Paul's Heart

Life As A Dad, And A Survivor

Archive for the month “February, 2023”

This “Left” Seems Right

Many times, I will get the subject of my posts from questions asked or comments made by fellow long term survivors. This will be one post, that not only benefits long term survivors of cancer, but those who have been fortunate to never have seen the inside of an oncologist’s office.

This is a very popular meme image that circulates around the internet. And since it fits in with my topic today, I thought I would make my own meme with the picture.

I am sure you have heard of the condition “reflux,” commonly referred to as G.E.R.D. (gastroesophageal reflux disease). It is the body’s reaction, a very acidic reaction brought on and aggravated by diet and stress. It is a fairly common condition, and its severity depends on the individual. Not sure if you have ever had to deal with it?

Comedian Rich Hall, gave a very clear and vivid description of reflux, using a term referred to as a “sniglet” decades ago on HBO during one of his comedic segments. A “sniglet” was simply a made up word, describing something that there was no other word for. In the situation of my post, he referred to a “vurp.” Care to take a guess at what “vurp” represented? It describes what happens with reflux perfectly, the combination of “vomit” and “burp” at the same time. If you have ever experienced this event, then you have had reflux at least once in your life. It is not pleasant, and the acidic aftertaste left in the mouth is just awful.

But there are those who must deal with this regularly. And its level of severity is determined by many conditions such as diet, stress, and other health conditions. Treatments can range from eating a diet with less acid (no tomato or orange products), or not eating fried or spicy foods, to daily routines such as not eating by a certain time of the day prior to going to bed or sleeping in a certain position, to using over the counter medications such as TUMS or stronger prescribed medicines.

A single event of reflux may not be such a big deal. However, if it is a situation that is repeated time and time again, it can be something quite serious. As I described above, if you are burping, and instead a small amount of vomit comes up instead of air, this is very acidic. We all had science in school, and know what acid does, eats away at things. Well, the more acid you have to deal with, the worse it will get. And for our bodies, in particular our esophagus, our throat, our mouth, and our teeth, this is a very bad situation. Because of the issues I deal with from my treatments for Hodgkin’s Lymphoma, this situation also almost killed me.

When most deal with reflux, it is often following a meal. We have an opportunity to do something about it, pop a TUMS or some other medication. Assuming we have not eaten just before going to bed, we are likely to stay vertical for a number of hours, allowing gravity to do what it needs to, to keep the stomach acid from creeping up into our mouths. If lucky, just a burp occurs or perhaps, a little bit of “vurp.”

If it advances to its worst timing, at night, while in bed, many problems can occur. Sure, your quality of sleep will be affected as you toss and turn, trying to get the GERD to stop. In my situation, I have two issues that I have to struggle with. Because of damage done to my esophagus from radiation therapy, I have a condition that not only traps food and particles in my esophagus, but also this stomach acid. This twice has led me to the emergency room with something called aspiration pneumonia, the trapped product bacteria gets breathed in to my lungs. My first episode of this, I went full septic, nearly dying. The other issue, is that I can actually “choke” myself out in my sleep as the acidic content fills my throat area. The problem is, I sleep through this event when it happens. So unless someone is around to hear me gasping, or my breathing gets interrupted that it startles me out of my sleep, the episode will not end well. Once I am woken up, it will be hours before I can fall back to sleep, and get the symptoms of the reflux event under control.

So, what can be done to help with this condition? Believe it or not, pretty much! As I mentioned, diet plays a major role. In spite of me being a picky eater, a condition that has me desiring the very acidic products that would aggravate the situation (tomato sauce, orange juice, buffalo wings, etc.), over the years, I have learned to do without these things. This does not mean that I no longer eat them, but it better well be damn worth it if I am going to pay the GERD price. And I do imbibe occasionally, and almost always will pay the price.

Stress, reduce and/or eliminate it. I do not need to go into detail. You know what this means.

Medications can help from over the counter TUMS and Pepcid to prescription level such as I have to take. Unfortunately, I am at a point where I take both, definitely not good to do, and certainly not as long as I have been taking them, nearly fifteen years now. But without taking them, this is not hyperbole, my quality of life is gone.

Timing, as I mentioned earlier, do not eat if you are going to be going to bed soon after. It is best to wait to go horizontal at least two to three hours, allowing for your food to travel where it needs to go, without coming back up.

