Solar Eclipse

Mike and I are traveling down to Carbondale, IL to view the total eclipse.  I hope to have some photos.  I will continue on with my thoughts after I had my heart attack and stents when I get back.  I also hope to share my thoughts on viewing a total eclipse.  So, till then, great void.

The Last Day, more or less, Of My Catalyst for Change

Once I arrived at the cath lab, Mr. Hawaiian had me scooch from my bed/gurney to the cath table. Before I knew what was happening, he pulled my hospital gown up and examined the area.

“They did a good job shaving you at Allen,” he said.

“Well, they shaved me again here, just to be sure.” I laughed. What else is one to do in a circumstance like that.

He folded a towel, a neat thick rectangle, and fitted it between my legs to cover the essentials. Yeah, I felt really covered. But I just took it all, the exposure, the guy commenting on my private area, all of it. I just took it, not saying a word. All I could think about was all that equipment around me. My head swiveled from side to side. Oh my god, I said in my head. I was sure this cath lab had to be used for more than just cardiac catheterizations. It could have been Dr. Frankenstein’s laboratory.

A woman breezed in. This is Andrea (not her name) she will be assisting.

Oh, cool, why didn’t she take care of my below area, I thought. Then both Mr. Hawaiian and Andre left me to sit and stew.

And stew I did. I couldn’t believe the enormity of the place, the equipment. And the place was deserted, nothing was going on, no people on the other tables. Empty. A ghost town. I looked at the bank of monitors. I had vague flashbacks from the cath at Allen. Did I see something on those screens then I wondered?

Mr. Hawaiian came back . “It won’t be long now,” he said as he busied himself doing god knows what.

“I’m getting kind of scared.”

“Don’t worry, we’ll be giving you something soon. You’ll be feeling really good.”

He drifted over to my right side where my IV was. He must have injected the feel good stuff because directly into my IV because from there, things got a bit hazy. I don’t remember when I went to my happy place. I just remember coming to now and then and seeing two doctors, I think they were both doctors, doing stuff around by my feet.

Then I had chest pain. A lot of chest pain. Incredible chest pain

“Ach, that really hurts. Is it suppose to hurt?” I said to those figures working by what felt like way down by my feet, but don’t quote me, my vision could have been distorted.

“It won’t be long now.” A voice said

I went back to my happy place only to be jolted back with more pain.

“Man, that hurts,” I mumbled. “How much longer,” I said out loud.

One of my sons recently was diagnosed with heart disease and had six stents put in. He told me that it hurt like having a heart attack when the stents were placed. Well, now I know first hand what he was talking about.

Then it was over. Somehow I got off that table and was wheeled back to my room. The pain was gone so I was allowed to go back to the dreamy state.

When I “came to” back in my room I learned that the sheath removed. Yippee! I was told that instead of putting pressure on the insertion site, the hole was stitched up and a ball of gauze was tapped to give it some pressure.

Mike stepped into the room shortly after I returned and told me that Dr. Park, one of the three P’s who did the heart cath, sent someone to the waiting room to ask him to go to a small conference room and that Dr. Park would be in to talk to him.

“I was scared,” Mike said. “I didn’t know what to think. Why did he want to talk to me in the conference room? Then Dr. Park came bursting into the room with a big smile on his face. He told me that every thing went well. He said they went in and blasted your arteries open and put in five stents He said that you are fine to travel back home but will have a weight restriction of 10 pounds for about week or so. He said you can get your valve taken care of in Wisconsin.“

“Wow,” was all I could think of to say.

“Oh, yeah, and he said that you will have more blood going to her heart than you will know what to do with.”

I could tell Mike thought that was terribly amusing I just think he was happy and relieved at the outcome. And that’s a good thing but I was still in a daze.

I stayed that night at Dallas. It was the best night through out my time in the hospital. It was all over. Done. It wasn’t till I was back at Joe’s that I wondered if I was going to be okay but that night was pretty good.

The next morning Dr. Park and Peter among a slew of other people, stopped by to see how I was and if I had any questions. Dr. Park said they would put together a CD with pictures of my cath to give my doctor in Wisconsin.

