Paul's Heart

Life As A Dad, And A Survivor

Archive for the day “January 6, 2013”

06 Jan 2013

Nose To The Toes


I am lying in a hospital bed for the second day in a row.  The room is in severe contrast to the room that I was in the day before, the emergency room.  I am much more at ease today.  For at least half of the day yesterday, I do not recall much.  But I do remember the end of the day being quite serious.  Today is the second day that I’m receiving a cocktail of three strong antibiotics through an IV-line.  I am being treated today for pneumonia.  Yesterday I was being treated for sepsis, a blood poisoning, based on symptoms and my health history while waiting for blood cultures to come back from the lab.  For the third time in my life, the second in four years, I am being cared for as a result of a life-threatening situation.  Each time I ignored obvious symptoms and just “toughed it out” believing that, in time, my symptoms would resolve themselves.    Each time I was wrong, near fatally wrong.  Cancer, blocked arteries, and severe lung infections do not just go away.

 I am known to push myself to all kinds of crazy extremes, especially when it comes to time conflicts.  I live to disappoint no one.  This prior weekend was no different–eight hours of sleep through the entire weekend and two slices of pizza–five events completed.  I got through Monday with no problem and went to bed around 11pm.  Approximately half an hour later, I woke to vomit.  But it was not a violent flu-like vomit, it just poured out.  This process repeated several times through the night, each episode leaving me to deal with chronic back pain, that normally I am able to sleep through.  My wife wanted to call 911, but I argued that I would be fine.  And later on in the day, I would recover.  But this situation repeated itself the very next night.  At 4am, Wendy did not hesitate and immediately called for an ambulance.

 There is a saying, “Always make sure that you have clean underwear on, in case of an accident.”  Be prepared for it.  Well, I cannot say that I am prepared at 4am in the morning for a raid by two police officers and two EMTs.  To leave some imagination to the story, I am hoping that the “package was wrapped before Christmas” to at least some degree.  I cannot recall and my wife Wendy is of no help, as she cannot remember either.  I would hate to be pulled over in my car by the police officer who responded to my home also, and then have him respond, “If you ever subject me to that appearance on an emergency call again, and I will charge you with assault with a laughable weapon.”  At least one officer pled not to be thrown up on and reminded me that he had a gun.  One EMT mentioned that he could not handle vomit and would vomit himself.  Fantastic, everyone is a comedian even that early in the morning.  All the while my young daughters have been rustled from their beds to find two cops, two ambulance guys, oh, and daddy strapped to a stretcher.

 Fast forward to my second day in the hospital.  Both days so far each shift I have had a nurse, an aide, and a tech.  I also had a nursing student.  The first night, the nursing student could have passed for a nurse.  She seemed already into treatment-mode, had a list of things she had to get to, unable and unwilling to spend any amount of extra time with me.

 However, on my second night, in walks into my room, cue the forestry noises, tonight’s student nurse, a young girl with a beautiful smile, a timid voice, and a strongly innocent demeanor.  She may as well have been twirling around in her dress in circles singing to the birds sitting on each hand being followed by the deer, rabbit, and skunk.  All she was missing was her cast of altitudinal-challenged men with pick-axes whistling while marching through the woods in single-file.  “Good evening sir, I’m Michelle and I am a nursing student.  I am here to check you from nose to toes.”  Aaaawww, that was so cute.  Wait a minute.  Did she actually say “nose to toes?”  Am I on the pediatric floor?  Or had someone sent me a specially dressed live telegram (wink wink) to cheer me up?  Then it got awkward, especially with her age (young enough to be my daughter) for me to offer any smart-alec response like “did you say nose to hose” or “nose we see where it goes.”  But then it hits me.  One of my daughters might pursue this career.  So, I go back into dad-mode and give her a very mature, “Sure you may.”  Now that my mind had been put back on the right track, I am thinking, how bad can it be?  She is just going to check my eyes, ears, throat, blood pressure, lungs, um…, um…, okay, all was cool as she went from my belly, nose, to my toes!  My feet of all things, was what I was going to be uncomfortable with.  Even while checking the area where “nobody goes between my nose and my toes” would not have bothered me as much as letting her see my feet.  I do not even ask my wife to rub my feet.  This poor girl did not deserve this.  But she did it, and with the same smile that she came into my room with, and left the room.  She had checked me from my nose to my toes.

In my life, I have heard criticisms about many professions, that longevity with an employer can make one complacent, and the passion for the job is not the same as it was decades earlier when the employee began. 

