Posts from the ‘Health’ Category

Day 14 of 100 Happy Days – Have a Hug, Old Man Winter.

Day 14-100

Day 14 of 100 Happy Days

It was -21*C in Edmonton yesterday. That was the air temperature. With the wind, it felt like -30*C.  That’s cold. That’s 10 minutes before exposed skin freezes. It was only 10*C colder on Mars…

I often wonder why Canada is populated.  Why didn’t the first settlers just say, “Damn it’s cold. Let’s move South”? Who knows, but they didn’t.  Instead they hunkered down in their sod huts, their layers of fur and toughed it out.

We sort of do a 21st century version of that, too. It is funny the coping mechanisms we use. Having lived all across Canada, I have heard all the catch phrases.

At least it is not -40*C for the 14th day in a row like on the Prairies,” they say in Eastern Canada.

At least were not getting hit by another blizzard like in the Atlantic Canada,” they say in Central Canada.

It’s a a dry cold!” they say in the West.”At least you can dress for it.”

Oh my, shut down the City…we got  1 cm of snow last night!”, they say in BC.

We use many strategies to deal with the cold. There are two extremes: to hunker down in your Snuggie, jam on the Netflix, and hibernate for a few months, or to kit up with super high tech materials and equipment and embrace the cold. I’d say that equal amounts of both are the best way to get through the dark, cold, Canadian winter.

There is some perverse satisfaction in having faced Old Man Winter, having stared him down – asking him to throw all he has at you – and coming out on top.

“Is that all you got, Jackie Frost?”

And as you warm up in the comfort of your house with the fireplace working overtime, the furnace humming efficiently, watching Netflix as the warm winter sun comes through the window, the fact that you took the cold on like a true Canadian creates that tiny aura of contentedness and happiness that comes with facing a little adversity.

Bring it on, Winter; I can handle it – I am a happy Canadian.

Later,

ASF

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Day 5/100 Happy Days – Baby Faces

 

shaving 2

Day 5/100 Happy Days

Twice a year, you can always recognize the serving Army guys. They are the ones sporting the hockey playoff beards, the mutton chops, the goatees and other facial hair during the summer and most definitely over the Christmas break.  I am not sure if it is some sort of low-level mutiny, a full-scale rebellion, or just a desire to take a break from the daily ritual of dragging a piece of steel across their faces.

Facial hair – you either love it or hate it.

And if 1 December is an indication, I am guessing the majority are not fans. I have never seen such looks of relief on so many partner’s faces as when the Movemberites shaves of the 30 days of growth.

Since I was a young lad,  I have been gifted with the werewolf look (except on top of my head). I had to start shaving at a young age, secretly at first.  My father warned me that my silky, but ugly, adolescent boy-beard would gradually morph into unsightly, coarse stubble. This transition was the gateway to manhood.

I remember watching my Dad using his Noxzema shaving cream, a cracked plastic measuring cup, and a double edged safety razor to complete this daily ritual, seven days a week. It was so manly.

I know this does not make sense to many of you. Maybe you do not have a beard; maybe you have a beard but you can shave with Kleenex. Maybe you put milk on your face and let the cat lick off your beard. If that is your fortune, you probably don’t get it.

But to many of us, shaving has just become one of those grooming things we have to do – like putting on deodorant or flossing our teeth. What a shame!

It is a unique rite of manhood!

As a 20th century man, I moved through a multitude of razors to achieve a closer and closer shave: first the disposable safety razors by Bic et al; then through the chain of cartridge razors – first the Mach series, and then Fusion series, and now I am wooed by the Pro-Glide FlexBall!.Oh, the money I have spent!

I have even tried the electric razor – but that experiment did not last long.

And I won’t even delve into the different types of creams – gels or foams, menthol or tropical breeze, tube or can  – or the pre-shave exfoliants, the post- shave balms, other razor burn soothers and the sometimes required step It is boggling.

Alongside the razors, the cream, and the various other products, I have adopted many different strategies to maintain the Army grooming standard. I am trying hard to forget the dry shave that many a man has tried while rouging it in the deep of winter – when warming up cold water and stripping off the shirt is just too manly to attempt.

I have tried hot shaving cream, hot towels, evening shaves, and shaving in the shower. For pure ease and convenience, plus the added benefit of spending time under soothing massaging jets, shaving in the shower is the winner – if you can find the right mirror that doesn’t fog and stays put!

I have always loved to grow outlandish facial hair when I could. To grow be Lemmy, the Fu-Manchu,  the Boer War Chops, or the Breaking Bad  has been fun – even if my wife and friends think I’m a nut!

After this Movember, I splurged for a relaxing straight razor shavette to smooth my bald pate and baby-faced cheeks. If you have not pampered yourself by fully reclining in an old fashioned barber’s chair, by having your face lovingly swaddled in almost too hot wet towels, by allowing liberal applications of facial pre-shave creams and hot mugs of foamy lather, by experiencing a slow, deliberate with-the-grain and against-the-grain straight shave, and ending with an invigorating facial massage – you are just not living to your potential!

It is the male equivalent of the pedicure and toe nail polish.  Expensive, yes – but I would argue, a periodic necessity!

During my time in the Army, I saw shaving as a necessity – something that had to be done, sometimes twice a day.  And even though I still can pull off the two minute panic shave to get myself to work on time, I believe that taking the time to pamper your face is important.

