A Robocop Picture From Rehab After My 2014 Stroke

 No, it did not hurt.  It was part of trying to get my right hand fully functional again.  It has never completely done so.

4mm Kidney Stone

 My urologist does an annual X-ray for stones.  This time it shows a 4mm stone so I am taking Flomax to encourage it to leave under its own power.  From what I have read Flomax is only statistically significantly better than placebo in the 5mm-8mm size, because <5mm stones usually pass without help.  The ureter inside diameter is 6-8mm so this should pass easily.

Nuclear Stress Test

No, not a North Korea problem.  The symptoms that I have been having of shortness of breath when under cardiovascular stress (like climbing my absurd driveway) caused the cardiologist to schedule the ominously named "nuclear stress test."  (The symptoms are much like the period before the horrendous aortic valve replacement surgery.)  Fasting, then a 4 hour test where they inject radioisotopes, look at blood flow, then inject a dilating medicine and check the blood flow again.  The good news is that if the aortic valve is failing, they no longer cut you open.  They do a transarterial valve replacement.  They run a cathether to the valve and put another valve on top of the old one.  Not without risk, but no worse than cutting a hole in your chest, and far less painful.

Cold-Induced Asthma

I have battled this for several years.  I bought a hunter's mask intended to solve this; a copper mesh over the mouth causes exhaled air to warm so your next inhale is warmed air.  My wife and I took the Springer Spaniels for a walk this evening at Eagle Island State Park, and pain in my lungs and rapid exhaustion held mne back on a flat and not terribly brisk pace.  The mask did little good.

It isn't cold air alone, I think, because without the mask, I was no worse off.  I worried that my aortic valve is giving up the ghost and this is oxygen deprivation, but 30 minutes at 2.1 mph on my treadmill in a nice warm house is not a problem.  I suspect that while cold air is a problem, the mask is adding a different problem.  It traps exhaled air so you are inhaling air that is now 4% carbon dioxide. The oxygen content is this reduced to 15%.  This is not enough to provoke the asphyxiation response from CO2 buildup in the blood, but I suspect the reduced oxygen is straining my system's cardiovascular capability.  The mask is no longer going to be used; if there was a mask that warmed incoming air (likely battery powered) but did not cause use of exhaled air, it might be worth trying.  Otherwise, I will not walk in cold weather.

There Will Be Blood

Not just a movie title.  The nurse removed IVs from both arms yesterday, and even hours later they were bleeding.  My daughter brought me home because Rhonda has the flu, and Hilary rebandaged both sites.  And Rhonda did both sites again in the evening.  At least at 6:00 AM, I remembered to apply styptic pencil to the still bleeding left arm hole.  It didn't sting, but it does seem to have stopped the bleeding.  The right arm site seems to have stopped.

I'm washing sheets in cold water and borax because hot water sets blood.

The pain in the right leg:  where they chainsawed me open (apparently a large incision required to repair a hole in an artery; those are high pressures pipes) hurts, but mostly a dull ache.  Some inches below there on the inner leg, I was having pain like a very precise blowtorch was being played along the inner part of my leg.  The vascular surgeon says that is a nerve, and will go away in days to weeks.  I iced it all of yesterday, and it is getting better; it doesn't always hurt when I stand on that leg now, 

I used to wonder how people could regard death as a mercy; I no longer wonder.

ER Again

Appendicitis?  Apparently not.  But catheterization site in my groin now has a pseudo aneurysm which a vascular surgeon is fixing in the morning.  There is sign of appendicitis and the hope is that pain in my lower right side is radiated pain from the pseudo aneurysm.

The good news is that my anemia is nearly gone.  I had something similar to energy today!  My hemocrit number is almost normal.

Curiously,  the  lower right abdominal pain is either gone or masked by whatever painkiller they gave me during surgery.  I can feel the place they chainsaw ed me open to get to the femoral artery, so I am thinking the "appendicitis" was actually caused by the pseudo aneurysm.

I need to find less traumatic ways to spend weekends.

After a,whole day, the abdominal pain is gone.   Glad I persisted as did the E/R doctor.

Two Mornings of Steak for Breakfast Are Doing Something

And the iron supplements and B12 the last few days.   I am less winded by walks.

Recovery From Two Procedures: Is the Time Additive or Multiplicative?

