MY CARDIOLOGY EXPERIENCES
INTRODUCTION
There are different ways that people first get diagnosed with heart problems. Some people get chest pains. Some go in for EKG’s and learn about it from the test results. With me it was none of the traditional methods.
The thought that I may have a heart problem never crossed my mind. I try to keep myself in good health. I get annual physical exams, don’t smoke, don’t drink alcohol, exercise regularly, and eat a sensible diet.
During the 1990’s I had an EKG, a stress test, and an echocardiogram that all came back with normal results. Although there is some family history of heart disease. My father died of a massive heart attack at the age of 70, despite the fact that several days earlier he had an EKG which said that his heart was in good shape. And my mother was diagnosed with congestive heart failure, although not until she was 82 years old.
THE LIBRARY VISIT
On the morning of Saturday, April 18, 2009, I was at the University City Library when I noticed a sign which said they were giving free EKG (Heart) Tests. Can’t beat a price of free, so why not.
The EKG was performed by a Registered Nurse named Ellen and a Student Nurse whose name I’m not now remembering. Afterwards Ellen said that the doctors wanted to talk to me about a problem that they saw in the EKG.
Two doctors called me over to their table. One of the doctors was looking at the EKG printout and said it appeared that I had Atrial Flutter, a condition which caused the top valves of the heart to beat faster than the lower valves. I look at the other doctor and said, “How about you? Do you agree that I have Atrial Flutter?” He said, “No, I don’t see it in this printout. I think that your heart looks fine.” I said, “Well, I’m going to listen to you. I’ve never been told that I have Atrial Flutter. I never even heard of it until right now.”
I left the library and promptly decided to forget the alleged diagnosis.
THE HOSPITAL VISIT
On the morning of Saturday, June 20, 2009, I went to St. Mary’s Hospital Outpatient. But it wasn’t with the intention of getting any cardiac tests. I went in to get a colonoscopy. This would be my fourth one, the other three being in 1997, 2002, and 2007. As with the other three, this one would be performed by Anna Niesen MD. Dr. Niesen’s specialties are Internal Medicine and Gastroenterology. She has been my primary care doctor since 1983.
The other three colonoscopy exams were all very easy procedures. Yet for some reason this one had me feeling nervous for several days before the test. During the week I even got pep talks from four different people hoping to try to build up my courage.
I awoke at 5:00 in the morning on Saturday, and killed a few hours watching television. Harriett picked me up at 7:00 and drove me to the hospital. Harriett is a Certified Nurse’s Aide who had done some work for my mom last year, and remained a family friend after my mom passed away.
In the Endoscopy Unit I filled out some forms and was given a brief interview of my medical history etc. When I was in the waiting room I said, “Harriett, if I decide to get up and walk out of here, you won’t let me do that, will you?” Harriett asked, “Why would you try to walk out of here?” I said, “You know, like if I get nervous or something.” Harriett replied, “Don’t be getting nervous. You admit that you’ve had the test before and didn’t have any problems.”
Around 7:40 a Registered Nurse named Sharon, asked me to come inside. As I followed Sharon inside, Harriett wished me good luck with the test. Sharon took me to a curtained off area, where there was a table with some IV equipment attached. She told me to get undressed, put on a hospital gown, and lie down on the table.
A few minutes later Sharon came in with another Registered Nurse who she introduced as Mary. She said, “I will start your IV, and Mary will assist Dr. Niesen during the colonoscopy.” I said, “Sharon, I’m starting to get scared. I’ve been nervous about this test all week long, although I can’t figure out why.” Sharon said, “We don’t want you to be nervous. Take some deep breaths, think happy thoughts, and just loosen up.”
I felt a brief stick when Sharon inserted the needle. That was no big deal, but when I was hooked up to the monitor it showed that my heart rate was way too fast. I knew that it was probably caused by the fact that I was nervous, but how could I calm down when I heard the machine making this loud beeping noise, to remind me that my heart was beating too fast? Do you see the Catch 22 situation that I was in?
Around 9:30 Mary came in and said that it was time to go into the Endoscopy Room to begin the colonoscopy. She wheeled me into the Endoscopy Room, where I saw the monitor and the colonoscope. Dr. Niesen entered the room a few minutes later. She asked, “What is going on with your heart rate?”I said, “I’m scared. I’ve been nervous about this test all week, and there is no good reason for it. I’ve had the test three times and everyone has been a very easy procedure. You’re a great doctor. The staff here is excellent. Intellectually there is no good reason for me to be nervous. But today my emotions seem to be overriding my intellect.” Dr. Niesen said, “When I start the sedatives hopefully your heart rate will drop. If that doesn’t happen I won’t be able to do the test. Roll over onto your left side, and let’s see what we can do.” I rolled over, and that was the last thing that I remembered.
When I woke up Dr. Niesen was standing at my bedside. I asked how the test results looked. She said, “I was not able to finish the test. I got about one third of the way through, and had to stop because your heart rate would not come down. I’m taking you into the Emergency Room.” I said, “Forget that. Just let me get dressed and I’ll go on home.” Dr. Niesen said, “That is not an option. I’m your doctor, and I am your friend, and I will not allow you to endanger yourself like that.” I said, “You’re right. Take me to the Emergency Room.”
Dr. Niesen took me into the Emergency Room, where a group of doctors and nurses immediately began working on me. They gave me some medication through an IV which they said would help to reduce my heart rate, hooked me up to some sort of a machine, and drew some blood from me. It wasn’t long before my heart rate dropped to normal. They told me that one of their top cardiologists, Dr. Lisa Reis, was being assigned to my case, and that she would be in to see me in a few minutes.
Several minutes later Dr. Reis came in and introduced herself. I said, “What is going on here? I came in for a colonoscopy, and suddenly I’m in the Emergency Room with a heart problem.” Dr. Reis said, “The colonoscopy did not cause the heart problem. I understand that over the years you have had EKG’s, stress tests, and echocardiograms, that have all come back with normal results. These are good tests, but they are not foolproof. The fact that this happened merely because you were nervous about a test means that there was a heart problem that had never been diagnosed. That being the case, don’t you think it was good that we found it out now when you were in the hospital, rather than having it surface when you were someplace where no medical help would be available?” I had to admit that she was correct on this point. Having the colonoscopy that morning may have saved me from a future heart attack.
A Registered Nurse walked up to my bed and said, “I am the Head Nurse on the Third Floor Cardiology Step Down Unit. Just as soon as a bed is available we will be taking you up there.” I said, “You mean for a few hours of tests?” The nurse said, “No. I mean you will be staying here overnight.” I said, “No, I am not staying in the hospital overnight.” The nurse said, “Yes you are.” By this time Harriett had been allowed in the Emergency Room, and she was standing at my bedside. She looked at me and said, “You need to listen to what the doctors and nurses are telling you. They are only interested in what is best for you.”
I said, “OK, I am willing to stay one night. But tomorrow I am leaving no matter what. I need to be back at work on Monday.” The nurse said, “You will stay here as many days as are necessary, until either Dr. Niesen or Dr. Reis decide it is safe for you to leave.” My response to that statement was not fit to be printed. But the nurse wasn’t about to be deterred. She said, “If you really want to leave we can’t stop you. It is your right to leave any time you want. But that right isn’t going to do you much good if you are lying on the floor dead from a heart attack.” I glanced over at Harriett, whose nod of the head suggested that I would do well to follow this advice. I said to the nurse, “You just won this argument. I’ll go upstairs with you, I’ll stay as long as is necessary, and I won’t cause any more trouble. And thank you for having the courage to insist that I do the right thing, rather than the easy thing.”
When I arrived on the Third Floor, I was once again hooked up to an IV, had some more blood drawn, given an EKG, and had a portable machine hooked up to my chest which would give a constant read out of my heart activity.
I’ve always had a great deal of respect for people who work in the health care field. And my stay in the hospital only increased that respect. This is a job which requires a great deal of technical knowledge, people skills, time management, ability to deal with difficult patients (like myself!), and the ability to correctly make split second decisions which may not be reversible.
Later that afternoon Dr. Niesen and Dr. Reis came into my room. There is a certain feeling of security with having two very fine doctors working together on your case. They explained that I had a condition known as atrial flutter. Wait a minute! That’s what one of the doctors at the University City Library said back in April after the EKG that I had. His partner had disagreed, so I had just concluded that the doctor who said “atrial flutter” must have been wrong. Looks like I should have listened to that first doctor.
Dr. Reis and Dr. Niesen explained that left untreated atrial flutter can cause some serious problems. However, if I take the medicine that they would be giving me when I leave, and follow their guidelines, I should be just fine. They listened to my heart, and mentioned that the last round of tests performed earlier that day all came back normal. I said, “So tell me this. With this condition will I be able to play the violin?” Dr. Reis said, “Of course you will.” I said, “That’s great. I’ve never been able to play the violin before.”Dr. Niesen laughed and said, “Listen to the comedian here. He must be feeling better if he is telling those kinds of jokes.”
I did stay in the hospital overnight. More tests and more blood drawings. I don’t like needles, but the staff was so good at drawing blood that I hardly felt a thing. It did get rather boring being confined to bed with nothing to do but watch TV and stare at the four walls. But I wasn’t going to complain. It was a small price to pay to get better. I was happy to hear that all of the subsequent tests came back normal.
On Sunday Morning Dr. Niesen came to see me. She gave me a printout of what I needed to do when I left the hospital, along with a prescription for the medicine that I would be taking. She also told me to call both her office and Dr. Reis’s office to schedule follow up visits.
I said, “Dr. Niesen, I want to ask you a favor. Understand that this is a great hospital. The staff is wonderful, and they have about the best hospital food that I’ve ever tasted. They could teach the restaurants a thing or two. But I would really appreciate it if you could see your way to letting me go home today.” I gave her a look which I hoped would say, “Work with me on this.” Dr. Niesen appeared to be giving it some thought then said, “Well what are you waiting for? Get dressed and get out of here. I’ll write a discharge order and turn it into the nurse’s station.” I said,“Thanks! You’re the best! Oh, and if you could have somebody come in and remove my IV. I’m afraid that if I try to do it I may bleed to death.” As Dr. Niesen was walking out of my room I said, “One more thing. Do you think that we can postpone the colonoscopy until next year?” Dr. Niesen said, “No. We will be doing the test again later this summer.” I said, “OK, I can live with that. And I promise you that next time I will be a braver person about the test.”