Occasionally you just need slow it down and to reconnect with males from yore. You need to wet the shaving brush, vigorously work up a lather in a shaving cream mug, carefully and liberally paint your face lovingly with warm , and slowly, deliberately and shave those whiskers off your face as you enjoy the unique sound of one thins steel blade dispensing with the whiskers in the traditional way .

In these hectic times, a slow, cautious, deliberate shave is a meditative experience that kindles thoughts of a simpler time! Something all we men deserve to be happy, happy!

Later,

ASF

Day 4/100 Happy Days – Ibuprofen and Hot Tubs

Day 4-100 Happy Days

Day 4/100 Happy Days

As many of you know, I have been ridden hard and put away wet oh so many times. Lengthy athletic & military careers and officers’ messes have taken their Knievelesque toll on my frame.  Multiple knee surgeries, bilateral tibia-fibula fractures, repeated broken noses and fingers, dislocated shoulders, cellulitis, and finally, a triple bypass, have resulted in many doses of Cepacol (inside army joke – sorry) and more than a few ice baths.

Many a specialist has told time and time again that maybe it was time to pack it in. But I couldn’t; I did not know how. Ever since high school I have lived by the credo that there are only have two speeds, “all out, or broken”.

Funnily enough, as I watched my son play rugby, I have realized that those words are the repeated mantra of youth and invincibility. I can remember when a whisper of tough skin spray and another layer of athletic tape could get all my teammates, and me, through the last few rugby games of the season, skating another shift on the ice, or setting up a few spikes with swollen. misshapen and sprained fingers.

Moe than one medic told 20-something Pal that perhaps it would be better to sit out the rest of the season – otherwise I would regret it when I was 45.  “Forty-five?  Who gives a sh*t about 45? Hell, that is over 20 years away, I might not even make it!  Tape me up doc there are still games left in this season!”

Foolhardy? Sure – when looking back at it as a 51 year-old. But would I take those moments back? Maybe…maybe not.

Many of those moments defined me… scoring the only three points in a lopsided rugby loss to West Point (though we hurt Navy a few months later), playing goal in several CF Regional Soccer Tournaments, numerous Army League hockey and broom-ball seasons with the soldiers of the Regiment, several half marathons and a full marathon where I was my only competition..

And maybe I should have taken it easy, because I tell you, I do hurt sometimes. But seriously, would that have been me?

Doubtful. I love sports too much!

I will continue to live vicariously watching amateur and professional athlete.  And as I seriously consider giving up hockey and rugby and soccer – save one last Ex-Cadet Rugby Game in 2017 to celebrate my 30th year since graduation , I will likely move to others that will provide the same thrill, but take less of a toll on me…whenever I figure out what those are!

Until then, I will continue to carry on in the tradition that many of us know well- the satisfaction and moral high ground of a solid cardio and strength workout, followed by a round of ibuprofen, and a comforting hot tub – like today! Despite the aches and pains, that keeps me happy…

Later,

ASF

ASF’s The Coronary Chronicles – The Final Act

Pic2

I was lying in critical care.

After five hours under the cardiac surgeon’s care, I have to say it was bliss in intensive care. The pain drugs flowed freely though the multiple number of lines entering into

Let's see...this one leads to the...ummm.....ummmm

Let’s see…this one leads to the…ummm…..ummmm

my neck and wrist.  Forget that my bed space and the area around my body looked the back of my High Definition TV set and home theatre. There were cables and lines and diodes everywhere…pain killers and beta-blockers and blood thinners and catheters and heart telemetry and blood pressure cuffs and pace maker wires and saline drips and chest drainage tubes, and who knows what else, were exiting and entering my body through a Medusa-like tangle.

I was wired for sound and without exaggeration, it took my nurse almost 20 minutes to untangle and create order from the plastic and rubber kitten’s ball of hoses and tubes. And honestly, I could care less,  I was as high as a  red-faced Metropolitan Mayor!

But eventually, Nurse Judy fought through the tangled mass and treated me to a wonderful bird bath, getting rid of the pinkish disinfectant – and the odd dried blood spot – that I was slathered with during the op.  I took stock of the 35 cm incision from collarbone to sternum and the 25cm incision down my left forearm, the IV in my neck and I chilled – a kind of Lucy in the Sky with Diamonds chill – which was okay, because as you remember, Ringo Starr was supposed to be one of my surgeons (see Act VI).

babel_fish_diagramI had visitors…my wife, my brother, and my Mom and Dad came to see me and spent some time chatting. At least that is what it sounded like in my brain. I have no idea what came out of my lips…gobbledygook for all I know. But it’s okay, they had a babel fish with them – or at least they smiled at the right times. I think I lasted about 7 minutes before I was too tired to form any semblance of words. My body was telling me to shut up. And rest. So I did.

But don’t worry; even after everyone left I was never alone.  I had a new friend that I had to carry 24 and 7, and that I never wanted to be without.

No – not morphine or other opiates

I was Linus van Pelt. I had my new security blanket. It was (and still is) my chest pillow.  I hugged my “chest pillow”… a heavy flannel sheet that was folded and folded and folded and folded like an origami swan, and then tucked into a pillow case. Hugging that pillow with every ounce of my strength was the only thing that stopped me from feeling like my chest was splitting wide open when I moved, which was rare, or when I coughed – which unfortunately wasn’t as rare as I would hope.  Moving I could control. But the cough…unexpectedly and inconveniently, I coughed the weak cough of the injured, as my lungs tried to take over responsibility for providing me air and getting rid of the phlegm in my lungs – an unfortunate side

I love my pillow...

I love my pillow…

effect of intubation and having a machine breathe for you for over 5 hours.

