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.