A Saga of the Golden Years

After some dental surgery and catching shingles and the pain of that—truly as all say the horrible pain like nothing else—and with her history of atrial fibrillation, Dee got so weak yesterday and her pulse was so thready that we decided to call 9-1-1 and have the paramedics take her to the hospital. I was impressed with the fast response. First the shorter firetruck came screaming down Lobdell and turned on to Sevenoaks, followed by the paramedics in their van, followed a bit later by a supervisor (or two, women) in their SUV. All the emergency personnel around the bed, Dee’s 145 heartbeats and then 80 and then 135 and then 150 was cause for real concern. Did an EKG and started an IV and finally lifted her from the bed to the gurney bottom bedsheet and all. She was scared, naturally, and not even necessary to say that. While I was changing shirts and getting my wallet and such so I could go in my car so I would have a ride home, I didn't realize they worked in the driveway in the paramedic van for a half hour to stabilize her heart before they ever started for the hospital. The paramedics and the supervisors in the SUV and me in Pearl Honda all left at the same time. 

From one in the afternoon and for the next eight hours, and since BR General is now a teaching hospital, we saw a total of nine doctors in various stages of being a doctor, from a whip-smart Chinese woman (Lin Wang) studying at Tulane to a supervising doctor of several other doctors. Throughout the day we began to realize how smart our dumbasses finally were since each told us how dangerous things were for a while with her heart. They even had a second IV in her arm in case , as one said, "things went south." Blood work, saline drip for hydration, potassium chloride drip, and finally after all the doctors had listened to the chain of events, dental surgery, shingles, heart I-got-ya-irregular-rhythm, one said with low sodium (strange) and extremely and dangerously low potassium it seemed to be the perfect storm of events. They couldn’t get her heart back in rhythm even after a dosage of her regular heart meds until they gave her a shot of something else that finally did the trick. I mean in five minutes her heart went from the 100's to 60 and the mid-50's, end of the marathon, you can stop running. Naturally with the slower pulse and the drips her color really improved quickly. We had great service until the late afternoon before the evening shift change. Heard they were three nurses short and it took until 9 p.m. for her to be taken to her room. Even as improved as she was she was still hurting from her bad back and the shingles pain and everything else, so when the ice pack leaked and wet her sheets and blankets, we tried not to complain too much since we were in the ER and surely some people were as troubled as Dee had been earlier and maybe some others also fighting to live.

For once we did the smart thing and didn't worry about calling the paramedics. Dee couldn't even get to the bathroom a few steps away without her heart racing and coming close to passing out. Both of us felt like we dodged a very large bullet. They kept her overnight for observation. Since she was stable and I had not eaten and the cats had been out all day and I had not had my heart meds yet, I came on home, exhausted from the emotion of it all.

Even though I have thousands of adventure stories that turned out badly and could advise what to avoid in life, I have limited my advice to three things: better save for your children’s education, better save as much as you can for retirement, and as imperfect as the people and procedures in health care may still be, don’t hesitate to seek care from someone who knows more than you do. My father died of a heart attack at age 58. At age 69, just some discomfort, I merrily drove myself to the hospital when I was having one. I was lucky. Despite hesitating for a few days with all the potentially deadly signs so visible, Dee was also lucky yesterday. And by loving extension, me also.

Heart Attack Friday

One year ago today . . .

After my father died of a heart attack at the age of 58, I had experienced sympathetic chest pains for months after the funeral. Despite being profoundly scared standing next to my father’s bed, knowing from that experience the symptoms of a failing heart, when my turn came over forty years later, I was not surprised I waited almost a full day before driving myself to the hospital, something the experts say you should never do. Famous last words in many cases, I guess, but the pain was hardly severe, not at all like the pain radiating across my father’s back that had made him sick to his stomach. What I thought while driving to the hospital—stopping at every red light—was getting a cure for the annoying discomfort before the weekend. I had books to read and writing to be done.

