Hopefully some have been wondering


Hopefully some have been wondering

About my past few weeks of light blogging and the absence for the past two. Here’s the story.

I had heart
surgery last Tuesday morning and have every reason to expect a full and complete
recovery. The wonders of modern medical science have done their thing and now
it’s up to me. I’m home and feel pretty good and with the help of a wonderful
drug named Darvocet am taking walks and feeling better daily. I came home at
Noon on Saturday and all is well. If you want the “backstory” read on. If these
medical gossip pieces bore you, now’s the time to hit “delete” and get back to
important things like the latest funny blog or video
I have known, really, that I would
need some help with my heart for about 40 years. A doctor told me there was a
“murmur” but that no one but an expert could hear it and not to worry, it was
minor. Minor by ass, he should have been with me the last week. My current HMO
doctor less one heard the unhearable murmur a couple of years ago and said I
should take an “echo” to set a “baseline.” That I did. He then proceeded about a
year ago to go into the Baptist equivalent of a monastery (I’m not sure there is
a connection) and I was thrown into that medical never land of having no doctor.
I liked the Med come reverend and his last non religious act to was send me for
another Echocardiogram. However during the process of finding a new doctor and
pissing off numerous doctors, med techs and schedulers, my second test, though
completed, was overlooked. Until, that is, I found my current internist.
  Richard Castillo is great, a good listener, and with just the right sense of
humor (As he’s listening to my heart he starts to laugh.  “We doctors love this
stuff.” – I was happy to provide the bit of humor in his life.) He found the
second “Echo” and sent me to a Cardiologist the next day. That was in July

Doctors specialize and so I had to
see someone who knew everything about hearts. Dr. Jack Farahi, is a trip. He’s
Farsi/Persian (That’s Iranian for those of you in the parking industry.) US
Trained and the age of my eldest son. He looked at the tests, listened to my
chest, and said that I had a “problem” with a heart valve and it would have to
probably be fixed. He explained that one of the valves wasn’t closing completely
every time it beat and therefore the heart had to work harder. He opened and
closed doors in the consulting room to demonstrate the issue. It reminded me of
one of those English country farces where people are popping in and out of rooms
or when Rick and Fred were never in the right place at the right time…There
hadn’t been any damage to the heart “yet” but would soon. “Maybe” it could be
fixed with drugs and he put me on a regimen and told me to come back in a month.
All this took a total of four minutes face time. He didn’t want to talk about
and alternatives until we “tried” the meds.

At the end of the month I took
another bunch of tests including a “stress” echocardiogram, and an angiogram.
The angiogram was actually fun.  You get to watch your heart beat and I actually
got to see my doctor again for the longest time since this process began. At
least I think it was him, he zipped in just before the actual test, was there to
see it, and the left. He was masked the entire time.  Frankly, he could have
done it from the beach, since all he needed to see was display so I figured I
got a deal. I met with him again after these tests and he told me that my
arteries were “clear as a baby’s.” He also told me that the tests confirmed the
diagnosis and that surgery was the thing to do. Cool…I was frankly most worried
that my arteries would be blocked as any of you who have ever broken bread with
me know that my diet is not the best. Thanks mom and dad, it’s the best legacy
you could have left. (We won’t get in to the Mirtal Valve

At our next meeting, he set me up to
meet the surgeon. The total time for this meeting, about 3 minutes. If this guy
was paid on the clock, his hourly rate was incredible. However he did exclude a
confidence and humor that I liked.  He told me this surgeon “did” almost the
same thing on his mother (this was a mixed comparison). I asked after his
mother’s health and he said she was fine.

A week later, after getting
insurance approvals for the meeting I met with the surgeon.

An aside– The”HMO” to which I belong
was working perfectly in its bureaucratic morass. It’s Pacificare – FYI.  All
the doctors had people that did nothing but talk to insurance companies and make
sure the paper flow was on track and except for one little hiccup, they did a
great job. These are the unknown heroes of this process.  I would like to thank
all the folks that didn’t have major issues like this, so insurance could afford
to pay for mine. American health care may be under attack, but I have no

HollywoodI went in to see the surgeon and
caught a few revelations.  First of all, he was renowned. There were pictures on
his wall of him with everyone from the Pope to all of LA”s mayors to the
governator and I think a president or two.  Best I could tell the pix were the
result of some good donations. But who cares, he had a good PR operation going
and that’s important, after all I do live in Hollywood.

