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Of CABGs and Kin part 2(Continued from Of CABGs and Kin part 1) At the beginning of the angiogram, I kinda wanted to ignore the entire thing, figuring the less I noticed about what was going on, the more comfortable I'd be with the tube winding its way from my right groin and winding its way to my heart. As it went on, I become fascinated with it, and wanted to know what was going on, just because it seemed pretty cool. So I lifted my head a bit to get a better look at the monitor, and the half-dozen or so folks in the room declared, "keep your head down." It was explained to me that because of how they went in, I really should not lift my head, because that would cause blood to move around a bit more than necessary near the entry point, effectively causing some kind of internal bleeding/bruising situation. Okay then, I wouldn't lift my head. I was told I'd need to keep my head down for six hours following the procedure. Also during that time, I needed to apply pressure to the dressing over the entry point if I had to cough, sneeze, or laugh. When the doctor explained the angiogram video to me (notably the part about recommending a three-way bypass), it also came up that there were signs of having had a heart attack in the last couple of years. That I didn't know about. You'd think I might have noticed something like that. I am still trying to wrap my head around that. I survived a heart attack I didn't even know I had. I'm admitted to the hospital and I'm given a room. My wife and parents are with me - they'd actually been there for quite a while at this point. But now they are being funny. I'm sure if I wasn't at risk for hematoma, they would have been entirely boring, but no, wisecracking abounds. I just keep steady pressure on the bandage. Since I can't lift my head, I declare that "anyone who wants to talk to me should stand right there," pointing up at a spot on the ceiling. After those unbearable no-head-lifting hours, things got pretty cyclical. Doctors and nurses checking the bandage area, giving me drugs, drawing blood, asking about my bowel activity more often than I thought was absolutely necessary.... I had plenty of time to think back to when my dad had his bypass done. In the position I found myself now, I felt strangely unaffected. I was going to have my chest cracked open, guts moved around, arteries rerouted, then put back together, and I was supposed to be functional again. Yet, I didn't really think much of it other than that it was kinda neat that it could happen. However, fifteen years ago, when it was done to my dad... Naturally, my dad is my template for manhood. I'm not talking about masculinity or machismo. I am talking about vitality and integrity, internal strength and personal decency. How a person should be right. So when I saw him connected to the machines - tubes and wires attached to machines measuring who-know-what and putting some variety of fluids into him, while he barely reacted to the conversation going on around him... That nearly broke me. Everything in my mind stopped working correctly. If there is one moment in my life that I could not handle, that was it. I broke down. I tried to hold back tears - not from shame, but because I didn't want him to be upset from *me* being upset. Clearly he had enough problems. I thought I would have no problem coming to terms with what I'd see, but once I saw him - I shook, I broke. On the other side of things... I was weirdly okay. Except that my mom would be going through this again. Fifteen years ago, she saw my dad the same way I did. In a couple of days, it would be my turn to do it to her. That made me feel pretty lousy. I know, it's silly to feel guilty for this, but I'm not sure I'd call it guilt, either. But I couldn't help thinking that if I'd only exercise a bit more, ate a little bit better, talked to a doctor more often, I might have avoided putting my wife and parents through this. At this point, there was no way out, though. A couple of days go by, waiting for schedules to resolve for the three possible surgeons and two potential facilites, and it's finally determined that Dr. Coletta would be doing open heart surgery on me Monday, September 21. More to come. Of CABGs and Kin part 1You'll forgive me a bit if I get a bit more personal here than I normally do. I want this to be clearly about human beings (not just me), and not abstractions. Names will be named. Don't worry, I'll go back to linking to ethnic musicians doing pop songs on Youtube soon enough. But right now? Things have been re-prioritized for me. Going back just over a week, to Thursday September 17, I had an early morning doctor's appointment (which works out to late night for me - I'd just gotten off of work). It was to be my first time seeing Dr. Lunde, and I expected to get a reasonably standard outcome: "Eat better, exercise more, here's a prescription, now go home." Dr. Lunde did something entirely unexpected. He listened to everything I said, including my family history. He put it all together. He explained that if I didn't have my family background, he wouldn't have been terribly concerned, but as it was he was prompted to give me an EKG test, and found something interesting on it. Interesting enough to call an ambulance to bring me to the hospital, apparently. The sirens I heard outside, which I had discounted as Hillcrest local color, were there for me. Even as the half dozen-ish EMTs were around me on the exam table, getting ready to move me to the gurney, I was kind of denying this could all be for me. I felt fine! As they had trouble maneuvering the gurney through the doorway to get alongside the exam table I was perched on, I said, "Um, I can walk, if it helps..." "You sure?" "Uh.. Yeah, I feel fine... I'm not really sure what all this is about..." During the ambulance ride, I tried getting more info out of the EMT. I still didn't understand what all the fuss was about. I asked, "Is it really this big a deal?" "Well, it's better to do this now than CPR later." Couldn't fault the logic. I was brought to the ER (a couple of blocks away, by my approximation; I could easily have walked it, I thought). They began running tests. Started with the fairly standard (blood pressure and temperature), doing another EKG, some kind of ultrasound (I really wish I'd gotten a recording of my heartbeat - I mean, it's not like I'd never heard a heartbeat before, but the sound on this thing was amazing and full. I wanted to remix it. The syncopation in in that I was digging may have been part of the problem, though) and some waiting around. With tube