It began Thursday evening with discomfort behind the sternum, from stress I thought from financial concerns in retirement and because my wife was ill. Took aspirin and meds for my arthritis and went to bed. Awoke at 4:30 Friday morning—long before daylight—with the same discomfort and knew that was unusual but went back to sleep for a while, always the best way to escape concerns, or the best way to die for that matter, as several people I knew had done, to sleep, perchance to dream before sudden painless nothingness. Inclined as most men are when it comes to doctors and hospital, I put off doing anything, always aware of the discomfort and now some pain on the back of my left bicep—something felt plenty of times from arthritic pain in that shoulder. For short periods of time, the discomfort and bicep pain were joined by slight pain along the jawline and all were with me until early afternoon Friday.

Getting admitted to the emergency room was rapid, dizzying. It became the beginning of the story of how to avoid paperwork and waiting in a room full of sick people. I told the ladies through the round hole in the glass, I know this may sound dramatic, but I need to see if I’m having a heart attack. From the moment of uttering those words until I was on the gurney in an operating room, naked except for a gown, shivering because it was so cold in the room until one of the men put a warmed blanket on me, in that span of an early quick EKG and an emergency room doctor asking if I knew I was in atrial fibrillation and had high blood pressure (no to the first, never ever had the second), from the moment of being on a gurney and racing down a hall while talking on a cell phone to Dee who was too sick to come to the hospital and telling her I was headed to the cath lab, from being amid a gathering heart team and after the cardiologist introducing himself and me sort of echoing my father by asking if the doctor was any good, from that first utterance about checking to see if I was having a heart attack to having a line installed from groin to heart along mysterious pathways and three stents installed in an artery with 99% blockage, in that time, thank you, thank you, thank you, far less than one hour had raced by.

I was never in a great deal of pain, feeling only flushed warmth during the procedure. There was some pain from two IVs, some slight pain from the shaved pubic start of the pathway to the heart. The endless blood gathering always hurt and bruised, but the most pain came from countless sticky contact pads for always awkward and tangled lifelines connected to them. Despite shaving various hairy areas, the worst pain was the removal of two hand-sized sticky pads stuck to chest and all the hairs upon it in case my heart needed some shock therapy. After just one firmly fixed pad was yanked off I was ready to confess all the bad things I had ever done.

There is always a value to serious illness. After my daughter’s battle with encephalitis, it was learning not to sweat the countless and ultimately meaningless small stuff that makes up so much of life. Her illness also brought an appreciation of living in the moment. True of all serious illness, I guess. But I learned something entirely different from having a heart attack.

Dreading it despite knowing it is mostly an infinitesimal part of living, I have always been afraid of the actual act of dying since I was old enough to understand the process. Somehow, lying there on the table before snaking a line up to my heart and installing three stents to save my life, despite knowing I could go into a full-blown attack and die, I felt no great fear, and part of that may have been the speed of the process from when I first spoke to the lady at the ER window. It was a feeling that one of the shoes had dropped, that finally the end process had become visible. Not that I wanted it or welcomed it, but it was a dance with the actual end game that binds all humans most strongly to each other.

I am not sure what the lack of fear during that dance with mortality meant ultimately. Maybe I became a slightly better person. Wife and children would have welcomed that early on. Maybe I appreciated even more the time I had left, a grand gift, enjoying family and watching granddaughters grow into beautifully brilliant young women. But other nagging fears crept in, no doubt to balance my earlier lack of fear when I was having the heart attack, small daily concerns: the blood thinner that immediately created problems; being told not to miss taking another drug because I now had foreign bodies in my artery and the body loves to clot around anything not its own.

Lovely.

A half-century after my father died from his heart attack, two decades after Jennifer’s illness, I was just glad there was another lesson learned from my illness: sometimes you do have to sweat some of the small stuff because some of it can kill you.

