Paul's Heart

When The Body Tries To Warn You – Part 2

If you haven’t yet, I recommend that you read part 1 of this series, so that you understand how I got here.

I arrived for my appointment on April 16th, early, not out of enthusiasm, but just because that is how I am. An IV was placed into a vein in my hand. This would be used to inject the radioactive isotope for when they would take any pictures for the nuclear scan. Of course, the hardest part of any procedure for me post-cancer, is getting an IV into me or blood draw, chemotherapy having destroyed my veins. Before I would head to the treadmill lab, it was off for my first set of pictures with the isotope having been injected, showing my heart at rest, a.k.a. no stress.

Once that was done, I was connected to telemetry, which would monitor my heart once I got on the treadmill. At this point, there were now four others in the room with me; a nurse, a tech watching the telemetry, and I am not sure who the other two were.

Then it was go time. I climbed up on the treadmill. The “exercise” tech explained to me how the test would work. The test would last approximately twelve minutes (I was definitely confident that I could handle that). Every three minutes, the belt would speed up, and the treadmill incline would increase. This would be done until my heartrate got up to the desired result they needed for the test.

Aaaaaaannnnndddd, go.

Of course as the test began, the belt was definitely slow walk pace, and flat incline. Got to the first three minute mark. And then, the first increase in speed and incline. Almost immediately, I began to get that tightness feeling in my chest and shoulder. But as I was not suspecting anything, I said nothing. I had nine more minutes to go. Then a nurse asked, “are you okay?” I responded, “yes, I am just starting to get that ‘tightness’ that I mentioned before.” The nurse asked, “can you go a little further? We are almost getting to where we need your heartrate.” Confidently with a bit of bravado I answered, “go for it.”

By the time I got to the six minute mark, I had the full tightness and pain in my chest and shoulder as usual. No one was saying anything to me at that point, so I just kept going. And then the belt increased again, and the treadmill raised its angle some more. In less than a minute, the tech said, “stop the belt. Mr. Edelman, you can step down.” All that I heard was that something showd on the EKG, something had happened. I was still oblivious, not connecting how I felt with the result of the EKG.

I was taken back to the lab, for another dose of the isotope, and then back to radiology for another set of pictures, this time, my heart having been “stressed out.” I did not feel any differently, as usual, the tightness and pain had gone away. Once this was finished, the IV port was removed from my hand, and I was told to wait out in the waiting room before being released. In the meantime, I could enjoy something to drink and something to snack on. I was starving.

And then I noticed something. People who had come in to the office after me, were leaving before me. I mean everyone. This was not a good sign. Something did not feel right. Was I forgotten? Then a nurse appeared and said, “Mr. Edelman, will you come with me please. The cardiologist would like to talk to you.” Yeah, this was deja vu, just as I wrote in my book. Cardiologist? Wants to talk to me? There’s nothing wrong with my heart. Right? Riiiiggghhtt?

Dr. S was a young doctor, quite possibly my age, very friendly demeanor, but had a serious message. “I don’t usually put things this way, but I am 100% certain that you have a blockage. The good news is, we can check you right in to the cath lab next door, pop a couple of stents in you, and you will be as good as new in a week or two.”

Blockage? Cath lab? Stents? Couple of weeks? The doctor did not need to tell me what the actual problem was when the Kubler Ross stages had already kicked in. Denial first. And then bargaining.

“Listen doc. I am sure this is serious, but listen, I have a wedding I have to DJ this weekend. How about if I come back Monday after the wedding and we can get this done?”

This was his response, “perhaps you did not understand me, you have a blockage to your heart. Your heart is not getting the blood supply it desperately needs. Time is crucial to get this repaired.”

These are the images that the doctor was looking at. As long as I picked out the right picture from my records, this is a photo of my pending death, or what would like be my demise. Though the doctor did not put it in those words.

Ok, the doctor had my attention. I would forget about arguing about the wedding. The doctor was saying I would be good in a week or two, if I got this done, and doing stents were going to be that easy, I was sure I would still be able to pull off the wedding anyway. But I was still not done tryin to gain some sort of control by bargaining.