After my IV was removed I got dressed and made my rounds (not to be confused with a doctor’s rounds) telling the staff members goodbye, thanking them for everything that they did for me and wishing them the best of luck.
I then walked to the front desk to see Michelle. She said, “I guess that you are all ready to leave.” I said, “Not quite. There is one more thing that I need to do.” Michelle said, “I can’t imagine what that would be. It looks to me like everything is in order.” I looked directly at Michelle and said, “I want to apologize for the way that I talked to you yesterday. I had no right whatsoever to say the things that I said to you.”Michelle laughed and said, “Don’t worry about it. When people are sick they often say things that they don’t really mean. I’ve already forgotten about it.”I said, “Yeah, but I haven’t forgotten about it. You and every other staff person on this floor are very fine people. Now you’d better get me out of here before I start to cry.”
I found it somewhat ironic that I was standing on a cardiology floor where I had just received a host of heart related tests, and was wearing a shirt which said, “Law Enforcement Run.” Hardly the type of shirt you would expect to see a cardiology patient wearing. As it happened, I didn’t actually run in that event. I got the shirt from a former co-worker whose husband worked for the Missouri State Highway Patrol. However, less than four weeks earlier I did successfully complete a 6 mile run. How did I go from there to here in such a short amount of time? Then again, there have been Marathon Runners who have died from heart attacks. So I guess it happens.
On my way home I stopped off at Walgreens to get my prescription filled for the heart medicine. When I arrived home and walked into the house, I found it hard to believe that so much had happened in just a little over 24 hours. I resolved to follow Dr. Niesen’s and Dr. Reis’s instructions to the letter, so that I would have no more problems. They are both great doctors, and I was lucky to be their patient.
That evening I got on the computer and found an E-mail from Bridgit at work. It was sent on Friday Evening. It said, “As we discussed at work yesterday, don’t be nervous about the colonoscopy on Saturday. You will do just fine.” I wasn’t looking forward to facing Bridgit on Monday, and telling her what actually happened. The reality is that I wasn’t convinced that at least some of the rapid heartbeat on Saturday Morning wasn’t caused by my fear of the test. And if that was the case, then I should be ashamed of myself.
On the evening of Tuesday, June 23, I wrote a number of letters. These letters were sent to Dr. Niesen, Dr. Reis, the Endoscopy Staff, the staff of the Third Floor where I was a patient, and the Emergency Room Staff. Each letter offered my thanks for everything that they did for me. I also wrote a letter to the President of Saint Mary’s Hospital (William Jennings), telling him about my positive experiences in the hospital.
FOLLOW UP EXAMS
On the evening of Monday, June 29, I came home from work and found a letter in my mailbox from Saint Mary’s Hospital, asking me to fill out a detailed survey of my recent visit to the hospital. I gave every department and every doctor, nurse, technician etc. who I interacted with a glowing report. Madison Avenue couldn’t have written something better. And I meant every word that I said. That got me to thinking, “How could any person with even half a brain be afraid to come to this hospital for a routine test or procedure?” The answer was that there was no good reason for me to be afraid, and I promised myself that next time I would not be afraid.
That evening at the bowling alley I was talking to Kathy, who was the wife of one my team mates. Kathy has worked as a Registered Nurse at a college health service for many years. I was telling her about my recent experience in the hospital.
Kathy talked to me for a few minutes about atrial flutter in general. She then said, “I know a person in denial when I talk to one. That rapid heartbeat that you had before the test may have been precipitated by a fear of the test, but the atrial flutter that was detected was not psychosomatic. You should consider yourself extremely lucky that of all the times for this to happen it was while you were in the presence of a doctor in the hospital. Whatever recommendations you got from your doctor and the cardiologist, you had better take very seriously. And don’t even think about not taking the medicine they gave you. Finally, if you are ever put in the hospital again for reasons related to your heart, don’t be giving deadlines for when you have to be released. Whether or not your doctor thinks you need additional tests, procedures, or observation is a lot more important than whether or not you have to miss a few days of work.” I realized that this was good advice that I would be wise to follow.
On Thursday, July 2, I was in Bridgit’s office discussing a work related issue. When the discussion was over I got up to leave. Bridgit said, “There is something else that I want to talk to you about. Close the door and sit down.” She said, “It has been almost two weeks since you were in the hospital. Have you called your doctor about a follow up visit?” I said, “No, I haven’t gotten around to that yet.” She then asked, “What about setting up an appointment for another colonoscopy? Have you done that yet?” I said, “No, I haven’t done that either.”
Bridgit then asked, “When are you planning on making that call to your doctor?” I said, “It may be a few weeks. This week is about over, with tomorrow being a holiday. And next week my calendar is really full.”Bridgit said, “You and every one else in the office. How long will it take you to call your doctor? Maybe five or ten minutes? Tell me this. Do you want to put yourself at risk for having a heart attack?” I said, “No, I don’t.” She asked, “Do you want to put yourself at risk for getting colon cancer?” I replied, “No, I don’t want that either.” She said, “Then stop procrastinating and make that telephone call.”
Bridgit is young enough to be my daughter, but her approach to this situation was a lot more mature than mine. Right now I was acting like a five year old child who was trying to justify why he didn’t need to go to the doctor’s office to get a shot. It was time for me to change that mindset. I said, “I guess that I really do need to make that call to my doctor’s office. I will do it on Monday. You’ve got my word on that. Thanks for making sure that I do the right thing here.”
OK, I didn’t get around to making the call on Monday. But I did make it on Tuesday. I talked to Dr. Niesen’s nurse named Krista. Krista said, “Your last set of blood tests really looked good. Both your cholesterol and your triglycerides were substantially lower than they have been the last few years.” Before my fourth colonoscopy a friend of mine named Helene had suggested that I eat a diet with a lot more fruits and vegetables, as well as making sure to use olive oil as a salad dressing. Because that diet seemed to give me more energy, I stayed with it after the colonoscopy. Maybe that is the reason why my cholesterol and triglycerides dropped. Or maybe it was caused by the heart medication that I was now taking. Or maybe it was a combination of reasons. In any case, it was good news. (I later asked Dr. Niesen about this. She said that the heart medicine probably would not have been responsible for the drop in the cholesterol and the triglycerides. So it’s sounding like it may have been the diet.)
During the next few weeks I had follow-up visits with Dr. Niesen and Dr. Reis. It appeared that the heart medication had the atrial flutter under control.
On July 28, I had an appointment with Dr. Reis for an EKG and an echocardiogram. As I was sitting in the waiting room I began to get nervous. I pulled out my cell phone and started to call Bridgit at the office, hoping that she could give me a pep talk to get me past this fear. I stopped half way through the dialing and said (silently to myself), “No! This nonsense stops here and now. Bridgit has a ton of work to do. She doesn’t need to be dealing with a 59 year old man who is acting like a 5 year old boy on his first day of Kindergarten. Besides, I know from my hospital visit that Dr. Reis is a great doctor. I should consider myself very lucky that such a fine doctor has accepted me as a patient. There is nothing to be nervous about. This visit will go just fine.”
And it did. I got an echocardiogram and an EKG that morning. The echocardiogram was performed by a man named Aaron. He was a very interesting person to talk to. He allowed me to watch the monitor during the test while he explained what he was doing, and even taught me some interesting facts about how the heart works.
The EKG was performed by a Registered Nurse named Diane. She was also a very interesting person to talk to. Both the echocardiogram and the EKG were entirely painless.
Afterwards, Dr. Reis came in and discussed the results with me. Both tests showed normal results. Apparently the heart medication had the atrial flutter under control to the point that it was not even showing up on the tests. Dr. Reis did suggest that I come back the following week for a stress test, just to be sure. I readily agreed with that suggestion, and set up an appointment for the following Tuesday.
So this was the visit that had me so nervous in the waiting room that I felt like I needed somebody to (at least figuratively) hold my hand! I guess that a certain amount of fear is a good thing. Perhaps it was my fear on the morning of the fourth colonoscopy which caused the atrial flutter to be diagnosed, and resulted in me being put on medication which would keep it under control. That part was good. But when the fear makes me hesitant to have important life protecting tests, that is where I have to draw the line.
As I was getting ready to leave Dr. Reis’s office I almost had a déjà vu incident from what happened on June 9, 2007, when I woke up from my third colonoscopy. (The incident was mentioned in another article.) At the front desk were Jo Ann (who scheduled my follow-up appointments) and Diane (the Registered Nurse who had performed my EKG.) I said, “It was really good to meet both of you. You are both very nice people.” Diane said, “But I am nicer than Jo Ann.”Jo Ann responded, “No you’re not. I’m nicer than you are.” They smiled at one another, indicating that the disagreement was merely a joke. I looked up at the ceiling and said, “Oh no, not this again.”
When I saw the puzzled looks on Jo Ann’s and Diane’s face, I told them the story about the nurses at St. Mary’s Endoscopy Unit after my third colonoscopy asking me to decide which one was the most beautiful. Diane laughed and said, “I can see how that question or today’s question could get you into trouble.” I said, “Let me just say that you are both equally nice, and before you have a chance to ask I will say that you are both equally beautiful. Now I really need to leave so I can get back to work.” Before either of them could respond I was out the door, walking toward the exit at a fairly brisk pace.
Although I complained about being asked a Catch 22 question, I wasn’t really complaining. It was all in good fun. The staff at Dr. Reis’s office, like the staff at Dr. Niesen’s office, the staff at Saint Mary’s Endoscopy Unit, the staff at Saint Mary’s Emergency Room, and the staff at Saint Mary’s Cardiology Step Down Unit are all really fine people. They are very good at the technical aspects of their jobs. But there is more to it than that. They are also caring and compassionate people, who carry out their jobs while making things as easy as possible for the patient. And sharing a joke and a laugh with a patient is a nice way to build a good rapport with that patient.
That evening I looked at the instructions for the following week’s stress test. That was when I realized that this was not an ordinary stress test like the ones that I had in 1993 and 1994. Rather, it was a nuclear stress test which would involve putting some dye into my heart through an IV while I was on the treadmill. I was getting scared just thinking about that one.