A teacher gets to sample what her career will be like by being a student teacher.  The experience often leaves them with a false sense of security and false confidence.  This microcosm of an experience, often controlled, fuels their desires, hopes and dreams of being a teacher even further.  Then after 30 years of abusive students, public criticism for salary and schedule, and administrative disappointments, the personal achievements and pride in knowing the positive impact made on young minds ends up lost for so many.

Doctors can grow callused due to seeing as many as 30 patients in a five-hour period, their symptoms all blurring together.  Take the oncologist whose profession it is to tell people that they have cancer.  Seriously, can you blame this doctor for not having a cheery bedside manner unlike what his or her personality might have been like in high school?

You can select any profession and this may ring true.  But in a time and place that are scary enough, it was an unexpected smile and a friendly demeanor which made me wish this young woman a very long and happy career.  What I initially took as a fairy tale-like entrance will forever be a moment that I never forget.

Posted in Cancer | Leave a comment
06 Jan 2013

He’s So Young


I have always appreciated the emotional sacrifice that my caregivers gave, whether nurses, doctors, or family members.  The following is but one possible thought that might be considered:

I have had this job for nearly ten years.  I have seen hundreds of people come through the doors of our office.  Patients have undergone cardiac stress tests performed by me for reasons such as physical shape, conditioning, cholesterol, age, and heredity.  One day does not necessarily stand out from another.

 This morning started out no differently than most others in my career as a cardiac technician.  My first patient is a 42 year-old male who has been sent to our office for a nuclear stress test by his general practitioner.  This is odd, and clearly a waste of time, money, and benefits.  There is no reason for him to be undergoing a test of this level.  In any case, I call him to the implementation room to install his IV line so that the radioactive dye can be injected for the x-rays to be taken prior to, and after the treadmill exercise.

 What a baby he is!  He is a cancer survivor and so intimidated and squeamish as I try to put in his line.  Yes, patients have a fear of needles, but this patient is so over the top.  With the IV now inserted, the dye is injected and the first set of x-rays are taken.  Nothing unusual is noticed.  I have him follow me to the exam room, where the next set of technicians are waiting to hook up his EKG lines and then he gets on the treadmill.

 I move on to my next patient, not thinking anymore about Paul.

 Within ten minutes, Paul is led back to the x-ray room.  That is odd.  At least a half an hour should have gone by before he returned to my care.  In any case, the second set of x-rays needs to be done which will now show the blood flow to his heart under stress.  Once the pictures are done, I will escort him back to the waiting room until the results are read, and then I will release him to go home.

 There is a definite age that you need to be in order to vote.  You have to be so old to get into an rated R movie.  There is a minimum drinking age.  These ages are so long ago, so young.  Cancer does not discriminate based on age.  Undiagnosed health conditions lead to shocking and sudden obituaries with high school student athletes.  So young.

 I am not the doctor.  But I do have basic knowledge of what these photos mean.  The colors on the film are either orange or purple.  In the beginning, his heart shows that blood flow is just as it should be and this is confirmed with the orange color, the blood.  But as stress is introduced, the treadmill, the orange changes to purple.  He has a blockage.  It looks fairly serious to me, and I am just a nurse.

 The waiting room is now mostly empty except for the first patient of the day.  This will be the last time that I see him.  He will be referred to one of our cardiologists and the staff that will be needed to save his life.  Mr. Edelman?  Oh my God, he is so young.  My children are his age.  This could be my child.  He is so young.  I want to cry.

 “I am going to take you back to Dr. S’s office.  Dr. S would like to talk with you.”  He is getting bad news, and he knows it.  You can see it.  But he still gets out, “Thank you, you have been so nice to me.”

 I do not know what exactly his diagnosis or prognosis will be.  I do believe in our doctors to save this man’s life.  It is just that he is so damned young.  It is just not fair.

Posted in The Heart | Leave a comment
06 Jan 2013

CABbaGe – Not Just A Green Leafy Vegetable


    I have never been a vegetable eater.  I will eat carrots and corn, but when it comes to anything green, not a chance.  So, ears of those who know me, perk up when they hear me proclaim how grateful I am for having “cabbage”.  As I don’t normally wear v-neck collars, just to look at me, one would never suspect that I am a survivor of heart bypass surgery, Coronary Artery Bypass Graft, or simply, CABG.

          Twenty years earlier, my body and soul had already been through a life-threatening battle with cancer, Hodgkin’s Disease.  It may be arrogance to have assumed that I should never be put through something traumatic again.  I had done my time.  I had already proven that “it can happen to me”.  I should have been safe being able to say “it will never happen to me – again”.  In true déjà vu fashion, from start to finish, I now faced another challenge.  But the difference this time, time was not on my side.  Time was clearly against me.

