Archives For The Journey / The Quest

Aside from being run down by a mad woman in a Volkswagen (Baha Bug) when I was sixteen, I have never spent so much time staring at my right foot. Back then is a long story for another time, but my foot had been caught between the bumper and some cinder blocks, just as I was jumping over them. I kept going, but I left some of the top of my foot behind.

For the most part, my foot healed within a couple of years, and I enjoyed many years free of any pain. As I stare at my foot right now, other than my immediate concerns that it is quite swollen, it concerns me that unlike my teen-ankle, “rest” does not necessarily equal any change for the better. Swelling of extremities seems to be a regular part of this experience called “heart failure”: Puffy. It looks like I have an impression from a tight sock on my calf, but I have not been wearing any. The color is slightly purple. These things stand out when I put my feet together, and I can see how “normal” my left foot appears.

Please forgive me if I sound like I am complaining, or if somehow any seeming lack of focus on the positive in life is offensive, but I am having an experience, here. It is a scary one. Two of the three times that my heart stopped, I was not even aware that anything was happening. Each time I thought I was just waking up from sleep, they were trying to save my life.

The one time of the three that I do remember, I felt extraordinarily light-headed, then it was if I was flying backwards and into darkness/sleep. For whatever reason that time, my heart started itself back up, and I regained consciousness just before I was about to go out. I asked the nurse, “What just happened to me?” She was answering my question when someone called her attention to the fact that my blacking out was due to missed beats.

Final. Over. Complete. Instant. In a heart beat.

There is an element of safety that is absent, these days. Sure, there is value in thinking positive thoughts, but I am haunted at the moment by awareness that consciousness is not even guaranteed to me long enough to cross a street without passing out. As far as I know, the battery they buried in my chest is the primary thing keeping that from happening.

My fingers feel fat as I type. Odd as it is to say it, the need to piss a lot the last couple of hours has been reassuring. Having to piss means I am getting rid of extra water. This is a good thing. Yet it seems I am damned if I do/don’t with this. I cannot exercise it away, I cannot rest it away, and I cannot medicate it away. At least not in the short term. Certainly exercise is beneficial in the long run, but other than feeling lousy to begin with, going for a walk just gets gravity pulling on my hands and feet all the more.

And now at risk of sounding really whiny, amid the sensations of retaining water, there is still the numbness and tingling from when my neck was broken. It affects both arms and hands. Knowing which sensation is due to nerve damage versus circulatory issues is difficult. The symptoms of heart failure started during physical therapy after the spinal fusion procedure that saved my life, almost two years ago (exactly two years in only eight more days).

In what seems to be a blessing and a curse, all seems well when I look in the mirror. If I did not tell people what was going on, they would not know. Fifty is headed my way in a little over a year, and I am finally seeing the signs of aging, but for the most part, I have retained youthful qualities that bely anything I am feeling on the inside.

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Okay. A bit of the positive…

I got over the hurdle of knowing whether or not I could push myself by going for a long walk in to town, last week. There are few places in this county that are flat, so the trek involved lots of hills. I did it. It wiped me out for a few days, but I did it. Now it is just a matter of adjusting the distance. Anyhow, I know now that I can get my heart rate up, and break a big sweat, without collapsing, on the spot (so far… tbc, right?).

“Diet”

That is a dirty word. I did not think I was so fond of salt and sugar until cutting back on them. It has been challenging. There are a few temptations that I could not resist (mainly sugar). However, I am doing pretty good with the reduced sodium part.

Not eating processed foods/eating fresh ingredients instead has been a priority. Legumes are frequently on the list, because they are affordable, and I can cook them in bulk so that I have salt-free protein, whenever I need it. Instead of tomato sauce, I just use fresh tomatoes – the common sense stuff, really.

One slice of pizza is one slice too much, so some things just have to stay gone, for good. The late-night cravings require some work. Even if it is a fairly healthy snack, it is still too many calories.

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Returning to what might be considered a life is something I wish to do. People have been through far worse than I have, and not only bounced back, but beyond where they had been.

Yesterday I was a strong buck, but today I am a cautious chihuahua (that sounds corny, and it made me giggle … my need for silliness is intact).

Thanks for listening.

One day at a time. Tomorrow is another day. Hush, sweet Charlotte. …Wait … what is that last one doing in here?

