Paul's Heart

Life As A Dad, And A Survivor

Archive for the category “The Heart”

26 May 2026

Surviving Sepsis


This is definitely a post you will want to share.

Heavyweight champ, Mohammad Ali. Muppet creator Jim Henson. Superman actor Christopher Reeve. Academy award winning actress Patty Duke Astin. Actress Tanya Roberts. Model Anna Nicole Smith. Singer Etta James. Actor Jeff Conway. Former president George H.W. Bush. They all share one thing in common, all passed away from complications related to sepsis.

I have three very serious triggers when it comes to health: cancer news, cardiac news, and sepsis news. Why? Because I have personal experience with all of them. This is the part where I also clarify that I am not a doctor, and I am relying on my own personal experience with the things that I am going to say.

The sports and racing worlds were rocked last week at the sudden passing of Nascar racing champ, 41 year old Kyle Busch. Though initially the cause of death was not stated, probably for no other reasons than waiting for final test results, his cause of death has now been stated by his family as severe pneumonia and sepsis.

Immediately, social media warriors came out with their moronic comments, “did he get the Covid vaccine?” (how are we still dealing with this stupid and false question yet?), “incompetent doctors,” and so forth. These stupid comments were coming out before even saying anything about Busch’s death. Several social media personalities are calling out that “something is not right”. Rather than learn about a condition, it is much easier to just give conspiracies and assumptions more fuel.

To be clear, I am not a racing fan, but I am drawn to news, when something occurs that I can relate to. As explanations began leaking out, that the young driver was not feeling well, having something like a cold, and that he had requested a shot (of what? it was not stated) following the race he had just won, it was the next symptom that triggered me. I know, because it happened to me. I had been there and done that. The difference between me and the social media warriors, I kept my opinion to myself until the official word came out. Makes the score Me = 1, Social Warriors = 0. It accomplishes nothing to say something just for the sake of saying something or to jump out in front, and then be wrong.

Busch was reported to be coughing up blood. The most common cause of this is an infection, such as pneumonia, which has also been stated he had with his cause of death. As many of us are probably prone to do, we blow off respiratory and cold symptoms, and just chug through. We are also reluctant to go to the hospital or seek medical care, preferring to just ride it out, or just “get a shot.” Soon after, it was reported that Busch had died. This was no cold. I knew that. I told those around me, I am guessing he had pneumonia and did not know it, and then went septic. Delays in emergency medical care are usually fatal. I say “usually”, because…

Back in March of 2012, I won’t give the exact date as it is a personal date to me, I was taken out of my house at 3am on an ambulance stretcher. I woke up suddenly in immense pain, and began spewing vomit relentlessly and violently. I was hallucinating. And then I passed out. The only thing else I remember, was being rolled out of my bedroom, passed my two young daughters, looking horrified that something had happened to me.

I do not know how long I was out, but when I came to, I was told that I had pneumonia, and was septic. I knew what both meant, I just couldn’t believe it, because when I went to bed that night, I felt fine. I had an exhausting week, working 60 hours, I had school board campaigning that had to be done for the upcoming election, I had a school parent fundraiser to prepare for that weekend, and my daughter’s birthday at the end of the week. I didn’t get to sleep a lot, and my diet had a lot to be desired, as in, I desired to eat, just did not get to. But when all was said and done, following the birthday party, sure, I was exhausted, I ate some food, and went to bed around 11pm, without any ill feeling of what would come four hours later. And then it hit me, four hours later, no warning.

The wild thing is, I had not learned my lesson, nine months later I would have another diagnosis of aspiration pneumonia, this time diagnosed as “double pneumonia.” Yep, I had it in both lungs. I was not septic this time, but my same stupidity of denial and grit could have easily led to it. I went to work that morning, feeling like shit, drove there, got to the parking lot, and then said to myself, “I can’t do it.” I drove back home, crawled into my bed with my winter coat on, curled up under the covers, which is where I was found 8 hours later. Back to the hospital.

This behavior is not good. Trust me, I know it. But when it is all you know, this toughness, at all costs. Besides my pneumonias, all three of my heart surgeries and my carotid artery surgery, ALL related to my cancer treatment history, and I still do not react properly and timely.

