Paul's Heart

Are You Sick Of The Weather Yet?

I stopped teasing my friends and family up north with images like these about three months ago:

This has been my first Winter away from the north, and down in the deep south.  All kidding aside, I used to enjoy the Winter.  I actually liked shoveling snow, driving on ice.  In fact, I would rather have dealt with frigid temperatures than try to find relief in the heat and humidity.

So as today, my friends and family up north are dealing with yet another major snow storm and cold temperatures.

For many, people flock to the south to escape the winter, the cold, the snow.  Also for many, people go fly south for their health.  My mother said something quite profound to me last week after their record setting low temperatures.  “You know, I am glad you moved south.  You would never have been able to survive up here.”  Under normal circumstances, I would probably have disagreed.  I spent 48 years of my life in the northeaster United States and endured many brutal winters.  I had skied in minus degree temperatures.  As a child, I played backyard football in a t-shirt and jeans.  And I was also known for wearing shorts at least until mid January.

But that all changed for me almost seven years now.  Following my open heart surgery for badly scarred arteries due to my radiation therapy, my body’s temperature tolerance dropped at least ten degrees.  And it was noticeable because the surgery occurred in the month of April when temperatures are normally on the upswing, normally.  When I was released from the hospital, it was in the mid-50’s, which previously for me, should not have been a big deal.  But I immediately felt the difference, at it actually hurt, and I am not just talking the newly repaired breast bone from shivering.

I called the doctor how I was feeling, and was told that this happens often.  My blood was flowing properly again, actually for the first time in many years.  But soon, I recognized another weather-related issue I was having.  With my body recovering from the cardiac surgery through rehab, I soon realized that I had another issue develop, or perhaps I had it previously and was unaware of it.  In the cancer world, we refer to it as “SOB”.  And as you may see this abbreviation defining something else awfully, so too does the medical definition spelled out, “shortness of breath.”

Everyone knows the important relationship between the lungs and the heart.  Which is what often makes it difficult to diagnose many cardiac episodes from the simplest of symptoms, a cough.  But many times, the two go hand in hand.  A fluid build up in the lungs can lead to affecting the heart which will not be able to pump properly.

Once my heart issue cause was discovered, and I was officially entered into  cancer survivorship clinic at Memorial Sloan Kettering Cancer Center, I soon found out what was behind my SOB.  My cancer treatments had done more damage than thought.  A thorough pulmonary function test revealed that I had lost 25% of my lung capacity from damage from cancer treatments done nearly two decades earlier.  In fact, the entire lower left lobe is considered “dead” and has at least once been the location of a severe bout of pneumonia.  I also have several unidentified spots on my lungs that are being watched annually to see if they progress into anything further.  The damage is irreversible and as time goes on, will only get worse.

Depending on how bad my SOB gets, it can throw me into a massive panic attack, because the tightness I feel in my chest from my struggling for air, and the increase in my heart rate makes me feel like I am having a cardiac episode, which is to be expected given what I have been exposed to.

Over the years, I have discovered two things that bring on these SOB attacks, walking an incline (like steps or a ramp), and extreme weather (high heat and humidity, cold, high winds).  I now had to learn to deal with these triggers as the only relief I was able to find was within my own body.  I was never a big “stair” person, so avoiding steps was easy enough.  And since there is no cure for this, other than a lung transplant, that means that I had to find a way to manage the SOB attacks when they occurred.

During the hot an humid summer months, the solution was simple, just stay indoors with the air conditioning.  And when I did have to be outside, such as walking from the parking garage into my building at work, I would need about a half an hour inside to “settle” my lungs down with the cooler and drying air.  Inhalers provide no relief for this.  On a rare occasion, this attack could last for hours, no particular reason why, or so I thought.  I will address that soon.

During windy periods, any time of the year, I needed to place something over my face to block the wind, the force of air into my nose or mouth felt like trying to blow air into a glass bottle.  So it was not unusual, even in fifty degree weather to see me wearing a scarf across my face or even wear a turtle neck pulled up over my nose.

But the most dangerous for me was the cold, winter air.  From the simplest of tasks, walking, to the most strenuous tasks, shoveling (which a cardiac patient should not be doing in the first place), once the extreme cold hit my body, not only would my lungs seize up, so would the muscles in my body.  And it was painful.  And having pain would just domino into other effects, such as insomnia.  This was hardly what I signed up for when I asked to be cured of my cancer, and it was clearly never mentioned on my paperwork that one day I could be facing these issues.

So I lived in the northeast where it is cold, and now live in probably one of the hottest and more humid areas of the country.  And since my health issues cannot be cured or reversed, the only choice is to manage each condition.  To manage these conditions meant that I had to learn to accept them.  And until they were accepted, I would continually subject my body to unnecessary stress fighting to prove to everyone what they thought I was still capable of.  The end result, the original level of stress, and now the much increased level of stress had an impact on each condition that I was dealing with, even the SOB.

My main doctor at Memorial Sloan Kettering Cancer Center told me at our first meeting, “I can’t cure you.  I can’t reverse the things that are happening to you.  But if we can manage what has happened, and is happening, perhaps we can at least slow the process down.”  And there you have it, like many other long term cancer survivors, unknowingly, I traded one sentence for another.  Please do not get me wrong, I would not give back the 25 years I have had, but the reality is, medicine had no idea what to do with cancer patients once they lived longer than what the studies of cancer treatments provided information of side effects for.

Knowing that stress amplifies any physical malady, not just cancer, it makes sense then to start managing my health by reducing, and if possible eliminating my stress.  This meant not just emotional stress, but physical stress.  I had three trips to the emergency room because I pushed my body too hard in ability and fatigue, that my body responded hard, real hard.  When you get to a point in your life, that you no longer listen to family and friends when they tell you to “slow down,” the next person to tell you to “slow down” will be your own body.  All three ER trips could have ended much differently.

So getting back to the comment by my mother, being glad that I moved down south, how exactly have I managed with my SOB given the high heat and humidity?  Actually a lot better than I anticipated.  With my first summer behind me, and it was a learning curve (what times of day to avoid being out, learning to minimize exposure to the humidity, and definitely not pushing myself physically), my episodes of SOB while still occurring, actually lasted less in duration all because of management.  And that was made possible by reducing or eliminating the stressors that played a role in triggering those episodes.  And now, as winter winds down, and summer approaches, I am not stressing about dealing with the summer down here for the second time, because I know what I need to do to manage my health.

Oh, and for the record, yes, my body has acclimated to the southern temperatures, and though rare, we recently hit the 30’s in temperature range, and it was a brutal reminder of what I would have had to deal with up north.  Perhaps my mother was right.  That’s right mom, you can put that one on the calendar “Paul admits mother was right.”