Month: August 2018

After the diagnosis

So, where were we?

Oh yeah, I’ve been diagnosed.  As I mentioned the surgeon wants me to get my blood sugars down below an A1C of 8.0.  It was 10.5.  Not good, I know.  (No lectures, please.)  So that’s where my focus is going to be the next few weeks.  I begin a stringent regimen of tracking my blood sugar numbers and eating less and better.  In true nerd engineer-like geeky fashion I created a spreadsheet to help me.  Those of you who remember Arlo Guthrie’s Alice’s Restaurant will remember the twenty seven eight-by-ten color glossy pictures “…with the circles and arrows and a paragraph on the back of each one explaining what each one was to be used as evidence against us.”  Well, I created a spreadsheet with rows and columns and colors and a key chart to be used to keep me straight.  Here’s an image of the actual spreadsheet, so far…

My endocrinologist today said that I have provided too much information.  It’s overwhelming and hard to narrow anything down, but that’s jumping ahead a bit.

Anyway, with my meter and my chart I track myself morning, noon, and night.  I have two appointments later in the month, the 28th with my endocrinologist, and the 30th with the surgeon where we will set the surgery date, providing my blood sugar numbers are down to being reasonable.  Today, as I write this, it’s the 28th.  Had my endocrinologist appointment this morning.  Two days to the surgeon’s appointment.  I’m just a little anxious, I want to get it scheduled and done, but I digress.

A couple days later my endocrinologist’s office calls and wants to see me for some diabetes education, so I set an appointment and we meet.  Ends up being two appointments over two weeks and some good information is exchanged.  The nurse marvels at my out-of-date glucose meter… she had to go look for the program to download it, it had been so long… so she gives me a new one.  Then, we’re both perplexed because the new meter’s smart phone app to track for me won’t download onto my phone.  Ya see, I have an Android v5.0.1 and the minimum version number is v5.1.  Figures.

Long story short, things are going  well and the next two and a half weeks go by fine without incident, until…

Headaches… and migraines

It’s amazing how busy a person can get even when something like impending heart surgery is looming on the horizon. It has been twelve days since my last post, and I have more stuff to say. But today we’re going to take a detour from my path to this point and talk about headaches… or more specifically, migraines (with aura).

I am not one to get migraines. Never have been. I’ve tried to understand what people who do suffer from migraines go through, but I’ll be honest and say that I don’t fully understand it. It’s not literally required that a person has to have “been there, done that” to fully know, but it often helps.

This past Friday, after lunch, I felt a headache coming on. Within about 30 minutes it had progressed so far so fast that it was almost unbearable. Intense pain, most only on one side, the right side, if I recall correctly, primarily behind and above my eye and radiating back into my head.  (I do get sinus headaches, so I needed to make sure it wasn’t that.)  Inability to focus mentally and really think, though if I absolutely had to I felt that I probably could. Aura, or visual disruptions, inability to focus visually, distorted vision, black spots. Oh, and did I mention the excruciating pain?

It wasn’t fun. But did I leave and go to the doctor? No. One, I don’t think I would have been able to drive safely. Two, I had just gotten back to work after two days in the hospital for what turned out to be something of a false alarm… but we’ll get back to that in a future post.

Anyway, it was incredibly difficult to work, and after a little over an hour it subsided. Not completely, but bearably miserable. Quitting time came and I was out of there and on my way home. Still had a non-migraine regular headache that hindered my concentration into the evening. Took a long nap that evening, and woke up with headache. Yay me. It didn’t finally go away until I woke up the next morning.

That day, Saturday, went well. No headache, no issues.

But Sunday. Woke up fine. Ok, woke at 1pm, but to be fair I didn’t go to bed until after 4am. Anyway, was fine in the beginning, then around 3pm it came back. It’s 9pm as I write this  Not migraine level, but bad enough. So I have to wonder, what causes migraines and/or headaches in general? Each of these incidents was preceded by a stressful event, so there may be that. I was also started on a new medication, some what I call a min-nitro glycerine pill that I cannot remember the name, and was told that it can cause headaches in some, so it could be that. At this point I really don’t know, but I don’t like it.

How did I get here?, Part 3… The Great Leap to the next step

The doctor (my cardiologist) gets my attention, and pulls me out of LaLa Land, and tells me the procedure is over.  I’m just a little taken aback… when did they start?  He then proceeds to tell me, very matter-of-factly, that I need to have heart by-pass surgery.

My reaction:  😐  Oh.  Ok.