Dr. Park gave me two cards from the company that made my stents. The stents are called Xience: Everolimus Eluting Coronary Stent System. On the card, little stickers with a part number and a lot number were lined up at the bottom. Below the sticker, the doctor wrote in the location of the stent. There are only four slots per card so I have two cards. One card has four stickers; the other only one. There is also a full color, sort of, three-dimensional representation of a heart. The arteries are shown on this heart image with labels supposedly to help with locating where the stents were placed. The cards say I should carry them with me and show them to any medical personnel who may be treating me.

Dr. Park told me I could go home that day, well, back to Joe’s anyway. Finally. It had been 6 days since I went into the emergency room. Six days on a roller coaster. Six days taken from the vacation I was to have with my husband and grandson. The vacation was essentially over. I did not realize then how this six-day journey would change my perspective. Change me. Push me to make changes in my life. How it would be a catalyst for change. These six days were just the beginning. The weeks following this journey, when I put things together, accepted some truths and made some decisions, that would be the real work.

The Catalyst epic continues part 5

So, backtracking a tad, now that I knew what was going to happen, that things were moving along and the light was shining brighter at the end of the tunnel, Mike and I enjoyed a nice lunch together. After we finished eating, we just sort of hung out together. It was the first time we could do that. Todd was in Dallas taking care of Gavin. Mike was free and I was lucky enough to have him with me.

Mike looked uncomfortable sitting in the stiff, plastic hospital chair. I moved over and patted the bed next to me.

“Come lay next to me.”

“Can I?”

“Come on. First of all, we’re married. Second, we’re not going to do anything.   Sheez.  We’re just going to lay here.”

Mike grinned, got up and settled in next to me.

No sooner had Mike settled in when the skinny woman to transport me to the cath lab came in my room. What, so soon? I thought.  It was only three o’clock. Maybe this was too fast.

Once I was down in the cath lab, which was immense, I was wheeled in to a large area that was lined with sections that were curtained off. There was a row of curtains on one side and another set on the other. I would say at least five or six per side. It looked like the sleeping area in the Nun’s story if you ever saw that movie. Some curtains were open, some closed. Some had people lying on gurneys, some were empty. Each area had their own set of monitors and equipment. My eyes bugged out thinking about the assembly line of cardiac catheterizations that were performed here. How often? weekly, twice a week, daily?

The skinny gurney woman, more like a girl to me, wheeled me into the very last one on the right side. She backed me in. with out the beep beep, parked me and took off with a wave. Eyes wide I scanned the area. Oh, no, I thought. Oh, no.

I saw a white board on the wall to my right. Welcome to pre-procedure, it said with other pertinent data. A nurse whizzed in introduced herself, did a little prep and then rushed out. I was alone for a while. I think I was the last one of the day because they squeezed me. There was a flurry of activity all around me behind those curtains. Because they were only curtains I could hear some of what was going on in the ones closest to me. In the area across from me, a woman was kind of moaning.

“Her IV is occluded. When can we bring her up,” a nurse, I assumed, said or she said something like that into a phone.

When she hung up she went to the woman. For some reason her curtain was open and I could see all.

“You have to keep your leg still,” she said. Oh boy, I know what that meant. For some reason, they left the sheath in. Well, I guess that kind of thing isn’t unusual.

Next to me, a nurse was talking to a man, I think he was some kind of driver, who brought in a guy from a nursing home. They were discussing where the guy would go after the procedure. Was he going back or would he be admitted?

Once the driver left, the nurse was on the phone. Apparently, the guy’s labs were in and his kidney results were elevated. The procedure needed to be put on hold. She hung up called someone else, “I have to get the driver back. I don’t know where he is,” she said. “The patient needs to go back. They are going to treat him with medication and wait to do the procedure.”

I heard a new comer enter a few curtains down on my side. It sounded like this new one was a male. All the nurses and whoever who was in attendance, busied around him to get him ready. Or that was what it sounded like. I think he was going before me. I heard the sound of a razor. I knew what was going on. They shave you down there before they do the cath. I was shaved at Allen but the nurse here at Dallas freshen it up, just to make sure. Can’t have a stray hair hanging around ready to botch things up.