I enjoyed my private room and around-the-clock care. I even had a great chat with one of the Veterans of the Battle of the Bypass… a blue vested cardiac volunteer (obviously wearing the smock prepares one for a future career as a Walmart Greeter).  Funnily enough, we had served together in the past and he had just recently celebrated his Depart with Dignity ceremony from the Canadian Forces – a medical release due to the operation. I had not even considered how this whole episode would likely end my Army career. Eeeek!

We talked briefly, once he overcame his shock over the fact I was a fellow member for the Zipper Club at 48 years of age. As I would find out later, once you become part of the Club, it is like you learn the “secret handshake” – there are just so many of “The Bypassed” out there. Every time I turned around, there was someone else telling me how they had blocked arteries and that a bypass had changed their lives.

Great news.  I just wish I wasn’t 20 years younger than them.

I was pretty content in my little drug-infused hamster ball.  But, sadly, nothing lasts forever – not even the super-drugged up nirvana of post-surgery opiates. And despite the wisps of hope that I would stay in Intensive Care because the cardiac post –op ward was full, it was not to be. A bed came free in “general population”’; I hope it was because someone was discharged, but no one could tell me.

So I was moved from my deluxe single accommodation to a semi-private room.

Now I have not written much about the several room-mates I had over the course of my almost two weeks in the hospital. For the record, I had five with a joint age of 324…the youngest at 45 and the oldest clocking in at 84. And save for one, the average stay together was for almost three days at a time.

I tell you, if you want to learn about people – hang around with someone who is scared to death but tries not to show it. I learned a lot about the human condition of those who face the prospect of open heart surgery. Yes it is routine – but it is complex and there are risks. And apparently you want to get a lot of your chest (no pun intended)

Firstly, there are no inhibitions or privacy…the flimsy little cotton curtain between bed spaces is not very sound proof. Whether you want to or not, you learn a lot about bodily functions, diagnoses, prognoses, family, lifestyle and a host of other things that you would never, ever, ever care to share with a stranger – unless you are a stranger sharing a hospital room and something critical in your body is not working properly.

I learned about my roomies’ relationships – as couples, with their children, with their families, with their friends. I learned about regrets and a few things that would change when the operation was all over.  I might have even shared a few thoughts myself…though I am more of a listener than a talker. It is amazing how a few well placed “tsks, tsks” and some reflective listening will calm the soul.

But back to post-operative care…

Being in general population sucked. I went from one-on-one care to one nurse caring for 8-12 patients. And at night, the ratio got worse. Funnily enough, CBC carried a

Noise...noise...noise...

Noise…noise…noise…

news-piece just after I was discharged reporting on the noise levels in a hospital ward. They reported it was terrible; hardly conducive to rest or sleep or recovery.  I can tell you it is brutal – day or night. Between alarms, call buttons, PA announcements, jovial staff, the food carts, cleaning staff, patients in pain, it was a wonder I slept at all. Add to that the sad and unnerving coughing of the post-operative smoker trying to rid their lungs of cigarette goo in their lungs, it was absolutely hellish.

pain2

I slept on and off – more a series of three-hour cat naps between the oral doses of pain killers. Unfortunately the pain killers came every four hours. It is funny – actually, sad – how your body knows it is time for another dose. I can only imagine the pain of the junkie as the glow wears off; I became a clock-watcher – especially at night. For the last hour, I slept in fifteen minute bursts hoping for the nurse to magically appear with the little plastic pill cup that contained another three hours of pain-free sleep. During that last 45 minutes of hell, I tried shifting into a comfortable position, by raising my back, or lowering my legs, or shifting on to my side, or arching  – but as I was weak and in pain, I could not even manage that to get relief. Several times I had to call the nurses to untangle me from the absolutely tortuous positions I had managed to slide into.  I tried to be brave, but I have to tell you, it pushed me to the limit. I tried to hold out as long as I could and wait for the nurses to help me, but more often I gave in, and pushed the call-button forl help and relief. I did not feel empowered or healthier or stronger. I felt weak and vulnerable and unhappy.  And I was a young, fit, robust fellow. I can only imagine how my elder room mates were fairing.But over time, things got better. My sense of humour never left me – it thought about being snarky and mean – but that is not me.  Plus, no sense in pissing off the pain relievers! As I got better, I learned to enjoy the little things in life: peeing without a catheter, orange Jell-O, a shower, clean socks, sweatpants and a hoodie. And I walked…first just to the toilet; then 10 m, then 40, and finally being able to walk to the nurses’ station to grab an apple juice and make toast.  Like I said, the simple things – smelling burnt toast without having a seizure – made every day better.

I often thought that I was not ready to go home – I had pain, my chest bone was still healing, coughing hurt like no one’s business, I had 60cm of stitches, and I had three holes in my diaphragm from various removed hoses that were trying to patch themselves up. I couldn’t imagine being without my meds and staff to move me.  But after 72 hours in general population, I was ready. I could not stand being there – eating steamed food that tasted like cardboard, sitting among the sick and injured, listening to the pain and agony, and trying to keep up a happy face. I wanted to be in my house, with my wife and my stuff. So after showing the staff that I could climb up and down and a flight of stairs, I was granted parole.

