This morning I watched pine cones pretending to be autumn leaves. They did their best parachute impersonation. Splat, crunch.
The morning light was a wan yellow haze. Glow permeated everything, even reflecting off the ever-browning leaves. No rain this month has left the air filled with dust and debris from autumn detritus. Milkweed and cattails have spilled their guts to the air.
Three weeks ago, I came home from the hospital. This time it was a short visit; only four days. Congestive heart failure caught up to me at last. My grandfather died from congestive heart failure not long after Mt. St. Helens blew up. I remember reading the National Geographic issue with the eruption as the lead story. Timing is everything. I was heading into fourth grade that fall. After his last call to my mom, he had explained that there was ash falling in Wyoming... miles and miles from Washington where the eruption occurred. As a kid, that seemed impossible. Bit by bit, as I watched the news and saw whole towns where day was turned to night by falling volcanic ash, I came to realize how enormous this eruption was. And then my grandfather died.
We never had all the talks we were meant to have. Only the brief talks kids have when they know there will be more time later on.
Six weeks ago my nephew Jack was murdered by the police on the road that led to where my grandfather had lived, and where recently Jack had lived too. Off the grid. Off the beaten path. Jack had been stopped for an outstanding warrant, but when he came out of his vehicle with a gun, he was killed. No judge or jury.
I learned about Jack's death from another cousin in Montana who I hadn't heard from in years. A few days later, I heard from David Hall, eldest son of my uncle Ed Hall. The last time I saw David I had just gotten married for the first time and was on my honeymoon road trip across the country. I think David was probably in high school. His call was a huge surprise. He and I talked about family stuff that we should have talked about over the last thirty years.... but we hadn't had those conversations. Timing is everything.
David told me about his younger brother Benjamin having had a heart transplant the same day that Jack was killed. Timing. Oy.
We talked about how David had experienced a heart attack when he was in his twenties. Ben had lived with an LVAD device until his heart replacement. My mother has congestive heart failure too. We all inherited it from my grandfather.
When I was in the hospital emergency room, my brain was on full alert. I hate our local hospital. They nearly killed me 13 years ago. This in the same hospital that kept me in a coma for 6 weeks waiting for me to die nearly every day. Going back to the ER was difficult. I had chest pain and trouble breathing. I had been told by my asthma doctors a few months ago that I just needed different asthma meds and my breathing would get easier. When I called the doctor that Thursday, they prescribed more medications. By Friday morning, the doctor's office called and said I should go to the emergency room. I spent the day trying to understand why I needed to spend hours and hours in the ER. What was wrong? They just kept telling me to go to the hospital. I finally relented at 3pm.
Over the next 9 hours, I would go from struggling to catch my breath after walking across the parking lot, to barely being able to breathe at all. My blood pressure sky rocketed. My anxiety and PTSD exploded in my chest. Leto was kind enough to join me in the ER. I was completely unable to get my panic under control. After the first eight hours of waiting to be examined, I finally was able to meet with a doctor to discuss my bloodwork, x-rays and EKG. He explained very gently that the x-rays showed dentritic formations, so they had been able to rule out pneumonia. He had asked that Lasix (a diuretic) be given. He was working under the impression that something was very wrong with my heart. The last time I had been in this hospital, thirteen years ago, I had been tachycardic for a few seconds while my body was septic after the anastamosis had failed and I was becoming septic.
The ER doctor finally said the words: congestive heart failure or cardiovascular disease.
Knowing that my mother had lived with congestive heart failure for the last thirty years, I figured it wasn't an emergency. As the doctor continued talking about the various tests that needed to be run, I asked if I should just go home and schedule these tests for another time. The ER doc was a fairly tall fellow. He stretched back on the examination stool, and looked at me. He adjusted his mask, cleared his throat and explained that if I went home, I would likely die.
Timing is everything.
Panic washed over me like a tsunami. After the doctor left the exam room, Leto resumed playing Robin Williams on YouTube over our phone. The ICU department brought down the big black standing fan so I could have moving air in the closed space. As soon as I saw the fan, I broke down. Tears streamed down my face. It was like seeing an old friend. That fan, that EXACT fan, had gotten me through the worst of my coma and my subsequent recovery. That fan had been my best friend while I sweated my way through pneumonia for over a week with a 104 fever, and had needed my trach tube suctioned every five minutes as it clogged with phlegm. The hospital allowed me to bring the big fan with me when I left the ICU and moved to rehab. It was my constant friend in the hospital. And here it was again!
As the night dragged into the next day, I was assigned a room upstairs. The staff moved me from the ER into my own room and they brought the fan up too. By now, I had been in the hospital nearly twelve hours and it was nearly dawn. I met the night nursing staff. They patiently set me up for the night, explaining about how my urine output would be measured due to the Lasix, and how blood would be drawn again at 5am. With the fan pouring over me, and the air conditioning on high, I slept for a few hours while Leto snored in the bed beside me. Yes, they let Leto stay in the room. I think they figured out early on that I would have someone by my side until I left the hospital.
