Saturday

Kaitlyn In Waders; Kaitlyn the Diplomat

Two visits by Kaitlyn covered on this post.

It was the visit in early June of 2008 that taught me that Kaitlyn was a diplomat good enough to rival the best in the U.S. State Department.


Pic of the Day
Siamese norther pike




 Posted by Hello


Kaitlyn Visit 4/25/08 -Kaitlyn Sees First Non-Animated Movie

The movie was "Nim's Island" and the review for it as well as "Kung Fu Panda" is HERE .

The weather was nice in late April 2008 but it was not time for the beach. Kaitlyn and I visited our favorite dollar store and went to a movie.

Below some pics from the visit and below this, a short movie of Kaitlyn showing off fine head attire in the Dollar store.

Kaitlyn montage 4/28/08


Kaitlyn montage 4/25/08




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Kaitlyn Visit 6/11/08-Kaitlyn As Diplomat

On this most recent visit by beloved granddaughter Kaitlyn Mae, I once again took advantage of a most delightful form of entertainment available right here in the swamps of Delaware.

I am a member of the Delaware Nature Society. This is an organization that I belong to mostly by my affiliation with the National Wildlife Federation in my position as a Backyard Wildlife Steward. So it's not like I joined the Delaware Nature Society specifically but through my roundabout membership, I chanced across the best form of entertainment for children Kaitlyn's age which is also educational and the best deal in town.

Here's the link to the Delaware Nature Society and here's the link to Abbotts Mill Nature Center , which Kaitlyn visited on this visit in early June in this Year of our Lord 2008.

I'd signed up for one of the "classes" offered for 4-6 year olds at Abbotts Mill before. At the time I was unsure how this would unfold but the session only cost $7.00 and was to last for an hour and a half.

At that time Kaitlyn and I were the only ones who showed up for the scheduled class but I was positively thrilled at both the beautiful locale and the nature lessons taught.

This was in 2006 and the day was ungodly hot. Still I had paid my $7.00 in advance and I do tend to keep an eye out for forms of entertainment that Kaitlyn and I both enjoy. I could not believe how beautiful Abbotts Mill was. Plus it's been modified to allow human access to all its beauty but without compromising the eco-system of the bugs and critters living happily in this beautiful piece of our planet.

There are three such "nature centers" managed by the DNS. As I understand it, the land was left to the DNS and they are run by dedicated employees trained to teach as well as maintaining the centers for visitors.

Even though it was just Kaitlyn and I during that first nature session in 2006, it was perhaps the best seven bucks I ever spent. Kaitlyn got one-on-one tutoring from a delightful lady who was patient and enthusiastic with her subject and her student. Kaitlyn had a wonderful visit and she was eager to hear that again we would be visiting Abbotts Mill for a session designed to teach the children how to catch critters with nets.

A few other children attended this session but still it's sad as all get out. Abbotts Mill is but about 25 miles from the famous beaches of Rehoboth Delaware and what a great afternoon it would be for young tourists in the summer. I get a nice booklet from the DNS with all the upcoming sessions, by age and locale, listed with dates and times. This method of pushing the nature sessions works for Delaware residents but a great big tourist industry is left off of the publicity scheme.

Which is, frankly, okay with me because Kaitlyn adores these sessions and the small classes delight me. It's the best money I could spend, penny for penny.

At this class, Kaitlyn donned waders, yes she did...those "boot pants" fishermen wear in the water. Yes Abbotts Mill had these things to fit a four year old.

Below some pics of Kaitlyn and below this, a movie made at Abbotts Mill, including Kaitlyn in her smashing waders as she roams the streams and creeks searching for critters.

Pic of Kaitlyn with PO from Kung Fu Panda


Kaitlyn montage at Abbott's Mill 6/11/08




Besides our visit to Abbotts Mill, Kaitlyn and I went to see "Kung Fu Panda" and afterward, as I like to do, we went to Route 1's famous McDonald's Playland.

Kaitlyn loves McDonald's Playland, what 4 year old does not? I usually take a book and I order up a kid's meal for Kaitlyn and a sandwich for me. Kaitlyn takes off her shoes in the playland area and has a great time running around on all the playground equipment with the many other kids in attendance. I can read, eat and keep an eye on Kaitlyn.

Kaitlyn is, of course, very busy with her playing and running, so needed after sitting at the movies for almost two hours. But she stops by the table to eat some French fries from the kid's meal and to keep me apprised of what kid she's playing with and how awful the boys are.

On this visit to McDonald's playland, Kaitlyn said something I found intriguing and, oddly, beyond Kaitlyn's maturity as I would see it.

"That girl over there she's fun," Kaitlyn told me between bites of fries and sips from her apple juice. I'd noted she was playing with one little girl and they seemed to be getting along quite well.

"She asked me if I would be her "best friend forever"",...or BFF in cell phone text talk. "Since she's nice I told her I would be but ...you know...," Kaitlyn told me, with a shrug.

I was surprised, first, that Kaitlyn seemed familiar with the term "best friend forever", a kind of childish phrase used between young girls and two, Kaitlyn was telling me, withOUT specifically telling me, that she only told the girl she'd be her best friend forever to be nice, that Kaitlyn was not so naïve to believe she'd likely ever see the girl again. I told Kaitlyn how proud I was of her and how nice that was to pledge to be her best friend forever even though she knew that was highly unlikely.

Kaitlyn looked at me quite seriously and said, "Well, I'm nice." She said it firmly as the truth that it is and seemed to be surprised that I didn't know that Kaitlyn is...well, nice.

She sure is nice and I'm glad she knows it. Four years old and a Diplomat to rival any in the United States State Department.

Heh.

More Kaitlyn posts HERE

Friday

Movie Reviews-"Nim's Island" and "Kung Fu Panda"

Both are movies involving the weaker as they strive to become stronger. One has a little girl trying to save her island and the other involves an overweight panda trying to save his land.

"Kung Fu Panda" is a Dreamworks animated movie that challenges the imagination and "Nim's Island" is a charmer. Both movies are geared to children but this adult enjoyed them as well.


Pic of the Day
Bedroom in a Box


Bedroom in a box...click on this link HERE to see it put together live.



Movie review header


”Nim’s Island”

From IMDB.com:

Plot:A young girl inhabits an isolated island with her scientist father and communicates with a reclusive author of the novel she's reading.


The short synopsis above is true enough. What follows is a fast-paced yet sweet story of a young girl and her desperate, sometimes funny, attempts to save her beloved island and namesake.

Nim’s father is lost at sea while Nim manages to contact the author of her favorite action hero book.

Said author of Nim’s heroic dreams, played by Jodie Foster, turns out to be a reclusive writer with a full-blown fear of the outdoors. Nim’s pleas for help spur the author to find Nim’s island and help the young girl in her time of need.

Nim's Island montage


The movie takes on two story lines. One has young Nim trying to scare off tourists and other riff-raff who would besmirch her paradise.

The other story line is the story of the frightened and mildly obsessed Jodie Foster character, Alexandra Rover, as she makes her way across the planet to find Nim’s island and help Nim with the invaders and help her find her father.

There’s also a hint of a love story as Nim’s father finally is rescued, by a pelican no less.

This is a fun movie very suitable for little kids. Kaitlyn Mae, at a tender age of four years, sat through the entire hour and a half, mostly quietly and happily.
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”Kung Fu Panda”

IMDB link for “Kung Fu Panda”/

We begin with a cute pic of Kaitlyn Mae posing by a giant icon of this movie’s hero, Po, the magnificent Kung Fu Panda who saves all the citizens of the Valley of Peace.

Pic of Kaitlyn with PO from Kung Fu Panda


So okay, nobody does animation much better than Dreamworks. For the animation in “Kung Fu Panda” was mesmerizing. The images were large, colorful, loud and impossible for even a four year old NOT to sit quietly and regard with amazement for the hour and a half length of the movie.

The story behind “Kung Fu Panda” was a bit difficult to comprehend although in due course the plot unfolded.

Kung Fu panda pic


An ageing turtle is charged with appointing the next Kung Fu Master. The turtle has fine and already trained choices from a group called the Furious Five, all taught the mastery of Kung Fu by Master Shifu, a little guy who once taught the dangerous snow leopard Tai Lung. Tai Lung turned out to be evil and had to be locked away for the safety of the citizens of Valley of the Peace.

The members of the Furious Five are a curious lot, products of a fertile mind that could create this hypnotizing tale. A tiger, a monkey, a praying mantis, a snake and some kind of bird are all members of the Furious Five trained by Master Shifu. But the wise turtle, due to a strange series of coincidences, appoints an overweight panda as the next Kung Fu Master that will save the Valley of Peace.

