April 01 '06

                                                    

Volume 513

                   


The Survivor Eleven Months Later

Since having a heart attack approximately eleven months ago, I’ve been more attuned to the signals my body sends to my brain than I was prior to April 24, 2005. Okay, that’s not true in the most complete sense, but, as applied to symptoms of a heart attack, I’m certainly more keenly aware than before.

This time last year, my body was signaling there was something amiss with regard to my heart. I recognized the symptoms as heart-related, but chose to do nothing until I was reasonably certain the problem really did relate to my heart. Luckily, I managed to survive that heart attack and was no worse for wear, except that a stent was placed in a clogged artery. I consider myself fortunate that medical technology has advanced to the point where repairs to the human heart are now passé and will admit that not in every respect was I truly born at the wrong time.

The Signs: About six weeks ago, spring appeared to have arrived. Pleasant warm days lasted roughly a week before winter announced it wasn’t ready to throw in the towel. Barbara and I and, sometimes, Sarah dusted off our walking shoes and hit the pavement in our subdivision. It didn’t take me long to realize I had been far too sedentary during the winter months. Walking the hills near the end of Ridgewood Drive left me winded, initially, and with sore leg muscles, later, both of which showed improvement as daily walks continued. But, rainy days and sometimes freezing temperatures interrupted our routine for days at a time, and during the next few weeks, our walks were sporadic.

Ever since having received the stent, I’ve noticed an occasional pain, one that feels as though it’s coming from the heart muscle itself. The first time I felt it was about a month after the stent was in place. I thought, at the time, that the stent was slipping nearer the heart. While I considered such highly unlikely, I do remember wondering if it might really have happened. Though less intense than that initial pang, subsequent sharp pains have randomly struck with a frequency of one or two a month.

On or near St. Patrick’s Day, the frequency of heart-pain increased to something on the order of a dozen each day. While walking the following weekend, I mentioned the pain I had been experiencing to Barbara, as I knew she’d prefer I didn’t just drop dead without some advance warning. I noticed my shortness of breath after walking uphill seemed worse than I remembered it being just weeks before. I also mentioned to Barbara that I felt I needed to see my cardiologist, not that I was overly concerned, but because I felt like he should hear about what I had been experiencing.

I’ve not mentioned the relationship of the stress factor to my present health, but lately I have experienced extreme work-related stress. There have been multiple occasions in recent weeks when I could feel my blood pressure rising, and I’ve tried to take a short break each time before reaching the boiling point. In addition to Barbara, I also told my boss about the stress and acknowledged it was something with which I should be able to cope.

The Visit: The Wednesday following St. Pat’s Day, I phoned the office of my cardiologist in Tupelo, MS, and asked for Dr. Estess’s nurse to return my call. When Laura Jo called me, I explained my symptoms and mentioned the stress I had experienced. She wasted no time in scheduling an office visit.

"Can you come over in the morning?" she asked. "If you can be here by 8:30, I think I can get you in to see the doctor. We’re overbooked, but we’re on vacation next week. I did this for one other patient a while ago, and one more won’t matter."

I told her that I could be there and advised the appropriate folks at work of changes to my schedule.

The next morning Barbara and I were in the office shortly after 8:00 a.m. After about an hour’s wait, I was called back. Barbara tagged along for my weigh-in and measurement (height). I’m still the same height, but after months of inactivity, I weighed almost ten pounds more than my last visit. How depressing, I thought my bulk was due to the extra layers of clothing, but it turns out I’ve got extra layers of fat.

A couple of nurse’s aids tended to me. One of them looked quite a bit like my older sister-in-law. Maybe, it was her jolly disposition and quick laugh. Nonetheless, Barbara felt the same way. It was while the look-alike of my sister-in-law was taking my blood pressure that she apologized for the growling noises of her stomach.

I commented that I was quite accustomed to hearing body-noises, from areas such as the stomach as well as from behind.

