How You Doing?

It's a question that I've been hearing a lot from my friends, so I thought I'd write about it here.

My health? -- it's good.

 

I'm coming along as I'm supposed to according to all the current tests. My post-op stress test showed that there were no loose wires in my chest and nothing was bleeding, and my recent cholesterol test was excellent. My numbers, generally very good, were even better, due in part, I'm sure, to the medicine I'm taking and the fact that I'm eating two handfuls of almonds a day (you be sure to eat yours too!). My twice daily blood glucose tests also are generally good, coming in at about 110. (They should be a little better of course--around 90. I think the docs are telling me I have type 2 diabetes.)

And I'm getting around pretty well. I finished up my 8 weeks of cardiac rehab without much trouble. In fact, I was doing less rehab (aerobic exercise and weight training) on the days when I had to attend cardiac rehab than on the days when I just stayed home and exercised on my own. I do aerobic nordic tracking for about 50 minutes a day, and I lift weights and stretch for 30 minutes/day. This is about where I was before my troubles started.

But being a post-open heart surgery patient is in a lot of ways a real drag.

Even though I feel good most of the time (just a few aches when I'm lying down or sleeping or stretching), there are so many things I can't do.

--I can't go out and walk around when it's over 80 degrees (and it's been in the high 90s for the last two months).
--I can't lift my granddaughter because she weighs over 25 pounds.
--I can't mow the lawn (hmm, that's really not so bad).
--I can't drink more than a glass of wine a night.
--I can't drink carbonated drinks (soda and beer).
--I can't drink anything caffeinated (trust me, it's hard to write when I'm not drinking coffee).
--I can't eat my favorite sourdough pretzels, and in general I have to watch everything I eat: the carbs, the sugars, the salts.

Some of these restrictions will probably fall away after my next stress test (August 10), but some I'm afraid are going to follow me around for a long time to come.

But there is good news too.

--My cardiologist said I can fly to Las Vegas.
--We're going tomorrow--July 24.
--There are no restrictions on my gambling.

I'll let you know how that goes.

__________________

If you want to read about my Heart Attack Cruise again, it's still here.

Heart Attack Update: Riding the Iron Rooster

I was great yesterday--I walked around the house 3 times for about 6 minutes each time, did these breathing exercises on the hour like I was supposed to, took it easy all day watching the food channel and poker on TV, but the night was terrible.

I couldn't sleep and there was a lots of pain. I gave up around 3 am and took some oxycodone and started reading Paul Theroux's Riding the Iron Rooster, a book about traveling through China by train in the 1980s.

Theroux is always wonderful. Especially after open heart surgery. There's something about his prose rhythms and the rhythm of the train trips he's describing that inscribes itself on your heart rhythms, no matter how wild and vacillicious they are. And there's wisdom there too.

Here's what he says about traveling to China by railroad:

"Sometimes it seemed like real travel, full of those peculiar discoveries and satisfactions. But more often it was as if I had lost my footing in London and had fallen down a long flight of stairs, perhaps one of those endless staircases designed by a surrealist painter, and down I went, bump-bump-bump, and across the landing, and down again, bump-bump-bump, until I had fallen halfway around the world."

Theroux could be talking about the heart attack I had or didn't have on the ship and the world it opened me up to.

I read Riding the Iron Rooster till about 7 when it was time for my first 10 pills of the day. They almost knocked me out. I started sweating and couldn't stop. Linda helped me to the couch. I lay there for an hour till I stopped sweating finally.

Heart Attack Cruise: Update

That's the EKG I got two weeks ago on the cruise ship showing the rhythms of my wayward heart. Since then, I’ve been grading papers for my online course and seeing the cardiologist.

Let me tell you, the former is less stressful than the latter.

Last week, Thursday, 8 days after my heart attack, I went to see the cardiologist my doctor here in Danville, Virginia, recommended. He looked at the EKG tests and blood word and cardiac enzyme counts I brought in and decided I hadn’t had a heart attack.

He felt that the elevated cardiac enzymes I was showing weren’t the significant ones.

This good news was immediately followed by the bad. My heart has some kind of arrhythmia that needs medication and further testing. He told me to start taking 10 milligrams of Coreg CR daily. He even gave me three weeks worth of free samples. I was feeling good about this guy.