It’s never made clear just why Po, the panda, has a father that is a duck but that’s just part of the charm of this nonsensical yet logical tale of he who learned to believe in himself causing a hero to be born and a villain to be defeated.

I guarantee that kids of all ages will love this movie. It has that kind of enchanting and imaginative aura about all aspects from animation to plot to the dialogue.

FOCUS ON MOVIES
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"Brokeback Mountain" was heavily hyped as a homosexual film. Which it was. I found the relationship with one of the film's protagonists and his daughter to be more revealing about the character than any same-sex relationship depicted.

Tom Cruise's love is featured in "First Daughter", a film about, well, a first daughter. Only totally not believable.

"Chicken Little" is an animated film about, well something about a sky falling. Kaitlyn Mae watched this movie six times in one weekend. Read why this movie appeals to children so.

This post features reviews of BOTH "Poseidon" movies. The best one chosen might surprise.

He was born a rat but he wanted to be a chef. Here's a review of a charming animated film that will capture the imagination of both your children and ...YOU! Ratatouille

Thursday

Loving My Heart-The Recovery is Worse Than the Surgery

Loving My Heart Header


While the medicos bombard patients with all sorts of information BEFORE they go into the hospital and of course while they are IN the hospital, it was after I was sent home with wounds all over my body that I realized how very little about the turmoil and tribulations of my recovery to come.

Here, in this final chapter in the tale of an ordinary woman's life turned upside down from the sudden diagnosis of a very distressed heart (with links to the first three parts of the story) I compose my own personal list about recovering from open heart surgery, all while it is fresh in my memory and even as my wounds hurt still from just a whisper of air upon them.

First thing, find every piece of clothes with buttons down the front and start from there. Read the rest in the post.


Pic of the Day
montage of origami folded dollar bills




Recovery...It's Worse Than the Operation

This will probably be my last post in the "Loving My Heart" series for a while. I've pretty much documented my experience in having a quadruple coronary heart bypass surgery, from symptom onset to diagnosis
through to the operation. This particular part of the tale is, frankly, the most helpful part of the whole thing in that I am going to document the minefield of recovering from such an operation. For when I left that hospital, besides a long discussion with Adreinne the charge nurse which was, helpful in a fashion, I had no idea what pain I would face, the perils of a normal cough, how much I should move about, how to best sleep for comfort and other recovery issues.

Beyond my personal tale, I have sure learned about America's health care system and this might surprise the hell out of yon reader, but I have formed some opinions about same.

While I was in pain during my three days in the hospital after my quadruple heart bypass surgery, it wasn't near as noticeable as the day I came home and the several weeks afterward. First, I had plenty of nursing personnel bringing me drinks as requested and pain pills were practically for free. Plus there was that happening hospital bed which went up and down with a touch, the La-Z-boy type chair by the bedside, the TV which moved anywhere, at any angle, with just a pull on the handle. Meals were delivered directly to my room, all hot and ready to eat.

The first night I came home, as happy as I was and with Darvocet allowed every four hours as required, I soon learned the horrible pain that a slim piece of material can cause as it innocently rests upon a surgical wound.

Sure, I donned a nice caftan type of attire that first day. I figured it was big, billowy, allowed me modesty but could be lifted easily for bathroom duties and could wrap close around my torso and legs should a chill descend.

The cloth resting upon my surgical wound caused the thing to get irritated beyond anything necessary. It was a pain I could have avoided had I only known.

It took me a day or so to realize that the best thing to do with that five inch chest wound was to expose it to air as often as feasible. Or course there are many caveats for such an action. Obviously it can't be too chilly or such an action would possibly cause a chest cold, something a recovering heart patient definitely does not want. It's also a lot easier to open that wound to air when one is wearing a shirt, blouse or dress that allows for the top part to be buttoned and unbuttoned as required. A zipper would work too. Also common sense would require some sort of lap cover that could easily be lifted up and over the wound should it get chilly.

In other words, forget any kind of shirt that can't be unbuttoned around and over that chest wound. The light weight of the material resting on that wound feels like a manhole cover rests upon your chest and with enough movement, the cloth will soon irritate that sensitive skin.

This was open heart surgery lesson 101 for me and once I figured this out, life became a bit happier.

Another warning to those recovering from open heart surgery that would serve patients well is that females will likely not be wearing bras for some time. Which was no problem for me as I am not big-busted but those who are uncomfortable with the notion of letting it all hang out should be prepared, mentally at least. Recovery takes time and it will take all the time it wants. There's plenty a patient can do to speed recovery along, make no mistake. But some things just ARE. Big slices in a person's chest take time to heal. The healing is uncomfortable and painful. But heal it will. I just wish someone had written down these things to expect for me. So I shall do it for a future patient recovering from this drastic surgery.

quaker shedds light montage


Now let's talk about hemorrhoids. If you've had one, or deal with them, then nothing will bring that nasty problem to life again like a body all discombobulated by a huge surgery and new drugs taken in the aftermath that also skew a body's former rhythm.

Indeed the last time I had issues with hemorrhoids was over ten years ago, when I was but 45 years of age. At that time I had a horrible occurrence of this particular brand of anal horror and it took three to four weeks but I learned the joy of Preparation-H and most important of all...NEVER GET CONSTIPATED!

So yon reader would grant me the wisdom of figuring out how to get around such normal aches and pains of ageing because it's just easier to change daily habits than to constantly battle flare-ups and use medication too much when our common sense should do. Thus I learned how to avoid constipation because that annoying ailment will cause a happy hemorrhoid to sit up and sing, sending its awful pain to the poor owner and being, literally, a real pain in the ass.

My own hemorrhoid sat up and sang almost the day I came home from the hospital. In fact, as was ten years ago when I learned to deal with the matter, I was busy dealing with other things and failed to notice that annoying pain in the butt and for sure I didn't keep track of my bowel movements. In fact, like most patients after a major surgery, I tended to have small appetite so I ate little and, using logic, didn't necessarily require a regular bowel movement.

Before I knew it I was dealing with this happy hemorrhoid driving me crazy and I ask, who the hell needs this what with big wounds smack in the middle of one's chest and cuts all up and down the leg, at least in my case?

Also, in my case and as the home nurse informs me, one of my new medications, something for Diabetes (I didn't even know I had this), has a notorious reputation for affecting easy bowel movements.

Be warned yon potential open heart surgery patient. It's enough to deal with your wounds for the surgery. Before leaving that hospital consider having a fiber-rich drink or something similar if appetite prevents proper nutrition. Consider keeping a gentle laxative on hand. Most important of all, consider life's normal biological activity and make sure that all continues to work well. Pay attention is what I'm saying here.

What to eat is also an issue I felt was not addressed when I was released from the hospital. Oh I recall hearing some vague warnings that I should cut down the fat, watch out for foods that raise cholesterol, keep the calories down. The same sort of thing you hear on some drug TV advertisements. For example, I am to understand, via the advertisement, that eating Cheerios for a month will lower my cholesterol. That sort of thing.

It's a whole new thing when opening up that home fridge and suddenly finding your entire body stopped cold with the horror of the sights before you. I saw that big tub of real butter on the center shelf. It was manufactured to be a small child's pencil box but I discovered it would easily hold four entire sticks of butter, opened and ready for use.

And boy did we use this. I am a cook who thinks butter is the foundation of life and practically no meal exists without the liberal use of butter.

I pondered what to do about the butter because surely this is a lifestyle change I should be making due to my heart issues, right? Although nobody screamed in my ear..."HEY PAT, GET RID OF THE BUTTER WHEN YOU GO HOME!!" But it seemed to me that butter was the enemy, right?

And salt! I'd always figured that salt was a bad guy. Though I am blessed with low blood pressure and really never had salt issues. In fact with all my turmoil of the heart, no one ever mentioned that salt was some sort of factor in anything. Once again, I remember those commercials advertising salt substitute and I recall others in my surround who had to decrease their salt intake for some medical reason or another. I was not a huge consumer of salt but I did make sure that my food was salted well as I cooked and on such as vegetables and more bland foods, I will sprinkle some table salt on top upon serving.

I think I am normal in terms of salt usage but once again, as one recovering from major surgery, I regarded the salt shaker as a possible harbinger of death.

First thing I bought at the grocery store, in fact, was some kind of fake salt and I was so damned proud of myself. I'd bought this item BEFORE my heart surgery so give me an attaboy for thinking a little bit ahead.

But when I chanced to mention to some hospital medico, mention with great pride may I add, that I already this great big fake shaker of salt (sung to that Jimmy Buffet tune), the lady almost jumped up in the horror.

