Paul's Heart

Life As A Dad, And A Survivor

Archive for the category “The Heart”

It’s About The Human, Not The Game


This morning, many of us, are getting an unexpected anatomy lesson of the heart. Though the catalyst occurred as an injury during a professional football game, the discussion around most breakfast tables and office water coolers is much more consuming.

Last night, the Cincinnati Bengals hosted the Buffalo Bills, in what was considered an unofficial “playoff game” with the end results affecting playoff positions for each team. In what looked like a normal tackle that football fans had seen thousands of times before, would soon become an event that no one would ever forget. Upon completing the textbook tackle, Bills Safety Damar Hamlin got up, as if to prepare for the next play, and suddenly fell backwards, unconscious. Hamlin is just twenty-four years old. And I use the verb tense “is”, because although reports claimed he went into cardiac arrest following that tackle, and needed CPR, and was revived on the field of play, he is currently being treated, in critical care. Everyone is concerned for this young man, and hopefully his full recovery.

Young man. Heart issue. Where have I heard these two phrases together before? Oh, that’s right, as I laid on an operating table at the age of 42, preparing for emergency bypass surgery for a fatal condition I was unaware I had, caused by treatments for my Hodgkin’s Lymphoma eighteen years prior. Since 2008, I have had two more additional heart surgeries, and will likely undergo more in the future. My purpose for stating this is not to say I am an expert, as I am not, is not to compare the situations, as they are not similar, but to say, I understand what is being explained as to what happened to this young football player.

Again, the play itself looked fairly routine, even if a bit more high energy, because it looked like a big play was being stopped. But as powerful as the heart is, its activities are often silent, or unknown to us. We go through our daily activities without giving the beat of our heart a second thought. It is something that just happens. But as myself, and plenty of other long term survivors of Hodgkin’s Lymphoma will tell you, there is so much more to the beat of a heart, and the various conditions that can exist. Unlike the normal and healthy human being, and perhaps the unknowing human, we are more aware of our heart’s condition.

I am not going to get too technical, as even I will get lost. But the heart has a basic rhythm as pictured above. There are five components, called waves, labelled P, Q, R, S, T. I honestly do not understand the mechanics, but I do know, that if there is an abnormality on your EKG, you will get attention. I do know that in my case, and ALWAYS gets a lot of attention from doctors unaware of my condition, that I have what is called an “inverted T” wave. As you can see from the picture below, compared to the one above, this is not a normal condition.

This “inverted T” wave can be a serious issue, as it is often a sign of what is called “ischemia”, a blockage, or what would likely result in an event of a stroke. Again, not going too deep into the weeds with this. Just know this, this inversion, shows that there is a potential effect on the blood flow through the heart. And this is where Hamlin’s tackle comes in to consideration.

It has been explained by various medical experts on various news programs, that a potential hit to the chest area, during this “T wave” part of the heart rhythm, could impact the flow of blood through the heart, and yes, causing cardiac arrest. While it has not been specifically stated by the Hamlin’s doctors, the speculation is that this “perfect storm,” the tackle and the stage of the heart beat, is what happened. There will likely be more discussed on this, days from now.

Nonetheless, the horror of watching any athlete collapse to the ground, is something we as fans just do not get over. But this time is something different. I recall watching the game where Washington Redskins quarterback broke his thigh bone during a game. I was watching both Jets and Lions games, when Dennis Byrd and Mike Utley were both paralyzed following collisions with their helmets (separate games). Even recently, with all the concussion injuries, these titans still manage to convey to us, usually with a “thumbs up” as they are carted off the field, this situation was different. Whether at the game or watching it on TV, this was different. Hamlin was unable to communicate with us. Everywhere you looked, fellow players, on both teams, were in tears. These seemingly tough guys, though trained to play through all kinds of pain and conditions, were suddenly witness to something, no one could have prepared for.

Of course, the conversation has begun on safety and just how common a situation this might actually be, even if occurring for the first time with the NFL. One news network actually stated a more common occurrence among teenagers aged 14 to 15, involving either a baseball or hockey puck to the chest. Stop and think about that, we hardly, if ever, hear about that. This situation can also occur during an auto accident. This cardiac phenomenon is called “commotio cortis”, caused by a sudden impact to the chest leading to cardiac arrest.

There are plenty of movies that innocently, and often times comedically show a recipient of a chest punch, gasping for air, with the assailant explaining “you will be alright in a few minutes.” One has to wonder with all of the boxing and MMA fights, we have not seen or heard of this before. I know with my own situation, a wired breast bone from my open heart surgery, I have always been sensitive to any impact to my chest for instance, wearing a seatbelt, knowing that in an accident, my breast bone could snap and damage my heart. And do not get me started on the act of CPR on me, if necessary, as it was explained to me how common it is, for ribs to get broken while CPR is being performed.

But this was such an unusual occurrence, and tragic. Hopefully Hamlin will recover fully, only time will tell. And unlike in 1999, when professional wrestler Owen Hart fell to his death from a rapelling accident during his entrance to the ring, and the WWE continued its Pay Per View after Hart had been taken out, the NFL did the right thing, and postponed the game.

