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Healthline contributor and former editor David Mills shares how an annual checkup with his cardiologist resulted in a surprising diagnosis that required open-heart surgery. Share on Pinterest I consider myself a classic car with a rebuilt engine, ready to tackle my 70s, said Healthline contributor and former editor David Mills (pictured above) after open-heart surgery. Image Provided by David Mills

Open-heart surgery is not, if youll pardon the expression, for the faint of heart.

In my case, it was an intense, 6-hour operation that ended up repairing a heart that was in worse condition than my doctors and I had realized.

It was preceded by a slew of pre-surgery tests during the months before the procedure as well as the roller coaster of emotions leading up to the fateful day.

And then there are the weeks and weeks of recovery that require precise attention to a detailed plan your cardiovascular team presents to you.

However, the rewards are there at the finish line.

A new, more grateful look at life. A closer bond with family and friends. A desire to seek out goodness and beauty in the world.

Today, I consider myself a classic car with a rebuilt engine, ready to tackle my 70s.

But it was a long, difficult road to get here. A diagnosis with no symptoms

The first sign of trouble came in the summer of 2023.

Thats when my cardiologist, Dr. Christopher Wulff, suddenly told me to be quiet while he was listening to my heart in his office in the San Francisco suburb of Walnut Creek.

Id been going to a cardiologist every year since 1997, when a tonic-clonic seizure led to my diagnosis of a fainting disorder known as neurocardiogenic syncope. Those visits had been in addition to an annual checkup with our regular family doctor.

The syncope was, it turns out, relatively easy to manage with lifestyle changes.

The yearly visits to the cardiologist had become so routine, in fact, that I almost stopped going on an annual basis.

Good thing I didnt. (Let this be a lesson on the importance of seeing your doctor every year.)

What Dr. Wulff heard on that day was a clicking. It was a sign, he said, that one of the two flaps that control blood flow into the mitral valve inside the left chamber of my heart was not closing properly.

That was causing about 50% of the blood being pumped out of my heart to flow back into the chamber, causing my heart to work harder. If left untreated, it could eventually lead to heart disease.

I was stunned. I had absolutely no symptoms. No shortness of breath. No chest pains. Nothing.

In fact, I felt great. I was exercising every day, including two-hour hikes on nearby Mount Diablo every Sunday.

Dr. Wulff ordered an echocardiogram to be done on, appropriately enough, Halloween. I got the results the next day, which happened to be my birthday. They were not encouraging.

The report stated that the left atrium in the upper chamber of my heart was severely increased. Dr. Wulff noted that this was probably due to the leaky mitral valve. The diagnosis was non-rheumatic mitral regurgitation.

Dr. Wulff said he wanted to monitor the situation and that all of this is fixable when it needs to be fixed.

Heart surgery for mitral valves is somewhat common and safe. However, my cardiologist noted that the operation is still open-heart surgery, and you dont want to do that until its necessary.

The following February, Dr. Wulff conducted a transesophageal echocardiogram, and nothing unexpected was found.

Life went on until the summer of 2024. Then, things shifted into a serious mode.

Dr. Wulff detected atrial fibrillation while listening to my heart. Another echocardiogram confirmed the AFib. My cardiologist said the condition had probably developed due to the enlargement of the upper left heart chamber.

It turned out the AFib was somewhat serious. It didnt produce any sudden rapid palpitations that a person would feel. However, the AFib was persistent. It was always there. My heart rate changed every three or four seconds. Over time, that puts quite a strain on the heart.

I was referred to Dr. Ramesh Veeragandham, one of the best cardiac surgeons around.

After some preliminary examinations, he and Dr. Wulff agreed I needed to have open-heart surgery. The kind where they slice into your chest, crack open your ribcage, stop your heart while a machine circulates blood around your body, then restart your heart, and finally stitch your chest back up.

Dr. Veeragandham would use tiny synthetic fibers to repair the mitral valve flap. He would then use whats known as a maze procedure to create scar tissue inside my heart to get rid of the AFib.