Saltless not necessarily good


"You've got to careful with stuff like that," the lady warned me. "Sometimes it's just potassium they put in that stuff and that's worse than salt."

So the one and only big deal about my diet after heart surgery turned out to be pretty damn important. I'd argue that the example of the salt above is a good reason why hospitals and medicos should address these matters BEFORE the patient goes home.

The point being here is that I felt entirely naked in terms of what to eat, never mind if I was even able to prepare those things I SHOULD eat as I was in great pain.

Now I understand that each patient is different. Perhaps those salt issues are more important in one with high blood pressure. Perhaps butter is just fine for others. So it doesn't go over my head that any information about diet given to a heart surgery patient going home would have to be basic and very generic. Well hey, what damage might I have done liberally sprinkling my food with Potassium all over the place? Don't tell me. I don't want to know.

Finally, for the record, those Quaker treat things, coming in at only 90 calories!…are the best treat for the money and caloric intake. The Shedds low-fat spread is also a good butter replacement. Be aware that it’s a tad watery so use on whatever, sparingly.

I don't suppose it's good PR for a hospital to have to break the difficult news to a heart surgery patient happy to be going home just how long they will be in pain.

As I write this it is four weeks after my heart surgery. I STILL am in a lot of pain with my wounds. My heart, God Bless It, is working fine. Surely the fact that I no longer have that crushing chest pain that sent me to the hospital to begin with is a sign that all the medicos, surgeons, nurses and physicians' assistants fixed the heart up good and proper.

I do participate in my morning walk around the yard as I described in the first chapter of this saga. Now I only walk six circuits around my jogging track whereas before the operation I did ten circuits. A "circuit" being defined as five complete walks around and dutifully noted by a chalk mark on my deck post.

But hey, I can walk those six circuits waaaaay better than I ever could before, yes I can. I can walk that circuit almost briskly, something I could not do before my surgery when a brisk walk around the track would send me bending over with great chest pain and projectile vomiting. In fact, it's only that chest wound that causes me any problem at all as I walk my morning circuits.

Here at four weeks I still feel like I have a pole cat hanging on dearly to my chest by digging in with all four paws and all twenty claws.

I thought I'd be dancing around after two weeks.

Which has been a disappointment but husband, who makes it a point, God Bless him, to investigate all this sort of stuff, says that his research states that the wounds will take four to six weeks to heal.

Potential heart surgery patients, you have been notified.

Another recovery trait that gives me great grief is the perpetual shortness of breath. Not a single soul warned me about this little side effect of heart surgery recovery.

Although everyone had to know about the shortness of breath, a result I must suppose of lungs weakened by surgery and a machine takeover. I figure the lungs must grow strong again over the course of time.

In fact the hospital did give me some sort of breathing device thing on which I was to "practice" my breathing every day. So perhaps I am being a bit unfair with my allegations that the shortness of breath was a surprise. And yet it was.

The device I had to practice breathing with...well there's a picture below.

Breathing Tester for Heart Patients


I was up to 1900 on the measuring part of the thing BEFORE the surgery. I have no idea what 1900 is...inches, gallons, grams...what? The measurements used follow along that line...from like 500 up to the 2000. My goal was to be able to suck in air on that intake thing with such a force that the little thingie inside would rise up to that magic 1900 pre-surgery mark.

In fact I did practice this every day although so far I have only been able to get it up to 1650, a couple a hundred somethings below my 1900 pre-surgery.

Thus I offer that all this caution that I must practice my breathing, not to mention that every medico I've seen after the heart surgery has always asked me "Do you get short of breath?" as if they already know the answer.

It had never been made clear to me that I would be besotted with shortness of breath for a period now up to four weeks in time although maybe I should have figured it out.

Which is not to say, I emphasize, that my lungs are not working fine and in fact I had a chest x-ray for my follow-up visit to the heart surgeon recently, and they told me my lungs were in "excellent" shape.

I'm very proud of my lungs and I must wonder how a three pack a day smoker came to have such excellent lungs that compliments come from every medico who chanced to work with my fine self. All I hear, every day, every minute of every hour, 24/7, is that smoking will ruin your lungs. Yet my own fine self has lungs that evidently rival a lifelong non-smoker so I send out one big fat HEH to all the liars. My belief is that such as lungs are hereditary and smoking sure don't help them but all this smoking hysteria, by my own body as proof, is but, heh, a big smoke screen.

But I digress.

I did have a right nasty cough when I smoked and now I rarely utter even a nice cough. Again, I've had a slew of chest x-rays and constantly my fine lungs get compliments. Medicos tend to think such as lungs are beautiful, unlike us more normal folk who look more on the outside for beauty.

If nothing else, this post-surgery shortness of breath is proof that the lungs from my smoking days must have worked okay because I sure don't remember such as gasping for breath from a simple walk across the room.

Now to avoid accusations of exaggeration, I can now do waaaay more than I could just a week ago without shortness of breath but I know that still my lungs are not where they need to be.

But they tell me my lungs are in great shape so whoop-di-do. I just warn future recoverers from heart surgery to be prepared. It will take a while for that ubiquitous shortness of breath to go away.

Just a few other bits of advice for those who are, or who might someday be, recovering from heart surgery.

Know that your mental attitude is as important to your recovery as is your physical capability. Make sure you keep the wounds clean, dress up nicely once in a while, even if only is a big caftan. Put on some lipstick, eye shadow and bit of blush. These things can’t hurt but watch the surprise of those in your surround.

“You look great!” they’ll say because let’s face it, loose draggy clothes, a plain Jane face and scraggly hair do not a beauty make. When someone tells you look great, why you start to feel great.

Make sure that you have a variety of places to sit with a variety of things to do. If you crochet or knit, get out, or start a new project. While recovering from a huge surgery is the best time to do this sort of thing. If you read get some books at the ready. Arrange to have those shameful gossip magazines picked up for the reading because now, yon ladies and gems, is when you can indulge in such a normally waste of time activity cause what else you gonna do? Re-landscape the lawn?

Have a comfortable seat located in various places in your house. One on the porch or near the gardens would be nice. One near the kitchen, the heart of the home, is wise. I warn that seating places that were okay BEFORE the surgery might not be so comfortable after the surgery and remember those hemorrhoids and avoid hard seating spots. You’re going to want some sort of chair in your bedroom as no way Jose will you be able to sleep lying down all night. In fact, if my experience in both the hospital and home is any indicator, sleeping in a sitting up position is the most comfortable. If you don’t have a comfortable chair in your bedroom, preferably with some method to raise your feet either via an ottoman or a La-Z-Boy type of affair, than find one. This is critical.

For sleep and good rest is critical to a recovery from this surgery and to not make arrangements will only prolong the recovery ordeal.

And so I write from a very non-medical professional standpoint but I’d argue that I present my suggestions from the most expert position of all…from one who has been there.

To bring up ALL "Loving My Heart Blog" Posts

Wednesday

Loving My Heart-Against Medical Advice

Loving My Heart Header


Leaving against medical advice, a weekend reprieve, the cost of health care astounds.

Pic of the Day
security camera blocked by tv




A Needed Operation Closing in on a Cost of $100,000

So I begin this chapter in my heart saga with a tongue-in-cheek explanation of health insurance.

HEALTH INSURANCE EXPLAINED

Q. What does HMO stand for?
A. This is actually a variation of the phrase , "HEY MOE " Its roots go back to a concept pioneered by Moe of the Three Stooges, who discovered that a patient could be made to forget the pain in his foot if he was poked hard enough in the eye .

Q . I just joined an HMO . How difficult will it be to choose the doctor I want?
A. Just slightly more difficult than choosing your parents . Your insurer will provide you with a book listing all the doctors in the plan . The doctors basically fall into two categories: those who are no longer accepting new patients, and those who will see you but are no longer participating in the plan . But don't worry, the remaining doctor who is still in the plan and accepting new patients has an office just a half-day's drive away and a diploma from a third world country .

Q. Do all diagnostic procedures require pre-certification?
A. No. Only those you need.

Q. Can I get coverage for my preexisting conditions?
A. Certainly, as long as they don't require any treatment.

Q. What happens if I want to try alternative forms of medicine?
A. You'll need to find alternative forms of payment

Q My pharmacy plan only covers generic drugs, but I need the name brand . I tried the generic medication, but it gave me a stomach ache . What should I do?
A. Poke yourself in the eye.

Q. What if I'm away from home and I get sick ?
A. You really shouldn't do that.

Q. I think I need to see a specialist, but my doctor insists he can handle my problem . Can a general practitioner really perform a heart transplant right in his/her office ?
A Hard to say, but considering that all you're risking is the $20 co-payment, there's no harm in giving it a shot .

