Night of the Widowmaker, ten years on

Ten years ago on these pages, I regaled my readers with stories of my heart attack. It was an exciting misadventure. Nobody in my family had heart issues and neither did I. I was struck down in the middle of a working day. The scientific name for my affliction is anterior ST-segment elevation myocardial infarction or STEMI. It’s commonly known as “The Widowmaker.”

I didn’t hear the term from a cardiologist until I was recovering in my hospital room. Such finality. It seemed so 19th century. "Night of the Widowmaker" could easily be the title of a thriller novel. Its shock value was too tempting for a storyteller to ignore. I used it hundreds of times in place of heart attack. When I took the time to describe it in detail, tossing in an encyclopedia of medical terms, I could see my listener’s attention begin to wane. Simply described, the left anterior descending (LAD) artery gets blocked by a clot or plaque and the heart reacts.

The signs are there should you pay attention. Chest pain, shortness of breath, excessive sweating, jaw pain. Mine was a belly ache. Since it happened during norovirus season, I figured I was getting ready to blow chunks and/or get the runs. I got neither. It was Dec, 17, 2012, and the eve of my birthday number 62. I might have to lay off the cake and ice cream. I was off work for two weeks so I could lie around and see what happened. After a week, I went to my GP and he thought I might have pneumonia so sent me for an X-ray. He had a perfectly good EKG machine out in the hall but that never entered into the conversation. The X-ray showed congestion and the doc prescribed an antibiotic and bed rest.

On Jan. 2, I headed to work but only made it as far as my front door. I couldn’t open it. I called my wife. She decided to come home and take me to the ER. When she arrived, she saw I was in pain so called 911. The EMTs got there quick, took my vitals, and said I was having heart failure. They bundled me onto a gurney and sped, sirens blaring, to the hospital. Tests and X-rays showed the heart attack and also congestive heart failure. Dr. Khan wanted to get me to surgery right away but held off because I couldn’t breathe. So he stashed me on the telemetry floor and prescribed Lasik to rid my body of fluids. The next day, I had an oblation which opened the LAD and I began to recover.

Then I started telling my story. My heart, left to its own devices for two weeks, lost some of its pumping power. They filled me full of drugs, sent me home with orders for several rounds of cardiotherapy. Six months later, I got the bad news that my heart had only partially recovered and that I was a prime candidate for Catastrophic heart failure. To avoid further drama, I needed an Implantable Cardioverter Defibrillator or ICD. So I got one. Its battery eventually ran down, so this last Thursday, I got a new one.

The ICD lasts from 7-10 years. I pushed mine to the end so Medicare and my insurance company would agree to foot the bill. Medicare reimbursement for an ICD is 23 thousand and change. That doesn’t include hospital and physician and other associated fees. That will quickly eat up my deductible so my out-of-pocket costs will be manageable.

Someone with a heart condition shouldn’t have to worry about affordability. Someone with breast cancer – my wife – shouldn’t have to worry about treatment costs. My son and daughter, both with mental health and medical needs, shouldn’t have to up their angst to find affordable treatments. Alas, that’s where we are in 2023 in the United States of America.

Next time, I'll explore the status of my heart ten years on.

For some of my ruminations on the widowmaker, put "heart" in the blog's search bar.

Do odd things happen to writers, or are writers just odd?

A question for my writer friends: Do odd things happen to you, or are you the odd thing?

The answer is important. The world is odd, filled with strange happenings that call out to be translated into poems and stories. But I may be the odd one for noticing and then spending hours/days/months on writing a story to make some sense of this odd occurrence. Maybe it doesn't have to make sense, it just has to be entertaining or thought-provoking. It may never be published, never. read by more than a few blog fans. 

To get on with the story...

I had a weird experience Tuesday at a Colorado hospital that will remain nameless. I was the subject of a Cervical CT Myelogram procedure. The docs and nurses in Radiology were supposed to start in on me at 1 p.m.. And then it was 2 and then 3. Finally, the head tech explained to me that the computer had hijacked the hospital. It mistakenly booked me in the fancy Radiology room next door and wouldn't acknowledge that I was waiting in the plain vanilla Radiology Room. I said why don't you put me in the fancy room. He said it was expensive, only used for the difficult cases. I was glad that I wasn't a difficult case. 

