He Walks! He Talks!

Hi folks!


John is actually doing very well. I went home Sunday afternoon, did laundry, picked up (2 weeks of) mail Monday & paid some bills, and came back Monday morning. DeWayne across the street is a treasure - he & his son went to Panera today and brought John's car home for us. It's been sitting there since he passed out at work and went to the hospital by ambulance. One less thing to worry about!


Today John took 2 walks outside the room in the hall, and stood up in the bathroom and did his own bath. He spent a good bit of the day up in the chair, and took some naps. All that's really left to do is switch him from IV amiodarone to pills - that's the drug that's keeping him out of ugly heart rhythms. And of course he needs to build up strength, after 2 1/2 weeks in bed. He looks great.


The docs haven't set an expected date to send him home yet, but I'm thinking he'll likely get out early next week. And we'll stay in town a few days after that. I have the hotel booked from next Monday to the Monday after that. And from Thursday to Monday I'll be staying with the friendly resident that's taking me in off the streets. The media folks are already moving into the hotel - mostly roadies at this point. The town is getting crazy. I had SO hoped to watch the game from a safe distance, but no such luck. But at least I'll have a roof over my head - that's more than most patient families will have.


So all in all, things couldn't be better.
Or: We're in pretty good shape for the shape we're in. :)

From Indianapolis

We've been in Indy for 2 weeks with John in IU Methodist Hospital. He passed out at work on the 15th - fell right on a huge cardboard box half-full of plastic cups so he didn't hurt himself - scared some employees, got taken to Goshen Hospital by ambulance, and on the 16th was sent by ground transport to IU Methodist, where IU's cardiac service is. He got a heart cath on the 20th, went into complete heart block (which we've been waiting for for 3 years, due to radiation damage to his conduction system), got a permanent pacemaker on the 23rd, started having V Tach (rapid & ineffective beating of the lower half of the heart - not a good thing) on the 25th, got an EP study (they took him to the cath lab & crawled through his conduction system) with ablation of some suspicious areas (cauterized the places that might be the source of said V Tach) on the 26th, and got a stent put in his right coronary artery on the 27th. They were planning to discharge him tomorrow (the 30th), but last night he started having some more V Tach, so they're tweaking his medicines to fix it, and he may go back for another EP study. This tweaking can take a long time, depending on how long it takes them to hit on the right combination for a particular patient. So we may be there for a while.

We were hoping to get out of town well before the Super Bowl crowd arrives, but no such luck. All the hospital families are scrambling to get a roof over their heads, since every hotel room in a 50-mile radius is booked for the game. I have to be out of the hotel by noon Thursday, since it is totally booked by media and they are arriving early. I thought I'd be sleeping in a chair in John's room (I went to college - I've slept in worse places than that), but a sympathetic resident offered me her spare bedroom and bath, and I'm taking her up on it. So I'm okay.

Jethro the dog is boarded at the vet and having a wonderful time. He and Willie play and romp, and he comes home and spends a week sleeping it off. This is doggy vacation for him. Good thing somebody's getting a vacation!

Concerning Casseroles

I find great hope and consolation in casseroles.

When I was little and I was unhappy about some event in my life, Mama would tell me to go think of something good about it.  I remember one time when I was unhappy that Daddy was going out of town on a business trip. Mama said to go and sit on the couch until I thought of something good about it. I remember sitting there and wracking my little brains until the light bulb went off. When Daddy was out of town, we could have casseroles for dinner!

There's some backstory here. Daddy wouldn't eat leftovers or casseroles - I think because he was a Depression child, and leftovers and casseroles were for poor people. Mama was also a Depression child - for her, leftovers and casseroles were for reasonable, responsible people. So Mama and I had them for lunch while Daddy was at work. (For some reason that didn't bother him. He was okay unless he had to eat them himself.) For me, leftovers were a second chance at something that had tasted really good yesterday, and casseroles were the greatest food in the world.

So all that started me looking at life in a certain way. Some folks think I'm optimistic and some think I live in denial. I think I look at life logically: ignoring the good is no more logical than ignoring the bad. And logic dovetails with theology here. If I believe that God is all-loving, all-knowing, and all-powerful, then it is only reasonable to trust that whatever happens in my life is for my good. Good is not defined here as comfort, earthly happiness, or preference. We're talking here about eternal good - something I can't reliably determine, being finite and human and sinful and all that.