There are four types of pneumonias: the common ones, viral and bacterial, and then two others fungal and mycoplasma. The viral one would easily have been suspected, as Busch claimed to have a cold, so he could have had anything from RSV to Covid, or even just a cold that got out of control, a viral pneumonia. For me, mine was bacterial, aspiration pneumonia. What is aspiration pneumonia you ask? Aspiration is when you inhale or swallow other than air, into your airways, common with people with reflux, food, saliva, etc. Have you ever drank something too quick and it “went down the wrong way” causing you to cough uncontrollably? That is aspiration. Your lungs are not meant to have anything other than air. In my case, not only do I have reflux, I also have something called a Venker’s Diverticulum in my esophagus, which as a result of my radiation therapy for my cancer, causes food and liquid to get trapped in my esophagus. If it stays there trapped, guess what happens? The body breaks the food down there and becomes bacteria, which gets inhaled into my lungs, and becomes aspiration pneumonia.

Because I was unaware of this happening, and feeling as I “normally” did, I continued on as if nothing was happening. And this should have been a fatal mistake from what I was told. It got so bad, according to my doctor, bloodwork confirmed, via the lactate acid level test, I was septic for over 48 hours. I should have been dead, not having gotten the necessary IV antibiotics I needed.

You need to understand how quickly sepsis starts and spreads. It needs a source, the original infection. Once the original infection gets too bad, and again, this could be a sinus infection or a cut, and the body’s natural immune system cannot keep up, the germs or bacteria or toxins of the infection break loose and enter the blood stream. And if you remember anything about health class in school, the blood stream goes to the heart, and from the heart, pumps out to the rest of the body. Imagine if you have ever seen a fire spread, or a hurricane devastate a coastline in real time, this is what sepsis does, and quickly. The body continues to get overwhelmed, causing widespread inflammation throughout the body, blood vessels get damaged, blood clots form. And once this happens, blood and oxygen get blocked, causing organs in the body to fail. This is called septic shock. Again, this happens all so very quickly. Sepsis is not the infection, but rather the reaction to the initial infection, whether it be pneumonia, a cut, a bite, or a cold.

And understand just how common sepsis really is, yet rarely talked about. According to the CDC, nearly 2 million people every year develop sepsis. To put some perspective, rememeber the numbers of Covid diagnosis? I will go smaller. Hodgkin’s Lymphoma has about 50,000 new diagnosis each year. Of those diagnosed with sepsis, over 350,000 die. This is a lot of deaths, and yet, sepsis does not get the attention it deserves and needs. I will bet anything most reading this post will not know how to watch for it.

Time, or TIME as the acronym is spelled out, begins the moment the doctor suspects sepsis. By then, sepsis is already so far ahead, the patient racing towards death if treatment not given soon. Busch was already not feeling well nearly a week earlier, and at no time was sepsis suspected. Could it have been? Perhaps. But unless you specifically bring up, “hey, I want to be checked for sepsis,” medicine isn’t just going to volunteer to look for it.

So I understand what happened and how to Busch. And it is sad, he was only 41 years old. Like I said, men, and women, do a lot of denying, a lot of “pushing through,” and depending what is happening, can be wrong, fatally wrong. And it is in moments like this, when it is fresh, we should be educating everyone on Sepsis. Because it is more common than we realize. A paramedic friend told me, so many people die of sepsis in the hospital unknowingly, because it is not something normally checked for. According to the AAMC, sepsis is the 3rd leading cause of death inside hospitals. Hospitals do not assume you have sepsis or will develop it. They are waiting for symptoms.

So realizing that the dead cannot talk, how about those who have survived sepsis? Singer Madonna. Actor Billy Porter. Actress Ashley Park. Survival in the hospital when being able to treat is 80% and drops rapidly without.

No one with the ability and resources wants to talk about it? Okay, I will do it, as I always do, one person at a time, always with the hopes it makes a difference to at least one person. As I said, I have survived sepsis, and I know others who have. I also personally know some who have died from sepsis.

Awareness, Pneumonia 101. This by no means will be a full tutorial in learning about pneumonia and sepsis, but it will be more, and easier to understand, so you can be better to watch out for.