I sent off an E-mail to my friend Cat asking for some (figurative) hand holding. Cat worked for almost 30 years as a nurse, which included experience in numerous different fields of nursing. I asked why they couldn’t just perform a regular stress test like I had in 1993 and 1994. Cat’s answer was, “Because this area of medicine has improved significantly since 1994. A nuclear stress test will provide your doctor with information that would not be available from a regular stress test. Your doctor is obviously up to date on current advances in this field. You have nothing to be scared about.”
On Monday, August 3, I was telling Bridgit about the following day’s nuclear stress test. Bridgit said, “Stop that.” I said, “Stop what?” She said, “Stop being afraid of the test.” I asked, “What did I say?”She said, “It’s not what you said. It’s the look on your face when you said it.” I said,” I guess it is that obvious. You always could read me like a book.”
Bridgit said, “You will do just fine with tomorrow’s stress test, and you will do just fine when you have your colonoscopy on August 29. You will go through with the colonoscopy this time. There is no reason why anybody should ever die from colon cancer.” I said, “Absolutely! You’re talking to the person who wrote an article on the subject. An article which is now 40 pages long, and stresses the fact that this test saves lives, and is nothing to be afraid of.” So why don’t I take my own advice?
I then said, “On tomorrow’s stress test, if I start to get nervous in the waiting room can I call you for a pep talk? I realize that once I walk past the front desk I’m on my own. But while I’m still in the waiting room, it would be nice to have a lifeline or a security blanket. Even if I don’t use it, having it available will still be nice.” Bridgit said, “Of course you can call me. But you won’t be alone when you walk inside for the test. You said yourself what a great staff they have at the doctor’s office.” She had a very good point!
That evening at the bowling alley my teammate Mike asked me why I was being so quiet. I told him that I was nervous about the following day’s nuclear stress test. He said, “I had that very same test two weeks ago. I was nervous also. But my wife Kathy, who is a nurse, told me it was nothing to be worried about. She was right. It was a very easy test. Not to mention that I got great results.” That would at least make it a little easier to sleep on Monday night.
I arrived early on Tuesday Morning (August 4), so I stopped off in the lobby of Saint Mary’s Hospital, which was right next door to Dr. Reis’s office. In the hospital lobby they had a piano which was“automatically playing” continuing songs. I was getting ready to leave to walk next door to Dr. Reis’s office, when the next song that began to play was “Someone To Watch Over Me.” I took this as a good omen, and stayed around until the song was over.
At Dr. Reis’s office a lady introduced herself as Robin, and said that she would be performing the nuclear stress test on me. She brought me into a room where there was a treadmill and some tables, and gave me an overview of what would happen that morning.
Robin began by inserting an IV in my arm, which would be used to transport the dye to my heart. As soon as the needle was inserted I began to get very scared. I said, “Robin, I’m really getting scared. I don’t think that I am going to be able to go through with this. I probably made a mistake agreeing to do this test.” Robin said, “You didn’t make a mistake. This test will give us some valuable information about how your heart is performing. Think of it this way. You and I are working together as a team here. We’re going to get you through this test with very little discomfort to you.” I asked, “Can you hold my hand for a few minutes?” She said, “I’ll do something better than that. I’m going to lower the table so you get more blood to your head. Then I’ll just stand here with you, and not do anything else until you are ready for the next step.”
A few minutes later the fear went away, and I was feeling better. Robin said, “You must be feeling better. You are smiling now.”I said, “I sure am. I’m not afraid anymore. Now I know that I can go through with this test. Thank you for being the good person that you are, and giving me the courage that I need to go through with this.”
I was taken into another room where I was told to lie down on a table and some pictures were taken of my heart. Robin said that they would take similar pictures from this same machine after I finished with the treadmill.
After that I was taken back in the room with the treadmill. A Registered Nurse introduced herself as Deborah, and said that she and Robin would work together to give me the nuclear stress test. I would be walking on a treadmill, which was flat and would walk or run at a slow speed. Every so often the speed would increase, and the treadmill would be raised to a slight incline. They would warn me before the speed and the incline were increased.
The treadmill provided me with a good cardiac workout. I try to run (or more accurately slowly jog) three times a week. In fact I came for this test wearing a shirt which I got from entering a 10-K (slightly over 6 miles) run back in 2005. I figured that may give me a little extra confidence. Deborah and Robin closely monitored my blood pressure and heart rate, among other things, throughout the procedure. We kept a conversation going until the time when the speed of the treadmill got to the point where I was no longer able to talk and “run” at the same time. Afterwards I thanked Deborah and Robin, and said it was really nice to work with them. They are both really great people.
Robin then took me back into the room where they took the earlier pictures of my heart so they could get “after the stress test”pictures to compare with the “before the stress test pictures”. As the pictures were being taken I said, “Robin, when we are done here today I really need to go back to work.” Robin said, “That is fine.” I said, “Maybe I need to ask this a different way. Do you ever have patients whose test results look so bad that you insist that they immediately go to the hospital?” Robin said, “That is very rare, but it does happen.” I said, “If it were to happen to me today, would it be possible for me to talk my way out of it?” Robin asked, “Do you honestly think that you could outtalk Deborah or me, much less Dr. Reis?” I said, “No, that would never happen.” She said, “Don’t worry. I haven’t seen anything bad in your test results today which warrant something like that. Dr. Reis is still going to have to look at some of the numbers which don’t mean anything to me. But that won’t be until tomorrow. Our office will call you tomorrow with the final results.”
As I was leaving I said, “Didn’t I tell you that with you and me working together as a team I would get through this test today?” Robin said, “As I recall, I was the one who said that to you.”
On Wednesday I got a telephone call from Melanie in Dr. Reis’s office. Dr. Reis had the chance to review my nuclear stress test results in detail, and determined that everything looked fine. So other than staying on the heart medication (for the atrial flutter), and one low dose aspirin per day, I could continue to live my normal life style.
Right now I was considering myself quite lucky in this area. I had a great Primary Care Doctor and Gastroenterologist (Dr. Niesen), a great Cardiologist (Dr. Reis), and a great Dentist (Dr. Pagano). For health care needs, a person can’t ask for more than that!
Now that I had gotten through all of the cardiac tests — with a lot of help from some really fine people — I could look towards the upcoming colonoscopy exam on August 29. I was confident that I would not be nervous about the test this time. That’s what I’m saying now. That confidence may quickly disappear on the morning of the test, but let’s hope not.
UPDATE: JANUARY 2011
On January 25, 2011, I had a follow up visit with the cardiologist. Dr. Reis has now left the practice, and her patients were taken over by Dr. Friedman. Dr. Friedman, like Dr. Reis, is considered one of the best cardiologists in Saint Louis.
Diane checked my pulse and blood pressure, and performed an EKG on me. The results of all three looked good.
Afterwards Dr. Friedman came in. He listened to my heart with a stethoscope and checked a few other things. He said that everything was looking good. He then brought in a plastic model of a heart and showed me how a heart normally operates, and then showed what deviations occur with atrial flutter. Fortunately the medicine that I was taking was doing a good job of keeping the atrial flutter under control to the point that it did not even show up on the tests. So he told me to keep taking the medicine and to continue to live my healthy lifestyle.
When I got back to the office I told Bridgit what had happened. I said, “As I was in the waiting room at the cardiologist’s office, I began to wish that I had asked you to give me a pep talk first.”Bridgit said, “Oh for heavens sake. A man your age shouldn’t need a pep talk for a routine doctor’s visit. It’s not like they planned on doing anything invasive. It’s almost 1:30. Guess you’d better be heading to your office for your conference call.”
MORE CARDIOLOGY ISSUES
On March 11, 2013, I had the first of two parts of my annual physical exam. I would get a variety of tests today. Then I would return two weeks later (March 25) to discuss the results with Dr. Niesen, and get the remainder of the physical exam.
To begin the exam, Kim drew some blood from me. Kim didn’t actually work for Dr. Niesen. She worked downstairs at Quest Laboratories.
Then Krista, one of Dr. Niesen’s nurses, took over the day’s exam. She began by asking me some questions to test the clarity of my mind. There was one that I really had some fun answering.
Krista asked me what season it was. I said, “I’m not really sure.” Krista said, “Would you like to take a guess?” I said, “Well, according to the calendar Spring begins on March 21. That is the day when the sun is directly over the Equator. That is known as the Spring Equinox. The word Equinox is Latin for “equal nights. So according to that criteria the Season is Winter. However, meteorologists consider the first day of Spring to be March 1. So according to that criteria the Season is Spring. If you would like, I can give you some pros and cons of each criteria.” Krista said, “No, that’s OK. I’ll just say that you got the right answer.”
Krista then proceeded with blood pressure, vision testing, hearing tests, and an EKG. Everything was looking good until she did the EKG and saw that my heart rate was way too fast. It was sort of a repeat of what happened on the morning of June 20, 2009, before my fourth colonoscopy. I said, “This can be one of the things that I discuss with Dr. Niesen when I come back on March 25.” Krista said, “No, I don’t think we should wait that long. I need to talk to her about this right now.”
Several minutes later Dr. Niesen came in and confirmed that my heart rate was too fast. She said, “I’m going to call Dr. Friedman (my cardiologist) and see what he suggests.”
So as I was sitting in the room I happened to look at my watch and realized that I needed to leave in a few minutes to get back to work for a 2:00 conference call. I picked up my coat and walked to the front desk where John and Krista were sitting. I said, “I’ll see you in two weeks.” Krista replied, “You’re not going anywhere, Mister. Get back in the room and sit down. Dr. Niesen needs to decide what we are going to do about your heart rate.” Trying to project a confidence that I didn’t feel, I said, “You need to decide something very soon, because I need to be back at my office for a 2:00 meeting. My boss expects me to be there, and so does his boss.”
I knew that if they insisted that I stay, I would have to do so. There was no way that I was going to challenge Krista, much less Dr. Niesen. But as it happened, Dr. Niesen came in a few minutes later. She said that I could leave. However, she scheduled an appointment for me with Dr. Friedman at 3:30 the following afternoon. In the meantime, I was to double the dose of my heart medication, and take one of the pills right now. As I was leaving Krista said, “You understand that if Dr. Niesen thought that you were in immediate danger — meeting or no meeting —you would not be walking out of here right now.” I replied, “I know that. That’s the way that I would want it to be.”