Q Will health care be different in the next decade ?
A. No, but if you call right now, you might get an appointment by then

Until we moved to Delaware, back when I was working full time and was the one with the employer-provided health insurance, we belonged to an HMO. At that time it was my daughter who required extensive health care. Husband and I were young, in the grand scheme of things. Daughter had mental health issues plus some physical problems that I think she had since she was a child.

An HMO makes health care easy. One only has to call the nurse and boom, appointments are made, referrals generated, x-ray and lab appointments committed. The HMO people do all this stuff, in other words.

Of course one of our major needs when husband and I moved to Delaware was good health care insurance and such was a priority when husband went looking for a job. We were both at the most crucial of ages, the fifties and/or early sixties, when medicare had not yet kicked in but when health insurance is most critical in terms of personal health care issues suddenly coming to the fore.

It was during this experience with my blocked heart that I learned, with a shattering shock, just how much health care costs. I also have come to understand that without easily accessible health insurance a sick person's care could be compromised.

Neither husband or I made much use of his employer-provided health insurance for the first five years after our move to Delaware. One time we both had a severe flu, a flu so bad that I had to fight the light at the end of the tunnel.

We both did, and still do, get the annual flu shots which are so easily and cheaply available in this part of Delaware with an older population. Beyond that, there was not much reason for either of us to access health care although our families might argue that we should take better care of ourselves.

I have always disliked going to doctors. Not that I have anything against doctors. They are fine people and should be allowed to live. I have also always hated taking any kind of medication, especially of the prescription kind. I watch the commercials on the TV and ponder that we live in a country where obtaining medicine is a capitalistic enterprise. On popular shows we are treated to commercials telling us to consult our doctors for relief from depression, acid reflux, asthma and arthritis. I am amazed that the big drug companies are so obvious in their reach for our pocketbooks. I'd always considered prescription drugs something one takes on rare occasions. The notion that we can, boom, ask our doctors for a prescriptions for eating too much greasy food boggles my mind.

I particularly love the depression commercials. Zimbalta I think is the drug advertised.

These commercials show, well I suppose they must be "sad" people. We might see a mature man sitting on the side of a bed while an obviously sullen dog awaits by the bedside, leash in mouth. Or perhaps we see a young woman who looks as if a smile had never crossed her face. She is disheveled in that manner of humans who are down in their cups.

Well damn! These are ACTORS!

These commercials go on and on about depression, how it sucks the life out of us, how we too can find happiness and joy again if we would only ask our physicians for....TADA...Zimbalta.

We then are thrilled to see that mature man happily walking a joyous dog. The young lady has combed her hair and eagerly shops for a new dress. We are to assume that these sad people consulted their doctor, got that prescription for Zimbalta...and boom, they are happy once again.

The commercial's obvious intent is to touch that inner sad child in all of us. For who amongst us hasn't felt sadness for God's sake? Some of us watching those sad actors might be in a particularly blue funk as, at times and as life goes, we lose someone we love, a romance goes sour, a career path veers in a disappointing direction. This sort of sadness, I'd argue, is hardly depression, at least in the clinical sense of the word. But if I'm watching that Zimbalta commercial hey, tomorrow I phone up my doc and make an appointment.

And what does this doctor have to lose by prescribing Zimbalta for my depressed self? He will somehow get paid for my visit, perhaps with a co-pay. At my urging he will scribble me up a prescription for Zimbalta. If I have medicare, Medicaid or health insurance of almost any kind, likely some part of the prescription is paid.

It's win-win, right?

Well I wonder but to be fair, however it all works has no effect on my life besides my rather esoteric musings. But I wonder if all these drugs we get, urged on by the commercials, don't have SOME effect on our overall health later in life.

So I'd never been one to go to the physician on any sort of regular basis but I was not so obtuse as to avoid a necessary visit should health require.

Which was, until my cardiac surgery, once in the entire five years I'd lived in Delaware up until then.

In an earlier post , I elaborated on how my heart pains began and how, as a result of a stress test at the Cardiologist's office, I ended up in the hospital

STENT


I was admitted to the hospital on 4/29/08 and this was the first time I'd been hospitalized since 1982 when I had my gall bladder surgery. Before that, I'd only been in the hospital once, when I had a baby. And before that, I'd never been in a hospital except maybe when I was born.

I was informed by my Cardio guy as a result of that stress test in his office when I went into a some sort of painful cardiac event after drugs were delivered to my system to speed up my heart for testing that I had Cardiac Artery Disease. Which meant that the veins leading into my heart were clogged.

I entered southern Delaware's famous Beebe Medical Center via the emergency room where I'd been taken by my daughter after that scary stress test at the Cardiologist's office. It took time to get all the info, then I was taken up to a room in the Cardiac unit.

At some point I was finally in a bed and settled in. I hated it. I hated being in that bed in that hospital more than I hated the mold that attacks my roses. I hated that awful hospital gown and that terrible hospital food and my roommate who continually shouted that she wanted to die.

"There's a 10% chance you will need a bypass. There's a 10% chance that medication will alleviate that blockage. There's an 80% chance that a simple stent will open up those arteries blocking ample blood flow to your heart."

Well I certainly appreciated my Cardiologist's reasonable estimate, complete with percentages he obtained from his vast medical training, as to what might be required to fix my ailing heart. I honed in on that bit about the stent.

In fact, the other various medicos at the hospital were convinced that I would likely need a simple stent to fix my ailing coronary arteries that the night nurse brought me in a TV and a video so that I could watch how an angiogram works and just what was involved with this stent thing.

A stent, as I learned in my sudden and intensive introduction to all things coronary, is a small metal type of device. It looks like what we used to call Chinese handcuffs as children. The pieces of metal were interwoven in a sort of "braid". When this tiny piece of metal was inserted in a clog or collapsed artery it would expand and open up the artery to its original width.

Vice-President Dick Cheney has a couple of stents in his heart. We often hear about a needed trip to the hospital for the VP as the medicos adjust his stent. Of course Cheney had a coronary bypass BEFORE he got those stents but at any rate, Dick Cheney is the most famous person I know with stents in his arteries. I daresay that yon readers probably have loved ones everywhere who have had stents put in their narrowing coronary arteries, perhaps some we didn't even know a thing about. I know once the word "stent" became common terminology in terms of my own familial discussions regarding my health that I suddenly received email from relatives far and wide who informed that this one or that one had a stent. My daughter had a few in-laws that had stents.

Wow. A small piece of metal placed inside one's artery and boom, life is good and the blood flows again. It's better than Zimbalta and is a medical concept that is such an everyday reality....

And I had no idea.

In my endless optimism and perhaps unreasonable avoidance to accept that something might be seriously wrong with my heart, I moved on from my original notion that my heart issues were likely a result of some sort of hormonal imbalance. On that first night in the hospital, with an angiogram scheduled for the following day, I was convinced that all I needed was one of those handy-dandy stent things. Indeed even my own Cardiologist gave me odds of 80% that a stent would cure my heart woes.

If the notion of putting an expanding piece of metal in one's coronary artery doesn't intrigue enough, consider the angiogram.

A coronary artery specialist...in other words another heart doctor specialty, takes some sort of metal thread thing. This Cardio specialist begins usually at the femoral artery, which is that great big thing around your groin. Using this magic rod, the Cardio guy threads it up through that femoral artery all the way up to your heart. Then some sort of dye thing is released into your veins and using some sort of imaging device, the Cardio guy can better look into those veins and see what's going on.

If , after the dye spreads through the body exposing the various veins and arteries for easier scrutiny, it is ascertained that a stent is required to stretch narrowing arteries, right then and there the Coronary specialist can insert the stent by threading it through veins now easier to navigate for the flow from the dyes, and insert it in the arteries as required.

“No, Mrs. Fish. I’m sorry. There’s no way I can repair this blockage with a stent. You’re going to need a coronary bypass.”

my chest scar coronary bypass


leg scar coronary bypass


I’d been administered a small dose of anesthesia for the angiogram so while I was a bit groggy, I heard those heartbreaking words from the Coronary Artery specialist.

A heart bypass. The term was scary. This final and firm diagnosis broke my already broken heart.

So it was back to my room for me. By then it was Wednesday night. The angiogram was done, the verdict delivered. I would need heart bypass surgery. It was too late to get me on any sort of surgery schedule for Thursday. The angiogram had not been completed until late in the day Wednesday.

Could they get me in on Friday?