I have already mentioned the four types of pneumonia, and at least how you develop aspirational pneumonia. As for the others, there is community acquired (catching a virus from someone else), hospital acquired, ventilator associated (why doctors do not want you on a ventilator for long), and health care associated.

Just as there is for recognizing a stroke, there is an acronym for helping to recognize someone with sepsis. But again, the key is, you have to recognize it, not blow it off or tough it out. The acronym is TIME.

T = temperature, usually very high

I = infection, tough to recognize if we cannot see it, or feel sick

M = mental decline

E = extremely ill (refer to what happened with me above), crazy level of pain

(image AI generated)

Let me tell you, the pain was ridiculous. The vomiting would not stop. And I definitely saw some “weird” stuff in my head. I was in bad shape, and clearly had been for some time. This is just one of several episodes I danced a little too close with death.

Busch did not know or suspect he had anything more than a cold. The diagnosis of pneumonia is simple enough. Simple use of a stethoscope to hear “crackling” in the lungs, sometimes you can hear with your naked ear pressed against the chest, and a chest x-ray will confirm pneumonia. Diagnosing sepsis is a little more complicated, and unless they are looking for it, will go overlooked. There are these tests: CBC (complete blood count), blood cultures, organ function (because your organs start to shut down when sepsis progresses), imaging tests, and as mentioned, the lactate acid level testing.

Once diagnosed, it will be only the highest broad spectrum IV antibiotics that will save a person from sepsis. And the only place to get that done is in the hospital. And NO, and I want to be clear, IVERMECTIN WILL NOT TREAT SEPSIS!!!! I can’t believe I even have to say that.

So now you see why Busch’s death is really so tragic besides his age. He knew he was sick, just not how sick, and got worse, rapidly. And whoever was responding to him, for “the shot”, was also wrong, wrong in that decision, and wrong for not insisting Busch go to the hospital.

When a tragedy like this hits, we need to talk about it, not wait “because it is too soon,” or worse, not even talk about it. Sepsis can be prevented, just as strokes and other medical crisis. But only if we know what to look for.

Posted in Education, Family and Friends, Inspired By..., Side Effects, The Heart and tagged , , , , | Leave a comment
24 May 2026

Paul’s Heart Milestone – 100,000 Views!


It certainly took long enough, definitely longer than I thought it would, and then last night, as I realized it was going to happen real soon, it took even longer. I was taking screenshots of the counter, for just before, and then when 100,000 was hit. But as most things in life, not having control, my counter went cuckoo as multiple visits registered at the same time.

Though I am a 37 year cancer survivor of Hodgkin’s Lymphoma, I did not start the concept of Paul’s Heart until thirteen years ago, five years after I became aware of the complicated health issues I had and was developing due to the treatments of my cancer back in 1988 at the age of 22, just out of college.

I have always enjoyed writing. I actually have kept school assignments from elementary, junior high school, and high school. I always got good grades. In junior high school, I began writing song lyrics (though very tacky and cheesy) and poems, but it was documentary and testimonial pieces I enjoyed writing most. In college, I experienced my first bad and quite rude critique, and the way I handled it was definitely wrong. My professor not only handed me my first “F” (I had never had less than an “A” on any writing assignment), but my professor also wrote in big RED letters, “you don’t have the intelligence to get past a comic strip page.” And with that, I dropped out of her class. I was devastated. I felt I was a good writer. It was one thing to get a bad grade, after all, grading a paper is subjective, but the insult definitely crushed me. And I stopped writing, for a long time.

But it was during my later years of survivorship, my passion and my need for writing returned. As a patient and survivor advocate, I often encourage people to put their feelings and experiences down in writing. There is a catharsis, a releasing of pent-up emotions, stress, or trauma, resulting in a feeling of relief, renewal, or emotional cleansing that comes when you let those feelings leave your body. This is especially good if you have an aversion to speaking to a therapist, which I can tell you, is also a good option.