The IT guys stormed the premises. They were not like the "IT Crowd" technos who told frantic operators this: "Have you tried turning off  the computer ans turning it back on?" They came to rescue. The problem seemed to be a tough one. The IT guys figured out they had to discharge me from the hospital and admit me all over again, trick the computer into thinking I was a new patient suited only for the cheap room. 

They did that and thought they had it licked when the computer changed its mind and put me back in the fancy room. There must have been ten people in the room, some working frantically on the computer, others preparing the room for the medical procedure that was sure to start any time now. I talked about books with a nice nurse who was writing a children's book in her spare time. Earlier, as she checked me in, she found out I was a writer and said that she thought that I looked like the creative type. I was flattered, as people usually think I look like Colonel Sanders. 

After two hours, they tricked the computer for good and the Radiology team jumped into action. The doc pumped me full of contrast, which one of the techs described as a "sticky oil" which, when scanned, highlights the details of my cervical spine. Once they pumped me full of sticky oil, one of the techs got on with tilting me at various angles on the table while another tech shot images on the scope. They tilted me head first and then prone. They tilted me forward for a second time to make sure the contrast reached into the furthest reaches of my upper vertebrae. I didn't object. I only wanted to do this once. They took some other pictures with me on each side and one of my neck and shoulders. Satisfied, they sent me over to the CT room where another tech scanned me. 

When I got back to the recovery room, a new nurse turned on her computer and looked for my chart. "You don't exist," she said. 

Odd, but I was lying right there. A few minutes later she found me.

"Looks like the computer discharged you" 

Of course. 

The nurse got me readmitted and discharged me again, because that was part of her job. 

As my wife Chris drove me back to Cheyenne, a few things occurred to me. It wasn't a bad way to spend five hours. It was 95 hot degrees outside, cool inside. Chris had taken the day off so we spent some quality time together. The staff was kind and patient. It made me wonder if they were this nice to all patients. The nurses admitted that many who come through their doors are very sick and usually older than me. Some of the procedures involve a lot of physical pain. Pain, as always, turns your attention inward and you are not always aware of others feelings. Me, well, I was in a little bit of pain but didn't want to be a pain. So, after lying around two hours waiting for the multimillion-dollar computer system to recognize me, I decided that resistance was futile. I could have told them to forget it and make me another appointment. But I didn't want to come back another day.  

It was very entertaining. The staff gave me a handful of cafeteria food coupons to make up for the delays. I hope I'm not back at that hospital any time soon, not even for chicken-fried steak night.

Happy Cheyenne Bike Week

Me and my Peugeot, back in the day. Bob Page photo.

Happy Cheyenne Bike Week.

That's "bike" as in bicycle. Bike Week as in Harley Vroom Vroom is a totally different animal (see Sturgis or Daytona).

Bicycle Week celebrates two-wheeled people-powered transportation. Sometimes it can involve three wheels, as you see in recumbent bikes for us oldsters with bad and/or replaced knees. Kids sometimes navigate the greenway on their trikes or on training-wheel-assisted bikes. That actually makes four wheels. But you get my point.

I once was a knowledgeable cyclist, riding all the time and aware of all of the makes and models and gadgets.

No more. Arthritic knees did me in. Waited too long to get them replaced and the orthopedic doc had one heck of a time making me new again. My first new knee is not so new now, replaced in April of 2015. The second knee was replaced in February of this year. For that knee, I just finished rehab. I was supposed to be finished a monthly ago but my doc decided I needed more time with the good and caring people at rehab. Their motto: "It's supposed to hurt."

Enjoyed listening to NPR's "Here and Now" report on Monday on knee replacements. One thing brought up several times was the crucial nature of rehab. You are moving that knee before the anesthesia wears off. Actually, a continuous passive motion (CPM) machine is doing the bending for you. Up, down, up, down, up, down. Mesmerizing to watch. Teaming up with the machine are strolls around the hospital and then around your house, usually with the help of a walker or cane. A week after surgery, you are off to rehab. Someone else drives, as you can't use your right leg and your brain is scrambled with Percocet. Once there, the dedicated therapists get you to bend your knee in uncomfortable ways. You occasionally hear blood-curdling screams. Some of them are yours.