The surgery was scheduled for Nov. 15, two weeks after my 70th birthday. Preparing for open-heart surgery

Before I could go under the knife, I had to undergo a series of pre-surgery exams, from an ultrasound to a CT scan to blood work to an intensive catheter procedure into the heart.

I even had to have a tooth pulled because there was an infection. You cant have any infections anywhere for this surgery.

I was also put on the blood thinner Eliquis. There is always a danger of blood clots and stroke when you have AFib.

To say all this was daunting would be an understatement. If I had symptoms, it would have been easier to wrap my head around. But to need this lifesaving operation when I felt great? It was a lot to process.

I tried not to think about exactly what the surgeons would be doing inside my chest. I had to trust the fact that they do this all the time.

Still, I rode the traditional roller coaster of pre-surgery jitters. Some days, I was fine with it. On other days, my anxiety floated up to my throat. There were quick bursts of frustration and short bouts of apprehension, but keeping busy and taking some matters into my own hands helped.

I gave up alcohol on Oct. 1. I adopted a healthier diet. I also increased my daily exercise. I knew that a fitness program before surgery could help make your recovery a little easier.

During my two-month routine, I strengthened my core and lost 10 pounds, bringing my weight to its lowest level in nearly 20 years.

On the Tuesday before the surgery, my wife, Mary, and I met with the surgical team.

The session started with a hospital volunteer named Alan, who had undergone bypass surgery in 2006. He told me what to expect in the hospital and when I went home. His words were invaluable.

There was also blood work, a COVID-19 test, and a chest X-ray.

Then, a cardiac navigator named Jodie gave me homework to do over the next few days. This included strengthening my lungs with a plastic breathing cylinder, applying a topical ointment in my nose to kill any potential bacteria, following special shower instructions for Thursday night, and drinking a nutritional powder on the morning of the surgery.

She informed me the surgery would be 4 to 6 hours. The incision in my chest would be 10 inches long. Id be on a ventilator during the operation to help my lungs breathe.

She also precisely detailed how the 4 to 6-week recovery would play out: a slow, progressive exercise buildup with daily home checks on weight, temperature, and blood pressure.

The scenario was a bit overwhelming, but information is power. Plus, at this point, I just wanted to get the surgery over with. The operation had been dominating my thoughts for two months.

So, I told myself that on Friday, I was going to be part of an amazing adventure that not many people experience.

During the next few days, I prepared for this long rehabilitation by finishing chores I wouldnt be able to do for the next four weeks. They included retrieving the holiday decorations from the attic and digging up the summer garden.

When I could feel anxiety rising, I would tell myself: The surgery is not today. You dont have to worry about it right now.

For inspiration, I recalled Marys courage and resiliency during her one year of breast cancer treatment in 2018, which included chemotherapy, mastectomy surgery, and radiation. My ordeal was nothing compared to what she went through.

I also tried to be grateful that there was a one-tie surgery that could fix my problem. There arent any such procedures for Alzheimers, amyotrophic lateral sclerosis (ALS), or a host of other deadly diseases. Surgery day

On surgery day, Mary and I arrived at 5:30 a.m. at the John Muir Concord Medical Center. I was relatively and strangely calm in the morning darkness.

We went to the cardiovascular care wing. After the usual check-in and pre-op set-up, I was rolled into the operating room shortly before 7:30 a.m.

When the anesthesiologist put the mask over my mouth, I was relieved.

The next thing I remember was slowly becoming conscious in a room in the cardiac intensive care unit. I was drifting in and out of some heavy slumber. It felt like I was fighting against ocean waves.

Two nurses, Lindsey and Sophia, were at the foot of the bed, yelling encouragement. David, David! Stay awake! Deep breaths! Thanks to their loud pleadings, I regained consciousness.

I would learn over the next 36 hours that the nurses in the cardiac ICU are the absolute cream of the crop. Its obvious the medical center selects the best of the best to work in this all-important unit.