In 2013, I created Paul’s Heart originally with the web address http://www.pedelmanjr.com , later adding http://www.paulsheart.com . I have published 1323 posts over those years, averaging about 8 posts a month, sometimes a lot more, sometimes a lot less. I still have 285 sitting in a cue to finish, stalled by writer’s block or distracted by other topics that came up in the meantime, now sitting in their own purgatory. I have 48 pages, short stories also published on this site, as well as links to other resources. I have allowed comments to my posts, well, except for a few trolls (their comments are actually saved should I ever decided to approve them). I avoid only two topics by choice if it can be avoided, politics and religion, unless there is a tie to cancer, health care, and survivorship.

It definitely took a lot long to hit this milestone than I thought. At least in the beginning, average views to the page were around 20, and depending on the topic, there would be hundreds of views. It had been my hope, that in spite of Hodgkin’s Lymphoma being considered a rare cancer, Paul’s Heart would hopefully finally get Hodgkin’s on the conversation map. I am a small fish, not like the American Cancer Society or the Leukemia Lymphoma Society, but unlike them, I am solely focusing on Hodgkin’s and long term survivorship. Little ol’ me, not famous, not rich, and without the help of anyone famous who had also recently dealt with Hodgkin’s who had an opportunity to draw attention to the cancer we shared (Michael C. Hall “Dexter”, Martin Fry – lead singer of 80’s band ABC, comedian Dick Gregory, actor DJ Quals, literal “Survivor” Ethan Zohn, Pittsburgh Penguin hockey great Mario Lemieux, Kansas City Chiefs Eric Berry, and though he has passed, Microsoft founder Paul Allen), though in fairness, as anyone who has dealt with cancer, nobody wants to stay in the cancer world once they are done with treatment and in remission. I am an anomoly. For me, it is my way of giving back for the efforts of those who saved me.

So yes, I am doing this one post at a time, one person at a time. I am also doing this organically. This count was done with the efforts of those who follow or read Paul’s Heart, and then share it. Word only gets out, when it gets passed around. Not once did I ever pay to publicize any of my stories here. 100,000 views is a legit and honest effort!

I have also expanded Paul’s Heart with 2 Facebook pages, both titled Paul’s Heart, I am on Youtube at @paulsheart, and have a Paul’s Heart page on Tiktok at @paulsheart2022 where I rank in the top 10% of creators with the similar follower counts.

I have been doing peer to peer counseling with patients and survivors nearly my entire survivorship. I have given countless survivorship speeches and interviews on cancer survivorship, though still waiting for that one big opportunity with major media, but I realize the big ones don’t care about publicizing happy stories. And then of course, I got to publish so many projects, newsletters and book anthologies for other organizations (like Memorial Sloan Kettering Cancer Center). I even got to have one of my stories performed by broadway actors, that was way cool (see the link on this page “My Dad Was Just Like Me”). And then finally, my biggest effort, publishing my own book, called “Paul’s Heart – Life As A Dad And A 35-Year Cancer Survivor,” available on Amazon. And I have four more book projects started and undoubtedly will either need to do another book on my survivorship as I have lived even longer, or at least do a second edition. I am also working on doing an audible version of the book. One other thing I would like to do, is create a podcast.

I have tried to balance my topics here not just with things related to cancer and survivorship, but with all things, life after cancer, a life that definitely was no longer like what I was doing before cancer. I have shared stories of other survivors, and memorialized those who have passed. I have dealt with everything from relationships (married twice, divorced twice), to employment issues, and even dabbled in local politics as a school board candidate (an interesting experience). But perhaps the biggest thing that I got to share here, was my experiences with parenthood. The BEST THING hands down about my 37 year cancer survivorship is being the Dad of two of the most wonderful, intelligent, beautiful, kind, empathetic, all around, best daughters a Dad could ever hope for. They were not there when I dealt with my cancer, but they have witnessed the last 18 years of my difficult survivorship with all the health issues that I face. Only in recent years do they understand the gravity how serious some of these issues are, because now as adults, they are included in all of my appointments. There is no one that matters more to me than my daughters and each and every moment I get to spend and witness with them. This unconditional love has been the bond that has kept us together, and going, and keeps me going wanting so many more years of time with them, to see what else they accomplish.

Today is a big day for Paul’s Heart. It is a compilation of so many things that have come together, hopefully achieving what I set out to do when I was told I was in remission, making a difference, wanting to inspire others facing cancer and survivorship, even if one at a time.