Proof Of My  Walk: The Hills Are Alive With Redbuds

Proof Of My Walk: The Hills Are Alive With Redbuds

 

 

 

 

 

 

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Right now I am two days shy of the heart attack being four weeks behind me. While I knew I was in trouble when I kept coding/blacking out, and after rquiring so many procedures within a short amount of time, I was still in denial about the gravity of my situation. Just minutes before being discharged I was informed, “Your diagnosis is congestive heart failure” (CHF). Whatever denial I had left was shattered. The words landed hard, and in anticipation of this, the nurse tried to play it off by saying that it was a big sounding name that implied my condition is worse than it is. – Not true.

No amount of sugar-coating the diagnosis would have made me forget the intensity of the experience: having a long needle shoved in my groin for 20+ hours, the placement of a stent, having a pacemaker installed, having it fail, and finally being ripped open in the same spot twice within hours in order to correct a broken wire. Even so, there was something about being told my diagnosis that seemed worse than what I had experienced, which was that I kept bouncing back. However, the diagnosis sounded fatal/permanent.

My entire left anterior descending artery is fried. I saw this myself while I was having the stent placed, and again for my first follow-up appointment with my surgeon/cardiologist. It is a given that more invasive procedures will be required. Exactly what and when are mysteries, but it makes sense to me that if they need to do a bypass, the sooner, the better.

It may sound like overstating the obvious, but having my heart stop several times (“coding”) and losing consciousness almost instantly has shifted my outlook on life, my attitude, and my peace at mind.

Working on my attitude and making dietary changes are things that are within my control. After the six-week marker, I can push myself and start getting some exercise to strengthen my heart, and shed a few pounds. I am looking forward to this, because I tend to shed weight quickly when I walk every day.

What challenges me today is looking at the scar. It is deep, ugly, and far from healed. And since it is from the pacemaker, they will have to open it back up again. It is just a matter of time. If I need open-heart surgery, I have no idea where they may cut.

Another big challenge brought itself to my attention right after I drifted off to sleep last night. I am not sure how long I was out. It could have been instant, and it did not seem I had been in a deep sleep. I woke up in a panic, feeling like I had just fallen back into my body – it’s like falling downward until I get to my body, then it feels like an upward fall. Weird.

The scary part was that I had the feeling that my heart had stopped, and I lost consciousness. Considering each time this happened in the past it took other people/interventions to snap me out of it, it is unlikely that my heart stopped in this case. Most likely I had a nightmare about it. Of course, it made my heart race, so it took a moment to calm myself.

When the human heart stops, the brain goes into sleep mode. As I noted elsewhere, it is like being asleep, without remembering the point at which I drifted off. So now I have this imprint of death in my psyche as being like drifting off to sleep. How much is trauma from the condition itself and/or trauma from the invasive procedures, I do not know. Most likely, it is a combination of both. My concern is that it made the thought of going back to sleep quite uncomfortable, as I lay there wondering if I died in my sleep, I could be living what might be my last moments.

This is a sword with a double-edge, for sure. On the one hand, I feel more at peace with being dead, because being unconscious seemed peaceful. My brain activity had not stopped, but at least I know if such a thing happens again, I will not be awake to experience it. On the other hand, associating sleep with dying is not fun.

The dietary changes are difficult, but not insurmountable. I have eliminated all canned goods at this point, and as much of any other processed foods as possible. The main thing I was told to avoid is sodium, and even with products that have small amounts per serving, it does not take long to reach daily maximums. Items promoted as low in fat and calories often have ridiculous amounts of sodium in them. I am also avoiding foods that are high in fat and cholesterol.

To my regret, I was told to reduce my sodium intake, nearly ten years ago. Since I was able to get my blood pressure stabilized, I told myself that I was part of the 2/3 of the population where this did not apply. While it seems I was destined to have heart problems sooner than later, the problem with the sodium is not just blood pressure – it is the retention of water/stress on the heart and kidneys that takes its toll.

All of this to say that CHF is a mind-fuck, and I am going to have to learn how to adjust to it. There are the practical adjustments, like afore mentioned dietary changes, then there are the deeper, sub-conscious challenges of the psyche.

1. Diet

2. Exercise

3. Mental Health

4. More surgery?

Ugh! More surgery does not sound like a good way to adjust, but if my artery is shot, having in repaired, if possible, will feel better. Knowing I have done all I can do is a better place to be in than knowing that more needs to be done.