“I know man, I’m sorry. It has to be done,” A male voice said to the guy who was being shaved.

My eye caught a woman entering a curtained area across from me a few space to my left.

“Hi, Dad,” her voice drifted to me through the curtain. “You’re doing great. I love you. I’ll see you when you get to your room.”

Her dad mumbled something.  The curtain moved and a middle aged blonde woman left.

Wow, I thought. All these people with heart disease. All these professionals, resources, time, money. For what? I didn’t feel worthy of the expense. Even though, obviously, I wasn’t alone. I felt damaged. Like I shouldn’t deserve this treatment because I didn’t take care of myself good enough. I let myself get heart disease. I don’t know if the other the patients felt that way but that was where I went with it.

A guy came in, he looked Hawaiian. His long jet black hair was tied in a pony tail that went down the middle of his back. He was tall and athletic looking.

“Hi, my name is, (insert name here, I don’t remember it). “I am one of the technicians taking care of you today. We will be bringing you back in a bit. Is anyone here with you?”

“Yeah, my husband. He is up in my room. Can he come down here?” I am sure I must have looked distressed because I was feeling stressed.  My eyes wide like a deer in highlights.

“Not a problem, I’ll go get him for you. What’s your room number.”

I told him and he turned on his heel and left. Shortly he was back with Mike in tow. Oh was I glad to see my Mikey.

“Mike,” I said.

Mr. Hawaiian guy left us. I think that guy smokes, I whispered to Mike once Hawaiian guy was gone. “I can smell it on him. How is it that some people can smoke, drink in excess, eat in excess do whatever in excess and yet here I am and there he is looking healthier than health.”

“It’s not your fault, Baby,” he said and patted my arm.

I smiled up at Mike and to change the subject I proceeded to fill him in on all the goings on.

The curtains emptied, the place became cavernous. I, the lone survivor,  with my partner in crime, Mike, was waiting to be picked up. Before long, Mr. Hawaiian came over to do just that. He instructed Mike as to where to wait and off we went.

The cath lab. I remember this cath lab. First, I was not given any Benadryl or Valium to pre sedate me so I was completely aware. And let me tell you it was scary.  The picture below is more or less what I saw.

A Cath lab

I think there should be a part six, hey?  So…

Part four of the epic catalyst for change

The bumpy, ride over to Dallas in the ambulance was uneventful but odd. It was odd being strapped and bundled up on a gurney in the back of an ambulance facing the door.  One EMT, the woman, rode in back with me but I couldn’t see her, after all I was facing the door.

“Do you mind if I put the oxygen cannula under your nose.  We like to keep the oxygen level at 98%”.  The EMT said from somewhere over my right ear.

I could see the monitor on my left with all my readouts: BP, heart rate, o2 level.  My o2 was at 96.  I shrugged  “Sure, go ahead.”  Couldn’t  hurt anything but I thought my oxygen level was fine.

An hour after I got to Dallas, admitted and settled in my room when it was safe for me to move around, I wasted no time in getting up to use the bathroom. What a luxury. This had to be a harbinger of things to come.

Although Texas Health Presbyterian Hospital Allen and Texas Health Presbyterian Hospital Dallas are in the same family they were worlds apart. Allen has 48 beds while Dallas beds are over 600. Allen has maybe 2 floors whereas Dallas is basically a highrise. This all makes a difference in the care I received.

I was still getting the shot in my stomach and the nitro patch. After all, nothing really had changed. All I had done was the cardiac cath, there was no intervention such a stent. When the nurses at Allen injected the blood thinner into my stomach the needle slid into my flesh with ease and I felt next to nothing, that is until the medicine started to spread, then there was burning for a while, like getting a bee sting if you are not allergic.

The trick with giving that shot is to bunch the skin and just go for the jab as if you are stabbing some one. I know because when my brother was hospitalized a couple of years ago I was recruited to administer these shots to him so he could go home. It was very uncomfortable to stand over my brother with a syringe getting ready to jab. But jab I must because that was how I was instructed to do it so there would be minimal discomfort. My brother told me I did good. Was he being nice? I couldn’t tell. But now that I got pay back by getting my own shots I think maybe I did do good.