There was also a permaplaqued
article from the Times that told his history and it was impressive.  He had a
team that operated all over the city and I guess the word was that he was as
good as it gets. It said he was 60, and I thought that since he was younger than
me, all was OK. Until I found that the article was written in 1994.

IndiaDoctor Taro Yakoyama could have
stepped out of central casting. He is a small man and exudes confidence. He took
his time, didn’t try to rush me at all,  and answered all my questions
completely. If my cardiologist was a combination of Jay Leno and House, he was
Mr. Miyagi and Marcus Welby. He told me there was a 90% chance he would be able
to repair my valve, that it would be “minimally invasive” and that I would be in
the hospital about 4-5 days. There were plastic incased valves on his shelf and
frankly I was surprised at how big they were. I had to make a choice, I could
have a man made valve which had a half life or 10,000 years or I could have a
“bio valve” which is the nice way of saying some cow or pig gave their all for
me. The difference was that with the man made valve I would have to be on a
blood thinner for the rest of my life. This is not recommended I am told. With
the bio-valve I would be back to normal in a few months, off most meds and be
able to live a normal active life. OK I may have to have it replaced in 20 years
but I figured that 20 years from now they will probably be beaming the suckers
in from India and it will e a 15 minute outpatient procedure.

However the doc said that in his
experience (he has “done” over 3000 hearts) he should be able to fix the valve. 
Leno/House agreed.  It was their only miscalculation for which both apologized

The insurance specialist (the key
person in this entire process) began by setting a date for the “approval” and
then for the surgery. Things were moving fast now. They were fighting
bureaucratic battles and I was off to the CPA in Canada, , the SWPA in  and the PAA in Florida

My surgery was scheduled for Tuesday
the 16th was some tests to be done on the previous Friday and Monday.

Up until this point I had been
looking at this as something that was going to be done in the future. But now
the time was being counted in days and hours and the stress was beginning to
take its toll.  I spent a day in bed in Albuquerque and my neck was so tight that I
could barely turn my head. I decided to take an earlier plane home from Florida and spend a bit of time with the Surgeon’s Physician’s Assistant. I just felt that
something wasn’t going quite right. I was correct. Seems that insurance would
cover the tests only if they were done by my HMO or the hospital and they could
not be done by the cardiologists. However the HMO didn’t have the facilities to
handle the tests. Stress was kicking in. I yelled at the PA and a few minutes
later she had it all worked out. I apologized and she said not to worry, she
worked for heart surgeons an in the yelling department I was a wimp. All the tests were to be done on
Friday or when I checked in on Tuesday.

I began the task of “who to tell and
what to tell.”  I decided that I would wait until “all was well.”  I did talk to
my staff but underplayed it a bit. Good thing. Andy said he spent most of Monday
Afternoon and Tuesday “talking them down.”  My staff are great folk and I love
them dearly. They kept Andy busy. That was the goal

The rest is a blur of cold rooms,
competent people, and little snippits. “I’m your (From here on spell check can’t
find the proper spellings so I’ll use descriptions) I’m the guy who will knock
you out during the surgery – note to file – this is a different guy than the one
who introduced himself as the one who would do same in the doctor’s office a
week ago – I’m the guy who will keep you alive during the surgery while they
stop your heart – I’m the nurse who will do everything else (she was a real
cutie, at least I think so since all I could see was her eyes) She was also, it
appeared, extremely good at doing the most important thing – getting me to feel
comfortable with a procedure that would cut open my chest and stop my heart. As
I was rolled in to the operating room, the Doc came by and told me he would be
back, he had a meeting. I was happy this was routine. I was being fitted in
between meetings. Hopefully has Blackberry was

Then I woke up and was feeling
really good. I don’t know what that stuff was but I now understand the lure of
the drug culture and why these drug guys make billions…Whoopiee. Then Dr.
Yokoyama told me that he had to replace the valve. I was now part bull….How well
did he know me, anyway? Hey I was awake, alive, and pumping on all valves.  A
friend told me the other day that actually I should consider it part “ox.”
Everyone else seems to lean toward “bull.”  I know what your choice will be. 