 

Heart Attack Friday

   According to one of the cardiologists, I had a “big” heart attack on Friday. It actually began Thursday evening with discomfort behind the sternum, from stress I thought from financial concerns in retirement and because my wife was ill. Took aspirin and meds for my arthritis and went to bed. Awoke at 4:30 Friday morning with the same discomfort and knew that was unusual but went back to sleep for a while, always the best way to escape. Inclined as most are when it comes to doctors and hospital, I put off doing anything, aware of the discomfort and now some pain on the back of my left bicep—something felt plenty of times from arthritic pain in that shoulder. For short periods of time, the discomfort and bicep pain were joined by slight pain along the jawline and all three were with me until early afternoon Friday.

   My father died over forty years ago of a heart attack at the age of 58, and I had experienced sympathetic chest pains for months after the funeral. Despite being profoundly scared and knowing from that experience the symptoms of a failing heart, I was still surprised I so willingly drove myself to the hospital. The pain was hardly severe, not at all like the pain radiating across my father’s back that had made him sick to his stomach. What I was thinking in going to the hospital was not being in annoying discomfort for the weekend. I had books to read and writing to be done.

   If you ever want to immediately get admitted to the emergency room, do as I did. Tell them, “I know this may sound dramatic, but I need to see if I’m having a heart attack.” From the moment of uttering those words until I was on the gurney in an operating room, naked except for a gown until one of the men put a warmed blanket on me, in that span of an early quick EKG and a doctor asking if I knew I was in atrial fibrillation and had high blood pressure (no to the first, never ever had the second), from the moment of being on a gurney amid a gathering heart team and racing down a hall, from that first utterance about checking to see if I was having a heart attack to having a line installed from groin to heart along mysterious pathways and three stents installed in an artery with 99% blockage, in that time, maybe, maybe, maybe far less than one hour had raced by.

   I was never in a great deal of pain, feeling only flushed warmth during the procedure. There was some pain from two IVs, some slight pain from the shaved pubic start of the pathway to the heart. The endless blood gathering always hurt and bruised, but the most pain came from countless sticky contact pads for always awkward and tangled lifelines connected to them. Despite shaving various hairy areas, the worst pain was the removal of two hand-sized sticky pads stuck to chest and all the hairs upon it in case I needed some shock therapy other than to the head. After just one was yanked off I was ready to confess all the bad things I had ever done.

   I believe there is always a value to serious illness. After my daughter’s almost deadly battle with encephalitis, it was learning not to sweat the countless and ultimately meaningless small stuff that makes up so much of life. Her illness also brought an appreciation of living in the moment. True of all serious illness, I guess. But I learned something entirely different from having a heart attack.

   Dreading it despite knowing it is mostly an infinitesimal part of living, I have always been afraid of the actual act of dying since I was old enough to understand the process. Somehow, lying there on the table before snaking a line up to my heart and installing three stents to save my life, despite knowing I could go into a full-flown attack and die, I felt no great fear, and part of that may have been the speed of the process from when I first spoke to the lady at the ER window. It was a feeling that one of the shoes had dropped, that finally the end process had become visible. Not that I wanted it or welcomed it, but it was a dance with the actual end game that binds all humans most strongly to each other.

   I am not sure what the lack of fear during that dance with mortality means ultimately. Maybe I’ll be a better person. Wife and children would have welcomed that early on. If it means I’ll appreciate even more the time I have left, that will be grand. I will enjoy my family and watching my granddaughters grow into beautifully brilliant young women. So far though other fears are creeping in, no doubt to balance my earlier lack of fear when I was having the heart attack, small daily concerns now: the blood thinner that has created problems already; no leafy greens in the diet because they cancel out another medicine; and being told not to miss taking another drug because I now have foreign bodies in my artery and the body loves to clot around anything not its own. Perhaps another lesson for me from my illness: sometimes you do have to sweat the small stuff.

  Lovely.

  I’m just glad I’m still in the classroom.