When I saw Dr. Friedman the following day, Diane gave me an EKG. Afterwards Dr. Friedman came in and checked me out. He said that the EKG looked fine, and that my heart rate was now normal. He told me to continue to take the double dose of my heart medication, and that should keep things under control.
On Monday, March 25, 2013, I returned to Dr. Niesen’s office for the second part of my annual physical exam. Everything looked fine, including my heart rate. So apparently the new dose of the heart medication had the atrial flutter under control.
TIME TO CORRECT THE PROBLEM
On March 17, 2014, I visited Dr. Friedman for what I thought would be a routine visit. I figured he would check my pulse, listen to my heart with a stethoscope, have me do my birthday trick for a few of the staff members, then leave to go back to work.
When Dr. Friedman’s nurse named Angel took my pulse I could see a look of concern on her face. She said, “I need to go and talk to Dr. Friedman for a few minutes.” Angel returned with Dr. Friedman. Dr. Friedman asked, “Does it feel like your heart rate is fast?” I said, “No.” He said, “Well, it is beating at 137 beats per minute. So you are in atrial flutter mode right now. I will have Angel do an EKG on you, then I will have my nurse Kayla come in and explain a procedure that we want to do on you.”
Kayla, who is a registered nurse, came in the room and introduced herself. She explained that I would undergo a procedure called cardioversion which would “reset the heartbeat” and hopefully put a stop to the atrial flutter. She explained the details of how the procedure would work.
From the beginning it seemed that I was ready to lock horns with Kayla. Kayla said that Dr. Friedman wanted me to have the procedure sometime this week. I said, “That is out of the question. I can’t just take off work on the spur of the moment. The soonest I can do this will be three weeks from now on Monday, April 7. And that is contingent on me checking my schedule, which I will do when I get back to my office.”
As Kayla was explaining the procedure she said that the test would begin with Dr. Friedman putting a tube down my throat to check for blood clots in my heart. I said, “No. That is out of the question. Nobody is putting a tube down my throat. Find a way to do the procedure without that step or I won’t be having the procedure.” Kayla left to talk to Dr. Friedman. When she returned she said that Dr. Friedman stated that we could do the procedure without the tube down the throat. Dr. Friedman did give me a prescription for a blood thinner that he wanted me to take every day until the day of the procedure.
When I got back to my office I checked my calendar and determined that Monday, April 7 was available. So I called Dr. Friedman’s Office and scheduled an appointment with Kayla. Kayla told me to report to Saint Mary’s Outpatient Area on Monday April 7 at 7:00 in the morning, and said that the actual test would begin around 9:00. She that because at least some sedation would be used, I would need someone to drive me home from the hospital after the test.
The following week I was telling my co-worker Bridgit what was going on. Bridgit gave me some pep talks before several of my colonoscopy exams and also before some outpatient surgery that I had for some minor skin cancer. When I got to the part about refusing the tube in my throat she nearly read me the riot act. She asked, “When did you graduate medical school and become qualified to tell a cardiologist how to do his job?” She already knew the answer to that rhetorical question.
She then asked, “Did Kayla or Dr. Friedman tell you the purpose of putting the tube in your throat?” I said, “I believe that Kayla did talk about it. But I was having a hard time coming to grips with the fact that I needed to get a procedure whose name I had never heard before. So I was only half listening.” Bridgit said, “Then I suggest that you find out the purpose of the tube down the throat and if it serves a legitimate function call the doctor’s office and tell them that you will allow them to perform that step.”
I researched this on The Internet, and determined that the tube down the throat did indeed serve an important function. It allowed the doctor to determine if there were any blood clots in or around the heart which could come loose during the procedure and cause a stroke. Ok, looks like it was time to forget my pride and be ready to say that I was wrong. I wrote a letter to Kayla acknowledging that I wanted to revisit the “no tube down my throat” position. I stated that my original response of “no tube down my throat” was a first impression, emotional response, for which there was no good reason. I further stated that if the tube down the throat would in any way make the procedure safer or more effective, then by all means do it. It was about as close as I could come to saying, “I behaved like a real idiot that day in the office”, without actually saying those words.
A few days later I got a telephone call from Kayla. She said, “I did get your letter. But I don’t think we will need to put the tube in your throat. When you said that you wouldn’t let us do this, that is the reason why Dr. Friedman put you on the blood thinner pills. That will thin out your blood enough so that there shouldn’t be any blood clots present by the morning of April 7. But I will tell Dr. Friedman about your position on this, just in case he would prefer to take that step.” Well how do you like that!
In the meantime I talked with Dr. Niesen. She had already talked with Dr. Friedman, so she knew what was going on. I said, “Give me your thoughts. Does it really make sense for me to have this procedure?” Dr. Niesen said, “It makes a lot of sense. The procedure itself is very safe, and while there are no guarantees, in many instances this procedure is all that is needed to reset the heart rate to correct atrial flutter.” OK, I guess it was time to stop second guessing myself.
My next step was to get myself a ride to and from the hospital on Monday, April 7. As I searched my mind for ideas, one came to my mind. A friend of mine named Golda works for AW Health Care. I knew Golda, along with her husband and children from the bowling alley. Not to mention the fact that we are Facebook Friends. So I sent Golda a message asking if this sort of transportation was something that AW Health Care could perform. She confirmed that these transportation services were done quite frequently. She said, “Let’s get together Thursday Evening and hammer out the details.”
On Thursday Evening I got together with Golda to arrange for my transportation to and from the procedure on Monday. I learned that AW health Care provides a wide range of services to clients. Transportation, Medical Home Health Care, Personal Home health Care, Outpatient Physical Therapy, Aquatic, and Adult Day Care, to name a few. I will definitely have to keep that in mind for the future.
On the morning of Monday, April 7, Larissa (the home health care worker) from AW Health Care picked me up at and drove me to Saint Mary’s Outpatient. After checking in at the Registration Desk, a registered nurse named Shelli asked me to come back. Larissa wished me good luck with the test.
As Shelli and I got to talking I realized that we already knew each other. We met back on June 20, 2009, when I spent a night on the Cardiology Step Down Unit. It was her birthday that gave it away. Turned out that we even shared some of the same Facebook Friends. Shelli asked me some questions about my medical history, and spent quite a bit of time explaining to me what would happen that morning, which was well appreciated.
Shelli inserted an IV into my arm which she said would be used to inject the sedatives. She must have been good at doing this because I hardly felt a thing. About 15 minutes later I commented on how the sedatives were already making me feel sleepy. Shelli laughed and said, “Somehow I don’t think that is the case. We haven’t even started the sedatives yet. That is when I looked over and saw that the IV wasn’t hooked up to anything. Yeah, I guess that was my mind playing tricks on me.
Shelli then asked me if I would like to have Larissa come in and stay with me until it was time for the procedure to begin. I said that would be great. I was explaining to Larissa the purpose of cardioversion and how it would work. When I got finished Kayla (the nurse from Doctor Friedman’s office) walked up to my bedside and said, “That was a good explanation. You actually sounded like you had done the procedure before.” I said, “Well, I’m more or less repeating what I learned from you. What are you doing here anyway?” Kayla said, “I knew this was the day that you were coming in for the procedure, so I just thought that I would stop by and wish you good luck.” I said, “Well, I appreciate you stopping by. There were a few times when I seriously considered calling and cancelling the procedure, but each time my talks with you convinced me to have the procedure.
As we waited for the test to begin several different nurses and doctors came by to say hello and wish me good luck with the procedure. Dr. Friedman came over and said good morning, and I introduced him and Larissa to one another. He gave me a brief overview of what would happen that morning. I reiterated that I was rather nervous about the procedure, and he promised that I would feel little, if anything. Dr. Friedman said, “The procedure sounds worse than it really is.”
A registered nurse came over and introduced herself as Sue. She said it was time to begin the procedure, and that she would be assisting Dr. Friedman during the procedure. She wheeled me into the room where the equipment was set up. She said that several pads would be placed on my chest which would allow Dr. Friedman to run electricity through to my heart as needed to “reset the heart rate”
Sue showed me some electric clippers and said that she would need to shave parts of my chest to clear the area where the pads would be placed to conduct the electricity. I said, “Normally I don’t allow anybody to cut any part of my hair, except for Audrey. She is the person who works at the beauty shop where I normally get my hair cut. But somehow you don’t strike me as the type of person who is going to put up with any nonsense. So go ahead and do whatever you have to do.”Turned out to be no big deal. She just took off a few small areas of hair. And Sue was a very interesting person to talk to. So we had a nice conversation while we waited for Dr. Friedman.
Dr. Friedman came in and said it was time to start the cardioversion. I was waiting for the procedure to begin, hoping that the sedatives would really make the procedure painless. The next thing I knew I was waking up in the same room where I had been when the IV was inserted. Dr. Friedman and Shelli said that everything had gone fine. Now it would just be a matter of seeing how long the procedure would last.
About a half hour or so later I felt well enough to leave. Larissa drove me home and here I am putting the finishing touches on my article. I hope that the cardioversion will put an end to the atrial flutter. I guess that time will tell. But in any case I’m glad that I had the procedure done, and glad that it was done by such a fine cardiologist at such a fine hospital.
PROBLEM STILL NOT CORRECTED
We thought that the cardiversion had corrected the problem. But when I returned to Dr. Friedman for a follow-up visit on May 28, 2014, he gave me some bad news. My heart was still in the atrial flutter mode. It was beating at a rate of 137. I said, “That’s not so bad. That is just a fast walking pace.” Dr. Friedman said, “Yes, but you are not walking at a fast pace right now. You are on a table.”
Dr. Friedman said that since the cardioversion had not worked the next step would be to try a cardiac ablation. This one is more invasive, running tubes and wires into the heart to try to identify where the heart is firing too quickly. I set up an appointment to return on July 14, 2014, to meet with Dr. Bauer. He is the doctor in the group that specializes in doing cardiac ablations. He is sort of the “expert of the experts” in the cardiology field.