We also set up a nuclear stress test and echocardiogram for this week Tuesday.

I was looking forward to the stress test.

I hadn’t had any exercise or even strenuous walking since my attack, and I was hoping that this would be a good workout. I dressed in some exercise shorts, T-shirt, and running shoes and was ready for anything.

First they gave me an echocardiogram (like a sonogram), and then they injected some kind of radioactive mineral into my blood stream. After waiting for a while to make sure it was moving around in my heart, they set me up on the treadmill.

I typically do about 45 minutes of aerobic exercise each day and expected this to be a piece of cake.

It was. It took me about 9 minutes to get my heart to the target rate (135 beats a minute), and I was feeling pretty good. Then,the nurse put a stop to the whole thing.

She had been monitoring my blood pressure, and she thought it was way too high, 190/100. My resting bp is about typically 120/60, and 190//100 was -- to use her word -- abnormal. She slowed the threadmill and asked me to take a seat until my blood pressure went down. It did, but very slowly, too slowly. This worried her too.

When the cardiologist stopped by and saw the blood pressure numbers, he reacted the way the nurse reacted. He immediately raised the Coreg CR dosage to 40 milligrams a day. A week ago I wasn't taking any meds, and suddenly I was doing mega-doses.

Although my blood pressure was high, I didn’t feel woozy, wonky, or dizzy. I did feel a little winded, but I figured that was because I hadn’t exercised in two weeks, and after all, the stress test had me marching up a 14 degree grade for 9 minutes.

Yesterday, Wednesday, the nurse called me with the results of the various tests. The good news was that I survived. Pretty much everything else was bad news. The cardiologist suspects I have a couple leaky heart valves and two blocked arteries. The valves aren’t a big deal, he said, but I needed to get the blocked arteries fixed.

He recommended he do a cardiac catheterization. That’s where he introduces a thin tube into one of my veins and works it up to my heart. He said that this would let him see how much blockage was in the arteries and whether I would need a stent or a by-pass.

At this point, I’m wondering “what’s going on?!?” Two weeks ago, I was living my normal life, exercising without a problem, eating peanuts and oranges (my favorite vegetarian foods), and now I’m listening to this cardiologist who I don’t know from Adam telling me I might need by-pass surgery and that, although he doesn’t do surgery, he could hook me up with somebody who’s really good.

Linda is of course going crazy, but I’m too drugged to notice.


PS--Linda just asked me to mention that the cardiologist wanted me to have the catheterization this coming Tuesday, but I told him that I couldn't because we're going to Las Vegas for a week with her parents Tony and Mabel. He shook his head and thought for a minute and said we could do it the following week.

I said, "Great."

Then he asked, "Didn't you have your last cardiac event on vacation?"

Heart Attack Cruise

“This is not a Death Certificate”

That’s what it said at the top of the Guest Removal Form I was filling out in the infirmary of the cruise ship the Independence of the Sea. The nurse gave me the sheet and asked me to sign it. I was about to when I suddenly saw that statement about how the form wasn’t a Death Certificate. That gave me pause.

I started reading through the form more carefully at that point. On the first side, there wasn’t much that you wouldn’t expect. The infirmary and the cruise line wanted my name and address and such, and I was prepared to fill that in. I had agreed to leave the ship to see a cardiologist in Lisbon, and that was the kind of information I knew the cruise line would need.

I needed to see a cardiologist because just the day before after walking on the ship's jogging track for about 30 minutes something weird happened. When I got down to my cabin to take a shower, I suddenly started sweating. I didn't know where that was coming from. The walking I did on the jogging track was pretty mild, and I hadn’t been sweating earlier when I was walking on the track. There was a pretty strong wind the ship was moving into and it whisked the sweat off me. Plus I was wearing my new micro-fiber hat and t-shirt and shorts and they all promised me that if I bought them I wouldn’t sweat and if I did I wouldn’t feel it.

But there I was in my cabin sweating.

I was waiting for Linda to get back from the fitness center, and I knew I had to stop sweating before she got back and we went off for breakfast. So I figured I would walk onto the balcony and cool off. It was always cool there, getting plenty of that wind that the ship was heading into, and I stepped outside and tried to dry myself off, but I just started sweating more and more, and I realized I was having trouble breathing so I sat down, but that just made my breathing harder and the sweat pour out of me faster.