I had to absorb this a bit.  The whole process up to this point from the tennis elbow up to this moment has been pretty mundane, almost kind of funny.  “Juuust to be safe”, now took on a whole new meaning.  It was serious.  We talk for a bit, they show me the photos they took, and explain that they went in, found several near-blockages (four or five, something like that), knew a stent or two wasn’t going to cut it, took the photos, and got right back out.  Took all of twelve minutes.

I listen.  It all makes sense.  Somewhat shocking, but it makes sense.  come back to the moment and ask the doctor directly, “Ok, so why haven’t I had a heart attack already?”

Without missing a beat (no pun intended), he says, “You’re lucky.”

I can buy that.  I also like his sincerity and forthrightness.  Just tell me straight up.

Fast forward a few minutes and, after they put this inflatable device on my wrist to ensure the artery does bleed out, they wheel me and my bed back to my room.  I’m reunited with Missy, and for reasons that are blindingly obvious, she’s upset.  Or, rather, was upset.  She has spoken with the doctor, called her mom, but has calmed down now.  When I see her she has sort of a “We have work to do, but we’re going to get through it.” resolve, which is exactly what I needed at that moment.

Most of the rest of the afternoon is somewhat relaxing.  I’m still in bed.  Still wearing the stylish hospital gown.  Almost kind of ‘chummy’, as we’ve gotten along quite well with our nurses.  My primary nurse comes in every so often to let some pressure off the wrist device and check up on me.  Another nurse comes in and does some sonic listening of my heart that I forget the name of.  Another nurse comes in and checks out the veins in my left arm.  This is where they will get the veins for my by-pass.  The nurse also checks my legs for the same reason, as a Plan B.  All this is unplanned, of course, but they’ve been through the drill before and are clearly competent at what they do.  It’s actually impressive at how they can keep their spirits up working in an environment where there is so much potential for disappointment and grief, not to mention that your ‘clients’ keep changing on a daily basis.

Anyway, a couple more hours pass as things are done, I’m eventually disconnected from all the wires, get some more information and explanations.  I meet the surgeon who will perform the actual operation.  Very serious man, but also has a very good reputation.  He says prognosis looks good, but since my blood glucose numbers have been up lately he wants them to come down a bit before he schedules the surgery (which has been going well), otherwise it would have been done in just a few days from then, almost immediately.  They want my A1C down to 8 or less, and it had been a bit above that.  An appointment is set for about four weeks away, and I should get a date scheduled then.  It will probably be pretty soon after that.  Until the, I wait… though it is nice to have some time beforehand to get things in order instead of having life take a sudden turn with no warning.

How did I get here?, Part 2… The Angioplasty

Actually, the nurse was trying frantically to call me late Friday afternoon.  And I’m the kind of person that rarely hears their phone, and I was driving anyway, so I missed the call.  They also called Missy, and she missed it, but she did hear the voice mail.  After an hour of phone tag we settled in with the notion that I would call Monday morning.

I finally get a hold of the nurse on Monday morning, and she’s kind of upset.  Says it’s urgent that I go in for an angioplasty as soon as possible.  She told me what was up, but most of it I didn’t catch.  I knew they wanted to possibly… probably… put in a stent.  We schedule for that Thursday.  I arrange to take the day off as I’m told the whole process will take about five-ish hours.

No eating after midnight the night before.  Only clear liquids… which includes coffee, soda, tea, etc., caffeine was ok this time, who knew?… only up until three hours prior to the procedure, which was scheduled for 1030 am.

We get to the hospital and sign in.  It was as if everyone was expecting me.  haha  I get a room and nurse… I’m going to call everyone except the doctors a nurse as I have no idea which ones were and which ones weren’t… and am told to undress to a certain point and put a gown on.  And let me say that hospital gowns have not changed for at least the last 50 years.  Anyway, eventually a second nurse comes in, who I believe was my primary nurse, and they poke and prod and hook stuff up and get all kinds of vital signs.  Everyone is super friendly, and professional at the same time.

Come time for the procedure they wheel my, still in my bed, out into the hall and down the hallway, around a couple corners, and into a room that looks like a surgery room.  It’s very sterile looking, but also very large and has an enormous set of equipment.  I have an IV in my left arm that was put there in my room.  The nurses… I must have seen a dozen different nurses that day, except for a couple they all seemed to have a single purpose… are all doing various prep-type things to get ready for the procedure.