and wires attached. It was becoming more and more clear that what I had expected to be a simple 1/2 hour doctor's appointment would be expanding into something else. Since it had been a couple of hours now since I'd left home, I figured I should probably let my wife know something else was going on. I'm pretty sure there is something wrong with starting any phone call with, "I'm okay, but...", though I really couldn't think of a better way. I tried to calmly explain to Cyndi that I'm feeling fine, but they have me in the hospital, hooked up to machines, feeling fine, running a variety of tests, and feeling fine. At this point, it's probably a good idea to explain why it's kinda silly for me to be downplaying this as much as I have been, and talk a bit about that family history I mentioned earlier. See, my dad's family has a very strong tendency toward heart problems stemming from high cholesterol. Okay, "tendency" is probably a tad weak for my purposes. My uncle Eddie died of a heart attack at 37 years old. My aunt Beth, who used to babysit for me when I was much shorter and was a mother of two, wasn't much older than that when she was taken. Another aunt survived a heart attack at 27. Fifteen years ago, my dad had a six way bypass at 45 years of age (I didn't realized there were six ways to pass). Out of nine sibling, seven have had some combination of cardiac bypass surgery or heart attack. I am 35. Thirty five years old. 5'7", 155 lbs. Relatively young, not apparently overweight. Not someone you would immediately identify as someone who ought to have open heart surgery, but no Olympic athlete either. But I knew it was coming; that's why I was going to the doctor - pretty much because of my wife's persistent insistence, as well as Amanda's concerns based on her personal story. So I find myself attached to a variety of machines, running tests whose results are being interpreted, fortunately for me, by some pretty smart people. Smart enough to see results in one test, and decide that doing the stress test (making me run a treadmill with the tubes and wires attached to show how all my stuff reacts to the situation) wouldn't give clear enough results, and they'd be better off skipping it and going to an angiogram. Getting the angiogram was not the first time this day that sparked me to think how fucking cool science is. It was, however, the beginning of me giving up on modesty and decorum. After doing a singalong of Alice's Restaurant (seriously) with Aaron (much to the (I am sure) delight (and completely not annoyance) of a clean-room full of his co-worker medical types), they began the actual test. Well, after getting trimmed to allow a very narrow tube into my right groin, that would travel up my torso and to my heart - which would then have its nearly unsettlingly clear image put onto a screen in real time. That was pretty neat. This begins the choruses of, "keep your head down." I just wanted to see what was going on, but apparently they don't think it's a good idea for me to lift my head. More on that later. After this procedure, I am shown video of my heart, and very specifically where three arteries around it are not quite allowing blood to flow, and one has completely shut down. Fortunately, that one that was completely blocked had managed to grow its own tributary or something and formed a natural bypass. Short form? I'd need coronary artery bypass graft surgery. More to come.
Healthcare Musings(Opinions expressed do not represent those of my employer or anyone but me. Sometimes not even me - I'm still trying to understand this myself.) The problem is primarily one of reportage, exasperated by attention whoring.
The story becomes about the knuckleheads at the townhall meetings who start yelling, rather than any actual concerns they might have. Attention focuses on the guy carrying a gun rather than the message. Anything real gets lost, the story is now about methods. The two main concerns regarding this issue have come about from misinterpretations of the bill(s): There are no death panels, and illegal aliens won't get free health care. No, I have not read the entire bill(s), nor have you (you can find it here http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf though). Thousands of pages each, several versions, several drafts. Many lies regarding them (Page 425 begins the section that Betsy McCaughey and Sarah Palin liked to present as the Death Panels. Really it's about enforcement of the patient's own choices regarding living wills and other end-of-life issues). Congressfolks claiming to have eliminated passages that were never there. Yelling and noise. How will it get paid for? Don't know. People are busy debating misinformation and being disruptive when they could be clarifying misunderstandings or presenting concerns to their representatives. From a capitalist perspective, universal healthcare would be very good for small businesses. If an owner of a small business needs a bit of help, there are wage minimums that may make it prohibitive to hire a worker even part-time (one more person out of work, one more business weakened). Assuming that business owner can budget payroll, odds are she won't be able to pay for health insurance as well. The employee in this case clearly cannot afford it on his own. Since the employee can't pay for healthcare and needs the income, he will work when he really should not, lowering productivity, spreading germs, costing the business more money (and long-term income with potential loss of customers). Government assisted health care would help alleviate that. More and stronger small businesses would make for a more stable economy. Why don't we hear an outcry like this when public funds go to support a private entertainment business (if a stadium is so great for the local businesses, shouldn't they be investing it it themselves?)? How about the communist aspects of eminent domain and its abuses (as far as I'm concerned, that's most if not all uses of it)? But if someone is broke and needs some help with their own physical well being, it's all WHARRGARBL!! Why health and not housing, food, and fuel? Ideally, this would mean fewer people on other government programs. Reality? No idea. Is it open to abuses? Probably. How will it be paid for? I'd like to know. Summary Rejected: Approved: Previously mostly against but find myself accepting more and more:
This dramatic recreation... with the implicit threat that you may be in danger from cardboard cutouts. Ever get the idea that some "journalism" is based on a dare? Keep an eye on those shipping cartons.
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