We do not know if Hamlin had any other cardiac issues. Like me at 42 years old, why would anyone suspect a 24 year old to have any heart issues? Why would any of us suspect to have anything wrong with us? But the truth is, it can happen, and depending on the circumstance, that is when we find out there is a problem. And for some it can be too late.

My thoughts are with Damar Hamlin, his family, and his teammates and wishing for a full recovery.

Making, Saving, Remembering Christmas Memories


As I wrote previously, I am not a big fan of this time of year. That is not to say that I do not have good memories. In fact, I have plenty, really the only reason I do not give up on the holidays completely, the hopes that someday, I can find a way to embrace them as I did long ago.

Many years ago, I recall making a comment, that my maternal grandmother, was the “glue” that kept us all gathering together on the holidays. That when she was gone, so too would be the traditions of Christmas Eve service, presents the next morning, and the best Pennsylvania Dutch Christmas feast featuring homemade stuffing (we did not call it dressing). My grandmother’s final Christmas with us, we had two tables completely filled. At the time, we were unware that would be her final Christmas.

1997 was her last Christmas, and as anticipated, the last time all of us had gathered together completely. There would be miniature gatherings throughout the two days of Christmas in the years that followed, but none as we had done in the past. Today, those Christmas’s are just a memory.

Any hopes I may have had of turning my attitude around about the season, came with the arrivals of my daughters. There had been both renewed traditions and new ones created, all to the glee of my daughters. As in my past, health issues and at least one tragedy would once again have a permanent impact on my anticipation of future holiday seasons. But of the years that were free of the difficulties, there are so many memories.

Unfortunately, divorce would have a major impact on the Christmas holidays between my daughters and I. I would not necessarily call it a bad impact, just different. With sharing time between their mother and I, I volunteered to let them spend the actual holiday with their mother, while I would see them the day after. This arrangement allowed me to separate the negative that I carry with me about the holidays, by not actually celebrating on the actual date, while recognizing the special time that I get to spend with my daughters each holiday. Over the last nine years, we have all of those memories.

So there is a new chapter of holiday seasons coming next year. With both daughters attending college, one has a unique schedule, which means that the Christmas holiday may just be the only time I get to see them both at the same time while they are in college. But we will continue to make memories.

I do not necessarily believe in horoscopes, but the one pictured above was sent to me. I read it in amusement, I cannot say that I anticipate anything new to happen with me or my friends, but January will begin a year of change. One that will finally bring me relief of stress, struggle, and conflict. I will hope, it is a lot to ask, to have a second consecutive year without a health challenge. This past year was wonderful not to be under a knife or poked. I cannot remember the last time that consecutive years of decent health happened.

Finally, as we enter this season, my heart is with all my friends and family, who are celebrating Christmas, some their first, without a particular loved one, whether it be a spouse, sibling, or tragically, a child. No matter who is missing from the celebration, the pains may be different, but they are still real for the person impacted. I know that I still grieve for both my grandmother and my father, which I guess is a way of still keeping them in my heart this time of year.

I am not sure if I will get another post off before the end of the year. As I mentioned, I have some fun planned for my daughters when they come to visit after the holiday. So, in case I do not get to write anymore this year, I wish you all a happy holiday (there are too many for me to list each one, the only reason I don’t – don’t read into it with political correctness), and I hope your New Year is healthy and prosperous.

A “Paul’s Heart” Christmas Carol


Every December, I am faced with the same situation as my birthday falls this month, renewing any or all of my driving information. My license is good for a number of years, as is my handicap placard, but my registration gets renewed every year, even though I have the option of multiple years. I choose not to do multiple years, because if something were to happen to my car, and I would need another, that would be a second registration I would have to pay. This scenario played out a few years ago, when my car was T-boned. The DMV, Department of Motor Vehicles does not give you a pro-rated refund for the time you no longer have the car, nor do they give you credit for the time left towards a replacement car.

There are very few places that you will wait longer in a line for service than the DMV; lines for rides at Disney, the post office in Naples during Christmas season, and a customer service line for any airline following the cancellation of a flight. But with a fully charged cell phone, I felt I could keep myself entertained for a potentially long afternoon, waiting to renew all three of my driving needs. Before I dove into my phone, I just looked at all of my paperwork to make sure everything was in order. For some reason, I immediately honed in on the “expiration dates”, or how long each would stay valid. This is when my mind started to take me down a path I try not to think about. Will I still be around when these things need to be renewed again?

As a long term survivor of Hodgkin’s Lymphoma, dealing with a plethora or multitude of late developing side effects, I live my life holding a “Pandora’s Box” underneath a “Sword Of Damocles.” I know most if not all of the health issues my body deals with in regard to the late side effects from my treatments. The only thing I do not know, is when each will become a problem to be dealt with immediately. One problem gets dealt with, another problem needs attention. And really, as bad as all this is, as long as I have skilled doctors who listen to their patient, me, and the knowledge I have about what I have gone through, I have managed to get through everything.