Once I was settled, I learned that Dr. Veeragandham had indeed repaired the mitral valve flap and had successfully built that maze wall to block the AFib.

However, when he was in there, Dr. Veeragandham also saw that a flap in the tricuspid valve was also broken, which he repaired. In addition, he noticed a tiny hole between two chambers in my heart. (Probably a birth defect.) He fixed that while he was there.

In the words of another surgeon at the medical center, the surgery had been extensive. The long road to recovery Share on Pinterest David Mills (center) walks down the hospital halls as part of his recovery program after open-heart surgery. Image Provided by David Mills

In the cardiac ICU, the recovery program began. The nurses keep an eye on everything from glucose levels to potassium to water weight to blood pressure to temperature to urine output.

Opioids were used to dull the pain from the incision on my chest, my broken sternum, and the drainage tubes in the middle of my abdomen.

I was also hooked up to so many machines that doing anything, in particular going to the bathroom, was a slow, painful chore.

Sleep did not come easy, either. Hospital beds are small and hard. Its also difficult to get comfortable when you are told not to shift too much. When you nod off, you are summarily awakened while a nurse checks one thing or another.

On the day after the surgery, I was able to walk to the end of the hall and back. The following day, I completed a loop around the cardiac care units.

With that, I was able to graduate to the progressive care unit next door.

When I landed there, I told the nurses I wanted to get off the hard-core opioids. I was concerned about the side effects, in particular, the horror stories I had heard about constipation caused by the strong pain medications.

I was put on a rotating schedule of Tylenol and a less harsh synthetic opioid. I was given one or the other every 3 hours. The plan seemed to work.

My walking increased. I was doing the cardiac unit loop three times a day. I looked forward to every one of these walks. I even cruised through the route without the assistance of a walker.

Mary came every day, and I received visits from my two daughters, both sons-in-law and two grandchildren.

Still, sleep deprivation made the days long and the nights longer, as did boredom. I could only read so much and do so many crossword puzzles. Mary and I started to watch old sitcoms such as Seinfeld and The Office on Comedy Central. That killed time, and it was so good to laugh. A new lease on life Share on Pinterest David Mills after undergoing extensive open-heart surgery. Image Provided by David Mills

Dr. Veeragandham informed me that the top half of my heart and the bottom half of my heart were both beating just fine. However, they could not synchronize properly. I wouldnt be able to leave the hospital until they did.

The solution was a pacemaker.

Dr. Anurag Gupta was called in. Hes considered the best around in this type of surgery.

The implantation of a pacemaker was scheduled for 2:30 p.m. that Thursday. The final piece of the puzzle.

Everything seemed to be in place. The finish line seemed near.

However, sleep deprivation and the series of disappointing reports I had received since the summer of 2023 took over.

Thoughts percolated in my mind as only they can when you are lying in a hospital bed at 4 a.m., exhausted with nothing else to think about.

What if the pacemaker didnt work? What if it couldnt get the two halves of my heart to synch? Would I be staying at the hospital indefinitely?

The doctors and nurses all assured me it would be fine. The pacemaker would work, they told me. It always does.

Thursday afternoon finally arrived, and I was wheeled into the operating room for the second time in six days.

The casual manner of the dedicated surgical team made me feel better. This isnt that big of a deal, I thought as the anesthesia took effect.

When I awoke, I was being transported to a recovery area next to the vast nurses station in the surgery center.

No one needed to confirm the surgerys success for me. I glanced up at the monitors and saw the two halves of my heart beating in a beautiful synchronized rhythm: beep-beep, beep-beep, beep-beep.

The team parked me in the recovery sector and went about their business. Dr. Gupta stopped by to tell me everything went well.

As I lay there, I realized what this meant. I could go home tomorrow. I could begin a 4-week recovery process in which I would get healthier and stronger every day.

A fitness routine that increased every week. A low sodium diet. A parade of pills to keep everything in check. Actual sleep in a big, soft bed. Visits from a home healthcare nurse and a physical therapist.