The nurses at Allen did that but this one nurse at Dallas put the needle in slowly, as in s-l-o-w-l-y. It burned going in, it burned when the medicine spread. I had to get those shots twice a day. I knew in the morning she would be back for another go at it but I said nothing to her. I endured it. Ach! What can I say?

I guess it was because I liked her. She was from Africa, tall, beautiful and had the most amazing accent. I could listen to her for hours. The thing is I felt she was lacking in self-confidence. I don’t know just a gut feeling. The way she held herself and seemed worried that she was doing things wrong. She was knowledgeable but I think she was worried about hurting me. She seemed hesitant before injecting me.

I was sent to Dallas to be seen by a specific cardiologist and surgeon team. Dr. Park, a cardiologist, Dr. Pool, a cardiac-thoracic surgeon and their physician’s assistant, Peter, the three P’s All three of the P’s came to see me in my hospital room to discuss my treatment.

Peter showed up first. When he walked into my room, Mike, my loving, supportive, husband of 37 years was with me. It has been rough on Mike these past five days. He couldn’t visit me as much as he wanted because he needed to be with Gavin, the adorable doted-on grandson. My son Joe, his wife, Min, not Gavin’s parents, and Mike took a team approach with Gavin. Mike took him swimming at Joe and Min’s pool one day. Another day, Min took him swimming at the pool of a friend of hers. By the time Tuesday rolled around Gavin’s father flew down from Milwaukee to fly Gavin back home. So, Mike was freed to spend the whole day with me. I am glad he was there when the team showed up.

 

After introductions, Peter told me I was famous, that they, the three P’s (he didn’t refer to their team as the P’s. To him they were the team) had been discussing me these past two days quite a bit. I was dead pan when he told me that. I wasn’t sure how to respond. I wasn’t sure what that meant. Was it a good thing or a bad thing? Peter proceeded to fill me in on some of what they discussed.

“The cardiologist over at Allen thought that your aortic valve stenosis was severe. Because of that, you were sent here because we have a great team that works on valves. There is a new procedure that is being used to repair valves. It’s called TAVR, that’s a transcatheter aortic valve repair. TAVR is a minimally invasive surgical procedure that repairs your aortic valve without removing the old, damaged valve. Instead, a replacement valve is wedged into the old one. It is less invasive because a catheter is threaded into your artery instead of opening up your chest.”

“Well, that’s good,” I said. I didn’t want to be sliced open again. Shudder.

“But we don’t really know how we’re going to proceed yet. Dr. Pool will discuss that with you. This is a good place to be, however. Dr. Pool has done many TAVR procedures. He’s top in his field. So is Dr. Park.

Peter left and sure enough a couple of hours later enter, Dr. Pool. Dr. Pool was tall, maybe in his late forties with short-cropped, dishwater blonde hair.

“Ms. Roberts. I’m Dr. Pool.”

“Hi, this is Mike,” I gestured over to where Mike was sitting by the window.

“We were looking at the reports that came over from Allen. You had three blockages. One of your grafts was 100% blocked, the other was 98% blocked. The 3rd blockage was in your right coronary artery. It looks like your heart was hanging on by a thread. As for your valve. I’m not sure that it is severe. We are going to do our own echo cardiogram and then make a determination on that.”

“Oh,” was all I could spit out.

“You see, we do a math equation taking into account the amount of blood in your heart before it is pumped out and the amount of blood that left the chamber. In the echo you had done at Allen, the numbers for that math didn’t add up. We will do our own test and if it is as I suspect and not severe we can go ahead and fix your blockages with stents.

“OK, I like that.”

“We’ll get that done right away and get you into the cath lab this afternoon.”

“Oh, that’s going to be awhile.” I looked at the clock. It was 10:00 am. “Can I eat. They put me on NPO (nothing by mouth) last night and I haven’t eaten anything since yesterday. I am really hungry.”

“Yes, you can eat. But eat before noon. Then nothing after that.”

I looked at Mike and we smiled at each other. “Thanks.”