She acted a little teased and asked with a giggle, "What do you do?"

Thinking the aide wanted to know what I meant by the noises "behind," I grinned and stated, "Flatulence."

Now, she really did look teased and tried to repeat the word as she left the room.

Barbara stated she thought I had misunderstood the question, so I explained my line of work dealt with technology opportunities for retail grocers. The aide then left the room, only to return moments later. She opened the door and announced, "I told them, Mr. Carter was using the f-word."

I laughed and told her to make sure she explained my f-word had more than four letters. Shortly thereafter, they took my blood pressure and hooked me up for an EKG that a different nurse supervised.

When Laura Jo came in to see me, she had been apprised of the f-word incident and sheepishly informed me that she normally used the four-letter version instead.

After we chatted for a minute or so, she left Barbara and me alone, stating as she closed the door, "Dr. Estess will be a few minutes. He has three more patients in front of you, so it may be a while.

"Tell him to knock first," I added. "We may be making out if he’s gonna be very long."

She laughed at the prospects of two old people smooching in a doctor’s office. I laughed myself.

Dr. Estess came in without knocking, and he did not find Barbara and me in a compromising position. He listened as I went through my laundry list of symptoms and concluded I should have a stress test. He also asked me to try a different type of blood pressure medication, thinking it might be possible to remove me completely from blood pressure medication in the near future.

"Have you ever had a stress test?" he asked.

"I have, but it has been a long time," I responded.

"We’ll do a blood work-up as well," he continued. "If the stress test turns up anything, we may need to do a heart catheterization, otherwise, I need to see you again in six months. First, though, let me see when we can schedule the tests."

Laura Jo came back into the room moments later to say the tests could be done the following Monday. I know she gave me a sheet of instructions and a phone number to call and check on the results sometime the day following the tests.

The Tests:  On Monday, Barbara and I arrived at the offices of Cardiology Associates around seven-thirty that morning. I was refused food or drink from midnight Sunday night until after the tests on Monday. I can never feel any effects of caffeine, and while I may be addicted to it, I can skip coffee at breakfast without any ill effects. However, my stomach was missing its breakfast.

It didn’t take us long at the registration desk, and we were soon escorted to a secondary waiting area near a room full of treadmills. We were prepared for a three or four-hour ordeal of hurry-up-and-wait. Several old folks were already in the waiting area. Within ten minutes of our arrival, I was called by a male nurse to receive my first injection of an intravenous dye that carried a radioisotope, which could be detected during the imaging process of the testing.

It takes about thirty to forty minutes for the dye to reach the heart, so I waited with my wife in the waiting area. It was then that I noticed several other patients had a device like mine, attached to the hand, for the IVs. I figured they must have had seven o’clock appointments.

The way the test works is each patient is injected with the dye and is later scanned, with something akin to an x-ray unit, while the heart is at rest. Afterwards, the patient is asked to walk on a treadmill that gradually increases speed and degree of tilt until the heart is stressed. A second injection of dye is given near the end of the treadmill test. The patient is scanned a second time following the test. Differences in the two scans allow the doctor to assess the condition of the heart. There is also a printout of the EKG, produced when the heart is under stress on the treadmill, which provides additional information for the physician.

If one has never had a stress test that employs a treadmill, I recommend it be avoided at all costs. How I’ve managed to endure three such tests in my lifetime is beyond me. Yet, I’m living proof that some folks survive treadmill tests. One of these days, I may just read the fine print above the line where I sign away my rights and sanity by granting permission for the test to be done. Sarah reminded me that people can die in the middle of a treadmill test. I knew that but figured I’d have sense enough to step off the contraption before collapsing.

The bad part of the treadmill test is the duration of it. Those charged with administering the test tell the patient in advance that it is important that ones pulse rate attain a certain level, in order for the test results to be helpful. Armed with this knowledge and seeing the darned motivational picture hanging on the wall directly in front of the treadmill will make one want to give it his or her best effort. I don’t remember the exact phrase beneath the picture of a tree growing in the crevice of rock high atop a desert canyon, but it was on the order of "You’ll never know what you’re capable of doing unless you try."