So anyway, that brings us back to Indianapolis. Everybody here expected me to be upset that John went into complete heart block; if he had to do it, there's no better place in the world than on the IU Methodist cath lab table. I was supposed to be unhappy that he needed a permanent pacemaker; it has allowed them to control his heart rate more aggressively, which seems to have taken care of his problem  with holding fluid and needing strong diuretics. I was supposed to be in great distress that he went into V tach, needed to be cardioverted, and got an EP study and albation; I'd much rather he did it here than at home, and thrilled that he got ablated and fixed. When the stent came along they felt so bad for me that they gave me two free meals; I'm glad the lesion was in a stentable place and am eager to see how much difference that makes in his energy level. I would tell Mama that all of this is good. I'm not being brave or self-sacrificing or anything lofty and commendable. I'm being logical. Which may or may not be better than being brave and self-sacrificing - that's another discussion.

So anyway, this is the week for casseroles - a very consoling and comforting food. I suppose the moral of all this is that when life throws things at you, just make a casserole and enjoy it.

With a Nod to Tennessee Williams

Like Blanche Du Bois, I am depending on the kindness of strangers.

We're still in Indy and John is continuing to provide entertainment and educational opportunities for all. His cath showed more mitral regurgitation (valve opening too wide) than mitral stenosis (valve opening too narrow), and the tissue around the valve was too calcified for them to be able to suture a mechanical valve to anything. So the best way to improve things was to slow his heart rate down. While the docs were discussing that, John went into complete heart block at a rate of 30-40, thus solving their dilema for them. So he got a pacemaker, and some changes in medicines allowed by the pacemaker. Then he started having rapid abnormal rhythms (V Tach, for the medical out there). Amiodarone didn't control it completely, so after a night of sustained V Tach requiring cardioversion (mild electrical shock), he went to the EP lab for them to find the tissue initiating the abnormal rhythm and albate (cauterize, get rid of) it. John threw a monkey wrench into the proceedings by refusing to go into V Tach in the cath lab. So they nosed (cathetered) around his left ventricle, found several places where conduction problems were indicated, and ablated those. Whether any of those were the true offender remains to be seen. Probably at 2 AM some day. That's when he likes to go into V Tach. Now about all those strangers:

Everyone here had been so kind to us. John's nurses love him - understandably, since he is the world's only perfect man. But they are also being very nice to me. I have solemnly promised not to answer call bells on any other patients, and they are letting me do all kinds of things for John and haven't thrown me out yet. Doctors and nurses that took care of John other places keep dropping by the room to visit and see how he's doing. They've begun to look for me in the cath lab waiting room, since I've spent 3 days there in the past week. The cafeteria cashiers chat with me. And the lady that I pay to get out of the parking garage shows me her knitting progress for the day, and looks at mine. But the greatest kindness of all was necessitated by the NFL.

In case you've missed it, the Super Bowl is coming to Indianapolis. This means a lot of money and a lot more inconvenience. What hurts the hospitals is that most family members are being kicked out of their hotel rooms. This isn't being mean or just wanting more money - the rooms have been booked for months for the game. The hotel I'm in is hosting media in all it's rooms, so I have to be out by noon on Tuesday. I've known this since we made our reservations - never dreamed it would be relevant  - I underestimated John's ability to come up with dramatic events in a short period of time. There are no hotel rooms available within an hour of the hospital. So I'd been thinking I'd end up bunking in the recliner in John's room. The hospital has showers for family members, and John has a pair of PJs that I could run around in and be decent. But a stranger came to our rescue. One of the residents that has taken care of John is taking me in Tuesday noon, for the duration. I am overwhelmed by such an act of kindness, and am very grateful to her.

So I thank all the kind strangers - that have taken me in, not thrown me out, talked knitting with me, smiled in the cafeteria line, laughed in the cath lab waiting room with me, listened to my hospital horror stories, and respected me as a nurse. I'm grateful to Fr. Nabil and Fr. Radislav (not strangers!) who have come and prayed with us. I'm grateful to all the doctors-nurses-nurse practitioners-fellows-residents-interns-miscellaneous who have put their wonderful brains together to figure out what is best to do for John; we can tell that they care, and he is better for their care. Not everybody who depends on the kindness of strangers has to end up like poor Blanche.