Cheers!

tbc …  ?

Related: Scars, Immortality, Religion And Hospital Case Management

Cardiac arrest

The Journey / The Quest 1: What Happens To Brain Activity When The Heart Stops? A Personal Take

The first time I lost consciousness was when they placed the stent in my LAD, shortly after I was flown to the hospital, following a delay of about 70 minutes (February 21, 2014). It seemed like I had just drifted off to sleep. I woke up to what I thought was annoying pounding on my chest, when it was CPR. For 20+ hours after the procedure I remained flat in bed, with my right leg immobilized by the catheter in my groin. Inside were the wires of a temporary pacemaker.

The second time I passed out was shortly after they removed the temporary pacemaker. They pulled it out of the catheter like fishing line. This time it felt like a massive, frightening head rush, and I went in and out of it, like a wave. Apparently my heart missed quite a few beats. It was enough to prompt them to put in a permanent pacemaker.

The third time I was out cold, for 45 seconds. It seemed like sleep, and I have no memory of the moment when it came over me. They printed out the data from the heart monitor, indicating I had flatlined, despite the pacemaker (later to be determined to have a faulty wire, but I did not know that until the following day, after a second “install”):

flat·line
ˈflatˌlīn/
verb

informal
past tense: flatlined; past participle: flatlined
  1. 1.
    (of a person) die.
  2. 2.
    fail to increase; remain static.
    “their share of the vote has flatlined at about 3%”

They snapped me awake by yelling my name; the startle restarted my heart. They also yelled at me to spit out the food in my mouth, as I was in the middle of eating lunch when I lost it.

In just under a minute my room was full of professionals. In addition to at least three of the nurses on the floor, there was an amazingly GQ heart technician, who steered the foot of my bed on the way back to ICU. I remember thinking that if I was going to die, I was surrounded by some really cool people, and I got to stare at a gorgeous being on my way out.

Another person in the room when I came to was “Supervisor Troy.” He and the others escorted me to my second stay in ICU: Supervisor Troy, me Troy, and other assorted heroes. When we entered my assigned room, they realized that my nurse for the night was also named Troy. On the way into the room, Sup. Troy said, “Oh, no. It’s a trifecta”! Someone out of my vision said, “It’s a Troy-fecta”! It’s funny now, but at the time I was in shock, and near tears, as I had no idea what was happening, or if it would stop. I knew they had to rip open the wound in my chest to fix the unknown problem, and I was not looking forward to it.

How long does brain activity last after cardiac arrest?

The common medical understanding is that cardiac arrest victims become unconscious within 20 seconds of the loss of blood flow (heart stops). That’s not quite the same thing as losing “all brain activity.” It just means the brain is incapable of keeping you awake.

All brain activity is thought to be over by about 3-4 minutes from the moment the heart stops, which is one reason why we want to start CPR as quickly as possible. Full Article Here

When this happened I was fortunate to have been in the “heart wing” of a renowned hospital that specializes in cardiac care, and I was treated immediately by the heart surgeon and the team at the “Catheter Lab”. Within that context, it seems I had plenty of time to spare without suffering any brain damage.

In this case my blacking out was a consequence of a faulty wire in the pacemaker that they installed after the second time my heart stopped. I spent the night in ICU, and they corrected the problem. I was transfered back to the heart wing the following morning, and was discharged two days later. I felt like the “Ajax Lady” in Cheech and Chong. Her antics after mistakenly snorting ajax at a party are classic, as is Chong’s statement to the police: “Can’t you see she’s been through a lot in a short amount of time?”

Presently, my surgeon stated that he has concerns about the pacemaker doing further damage to my heart. The 70 minutes it took for the helicopter to get me there was not helpful, but I forgot to ask him to clarify exactly how so. I had been distracted by the images from my angiogram that showed my entire LAD is shot, including the valve, and that I am at high risk for future clogs in that artery.

The next step is checking in with the pacemaker nurse, and my surgeon, next month. The bandage has not fallen off of the sutures, but it is starting to itch. It is still quite tender. It is weird to feel something like an MP3 player, sewn into my chest. It seems this may be just a beginning.

Next entry? I have been pondering writing a post about diet changes:”How To Gain And Lose 5 Pounds In 12 Hours With Fiber” …

Cheers!

Just before the police arrive –

Club flatliners journey quest