Communion Of Dreams


Happy (re)Birthday to me …

A year ago yesterday, I met my cardiologist for the first time. After looking over the results of my stress echo-cardiogram and discussing what it possibly meant with me, he said that I needed to have a cardiac cath procedure sooner rather than later. Since he’s one of the premier heart surgeons in the mid-west, and always in demand, I expected that this meant I’d get put on a waiting list and have it done sometime in the next month or so when there was an opening in his schedule.

I nodded. “OK, when?”

He looked down at my chart, then back at me.  “What are you doing tomorrow?”

Good thing I don’t panic easily.

* * *

Well, as I recounted a few days later, the procedure went smoothly, though longer than usual, with the end result that I had a couple of stents placed to correct a congenital heart defect. It took a while for all the ramifications of what I had lived with, and what it meant to have it corrected, to really sink in. Part of that was coming to full understanding of just how close to death I had come, because even the slightest amount of atherosclerosis, even the tiniest little blood clot, would have triggered a massive heart attack.

But now it’s been a year. I saw the cardiologist several times over that year, most recently a few weeks ago. And, basically, I’m now past it all. I’m no longer taking any blood thinners, I don’t need to take any real precautions, I only need to check in with the cardiologist once a year or if I notice a problem. If I’m smart, I’ll continue to get regular exercise (I now walk three miles each morning, and get in plenty of additional exercise doing yard work and such) and be a little careful about my diet, but those are things which any man my age should probably do.

So, basically, today’s the first anniversary of my rebirth.

And it feels good.

 

Jim Downey

 

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Everyday miracles.

This is a follow-up to my previous post.

I just sent the following message to my primary care doctor:

Dr M,

I wanted to take a moment and thank you. Your recommendation that I take an echo stress test likely saved my life.

You’ll probably get the cardiac cath results from Dr W, but it may not include an observation he made when he first examined me: that had I come to his practice for a routine exam, presenting the same symptoms I told you, he probably would not have suspected such a serious condition. But the echo stress test clearly demonstrated that there was a major problem. And that the cath procedure showed just how bad it was: 95-99% blockage in the lower part of my RCA.

The seriousness of that condition was masked by my overall/otherwise heart strength. But it could have *very* easily resulted in a serious M.I. or even death. Had you not picked up on the subtle indications we discussed, and taken the prudent step of recommending the echo stress test, my true heart condition may not have been discovered until it was far too late.

So, thank you. Your intelligence, education, and experience probably have added decades to my life.

Why am I sharing this?

Because I got extremely lucky. And I want others to benefit from that luck, and my experience, if possible.

As it turns out, the overall condition of my heart is remarkably good. The strength and efficiency of that muscle is at the very top range for normal healthy people, or at the lower end you’d find in a serious athlete. Furthermore, there are no other indications of atherosclerosis or plaque build-up.

However, due to either a genetic or developmental defect, the lower part of my RCA is badly kinked/convoluted, creating a situation where eddies in the blood circulation form, and allowing what plaque I do have in my system to accumulate, like a sandbar will develop as a result of a bend in a river. In my case, that accumulation had progressed to the point where just the slightest additional clump of plaque could have closed off the artery completely, allowing a part of my heart to die. That’s a classic heart attack, folks.

But the strength of my heart overall was such that it almost completely masked the condition of my RCA. It wasn’t until I was up to about 90% of my heart rate maximum while taking the stress test that indications of the problem surfaced. And even then, just how bad the situation was wasn’t fully known until the cath procedure was done. But when the cardiologist went in and directly observed the condition of my coronary arteries, he saw the problem. And with about 90 minutes of hard work, corrected it with a couple of long cardiac stents.

That was just three days ago. I actually left the hospital the next morning, and have been playing catch-up on things since then.

Think about that: for 90 minutes, a team of medical professionals were playing roto-rooter with the inside of a major artery of my heart. I was completely awake and unsedated through the whole thing. The next day I left the hospital, walking on my own without difficulty. This morning I got in my usual morning walk of a mile. For about another week I have to take it a little easy, to let the puncture site in my femoral artery completely heal, and for the next year I need to take blood thinners, but otherwise I don’t need extraordinary care.

That’s pretty miraculous, in my opinion. One of the everyday miracles which surround us, and which we seldom give due consideration. Stuff that not too long ago would have been considered science fiction.