On Being Off the Clock

I'm no good at being in a hospital and not on the time clock. After 20 years, when I'm in a hospital I want to DO THINGS. Things that visitors can't do, aren't supposed to know how to do, and certainly aren't supposed to want to do. There was an emergency on John's unit today; I sat there gritting my teeth and repeating to myself, "I'm not on the clock. I'm not on the clock .  .  ." Nurses are nice to me; after determining that I'm harmless, they let me do lots nursing things for John. Doctors are nice to me; they speak medical shorthand to me and I translate when John needs it, which isn't often after 34 years with me.

I must still ooze hospital from my pores - today a cafeteria cashier asked me if I wanted to pay with my employee card. I do still have the walk. John says that we'll be walking along together at the same speed, and when we walk through a hospital door my walking speed increases and I leave him behind. And I feel so at home in a hospital - any hospital, but the bigger the better. Today when I came back with my lunch I walked right past John's room; I was looking at the storage layout of the unit. Hospitals are in my blood. There's just nothing to be done about it. 

Now to update everybody on John: After a bunch of testing they have demonstrated and quantified his mitral valve stenosis, and decided that they can repair the valve instead of replacing it. It will be a cath lab procedure instead of heart surgery, which is always preferable. They will thread a catheter from his femoral vein (the one in the groin) up to the right side of his heart into his right atrium, through the atrial septum to his left atrium, and then to the mitral valve. They will inflate a balloon in the valve opening, to spread the valve leaflets out and let more blood get through. His cardiologist said that surgery can be done if necessary, but this is certainly worth a try and will almost certainly do the trick. His mitral stenosis is quite severe, which is what I've been telling everybody, no matter how minimal it looked on echo.

Nothing will happen tomorrow, so we'll just be hanging out. We really enjoy just hanging out together. They'll do the valve on Friday or Monday, depending on the schedule. He should go home all fixed up. And I'll have learned my way around another med center. Off the clock.

It's a Nuisance, Not Crisis

ROAD TRIP!

I'm in Indianapolis, after an adventurous day. This is actually quite typical of my marriage to John. He went to work yesterday and passed out, falling on a very convenient box full of plastic cups so he didn't even get a bruise (no word on the fate of the cups). So after scaring his co-workers and taking an ambulance ride, he seems to be fine.

Discursus for background: He had Hodgkins Disease when he was 19 and got 4 rads of radiation. He's been dealing with the results of the radiation ever since - 2 heart surgeries for scar tissue in his coronary arteries, 1 brain surgery, carotid artery surgery, lung cancer, and scarring of his mitral valve. And all that radiation didn't work anyway. The Hodgkins came back as our 3-month anniversary present. He got chemo that time, and it did work. If he'd just waitied a few years until the chemo protocol was out, all this could have been avoided. And life would have been much less exciting. 

Anyway: We've been watching the mitral valve for a couple of years. The scar tissue is narrowing it and causing congestive heart failure. They kept him in the hospital overnight to be sure he was okay, then his cardiologist came in this morning and said he was sending him to IU to get him valve replaced. Today. ASAP. So John left by ambulance a little after noon. I followed after getting the dog boarded, the trash to the street, John's things packed, my things packed, food packed for the week, the dishwasher unloaded and reloaded, and I don't remember what all else.

As I said, this is typical for us. Whenever he has an emergency his mother just sighs and says, "It's a good thing he married a nurse." And he does have emergencies. (NB - He's never had a crisis. To a critical care nurse anything that can be gotten over is a nuisance, not a crisis.) And he's the least dramatic person on the planet. When he was diagnosed with lung cancer last summer and told he'd probably survive a few months, all he said was that he would try to live long enough to do the taxes. This is not duty and self-sacrifice on his part; there are few things he enjoys more than doing taxes. This was an incentive toward survival. (I'm not too normal myself. The first thing I thought - and, of course, said - was that at least he could have a port for chemo this time. His last chemo was before ports were invented. The oncologist was shocked. He shouldn't have been. He's known me for years.) The incentive worked; this kind of cancer doesn't go into remission but it's at bay, reduced from before chemo, and he's been promoted to maintenance chemo. So paying taxes is actually good for you. 

