Tuesday, March 31, 2015

How My Heart Attack Saved My Life

There are strange days that can change everything. February 6, 2015, was that sort of day for me. I became a Medicare patient as of February 1. As they say, timing is everything and location is everything else. Both played major roles in the events that followed. This blog is based on notes I wrote in hospital, Feb 6-8. On February 5, I underwent my “Welcome to Medicare Fitness Examination .” I had been plagued by chest pains for over a year and a half. I was given a stress test to rule out my heart. Was in treatment for acid reflux disease and, recently, an ulcer. The reflux condition allegedly was giving me the heartburn I was experiencing. I was taking Nexium, watching my diet, and otherwise behaving relatively normally, but the episodes of heartburn continued. The dose was doubled. When I came in for a follow-up to get a new prescription for the Nexium, my care provider decided that this was too long a stretch, that the pain should have gone away. A blood test revealed I had an ulcer, and I underwent treatment for that with a course of antibiotics. The day I finished that course, I went in for the Medicare check-up. The night before the exam, I had a severe episode. It passed, and I attributed it to the chili I had for dinner. Except for the ulcer (under treatment), my right hip(arthritis), and poor eyesight (cataracts), she gave me a clean bill of health. The blood work revealed nothing alarming: my kidneys were in great shape, my liver normal, my cholesterol levels where they should be or better, my heart sound. She even ran an EKG that revealed nothing past or present, though she did wonder at my fixation with my heart. Given my family history and my anxiety, she was most pleased to once again rule out heart problems. It was a nice Friday. I worked at my job as janitor at Joe Blogz from four am until seven. Once home, Di and I had breakfast, watched the first twenty minutes of The Today Show to find out what didn’t happen in the world, and then attacked the backed-up DVR. MSMBC’s golden quartet – O’Donnell, Matthews, Hayes and Maddow – gave us better coverage with that liberal slant we both love so much. Then we watched Elementary and Backstrom. It was after twelve when Joop, our friend, called to tell us that the Chesapeake Bay crabs he had ordered had arrived, would we please come get it so Di could prepare it for Tuesday? After Backstrom, I got up, intending to go potty, get my shoes, and drive over to Joop’s to collect the crab. It was exactly one p.m. I went to the kitchen to bus a plate on my way, and to check the outside temperature to see what outer garment I might require. It was a balmy 51 degrees, downright hot for Montana standards in early February. Then the earthquake hit inside my chest. For want of a better metaphor, someone had placed a heavy box about the size of a small priority mail package inside my chest and then set it on fire. In the flames, my heart muscle began to constrict, to cramp, and pain radiated down my left arm from the elbow to my fingers and my right shoulder. I could breathe, but in desperate gasps because I could not get on top of the pain. It was like nothing I had experienced before. Still, I thought I could ride it out. I had gotten through fairly severe episodes before, and was able to control them through a change of position and controlled breathing. This one got away from me at the start as if I were a jockey thrown off his thoroughbred but with one foot still caught in the stirrups. Over the next five minutes I struggled to the bathroom, still in severe pain. When I finished I collapsed to the floor seeking the cool of the linoleum. I hollered for Diane, who came running. By now perhaps five minutes had passed and the pain was just as intense, and I began to feel like giving up – please let it end. It’s hard to judge time when you’re in pain. Di called 9-1-1. Even though we live in rural Montana, we have a fantastic Emergency Medical Technician unit just a few minutes away, just down the road. By now, ten minutes had passed. the pain now ebbed and crested like waves on a surfer’s paradise. But it did not stop. The EMT’s got there quickly. In all, fifteen minutes passed by the clock between the initial attack and the moment one EMT gave me nitroglycerine while assessing me. It took two nitro tablets, but then the pain was gone, completely gone. I was never so grateful in all my life. And the pain has not come back. Then the ambulance ride, more assessing, admission into the cardiac ward, tubes and drugs and blood draws and monitoring, and now I sit at 4 am, jotting all this down. Hard to believe 24 hours ago I was clocking in to work. More later: think I’ll catch some sleep. Angio tomorrow. It may as well be Anzio. I’m not being glib here. There is a real chance that the pain I have been dealing with for the past eighteen months will be vanquished from my body in the next eight hours. It turns out that esophageal issues and cardiac issues often mimic each other. What we thought was one thing, turned out to be the other. I had stress tests and EKG’s to rule out heart issues, but the issue hid. In my case the Lateral Anterior Descending artery, the LAD, was 95% blocked. They call that artery the widow maker because you essentially have to be in the middle of a crisis for it to reveal itself. Stress tests and EKGs and enzyme levels in blood tests tell nothing; in fact, the only difference between my blood work for the Medicare exam and after the attack was a spike in the cardiac enzyme troponin. I look healthy. I shovel snow and don’t get short of breath. I carry reasonably heavy loads. I can walk for miles and miles. I have maintained a reasonable weight for several years. My veins and arteries are virtual hoses by virtue of the fact that, as a mail man, I walked for a living. I am proof of, perhaps a poster boy for, the fact that this could happen to anyone. The angioplasty revealed that most of my vasculature is reasonably healthy for a man of 65. The one blocked artery required a substantially long stent to repair, but repaired it is. I am on a pill regimen designed to keep my blood pressure and heart rate low, as well as to allow my body to finish the repair without forming clots or attacking the foreign material. I began cardiac rehabilitation two weeks after the attack, along with my son’s father-in-law Frank. Frank had triple bypass in December. More than half my fellow patients in rehab have had open heart surgery. I was lucky. Now I can say I am healthy, except for the heart attack. And that issue was resolved. In a sense, I have won the lottery for a second time in my life (the first time is a completely different story). No cash but great value. If I had not had the heart attack when and where I did, I would still be suffering the same symptoms and probably, some even stranger night, I would have died. My heart attack literally saved my life.

