Tuesday, December 05, 2006

The Year of Living Sedentarily (or the longest post ever)

Normally, I'm here to write about arts related things. Today is a fairly arts-free entry, in part because it lets me tell people, "just go read my blog." All the same, I'll try to keep it brief, difficult for me. Imagine if I told it over and over and over.

Most people seem to think of me as being fairly active, usually due to some performance they've seen me do. This past year, however, has been fairly sedentary. I haven't performed since January and so much of my life was spent at the computer working on Able to... and the promotion of that. The day job is in retail and so I spend about 40 hours a week on my feet, but it's not exactly aerobic exercise.

So I'm not saying that what follows is the result of the past year, but I can't prove it isn't. It does let me use a word like "sedentarily."

Tuesday, November 28, 2006

Just before heading into the day job, I started feeling a very mild pressure in my left chest/shoulder. After being at work a couple of hours, I went to the health shelves (my day job is at a book store) and looked up "heart." From the dictionary definition, I felt secure that I was not having a heart attack. "Angina" did fit what I was experiencing, but that said it was not a dangerous thing and usually passed after 15 minutes or so. Of course, I'd been feeling it for nearly 2 hours.

So I waited a couple more hours. After 4 hours at work, I told a manager I should probably go to a doctor. One of the managers drove me to a nearby clinic, which, it turns out, didn't have an ER. They chastised me for not dialing 911, and gave me a lookover. EKG was good, blood pressure good, no real reason to believe anything was going on, really, but they gave me a patch of nitro and called an ambulance to take me to an ER anyway, for further overlooking.
Shortly, I was in the ER of St. Luke's Episcopal Hospital here in Houston. After more blood and more EKG, they still couldn't find anything that suggested my heart was a problem, and my chest pressure had been relieved. The ER doctor gave me the option of going home, but he also said, "If my brother had gone to another ER with your symptoms, and they'd just dismissed him, I'd be pissed." The seed of doubt having been planted, I agreed to stay the night for a stress test in the morning. I was a little pouty and didn't want to spend the night, but I hunkered down and accepted my fate. Meanwhile, the nitro had given me a migraine. I hadn't had lunch and by the time they brought me supper, I couldn't eat much. That was the worst pain I'd felt all day and I went to bed swearing I would never go see a doctor, ever, again.

This was my first night in a hospital as a patient. Ever.

Wednesday, November 29

They wake me up several times in the night to take blood and blood pressure and finally to give me the stress test. This has to be done on an empty stomach, of course, so I was ravenously hungry and was pretty sure I would pass out from that alone. They gave me a CAT scan, and then put me on a treadmill. The treadmill tech was sort of like a P.E. teacher, and so I didn't respond too warmly to her, especially when I said I'd like to stop and she said, "Can we go one more minute?" I felt more intense pressure, more like pain, in the same area as the day before and they gave me a nitro pill (which I resisted because I didn't want another headache, but was convinced that a migraine was better than a heart seizing up), and then another scan. They returned me to my room and gave me lunch (bland bland bland, but oh I ate it all up).

After much waiting and a day of "you'll likely go home this evening," I was told, around 7pm, that the stress test suggested some blockage of one artery, so I would have to stay another night and they'd do a catheterization of my heart the next day, to determine the extent of the blockage and subsequent treatment. .

I asked my friend, Celina, to get me a pair of sweat pants and a t-shirt because all I had was what I had worn to work the day before. She brought me a duffle bag full of new clothes from Target. There were some things on sale. Misha also came that evening and so I had my first hospital visitors. A good time was had by all. When I wasn't pouting about spending a second night in the hospital.

Thursday, November 30

About 3am, I wake up with more severe pressure in my chest. I call the nurse, she takes blood (I later realized all the blood-letting was to determine if my heart had released enzymes that defined a heart attack), takes blood pressure, takes EKG. No heart attack evident. She gives me some nitro, which doesn't really help me. She gives me some morphine, which helps some.

Here's a thing that got on my nerves: I kept being asked, "On a scale of one to ten, where is the pain." Sometimes, it was "On a scale of one to five," which made me crazy because I felt like I had to do some algebraic conversion to another scale. Dumb, I know. Anyway, up until Thursday morning, I had been no worse than a 4 (on the ten scale) during the stress test. I said the Thursday morning pain was up to 7. And all the while, I kept asking myself, "If a 10 is the worst possible pain . . . well what is that? I seem to tolerate pain pretty well, so what if this is really a 10? HOW DO I KNOW???"

Finally, my turn in the heart catheter room is up. Let me tell you, if this had been happening to someone else, this would have been fascinating. What am I saying, it was fascinating anyway. You stay awake for the procedure, during which they stick a tube into your groin and up a very large vessel that goes straight to the heart. They pump iodine into the heart to see where a blockage is. They also pumped something else in there at some point. I'm not sure what it was, but the doctor said, "Mr. Orts, you're going to feel a rush of heat throughout your body." Shortly, I felt this heat hit my heart and then disperse throughout my torso. It was amazing. Kind of felt good, even. I watch as much of this as I can on a screen they have set up for that reason.