And the final thing that can help with “vurping,” positioning. To prevent an attack coming on in my sleep, I have actually had to adjust the level of my bed, by about two inches, the headboard end of the bed only, so that my bed is in a downward slant, which allows for gravity to do what it must, to keep the acid where it belongs. All this takes is a simple piece of wood under each foot of the bed at the headboard. But, of course in my situation, this is not enough for me, and that is where the meme above comes in. This is also not the first time, the position that I sleep in, dictates my comfort level.

Back when I had my first heart surgery, done open heart through the breast bone, I was forced to lay on my back, just from the discomfort from the destruction of my chest and rib cage, not a position I normally sleep in. My favorite position has always been on my stomach. In the hospital, my bed was elevated, so being on my back did not bother me. Once at home, sleeping on my back did not work at all. And so, I began to lean to my left so as to change my position enough to get comfortable. A pillow would be placed behind me to hold me in that position. Seemed simple enough, just enough lean, not to be flat on my back.

Then terror struck. No, I had done nothing to my incision or rib cage. I felt as if I was on the verge of a heart attack, as if my heart were going to explode. The beat of my heart was pounding against my rib cage. I began to panic. I removed the pillow from behind me, allowing me to return, flat on my back. Odd, the pounding stopped. I really cannot explain why I did what came next, but I leaned to my left again. Again, that pounding had returned, and I leaned back flat again. Ok. This was weird. But at least I no longer thought I was having a heart attack. Now I was curious. I decided to lean now to my right. This time however, there was no pounding. I would return to my back, and once again, turn to my left. Sure enough, the pounding resumed. Flat, nothing. To my right, nothing. So I was not going to make an emergency phone call or a trip to the emergency room, but clearly someone forgot to fill me in on a very important detail. What the Hell was done to me, that my heart “shifts” when I go to lay only on my left side, that it feels as if it is touching my rib cage, making me feel as if I am sleeping on a bass drum?

An article on “” explained that the apex of the heart being closer to the wall, when sleeping on the right side, the mediastinum (a thin lining), holds the heart in place separated from the lungs. Sleeping on the left side, the heart will shift slightly. Combined with my surgery, and things likely moved around internally, this is exactly what was happening. Though it has been studied, the website did not cite the study, but expressed that according to ECG (electro cardiogram) readings, there was a noticeable change in the heartbeat, when laying on the left side, and none, when laying on the right side. There is nothing reported if side sleeping is dangerous or not, nor does it contribute to any kind of heart ailment. For the purpose of this post, that is where I am ending this part of the left side sleeping discussion.

With reflux impacting my sleeping position, I found another discovery about me sleeping on what has become my dominant position now (with me ignoring the pounding heart beat). In spite of the prescription I take, watching what I eat and when, and position of the bed, all too often, that has not been enough for me to get through a night without either choking myself out from the rush of stomach acid, or worse, as mentioned above, developing aspiration pneumonia. I have found, sleeping on my left side, I do not have episodes of reflux. When I begin my night trying to sleep on either my right side, or even attempting my stomach, flat on my back has never been a consideration, my reflux fires up, and sleep is impossible. The problem for me occurs, if I successfully fall asleep on my left side, and if I fall deep enough, I have a tendency to roll flat on to my back, and then, you guessed it, my reflux acts up. This becomes a major issue, because I do not always wake up when this happens, hence, not until I am basically choking on my vomit, I normally wake myself up. If I am lucky, someone hears the gurgle and gasping for air before it gets worse. Once awake, I end up, getting up from the bed, going into the living room, and sitting in a chair for the next few hours, trying to get my chest and throat to settle down.

So of course, I am curious about the “left side thing” in regard to my reflux. According to a the NIH actually confirms the difference between sleeping on the left side versus the right side( ). One hypothesis holds that right-side sleeping relaxes the lower esophageal sphincter, between the stomach and the esophagus. Another holds that left-side sleeping keeps the junction between stomach and esophagus above the level of gastric acid ( ).

There you have it, something from a long term cancer survivor that can actually benefit someone who has never had cancer, but has the nasty torture of reflux and lack of sleep. So yes, if I am laying on my left side, this is exactly what I am thinking about as I go to sleep.

A Super Side Story

(apologies for the delay in this story, but life happens.)