Time for the procedure comes, and I had been paying attention to my surroundings and all the bustle up until then, and one of the nurses tells me they’re going to inject the anesthesia into my IV now.  I say, “Ok.”, and off we go.

And I mean “off we go” very literally.  This is the same kind of anesthesia that they use for procedures like colonoscopies.  You’re ‘out’, but not out cold.  It’s kind of hard to explain.  Anyway, I say “Ok.”, and they keep bustling around, and my mind wanders a bit.  I think I’m still with it.  Before long I’m no longer aware of my surroundings, though I think I am.  They did tell me when they were going to insert the tube into my artery in my right wrist, I do remember that.

As a side note they go through the wrist now, preferably the right, instead of the groin, though the groin is sort of a ‘Plan B’, if necessary.  And it strikes me as odd that they have to go through an artery, though maybe that’s the only place big enough for the tube, I don’t know.

So there I am with my mind wandering… and wandering… and wandering… thinking I’m aware… and wandering… when they suddenly get my attention.

To be continued.

How did I get here?, Part 1

This has been an interesting journey, so far.  It started around Memorial Day weekend, I was experiencing some sharp pain in my left elbow.  It would at times radiate down to my wrist and/or up to my shoulder.  I lived with it for over two weeks trying ibuprofen to keep it in check.  It was affecting my sleep, keeping me awake at night.  After a couple weeks of no discernible improvement, I finally gave in and went to the doctor.  Urgent care, on a weekend.

The doctor diagnosed me as having tennis elbow.  I was not expecting this, but it made sense.  It felt muscular, not heart related.  Got some advice to take lots of Alieve and use occasional cold compresses.  I also got a rest pad for my elbow at work.  Over time my tennis elbow improved, and is very manageable now.

Anyway, while there, juuust to be safe, the doctor wanted to do an EKG.  We get the EKG done, and he has it read by an on-call cardiologist downtown.  The results come back normal, except a small abnormality that he has concerns with.  They think that maybe I had had a heart attack previously and never knew it.  The set-up an appointment with a cardiologist for a better exam the about five weeks later.

I get to the cardiologist appointment and he essentially says the other cardiologist didn’t know what he was talking about.  I had definitely not had a heart attack previously.  Everything was fine.  However, juuuust to be safe, we’re going to do a treadmill stress test… a nuclear stress test.  So we set it up for the net week.

This nuclear stress test is a two-day stress test.  The first day is a resting stress test.  They take my vital signs.  They inject me with the nuclear stuff.  I go eat a light meal… I ask what the meal is for and they say it’s to ‘push’ the nuclear stuff through to the heart and kidneys, or something like that… then I go in and get pictures taken of my heart from a very expensive looking piece of equipment.  Then I go home.  No caffeine for 24 hrs, btw, for the next test.

The next day I get more vital signs.  I get hooked up to ten electrode things, and they put me on a treadmill.  It starts somewhat fast, I thought, and increases speed and incline as I go along.  Once I get to a certain point they inject more nuclear stuff and keep increasing the speed and incline.  No meal necessary this time, as the higher heart rate pushes the nuclear stuff through just fine.  This did not go well.  I am very out-of-shape.  Once finished I did calm down fairly quickly.  Then for more photos of my heart, for comparison.

The next day I get a phone call from the nurse.  They did not like the photos.  There was a dark area near the bottom of my heart.  I am told I need to go in for an angioplasty, and maybe get a stent, or two.  It’s scheduled for later that week.  At this point, Missy is worried.  I’m, somehow, unconcerned.

To be continued.

Hello!

Hello.

I’m Ken.  I’m normally a very private person, so my sharing of personal stuff will be surprising to some, but I feel compelled to share my experiences with my current heart health situation.  Maybe my experiences can help someone understand what they’re going to go through.  Maybe my experiences can help calm the feeling of uncertainty and of the unknown.  Maybe my experiences can just be a little educational.

Please note that my experiences are just that, my experiences, nothing more.  These are NOT any form of medical advice.  From time to time I may share an article that I come across, but I am not a doctor.  Please consult your doctor for medical information and advice specific to you.  This blog is intended to help those get through a tough time regarding ancillary issues that you may not hear from medical professionals… i.e. how you feel physically and emotionally, potential timelines, what you may expect in recovery, and so on.

The plan is for my wife, Missy, to also be a contributor here.  I will give the perspective from the patient’s side, Missy will give the perspective from the other side, the person taking care of the patient.  You don’t normally see it from the other side, so this will be great.

So sit back and enjoy.  Comment, if you like.