Dr. Pool left and Mike and I pursued the menu. We didn’t discuss what we had learned much. I mean, I think we were in a state of shock about the whole thing.

Anyway, the echo was done. The technician just wheeled the whole machine into the room and did it right there. The same happened with an x-ray I had. No more having to be brought done to these departments to get tests done. Very convenient, very efficient.

Just as Dr. Pool thought it was not severe.

At 3:00 a very, young woman, she looked to me to be a teenager, took me, bed and all, down to the cath lab, talking all the way down about how skinny she was and how she should eat more.  She was skinny.  Her yammering did take my mind off what lay ahead.  I got involved in telling her to be herself.

The cath lab and the aftermath I will save for another day.  There was a lot going on that day, the day of my second catheterization.  Frankly, I didn’t want to have another hole poked in my femoral artery.  It was still bruised.  I just got the dang sheath from Monday’s pulled out.  What’s a woman to do?  When’s it all going to end?   Tomorrow hopefully.

The Catalyst Part 3

Monday finally rolled around. Surprisingly, I was not restless lying there in my hospital bed in Allen. Anyone, who knows me knows that is unprecedented. It is hard for me to sit still.

At ten a.m., I was taken to the cath lab to begin the start of my journey. I got some drugs that put me in a twilight sleep. While in this dream like state, I vaguely remember seeing a bunch of monitors and heard people talking. It all went by pretty fast. I was blissfully unaware of what was going on. Even when I was sent to the ICU to recover, I hadn’t a clue as to what the result was of my cath. When I did find out it wasn’t good news.

Apparently, when the doctor read the results of my echocardiogram, the sonogram of my heart they did over the weekend, he felt my aortic valve stenosis was severe. Then when he took a look at my coronary arteries during the cath, he determined that what I needed done was too extensive for their small hospital. But what did they find? What exactly is too extensive? I don’t recall him giving me the details and I didn’t ask. I was still under the effects of the drugs.

Anyway, the bottom line was they were going to transfer me to Texas Health Presbyterian Hospital Dallas. And because they hoped I would be going soon, they left in the sheath that was inserted into my right femoral artery that allowed for the instruments and things to be threaded up to my heart. As a result, I needed to lay on my back and keep my right leg straight. I couldn’t sit. I couldn’t stand. I couldn’t roll over. Nothing. It was very important for me to remember to keep that leg straight or I could bleed out.

The worst of it was that I was not transferred to the other hospital that day. No, I didn’t leave till the following day, Tuesday. For 24 hours I laid on my back in the ICU, keeping my leg straight, getting the backache of the century, trying to shovel food in my mouth while lying down.

Many people came in to check on me while I was there but my main nurse was a young-looking blond who called herself the singing nurse. She called herself the singing nurse not because she sang but because she would recite music lyrics that popped into her head. She seemed impressed that I told her the song from which she quoted. Well, the singing nurse bustled around me with more energy than I could deal with checking my blood pressure, checking the site where the sheath was, asking me if I had any pain.

“I have to pee,” I told her at last wondering how they were going to manage that.

“I’ve got something for you,” she said.

She busied herself off to my left, unwrapping stuff, putting stuff together.

“Okay, this goes between your legs.”

She handed me an apparatus shaped like the front part of thong underwear. It was flexible and contoured..She helped me position it by my urethra. I looked up at her confused.

“Now, when your ready just go.”

“Just go?”

“Yes, it will be alright. You shouldn’t get wet. The minute you start going a small will vacuum will your urine out and it will collect in this container over here.” She pointed to my left but I couldn’t see anything.”

Singing nurse left the room and I was supposed to do my thing. Yeah, right, like that was going to happen. Singing nurse swept back, “how’s it going.”

“Its not. I can’t go.”

“It will take some getting use to; just relax. It will work.”

She left again. I worked and worked at it and at last I was able to let a little come out. I heard a noise and felt a coolness. I let a little more out and finally I was able to completely let go. Ahhhh, okay, that felt better. One problem down. Now what was I going to do about my back ache. And when was I going to get out of there. Everytime some came in I asked when I was leaving.

“Haven’t heard anything yet.” was the answer.