It would turn out that I could not be put on the surgery roster until the Monday following that fateful Wednesday. Until that Monday, I’d be a walking time bomb. The angiogram revealed all four of my coronary arteries to be severely blocked. Though none of the medicos said so, the thought hovered” “How on earth has this woman been walking around with such a messed-up heart without keeling over, much less mostly symptom free?”

I’d refer yon reader to my first story on this strange and scary saga. I’d softly suggest that I have a guardian angel who looked out for me. I’d hint that perhaps it was my own actions, based on my own secret, scary suspicions, whereby I’d stopped smoking my three pack a day habit and managed to walk around in my own back yard for over a year before my heart began to complain more forcefully. Somehow, through some unseen impetus, I managed to get myself healthier and against all odds.

Who knows, maybe I was destined to write this story. Perhaps some other female of my same demographic will read it and take an action that would have been avoided but for the reading. My demographic, by the way, mid-50’s, thirty to forty pounds overweight, mostly healthy and active, is quite likely one of the largest populated demographics in our country today. I base that assertion on nothing more than a hunch. I am so ordinary as to be outstanding in my ordinariness. My picture should be under the phrase “50-ish year old American female”. Already I have received much email from the first part of my story.

I’ve so much more to tell.

Well it might sound nice and noble and what better launching point for a new and dedicated life than the rebuilding of one’s very heart?

But what about that long weekend before the surgeons could get me on the table for that much needed coronary bypass?

I’ve already professed a profound hatred for all things hospital. Which is not to cast aspersions on Beebe Medical Center. Indeed not. For my experience with that institution was beyond stellar. In fact, I’d wager that for a person of my demographic in need of some serious heart care I couldn’t do better anywhere in America than southern Delaware’s Beebe Medical center. Much more on this later.

No way, no freaking, living, breathing way, was I going to stay in that hospital through Friday, Saturday and Sunday until they could finally heft me on that table the following Monday.

First, I felt just fine and the medicos already had me on medicine to thin my blood that it may flow around my heart’s many blockages better. Second, I was facing a very serious operation followed by a long recuperation. I had a thousand, make that a million, things to do in my own home. Third, while I might be in a hospital safe from a runaway blood clot that might, against the odds I add, break off and cause a heart attack, you might as well kill me straightaway than to sentence me to three days in that hospital bed.

My Cardiologist, that long ago fellow who’d administered the stress test, was the physician responsible for releasing me. He refused to sign me out.

Hospitals are not jails and patients are not inmates. God Bless America but no one can legally keep a patient in a hospital if said patient does not want to be there. Oh I suppose there’s provisions for the mentally disabled but an individual can, until Barack Obama gets elected President, choose a medical course of their own choice. My Cardiologist was under no obligation to sign me out no matter my pleas. I was under no obligation to stay.

I signed out on something called “AMA”…”against medical advice”.

Hey, I have no problem with my primary physician’s refusal to sign me out. He talked to me straightforward and sincerely. He told me hearts were complicated things and he worried that a blood clot might fell me cold and this so close to the operation that would cure me.

I listened to his concerns. He gave me my prescriptions and he informed me that he would not release me from the hospital. I told him that I was leaving anyway.

Most of the nursing staff and other medicos agreed with my decision. Logic and common sense dictated that it would be a waste of medical resources to keep my very healthy self in a hospital bed all weekend, even if my health insurance would cover me in full. I checked to make sure that this same medical insurance would not penalize me for leaving against medical advice. If that were to be the case I would have stayed. Logic and common sense do not pay huge medical bills.

My cardiac surgery, the surgeon’s fee and my follow-up hospital care were all approved for the week following by my health insurance.

I was free to leave. I just had to take responsibility myself.

That was fine. I was warned. My doctor had every right to take a position that he was wary about letting me out of there. The man knew I wasn’t going to hang around. In fact he hurried from seeing patients far away just so he could write my prescriptions, give me my warnings, before I walked out of there. I waited around for him although I was no under no obligation.

I’ve since gotten the hospital bill for those two days. The total, for just TWO nights, including the angiogram and all medical services administered, was, get this, $17,589.85!

How on earth much would that bill have been had I stayed those extra three days? Not to mention my mental stability at hanging around a place that I hated when I could be home and enjoying those last few days of my un-sliced self?

Next, a weekend reprieve and the big surgery.
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To bring up ALL "Loving My Heart Blog" Posts

Tuesday

Loving My Heart-The Pain Begins

Surely the heart of a remarkably healthy 56 year old wasn’t protesting so vehemently? Surely that jaw pain and nausea were figments of my imagination.

In this new series, Loving My Heart, the story begins of a painfully protesting heart, a major operation and the road to recovery/


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Journey to a Quadruple Heart Bypass

The medicos tell me that the beginning of the plaque buildup in the arteries leading directly into my heart probably began sometime when I was around fourteen years old.

Of course that sludge of the foods I consumed during the ensuing years up to age 56 when those same arteries began their painful protest of the strain likely started out slow, a flake from a shrimp here, a globule of fat from a fine steak there. We are talking, by my calculations, a period spanning 42 years.

The coronary arteries seem to be the end base for weirdly named things such as triglycerides and cholesterol. The body's blood transporting such things tends to leave these nasty bits in the coronary arteries rather than allow them to pass through the heart muscle which would really cause bodily havoc as I understand it.

At any rate there are four main arteries leading into one's heart from various body parts. Inside this part of the heart, the blood is re-oxygenated and sent out the other side for re-delivery throughout the body.

Hey, I'm doing this in the layman's terms as I've studied the issue but it's not that difficult a concept. We all have pipes that bring in our water and pipes that take out our sewage. We understand such as sludge and nasty blockages and how fluids tend to slow down then stop when enough of a clog bars the way.

While not allowing the blood to enter freely and abundantly into the heart chamber for thorough oxygenation, coronary artery plaque buildup presents an even more insidious danger in the form of a blood clot. For bits of the sludge buildup in the arteries can break free from where they cling to the sides of the artery walls and propelled by the blood being sucked in by the normal beating action of the heart can then be pulled down deeper and closer to that heart muscle until it lodges and cannot move, thereby shutting down blood supply to the heart completely.

Hearts don't like this sort of thing and tend to shut down completely in protest.

In my case, and in many cases, the heart begins its protest way sooner than when a complete blockage prevents its normal beat. My heart spent about an hour protesting some sort of distress on a pretty Fall day in 2006, during a visit from my mother-in-law from out of state, coincidentally.

We'd just taken a morning jaunt down to Delaware's Rehoboth Beach for breakfast. Husband was driving the Jeep and he was giving an impromptu tour of famous plumbers' houses with detail as to the status of each. This part of southern Delaware had been going through a renaissance during that period, husband sold plumbing parts, the morn was pretty and the drive was nice. The whole thing might sound boring but it was, oddly, pleasant.

Except for the awful pain emanating from my chest up through my jaw. I sat quiet as this scary pain coursed over my upper torso and as I pondered if I could possibly, an age 56 remarkably healthy female, be having some sort of heart attack. Husband continued his talking tour duties, mother-in-law responded as if a view of plumbers' houses was worthy of Hollywood and I wondered if I should mention my pain.

Then my stomach lurched with a jolt of nausea and now I was terrified.

"Something's wrong," I told the other occupants of the Jeep. "My chest hurts, my jaw hurts, and I now I feel like I'm going to throw up."

There was then great movement to obtain some sort of bucket should I vomit then great concern re this painful onset of troubling symptoms. I held up my hand that all was sort of okay. Husband and mother-in-law regarded me with troubled eyes. Finally the Jeep pulled into the driveway. Husband helped me out of the seat. Mother-in-law queried husband as to the locale of the nearest hospital.

We all got into the house but mother-in-law was very worried and husband was wringing his hands. I swallowed the large quantities of saliva generated when a stomach is about to upheave its contents and considered the hospital option.

My mind assured me that there was simply no way, no way at all, that someone in my health could all of a sudden, out of the clear blue sky on a crisp Fall day, be suffering some sort of heart attack. The notion did not compute. The concept did not fit my preconceived idea that it was more likely husband, a small at times sickly sort of fellow the same age as me, who would be suffering a sudden heart attack. I was a big strapping female. I tilled the gardens, I ate heartily, I carried heavy objects and I ran the household.

So why did my jaw hurt ominously like that and would my stomach finally expel its contents as the nausea threatened?

If yon reader should ever have jaw pain like I describe, don't question a thing, don't pass go, do NOT collect $200. You will know it when you feel it. I knew that jaw pain was a result of a straining heart, I knew it deep in my soul and in every cell of my being.