So anyway, road trip. We're here for a week - or 2 - or goodness knows how long. Thankfully I have an understanding boss and veterinarian. Jethro the dog is happy as a clam. Being boarded at the vet's is vacation time for him. He has a wonderful time, then comes home and spends a week sleeping it off. We may need a week sleeping it off, too. When we all get home we'll form a mammal mound on the sofa, put on ESPN, and recover from it all. Until the next excitement comes along. It really is a good thing he married a nurse.

Of Geeks and Octopi

I am a geek. I say that without shame, apology, or equivocation. And I love TV shows that show geeks as healthy, useful people - shows like Mythbusters and the late, lamented NUMB3RS. I was probably born one. But I remember very well the day I came out. I was in 5th grade, so we're talking about 1965 here, and we're in the Deep South. Geeks there were, but they were seldom girls.

Those of us who rode the early busses had about half an hour until the late busses got there and school started. We generally hung out in our homerooms. I was doing said hanging out one day, when I looked up and saw Keith running toward me with a jar in his hand, and in the jar was an octopus preserved in formaldehyde.

Pause here for backstory: I was an only child - not by choice; my mother miscarried four times. Not by my choice, either; there is nothing to distract your parents from your behavior. Sometimes on cold, rainy days when there wasn't much to do, so I would lie on my stomach on the living room rug and read the World Book Encyclopedia. My favorite part was human anatomy, with all the overlapping plates showing how the organs, bones, and muscles lay. I adored biology. I ended up majoring it in when I went to college, changing my major to nursing after 2 years - exchanging pure biology for applied biology.

Anyway, back to 1965. While Keith was running toward me, I was thinking. He wanted me to run away screaming. If I did, I'd end up popular and date a lot. If I didn't, I'd be one of the guys and they'd never even consider asking me out. But if I ran away and ended up dating somebody, I would always have to pretend I was really like that. If I didn't run I might never have a date, but I could be myself.

As Keith approached with the pickled octopus, my future flashed before my eyes - in 2 versions. I knew the choice was crucial to the course of my life. So I made one of the most important decisions I've every made. I met Keith halfway to get a closer look at the poor pickled creature. All the guys gathered around and we had a lovely morning examining all the preserved fauna in the classroom.

Well, I did become one of the guys. We moved away before dating started, but not before 2 guys nearly came to blows to get the last dance of 7th grade with me. And I married a wonderful geek that loves being married to another geek. I wasn't popular until 8th grade. (Sure way to popularity: Have a strong southern accent and move somewhere else. It makes you exotic, fascinating, and completely irresistable. And it's effortless.)

It seems that this story does have a moral. When being yourself has a price, pretending to be someone else will always have a higher price. And the world needs geeks. So if you've got it, flaunt it!

The Great White Silence

Most of our snow has melted now, but it was beautiful for a couple of days. We didn't see much snow in Atlanta, so I grew up getting excited about it when it came. I've lived in the midwest for about 25 years, and I still get just as excited. It's what snow does to flat, empty land.

Our living room window looks south toward Terry's farm, where he alternates corn and soybeans. When it's all been harvested, like now, we can see nearly a mile over flat fields to the next line of houses, barns, and outbuildings on the road a mile south of us. It's a beautiful view all year, but under snow it has a silent, majestic dignity about it. Snow turns the landscape into a vast, white, empty, silent wilderness. There is something contemplative about the countryside in snow.

 I do morning prayers at that window and watch the sun come up, turning the sky and snow the same colors of pink, blue, yellow, and peach. I see the bare trees naked against the sky. Each species of tree has its own branch pattern, and each tree is a variation on a theme. Then there are the old bird nests and squirrel nests that can be seen. Limbs lost to storms, or to the Tree Police - what we call the county folks that cut them back to lessen the number of power outages in storm season. A tree bare against the sky is just as beautiful as one in full summer flower. It's just a different kind of beauty, one approproate to the season.

And the season is about hunkering down, simplifying, waiting, turning inward as we get out less. My prayer changes as the view out the window does. And prayer this time of year is quieter, more centered, more settled and inward, and longer. It is easier to turn inward when nature does the same. It is good to have winter between the Feast of the Nativity of Christ and the Great Feast of Pascha (Easter, in the West). The inner work of Lent can be done with fewer distraction in winter.

 How this works out in the Southern Hemisphere, I have no idea. But being a flaming introvert, I cherish the great white silence of winter.