckily, she, uh. She did

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

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

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

other issues since that. Since 2020. That feels more

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

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

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

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

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

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

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

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

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

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

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

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

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

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

are often determined by quality of life outcomes,

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

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

to get back to the quality of life that I

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

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

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

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

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

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

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

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

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

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

You were coping ahead, which is a skill that we

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

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

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

a therapist? You know, I've never seen

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

but I would not hesitate in a heartbeat,

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

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

podcast, and, I mean, it's

obviously such a personal choice. And the

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

diagnosed with heart conditions is so personal.

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

experience prior to the diagnosis

day really does impact how you process

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

curveballs like this, it's hitting me differently.

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

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

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

that's amazing. And then to be thrown this

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

rear view mirror, and this curveball is really

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

It is such a 90 degree term. Are you on

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

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

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

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

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

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

just take my 1 or 81

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

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

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

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

the biggest things is maybe some weird heart arrhythmias,

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

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

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

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

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

So pretty easy road in the

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

imaging every year? No, not every year.

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

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

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

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

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

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

Before we wrap up, what has given you the

confidence to return to activity in the mountains,

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

treadmill. I'm hearing a healthy dose

of determination and

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

play in the mountains. It

does serve us well at times. But what ultimately

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

mountains and not worry about dropping dead? Yeah.

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

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

had and what happened to me, you

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

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

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

many, particularly cardiac health

professionals or cardiac specific health professionals, and really understanding

what I had done to me, what could be the

potential issues there and what to look out

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

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

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

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

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

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

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

think really understanding what my condition entailed,

what my fix was and what that meant

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

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

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

drink alcohol at a pretty moderate level. I'm

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

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

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

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

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

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

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

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

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

the good example here is I just got back from

finally I made it to Pakistan and we

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

gasherbrum one and gasterbrum two. Two 8000 meters peaks

and going to gastroom one. We did gastroom two

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

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

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

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

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

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

ways we hadn't before at those altitudes. And

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

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

like system fatigue more. And in

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

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

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

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

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

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

often associated with fatigue, lack of rest, potentially

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

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

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

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

things that were happening from other issues rather than my

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

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

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

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

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

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

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

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

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

research about facing

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

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

this recording with you, and I have been using

an app that is called recognize, and

it actually has me flashing

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

choose the discrimination between right and left. How this came

about was researchers did. They looked into

people with back pain and those who would not

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

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

Anyway, those who would not look at their backs

actually had persistent, lifelong pain. Those

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

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

So if we choose to face any

situation head on and not be afraid

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

nervous system, which turns down the pain response. So

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

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

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

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

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

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

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

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

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

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

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

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

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

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

really consequential climbs and, you know,

8000 meters peaks. For those listening who

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

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

of awareness of your body because it's not an

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

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

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

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

Billy, we could talk for hours about this

is, before we close, is there any

lingering nuggets of wisdom you want to impart

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

surgery? What is like the nagging piece of advice

you just want everyone to know to be able to thrive

post open heart surgery? I guess the first thing is

every, you know, if you have a sternotomy and

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

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

I was able to basically return to my activity at

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

same for everyone, you know, like these structural issues

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

fixes and solutions and outcomes and stuff and. But

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

had this nice reinvention of myself, but there are

upsides. Like, I am definitely a different person

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

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

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

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

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

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

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

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

go well. Like, I'm definitely okay with

success and failure more. And I'm much

happier when I see friends or others doing things

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

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

didn't do that whatever and stuff. So call

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

on things like that is important. And,

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

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

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

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

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

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

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

relaxed. This sounds, like really

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

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

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

Live Letterman interview with him. And he at the

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

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

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

every sandwich is something like that. And that I

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

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

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

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

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

oftentimes that change can be. Can be pretty positive and

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

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

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

than he was prior. So just focus on the things

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

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

stop. Enjoy every sandwich. I love it.

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

Yeah. Thank you. Thank you

so much for this. I'm

better for it. I needed this today and I

am just continuously amazed at the power of the

human spirit to overcome the biggest of

challenges. And you are. You

exemplify that today. So where can listeners find

you? I have a pretty modest Instagram account

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

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

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

the hi route.com.

but soon I should have an article on that

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

more depth to my experience with my heart

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

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

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

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

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

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

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

those who are wanting to follow along,

sure that you have subscribed to this podcast and

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

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

on Apple, Spotify, wherever you get your

podcasts really do matter, as well as

following the podcast. And I have a

Patreon community I'm just now launching in 2024,

September of 2024, and it's going to have

two options for Zoom meetups every

month. I am hoping to accommodate those

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

mountain standard time to catch some of my european

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

member of Patreon. You can find me at Patreon.

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

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

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