As many who have no vested interest in the Super Bowl (meaning my team was not playing), I am prone to want to pay attention to the extra stories that occur over the two weeks, and the game itself. This is a tradition that began for me back in 2006, when the Seattle Seahawks (my team) went to their first Super Bowl, and I completely missed the game, as I was in the process of adopting my youngest daughter. Every year, as Super Bowl rolls around, regardless who is playing, including the two additional appearances by the Seahawks, the first thing that always comes to mind, is that trip all the way around the world.

This year’s game, had many special stories behind the game. There was the first match up of biological brothers playing on opposite teams. This story so entertaining, even their mother, any time she was seen, was wearing “split” clothing, representing both the Philadelphia Eagles for her son Jason, and the Kansas City Chiefs for her son Travis.

There was the historical milestone of having two black quarterbacks starting the Super Bowl.

And then, there was the fact that the head coach of the Chiefs, at one time, had been the coach of the Eagles, and while haven gotten the birds to the Super Bowl, the did not win. “Big Red” as Andy Reid was known by, soon found himself out of favor with the fans, and the team, landing in Kansas City, where he won his first Super Bowl as a coach last year.

But the most special moment for me, occurred at two separate moments, both before the game had begun. The first happened in the hour before the game, an interview was held by former New York Giant Michael Strahan, with Buffalo Bills Damar Hamlin, who gained unintended fame having collapsed on the field, during a game between the Bills and the Bengals near the end of the season.

After some questions to Hamlin about how the day began, and what was at stake, Strahan then asked a most difficult question. I am paraphrasing it, as this happened to be an emotional moment for me watching this interview, explanation will be coming shortly, “what went through your mind, as you got up after making the tackle, only to collapse right after.” Hamlin responded that he was not able to answer that question yet, as tears started rolling down his face.

Of course, the question was likely to provoke a response about the sudden blackout, fear, helplessness, and as his heart beat stopped on the field, would he have had any memory of that moment? The interview ended soon after that.

Whether for good or for bad, when the body decides to allow or disallow memory of certain trauma, whether remembered or not, often stirs an emotional upheaval, none felt like ever before. While I will not speak for Hamlin, myself, a cardiac patient as Hamlin, I often still struggle with my emotions every since my first major open heart surgery almost fifteen years ago. And I cannot explain it. I do not personally remember anything after the oxygen mask had been placed over my mouth. Reading the surgical report, I know my heart had been stopped, drained of its blood so that the surgery could be done. And then my heart was filled back up with blood, and restarted. I offer my apologies to my surgeon as it was really way more complicated than I made it sound. But my point is this, I remember nothing about what happened, once I was put under anesthesia until I came to after the surgery. And yet, whenever I witness or hear of someone else go through an experience with the heart, or cancer, I lose control of my emotions.

As I write this post, I am aware of a fellow long term Hodgkin’s survivor like me, going on over a month now since his heart surgery. He is also facing new emotions as he struggles with his recovery, as well as the trauma of what his body had been put through.

When Hamlin is ready, he may finally discuss what he has been feeling, struggling with. Maybe his won’t. But one thing that I truly admire about Hamlin, like many other survivors, they take the experience of that traumatic event, and try to make something good come of it.

Hamlin is alive for only one reason, CPR being performed on him, almost right away. Time is the most critical when the heart stops beating, and medical personnel were able to begin CPR right away, buying the time necessary for better methods to be employed, eventually saving this young man’s life. It is truly an inspirational story, fan of football or not.

And so, the second moment of yesterday’s telecast came, during introductions of the game, many medical personnel who tended to Hamlin, and training staff from both teams were all introduced on the field. And yes, it was predictable, but wow, what a powerful moment, Hamlin was introduced, and embraced all who were there. Yes, the tears were not only falling, but out of control for me. Hamlin was wearing sunglasses, but anyone watching knew what was happening in that moment.

I reunited with my hospital caregivers a couple months after my emergency bypass had been completed. I wanted to let them all know, their care was responsible for saving my life, and I was not only going to live, but make the most of my life, and I would forever be grateful for the care that they gave me.

In the meantime for Hamlin, he is using his “event” to raise awareness and advocate for everyone to learn a newer version of CPR, his life definitely being saved from someone immediately able to perform CPR on him after he collapsed. As anyone knows, timeliness is critical in reviving someone whose heart has stopped.