Over the next three and a half days, I would have a dozen blood draws, six different nurses and six different aides, six different hospitalists, two cardiologists... and finally a trip to the cath lab. The catheterization was why I had needed to stay in the hospital over the weekend. Rural hospitals dont do catheterizations on the weekend. No staffing. They couldn't even do an echocardiogram.
Monday morning, 7am, I was wheeled down the dark hall towards the ICU and the cath lab. I thought I had forgotten that hall. Nope. It was just as horrifying as the last time I had been wheeled down that hall.
As I laid in the prep room, and my arm and groin were shaved in preparation for the catheterization procedure, the cath nurse started explaining the procedure. What they could and couldn't do at this hospital. Since they didn't have a heart surgeon on staff, there was not a ton they could do if I had complicated blocked arteries. Leto asked what would happen if they discovered complications... and she said that I would be flown to Rochester to Strong Memorial. I nearly shit myself. We were no longer okay. Everything spun. My heart rate went through the roof. I think my blood pressure might have doubled. I remember being given some Valium.
I was surprised when the echocardiogram started. I didnt realize they would do it in the prep room. After fifteen minutes of trying to get a good image of my heart, they gave me a dose of contrast agent. The tech performing the echo was quick, efficient and patient. She said something about my ejection fraction but the rushing in my ears kept me from understanding. Next thing I knew, I was being wheeled into the catheterization theater. Operating theaters are awful places. Especially if you are laying on your back. You are one step away from the abattoir. The room was chilled down to about 60F and I was suddenly much more awake than the Valium should have allowed for. They started to transfer me from the gurney to the exam table, and I asked if I could just get up and walk over to the table myself. All of a sudden, they realized I was fully capable of moving myself into position. The cath lab nurse and I continued to talk about chai, yes chai tea. We had been talking about where to get good cardamon seeds for chai.
One of the things they had told me before my procedure was if they needed to put a stent into my arteries I would be spending the night in the ICU. If that wasn't necessary, I would be returned to my room and would go home the following day.
Before I knew it, I was being cleaned up and wheeled back to my room. Apparently my arteries were clear as a bell and big enough to drive a truck through. My ejection fraction though. They kept using that phrase.
Later on Monday afternoon, I got my first visit from the three cardiologists. One was the ghost of Christmas past, one was the ghost of Christmas future, and the other remembered I was a Jew and don't celebrate Christmas or believe in ghosts. The first cardiologist said that I could go home tomorrow, Tuesday. The second cardiologist said so many things, but her favorite word was "mortality". If it had been a drinking game, I would have been laid flat on the floor with the number of times she said: mortality. Then she explained all the new drugs. They had stupid names. Like names of designer clothes or perfumes. Made up fancy names. Then I met my "new" cardiologist.
My new cardiologist looked at me and started right in with saying the same things that everyone else had said. Arteries clear but ejection fraction below 35%. He said I would be going home the following day with follow up, blah blah blah. I asked if I could resume my normal activities. He said something about avoiding typing for a few days to keep the wrist area where they had inserted the catheterization device from having any issues. I asked if I could work in the garden. This would be the first of our many misunderstandings.
He thought I meant pick a few berries or zucchini. I explained that we move multiple wheelbarrow loads of compost every day. We plant dozens of plants every single day. He said something about how we were actually farming. Leto and I both laughed... oh, no. We are definitely gardeners. We started explaining about how we garden for our critters and birds. He was very confused at this point. We explained that we have multiple ravens who fly overhead each day to check on what we're doing. He immediately said that there were no ravens in our area, they only fly singly, and what we saw were crows. I laughed and explained how we had watched these ravens for three years, knew them by their calls and he kept interrupting to say that he was sure they were crows. Finally, Leto sat up in bed and said "what black bird in North America has the wingspan of a red tail hawk and a beak over three inches long and croaks?" The cardiologist said "who are you?" Leto explained their relationship and then explained that they were an animal behaviorist. They went on to explain their research into the behavior of cichlids from the African Rift lakes that they had researched at Reed College. Needless to say, the cardiologist finally acquiesced.
On Tuesday, the let me walk out of the hospital. No wheelchair, no supervision. I explained that I drove stick shift. They suggested I take it easy on the drive home. Yeah... impeccable timing.
So here I am three weeks later, having seen the cardiologist yesterday. I have appointments for more tests and another echocardiogram in two months. In the meantime, I will be outside at every opportunity, conversing with our resident ravens. Moving wheelbarrow loads of compost and woodchips. And having conversations with my grandfather in my head.
No comments:
Post a Comment