Paul's Heart

Life As A Dad, And A Survivor

Archive for the category “Side Effects”

19 Apr 2020
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A Tribute To Those On The Front Lines Of Covid19


I want to try something.  I have made no secret over the last many years, the huge amount of respect and appreciation for those who chose the field of medicine as their life.  They did so in complete disregard for their physical and emotional needs, for one reason, because they were special.  They possess an ability and skill to care that we could only aspire to possess.  Over their careers, I am certain they have had their shares of successes and tragedies.  But nothing could have prepared them for what they are dealing with today, Covid19.

I have many friends and acquaintances who are doctors, nurses, EMT’s, techs that I could not possibly name them all, not just because my memory is no longer what it used to be, but I would not want to forget and leave anyone out.  So, instead, what I want to do, is share a personal story about two nurses that show why everyone on the front lines in the hospital deserve our respect and appreciation for the sacrifices they are making.  And then, I would like you to offer a story of a nurse or doctor or tech that you dealt with, that went above and beyond, in a time when Covid19 was not even a thought.

It does not matter if you comment here, or on Facebook.  And I want you to share this story.  I want to fill social media with stories that show how much these heroes mean now, and what they have meant to us before, and what they will mean to us after this crisis has passed.

I have one experience involving two nurses.  At the beginning of my heart issue, when I went in for a simple catheterization, I had a nurse named Heather.  She spent a lot of time talking to me, and comforting me knowing I was scared with the uncertainty that I faced with a potential heart problem.

Fast forward to the discovery that I actually needed and went through an emergency heart bypass, thirty six hours later, when I came to in the ICU, Heather was at my beside along with my ICU nurse Joe.  She was happy to see me and that I was alert.  I was unable to talk because of all the machines that I was hooked up to.  She had completed her shift in the angio unit, and had heard that I underwent this surgery.  As one of her patients, she wanted to see how I was doing.  And it was not the only time that she checked up on me while I was there.  The point is, she did not have to.  I had so many nurses, and saw so many doctors, but she was the one that was concerned about me, and my outcome.

Meanwhile, Joe, my ICU nurse for the first twelve hours, was relieved by Jackie.  Jackie would be my nurse, seemingly for longer than a twelve hour shift.  I had no concept of time, but I do not remember seeing any other nurse.  I was more alert.  I was taking off the ventilator.  I could finally see that she had another patient that she was responsible for observing.

The time eventually came for me to leave the ICU for the next level of care.  Two days later, in the middle of the evening, a shadow had peeked through the door of my room.  It stayed there for a couple of minutes, and then quietly began to exit when I called out.  “Who’s there?”

“It’s me, Jackie.”  I scolded her for attempting to leave without giving me the chance to say “hello” and “thank you” for all she did.  She had been off from work  the prior day.  She decided to track me down on her break, and come to see how I was doing.

In my life, I have been blessed to have the best care for my health.  And I am not just talking about the actual care, I am talking about the compassion, a facet of their career that is just as important, especially to the patient.  The doctors and the nurses that I have, or have had, have gotten me where I am today, still alive.  The majority of them now face the biggest challenge of their careers, and it is not just Covid19 risks itself, but emotional and physical stamina.

So I ask you, to comment and share, your story/stories, of a health care worker that is your example of proof of the unwitnessed extraordinary sacrifices you know are being made today, because you have personally witnessed them.

Posted in Cancer, Education, Family and Friends, Inspired By..., Side Effects, The Heart and tagged ,
17 Apr 2020

The Fantastic “Voyage” – 12 Years Later


At this time, twelve years ago, I was laying on a table, with no heartbeat.

I had been taken to the operating room around 4am, with a detour at the hospital chapel.  I was scheduled for an emergency triple bypass that was discovered only because I was annoyed by a symptom that I could no longer ignore after four months.  Less than twenty-four hours earlier, I had undergone a catheterization which was believed to have been good enough to correct the suspected blockage.  Instead, my cardiologist had discovered, I had a blockage that gets the dramatic nickname, called a “widow maker.”  Because that is what the type of blockage leads to, a fatal heart attack, not if, but when.

I have written before about the procedure, and you can view the page, “CABG – Not Just A Green Leafy Vegetable.”  Instead, as I have had time to do during this social isolation, I went through my medical file that I have a copy of every record from April 17, 2008 on.  I came across my surgical report from this bypass surgery.