And though I am sure that old battleax of a professor is no longer in this time and place, whereever she is, I am hoping she can see the two finger salute I am giving her. Her words did not stop me forever and I am quite proud to have done what I have. And finally, my daughters have their legacy of their Dad to be immortalized forever, right at their fingertips.

Posted in Adoption, Animals, Bullying, Cancer, Education, Family and Friends, Food, Inspired By..., Politics, Recreation, Side Effects, The Heart | Leave a comment
23 May 2026

Risk Reduction/Prevention For Surgeries/Procedures


For this next story, I need to provide a little context. I was 18 years old in this photo. In the 1980’s there was no such thing as a selfie or a desire to take a lot of pictures, so this is one of the last photos of me prior to being diagnosed at the age of 22 with cancer, Hodgkin’s Lymphoma.

To my knowledge, there were three others, young like me, also being treated around the same time. I never got to meet them, and the only thing that was shared with me about them, was that I was tolerating my treatments so well, I was the only one of us, who was taking the full dose of everything. I never got to meet them and I have no idea, what has happened to any of them. Later on in life, I would meet another fellow long term survivor, who was treated where I was, but that is another story.

A few years later, an opportunity came up that would change my life forever as a cancer survivor. Though it was through a group email listing, I would get to meet three other Hodgkin’s survivors, all younger than me, who had just gotten finished with their treatments. This was going to be my “give back” moment, to share and inspire those after me, that survivorship was possible.

And for many years, all of us enjoyed living life after Hodgkin’s Lymphoma. Sadly, two have since passed, leaving only “T” and I. I remember T for a long time, chugging through life, not a care in the world, seemingly being able to forget that she had cancer, in spite of my pleas to be aware and proactive, things to watch out for. Nearly ten years ago, she faced her first late side effect issue, like me, the worst of all, the heart. And just with my bypass, I tried to advise the importance of staying dilligent, because this likely would not be the last thing she had to deal with. But knowing T, she was not going to be deterred in getting back to normal, as she did post-Hodgkin’s. And of all people, T was in good conditioning, a good diet, and a great attitude, if anyone could do it, she could.

The thing about those of us who have gone through chemo and radiation, there is a saying among us survivors, referring to our treatments as “the gift that keeps on giving.” Those of us at this long enough (like me), know this philosophy all too well. Don’t get me wrong, you still have to live life, albeit maybe a little more aware and careful, but I have not had 37 years of memories by just folding up into a ball, sitting in a corner.

I have gotten to experience so many things. My most important memory happened a couple of weeks ago.

So that is the background of this text. And just as I said, “the gift that keeps on giving,” T found herself in another situation, with her heart. She needed to have another situation, like I had, replacing the aortic valve. It was even supposed to be done the same method as I, so I was all confident when I explained to her my experience, encouraging her that with her conditioning and age (a number of years younger than me), she should do great. I am sure she was still nervous, but I think a bit more at ease, and definitely looking forward to feeling better, and as quickly as I described.

Then, the day of the surgery, she was informed her surgery had been delayed. She was crushed, but the decision was the right one. It was an error in communication on their part, but as a result, the decision to postpone had to be made. Surgeries are risky enough, but I have seen too many times, my fellow survivors, we carry enormous extra risks, if they are not all addressed, the procedures could go tragically wrong.

If you have ever had a doctor appointment, many of us go through a painstaking process of having to recite what medications we take. I myself take more than a dozen medications for everything I deal with. Well, between those meds, my medical history, and my body, there are concerns that need to be addressed prior to any surgery or procedure, and all of those from doctors to anesthesia, need to be aware of everything. There are certain medications that need to be stopped, and there are precautions that may need to be taken.

In my case, I am on blood thinners. So anything I do, from a tooth pull, to a colonoscopy, to surgery, I need to stop blood thinners (I am on two) as directed by the doctor. There may be blood pressure meds I need to stop depending on the procedure. I am not able to receive pure oxygen due to my chemo history, being given bleomycin (complications too complicated to include in this post). And then there is my trachea that gives doctors fits. I cannot receive twilight anesthesia, because of radiation damage to my throat area, my trachea collapses, and I experience something called hypoxia (three times now, because some refuse to pay attention to my chart or my warnings). Short explanation, George Floyd was murdered when a cop kneeled on his neck, collapsing his trachea, causing the loss of oxygen.