But there is a darker side to my survivorship, and shared by many other survivors, a stronger recognition of our mortality. Because long term survivorship is still a relatively unknown field in medicine, though medicine is beginning to catch up, unfortunately, not fast enough for us. With the internet and social media, fellow long term survivors can share their experiences with others, allowing us, in a way, to teach or train doctors how to handle patients with our needs by learning from survivors. In the circles I associate with, there are well over a thousand members on one of our social media groups alone, located all over the world.

Many of us survivors develop close bonds to others, even meeting other survivors in person. I can tell you there is no other feeling, that seeing someone in person, who is experiencing similar to what you are going through and the understanding that is shared and felt.

I mentioned mortality earlier. Most of the other survivors I know, we all know, that regardless how long we have survived our Hodgkin’s Lymphoma, while a great number of survivors may be fortunate to never have to deal with any late developing side effects from their treatments like I have, there are many who have. And then there are those who are completely unaware as to the mysterious things that are happening, unable to put two and two together, to connect the dots between declining health and late side effects. Because they just do not know, and were never told it could happen.

In any case, if we are lucky, we have a doctor that has knowledge and understanding of our unusual health history. We are even luckier if the health issue de jour that we are dealing with, can be dealt with and healed. And then there are times, that our luck turns south, and the prognosis is not good for a recovery. And then, there is the everyday dangers that even healthy people face if we overcome our health issues, crossing the street, driving a car, slipping in the bathtub, also known as a sudden accident. The dangers for us long term survivors is that our bodies have been through so much trauma, we are already at a disadvantage for a doctor trying to save our lives, with our deteriorated body conditions. The most glaring of the facts of our mortality, while the survival number of years is in the decades, that does not mean well into our years of life. In fact, as one fellow survivor once wrote, many do not reach past the age of 60. Combine that with the longevity of my paternal side of the family with an average age of 55 years old, and I am more than aware of the odds against me.

I have laid the groundwork. I am at the DMV. I am aware of my unique mortality. I am approaching another year older, another year older as a cancer survivor. While I wait for my number to be called, for the DMV that is, not the mortality, my mind begins to wander. I can visualize someone, looks like my late father. Acknowledging a conversation that we had with each other when he was alive, he reminded me in this thought, that I was a survivor, there is no such thing as giving up.

My father was absent most of my childhood, yet he was able to remind me just how “good” my life turned out to be. No, it was not a “Norman Rockwell painting,” but I did okay with what I had and who was not in my life.

And then we began talking about my early adult years, in particular, the years that I fought Hodgkin’s Lymphoma. We talked about my later years, with all the health struggles I had faced, but he would remind me, all the lives I had touched, including his as he faced his own battle with lung cancer. The fact was he reminded me, I had done so much in my life, not just for me, but for so many others.

And then the image faded away. In fact, not just my dad, but all the things we had talked about, were all gone. While I did not have a “grim reaper” in this moment of wandering, it was clear where my mind was. I am between two age medians, my paternal average of 55 years of age, and the seeming equivalent to climbing K2, reaching age 60 as a cancer survivor of over thirty years.

Tomorrow is my birthday, turning 57 years old. The awareness of my mortality is both a blessing and a course. So far, having the doctors that know how to deal with the issues from my late side effects, has kept me alive. Constant surveillance keeps my health from getting to the life and death moment as happened in 2008. As they say, what is happening to me cannot be reversed, but it can be slowed down, and managed (to a degree).

But I have a knowledge of so many other survivors who have passed, and while many have passed as a direct link to their late effects, there are also others who passed away due to an otherwise common event.

Finally, there will come a time, that all the things that doctors have done to save my life over the decades, will need to be done again. My history and treatment of Hodgkin’s Lymphoma, made every one of these original surgeries high risk for complications and death. Having to do any of them again, the risk is even greater of a complication.

No, I do not need that ghost of future standing in front of me. And if I had the chance, I would give him the push into the grave, because in my heart, I am far from ready to have this thing called life, end. One time unthinkable when this all began, getting to watch my daughters grow, I have seen them come to the end of high school, and begin college. And there are more milestones that I want to see that involve them. And at this point, the way I feel physically, I believe I will get to see those days.

But then there is a point when I say, no more birthdays, the I will not get older. No more new years so that I will not pass another year of survivorship. Just let me ride this thing out to watch my daughters do what I have dreamt their whole lives to do.

It is important that anyone reading this understands, I do not go through my life, worried or thinking I am going to die every day. Far from it. Each morning, I wake with the intention of seeing another day. I have so much I want to do. It is the reality of the knowledge I have, that just reminds me, I am not the one in control. To quote the lyrics from the Bon Jovi song “Live Before You Die,”

“I made mistakes I caught some breaks. But I got not regrets. There’s some things I don’t remember, but one thing I don’t forget. When you’re young you always think the sun is going to shine. One day you’re going to have to say hello to goodbye.
Shout it out let someone somewhere know that you’re alive.
Take these words wear them well, live before you die.
You learn to love to live. You fight and you forgive. You face the darkest night. Just live before you die.”

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