CINCINNATI IMAGES -- January 2006
The city takes accent, food and poverty from both north and south. You can tell that when warm weather comes it will be very green, but in January it is bleak.
The Marriott Kingsgate Motel is an outpost in the fortress that is “Pill Hill”, a large area of hospitals surrounded by rundown houses and dangerous people. I went out to get a sandwich. It was raining hard so I stood on the porch of one of the houses for while. I don’t live there, but that is just luck.
Our room for 10 nights cost us a non-means-tested $69 per nights instead of $150. It was very nice and quiet, with fantastic bedding that I understand you can buy for your own bedroom, so you never have to come home. Large windows and Internet access expanded our world. Staff were exceptionally considerate; some became friends.
Marion, my wife, sat at the end of the bar, drinking a Marguerita and eating a hamburger. TVs are flashing sports, card game is going on at the other end of the room, a couple of traveler regulars sit at the bar, they order the same thing every time, maybe they miss home? This became a comforting ritual for my wife, especially when I was in the hospital.
Bruce, one of the bartenders, aged about 61, plays in a band, gives me one of his CDs when he heard I was a musician. It was called, “Nothing”. Guess what the title of the first song is? He is a good-looking fair- haired guy, the kind to whom you say, “Boy, you look a lot younger”, a natural companionable type, not in-your-face. On the other hand, Carol, who is African American, was all different colored clothes and hair. Her next thing was to buy a pair of fur-lined, fur-covered boots for $229 that she would wear at the motel party that was coming up. "But what about your 401k!” never made it past my lips. I would never argue with living in the present.
Pre-op night in my room in CICU. We sense Dr Wolf’s power when we were told that he doesn’t put people in the night before for a heparin drip (which stops at midnight no matter when it is started) but to simplify the morning pre-op procedure. Maybe so, maybe not. I also had a pretty large room, if that means anything.
...Not too bad a night. Little did I know that I would be cold, sleepless, nauseated (no food for the first 2 ½ days) and constrained if not hurt by pain. Some of this was my own choice – not “wanting to be a burden” so that my nurse could be free to tend her other patients, and maybe so she would like me better and perhaps give me the “Best Patient in the Class Award”!
Post-op on my back, my body the hub of nine lines and five electrodes, as immobile as a fly in a spider web. There are 3-inch incisions between my third and fourth ribs on either side below my armpits, and, on either side, a couple of one-inch incision below through the intercostals muscle below my seventh rib or thereabouts. The surgeon can see through the larger incisions, supposedly giving him a leg up of those who must depend totally on scopes – my smaller incisions are used for the latter purpose and for tools. Lots of things happen in the three- or four-hour procedure; you can see a video starring Dr Wolf on the IN.
Nauseated from Fentanyl, can’t sleep, can’t get up without being unhooked, only 6 hours to go until dawn, I watch ESPN mad-ant football highlights until that makes me sick. CSI, which I don’t like, is a godsend.
The smell of fresh blood, unavoidable because it was coming from my nasal passages, dried out from inside winter air and O2.
The sound of the respirator next door: “Shhh/clang ------shhh/clang ------ shhh/clang --------------------- whump-whump----whump” (I write into my Living Will, “That will never be me! Over my dead body!”) The loud sounds of Appalachia relatives of this almost-dead person -- who was once a carefree teenager-- partying late into the night kept me awake, but I didn’t think of complaining. I wished them all they the fun they could have.
The day after the operation, during which I went into NSR, Dr Wolf and others take another look at the calcium that showed up on my CT scan, the raised ST segment on the ECG and enzymes that could have been released from cells damaged during the operation -- or from a blockage of a coronary artery. They decide that it would be a good idea to find out more.
Dr Bondoc, an intense Philipino first- year resident stands at the foot of my bed after the catheter exploration of my coronary arteries, his hand on my calf, saying words that turn out to be an exaggeration, “I am very sorry to have to tell you this, but you are having a heart attack.” Jenny, my nurse, holds my hand. “OK, what next?”, I think.
“What next” is moving fast down the hall, like some ER TV show, except that the person at the head of the bed got temporarily caught in an automatic door that somehow got confused.
They cleared and stented a 60% artery, leaving a tiny 80%, and a 20% and a 16%-er to the drug industry.
A couple of more nights in the hospital because in these back-to-back procedures. Still tethered because there was no room in any unit where I could have used a portable monitor.
Discharged in NSR! Carol, one of Dr Wolf’s very capable assistants called back over her shoulder as she was leaving, “I love dealing with smart people.” That made me feel bad – a feeling that does me some credit, even if whatever I did to deserve the comment doesn't.
Diltiazem, Plavix, lisinopril, Zocor, prednisone taper, baby aspirin, magnesium, taurine, COQ10, pomegranate juice, bananas/ lo sodium V8 juice, fish oil, selenium, folic acid, vitamin C, vitamin D, Total cereal --- >>Sing along with with me now …”On a Big-Boy double-decker bun!”
I spent time with a number of people who impressed me greatly. They reminded me of things that are important and heartened me with the hope that there are such people sprinkled around in what sometimes seems to be crowds of drones or intellectual machines. I won’t try to describe them because I would spend too much time trying to do them justice and would end up failing. It was the most important part of the trip.
The other important person was my wife. It was wonderful to see her connect with the nurses, as they talked about work and hospitals. This familiarity meant that we were more like guests than a patient and his wife. I will remember this time with her with special feeling.
“Oh Prednisone!! For three+ weeks, you are providing me with a steady-but-decreasing supply of mental and social energy, allowing me to absorb situations that would ordinarily drain me. You substitute for the exercise and music I cannot do for awhile. Except for physical weakness, I am better spirits than I have been for many years. What will happen when you leave?”
After one week, I am back in AF. Prednisone holds my hand.
I knew this could happen as it does in maybe half of patients and had been told that there was no correlation between the presence of absence of AF during the first months and cure. The heart is simply unsettled from impolite jostling. The AF circuits are reactive and will either die back when their reason for being goes, or easily surrender to cardioversion alone or with a few months of anti-arrhythmic medication. If these don’t work there are additional measures that can be taken (for example, touch-up ablations). Do I believe all of this? I really want to. I do know that this really spoiled the party !!
At home, I write about my experience and put down some ideas about AF-related matters to pass on to others because it helps me try to finish the experience..
Thanks for listening! --Dick Inglis
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