“Look, this really caught me off guard. I need to go home tonight, I need to wrap up a few loose ends. Most importantly I need to see my daughters. I’ve never been apart from them, and I need them to know I am fine.” The doctor replied, “okay. Just please, do nothing else at home. Just relax, get here first thing in the morning.” So I replied, “perfect. Nothing but relaxing. In fact, I’ll spend time relaxing mowing my lawn.” His actual response, “are you an idiot? Didn’t you hear me? I said nothing but relaxing.” I interrupted, “but mowing the lawn is relaxing to me.” I could tell from his expression I needed to rethink my idea of relaxing.

It was an hour drive home, and it still really had not hit me, “I’m going to have heart surgery tomorrow morning.” How could that be? I’m too young for this. I’m in good shape, I’m happy, things are going good for me. This isn’t right or fair.

When I put my daughters to bed that evening, I told each of them how much I loved them, hugged them, and kissed them goodnight. I explained that I would be gone in the morning before they headed off for school and daycare, but that I would see them afterwards. We had never been apart from each other, and it was not going to start now.

When The Body Tries To Warn You – Part 1

Every year around this time, my mind plays this endless loop. I cannot stop it. This story, and the parts that will follow, are not just about cancer survivorship, because the situation applies to everyone, regardless if you have ever had cancer or not. Because the truth is, you do not need to have gone through cancer to experience this. And we all have heard it referred to as this, “the silent killer,” and likely know someone who suffered this fate. My story still haunts me to this day, and every time that I hear someone describing what I experienced, something clicks and I urgently try to convince them, to seek emergency help right away. In fact, there are several reading this who are alive today because I heard them describe their symptoms and I urged them to go to the emergency room.

It had been eighteen years since I finished my treatment for Hodgkin’s Lymphoma. As any cancer patient hopes for, I was living my life again, without cancer. Sure, it was not as I had planned, but life was good. I got through my first five years of remission without relapsing, so I was told I no longer needed to see my oncologist as the chances of my cancer coming back at this point were slim.

Over this time period, I had done my share of traveling, literally all over the world. Finally I locked into a job I could call a career. And the most important part of my cancer survivorship, I became a Dad. I was now 42 years old, and still cancer free. My focus was now on my daughters, ages 5 and 3 years old.

Now, here is the part YOU MUST PAY ATTENTION TO!!! What I am about to share with you, you do not need to have had cancer to have this happen to you. And not hyperbole, it might just save your life.

In early to mid April, I made a phone call to my family doctor (who I had known for decades). I was not someone known for complaining about my health issues, and truly she only saw me maybe once a year to administer an annual seasonal allergy shot. In spite of my cancer history, I was fairly healthy. There was this one time I tangled with some poison oak, ended up with painful huge blisters. I went in to the office, and even the receptionist was like, “this has to be pretty bad if Paul is in here.”

This was the conversation that I had with Dr. J. on the phone:

“I need your advice. I am dealing with this weird pain/tightness, in the upper left side of my chest. It doesn’t last more than a minute, but it happens damn near all of the time when it does. I am doing something physical, I get that discomfort, and about a minute later, it goes away. I could kind of describe it as the sensation you get, when you go jogging in the cold, like a “side sticker”, only not in the side, but in the upper left of my chest and shoulder. It is so annoying, is there anything I can do to get this to stop? It has been going on for months.”

I want you to re-read that last sentence again. It is bolded and in italics for a reason. Because what you will read later on, will hammer the point home, just how lucky I was.

Over time, I play back this time period again and again. I don’t recall when this sensation started, but I am able to remember as early as January of 2008, because I was shoveling snow when I would get this feeling. But as the weather warmed, and I would mow the lawn, yep, got that feeling. At work, I moved heavy equipment, and felt that pain every day. And though I could never be misidentified as a Mr. Olympia, I was in good shape because I went to the gym every day, and yes, I felt that chest tightness while at the gym.