No driving for another three weeks. In fact, I needed to sit in the back seat of a car when I was being transported, mainly because the doctors didnt want an airbag hitting my chest. (Yeah, me neither.)

Mary told me she learned from her cancer treatment that you come out the other side with a different view of life. I could already see the visual outlook changing.

Itll be interesting to see how all this manifests in the weeks and months ahead.

Mary and I have a new lease on life together. She, the cancer survivor, and me, the heart surgery survivor.

All that, however, was ahead of me as I lay in that recovery area, just staring at the monitors. Beep, beep. Beep, beep. Beep, beep. Perfect harmony.

As I watched, tears began to leak from my eyes. I kept wiping them away. They wouldnt stop coming.

I mentioned the wave of emotion to one of the nurses as he began to unhook me from the various machines.

No shame in crying in this room, he said.

He was right. Tears of joy were absolutely appropriate right now.

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In Halifax’s night-time economy, no one is holding back over what is required in the budget

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In Halifax's night-time economy, no one is holding back over what is required in the budget

In the upstairs bar of a slick new brewery, the cheese-lovers of Halifax are paying “homage to fromage”.

It is one of the first events in the historic West Yorkshire town for the monthly cheese club and there is a decent turn-out.

Sky News visited Halifax's clubs, bars and restaurants to get an insight into people's priorities
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Sky News visited Halifax’s clubs, bars and restaurants to get an insight into people’s priorities

The night-time economy in Halifax is a useful measure of how the landscapes of our town and cities have changed
Image:
The night-time economy in Halifax is a useful measure of how the landscapes of our town and cities have changed

Discussion of Wednesday’s budget is not as popular as an accompaniment to the cheese as the selection of wines. But no one holds back on what is required of the chancellor.

Natalie Rogers, who runs her own small business with her partner, said there needs to be focus.

Small business owner Natalie Rogers wants to see more investment in local industries
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Small business owner Natalie Rogers wants to see more investment in local industries

“I think investing in small businesses, investing in these northern towns, where at one time we were making all the money for the country, can we not get back to that? We’re not investing in local industries.”

At the next table, with a group of friends, Ali Fletcher said there needs to be bigger targets.

“I think wealth inequality is a major problem. The divide is getting wider. For me, a wealth tax is absolutely critical. We need to address this question of ‘Is there any money left?’. There’s plenty of money, it’s all about choices that government make.”

More on Budget 2025

At this monthly cheese club, people told us about their priorities ahead of the budget
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At this monthly cheese club, people told us about their priorities ahead of the budget

The evening’s cheese tasting was being marshalled by Lisa Kempster. “The impression I get from talking to people is there’s a lot of uncertainty, but when you ask them what they’re uncertain about, they’re not really sure, there’s just a general feeling of uncertainty and being cautious.”

Ali Fletcher reckons wealth inequality is a major problem
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Ali Fletcher reckons wealth inequality is a major problem

Read more:
Budget will be big – and Starmer has some serious convincing to do
Reeves vows to ‘grip the cost of living’
What tax rises could chancellor announce?

This corner of Halifax, close to the town’s historic Piece Hall, is buzzing with clubs, bars and restaurants, trying hard to defy the crunch in the night-time economy. It is a useful measure of how the landscapes of our town and cities has changed.

“Whenever there’s a budget, for a few days afterwards, there’s a drop off in trade,” said Michael Ainsworth, owner of the Graystone Unity, a bar and music venue in the town.

“I accept the government needs to raise money but, in this day and age, there’s better ways to go about doing that, like closing tax loopholes for the huge businesses to operate up with banking arrangements outside the UK.”

Michael Ainsworth owns a bar and music venue and thinks the chancellor needs to close tax loopholes
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Michael Ainsworth owns a bar and music venue and thinks the chancellor needs to close tax loopholes

In the bar, a folk singer is going through a quirky and caustic set. In the basement, a punk band called Edward Molby is considerably louder.