Mother-in-law and husband were ready to call an ambulance or transport me physically to a nearby hospital but at the time I was busy rationalizing that I was no candidate for this type of thing and I would not give in to the very obvious symptoms.

After about a half an hour of nausea and jaw pain, all hurt disappeared and I mentally congratulated myself for refusing to give in to what I considered to be a statistical improbability. Husband and mother-in-law sought my reassurances constantly that all was fine with me, and it was.

In fact, I never had another single symptom of a troubled heart for well over a year after that. I could have done so much in that year had I simply followed my gut instinct and arranged a simple visit to a heart doctor to check out what all that pain was about.

Pat Fish week after heart surgery


Although I did, during that year of no symptoms take some actions that would bring me kudos for my forethought. I'd mentally decided that there HAD been something weird going on with my heart that weekend and perhaps it was time for me to do a health assessment and take some actions that would help my strained heart.

In the Fall following that first heart episode, I went on a diet and lost 60 pounds. Which, impressive as that might sound, wasn’t all that my body could handily have lost but it was a very good beginning. The February following that weight loss, February of 2007, I stopped smoking.

Indeed I was a heavy smoker. In fact, I entered into that weight loss program in anticipation of the cessation of smoking. Smokers notoriously gain weight upon quitting their habit. I figured I’d lose the weight first then, with the help of an exercise program, I would be able to stop smoking without a huge weight gain.

Still, I remind yon reader, there had been not one single symptom of any heart issues during this entire period. But I’d not forgotten the deep ache in my jaw that I knew was nothing other than my heart. If I was lucky I could finish all these noble healthy actions and perhaps I’d never hear so ominously from my heart again.

I should have, with the 20/20 vision of hindsight, gotten myself to a Cardiologist of some sort and began a medical protocol to ascertain what that jaw pain and nausea were about. This action, along with the weight loss program, the cessation of smoking, and my happening exercise program, would have been a complete and thorough action to take towards a healthy heart.

Such as doctors and endless medical tests scared the hell out of me. I figured should any more heart pain come upon me, THEN I would consult a doctor.

My exercise program consisted of walking in circles around and around in my own back yard but by me, even to this day, I consider it a stroke of genius. I have a dog and I had been walking said dog on a daily basis. On two separate occasions my dog was attacked by dogs running loose.

They were little dogs. My dog is a big Belgian Malinois. She’s got big teeth. She defends me and herself when dogs rush from inside their very houses out onto the street to attack her. With one enormous clamp of those jaws she grabbed a little cocker spaniel, in one instance, and some sort of fancy show dog with lots of hair in another. Each of the dogs, for reasons understood only deeply in the brains of these dogs evidently intent on a suicidal mission, were quickly dispatched by Jo-Ann, who clamped down on the mutts daring to attack her. She shook those dogs as if but small rag toys with which she loved to play. Those dogs yelped and screamed and I managed, somehow and shaking in great terror, to get the dogs loose from my dogs’ jaws.

Jo-Ann didn’t kill those dogs but she could have. Easily. I resorted to carrying a big can of pepper spray but once again an adorable little Bichon Frise comes running from its house one day. I used the pepper spray. Jo-Ann and the Bichon did not have a fight but I decided right then and there that the terror of the dog walk was not worth the benefits of the exercise.

Of course I was bitter. On all three of these instances my dog was fairly and firmly walking, fully tethered from leash to collar to harness, on a public street. The damn dogs were loose. I don’t know what brand of insanity would have a little poodle type of mutt attack a great big Belgian shepherd but I don’t make it up. I had to take Jo-Ann to a Vet because the dogs DID attack her. The local SPCA came out. It was ascertained that Jo-Ann is not at all a dangerous dog, mostly because she’s NOT.

It took a while for Jo-Ann to acclimate to the notion that walking a circle in her own back yard was somehow akin to a morning walk along public streets with its many different sights that would intrigue any dog. But every day I went out into my own backyard. I took a cup of coffee, some chalk, an umbrella or sweater as required, and I walked around my yard in circles.

So lock me up in my own insane asylum because the public street wasn’t working for me. To add to the serendipity over the dog walking, at one point there even was a damn dog on the other side of the big 5’ fence in my own yard, this dog trying desperately to get INSIDE of our yard to attack my dog in her own damn yard!

Yes I write fiction but no way I could make this shit up.

In due course I came on a system which worked well with me and I’d recommend my own brand of genius to everyone. For many of us regularly walk upon a treadmill which takes us nowhere and on which dogs generally cannot join in. So why not walk around your own yard in circles? Dogs are mostly happy to be walking alongside their masters and don’t much care that they are walking in their own yard.

I’m a bird watcher so I use the time to regard the many birds who visit my yards, either for the feeders or during times of nesting. I’ve worked out a system where the dog is free to run like the dickens inside of our own well-fenced in yard as I walk the first half of my morning routine. Over time we’ve learned to play certain games that would have me pretending to take her ball or toys and she’ll run around trying to keep her cherished objects from me. Meanwhile I walk around, she runs, we exercise.

For the last half of my routine I slip a leash on Jo-Ann. By this time she’s tired from running so much. Recall that on our former public walks, Jo-Ann never had the opportunity to run free and play so happily as she did in her own yard. For half of my circuits I walk with her. She joins me in the walk, this after her own playful romp. She’s tired by then, she walks along by my side, dutifully and happily.

There’s also such as Ipods and other distractions that can be used for these walks and an existing backyard is always cheaper than a treadmill. Certainly it’s not for everybody but it works for me.

After I quit smoking, which wasn’t easy as one might imagine, I began this morning exercise routine, all to keep me from gaining so much weight as to negate any health benefits caused by the cessation of smoking. And still, despite my best efforts, I gained about 30 pounds back of the 60 pounds I’d lost. Mostly, as I now understand, I was slowing down all of my movement due to a straining heart.

For my heart was in trouble and despite all my efforts, symptoms returned.

This time, of course, I did not ignore the symptoms. This time I sought medical help. This time I knew something was seriously wrong with my heart but at least I was through with the smoking, I was a bit smaller in terms of weight, I’d been regularly exercising every morning except Sundays for almost a year.

I was in the best shape an overweight woman with a serious heart problem could be, if such a thing is possible.

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Beebe Medical Center


The symptoms began as a racing heart. Indeed. At times my heart would launch into some sort of weird but not necessarily painful, episode of a heart on a rampage. I didn’t know what to make of it. Is such a thing considered a medical emergency I wondered? Does one call an ambulance with a complaint that one’s heart seems to be running amok although no, technically there’s no pain? Would I be arrested for presenting myself at an emergency room with such a complaint? Further, aren’t hearts supposed to, from time to time, launch into little racing episodes, say when danger is upon or fear permeates the body?

Although I really wasn’t fooled. Many times when my heart would go on this sort of racing rampage it would beat wildly, sometimes for hours at a time. I’d sit in a chair almost curled up in a fetal ball, wondering what to do, what was happening to me, why was my heart doing this?

Which wasn’t at all a symptom like the ominous one then almost a year and a half prior when my mother-in-law was visiting, my jaw aching and my stomach nauseated almost to the point of vomiting. This racing heart thing was completely new to me and for sure, what with my cessation of smoking, the weight loss and that regular exercise program, well I had to be imagining things right? I was on my way to being a happening healthy woman, free from the dangers of the cigarette and dedicated to my morning walks in my own back yard. Why was my heart giving me a hard time now?

During one racing heart episode, I became so nauseated that I did, indeed, projectile vomit so violently that I knew it was time to seek out medical help.

“Something is wrong with your heart,” the Cardiologist told me, kindly but firmly. The ECG taken during that first visit showed up abnormal and a prior heart attack could not be ruled out. The Cardiologist might not have known at the time just what was amiss with my protesting heart but God Bless America’s medical system, the machines indicated it was time for further tests.

Something was wrong with my heart.

Of course the Cardio guy was delighted that I was, by then, a FORMER smoker, and that I was thirty pounds lighter than I’d been. He was happy that I exercised regularly and he told me that walking was the absolute best exercise for me, given my circumstances and the state of my health. He thought I was a good 40 pounds heavier than I should be and I was. I don’t know, by him I was likely a medical basket case but it was important to me that he understood my history that year and half prior to my visit. He figured the racing heart was some sort of tachycardio thing and he prescribed something called Beta blockers. He sent me on my way to obtain chest x-rays, blood work ups, echocardiograms and finally, a stress test during which my heart would be put to the ultimate test.

It was a sane medical protocol for this middle aged woman suddenly presenting with complaints of a racing heart from out of nowhere.

The blood work showed that my cholesterol was way high. The echocardiogram, an
Ultrasound of the heart muscle as I understood it, didn’t show anything unusual with my heart muscle.

