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.