On July 14, 2014, I had my appointment with Dr. Bauer. I first had a consultation with Ramona, who was Dr. Bauer’s Nurse Practitioner. She had a fairly long discussion with me where she asked me a variety of questions about my general health, and specific questions about my heart. She was obviously a very knowledgeable person. She then explained to me some of the problems associated with atrial flutter, and explained how a cardiac ablation can help.
Afterwards Dr. Bauer came in and introduced himself. After we talked for a while he agreed that a cardiac ablation would be the next step to try. His past record with this procedure had about a 95 percent success rate. He explained how the procedure would work, and stated that it is normally done in Saint Mary’s Cardiac Cath Lab (the same place where the cardioversion had been done in April) on an outpatient basis. Although patients who undergo this procedure can usually go home the same day, occasionally they will keep the patient overnight. Afterwards the patient will generally take off work for two days to recover. Since this would require me missing three consecutive days of work I stated that I would need to check my schedule when I got back to work, and would probably not be able to have this done for at least 3 to 4 weeks.
I was then sent across street to Saint Mary’s Cardiac Cath Lab to have an Echocardiogram. The procedure was performed by a lady named Dana. She was a very nice person, and interesting to talk with. However, several times during the procedure I noticed a look of concern on her face. I said, “I can tell from the look on your face that you are seeing something that you don’t like. Do you want to tell me something about how everything looks, if you are allowed to say”. She said, “I’m not allowed to say anything to you about what I’m seeing. But I will report the results to Dr. Friedman and Dr. Bauer.
The following day I got a telephone call from Ramona. She said it was important that I set up an appointment for the Cardiac Ablation as soon as possible. I said, “I explained to Dr. Bauer yesterday that the soonest time I had available was in 3 to 4 weeks. He didn’t have a problem with that.” She said, “Yes, but that was before we got the results of your Echocardiogram. One of the numbers — the ejection fraction — which tells how strongly your heart is pumping came in at 25 percent. A normal rate is between 50 and 60 percent. When you last had the test in 2009 it came in at around 60 percent. So your heart is getting much weaker, probably as a result of the atrial flutter. That is why it is very important to get this fixed as soon as possible. I want you to talk to Rita in our office and set up an appointment with her. When I talked to Rita we set up an appointment for Wednesday, August 13, 2014.
So now I had several weeks to debate with myself whether or not I was doing the right thing by having this done. Luckily, I got several pep talks. Dr. Niesen called me one day and explained to me in medical terms and also lay terms the risks and benefits of having a cardiac ablation. Clearly the benefits outweighed the risks. As she explained it the greatest risk was to just do nothing. Things would not get better, they would only get worse. That cinched the matter as far as I was concerned. No more second guessing. I would go through with the procedure.
The following week I talked with two of my Facebook Friends — Joan and Kathy — who work in Saint Mary’s Endoscopy Unit. They were quite familiar with how a cardiac ablation works. They both said that they had friends who worked in the Cardiac Cath Lab and would see to it that they took good care of me when I came in for the procedure. They asked me to promise that when it was over I would let them know how everything turned out.
About a week before the procedure I got a telephone call from Kayla (who is mentioned above), one of the nurses in Dr. Friedman and Dr. Bauer’s office. We talked for a while as she gave me some guidelines on what to expect from the procedure. I said, “So you think that I should have the procedure.” She said, “Absolutely. Getting this fixed will make a big difference in your overall health.” I said, “That is what everyone is telling me. But it is good to hear one more person say it.”
The procedure was one which required that you have a ride home, as I would not be able to drive myself afterwards. My brother, my sister, and my sister-in-law had all given me standing offers to provide transportation to and from any doctor or hospital visits that I may need to go to. Based on what I knew they had on their plates during the week of the procedure I decided not to burden them with one more task.
I got together with Golda who had arranged for my transportation to the cardioversion on April 7. Because of the “middle of the day” time of the procedure she set me up with two drivers. George would drive me to the procedure in the morning. (The procedure was scheduled to begin at 12:30 in the afternoon, but they wanted me to check in at 10:30 in the morning.) Leander would pick me up when it was time to leave. (They expected the procedure to be over at about 4:30, but explained that afterwards I would probably be laying flat in bed for 3 to 4 hours. So it would be late in the evening before I would be coming home. Unless they decided to keep me overnight.)
On Saturday, August 9, I had lunch with a group of my Facebook Friends at a restaurant. One of the ladies was Pam, who is the mother of my co-worker Bridgit. I was telling Pam about my upcoming procedure. I said, “Before I had my last colonoscopy in May 2013 Bridgit told me that if I tried to cancel the procedure she would tie me up and drag me to the appointment. Now she is telling me the same thing about this upcoming cardiac ablation. Do you think that she would really do that?” Pam said, “Yes, I actually think that she would. She would do it because she cares about you as a co-worker.”
I should mention that before arriving at the restaurant I stopped off at Shop & Save. In the Pharmacy Department they had one of these “customer self service” blood pressure and heart rate machines. I checked it out. My blood pressure numbers looked good, but my heart rate was 140. I had done nothing that morning to account for such a high reading. So this was the icing on the cake as proof that it was time to have the procedure done.
On Monday, August 11, Bridgit came into the office early. I asked, “Why are you here so early?” She said, “Because I knew that you would be here early. Come into my office and close the door. You didn’t really I think I would let you go into that procedure without a pep talk, did you?” She said, “I really had no idea what a cardiac ablation was. But I did research it on the Internet. This appears to be a well established procedure for the problem that you have. The fact that your primary care doctor plus two cardiologists are recommending it tells me that this is something that you need to have done.”
That was hard to argue with. She said, “If you need another pep talk between now and Wednesday just say so. And if you would like to have a visitor when you return to the recovery area after the procedure let me know.” I said, “That will be great. A familiar face would be nice to see about then”.
THE DAY OF THE PROCEDURE AND AFTERWARDS
When I awoke on Wednesday I realized that the day of reckoning had arrived, and I just hoped for the best. The instructions were nothing to eat or drink after Midnight. Doing the arithmetic led me to realize that I would probably have nothing to eat until maybe 5:00 in the evening. Right now my concern was whether or not I would starve before the day was over.
George picked me up at around 9:45 and drove me to the hospital. George was an interesting person to talk to, which helped to take my mind of the fact that I was getting a little more nervous with every minute.
After checking in at the Cardiac Cath Lab I was turned over to a Registered Nurse named Stephanie. She had me undress and put on a hospital gown. She was a very nice person, and easy to talk to. I figured the more that we talked the less nervous that I would be. Turned out that we had some of the same friends who worked at Saint Mary’s.
Stephanie told me that it was time for her to start my IV. I said, “This is the part that gets me really scared. So I’ll appreciate anything you can do to make this less painful.” She must have known what she was doing, because I felt little more than a brief stick. I said, “Now that the IV is in, I guess that I’ve reached the point of no return. I can’t change my mind now.” Stephanie said, “You are always allowed to change your mind. But if you do that, I may just call Bridgit and tell her to come down here to tie you up and drag you into the operating room. (In case you’re wondering how Stephanie knew about this, I had mentioned it to her earlier.) I said, “I don’t know if you’re serious or joking. But I don’t think that I want to test you to find out.”
As I was waiting two other nurses came over to say hi to me. Shelli and Sue. Shelli was the same Shelli who I met in June 2009 when I spent a night on the hospital floor, and later saw in April 2014 when I had the cardioversion. Sue was not the same Sue who worked with Dr. Friedman during my cardioversion.
The next person to visit me was a Registered Nurse named Jason. He was the Nurse Anesthetist who would provide me the anesthesia during the procedure. I asked, “Now is this just conscious sedation? Or is this full anesthesia?” Jeff said, “No, this is full anesthesia. That is why they need me.” I said, “The last time that I had full anesthesia was 55 years ago this month in August 1959. They used Ether, and afterwards I was sick for the rest of the day. Tell me that you will not be using Ether today. Jason laughed and said, “You don’t have to worry about that. I don’t think Ether has been used as an anesthetic in over 40 years. The ones we use today are much easier to deal with.”
Jason was a very interesting person to talk with. We were talking about military service. I asked, “Did you ever serve in the military?” Jason said, “No. How about you?” I said, “No. But I’ve read enough books and watched enough movies to talk a good game.” Jason said, “Same with me.”
Dr. Bauer came over and said it was time to go into the Cardiac Room and begin the procedure. He asked how I was doing, and if I had any questions. I said, “I think that I’ve had all of my questions answered except one. Nobody can seem to tell me if I will going home after the procedure or if I will be spending the night here.” Dr. Bauer said, “That is because it is too soon to know the answer. It will depend on how the procedure goes. If nothing out of the ordinary happens you should be able to go home after a 3 to 4 hour recovery. The recovery will involve you just laying in bad flat on your back to keep from immediately aggravating the incision site.” I said, “I guess that you and I are both kind of surprised to see me actually going through with this.”
Dr. Bauer, Jason, and another nurse wheeled me into the Cardiac Room. I can’t remember when I’ve seen something so “hi tech” that looked like it was right out of a space movie. There were at least 5 other nurses and technicians in the room. We introduced ourselves, and Jason suggested that to break the ice I tell everyone what day of the week they were born. (He had seen me performing the trick earlier.) Jason put a plastic mask over my face which he said would smell like the outside of a beach ball. He was right about that. He said, “Just breathe normally and you will be asleep shortly.”
The next thing I knew I was waking up. I was very sleepy and sore around the incision site. Dr. Bauer was standing there and told me that everything had gone fine. He said, “This procedure normally takes about 4 hours. I was able to complete yours in around 2 1/2 hours. I had a suspicion where the problem area was located, and it turned out that I was correct. So I got it fixed. We will be taking you to the Fourth Floor Cardiac Recovery Floor. You’ll spend about 3 to 4 hours just lying flat. Then we’ll bring you some supper, and after that I’ll sign the discharge orders and you can go on home.” I said, “You mentioned food. After not having any food or water since Midnight, you may figure that I would be starved by now. But for some reason I’m really not even hungry. By the way, thanks for everything.” I shook hands with Dr. Bauer and said he had just become my new best friend.