Reading this report reminded me of a movie that I had seen on multiple occasions as a child, “Fantastic Voyage,” featuring Raquel Welch.  It was a sci-fi thriller that had doctors shrunk in size, placed into a submarine type vehicle, the inserted into a syringe, injected a patient.  The vehicle would travel through the body into the various systems finding themselves under attack from white cells, that were only doing what intended, attacking foreign bodies, and other creative situations, all in the attempts to perform a surgical procedure from within the body itself.  Seriously, check out this movie if you can find it.

Anyway, as a Hodgkin’s survivor, I was taught the importance of keeping a copy of my records for everything.  Because not every medical personnel you deal with will have necessary and immediate access.

This is not the first time I have read my surgical report on my bypass.  But as I do, I am still amazed at the detail, the effort, and the literal “life and death” status, not to mention a whole bunch of big words, that to this day, I still have not looked up as to their definitions.  The report, as understood on its own, is enough for me to handle.  So with that, I want to share some of the “cool” things that were done to me during this process.

“median sternotomy incision made… sternum divided…”

“divided left mammary artery”

“anterior pericardium was opened”

“The patient was placed on bypass, cooled, and emptied.  With the heart emptied, a crossclamp was placed and one liter of antegrade cardioplegia solution was given through the catheter in the ascending aorta.  The heart became asystolic.”

This one really got to me.  My heart was emptied of any blood, and it was stopped from beating.  I was dead.  I was on a bypass machine, but my body for all intents and purposes was no longer capable of living on its own.  The bypass procedure was now literally on the clock.

“Hot shot of warm oxygenated blood cardioplegia solution was given.”

“Valsalva maneuver was performed” (artificial respiration technically)… “the heart was allowed to fill” (with blood).

“The heart fibrolated at this time.”

“off bypass…”

“wired the sternum, closed the wound in routine fashion…”

With that, I was taken to the ICU, where I spent an unknown amount of time.  I had no windows so I have no recollection if it was even days.  The entire report is amazing to read.  It makes my experience even more remarkable because I not only lived it, but survived it.

This was the turning point for me in my survivorship of Hodgkin’s Lymphoma, a hyper-awareness with my body’s health.  I learned all of the other issues my body deals with because of the treatments that I went through to save my life over thirty years ago.  Of course now, I wonder the status of the bypass, not necessarily a lifetime solution.  No doctor is willing to give me a time-frame on the bypass lifespan.  But twelve years out, and with the progressive damage still occurring, I know that I have to still be observed not just for this, but all of my other issues.

But given the reality of the Corona Virus crisis that we are in, I have a different point that I want to make.  Though not every outcome results in a positive end, our health care personnel are amazing with what they not only can do, but the circumstances they must perform under.  I will always have the utmost respect for my doctors, nurses, techs, and all of the other personnel not just to care for one patient, to care for all.

I am thankful for you all, whether you were in that operating room or not.

Posted in Cancer, Education, Family and Friends, Inspired By..., Side Effects, The Heart | Leave a comment
14 Apr 2020

Cause And Effect


There is a great debate going on during this Covid19 pandemic, recording statistics accurately.  There are two main sides.  One side is genuinely concerned about preventing further spread and saving lives.  The other side is more concerned with the politics of what is happening, and it is odd really.  Because politics should never determine if someone lives or dies.  But when statistics get used to attack a perceived favorite representative, who literally has nothing to do with the cause of the outbreak at all, the concern turns to a number that possibly could be used against that representative, as in some possible failure to lessen the impact.  And the only way to lessen the impact, is to lessen the number.

The objection, and unfounded claim, is that some deceased are being declared a casualty of the Corona Virus, even if other factors may have been involved.  The argument being made is that it is not fair to declare the death to Covid19 if something else was wrong or happened.  That is such a flawed claim.  And here is how I will prove it.

I apologize for the extreme example, but I am not open to debate.  A person is shot and killed  Is the person dead because of the gunshot, the massive loss of blood, or cardiac arrest?  Of course the cardiac arrest is what killed the individual, but the other issues, the blood loss, and of course, the gunshot cannot be ignored.  One thing led to another and resulted in a death that should have occurred later in that person’s life.

Now, I am not saying that a person with Corona Virus that randomly gets shot and killed should be declared a death of Covid19.  That is ridiculous.  But does a person with the virus en route to the hospital, either on foot or in a vehicle, involved in an accident resulting in death get declared a Covid19 death?  Absolutely.  And here is why.  If someone is that immersed with the virus, that medical help is necessary, it is likely that there is so much internal damage to the body from the virus, making sustaining or recovery impossible, especially with the virus affecting the lungs as it is known to do.