Then I went into the shower and turned on the cold water, but that didn’t do any good. I was still sweating like an Arkansas hog.

I’d been sweating and having trouble breathing for ten minutes, and suddenly I noticed that my heart was beating at a clip. I jumped out of the shower and grabbed my wristwatch and tried to time my pulse.

But I couldn’t keep track of the beats because I couldn’t count that fast.

Listen, you know you’re in trouble when you can’t time your pulse because the beats are coming too fast. As soon as you try to count 100 beats, you know you're missing dozens of other beats. Nobody can count that fast.

I knew I couldn’t get to the infirmary on the first deck without Linda, so I sat down naked in the middle of our cabin and waited.

Thank God, she didn’t stop to gamble in the casino.

She saw me there sitting on the chair, sweating, naked, and she said, “What’s wrong.”

I said, “I think I’m sick.”

She called the infirmary and told them we were coming down.

I threw on my t-shirt and shorts and started walking down the corridor to the elevators. Linda said, “You don’t have your shoes.”

I didn’t go back to get them. I just kept walking.

We got to the infirmary and the place was packed, but the nurse looked at me and told me to sit down and took my pulse and then helped me to the emergency room. The doctor came in, and she took my pulse too and couldn’t believe it.

It was 207.


They gave me a shot of something to regulate my heart because it was – according to the doctor who was making these motions with her hand – contracting like a crazy octopus when it should be contracting like a languid jellyfish.

The injection was amazing. As soon as the doctor shot it in my vein, she asked me how I felt, and I paused my shaking and beating and sweating to see how I felt, and it was like I could feel whatever it was that she gave me moving through my body like a slow stream, up from the vein in my arm, across my chest to my heart and up my shoulder, and up and over my neck to my lips and eyes and brain. A slow steady rising stream of ease that calmed down all that bounding my heart was doing.

After that, for the next 6 hours they ran tests and had me resting between them, and what they found was that I had had a cardiac arrhythmia with an atrial fibrillation and elevated levels of cardiac enzymes.

After the tests, they told me that I had had a heart attack and that I should definitely see a cardiologist at the next port, Lisbon.

As you can imagine, I thought that was a good idea, and the next morning, Linda and I were in the infirmary, and I was filling out the necessary paperwork for leaving the ship so I could see the cardiologist.

That’s when I was stopped by that phrase “This is not a Death Certificate” on the top of the page, and I started to read the form carefully.

The second page made it clear that if I filled out the form and left the ship it was possible that I might never be able to get back on it. The cardiologist in Lisbon could declare me unfit to travel if he thought I was too weak. In which case, I was stuck in Lisbon.

I didn’t want to be stuck in Lisbon, and I didn’t want to hassle with the rigmarole of trying to find a way out of Lisbon when most of the flights in Europe had been cancelled because of that volcano erupting in Iceland, and ultimately I didn’t want to die in Lisbon.

For that matter, I didn’t want to die anywhere. Death was not something I wanted to be seeing in my future. Three of my friends had died in the previous month, and I didn’t want to die. I had this crazy idea that if I could stay on the cruise ship I would be healthy and swell and the atrial fibrillations would never come back.

I figured that not filling out the form that said “This is not a Death Certificate” and not leaving the ship to see the cardiologist was the best way to go, and I told the nurse that. She was a very nice person, from the Philippines, and had been with me throughout my tests, and when I told her that I wasn’t going to see the cardiologist she said in her Spanish accent, “You must see the cardiologist. I know how you were when you came in. It was bad. You weren’t like this, standing and breathing like a living man. I see you now and you think you are better, but when I saw you then you were very bad, and I feel you still are.”

I said, “I don’t want to leave the ship.”

“I can’t tell you what do to, but if I were you and had been that sick, I would leave this ship, see the cardiologist.”

I said it again. “I don’t want to leave the ship.”

She said, “I see.”

I smiled and shook her hand and said, “I hope I don’t see you again.”

She shook her head and said, “And so do I.”


___________

PS--Linda took all three photos. The last two are of sculptures in Vigo, Spain, two days after my heart attack.

In the last one, I'm sitting next to a statue of one of my boyhood idols Jules Verne.
Like me, he visited Vigo once.

PPS--I'm seeing my doctor tomorrow and the cardiologist on Thursday.