There were problems but throughout that month of April in the year of our Lord 2008, nothing terribly unusual came to the fore as regards my protesting heart. The Beta blocker medicine seemed to work as the racing heart episodes stopped but a time or two during all that medical protocol, my heart would suddenly seize up with chest pain and a time or two I’d get so nauseated I’d vomit violently. The Cardio guy told me to get myself toot de sweet to a hospital emergency room in the event of such chest pain but always, once I stopped whatever I was doing when the pain came upon, it would go away. I figured why rush to a hospital when by the time I’d get there the pain would be long gone? I figured in due course the Cardio guy would find something.

All hell broke loose on the day of the stress test.

My daughter and husband were by now well aware of my heart issues. They knew that something was not right but ever convinced that a fine strapping woman such as myself couldn’t possibly have an ailing heart, I was sure that my problem was probably hormonal, a bad signal sent in error to my healthy heart that confused that muscle all to hell. Daughter arranged to go with me the day of the scheduled stress test.

I got on the treadmill as instructed and the nurse told me to start walking. “You need to get your heart up to 140 beats a minute,” she told me. The Cardiologist was in the room as well, urging to speed up my walk, informing me that I was only up to 109 beats a minute and already I was struggling for breath.

I’d been fairly smug that day. Hell I walked around my yard every damn day. How hard could a treadmill be? Only my walks around my yard were monitored in terms of speed by me and my heart had been deteriorating for so long that I’d automatically been slowing down the speed of my walk as we are all wont to do based on the demands and strains of our heart. The treadmill showed me no mercy.

“I can’t do it,” I gasped, finally falling off the treadmill gasping for breath.

The nurse told me it was no problem, that they would use chemicals to speed up my heart.

My screams of pain could be heard up and down Route 1 in Rehoboth Beach Delaware.

I begged for relief. The pain was beyond anything I’d ever experienced before in my life. I wanted to die.

“I’m putting in the antidote,” the frazzled nurse told me, holding my collapsed body over her own as she hastily inserted a needle into a prepared injection site. “It will be over soon,” she told me. The Cardiologist was wringing his hands with concern and from my painful screams, no doubt.

In due course, very quickly probably, the pain stopped. I was able to get up and for the most part, life was normal again.

“I am very sorry,” the worried Cardiologist told me. “You have Coronary Artery Disease. You need to go to the hospital. Your heart is in serious shape.”

Thank God my daughter was there. In fact I did go to the hospital. In fact I was admitted and over the course of the next week and a half, I discovered how close, how very, very close, I came to dying, walking around with a ticking time bomb in my chest.

Monday

Loving My Heart-Quadruple Coronary Bypass Surgery and the Best Hospital Around for Such a Procedure

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How precious the time span between normalcy and being sliced apart. Then the chest is split, the legs plundered and pain becomes the norm. A chapter in the saga of a quadruple coronary bypass.

The operation, the aftermath, the letter to the hospital Board of Directors


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The Operation of a Lifetime

Part 1 of this story here-The Realization and Diagnosis, and Part 2 of this story here-The Stress Test of Death.

The Friday, Saturday and Sunday before the day of scheduled coronary bypass surgery were not only literally beautiful, they were beautiful in terms of appreciating life, savoring the joy of a bite of chocolate, enjoying the songs of the birds and the simple sensation of breathing.

Yes, I knew that the Monday following, May 5, 2008, would change my life forever. Of course the final change would be for the better but there would be a long span of time in between when I’d definitely toss that coin for it changing for the worst.

I slept fitfully the night before the medicos would slit my chest open, before they would spread my ribs apart, before they would literally stop my body’s life functions and assign a machine to such chores as breathing and moving blood. I was scared. All surgery presents a danger. Open-heart surgery is arguably the most dangerous surgery of all.

First, and yet again, I cannot emphasize enough how wonderful my hospital experience was, if a hospital experience can ever be described as wonderful, especially a hospital experience as sobering and as painful as mine.

Sussex county Delaware is a very large county in terms of land area. This even though it is located in one of America’s smallest states. Until perhaps ten years ago, hardly anyone lived in Sussex County, Delaware. It was mostly farm country with a tiny spot hip and happening for its proximity to the mighty Atlantic Ocean. A few fishermen lived in Lewes, Delaware and the Rehoboth Beach area was an alternative for nearby Maryland’s Ocean City and was inhabited largely by a colony of homosexuals.

Then the state of Delaware passed legislature to legalize gambling. This action gave Sussex county Delaware a real boost. Bored adult tourists could ride up the road from Ocean City, Maryland, about thirty miles or so, for an evening of gambling for that Oceanside haven in Maryland will likely NEVER give in to the lure of the gambler.

Delaware has no sales tax and soon outlets of famous manufacturers built shopping malls near the Oceanside towns of Dewey Beach, Rehoboth and Bethany Beach.

People started moving to Sussex county Delaware in droves, people who would include husband and myself. And in that old game of demographics, husband and I would roughly fit right smack dab in the median of the demographic moving to Sussex County Delaware in the early twenty first century.

That Demographic, I conjecture, would be adult couples with grown children, aged 50 and older, of moderate but comfortable income, near or at retirement age, most from surrounding states to include Pennsylvania, Maryland and Virginia. There are few native Delawarians living in Sussex County. Beebe Medical Center was but a modest building located in Lewes, Delaware, once a medical haven that treated the fishermen and few year-round residents of the area.

Suddenly, when surrounded by an influx of people voted by every census as most likely to need a hospital…ie adults aged 50 and older, Beebe Medical Center grew ten-fold.

The Lewes, Delaware campus of the hospital built a few brand new wings and a brand spanking new covered parking garage was added to accommodate the many cars the narrow street of Lewes, Delaware could not handle. Beebe Medical Center’s Lewes, Delaware campus is one of the few hospitals in America I would suspect which stands proud and tall smack dab next door to a huge cemetery. I tell you, it’s weird as all get out.

Beebe Medical Center, started by physician brothers in the early 1900’s, soon built another modern and beautiful campus near Delaware’s Bethany Beach. Every year a new structure for this large and damn near medical empire is built and grand openings with free hot dogs fill the newspapers.

I wager yon reader ten to one that there is no better place on this planet for a fifty-ish female to get a quadruple heart bypass than Beebe Medical Center in Sussex County Delaware.

Cardiac bypass surgery montage


I’d love to get some statistics on how many of this sort of operation is done at this institute. Throw in such as angiograms and stents and…well just for example, the Lewes Beebe campus has five floors. Two of them are devoted for heart care only. One floor is an emergency room and one is general medicine. I don’t even think they have a nursery as a hospital would surely languish waiting for Delaware’s Sussex Countians to fill their rooms with newborns.

But I write with tongue in cheek.

So in a bit of serendipity I’d offer just for reader amusement, even though I grew up in the shadow of Baltimore’s famous Johns Hopkins hospital, I’d argue that come the time to get my heart re-plumbed, my dear Lord landed me in the best spot in this country, maybe on this planet.

Beebe Medical Center had coronary bypass operations down pat is what I’m saying here. My operation plus my subsequent three day stay at the hospital revealed in every action and care how true that assertion is.

Beebe Medical Center


I do not, naturally, have many memories of the actual cardiac bypass operation save my final kiss goodbye to my husband at around 7:30 am in the morning and my awakening at 6 pm that evening.

My daughter, son-in-law and husband were by my bedside. I remember waking up. I remember the nurses shouting at me gaily as if I were some friend they’d spotted high in the bleachers at the stadium. I remember looking at the clock and being startled that I’d been out of it for damn near close to twelve hours.
I remember the nurses telling me to stay still. I remember a tube being yanked out of my throat.

Husband, daughter, son-in-law all had something to say, mostly joy that I was still alive if my groggy memory serves, and I recall a bit of grousing at how worried they were getting in that I’d been out of the operating room at 3:00 pm, a full three hours before I finally opened my eyes and saw the nurses waving at me from the bleachers below.

My loved ones had been worried. They stayed for a while but I could see the relief in their faces. All kissed me and I told them I was fine. I don’t remember much after that save they all said they would see me the following day.

Instead of re-writing about my experiences in the hospital in those days following my surgery, I am going to copy below, in full, my own letter I sent to Beebe Medical Center’s Board of Directors regarding my experience for the period from 5/5/08 through 5/8/08. Yon reader should note that I did have ONE major issue with my care at Beebe but it is my hope that the letter illustrates my admiration and astonishment as to the top-notch technology and a+ patient treatment at the facility.