Back to bikes. Thee only bike you rise during your recovery is the recumbent bike in rehab. You may want to get back on the ten-speed or mountain bike and ride to Chugwater. But that would hurt too much. And you are still on drugs, which they don't cotton to in Chug.

I may never ride a bike to work again. First of all, I'm retired. Second, my bike needs some serious work, or I need to replace it with a 21st century super-bike that costs more than my monthly mortgage payment. One bike I looked at online today has the following attributes:

New frame with updated commuter friendly geometry

Carbon fork makes the bike lighter & reduces some of the vibrations for a smoother ride

Shimano Alfine i8 internal gear hub

Shimano hydraulic disc brakes

Gates belt drive

It is beginning to sound a bit like a $20,000 Harley, although the list of goodies would be much longer. Suffice to say, this $1,100 "Raleigh i8 Flat Bar Road Bike is the apex of the Cadent line of bikes." The apex of the Cadent? It must be good. And pretty typical of the type of bike I want.

But there's a third thing that may prevent my return to cycling. Fear. Ever had a bike wreck? I've had several. No broken bones but plenty of lacerations. In my later years, I wore a helmet now and ride mainly on the greenway. My new bike undoubtedly will be street legal and I will obey all laws, which is what retirees pledge to do when presented with their Medicare card. But a spill may wreck my knees and I am not ready to face that pain again. NPR's report said it straight -- the pain is substantial and takes time to heal. Interviewees said they knew people who took their new knees back to the jogging trail and tennis court. The producer they interviewed said it took him a year to get to the almost-pain-free stage. I am not there yet. When I reach that apex, I expect it to be all downhill from there. That used to be my favorite part, flying down hills and mountain passses. But dangers awaited around every bend. Gravel. Slick spots. Animals. Human motorists. 

My bike adventures from now on will take place on stationary conveyances. I can still manage a great workout and, unless I get the vapors, probably will stay aboard until the timer goes off and I can move on to the weight machines. And then to the showers. And then to the brewpub. Ever tried an Apex IPA? Me neither, but I keep searching. 

Reflections on a new knee

Funny how surgery can throw you for a loop.

Fifteen days ago, I had a knee replaced. Pulled the 1950 chassis into the OR, went to sleep and woke up with a new part. The old knee saw me through 64 years. Not bad for original equipment. I could say that they don't make them like that any more, but that's not true. Blood and bone and sinew continues to be manufactured into humans on a daily basis. Thanks to modern medicine, the old, worn-out stuff can be replaced. Knees, shoulders, hips, heart valves -- all available for the asking and the affording.

I took the long route to replacement. Despite daily pain, I had the left knee scoped the same weekend Hurricane Katrina hit New Orleans. I watched round-the-clock hurricane coverage almost guilt-free. The weather was glorious in Wyoming and I would have felt awful staying inside to immerse myself in tragedy. But I had an excuse. For the next decade, I relied on exercise and Alleve and occasional steroid injections. Finally I got the word from my orthopedic doc. I had four options. I could do nothing, always a popular option for us procrastinators. I could rely on the calming ministrations of Alleve. More injections. Finally, surgery.

This is elective surgery but should not be undertaken lightly, especially if you're a heart patient, as I am. Dr. Shannon sent me to my cardiologist and my family doctor. After a battery of tests, including a stress test that wasn't too stressful, they cleared me for surgery. Meanwhile, I wrecked my car. There was no replacing parts in my Ford Fusion. Totalled. Not something you want to hear about your favorite car or favorite human. So, I got a total car replacement.

Until Jan. 2, 2013, I had been a stranger to hospitals. I was ten years old the last time I was a hospital patient. I was 62 when dragged to the ER with a heart attack. A five-decade hiatus -- not bad. My heart attack and subsequent surgeries made me comfortable with hospitals. I almost look forward to visiting them now.

Almost.

Knee replacement surgery takes less than an hour. The surgeon applies a tourniquet so staunch the blood flow. The experts work fast. Soon I'm in the recovery room wondering what the heck happened. I'm hooked up to oxygen and IV. My left leg was being flexed by a CPM. Must move that new knee -- no rest for the stunned.

So here I am -- 15 days out. The pain is lessening. Dr. Shannon's assistant removed the 32 staples that sealed the incision on April 8. Doctor's orders say I must keep moving and keep recuperating.

OK, doc.