Hallelujah!  A quick visit by my Surgeon and I was sprung free. With discharge instructions that included restrictions on how much I could do, how much I could lift, how much I should eat, I was allowed to leave. My wife helped me out of the hospital, and as I waited in the hospital lobby while she went collect the car, I was dazzled by the sheer volume of noise and activity around me: conversations and food line ups and questions to the Info Desk; the smells of Tim Horton’s coffee and muffins. Though my life had been on hold for over two weeks, for everyone else the game of Life had gone on. I was like a country farm-hand in the Big City, marvelling at the chaos and cacophony. I was no longer a patient, I was just a guy.

And off we went into uncharted territory. Armed with only a few manuals, some well-intended verbal advice, a couple of 8.5×11 sheets on post-operative issues and pain 3x5fragile-largemanagement techniques, we headed off. The ride home was nerve-wracking for both my wife and me – I had the resiliency of a raw egg. The only thing between my breast bone and the seatbelt was my “issue heart pillow/security blanket” – a cheerful, red, overstuffed pillow the size of a kids’ rugby ball, snuggled firmly in place to absorb any jostling, bumps, sighs, sneezes or coughs. I hugged that pillow like it was toilet paper from the Carnival cruise-liner Triumph.

And that was the tone for the first few days of recovery: angst, hesitation, worry…every ache and palpitation, every heavy heart beat, every sharp pain, every perceived redness or soreness around an incision was a siren call to my internal hypochondriac. I imagined misaligned grafts and an over-taxed heart or rampant infection. I was not that strong mentally or physically, despite what my external face said.

But that did not last forever. With the strong support – physically and mentally and emotionally – of my wife, my kids, my parents, my brother and sister, and the multitude of friends far and wide who sent me positive energy, I moved through the yucky bit and beyond.

And now, here I am at Surgery plus 16 days: full of vim and vigour and appetite. The strength has returned and so has the humour. I walked almost 2km today. And I am getting better.

And with that, I will sum up the Coronary Chronicles.

It has been a wild ride. I hope that my exercise in self-indulgence has entertained you as much as it has helped me. I also hope that I have been a cautionary tale for some of you – especially for you guys out there who are in my age bracket. Alpha male or not, recognise we are not invincible and immortal. Many of us have been ridden hard and put away wet.

Listen to your body…get things tested…check for bumps and discoloured moles.  Early warning will increase the odds; go into hand with pocket Kings and show the House that it can be beaten.

And now on to bigger and better things…when I write again, I will be just be a regular simple fellow…albeit a little more battle-scarred.

thats-all-folks1

Later,

ASF

ASF’s The Coronary Chronicles – Act Six: My Achey Breaky Heart…

Ground Control to Colonel Pal...

Ground Control to Mister Pal…

During heart surgery, the beating of the heart is temporarily stopped and life is maintained through a cardiopulmonary bypass (also called CPB or the heart-lung machine). The heart is stopped either through decreasing its temperature or through the injection of a preservative. The heart-lung machine then keeps the blood pumping through the body, adding the necessary oxygen and nutrients.

I guess, if you consider a beating heart as a necessity for life, I was technically dead for a few hours. I suppose my brain was alive; but if you asked me what happened between the hours of 10am and about 3pm on 2 November – I could not tell you. Those five hours did not exist for me.

But as for the hours surrounding that…

Having just been bumped due to a higher priority heart emergency on 1 November, at about 10pm I had enough of Friday. I brushed my teeth, and readied myself for bed hoping that tomorrow they would fix my heart. I was still nervous. I was also very tired. Almost 24 hours of mental preparation for the postponed operation had left me fatigued.  And though I had a verbal promissory note that Saturday would be the day, as I had experienced today, there were no guarantees when it came to affairs of the heart.

So after asking for a sleep aid – as I figured sleep might be a bit elusive otherwise –  I toddled off into bed after an iodine scrub shower, feeling very pink and very shiny.  And I slept.

I'm here for the surgery...

I’m here for the surgery…

I dreamed that night…and while I do not recall all the details, I do remember that it had a surreal quality to it. Sort of a Beatles animated movie

Clickety-clikey

Clickety-clikey

feel or a Tim Burton feel – alternating between Ringo Starr and Edward Scissorhands as my surgeon. Freaky…

I must have slept well because promptly at 0600 hrs, it was vital signs’ time  and the start of The Wait Part Deux. It was dark and the rest of the ward had not woken up yet. There was a sombre, suspenseful feel to the air  – I can only describe it as that slow motion period in The Terminator when you know Arnold Schwarzenegger is going to come around the hospital corner into the shot, but the frame continues to be empty. I knew what was coming, but I was dreading it slightly.

I contemplated what would happen next – trying to create a mental image of the words I had read and the steps that would happen, much like we are taught to mentally rehearse our actions for specific drills to prepare ourselves for the task at hand. Adding to the surrealism,  I could hear the occasional snort from my roommate who was having a lie-in. He was not on until Monday.

And soon I heard footsteps in the hallway. And no, it was not Arnold.  It’s funny, when you lie in a hospital bed for long enough, you get pretty good at discerning who is who based on their footsteps. Their gait, their strike, their pace, their footwear, the noise of the equipment they are pushing or pulling, are great clues as to whether it is the floor nurse, the ECG technician, the blood work technician, the food lady or the cleaner. In this case, it was neither. First it was my daughter, then the comforting clack-clack-clack was my wife’s, accompanied by my parents and my brother. They made it in at 0630 hrs if I was whisked off promptly at 0700 hrs.

I am glad they made it in. I can imagine nothing worse than not being able to say, “Good luck. See you later. I love you,” as you arrive too late and are faced with an empty hospital bed.