          There I was, 42 years old and trying to stay, rather, get into shape.  I was slightly overweight (translation – really overweight), and not very active.  But for four months, I had been spending close to two hours a day, five days a week at the gym, and making great progress.  But for those four months, I also had developed a symptom that I had ignored, not just at the gym, but everywhere else that I was exerting physical stress on my body.  It was a tightness across my chest which lasted only several seconds into my workout.  I was not worried as it was not excruciating pain as described by people who have had heart attacks.

          I spoke to my family doctor of twenty years. She made comments of my cancer history, and current physical being, but made the suggestion to undergo a nuclear stress test with a cardiologist just for giggles.  Of course, just as in my Hodgkin’s past, I was not putting two and two together.  Though I knew what a cardiologist was, I did not realize that was the direction she was sending me in.  At age 22, I had no idea what an oncologist was either.

          I arrived at the cardiologist’s office, naïve, dressed in shorts, sneakers and having all kinds of wires attached to me.  A dye was injected into me, and the tech took the first set of pictures.  No big deal.  No bells and whistles went off.  Then the tech showed me to the treadmill.  While I did not anticipate a marathon on the mechanical track, I did expect to go longer than three minutes.  The test had been stopped as something appeared on the EKG.  But still, I did not suspect anything.  One more set of pictures, then it was back to the waiting room.

           Then I watched people leave who came in after me.  I had done that drill twenty years before when I was diagnosed with my Hodgkin’s so I now knew something was going to be wrong.  I met the cardiologist who drew the short straw getting me for a patient.  He was young and had a nice bedside manner, and confidence.  He was certain that I had a blockage, and he wanted me to check in next door to the hospital for catheterization the next day.  I would be good as new with a stint and back to my grind within a week.

         For the second time in my life, I would face Elsabeth Kubler-Ross’s stages of grief (denial, anger, bargaining, depression, and acceptance).  Unlike with my cancer diagnosis, I skipped right past the denial and anger.  “Doc, look, I’ve got some things I need to take care contractually with some clients.  I’ll get back to you in a few weeks when things slow down.  I’m disc jockeying a wedding this weekend and have two gigs the following weekend.”  His response?  “Mr. Edelman, perhaps you don’t understand, I don’t want you even going home.”  The bargaining kicked into high gear.  “Look, I need to go home, and explain this stuff to my wife and make sure that she knows everything she is going to have to take care of with the kids and the house, and everything else.”  Dr. S. said, “Okay, fine.  But I don’t want you to do anything other than go home and rest.”  Then I backstepped into the denial.  “So I can’t even mow my lawn which needs to be done?  Mowing is relaxing to me.”  You can finish that conversation with what you think he might have said after that.  Let’s just say in kind words, my intelligence had been questioned.

        The next morning, my wife drove me to the hospital.  As I came out of the anesthesia, there was Dr. S along with my wife, and a co-worker who stopped by just to visit.  “Our attempt to stint was unsuccessful.  It seems that some of the therapies that were used to treat your husband’s Hodgkin’s, over time have caused some severe damage to his cardiac system.  Your husband has been set up for emergency bypass surgery first thing in the morning.  He has three blockages but of the most concern is the left anterior descending artery which is 90% blocked.”  I do not recall my wife’s reaction but she told me of her knees buckling under her while I lay coming out of the anesthesia babbling “bypass… okay… bye bye… bypass… see ya in the morning…cool… bye bye bypass.”  But I will never forget my co-worker’s words.  As an EMT, she immediately knew what was happening and commented, “Oh my God, it’s a widowmaker.”  To which Dr. S responded, “simply put, yes.”  Blood was being restricted to my heart 90%.  It was not a question of “if” I would drop dead from a fatal heart attack, but “when.”  Dr. S. called me an “extremely lucky man” that I actually prevented my heart attack from occurring.  Okay Doc, you got my attention.  On to acceptance.  The easy part about that, was that I had less than twelve hours to worry and be frightened.  However I was still coming out of the anesthesia, and then for the next many hours, underwent many pre-surgical tests.  I did not have a lot of time to think about what was happening to me.

         And so, the next morning, I would have my first experience with “cabbage”, CABG.  There are a lot more details to this event.  But the long story short, I now owe my life to something that sounds so similar to something that I have avoided my whole life, cabbage.  And no, I still do not eat it.

Posted in Cancer, The Heart | Leave a comment

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