Anyway, here’s my advice, though you’ve heard it before: pay attention to your body. Don’t succumb to toxic masculinity. Or, if you’re a woman, to the illusion that you’re immune. If you think that something is going on, get it checked out. A little embarrassment at being wrong beats dying.

 

Jim Downey



Shorter of breath, and one day closer to death.*

“Well, I’d hate for you to have a heart attack,” said my doctor. She was standing against the wall in the small exam room, arms folded in a classic body language message of being skeptical about what I had just said.

* * * * * * *

I wrote this in September 2007:

And as I stood there at the sink, washing the dishes, thinking favorably on the option of having a heart attack, it sunk in that I was done. I mean, I’d been considering that a heart attack might be the best solution to my problems. Yeah, a heart attack. Hell, at 49, I’d probably survive it. It’d come as no surprise to anyone, given the kind of physiological and psychological stress I’m under. No one could blame me for no longer being a care-provider for someone with Alzheimer’s. Hey, it might even get someone to think about noticing my writing, since a tragic character (whether alive or dead) always gets more notice as an artist than does someone who has their life, and their shit, together.

That was a few months before our care-giving journey ended, and Martha Sr passed away. For those who don’t know the story, I was able to re-center, and continue with my role as a care-provider the next day. The following year was spent recovering from the stresses of that role, and getting my shit back together. Because in spite of the perspective indicated in the final sentence of the passage above, my hold on things wasn’t nearly as solid as I thought at the time.

Such is often the case. I think it’s a defense mechanism, with more than a little toxic-masculinity.

* * * * * * *

Did I say toxic-masculinity? Why yes, I did. Such as in this timely article:

Men, in short, are less likely to seek preventive care than women and more likely to put off seeing a doctor when in need of medical care. They also prefer to seek out male doctors, but they tend to underreport pain and injuries to male doctors, thereby compromising the chances of receiving optimal care. And all of this, it should be said, is particularly true among those men who prescribe to masculine ideologies.

“Masculine men tend to not go to the doctor, and when they do, they tend to pick male doctors whom they then underreport their ailments to,” Sanchez said.

* * * * * * *

We recently had a change in our financial situation, thanks to the sale of some property we owned. That, combined with the protections of the ACA which mean you can’t be as easily penalized for a pre-existing condition, made it a lot easier for me to make the decision to having something checked by my doctor.

Howso? Well, our income has never been huge. In fact, it’s always been pretty modest, though in recent years it has gotten better and become more stable. But still, if I had something turn up which required me to miss a significant period of work, or which came with a large insurance co-pay for treatment, we would have lost what progress we had made. And not having to worry about having a documented ‘serious health issue’ mess up my insurance coverage in the future is a huge relief.

In other words, I’m financially stable enough to get sick. Hell of a system, isn’t it?

* * * * * * *

“Well, I’d hate for you to have a heart attack,” said my doctor. She was standing against the wall in the small exam room, arms folded in a classic body language message of being skeptical about what I had just said.

Which was that I was reluctant to go see any medical specialist, since the way the system works it’s almost guaranteed that they would find something which needed ‘treatment’. After all, none of us are walking perfect models of health. And, as the old adage goes, never ask a barber if you need a haircut.

But I nodded my head, sitting there on the exam table.  I had my shirt back on after they had done the in-office EKG, which showed that everything at present was OK, but that there were possible indications of problems in the recent past. And the very mild symptoms I had recently were possibly indicative of a coronary arterial blockage, and it runs in my family on my father’s side. “Yeah, me too. OK, go ahead and book me for a stress test.”

She nodded, we chatted some more, and she left.

I had the stress test last Friday. Got the call with the results yesterday.

No complete blockages. But some constrictions which need to be addressed. So yeah, sometime soon I’ll be seeing a cardiologist, and we’ll discuss options from there.

It’s not good news. But it’s not horrid news. After all, this is one of the most common medical problems around the world. So we’ll see what happens.

But I’m glad that I’m lucky enough to be in a position to have it found, treated (to whatever extent possible), and not worry about it completely ruining our financial situation. And I’m also glad that I’m not quite macho enough to think that I should ignore the classic symptoms, as mild as they were.

 

Jim Downey

*Of course.

PS: if you feel the need to post a political comment related to the ACA … don’t. I’ll just delete it.