But that wasn’t the case as we settled in to wait the last call for the surgery. Before too long, Dr Payne arrived, offered his good mornings and told me that he had a quick procedure to do first and that I was on for 0930 hrs. I smiled wanly, I had heard this refrain before. But I also saw a determination in his eyes that he had no wish to leave me twisting in the wind. So we waited.

There were no new skills learned overnight that made the wait any more bearable. It was still tense and uncomfortable. We all knew it was risky and invasive. We all knew what could go wrong. But we also knew, as we did the day before, you gotta start before you can finish.

And at about 0900 hrs, a stretcher rolled down the hallway, flanked by the cardiac surgical nurse. My chariot had arrived. I had a nervous pre-game pee, and then said my

Bye Mom and Dad...see you soon...

Mom and Dad…18 hours after surgery. Benefits of a good drug program…

bye-byes to my family. Now while I am an affectionate fellow, the family has demonstrated various degrees of physical affection depending on the circumstances.

Sometimes the hugs can be in short supply.

But on this day, the hugs, kisses and “I love you”s were not held in reserve. I could see worry on my parents’ face, my daughter’s, my brother’s and most sadly, on my

wife’s. They were all being brave. We all know that not showing your fear and worries is the Unwritten Rule in such cases.  I climbed onto the gurney, ass flapping in the breeze, and after another quick round of farewells, I was wheeled to the Operating Theatres, flanked by my wife.

Now a hospital is a maze at the best of times, but I remember thinking, I hope my wife is leaving a trail of bread crumbs, because I have no idea of how to get back. And selfishly I added a personal post-script – “I don’t need to, because I’ll be out of it when I head back this way.”

As we continued the long trek into the bowels of the 2nd floor operating theatres, I couldn’t help but look at the passing fluorescent ceiling lights and hear the clickety-click of the gurney without thinking I was in some cheap grainy made-in-Canada TV special. It was like I was watching a bad movie.

We arrived in the operating waiting room and I was greeted by the Chief Surgical Nurse, Tammy, who checked my identification and files and bracelets and asked me questions to determine if I was of sound mind and right body, and briefly explained that in a few minutes we would head off to the operating room and meet the remainder of the team. When she had finished reviewing the huge red binder that was my hospital life, she left my wife and me alone for a few minutes to say bye. There were no violins, no tears – at least that I could see or feel – and with a hug and a kiss, off she went.   I hoped she could find her way back to the Family safely.

And I began another four-minute roll to the operating room where my heart would see the light of day – or at least the fluorescent lights of KGH OR.

The next five minutes were a dizzying flurry. In a rapid series of staccato 5-second introductions I met the anaesthetist, the heart-lung machine maestro, the artery harvester, the surgical resident, the head surgical nurse, the second assistant and a couple more people who I have no idea about. I was asked rapid fire questions about my health and my weight and some other general questions. I was befuddled – who do I answer first? Let me think, dammit!

We're reaaaaaaaadyyyyyy...

We’re reaaaaaaaadyyyyyy…

All these questions!

I was asked to move from the gurney to the operating table – which let me tell you – is not built for people with girth like mine. I felt like I was going to fall off at any moment. Soon my arms moved to my side in the crucifix position and I felt pokes and prods and pushes. Checklists on bodily function, equipment readings, drug solutions, IVs, telemetry outputs were being read out confidently and rapidly, and confirmed and repeated by assistants. Soon a confident reassuring voice, probably coming through a smile if I could see past the surgical mask, said,

“Pal…it is time. We’re ready. Are you?”

In that five minutes it had taken for the team to get everything ready, they had overwhelmed me and stunned me into mental paralysis. Between the sedatives to ease the anxiety, and the questions to keep me distracted, I had not even thought of what was going to happen now – man, they are going to harvest arteries from my arm, then cut my chest open, then saw through my breastbone, then crank open my ribs, then retract my chest to open the cavity, then transfer all my breathing and blood circulation to a machine, then stop my heart and then sew things to it, and then close me up. I had not had one negative thought or forgiving during that entire time that I had entered the operating room to the moment that I was going to be rendered unconscious. Man they were good!

And with a last look at those cheery eyes, I went under the knife.

Now I could jump to the post-operation recovery, but that would not be fair to my family, who had to find ways to occupy the better part of 5 hours. Thankfully it was early, so they all could while away a few hours eating a Fat-Boy special breakfast. And that they did. They also walked around Queen’s looking at preparations for the Science Formal that my daughter and her boyfriend would attend later that day. Apparently the 3-story castle the Engineer students built inside the Hall was magnificent.  But even after that they waited over another three hours…reading…napping…drinking bad coffee…making lame jokes…and mostly worrying and worrying. As for how they felt, you will have to ask them. I cannot imagine it was positive energy.

And then I surfaced. So I am told. I was wheeled into critical care, past my family, who depending on their personal desires, wanted to see me right away, or wanted to wait until I was looking more human and less machine.  My wife and my brother came in right away – I do remember playing charades, unable to talk through the intubation – and mimicking I was cold. My reward was a nice pair of winter socks. They felt grand.

Still freaks me out...

Still freaks me out…

And then I fell under the spell of the anaesthetic and the pain  killers, and drifted in and out of consciousness. I vaguely remember the intubation being removed, I foggily remember my Mom kissing my forehead, my Dad looking stunned and pleased at the same time. But these could be just things I made up because like David in the minivan, I was not sure it this was real. But, as I was in for a long day and night of slipping in and out of consciousness, the family had a last word with the Surgeon before calling it a night.