Tuesday, March 24, 2015

Missing the Spark: distractions and inspirations

Missing the Spark I know I sometimes can be hard on myself. I think that’s true of everyone, at least everyone I know. We all have lists of things to do – some are kept in our heads, some, like mine, jotted down on paper, sheet after sheet in sub-divisions according to task and priority. My lists run like a budget ledger: when to pay this bill with that money; when to call the propane guy; when the next doctor appointment is scheduled; when, where and what to buy on payday. I have lists to tell me where my lists are. I also have notes. I have notes that are suggestions for plot lines or essay subjects. I have notes that are actually completed poems awaiting a rewrite with an editor’s view. I have lists to tell me what notes to prioritize, and how to go about it. I do refer to the notes and the lists on a daily basis. Right now, what I don’t have is a great deal of motivation. The spark is missing. I can accept that. I have been through quite a bit over the last two months, and the Muse has slipped quietly into the guest room, minding her own business. My calendar is filled with appointments and therapy sessions that rapidly eat up my day while I search for that elusive companion to the Muse – a solid block of time. I have gotten into the habit of watching the sometimes hilarious and sometimes depressing analysts for the day’s news stories, who serve as an illuminating distraction eagerly sought. The overwhelming desire to write, and writing is my life’s blood, seems to be on hold. I am not merely putting it off (procrastinating). I just don’t feel the spark. In the last two months I have composed half a dozen poems and a handful of blogs, and that’s it. Normally, I write every day and cannot stop myself. I carry a notebook with me just in case and invariably use it, even in the middle of a conversation. It can be annoying, really, to the other person. William Goldman once said that, if it’s going badly, you can be in the most idyllic, quiet, uninterrupted setting in the world and nothing will come; when it’s going well you can write in an elevator. I am on vacation. There’s not a single lift in sight. But I have hope. I hear the Muse stirring in the south forty, whistling softly as she makes her bed and prepares to lumber out for coffee. I keep waiting for her to finish what she is doing, and pay some attention to me. I know the world awaits. I know the world is a little busy at the moment, but she still must be eager to hear from me. I know the world has deadlines, and I work well under the pressure to produce. It’s just that the world has not specified what the deadlines are, and it keeps throwing me more curves and more distractions. Vera Brittain: profound. Doctor Who: when? Ted Cruz: really? Distractions abound, but now and then one becomes an inspiration to think, and then write. Coffee anyone?

Sunday, March 22, 2015

Old Eyes and New Vision: Vera Brittain

Philosophical Wax: In Vera’s Words This one will be brief. I am sitting at the table in my sunroom enjoying a beautiful spring day under Montana skies, relishing in the fact that my vision has improved markedly since my second cataract surgery last Wednesday. Coupled with my continuing recovery from stent surgery six weeks ago, I feel like a new man. And yet, I see like an old one, or, rather – hopefully – a wizened elder. This makes me look at the world in a peculiar way, noting the troubles that surround not me, but the younger people coming of age. Their world is much more rapid but equally dangerous to mine from the same age, and I naturally despair. I am reading a book that talks about this very thing, called Testament of Youth. It was written in 1933 by Vera Brittain. It is her words I wish to leave you with today: “I do not believe that a League of Nations, or a Kellogg Pact, or any Disarmament Conference, will ever rescue our poor remnant of civilisation (sic) from the threatening forces of destruction, until we can somehow impart to the rational process of constructive thought and experiment that element of sanctified loveliness which, like superb sunshine breaking through thunder-clouds, from time to time glorifies war.” Brittain was a convinced pacifist, and for good reason. She was writing her memoir between the two world wars. Her point remains true today: war is horrid and cruel and rarely fought for the reasons given to the fighters, but until the thrill and glory that war projects is shown and accepted to be false once and for all, it will come and young men and women will rush into its allure only to become disappointed or destroyed. We have not grown up; the greatest sadness in my life is knowing that truth.