I am also without a spleen, which means I am more susceptible to infections, so prophylactic care must be taken, often antibiotics before hand, to keep infections up to and including the fatal sepsis from developing.

So when I have something scheduled, I am fairly confident I have every base covered. Or so I thought. I recently started a new medication for my diabetes and A1C. And what I did not know, might just end badly for me.

I am going to bring back my reluctant survivor back into the story. T also happens to be on a similar drug for her diabetes. And it was this drug, that was responsible for her surgery getting delayed, because it needed to be stopped, per her doctor’s recommendations, three days before. As of the day of her surgery, she still had not stopped it.

The drugs I am referring to, Jardiance and Farxiga. I want to be clear, I am not a doctor or pharmacist. I am only reciting confirmable facts on the drug sheet, and via the fine print on their television ads. Which by the way, Jardiance does not state on their ads (at least the one that I saw), the particular concerns I am stating here. Sure, they list all the other side effects, you know, the diarhea and everything else, but they left out this one.

Jardiance and Farxiga are SGLT2 inhibitors which can increase certain risks with surgeries and anesthesia. The main concern, euloglycemic diabetic ketoacidosis (eDKA), and that is a real bad thing. If it sounds familiar, you might be a fan of the television show “House,” as this was an occaisional diagnosis. EDKA is a dangerous acid buildup in the blood that can happen during fasting for surgery, dehydration, surgical stress, infection, or reduced food intake. What makes it complicated, is that the blood sugar doesn’t even need to be elevated or near normal, so it is hard to recognize.

Symptoms may include nausea, pain, breathing issues, confusion, fatigue, dizziness or weakness. It is often recommended to stop taking these drugs three days before but could be longer if kidney funtion is impacted. The doctor and anesthesiologist needs to watch the blood pressure, kidney stress, electrolyte imbalance, and any issues during recovery.

It is even more important for diabetics who also deal with heart issues, like me, because these two drugs are so beneficial in managing our heart issues. So my cardiologist is included in the concerns. Together all three participants in the procedure need to figure when to stop, when to start, and how to handle the blood sugar.

I have had many surgeries and procedures over the last 18 years of my survivorship, and I do what I can to advocate for myself, because it is in my best interest to participate, to make sure everything gets addressed. I have now added Farxiga to my “pre” plan lecture of what to look out for.

Finally, T was rescheduled, and as of yesterday, got her new aortic valve, after being off of her drug the necessary three days. I am waiting to hear from her, but I am confident, she had the right doctor and team, the things were done that needed to be, and with any hope, like me, she is going home today, the next day after having heart surgery. Most importantly, feeling better.

I know and have known thousands of other long term survivors over the decades, and many who have survived 40 and 50 years. But T is special to me, because we go way back together when we both began our journies in survivorship. There is no one cheering more loudly than me (okay, her family likely is).

What makes this even more important, because of T reaching out to me, SHE has made a huge impact, not just among thousands of other long term Hodgkin’s survivors, but cardiac survivors as well. Our survivors often only have a fighting chance because we talk and share among ourselves. All too often, we have doctors who are unaware of what they are dealing with. And in this situation, that is exactly the case. I immediately shared this info with all of my groups in the cardiac world, and cancer survivorship world. Unofficially and unscientifically, here is what I discovered, only have of the cardiac patients already knew about this concern, likely because they had already dealt with it. But hardly any of my fellow Hodgkin’s survivors were aware of this, and this is something that is a major dangerous game changer. And thanks to T, she has undoubtedly, saved lives, so that our other survivors now know something else to be aware of to advocate for themselves.

Her story, like mine, has so many more chapters to be written. And T will get that chance I am sure.

Speaking of which, Paul’s Heart is just 54 hits from a major milestone.

I never thought I would ever reach 100,000 hits on this page when I started it. And now, which one of you is going to be the one that makes this possible?

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

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