Dr Payne was extremely pleased with the surgery – it went very well – despite my stubbornness in allowing him access to my harvested artery (which he apparently had to dig for like gold) and that my rib cage was tighter than a drum. Thank goodness he was a strong man, he needed every bit of his anaerobic strength to crack me open like a walnut! And while we had known that I needed a double bypass, in the end, he decided to add 50% free, just to save us the pain of cracking me open again in 10 or 15 years.

I was good to go again, completely re-tooled with clean hoses and valves, enjoying one-on-one nursing in a quiet, clean and calm intensive care hospital room with calm lighting. One little whimper, and the nurse was at my side with pain killing support and a reassuring word.

All that was left was the recovery. And thought at the moment, life was beautiful. I should have enjoyed it more.

Because, in less than 24 hours I was going to fall off my nice, soft, fluffy cloud and realise just what trauma my body had experienced…

End of Act Six

Later,

ASF

ASF’s The Coronary Chronicles: Act Four – What should I do?

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(Note: Surgery did not happen when planned; a sicker heart had priority and occupied my Surgeon for 8 hours.  Bad news: I was bumped. Good news: I can still wipe my own bottom.)

As I left you faithful reader, I had just learned that my heart was sick and that despite my age, outward appearance, physical activity, and general good health (at least compared to the others on the cardiac floor…) I had heart disease. Whether it was lifestyle or bad habits or a predisposition to generating plaque were irrelevant to the situation at hand –  my heart liquid plumbrarteries were in need of some cardiac liquid plumber.

The angiogram was still a bit of a mystery, but the diagnosis was clear:

  • My main heavy-lifting arteries were pristine, clear and showing no distress whatsoever
  • A series of secondary arteries, that wrapped the heart, were bunged up; substantially, and for some length. In some places the arteries only had 15% capacity – that’s a shit-load of gunk lining the artery walls. Further constriction and the possibility of the plaque destabilising and completely blocking the artery were real concerns.

And the prognosis was clear: sort this out, STAT before it sorted me out.

But the question was how? The location, length and thickness of the blockages meant that the “Master AngioPlaster” would have her work cut out for her. This fix would need a lot of stents and in some uniquely, weird locations. And because some were near junctions of arteries and veins, the Doctor was unclear of second and third order effects on the major flow patterns. It was not a simple case of one, or two, or even three stents removing the pea from under the mattress. If it was angioplasty and shoring with the mesh stents, this was going to be the equivalent of a cardiac Chunnel.

This required a major cardiac huddle between the Interventionist and the Artery Plumbers to discuss options.

And so, with that, my femoral artery was closed up and I was wheeled back to my room and my wife.

Now it is not easy to look someone you love in the eye and deliver the emotional equivalent of throwing them in a pool of ice water. But I figured, since my face said it all already, it was best to take the Band-Aid off in one quick and rapid motion.

“It’s not good. I have several blockages that need more than a simple stent.  We’re here for a while.”

And with that, we entered a whole new realm.

A bypass?

Jesus.

I had heard about those. I knew that they opened your chest and stopped your heart and sewed some stuff on. And I had heard about singles and doubles and triples and quadruples. It sounded desperate and complicated and scary.  But honestly, I knew nothing. I only had notions.

There is a lot of good reading on the topic of heart health and heart disease, on heart maintenance and heart repair. And over the next 12 hours, between moments of sheer disbelief and bitter acceptance, I read a lot.  I read about angioplasty and stents; about all those drugs I was taking and all about coronary artery bypass grafts. I read about probabilities and risks and success rates and quality of life after.

And I thought. And then I though some more.

I asked myself is this all my doing. Did I just ruin the most important thing that I have been given; my heart. Did I ruin because I like eating the fatty bits of the medium rare prime rib? That I enjoy my fine scotches and craft beers? Love my occasional bag of potato chips? Cream cheese? M&Ms?

I have always believed that you can live a Wilde life: everything in moderation, including moderation. But maybe I was wrong. But how can this be? I just ran a half marathon five weeks ago. I quit smoking over 4 years ago. I dropped 30lbs from my heaviest in 2004. I was not exactly a poster child for the healthy heart foundation, but I definitely wasn’t a poster child for heart disease either.

lets-make-a-deal-doorsAnd I brooded and worried and became stressed. In hindsight I expended a lot of energy wondering how I got here. It made me a bit of an angry man. I was experiencing all the stages of loss. I had moved through denial and was now working through the anger. I was bitter that this had happened to me. There were fatter and very idle people out there…how come they weren’t having heart attacks? Why were they out enjoying the weekend sucking on their cancer sticks, drinking Kilkenny’s, and scoffing down large bowls of gravy and cheese curd laden poutine while I had to decide between Cardiac Curtain Number One or Curtain Number Two. It just wasn’t f*cking fair.

But I am not by nature an angry man.  I like to think am rationale and at times I am a fatalist.  Que sera, sera. My mom always told me that things happen for a reason. We just don’t see it until later. And after a day or two, I started seeing it. It sorted came at me like a ship through the mist. Maybe this was an opportunity.

I talked to the specialists. As we all know, I could have helped myself by being a little lighter, by making a few smarter eating choices, but overall I understood and ensure that I got the necessary OMEGA-3s and grains and greens and vegetables and fruit and proteins. I was not a fast-food junkie or a cola addict. I ran and rode my bike. And though I enjoyed life and its finer things, I was doing all the things you need to do to be good to my heart – not dogmatically, but sufficiently I thought.

The only joker in the deck was my ancestry.