A Registered Nurse approached my bedside and introduced herself as — Would you believe that I don’t even remember her name? I guess that I was still half asleep from the anesthesia. She said, “Well, we finally get to meet. I recognize your name from Facebook. We have some of the same friends, the ones who work in the Endoscopy Unit. I’ve read a lot of your posts. You’re the one whose Profile Picture has you standing next to a 1964 Buick LeSabre.” I said, “Actually, it is a 1963 Buick LeSabre, but you’re very close.” She said, “I’m taking you up the Fourth Floor Cardiac Recovery Floor.” I said, “Well, tell all of our mutual friends that I said hello.”
When I arrived on the Fourth Floor Cardiac Recovery Unit a Registered Nurse introduced himself as Nick. He asked how I was doing. I said, “Tired and sore, especially at the incision site. Nobody told me how sore I would be after the procedure. Which I’m glad they didn’t tell me. Because if I had known I may not have gone through with it. And I really needed to go through with it.” Nick said, “The soreness should drastically reduce after about 24 hours.”
Nick turned on the TV for me, and showed me how to call the Nurses Station if I needed anything. As I was watching TV, Bridgit walked in my room and asked how I was feeling. She said, “You won’t believe how hard it was to find you. I must have asked a dozen people before I found someone who was able to give me your room number. So are you glad that you finally went through with this?” I said, “Yes, I am. Thanks for all your pep talks. They made a difference.”
Nick came in, and I introduced him to Bridgit. Nick gave me a menu for supper and showed me how to place an order. He did warn me that I was on a “heart healthy” diet restriction, so if I tried to order something that did not qualify they would tell me to order something else. I ordered corn, green beans, a banana, and a glass of orange juice. And they all tasted good.
As Nick, Bridgit, and I were talking Leander walked in and introduced himself. He was a very interesting person to talk to. We soon realized that we shared common interests in bowling, running, and older cars, among other things. I promised to send him links to some of the articles that I wrote on that subject. Leander also worked part time as a fitness instructor, and was well trained in martial arts.
Bridgit said, “Well, I’d better be leaving. Don’t know how my husband would like the idea of me being in the presence of three handsome men, especially one who is in bed. Take care of yourself and I’ll see you on Monday.”
Nick gave me a typewritten list of post-procedure instructions. I read through it occasionally stopping to ask him for clarification. He then pulled out his cell phone and called Dr. Bauer to let him know that I was doing well. Nick and Leander stood next to me as I walked around the room to be sure I was OK.
Three nurses entered my room, and said that I could leave and go home. One was named Rachel, and right now I’m not remember the names of the other two. Rachel said, “I will bring up a wheelchair to take you downstairs.” Leander said, “Wait a minute. Nobody told me that you had a wheelchair. That won’t fit in my car.” I said, “I can walk on my own. You just saw me doing it. The wheelchair is just part of a hospital policy to get me to the front door.” Leander said, “That’s right. What am I thinking?’
Rachel wheeled me out to the East Entrance. We told each other goodbye, and I got into Leander’s car. It was around 8:05 in the evening when I arrived home. I called the office and left a message on Bridgit’s voice mail letting her know that I had arrived home safely, and thanked her again for coming to see me and for the pep talks.
I spent Thursday at home doing absolutely nothing. It gave me a good chance to watch some TV and catch up on some reading. By Friday I was able to go out and drive my car. On Saturday, I returned to the Shop and Save Store where I had my heart rate checked on a customer self service blood pressure and heart rate machine. Last Saturday my heart rate came in at 140. This time it came in at exactly half of that number — 70.
During those days after the procedure I got a large number of E-mails and Facebook Messages from people asking how I was doing. Dr. Niesen, Joan, Kathy, Bridgit along with several other co-workers, Pam, Golda, and many more who I’m just not now remembering.
I returned to work on Monday, August 18. Although I was still in the recovery phase I immediately noticed that I was no longer getting tired easily during the day. I hadn’t even realized that there was anything wrong with how I felt. I guess that I had just gotten so used to it that it wasn’t until I had the chance to compare “before the procedure” to “after the procedure” that I recognized how much of a difference the procedure made.
TIME TO REBUILD THE HEART
On September 9, 2014, I had an appointment at the cardiologists office with Deborah. She is the nurse practitioner who, along with Robin, performed my nuclear stress test that I had on August 4, 2009.
As I was waiting for Deborah, Robin came in to say hello. She still remembered me after all those years. Then Katie, a technician who was also attending nursing school, came in and took my blood pressure and pulse. Both of those looked good.
Then Deborah came in and told me about our plan of action. We would meet for about 90 minutes today to put in place a program to rebuild my heart. After today we would meet every few weeks or so to keep track of my progress and make changes as needed.
I said, “Wait a minute. My heart is already in good shape. That is why I had the cardiac ablation four weeks ago.” Deborah said, “No, the cardiac ablation slowed your heart down so it won’t suffer any further damage. But it did not undo the damage that was already done. That is what we need to concentrate on now. Part of the repair process is to do cardio exercises, which it looks like you are already doing. Part of the repair process will be getting periodic blood tests to see how you are improving. And a big part of the repair process is changing your diet to one that is heart healthy. And that starts with cutting back on foods with sodium so that you take in no more than 2,000 milligrams of sodium each day.”
I asked, “Now how am I supposed to do that?” Deborah said, “I’m going to teach you how to read food labels so you know what you can eat, and how much of it you can eat. When you walk out of here today you will have a much better idea of how to read food labels, particularly when it comes to searching for sodium. Also, be aware that most chain restaurants will give you information on the Internet of how much sodium is contained in their various products. At the same time you will have an idea of how much fluids to drink each day. You will want enough that your body stays hydrated, but not so much that you risk fluid retention, which is hard on your heart.”
One other thing that I took away from this is that if I start eating more foods like fruits and vegetables not only will the result be that I cut back on sodium, but I will also save money by eating out less. Kind of a win-win situation.
After about 90 minutes of a very interesting learning experience, Deborah listened to my heart with the stethoscope. She then had Katie come in and perform an EKG on me. My heart rate numbers were looking a whole lot better than they were before the procedure.
Deborah said, “Now I am giving you the tools that you need to rebuild your heart, but ultimately you are the one who will need to follow through with this.” I said, “I plan on listening to you. And there are three reasons. First, it is obvious to me that you are a very smart person who knows what you’re talking about. Second, I want to rebuild my heart. Third, I’m scared to say no to you.” Deborah fixed me with a hard gaze and said, “You had better be afraid to say no to me.” I raised my hands in surrender and said, “Trust me. I am.” Then she smiled and said, “I’m only kidding. I’m not your boss. Think of this as a partnership between us.” Now it was my turn to smile. I said, “I think that we’re going to work very well together.”
After leaving I had an appointment with Dr. Niesen. Just a coincidence that I happened to get two different doctor’s appointments scheduled the same afternoon. My visit with Dr. Niesen was a “mid year one”, as opposed to a complete exam. So we spent most of the time talking about what was going on with my heart. Dr. Niesen checked my blood pressure, pulse, listened to my heart and lungs with a stethoscope etc. She said that everything was looking good, and she liked the plan that I was starting in order to rebuild my heart.
THE PROBLEM RETURNS
For almost two months after the cardiac ablation my heart rate had remained normal. All of my doctors were optimistic that the problem had been corrected. I thought that I could close out this article by saying that everyone lived happily ever after. Then along came October 11, 2014.
On that evening I went for a sleep study at Saint Mary’s Sleep Institute. Hard as I tried I just couldn’t fall asleep. The bed was fine, the room temperature was fine, the darkness of the room was fine, and the technician who I was working with (Larry) was a very fine man. And very interesting to talk to. But somehow I just couldn’t fall asleep with all those wires, belts etc hooked up to my body. I essentially spent the whole night awake, admittedly with my eyes closed.
But when the sleep study ended at 5:30 the following morning (Sunday, October 12) Larry pointed out that around 4:30 my heart rate had suddenly jumped from 65 to 141. I wasn’t too concerned, figuring that it was just a temporary thing. Within a day or two my heart rate would go back to normal.
Well, it didn’t happen. The following Friday (October 17) I had an appointment with Dr. Bauer for an echocardiogram. When he saw how fast my heart was beating he decided to skip the echocardiogram for right now. Instead he decided that I should have another cardioversion done. I told Dr. Bauer that I would check my schedule at work and get back to him about setting up a day and time.
I rescheduled the cardioversion for Tuesday, November 11. During those next few weeks my heart rate remained high despite special medicines, supplements intended to reduce the heart rate, and even a few alternative therapies that I read about on The Internet.
The day before the procedure (Monday, November 10) I managed to get several different pep talks. Bridgit gave me one at work. That afternoon I had an appointment with Dr. Niesen. She agreed that another cardioversion was the best way to go. She observed that while my heart was beating fast, it was at least beating regularly.
That evening I got two pep talk messages on Facebook. One was from Pam, who is Bridgit’s mother. The other was from Kathy, who works in Saint Mary’s Endoscopy Unit. They both wished me good luck on the following day’s procedure. Pam told me to give her a call if I needed anything. Kathy told me that she had several friends in the Cardiac Lab, and would tell them that I was coming.
The following morning a friend of mine named Mike picked me up from home, and drove me to Saint Mary’s Hospital. When he dropped me off he said, “I’ve got a few things to do, so I am going to take off. Call my cell phone when you are ready to be picked up.”
After giving my preliminary information to Patricia who worked the front desk I was turned over to a Registered Nurse named LuAnn. She said that she would be the nurse in charge of my care before, during and after my cardioversion. As she was confirming my medical history with me she asked a Registered Nurse named Donald to start my IV. Donald must have been good at this because I hardly felt a thing when he inserted the IV.
As I waited for the procedure to begin I had quite a few doctors and nurses come over to talk to me. I met both the doctor and the nurse who would be handling my anesthesia. Shelli and Sue, both of whom I knew from previous visits, stopped over to say hi. Then Sally came over and introduced herself. I said, “I recognize your name. You and I are both friends with Kathy who works in the Endoscopy Unit. Kathy said that she was going to talk to you about making sure that you take good care of me.” Sally said, “Well, we do that for all of our patients anyway.”