On a sofa in the main bar, recent graduates Josh Kinsella and Ruby Firth, newly arrived in Halifax because of its more affordable housing, pinpoint what they want on Wednesday.

“Can we stop triple-locking the pensions, please? Stop giving pensioners everything. For God’s sake, I know they have hard times in the 70s and the 80s, but it just feels like we’re now paying for everyone else.”

Josh Kinsella and Ruby Firth feel there's too much focus on pensioners
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Josh Kinsella and Ruby Firth feel there’s too much focus on pensioners

Ben Randm is a familiar face at the bar and well known on the music scene with his band, Silver Tongued Rascals.

“Everyday people are seen as statistics, we’re always the afterthought. When the cuts are done, we’re always impeded and the ramifications that has for people’s livelihoods, for people’s mental health, for people’s passion and drive… it’s such a struggle.”

He, like many in the night-time economy sector, wants extra help for hospitality and venues that, he says, provide a vital community link.

Ben Randm who has his own band reckons everyday people are 'always the afterthought'
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Ben Randm who has his own band reckons everyday people are ‘always the afterthought’

David Van Gestel chose Halifax to open the third branch of MAMIL, a bar in jokey honour of those cycling “middle-aged men in Lycra”. On a busy quiz night, he said venues had to provide something different to get people out of their homes.

“I think the government needs to start putting some initiatives in place. They talk about growth but the reality is that the only thing we’re seeing grow is our costs.”

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TikTok boss insists teens’ safety not at risk from AI moderation

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TikTok boss insists teens' safety not at risk from AI moderation

There’s a lot going on at TikTok right now. 

As well as online safety updates and new features, the company is introducing sweeping changes to how it moderates the platform’s content.

At the same time, there’s an intense focus on online safety, particularly here in the UK.

With all that going on, Sky News got a rare, exclusive sit-down with one of TikTok’s senior safety executives, Ali Law.

The increasing role of artificial intelligence

One of the biggest changes happening at TikTok is around artificial intelligence.

Like most social media companies, TikTok has used AI to help moderate its platform for years – it is useful for sifting out content that obviously violates policies, and TikTok says it now removes around 85% of violative content without getting a human involved.

More on Artificial Intelligence

File pic: Reuters
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File pic: Reuters

Now, it is increasing its use of AI and will be relying less on human moderators. So what’s changed that means TikTok is confident AI can keep young users safe?

“One of the things that has changed is really the sophistication of those models,” said Mr Law, who is TikTok’s director of public policy and government affairs for northern Europe. He explained that AI is now better able to understand context.

“A great example is being able to identify a weapon.”

Whereas previous models may have been able to identify a knife, newer models can tell the difference between a knife being used in a cooking video and a knife in a graphic, violent encounter, according to Mr Law.

“We set a high benchmark when it comes to rolling out new moderation technology.

“In particular, we make sure that we satisfy ourselves that the output of existing moderation processes is either matched or exceeded by anything that we’re doing on a new basis.

“We also make sure the changes are introduced on a gradual basis with human oversight so that if there isn’t a level of delivery in line with what we expect, we can address that.”

Human moderator jobs being cut

That increasing use of AI means TikTok will rely less on its network of tens of thousands of human moderators around the world.

TikTok moderators and union workers protested outside the company's London headquarters over job cuts
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TikTok moderators and union workers protested outside the company’s London headquarters over job cuts

In London alone, the company is proposing to cut more than 400 moderator jobs, although there are reports a number of those jobs will be rehired in other countries.

On 30 October, Paul Nowak, general secretary of the TUC union, said “time and time again” TikTok had “failed to provide a good enough answer” about how the cuts would impact the safety of UK users.

Ali Law speaks to Sky News from TikTok's European headquarters in Dublin
Image:
Ali Law speaks to Sky News from TikTok’s European headquarters in Dublin

When Sky News asked if Mr Law could ensure UK users’ safety after the cuts, he said the company’s focus is “always on outcomes”.