I am not blaming anyone, but you cannot run from genes. High blood pressure, diabetes, and stroke are part of my ancestral family medical history. But there is so much that is unknown – in pre 1960s India, people died and no one knew or cared why. There was grief. And then there was land to be divided. Who knew whether it was heart disease or not?  All I know is that I have heart disease. My body produces cholesterol and plaque and my body will continue to produce cholesterol long after my arteries are repaired.

Maybe, this episode, this minor heart attack, this signal, was the chance to start over again. To take stock, and assess the devil-may care attitude, and perceived invincibility of my youth and early middle-agedness, and decide if I could keep up that pace forever. And I could…if forever was 49 years. But in my vision, forever was much longer than that. Yes there would be moments of craziness, but I needed to make sure that “Crazy ASF” understood that in the future there would be some cheques he shouldn’t write – his heart may not be able to cash them.

So eventually, after a day to think about, I chatted with the cardiac surgeon. And I was ready. I had three options:

  • If I was an 80-year-old man, who was unable to stand the rigours of surgery, and who was going to sit on his butt and do nothing but stare out the windows at the pigeons, then perhaps we could go with medications to control pressure and flow and rates and stuff…meds would buy the time for something else to fail catastrophically, like my liver

stent

  • If I was a relatively inactive fellow who was willing to live a relatively sedentary life of long walks in the rain, and wanted to always watch what I eat while taking a very large daily medical cocktail of anti-rejection drugs, cholesterol pills and a host of other heart regulating agents, then the stents would be perfect. Upside? Less intrusive, quick recovery. Downside? Second guessing every tweak and pain as I tried to live my life as I wanted would cause me mental distress. And anyway, a stint was like paving a pothole. Effective, but eventually you have to pay the piper and replace the road.
  • And the granddaddy of the option, the coronary artery bypass graft (CABG). A complete new superhighway for my heart akin to replacing Montreal’s crumbling turnpikes. The downside? My chest would be displayed to the world as a machine kept me alive. Risks include stroke and infection and just bad luck. The upside? After convalescence, I would be the old me – minus a few bad habits. I would be able to run, to dance. I could even swim the dolphins if I wanted. I would be on a less strict regimen of heart pills, but I would be me again. Plus I would have a pretty wicked scar to show off as part of the Zipper Club
Go for it!

Go for it!

For those that know me, I am pretty sure you could guess which I would choose. Being active and full of life, being who I am, there were no half measures. As a young lad, with great prospects at recovery, and with a robust immune system, I was sure. And I decided.

CABG it was. I knew what I had to do.

End of Act Four…

Later,

ASF

ASF’s The Coronary Chronicles: Act Three – You have now entered the Twilight Zone…

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“There is a fifth dimension beyond that which is known to man. It is a dimension as vast as space and as timeless as infinity. It is the middle ground between light and shadow, between science and superstition, and it lies between the pit of man’s fears and the summit of his knowledge. This is the dimension of imagination. It is an area which we call the Twilight Zone.”

Pale yellow light bathed my hospital room as I tried to figure out in which direction my home was. Call it my training or whatever, but knowing which way is North always makes me feel better. I needed to do what I could to try to make more sense of the world because right then my personal gyroscope was malfunctioning. I had no real frame of reference to understand why I was there, and what had really happened.

I guess once they have severed and cooked and served you your perception of reality on a plate, you grasp any straw you can.

Double Big Mac Supersize Me. Nom nom nom.

Double Big Mac Supersize Me. Nom nom nom.

A heart attack. Un-buh-leave-ah-bel.  Un-f*-king-buh-leave-ah-bel. Morbidly obese people who chain-smoke and eat their Double Big Macs supersized with a barrel’o’coke have heart attacks. Frail old men who are at the end of their lives have heart attacks. And on the rare occasion, élite athletes who have doped, get heart attacks.

Yes, 48-year-old men can have heart attacks – but not this 48-year-old man.

I lay there beating myself up for almost 2 hours as I watched the sky lighten. Occasionally I became aware of my surroundings and wondered why my window provided such a shitty view of the inner bowels of the Hospital Courtyard. My only company was my new roommate’s snoring – the one I had yet to meet…no one is really friendly at 0430hrs. And as I found out later, no one even notices any noise on the floor – it is like hearing the sentry coming to wake you up for your 0200 -0300 hrs shift when deployed on manoeuvres. Your best bet is to pretend it’s a bear and play possum.

To add to the misery, I was starving, and there was no food forthcoming – I’d even take a cholesterol friendly rice cake. Breakfast may or may not show up – I was a late arrival at the starting gate so who knew.  And even though my mind was racing, I guess eventually even it had enough and so it shut down to let me doze off for a bit.

And later, after the new shift nurses took blood, my O2 levels, my temperature, my blood pressure, listened to my heart and lungs, made sure my legs weren’t swollen and I was not retaining water, I waited for someone to come and be with me. And then the day brightened and became more bearable the moment my wife walked in.

With a sheepish grin, I shrugged my shoulders and with my eyes said, “I’m sorry. I’m sorry to introduce this steaming pile of dog doo into our lives.  I wish I could take it back.”

And her eyes and body and hug said, “You’re an idiot. It’s not about what has happened it’s about how we fix it.”

Things are always better when you’re with the one you love.

After what seemed a long time, because time drags on when you are wearing one of those ill-conceived gowns and your world is upside down, the Head Honcho of the

I love the beer....