The newer procedure for CPR came about for several reasons, from reluctance due to Covid-19 risk and sadly homophobia in some cases, to discovering that chest compressions were more critical to keep blood flowing until emergency personnel arrives. The American Heart Association now recommends up to 120 chest compressions per minute, and if possible, using a chain of rescuers. Even if you have never performed CPR on someone with the older method, and just been certified using a “dummy,” performing chest compressions for a long period of time, combined with the emotional adrenaline, can be exhausting.

But learning this new technique, is not only easier, it just might make a difference when you least expect it. Like in front of 65,000 fans during a football game.

Hey Frontier Airlines! I Just Want You To Know…

Hey Frontier Airlines! I just want you to know… that you SUCK!

Oh, you do not have to worry about me thinking you care about the inconvenience you caused yesterday. The loss of time with my daughter yesterday and this weekend clearly is not your problem. But here is your problem. “Du bist mies” (German).

Forget the fact, that this was the second flight in a row that you have cancelled for me in a month and a half, after I had already checked in. You clearly knew the flight was going to be cancelled sooner, yet, it was not until my daughter was on her way to the airport, and a notification by Flight Aware, not you, Frontier Airlines, that the flight was cancelled. “Vous etes nuls” (French).

You never offer any explanation as to why the flights have been cancelled. This is quite arrogant of you. It is quite obvious why you do not offer explanations. If it were the weather, you could just say so. No one would ever blame a judgment call because of bad weather. But yesterday’s flight cancellation was not because of weather, though clearly weather did cause a great number of delays. Frontier Airline and Countour Airline (had never even heard of that one before) were the only ones to cancel flights. All other flights took off. It was not the weather. “Pesimo” (Spanish).

On average, your airline only has one flight to a destination per day. Why is it that you cannot even get just that one flight out when other airlines get multiple flights out, even if late? You will not say. “Jestes do bani” (Polish).

Do you remember that one flight that you lost my luggage in spite of your flight being non-stop? I do. There were about 30 of us at that airport, trying to find out what happened to the luggage that was loaded at the departing airport, but did not arrive. Your personnel offered no explanation other than “we are looking into it.” When it turned out, another passenger had a tracker turned on for a device in his checked bag (he must have experienced this before), he discovered that his luggage was indeed back at the departing airport. Why was he able to figure that out, but not your employee? And then, all your employee would offer, was that the luggage would be flown here “as soon as possible,” in spite of a second departing airplane from that same airport an hour later, refusing to guarantee the luggage would be placed on that plane. And why was the luggage bumped from the airplane in the first place? Was it true that “contracted cargo” bumped passenger luggage for space on the airplane? “Bena vagy” (Hungarian).

Even during the Covid-19 crisis, somehow you managed to operate more reliably than now, especially with the extra steps of disinfecting the planes and surveillance upon boarding. The government even gave your airline relief funds to help you survive the pandemic and restrictions by retaining your staff. But did you keep your staff? “Du suger” (Swedish).

The kicker? While you are forced to give refunds for flights that you cancel, it is hysterical that you offer a credit voucher for your “inconveniencing” me. So just because you think I have a low enough IQ, you want me, to schedule more flights with you, in spite of the frequency of cancellations, and you are going to bribe me with a $50 voucher (that cannot be exchanged for cash to say… purchase a ticket for another airline to get to my destination). You want to keep me hooked, for the possibility and the unreliability that the next flight could get cancelled as well? “Unasinya” (Swahili).

I would like to talk to you about a better way to resolve this issue, but there is no one to talk to in customer service. Customers are told to communicate via the Frontier app or on line. How convenient that this allows you to not subject an employ to the true impact of customers and the inconveniences caused by your airline by supplying what I feel are likely automated generated AI responses. At least gauging by the responses I got in return, the responses were computer generated. So there is no chance, any customer is going to be made whole for their inconvenience and losses because there is no one on the other end. “Fai schifo” (Italian).

There is an expression, “you get what you pay for.” And while no one expects a “discount” airline to be perfect, reliability should not be the thing that is discounted or eliminated. Sure, Frontier Airlines is not as bad as other airlines. I would not think that is a bar that your airline would want to strive to be. But you are getting there. “You suck!” (English).

You do not have to worry Frontier Airlines. I am not going any further with this. As an advocate, I have much more important things to fight for. A losing cause is not one of them. I feel your airline clearly does not care about its customers and customer service.

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