LuAnn brought over a pair of electric clippers and said that she needed to shave some of the hair off of my chest. I said, “I normally don’t allow anyone to cut any of my hair except for a lady named Audrey. She is my barber, if that is the right term. But I’ve got more sense than to argue with you.” LuAnn said, “I’m glad that you see it that way. Besides Audrey isn’t here right now.”
LuAnn wheeled me into the room where the cardioversion would be performed. Besides Dr. Bauer, there was one other doctor and at least five nurses. All these people just for me. I kind of felt special.
A nurse named Jerri came over to my bed holding some device with a long tube, and told me to roll onto my left side and face her. I said, “I don’t think that I like this idea. The last time someone held a tube and told me to roll onto my left side it was to get a colonoscopy.” Dr. Bauer said, “This is different. This tube will go down your throat. We need to make sure there are no blood clots near your heart that will come loose during the procedure and give you a stroke. To anticipate your next question, we can’t do the cardioversion without doing this first. It would be too risky.”
I rolled over, looked at Jerri and said, “You’re younger than I am. But right now I feel like a 5 year old boy who is facing a nurse who is about to give me a shot and I just want to be told that it won’t be too bad.” Jerri said, “I’ve done this procedure countless times and I can tell you that it is a lot easier than it sounds.” Dr. Bauer sprayed something in my throat which he said would have an anesthetic effect, although he admitted that it would probably taste bad. He was right, it did taste bad. But I had no trouble swallowing the tube, and that was the last thing that I remember. Jerri was right, what she did was not bad at all.
I woke up in the same room where I had the IV inserted. LuAnn was at my bedside and told me that everything had gone well. My heart rate was now down to normal. I said, “So how bad of a patient was I?” LuAnn said, “You were a wonderful patient. It is patients like you that help to brighten our day.”
I was sleepy from the anesthesia, and had a sore throat from the tube. Most patients who have had things put down their throat say that they have a sore throat for the next day or even two days. In my case the sore throat was gone in less than 30 minutes. And the anesthesia wore off fairly quickly. First they had me sit up, then they had my stand up, then they had me walk around the room with two men holding onto me for support, and finally they had me walking around the room on my own. When I reached the point of being able to walk around the room on my own, they said that I was ready to leave.
I pulled out my cell phone and called Mike’s cell phone number. He said, “Actually I am in the waiting room area right now. If you give me about 5 minutes I will get me van from the parking garage and pick you up at the front door.” Mike drove me home. When we arrived at home I asked Mike if I could give him something for his time, the gasoline that he used etc. Mike said, “Why don’t you hand me a five dollar bill, and we will call it even.” That sounded good to me.
When I got in the house I got on Facebook. I saw that Pam was also on so I sent her a message telling her that I was home from the hospital and that everything had gone well. As I was chatting with Pam her daughter Bridgit called me on my phone to see how I was doing. So I got to fill them in together. Afterwards I sent Kathy an E-mail to give her a synopsis of what had happened.
On Wednesday I was back at work, and I felt fine. So far my heart rate has stayed in the normal range. For the most part it has ranged from 70 to 85, rather than the 120 to 145 that it had been since October 12 before the cardioversion.
But last night (Friday, November 14) I checked my heart rate and it was at 60. And my blood pressure was quite a bit lower than it had been the last few weeks. What happened? Well, perhaps it was because on Friday I had gone out of my way to follow the advice of Deborah who works as a Registered Nurse in the Cardiologists Office concerning my diet. I ate almost no sodium that day and ate mostly fruits and vegetables, along with some olive oil, and some fish.
TIME FOR ANOTHER CARDIAC ABLATION
For the next few weeks I found my heart rate going up and down. It would jump up for a few days then drop back down for a few days. When I visited the cardiologists office to see Ramona and Deborah on January 6, my heart rate had jumped back over 140. Ramona said, “I can’t let you leave until I’ve talked to Dr. Bauer about your heart rate. He is over at the hospital today, but I will have him paged.”
After Ramona talked to Dr. Bauer she said, “We will need to do another cardiac ablation. I’d like you to set something up right now for this week.” I said, “No chance of that happening. I have too much going on at work the next few weeks to go through a procedure that will require me to miss a minimum of three consecutive days of work. Plus I’m not going to be able to find somebody to drive me to and from the hospital on such short notice.”
A few days later at work I was talking to one of my co-workers about this. She said, “One of my friends was diagnosed with atrial flutter. Turned out that he was dehydrated. Once he started drinking more water his heart rate went way down. I mention that because I almost never see you drinking anything at work.” Maybe there was an angle to this. So I began drinking an extra glass of water in the morning and an extra glass of water in the evening. In less than 48 hours my heart rate went down to normal.
I called Deborah, told her what was going on, and explained that in view of the fact that I had gotten the heart rate down on my own I saw no reason to have another cardiac ablation. Deborah said, “That is fine if the heart rate stays low. But I suspect it won’t be long before it goes back up again. Your problem isn’t going to be solved by a couple extra glasses of water. Also, I talked with Dr. Friedman and Dr. Bauer. They would like for you to repeat the sleep study that really wasn’t completed back in October. They suspect that there is at least a 60 to 70 percent chance that you have sleep apnea. If so, no matter how many time we fix your heart rate it will keep jumping back up. Sleep apnea causes your heart and the rest of your body to be deprived of oxygen while you are sleeping, and that causes your heart to have to constantly work overtime.”
A few weeks later my heart rate jumped back up again. So it looked like Deborah was correct when she said that drinking the extra water was just a short term fix. Over the following weekend I got an E-mail from Bridgit. She said, “I got the feeling that something wasn’t right with you on Friday. Is something going on?” So I told her about the latest heart issue. She said, “We need to talk.”
I got the message. What she really meant was, “Come into my office first thing on Monday Morning so we can decide what you need to do.”
On Monday Morning, I walked into Bridgit’s Office before work. She motioned me to close the door and sit down. She said, “You need to call your cardiologist’s office today and set up an appointment for a cardiac ablation. Do you want to make the call yourself? Or do you prefer to have me come in your office when you make the call?” I said, “I will make the call myself. But if I decide that I need some help I will let you know.”
That week I accomplished two things. I made an appointment for the cardiac ablation for Friday, February 20. And I scheduled another sleep study for Saturday Night, February 7.
On February 2, I had an appointment with Dr. Niesen. I had been keeping her posted on what was going on with my heart. She checked my heart and lungs. The good news was that my heart was beating regularly, and my lungs sounded clear. The bad news was that my heart rate was beating way too fast. Somewhere in the neighborhood of 130. Dr. Niesen agreed with the plan that Dr. Bauer and Dr. Friedman had laid out. Both the sleep study and the cardiac ablation.
On the evening of February 7, I had the sleep study at Saint Mary’s Sleep Center. Unlike my first sleep study I was actually able to get some sleep this time.
When I saw Deborah on February 11 during my visit to the cardiologist, she gave me the report from the sleep study. I did have sleep apnea, and that was likely playing a role in the heart problems. So that would need to be resolved soon in order to prevent any more damage to the heart.
I contacted Golda about getting a ride to and from the hospital on February 20. She arranged for a driver to pick me up from home and drive to the hospital in the morning, and then another driver to take me home from the hospital after I recovered from the procedure.
During the week of February 16, I got pep talks about the upcoming procedure from a lot of different people. Dr. Niesen and her staff. Various people from work (Bridgit, Connie, Shelly, and Regina). Various Facebook Friends (Joan, Kathy, Marian, Pam, Golda, and Mimi). People who I knew from bowling and dancing. Among others.
On the evening of Thursday, February 19, I got a visit from Catie. She is a Registered Nurse who works for AW Healthcare. She checked my blood pressure and heart rate, and had me fill out some papers to get things set up for my transportation the following day.
On Friday I was on a “No food or drink after Midnight” restriction. So I expected to be quite hungry by the time that the procedure was over. Dawn, the driver from AW Healthcare picked me up and drove me to the hospital. Dawn was an interesting person to talk to, so we kept a conversation going during the drive. I was telling her some interesting trivia about the spot where AW Healthcare was located. Dawn mentioned how in addition to working she was also studying massage therapy. When we arrived at the hospital I told Dawn that she could leave, but did get her telephone number in case something came up where I needed to call her.
After Dawn dropped me off I checked in with the front desk and gave the person all of the necessary information. As I was sitting in the waiting room, Ramona came out. I thought that she was calling me to come in, but she said that she wanted to give me a pep talk about the procedure. I said, “That’s nice, but I’ve already had a lot of pep talks this week.” Ramona asked, “Have any of those pep talks come from nurses who specialized in cardiology?” I said, “Well, no.” Ramona said, “Then you are going to get one more pep talk.” Ramona took me into one of the side rooms, where she checked my heart rate and blood pressure. She then explained to me why it was important that I have the cardiac ablation. OK, I was convinced.
As we were talking Ramona and I learned that we each had an interest in running. I promised to send her a copy of the article that I wrote on my running career. Somehow I also happened to mention the article that I wrote called “Messages From Beyond The Grave.” She seemed interested in hearing more about that. So I promised to give her a copy.
A Registered Nurse named Christine called my name. I pulled out my wallet, looked at my driver’s license and said, “That’s me.” Christine took me inside of the Cardiac Cath Lab. She told me to get undressed and put on a hospital gown. A few minutes later she came over and said that it was time to begin my IV. She must have been very good at doing that, because I hardly felt a thing. The next thing that I knew the IV needle was in.
As I waited for the procedure to begin many of the doctors and nurses stopped by to say hello and see how I was doing. These included Shelli, Sue, Sally, and several others whose names I am not now remembering.
Ramona approached my bedside and said, “We’ve had a change in plans. Dr. Bauer’s wife had a baby girl last night, so he is not going to be able to do the procedure today.” I said, “Ramona, I went through a lot of trouble to schedule time off work for today and also for next Monday, and also arrange for transportation. If we don’t do the procedure today I can’t promise you when I will be able to get back here.” Ramona said, “I understand that. I’m not saying that we won’t do the procedure. I’m just saying that it will be done by a different doctor from our office. Dr. Bamimore. Dr. Bauer believes that Dr. Bamimore is an excellent cardiologist who has an excellent record with this procedure, and I agree.”