Saturday, March 21, 2015

Allies and Rogues: Israel, Iran and US

I just got off the phone with my brother after a lively political discussion. He made a compelling point. He recalled that many people he knows have stated that Israel is our best ally in the Middle East. Thinking about that, he came to the conclusion that these well meaning people were incorrect, that in fact the reverse is the proper statement: the United States is Israel’s best friend. Consider: the US gives Israel $8.5 million dollars in military aid every day. The US has vetoed resolutions critical of Israeli actions 36 times since 1980 (eleven since 2001). We have been Israel’s staunchest defender since the country’s inception. This begs the question, how dare Netanyahu try to undercut negotiations between six western countries, including but not only the United States, and Iran, negotiations that are designed at least in part to enhance Israel’s protection? For that matter, how dare 47 Republican senators try overtly to undermine that same negotiation meant to make the region – and the world – a safer place? I keep asking myself, in what scenario is an Iran that is more closely monitored and included in the world of nations more dangerous than an Iran that remains “rogue?” The negotiations going on as we speak are not intended to solve all issues between Iran and the West. They are a step, a huge step if successful. They also are not plagued by myopic idealism. Iran, for example, would like to see sanctions removed upon their promise to commit to the terms; the six western powers will not remove sanctions until Iran shows physical compliance. If the negotiations break down, it will be over that sticking point – or should be. Yes, Iran’s leaders have said and done dangerous things in the past. So have we all. Do not forget the past but forgive it – and move toward the future with a wary but progressive eye. As a nation, we have done exactly this time and again. But the rhetoric coming out of Republican dominated Congress, as well as from the leader of Israel, sounds like war-mongering. If they want a holy war, let Netanyahu and his American senators be the ones to take up arms and put their own boots on the ground. Otherwise, why not give peace a chance? The alternative I see is a re-designation of who in the world are rogue states – America and Israel. I doubt anyone, especially the citizens of those two countries – want that.

Tuesday, March 17, 2015

Cataracts and the Vote

The world seems to be going on splendidly without me, for the moment. I have been unable and uninspired to write of late, although I have kept one watchful eye on the world’s events while the other eye heals. I had cataract surgery on the 11th on my right eye, and the healing process has been slow and a bit frustrating. Still, the eye gets better every day. Tomorrow I have the second eye done, and, given the experience of the past six days, I expect to be pretty much restricted visually for some time. So many kind people I know, who have had great success with this surgery, and who anticipate great things for me, neglected to inform me, or simply forgot after the fact, that the visual miracle might not be immediate. And, being both anxious and impatient by nature, I have been somewhat of a bear to be around for the past week – and not a hibernating one! So I anticipate that I will not be writing for a short while. The world will go on. Somehow. I do take solace that, even on the worst day of my visual life, I see more clearly than our current batch of Republican Senators. Surgery won’t help them. Surgical removal might help the country – i.e., VOTING. The American people have the opportunity to perform said surgery every two years, if they show up. To not vote is to be truly myopic.

Saturday, March 7, 2015

Recovery, Rehab, and Re-writes

Been a While -- I am sitting in my living room watching NCIS and resting up after carrying our Christmas decorations in their big plastic storage tubs to my outside shed. I worked for about an hour, first having to evict Jumpy the Squirrel from the warm, cozy shed – which meant shoveling out all the pine cones he managed to store in there over the last two months. I had evicted him before, several times, but he is stubborn and persistent. He is also angry with me: he squawked and squeaked at me while I was doing the deed, from the tree directly above the shed. Then, after I had come back inside, he stood on the railing just outside the front door like a soldier on guard. It has been a while since I have felt like sitting down to write. It has been four weeks and a day since my heart attack and resultant stent surgery, two since I began cardio therapy, an intensive personal training program at the Summit, prescribed by my cardiac doctor. On Wednesday I undergo cataract surgery on one eye, a week later on the other. In many ways, I have given myself up to my medical needs – for now. And though I often feel guilty for not working on the real work, I am enjoying the time. I call it recovery, though that sounds way too serious. When I see the other patients in the rehab program I realize how fortunate I am. For 65 years old, I am in pretty good shape and pretty strong to boot. Except, of course, for the heart attack and clogged artery. And, of course, the heart attack revealed the clogged artery, and that artery is no longer clogged. So, therefore, I am in pretty good health. The best part is the pain I experienced almost daily during the year and a half before the incident is gone. Now, that’s something to write about.