Let’s put aside the virus for a second and use a different example, as often comes up in the world of cancer survivorship.  A similar argument comes up frequently as the virus cause and effect argument.  Is it right to blame the health issues that we long termers deal with, on the treatments, even thirty and forty years after treatment?  Is there an infinite and blanket blame?  The short answer is yes.  Here comes the long answer.

Prior to my Hodgkin’s Lymphoma, I was an otherwise healthy individual as far as I know.  But I had my spleen removed as part of the diagnostics.  That surgery has now left me immuno-compromised for the rest of my life.  The loss of my spleen has caused a permanent change with how my body protects itself, BUT, it has not caused my death.  Should I contract this virus, there is a likelihood that I would not survive.  So would my cause of death be listed as being asplenic (no spleen) or the virus?  I lost the spleen thirty-two years ago, but clearly had I had my spleen I might have been able to fight the virus better.  So that is not the virus’s fault, right?  It is a stupid concept.  My death would be Covid19.

Another example, recognizing that the main problem with the virus, is the pneumonia that it causes.  Already immuno-compromised from not having a spleen, I battled two cases of septic pneumonia within a nine-month period.  My pneumonia was not caused by catching a virus.  It was bacterial.  You see, the radiation therapy that I went through for my Hodgkin’s, damaged my trachea and esophagus.  Weakened from the damage over the years, there is a condition that traps food in the airway, which of course ends up decaying there.  Called “aspiration” pneumonia, I inhale that bacteria from the trapped and decaying food into my lungs.  Also, a side note, the left lobe of my lung is considered “dead” and non-functional leaving me with a diagnosis of restrictive lung disease.  Not bad enough?  I have unidentified spots on both my lungs, which are just being watched at this point, for the potential of being cancerous.  Now, let’s say.  I get Corona virus.  It turns into the pneumonia.  I die.  Are you going to try and tell me that I did not die from Covid19 with so many other issues against me?  I get by in my life in spite of my ill health.

I have another ten health issues related to my cancer history, all which leave me susceptible to the Corona Virus.  But for the sake of “feeling good” and not piling on scary numbers, if I were to get this virus and die, I had enough against me to make it okay not to count?

I get it.  Telling scary numbers makes our president look bad.  And this post is not about armchair quarterbacking.  Throughout history, we have learned all the who’s, what’s, why’s, when’s and such, after everything has passed.  We learn from history so that we do not repeat it.  And the only way we can have an accurate accounting, is with accurate numbers.

This is a fact.  In a family of four, if one member is tested and confirmed positive, the other three members are presumed to be positive.  That should mean four more in the total of positive cases.  It is not.  The confirmed cases of positives are based solely on those tested.  So, if you have not gotten tested, you do not count in that total.  As of this post, we are nearing 600,000 confirmed cases.  If I am being generous by just doubling the number allowing for presumed, which without confirmation of could be or might not be, as contagious as this virus is, likely, we would be well over a million, and probably more.  This makes a big deal when you compare that number to the rest of the country.  What about the other 349,000,000?  How do we know if they have or have not been exposed?

We are struggling to get this under control as a country.  A good majority of us are doing our part, listening to the guidelines put forth by the president.  When the dust is settled, and the time is appropriate to look back, there is a chance, it will not be kind.  Understandable, this was the first time we are dealing with this monster.  But the biggest judgement of everything, were decisions informed, ignorant, or wishful thinking?  That is for a later time.

But of all the numbers that are important to report, yes, the fatalities.  I am not sure if it is trolls or bots trying to spread the nonsense of what is actually a Covid19-related death or not.

Just as everything that changed about my body in 1988 with the diagnosis of my cancer, everything that has happened since, gets attributed to those physiological changes because I would not otherwise have these cardiac, pulmonary, and immunological problems if I never had my cancer.

Cause and effect.  If a death was caused directly or indirectly from Covid19, no matter if there were underlying causes, it is a Covid19 death.  Arguing over such a triviality in the midst of still so many fighting for their lives, or hoping to avoid getting the virus, is truly a waste of time.

 

Posted in Cancer, Education, Inspired By..., Politics, Side Effects, The Heart | Leave a comment

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