I love the beer….

cardiology ward came in and chatted. His assessment was pretty fantastic! Yes, I had contributing factors – 10-15lbs, high normal cholesterol, ex-smoker, cream ales and red meat. But I had a lot of things going for me: I was a “runner”, an active fella, relatively healthy – I mean I aced the Forces’ fitness test (those in uniform can groan now); the only unknown was my ancestry.  As many find out, you can run from a lot of things, but you can’t run from your genes. But that is Act Four…

And we spoke. He was a runner, too, and a triathlete and he saw my numbers and my history and my chart and he was fairly confident. He talked about an angiogram – an Unmanned Aerial Vehicle for your heart – and from what I gathered, an angioplasty and stent would probably be enough to take care of any nasty constrictions in my arteries. He ended with a chuckle and a grin, closing with how I might need to do things in a different way in the future and told my wife that I should be back and running in 30 days.  The angiogram was scheduled in 48 hours, on Monday, unless something changed.

So I settled in. With Wi-Fi and my laptop and Netflix, I was set for a slow but not necessarily an unpleasant weekend.  I would rather be home, enjoying a weekend with my lady, but if I had a coronary incident, it was playing out rather tamely. I realised that heart attack may be too strong a word; what I really had was a heart “skirmish”. Things were ok.

And then things got even better. Mid-afternoon, I learned someone had a critical heart attack and Team Angiogram, led by the “Interventionist” (yes, no kidding, that was the term used to describe the expert who does the angioplasty. I prefer “Master AngioPlaster”…but I keep thinking of Mr. Wolf of Pulp Fiction fame.) was coming in and that they would be able to “fit me” in immediately after. And if all went well, I would be able to catch Sunday Night Football and all would be right with world with some follow-up and good care. I felt a wee bit guilty that someone else’s critical heart attack was making me happy – but, hey, you take your small joys where you can.

This heart thing wasn’t turning out so bad after all. Not great, but not at all as dismal as I expected. The health system seemed to have responded very well to all our triglycerides and trans fats and sugars and stuff.

And not too long after I was prepared with a happy pill, locally anaesthetised and wheeled into the operating room. As is my nature, there was banter. In the space of 10 minutes the angio team and I had talked about running and half marathons and how it was surprise I was there and how it was probably going to be a quick in and out and how an angiogram worked and the steps of the angioplasty procedure and the mechanics of the stent and an overview of the anatomy of a heart. And because I had been given joy juice to ease the anxiety, I kept up with the conversation and probably even increased the revs by inserting questions to keep the conversation going because I was nervous and a little afraid of the unknown.

Well, it's a little smaller than this....

Well, it’s a little smaller than this….

The angiogram was a lot like watching a military drone fly over a target area. The heads up display board of six TV monitors provided vital stats, some sort of spatial referencing system, catheter status,  and then on one main screen, a picture of my heart.  That looked like a thermal image through a weapons system’s lens or a pregnancy ultrasound – depending on your experience you’ll get the essence. The Doc gave me an aerial tour of my heart and she explained it all.  But it was like the Enigma code to me; I could not understand any of it.  To tell the truth, I was really, really lost. The Grade 12 frog’s heart I dissected looked nothing like this.

The banter continued and then abruptly, it stopped.

“Hmmm…that’s interesting…”

Those words mean so much in so many contexts:

  • At home reading a magazine, it usually means, “Here’s an interior decorating idea we should use.”
  • About the internet it means, “we should try this restaurant”, or “let’s go see this movie.”
  • Amongst guys at the bar rail it means, “Sum up. Your story sucks.”

But in an operating room, while a cardiac interventionist is looking at your heart from inside your body, it sounds a lot like,

“Hmmm…you’re f*cked.”

And for three of four minutes she looked at my heart with all the intensity of a….of a… a….well,  with all the intensity of a heart surgeon, I guess.

And then she said, “you have a fair bit of arterial hardening.” And she showed me what can only be described as opaque lines in sea of billowing gossamer spider webs. I had no idea of scale or scope or whether it was the front of my heart of the back. I was hearing terms and references that were foreign to me. But this was my heart and I had to understand exactly what she was saying.

So I parroted back what I thought she was saying in terms in that I understood. And after that layman’s read back, I understood that while my major arteries were in fantastic shape, two smaller ones were heavily, and quite extensively, blocked.  At times all I heard was a Charlie Brown-like “bwah bwah bwah” as my mind scrambled frantically to understand what was being said.  Some words resonated, others didn’t:  heart disease, atypical, unique locations, awkward dispersion, angioplasty may not be the best option, must confer with my colleagues.

Wish mine looked this good...

Wish mine looked this good…

And all I could get was that this was now a whole lot more complicated and that I was not going to be a “quick patch and go”. There was no easy fix, no small stent, no going home quickly. No Sunday Night Football.

My heart skirmish was telling me that my heart was not just pissed at me…no, it was telling me any more bullshit and it was about ready to go on strike! I was not just a guy who suffered a scare – I had some serious heart disease. And running, or eating better, or cholesterol medicine, or happy thoughts weren’t going to fix this puppy.

I was crushed.

Again.

But much worse than before because after the first news there was hope this was might be easy. Now, as far as I knew, that easy road had been cratered. I had no idea what to tell my wife, or my kids, my family.  And I was speechless.

All I could hear was the Rod Serling voiceover “…the Twilight Zone, the Twilight Zone, the Twilight Zoen…” over and over again.

End of Act Three…

Later (like after my surgery and when my Tyrannosaurus Arms can use a keyboard again…),

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ASF