I think I’d rather have had a rock to throw at that picture, near the end of my test, than the words the nurse uttered, "Can you make it twenty more seconds?" but I made it. I don’t know that I was any more spent than a racehorse having finished in first place, but I’m pretty sure I was breathing as hard as a horse.

I was a little alarmed to see my pulse rate hit 150, when it’s normally about seventy, and the last time I saw my blood pressure on the display it was 198/ 96, which I didn’t think was all that bad, considering what I was doing. When they finished unwiring me from my harness, I was given a twenty-ounce cup of water to drink and told to return to the waiting area.

The final set of scans was made about five minutes later. The doctor asked me to finish the water, if I could, as that should help with the imaging, something to do with contrast or background, I think. He said my pictures turned out good and that I didn’t have to eat something and return for more pictures as is sometimes necessary. So, in slightly less than two and one-half hours, I was done and on my way to work.

The Results:  I dropped Barbara off at work in Pontotoc before I headed for Philadelphia, MS. When we got home later that day, the message light on the answering machine was blinking.

"Hello, Mr. Carter, this is Laura Jo, from Dr. Estess’ office," a familiar voice said cheerfully. "I came by the office to check on my computer and saw the results of your stress tests. Your heart function is normal, and everything looks fine."

Laura Jo had taken time on her day off to contact a patient to relay some good news. To Laura Jo, I’m just another old guy waiting on test results or someone she sees in her line of work. We have no relationship other than that of nurse/ patient. Yet, she’s dedicated enough to her work and concerned enough about the welfare of one of her patients to burn a few minutes of her vacation time, nobly.

There is some stress associated with ones health concerns, and I was glad Laura Jo phoned to relive a part of that stress. The next day, a different nurse called me with the partial results of my blood test. A sample was sent off for analysis, but that which is done in-house showed my total cholesterol level at 120 and my triglycerides at 84, both down two points from last July.

"It looks like your medicine is working for you, congratulations," she stated.

Thus, ends the latest episode of the survivor.


Somebody Special Airport Comfort Inn

The details of my recent efforts to reserve a couple of rooms at the Comfort Inn in Pearl, MS, is a story in itself, but for space considerations it must go untold for now. But, the uniqueness of my stay there will be sufficient for this article.

This past Tuesday, I entered the lobby of the Comfort Inn to see a sign in front of the registration desk with a welcome message personalized for me. It read, in part, "Our special guest of the day: Wayne Carter." I had often seen such signs in other motels throughout my traveling career, but I had never seen one bearing my name.

I excitedly explained to the young woman at the desk that I was the "special guest." She smiled as she proceeded to make my room assignment.

"And, I suppose, my name was drawn from the many who will be staying here tonight," I suggested.

"That’s right, sir!"

"That’s nice. Do I get treated to breakfast in bed?"

"No, there’s a continental breakfast from six until ten, but there’s something in your room for you?"

I knew I wasn’t in a five star hotel, and I knew the typical no-frills motels that I stay in don’t have much in the way of room service and certainly nothing as luxurious as breakfast in bed, but I saw no harm in asking. A pleasant surprise awaited me in my room. Just inside the door and on the desk was a modest gift of food items neatly arranged inside a clear plastic bag. Beneath the arrangement was a sheet of paper with a welcome message similar to the one in the lobby, and under the message was the current copy of USA Today.

It wasn’t a monetarily significant gift, probably worth less than two dollars if the items were purchased at retail value, but I found it to be a pleasing gesture, and I certainly appreciated being recognized as "special guest" for the day. Even though the odds of it happening to me again at the Comfort Inn in Pearl are pretty slim, I imagine the next time I need to spend a night in Pearl, I’ll be contacting the Comfort Inn.


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