Finally, the doctor said, "Mr. Orts, there are three major blood vessels to your heart and one is completely blocked." He paused dramatically, so I said, "Really? Wow." Or something equally inane. Then he said, "There seems to be some blood circulation to that part of the heart via minor vessels, so that part of the heart isn't dead, yet." This became the biggest thing I learned all week: A part of my heart could be dead and I could still be carrying on a conversation. (Certain past dates may say they knew this already.) After another dramatic pause, the doctor went on to say that they were calling another cardiologist to consult with them about whether to try to open up the vessel with a balloon and stent or if they should just crack open my rib cage and touch my heart with their bare, latex gloves. (He may not have said exactly that.) After a bit, they informed me they would try the stent. A little bit later still, the doctor said, "Mr. Orts, your artery is open."

"Thank you," I answered politely.

Outside the catheter room, people started passing around my paperwork and reacting with "Wow." and "whoa!" and "you came in with only a little pressure on your chest?"

Silly as it seems, this was the first time I started to understand this was really serious. Because, you know, serious things only happen to other people.

They did bring me a sandwich as I was waiting to go the Cardiac Care Unit. I laughed as I opened the thing. There was a package of mayonnaise on the side. I said to the nurse, "So I just had a completely blocked artery and you give me mayonnaise? I LOVE THIS PLACE!"

I had to spend the night flat on my back and never bending because of the puncture wound in my groin, where the catheter went in. I had a couple of visitors. Otherwise, the rest of the day was uneventful.

Friday, December 1

Not much to report on that day. Doctors came in and said cryptic things about needing to watch me closely and then evaporated into mist. A couple of guys came into the room to do a sonogram of my heart. I watch the images on their screen. Honestly, if you've seen one sonogram, you've seen them all. A month old embryo flutters murkily much like a 43 year old heart. I suppressed the urge to ask if it was a boy or a girl.

They said that post catheterization, heart attack enzymes were showing up in my blood.

In the afternoon, I was allowed to stand up and sit in a chair. I ate supper sitting up.

The main thing I learned that day was that most people with a stent go home the next day. Most.

Saturday, December 2

Just another day in paradise. I finally ask Celina to raid Doug's, her husband's, library (he's an English phd student) for a book or two. I ask Misha to bring me some doodling (AKA art) supplies.

The weekend doctor told me that the enzymes were trending down, so that looked good. She also said that they were still wanting to watch me to make sure I wasn't having a silent heart attack. I asked her if they were now saying I actually had a heart attack. She said, "Not technically, but it's really splitting hairs."


My pastor dropped by and left a bulletin for Sunday's service (which I saw was "good hymn Sunday"). I spoke with a hospital chaplain. I washed my hair.

Sunday, December 2

A different weekend doctor saw me that morning. I asked him about the sonogram, since no one had said anything more about it since it was taken. He pulled it up on a computer. He showed me how one side of my heart was beating a little bit better than the other side, so I had suffered some minor scarring. He said it was very minor, especially considering the extent of my blockage.

I watched TV, I read a bit, I spoke to people on the phone.

They told me I would either go to a regular room that night and go home the next day or just go home from CCU the next day. Either way, they felt confident I was leaving soon. It all depended upon whether they could find a room

Finally, at about 8pm, I was transferred to a regular room. I'm not sure why finding a room was such a problem because it was a semi-private room, but the other bed was empty. Doug said, the next day when he came to get me, that they literally couldn't find the room, that, like he, they got lost looking for it. Could be. Hospitals always strike me as being layed out so as to confound navigation.

Monday, December 3

They discharge me shortly before noon. The internist, the cardiologist, and the RN all give me slightly different instructions, but mostly I learn that the largest concern is for the puncture wound in my leg. All the lifting restrictions, for example, had nothing to do with my heart, but about not rupturing the groin. Suddenly, my heart was only peripherally important.

I had the handful of prescriptions filled. Only one is forever, the one that keeps my white blood cells from attacking my stent. The others might (might) be phased out later. Counting the baby aspirin, I have 5 different pills to take daily. One, I have to take twice a day.

When I get home, my cat is furious with me and maybe a little traumatized. He runs from me, talking the whole time. "Don't you touch me, don't you dare touch me, you bastard. Leave me alone for 6 nights, sending strangers in to touch my food, who do you think you are? You think you can just abandon me for 6 nights and then expect to touch me?" (That's translated from "meow meow meow meow meow meow meow meow meow meow meow meow.") He has since come to sit on my lap for extended periods of time, so I think this, too, has passed.

Tuesday, December 4

Today, I started in resenting. How dare my heart get clogged? How dare my heart turn me into one of those people who has to remember to pack my meds when I travel? And yes, I am carrying the cordless phone around the apartment with me. Doesn't mean I'm worried or scared or anything like that.

In short, I'm great in a crisis—calm, cool, collected—but I think the crumbling could start soon. Or not. It's hard to predict these things.

I go back to the bookstore tomorrow to face the holiday crush.

For those of you who read all this—wow, what stamina. And it was for you that I wrote it. I'm already tiring of telling the story and I'm forgetting who I told what. Here's as good a place as any to tell everyone at once.

And the moral of the story is: The stress test is your friend. If your insurance covers it or if you can afford it, I'm thinking it's a good thing to do every year. It was all that headed off what could have been a massive coronary event.

Okay, back to arts related stuff next time. No more heart talk from me on the blog (unless I get my hands on the video from the catheterization and/or the sonogram and this becomes a performance).