Beebe Medical Center
424 Savannah Road
Lewes, Del. 19958

ATTENTION: Board of Directors

Janet B. McCarty, Chairperson
The Honorable William Swain Lee, Vice Chairperson
Jeffrey M. Fried, FACHE, Secretary
Paul H. Mylander, Treasurer
James D. Barr
James Beebe, Jr., M. D.
Steven D. Berlin, M. D.
William L. Berry, CPA
The Honorable Eugene D. Bookhammer
The Honorable Joseph W. Booth
Stephen M. Fanto, M. D.
Joseph R. Hudson
Thomas L. King
Halsey G. Knapp
Robert H. Moore
Jose A. Pando, M. D.
Esthelda R. Parker-Selby
Anis K. Saliba, M. D.
Patricia D. Shreeve
Robert J. White
Michael L. Wilgus
Jacquelyn O. Wilson, Ed. D.

Re-My recent stay at Beebe Medical Center-5/5/08

To all Honorable Members of the Board of Directors of Beebe Medical Center as indicated above:

My name is Patricia Fish and I am but a young 57 years of age. Thus it was to my complete and sudden surprise when, as a result of several bouts of rapid heartbeats, subsequent medical investigation landed me in Beebe Medical Center on 5/5/08 when I had a quadruple coronary bypass.

My experience at this fine medical institution for which you all serve was so very positive that I had to take the time to write of my experience. For too often we may take the time to air our complaints and disgruntlement and too seldom we take the few minutes required to both thank and seek recognition for those fine professionals who made life so much better for one scared and hurting and most ordinary female citizen of Sussex county Delaware.

Before I left I tried to get as many names as I possibly could. It is my fondest wish that these wonderful people that I may mention know that I have taken this time and effort to insure that they are aware that their efforts have been brought to the intention of those charged with the oversight of your fine institution.

Which is not to say that I don't have complaints about my recent stay and I will too address an incident that so disturbed me that I consider a review of the events leading to the unfortunate encounter would be prudent for your patient review. I emphasize, however, that in total, the many fine, smiling medical professionals who assisted me during those frightening days after my operation greatly outnumbered those who I perceive struck an errant chord in my interaction.

I begin with CCU male nurse, George. Please forgive that I do not have these peoples' last names. It was all I could do to scribble so many of their first names for this letter I vowed to write just as soon as my recovery allowed.

George was a most wonderful medical provider and I could not have been cared for so carefully, yet firmly, by anyone better during those initial hours after awakening from my anesthesia. I spent many seconds and minutes, indeed hours, begging George for slivers of ice such were my dry lips and thirst. George carefully rewarded me with ice but cautioned me from too much, warning of an upset stomach to come should I over do it. Well patients who thirst, especially patients with hurting chests and tubal protrusions thrusting from everywhere, do not think about such things. In the course of an evening's shift, such as providing ice slivers, carefully apportioned to avoid a nausea to come yet given in enough of a quantity to somewhat satisfy a demanding and groggy patient, might not seem like much of a major medical activity in the grand scheme of things. Yet it is my first memory of my recovery care and, indeed, when George had to heft my rather large body from the bed the night of my operation, I did feel a bout of nausea but I did NOT, I repeat, I did NOT vomit.

George did his job and he did it well. I shall always remember him fondly.

Next I met Casey, a young nurse, just as sweet, pretty and kind as a spring day. She was the nurse assigned to me in the step-down unit upon my transfer to that unit after my day with George.

Casey helped me whenever required, she explained whatever needed explaining, she helped me move about and she was a smile and a hope for a sometimes garrulous patient. I chanced to query Casey about her future in the medical profession and was delighted to hear that she had grand plans for further education, that she enjoyed her chosen career path and intended to stick to it.

Please keep an eye out for Casey and her future. She's got something very special going on and the world should be filled with such fine young women.

Then there was Peter Chung, who was a Physician Assistant in the step down unit and if I gave anyone a hard time during my stay, it was Mr. Chung. On my first night in the step down unit my heart went into some sort of arrhythmia which caused Mr. Chung no end of worry. There's a bit of serendipity about this incident for it was sudden and strange arrhythmias which caused me to first seek medical attention that led to my heart operation from the start. In fact, I responded a bit cavalierly about the matter, declaring that I came to have my roof fixed and the thing still leaked. The night nurses told me that Peter stayed around a while after the incident of my rapid heartbeat such was his concern.

I'm not at all sure if this is true and I emphasize I am repeating what I heard. It was the following day that a medical incident involving Mr. Chung also brought about my only bad interaction with a Beebe Medical Center personnel during that stay.

Somehow I managed to dislodge the tube draining my fluids from my chest cavity. I don't know how it happened but just as soon as it did a pain pierced my side like nothing I'd ever felt before in my life.

While I was not the most perfect patient to cross your facility's threshold in your history, I did try to my best to cooperate with all medical personnel and firmly vowed that I would be as much a participant in my recovery as all those dedicated professionals helping me along. This drainage tube, however, was excruciating and I wasn't as calm and collected as I wish I could have been.

Casey did her best to help me through that horrific episode, remaining by my side, helping me breathe away the pain, seeking painkillers as required.

Make no mistake that I moaned and groaned to my complete embarrassment. I did summon my medical caretakers and apologize profusely for my behavior but all I can say is that it hurt, and prisoners of war are allowed to shout their pain and so too should a hospital patient be given some leeway for a pain they don't understand and have difficulty enduring.

I don't know who "Libby" is. I am not even sure if she's a nurse. I only know that she stopped by the door to my room and YELLED AT ME!

She told me that other patients on the ward were trying to sleep. Now I must point out that this incident occurred around 11:00 am in the morning so it was not exactly the middle of the night. She told me I should shut up and she said a lot of other really unkind things. Believe me, had I a gun I would have gladly shot myself in the head that I not bother other "sleeping" patients in the middle of the morning and for sure that I do not offend Libby the Hun.

In fact, Peter Chung himself eventually came in and removed the drainage tube completely even though it was not due for removal until the following day. Just as soon as he pulled out the tube blessed peace descended on me. So it isn't as if I was making it up or anything.

At some point Libby herself did come in and speak to me. She didn't apologize and by that time I was so doped up I didn't know who I was talking to. It was Casey who told me that it was Libby speaking to me and that she (Casey) suggested that she (Libby) apologize to me. Libby did speak to me softly so I assume she was trying to make amends.

I don't necessarily expect apologies although I sure gave plenty of heartfelt ones myself. And to be somewhat fair to Libby the Hun, I must suppose she was trying some sort of misguided "tough love" routine in an effort to shock me to strength.

The plain fact of the matter is that I was in great pain and if one of our fine soldiers at Guantanamo Bay had scolded one of our prisoners of war so severely as Libby the Hun treated me, you can believe the United Nations and New York Times would have envoys flying in for investigation and bad publicity to follow.

Yes, of course I am a writer and, at times, I have my tongue firmly in my cheek. In fact I taught writing for adult night classes at Indian River School District a few years back. I have a Blog and intend to write not only about my experience as a heart bypass patient on my Blog, but I shall document my recovery and learning experiences along the way.

I'd like to also mention Kelly, my cardiac nurse who prepared me so well for the operation. Then there was Shirley, Judy, Marcie, Bev and Beth, all on the step down cardiac unit, all on different shifts, all so nice, personable and happy to encourage me every step of the way.

Finally, there was charge nurse Adrienne, one happening bundle of medical enthusiasm. It was Adrienne who went over my discharge instructions, who spent as much time as I required answering my, and my husband's, many questions. Adrienne will always be the smiling face of encouragement that fills my last memories of my quadruple bypass surgery at Beebe Medical Center early one scary May in the year of our Lord, 2008.

I tried the best I could to mention by name all the medical professionals that aided my recovery so well. Besides my one strident discord with Libby the Hun, in fact, every single employee I encountered during my stay were professionals, likeable and impressive, every step of the way from the parking lot to housekeeping.

The hospital hummed smoothly and I was always yet again impressed at every turn at how well-run and dedicated your institution is. At times, even the food tasted halfway decent.

I will be writing about my experience at your hospital on my Blog and will be writing about my recovery. I have a diverse and wide reader base and I write the truth, yes I do, I write it well and I write it strong.

Please insure that those whose names I mentioned get some sort of "atta boy" for their jobs well done. Deal with Libby the Hun as you will. She definitely needs a little lesson in public relations I see it.

Take care and continue your fine oversight of one of the finest medical institutions I've chanced to enter during my life. And I've worked in THREE hospitals in the Baltimore region, lest you think I am totally without a clue.

I am,


Patricia Fish
http://patfish.blogspot.com/


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