1 o’clock, 2 o’clock, 3 o’clock. No news. My back ache was becoming unbearable. I was told I could bend my left leg to ease myself. That didn’t even make a dent in the pain.

4 o’clock. Overwhelming grief overtook me. Tears rolled down my checks. Once the waterworks started I went into full-out crying but quietly so as not to disturb anyone, although I was in a room by myself. My stomach bounced up and down. I silently gasped. Mucus filled my nostrils. I choked on the mucus. I opened my mouth to let out a silent wail.

Singing nurse bounded into the room.

“Whats wrong,” she said. “You’re blood pressure is up.” Then she noticed my crying.

“Oh, Sweetie, what’s wrong?”

I was in no shape to object to the term of endearment. Although I did feel a little bit ruffled.

“My back.” I rolled my head back and forth.

“You have orders for Morphine. I can get you some morphine.”

I didn’t know what to say. Was morphine a little extreme? “Okay,” I finally choked out.

After she administer the morphine directly into my IV I felt a warmness spread over me. My back still hurt but I was more relaxed. I calmed down. My blood pressure came down. I was able to rest more comfortably. For like about a half an hour.

The singing nurse went off shift and on came the 7pm to 7 am shift nurse who I absolutely adored. She was gently, caring, attentive. She was from India and she was beautiful and an angel.

She was informed about my back so when I complained about it she asked me if I wanted morphine.

“Not really, that stuff doesn’t work the best. What if you gave me two Tylenol and a Benadryl then maybe I could get some sleep.”

She thought that over and then told me I had an order for a longer acting pain reliever.  I think she said it was Oxycontin. So I tried that. She was right. I was much relieved all night and was able to get some sleep on and off.
The next morning Tuesday, I was still in the ICU in Allen, still had the sheath in, still lying on my back, still dealing with my back pain.

The day shift nurse who took over for my angel was also from India. I’ll call her Sras. I forget her name. I shouldn’t have she was the most helpful.

It was Sras who put a pair of hospital issue underwear on me to keep that urine vacuum machine in place. It was Sras who told me that the hold up with my being transferred was that I was classified intensive care and Texas Health Dallas didn’t have any intensive beds. It was Sras who told me that the doctors said my sheath could finally come out. It was too old to use at this point. It was Sras you took the sheath out and press down, hard and hold the pressure for at least 20 minutes on top of where the sheath came out to stop any bleeding.

Sras wasn’t alone taking out the sheath though. Another nurse needed to assist by feeling the pulses in my feet to make sure circulation wasn’t being cut off. After about 15 minutes Sras was shaking from maintaining the pressure. She said she couldn’t understand why she couldn’t hold the pressure. She usually didn’t have a problem. She was reluctant to give up but eventually she stepped back and allowed the other nurse to hold the pressure.

Finally it was all done. The sheath was out, The site did need to be monitored for bleeding and pus but things were looking up. I still needed to keep my leg straight for 5 hours which was downgraded from 8 because it had been in so long, lucky me.

Now that I was sheath free and no longer needing intensive care, a bed opened up at Dallas and at 4 o’clock an ambulance arrived to transfer me to Dallas. I was strapped into the imbalance gurney and wheeled down the hall. When I passed the nurses station I saw Sras sitting at the desk.

“Bye Sras,” I waved. “Thanks for everything. I’m going to miss you.” I smiled at her.

She looked up smiled, waved and said good-bye. I thought I saw a look of sadness at seeing me leave. While she took care of me we laughed and joked and really had a good time. I miss her. And I don’t even remember her name.

It was such an ordeal dealing with the sheath that I didn’t have time to think about what lay ahead for me at Dallas. I was just glad to know that once I got there I would be able to get up and move around. Small pleasures.

In retrospect, although I liked the cardiologist and the nurses, I wonder how much of that was necessary. If that sheath hadn’t been left in, I would have been at Dallas sooner and been spared much discomfort. But then I felt so nurtured by Sras, I can’t honestly get angry about it. Sras’s caring and even friendship overshadowed all that crap.

But the real crap was about to hit the fan once I was at Dallas.

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