The eliptical machine. This exercise machine gets both the credit with saving my life as well as almost costing me my life. And to this day, the trauma of my experience still terrorizes me when I am made to use it (as in ordered to use in physical therapy). My daily routine back in 2008, in April and before, I would go to the gym, get on this machine (I preferred it because of the calories I could burn), and then head over to the weight room for the rest of my workout. If you notice on the handles, just below the control panel, there are two silver grips. These are sensors. I chose to hold on to there, of course not getting the full workout by using the full handles but what this allowed me to do, was to watch my vitals, mainly my heart rate, to make sure I got the heartbeat into the range to burn calories.

But as I said, I had this tightness in my chest whenever I began doing something physical, and the eliptical was no exception. But as I held on to the sensors, I saw the display with my heart rate. It was climbing, rapidly, like an 18-wheeler rolling down a road with no brakes. And that tightness and pain was getting worse. It was less than a minute, and my heart rate was at 152. It should only have been less than 110. This lasted approximately a minute, and then the tightness and pain stopped, though the heart rate remained. I kept going as I felt more comfortable, finished the eliptical an hour later, and went over to the gym to finish my workout. I had a feeling something was not right, which is why I called Dr. J. She would not take this call lightly, as I said, I don’t complain about anything. From my description to her, this was her response:

“Given your history with cancer, I don’t think it is unreasonable to order a nuclear stress test.” Okay, so if you read my book, I had no idea what an oncologist was when I was sent there for my cancer, I had no idea what a nuclear stress test was or what it was for. But that is the trust I had in my doctor. She knew what she was doing, even if it might have been a hunch on her part. She was always spot on.

Now, if you personally have ever tried to make an appointment for an xray or any kind of test, hell, even an appointment to see a doctor, we, as the patients are lucky if we can get seen within a year these days. Back in 2008, it was not that bad, but yes, you could wait weeks or even months to get in. This is where I really got lucky, as she (her staff) called and set up the appointment for April 16, 2008, six days from today’s date.

I continued on with my routines, work, exercising, mowing the lawn while I waited for that date, and still experiencing those symptoms. I was given instructions how to prepare for the test, fasting orders, what to wear (as I would be walking on a treadmill), and how the test would be performed. With my history as a cancer survivor, I can say, I was not afraid, nor concerned. I was a happy and health 42 year old Dad, with everything going for him. This wasn’t going to be anything serious.

Paul’s Heart, A Movie? Art Imitating Life

Two books, both based on a common thread, cancer, Hodgkin’s Lymphoma to be exact. Obviously, the book on the right you may recognize, my book based on my story with cancer and the next thirty-five years of my life. But the book on the left, “Walking Through The Fire” by Laurel Lee, was published in 1977, nearly 40 years before my book, “Paul’s Heart – Life As A Dad And A 35-Year Cancer Survivor”.

Lee passed away in 2004 at the young age of 58 years old, from a secondary cancer, pancreatic, most likely attributed to the lesser understood late side effects from the treatments of her Hodgkin’s Lymphoma, much like you have seen me mention here on Paul’s Heart. In fact, I would bet dollars to donuts, there was never a connection made between her pancreatic cancer and late side effects from her treatments, because at the turn of the century, this issue of long term cancer survivorship still was not commonly being discussed, understood, and shared at the level it should have been talked about.

Anyway, her book chronicled in journal format, following Lee from her diagnosis at the age of 30 with Hodgkin’s Lymphoma, and oh by the way, pregnant with her third child. This is actually a common situation to face by women, discovery of Hodgkin’s only because of the prenatal appointments, having to treat cancer while pregnant, with the cancer and the treatment both a risk to both mother and child.