I said, “Ramona, did you ever see the episode of Arrest and Trial from 1964 where Sergeant Nick Anderson was the only witness to a crime? When his partner Sergeant Dan Kirby got on the witness stand he said ‘I didn’t see what happened, but if Nick said he saw it that is good enough for me’”? Ramona said, “No, I never saw that one. I wasn’t even born yet in 1964.” I said, “Well anyway, this is the same thing. If Dr. Bauer and you both say that Dr. Bamimore is excelllent, that is good enough for me.” Ramona said, “That is what I was hoping that you would say.”
About 20 minutes later Dr. Bauer came over with Dr. Bamimore and introduced us. I said, “Congratulations on your new daughter. And I look forward to working with Dr. Bamimore.” Dr Bauer said, “Thanks. And I wish you good luck with the procedure. I’ll see you when you come in for your next visit.”
One of the nurses whose name I am not now remembering — I believe it was Jean, but I could be wrong — wheeled me into the procedure room. The same room where they performed the procedure on August 13, 2014. And we even had the same nurse anesthetist, who was Jason.” Jason said, “I still remember you from last time, and how you did the birthday trick. What do you say you do that again for everyone.” As I was going around the room one nurse mentioned that she was born on August 12, 1959. I said, “That was a Wednesday, and I can even tell you what I did that day. That was my very first trip to Jefferson City and Columbia.” Jason put the mask on me and told me to breathe deeply. That was the last thing that I remember.
When I woke up Dr. Bamimore was there with several nurses. Dr. Bamimore smiled and told me that everything had gone fine. They would take me up to the Fourth Floor Recovery Unit. I would lay flat on my back for a few hours, eat some supper, then could go on home.
Thanks to many fine doctors, nurses, technicians etc everything went smoothly, and the procedure was a success.
And at the risk of opening a door that maybe should be left closed, I may have had some other people watching over me that day as well. Family members and friends who had passed on.
Shortly after arriving on the Fourth Floor Recovery Unit, a lady came in my room and wrote some names on the board. The head nurse was Julie, my direct nurse was Karen, and the Nurses Aide was Rosetta. Here is the conversation that took place.
Rosetta: I’m Rosetta.
Me: Can this day get any stranger? I feel like I just crossed over into the Twilight Zone. Do you know how old I am?
Rosetta: I see on your chart that you are 65. But if I can give you a compliment I would say that you look a lot younger.
Me: Thanks for the compliment. But the question I was really asking is whether you know my age in days. That answer is 23,790. Half of that number is 11,895. That is the mid-point of my life right now. That comes to July 28, 1982. On that day I met a private duty LPN who also did hand and foot reflexology on the side.
Rosetta: That is interesting, but what is the significance of it?
Me: That lady’s name was Rozena. Not exactly Rosetta, but fairly close. She is the only person who I ever knew named Rozena, and you are the only person I have ever known named Rosetta.
Rosetta: That is strange. I was named after one of my great grandmothers. And I did have an aunt named Rozena.
Me: Would that perhaps have been Rozena Burks, who lived near North Oaks Shopping Center, and passed away in 1995?
Rosetta: No, my aunt named Rozena lived in North Carolina. And she passed away a long time before 1995.
I was expecting to be very sore from the procedure, but it wasn’t that bad. The hardest part was just lying flat on my back. For supper I ordered a turkey sandwich, a glass or orange juice, and a banana.
Karen said that my driver had come by around 6:30, but they had to send her away since I wasn’t yet ready to leave. They told her that they would call her back when I was ready to leave. Karen had me walking around the room with her supporting me. Then she let go and watched me walking on my own. At this point she said that I was ready to leave, and gave me the discharge information.
Karen took me downstairs where the driver from AW Healthcare was waiting. Would you believe that right now I am not remembering her name?
As I was riding home from the hospital I had the following conversation with the girl who was my driver.
Me: Have you worked for AW Healthcare very long?
Girl: No, I just started a few months ago in November. Prior to that I worked for Delmar Gardens Chesterfield.
Me: I know that place quite well. My Aunt Gertrude was there for many years. Plus I used to bowl with the Company President, Gabe Grossberg, and his two children.
Girl: Your Aunt Gertrude. Would that have been Gertrude Dublin in Room 210?
Me: Yes it was. Gertrude was my mother’s sister. So it sounds like you knew her.
Girl: I sure did. I was one of the people who was responsible for taking Gertrude to and from the lunch room everyday. When you see her tell her that I said hello.
Me: I’m afraid that won’t be possible. She passed away on December 2. I guess you didn’t know that since you left in November.
Girl: I’m sure sorry to hear that about Gertrude.
Me: She did live to the age of 86, which was a lot longer than any of her doctors predicted. A long time ago I also had two other relatives in Delmar Gardens Chesterfield. My Uncle Gilbert was there from 1991 to 1993. And my Great Aunt Sophia was there in 1992 and 1993.
Girl: That would have been before my time. I was born in 1993.
Me: When is your birthday?
Girl: November 27.
Me: That would have been a Saturday. And also my mother’s 24,800 Day Birthday. She was born on January 3, 1926.
Girl: How did you figure that out so fast?
Me: Just something that I learned how to do.
So perhaps my Mom, my Aunt Gertrude, and Rozena were also watching over me that day. And I could all the watching over that I could get. As the driver was pulling into my driveway we noticed that the rain that was falling was just beginning to turn to ice. I said, “Thanks for everything. Not be sure to drive carefully on your way home.”
On Saturday I sent out several E-mails letting people know how things turned out. Bridgit called me, concerned that I had not contacted her the previous evening. I said, “That is because I didn’t even get home until almost 10:00 in the evening.”
I was somewhat sore for the next few days, but have since recovered from that. My heart rate has been between 55 and 80 since the procedure. And I now have taken steps to get the sleep apnea under control. So things are going in the right direction.
A NEW BEGINNING
When Dr. Bauer and Deborah first suggested that I may have sleep apnea in September 2014, I found the whole idea to be completely ridiculous. I knew the symptoms of sleep apnea, and I did not have any of them.
However, two sleep studies later and I realized that I did in fact have sleep apnea, and a rather severe case of it. So on February 28, 2015, I got an APAP Machine. An APAP Machine is similar to a CPAP Machine, but is a little more advanced. CPAP stands for continuous positive air pressure, while APAP stands for automatic positive air pressure. Essentially CPAP delivers air at one continuous speed, while APAP delivers air at various speeds depending on the patient’s breathing.
I’ve heard some people say that it took them weeks, months, or even years to get used to sleeping with that breathing mask around their face. That was never a problem for me. By the second night I was used to it. Right now I would not want to sleep without it. I no longer feel tired when I wake up in the morning, I no longer get tired during the day, and my heart rate has remained normal. So the machine has made a big difference in my life.
On June 18, 2015, I visited the cardiologist’s office to get two different tests — an echocardiogram and a nuclear stress test.
When I had my last nuclear stress test on August 4, 2009, Robin began by inserting an IV in my arm. This time Robin once again inserted the IV in my arm. But unlike my last nuclear stress test, this time I didn’t get scared when she inserted the IV. It was a very simple procedure.
Robin said, “We’re not ready to start your nuclear stress test just yet. So I am going to turn you over to Deborah to do the echocardiogram.” I should at this time mention that the Deborah who performed the echocardiogram is not the same Deborah who worked with me during the 2009 nuclear stress test, and gave me guidance on building up my heart in September 2014 and several subsequent visits. I guess they have two (at least two) people named Deborah working there.
Deborah was a very interesting person to talk to, and we kept up a conversation going during the echocardiogram. Here was a person who obviously liked her work, and was good at it. I was telling Deborah about some of the articles that I had written. Including, of course, the one about my cardiology experiences right here. When I also mentioned that I had written an article about my colonoscopy experiences, Deborah mentioned that she had a friend who would soon be undergoing that test for the first time, and asked if I could send her the links to the article to send to her friend. Later in the week I sent that link and also the link for my cardiology article to her Facebook Page.
As with the last nuclear stress test in August 2009, this one involved taking pictures of the heart both before and after the test. The nuclear stress test was performed by a Registered Nurse named Amanda and (similar to last time) Robin. They had me walking on a treadmill and slowly increased the speed and the incline to try to get my heart rate up.
Now here is where it gets ironic. So many times I have come to this office only to be told that my heart rate was too high. Guess what happened this time? My heart rate was too low. Even with the treadmill going at a good speed they could not get my heart rate over 106. Amanda and Robin said that they needed to get my heart rate up to at least 130 to get meaningful results from the test.
In order to do that they would need to inject a drug into my IV which would temporarily increase my heart rate, while I was sitting on the table. They warned me that some patients experience chest pains, dizziness, and rapid breathing when this is done. At that moment I gave serious consideration to saying that the test was over and that we would just have to skip that step. But I had come too far to stop now.
When the drug was injected into my IV I did feel my heart rate going up, began breathing rapidly, felt some chest pains and dizziness. I yelled, “This is too much. Make it stop.” Amanda and Robin each got on one side of me and each held one of my hands. Amanda said, “We’re not going to let anything happen to you. What you’re experiencing is a normal reaction to the drug, and it will go away in just a few minutes.” She was right. It only lasted a few minutes, and there were no after effects. Afterwards I said, “You know, the three of us make a really good team.”
After the tests were over I was able to return to work. That evening I attended the circus, at the invitation my dentist, Dr. Pagano. So it was quite a day.
The following day I got a telephone call from Kayla. She had some great news for me. She said that the echocardiogram showed an ejection fraction of 60 percent, which is well within the normal range. And that is more than double the 25 percent that was determined in July 2014. Kayla did note that there may be some blockage in the heart, but Dr. Friedman would need to review the results in more detail to know for sure.
On July 24, 2015, I had an appointment with Dr. Friedman. The news was good and even better. He was very pleased that my heart’s pumping power (the ejection fraction) was more than double what it was last year at this time. And the possible blockage in the heart — after he reviewed the images in more detail he realized that there was no blockage. Just a false alarm.
So right now I am being cautiously optimistic that the heart problems have been corrected or at least well under control.
Sports and Fitness 