“Our focus is on making sure the platform is as safe as possible.

“We will make deployments of the most advanced technology in order to achieve that, working with the many thousands of trust and safety professionals that we will have at TikTok around the world on an ongoing basis.”

Dame Chi Onwurah speaks at the House of Commons. File pic: Reuters
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Dame Chi Onwurah speaks at the House of Commons. File pic: Reuters

The UK’s science, technology and innovation committee, led by Labour MP Chi Onwurah, has issued a probe into the cuts, with Ms Onwurah calling them “deeply concerning”.

She said AI “just isn’t reliable or safe enough to take on work like this” and there was a “real risk” to UK users.

However, Mr Law said that, as a parent himself, he is “also highly concerned and highly interested in issues of online safety”.

“That’s why I’m so confident in the changes that we are making at TikTok in terms of content moderation as a whole,” he said.

“The power really comes in the combination of the best technology and human experts working together, and that still is the case at TikTok and it will be going forwards as well.”

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UK’s online safety rules: One month on

New wellness tools

The interview came at the end of an online safety event at TikTok’s Dublin office, its European headquarters.

During the conference, the company announced a number of new features designed to increase user safety, including a new in-app Time and Wellbeing hub for TikTok users.

The hub is designed with the Digital Wellness Lab at Boston Children’s Hospital and gamifies mindfulness techniques like affirmations, not using TikTok during the night and lowering your screentime.

Ali Law, TikTok's director of public policy and government affairs for northern Europe
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Ali Law, TikTok’s director of public policy and government affairs for northern Europe

Read more from Sky News:
Meta to block Instagram and Facebook for users under 16 in Australia
Half of novelists fear AI will replace them entirely, survey finds
How violent extremists are thriving online – and why it’s getting harder to catch them

Cori Stott, executive director of the digital wellness lab, said many people use their phones to “set their wellbeing, to reset their emotions, to find these safe spaces, and also to find entertainment”.

The hub was built as part of the TikTok app because young people want wellness tools “where they already are”, without needing to go to a different app, she said.

Still, there are plenty of reports suggesting that phone use and social media has a damaging effect on young people’s mental health… is TikTok trying to solve a problem of its own creation?

“If you are a teen on the app, you will load up and find that you have, if you’re under 16, a private profile, no access to direct messaging, a screen time limit set at an hour, [and at] 10pm sleep hour suggestion,” said Mr Law.

“So the experience is one that does try and promote a balanced approach to using the app and make sure that people have the options to set their own guardrails around this,” he said.

“I think the other thing I’d say is that the content on TikTok is, in the main, inspiring, surprising, creative.”

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£1,000 side-hustle rule explained – from Vinted to Xmas markets | Money newsletter

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£1,000 side-hustle rule explained - from Vinted to Xmas markets | Money newsletter

Sky News has launched a free Money newsletter – bringing the kind of content you enjoy in the Money blog directly to your inbox.

Each Friday, subscribers get exclusive money-saving tips and features from the team behind the award-winning Money blog, which is read by millions of Britons every month.

Sign up today, and this coming Friday you’ll find the following in the newsletter:

  • The tax rules for side hustles explained – from Vinted to Christmas markets;
  • Why Black Friday might not be the best time to buy a TV;
  • Early access to our weekly Money Problem feature – this week’s concerns a reader’s row with Asda about late deliveries;
  • And we outline the best deals available in five key areas for your household budget.

So join our growing Money community – and thanks to the thousands of you who already have.

What to expect each week

The newsletter is your essential personal finance companion, with digestible information to help you make smarter decisions on your savings, mortgages, holiday money and much more.

As a subscriber, you get additional exclusive content that goes beyond the blog.

At a time when the global economy faces so much uncertainty, we have analysis from our trusted economics teams on the big stories that affect the cash in your pocket.

You also get first looks at popular features such as Money Problem, Cheap Eats, What It’s Really Like To Be A and our weekend Long Read.

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