Lee’s pregnancy was pretty much the only difference between she and I. I was diagnosed roughly eleven years later at the age of 22, with our experiences pretty similar, unlike those today, who are dealing with Hodgkin’s, reading what I went through thirty-five years ago and are probably like WTF! Like me, Lee had her biopsy, which would confirm her Hodgkin’s, and force her to choose, keeping her baby, risking health to both mother and baby, or abort. I have seen this situation so many times on my social boards. She made the decision to pursue both her pregnancy and her treatment for cancer, both with procedures to be done. Lee actually underwent upper mantle radiation in the final stage of her pregnancy, clearly risky for the baby. But with timing imperative for treating Hodgkin’s, her choice to keep the baby, left no choice to the risk.

Barely time to hold her newborn, Lee quickly resumed the process for dealing with her Hodgkin’s. She underwent a lymphangiogram (not fun I can tell you), resumed her radiation therapy, following she had a laparotomy done (doctors remove the spleen, and biopsy lymph nodes and the liver). She talked about, and I can confirm, the unimaginable pain from having an eight inch verticle incision on your abdomen. This is where I am going to leave the book. And I can tell you, everything is definitely relatable.

In 1979, CBS made it Lee’s story a television movie. I saw it late night for the first time, in 1990 after I saw an advertisement, and it mentioned Hodgkin’s Disease, something up until that moment, I had not heard mentioned about anyone else.

The movie was star-studded, with Bess Armstrong playing Laurel Lee. I did not get to finish watching the movie as it was late, and I was exhausted from my treatments. It turns out that it may have been just as well because, well, between reading her book, and my own experience, it was safe to say, Hollywood took some liberties when they had a chance to portray something real. It was during the movie when she underwent that laparotomy that I had enough and called bullshit. I mentioned that the surgery involves an eight inch verticle cut on the stomach, through muscles. It hurts, A LOT!!!! And we got a lot of pain medication to deal with that pain, and when we moved, we did so very gingerly. That was not how Hollywood portrayed it. Lee was up and about from her hospital bed the next day, showing no signs of pain or discomfort. That was definitely not how I remember how mine went.

I get it. When Hollywood tells a cancer story, they don’t want a feel good cure story, a happy story, one without the pain, the stress, the emotional challenges. Hollywood prefers sad movies like Brian’s Song, or Terms Of Endearment, or Beaches make good movies because the characters die. Television is no different.

(photo courtesy of Apple TV)

Times have not changed. One of the latest shows I enjoyed binging has been Shrinking with Jason Segal and Harrison Ford. Out of respect, I will try not to spoil as best as I can, but a new issue develops in Season three, again something that I have personally experienced, and thought, “wow, this will be relatable.” Now I realize these episodes only being a half hour long, you cannot go into too much detail or story line. But in this case, as soon as I saw things begin to develop, my heart skipped, and my eyes began to water, because my intuition was telling me, the story was going to take a hard turn, one that I have personal experience with, and still struggle with emotionally when witnessing someone else face it.

A character, who I will not name, develops a heart issue, in fact, the level of severity that I faced back in 2008. The character undergoes corrective surgery, it is never said what so I assume it was the simpler trans catheter method (not open heart), but then I see the character holding a heart pillow to their chest, which would indicate it was open heart surgery after all. And of course, being Hollywood, the character was sitting up, in the room immediately after the surgery, no wires, no drain tubing, no machines, and no pain. Though there are hints emotionally as to the toll, I definitely feel Shrinking fell flat on this story line. I really wish they had not because there are so many people who undergo this surgery, and will see something that just doesn’t happen that way. Shrinking has been good dealing with Ford’s character’s Parkinsons. But if they were not going to get more into the emotional toll of a life and death cardiac situation, they were better off leaving it alone. And no, I won’t spoil what happens with the character.

In my book, I go into details. I tell the whole story, and so many survivors who have read my book, are amazed and unfortunately some re-traumatized by just how vivid my memory was when I wrote the book. In any case, I doubt Hollywood would ever make my book a movie. There is definitely a lot of drama from medical to personal. But spoiler alert, the main character does not die, so, sorry Hollywood, this story has a happy ending. It does get me thinking, who would I want to play my character if Hollywood did make my book a movie.