The day of the surgery was a haze,
the second day was the most uncomfortable, until I found that all you had to do
was tell them that your pain was a seven on a scale of 1-10 and they would give
you a couple of pills that made everything all right.  There was a TV in the
Cardio ICU and it was on but I didn’t have my glasses.  Andy tells me I was
watching game shows but who knows. I guess I was a little grumpy in the ICU
because after they moved me to a room most of the people who were taking care of
me would throw their hats into the room before they came in and then were
surprised at “what a nice guy I was.” My ICU personality (my real personality)
preceded me. 

From then on it was simply hooked up
to this, waking at 3 am to take blood pressure, watching a lot of TV (mostly USA
Networks at 4 AM)  disconnected to that, but you have to walk and can as soon as
we unhook this or that, Dr. Yokoyama showed up every morning around 6AM. He’s a
dapper man with a Tony crewneck under a brown blazer. He would spend a few
minutes, look fatherly, nod his head and said I could go home as soon as the
cardiologist said I could.  His job was done. 

By day three, I hadn’t seen any
cardiologist, Doctor Farahi was among the missing. So I picked up the phone and
called his office. To his credit he arrived about an hour later. It seemed the
minor tidbit of the date of my operation had not been communicated to his
office. As formal as Yokoyama, Farahi was casual – open shirt with a ring on a
leather strap around his neck. He always had a smile. But he was there now and
frankly up to then there was nothing for him to do. I did love the way he
glanced at the charts and the monitors and then said that everything was

Aside two:  Nurses and assistants
are great, but they give conflicting information. Some say that the numbers are
OK, others say they are “high” and others that they are “low”. The years spend
in medical school give AND years spent doing this over and over give doctors the
experience to know the difference. Farahi said that arrhythmia was normal in
half the cases and a drug would get my heart back pumping like a champ in no
time. In fact it took the drug about an hour and that surprised even him. 

The next day he blasted in about 10
am and basically said – Time to go home. So I did. With a list of drugs to take,
follow up appointment to make, and exercises to do.  I have spent my first night
in my own bed and love it. Slept like a baby.   

It’s Sunday morning, the birds are
chirping, the dog is wet (he needed a quick bath, 500 junk emails are erased,
and all is right with the world. 

I know it sounds trite, but this is
done by a team, not by two doctors. There’s the technicians who give the tests,
the medical specialists that put you on the machines and keep them running, the
cardio tech that assists the surgeon and then removes the drains and makes you
feel good, even though he went to USC – you are forgiven, Chris, and the
Physician’s assistant who basically was in charge of this group and made sure
everyone showed up and the right time and did the right thing. Thanks team.

This was a strange event. From the
beginning I had no symptoms. No pain, no swelling, nothing, zip. Had Doctor
Chen, (now a reverend) not insisted on the test, and Dr Castillo not insisted on
the cardiologist, and Dr, Farahi not used his skills at listening and reviewing
tests and the wonderful hands of Dr. Yokohama done their thing I would have done
permanent damage to my heart and this event wouldn’t have been a few days in the
hospital.  Thanks 

I’ll try to keep you updated on my
progress and keep those cards and letters and emails coming in.  I love to hear
from you all.  I won’t make it to the NPA, but I’ll be thinking of you. My phone
will be forwarded for the next few days but I will be answering emails and begin
taking calls by mid week


Picture of John Van Horn

John Van Horn

2 Responses

  1. Hi John,
    I was one of those wondering what had happened to the American parking gringo and missing your amusing comments and sense of humour. I must also be a sad case.
    As you can see from my second surname “de Toro” (of Bull) we now have something else in common.
    Keep taking the drugs and hope to see you soon in London.
    Manny Rasores de Toro
    Anglo-Spanish Parking Junkie & Consultant

  2. John,
    Wow! I had no idea but am glad you are back to being yourself. I just saw you what a couple of months ago in Ft. Lauderdale? Either it was that quad black eye extra strength espresso or my running late for our meeting!!!
    With the stress and grind of the parking biz, you are a perfect reminder for all of us old parking folks to get checked up frequently past the age of 22!!
    Welcome back!

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