I was told that recovery from hernia repair would take a month.  I cannot find an expectation of how long recovery from angioplasty should take.  But do you add those times or multiply them?

The place in my groin where they inserted the catheter into my femoral artery is such a mass of bruising, I find myself wondering if they put a tool there and used a ball peen hammer to drive it in, often missing the head.  It is still sore.

Better than dying, of course.

Let Us Now Praise Western Medicine

For all the hype I hear from the soy-drinking hippies about the superiority of Eastern medicine, I have yet to hear anyone comment about angioplasty.  Had this been in common use in the 1970s, my father would likely have survived.  Think about it for a moment:

1. Push a tube from femoral artery up to arteries in the exterior surface of the heart.

2. Use a balloon or wire at the end of the tool (sometimes a rotating blade) to expand the artery to knock plaques out of the artery.

3. Stick in some stents (little mesh tubes) that keep the artery from shrinking back and clogging again (at least there).

4. Pull the tool and catheter out.

Next day, you go home.  Miraculous stuff!

I Think I Have Figured Out the Anemia

My wife is gluten intolerant and so wheat was no longer appearing in our home the last few years.  We eat out ar Mexican restaurants a lot and she always insisted on corn tortillas.  Guess what?  Wheat bread has 4x the iron of gluten-free bread, and flour tortillas have 4x the iron of corn tortillas.

Interesting Hydraulics Problem

Before the angioplasty,  anytime my blood pressure went above 130mm, I had chest pain. Then they gave me nitroglycerin, the pressure dropped into the 130mm range and the pain stopped.   The student will identify which variables are required to identify the amount of blood flow reduction in the circumflex artery.

Please: For Your Own Long Term Benefit

Eat less.  I am hoping that enough oxygen to the furnace will increase calorie burn, but it would have been better not to have even reached this point.

Best Night's Sleep in Many Months

And in a hospital bed. Working hearts are wonderful.

Being discharged as I blog.  The circumflex artery was 90% blocked.  The left anterior descending artery which was cleaned and stented in 2014 needed additional cleaning and stenting.  Anemia still explains some of my recent exhaustion but that is easily fixed.   While it is nice to have such a relatively easy fix for this,  losing weight is even more important.  Of course, this may get easier with enough oxygen feeding the furnace. 

And yes, angioplasty is relatively easy compared to bypass surgery.  Still very unpleasant even with a wonderful hospital like St. Alphonsus.

Blogging Very Limited

Heart attack Thursday  morning,  but fortunately a small one.  I had angioplasty absurdly early this morning.   This was through the femoral artery so I cannot stand or or walk for a 10 hours and to call the channel choices bad is like mistaking a hospital bed for a place to sleep.  ]

Going home in the morning.   The pain is gone, and they found arteries with limited capacity that needed stents.

The Enzyme Level Was >0

When i went to E/R this morning.  I am now in the hospital,  waiting for an angiogram and angioplasty.   The back artery that was not cleared in 2014 because I had a stroke probably needs cleaning.   This is fortunately a simple procedure,  usually out next day.

I am so glad that I live in a country with a spectacular health care system,  in spite of the Obamacare blunder.

I Mentioned Watching Twilight Zone: Rod Serling's Lost Classics

last night.  There is a reason that Rod Serling's early death was such a disaster to the arts, and this one of them.  The first of the story's either a descent into mental illness, or a supernatural discovery of dangerous predestination as were many of the episodes of the original series.  The second story is one of those reminders of how much of the mainstream of our culture has changed over time.  Like many of Serling's stories, death is an inevitable process not to be feared, even if there is nothing afterwards, but as one line observes, "like going to sleep after a long and tiring day."  In this Serling captured well the dominant Judeo-Christian perspective of Western Civilization even ignoring the assumption in Daniel 12:2:

Multitudes who sleep in the dust of the earth will awake: some to everlasting life, others to shame and everlasting contempt.

The older and sicker you get, the less frightening death becomes: only the prospect of a painful death remains truly frightening.  I have obviously spent a lot of time contemplating the inevitable since my 2013 aortic valve replacement.  Even without the hope of John 10:28:

I give them eternal life, and they shall never perish; no one will snatch them out of my hand.

Death becomes more and more: "like going to sleep after a long and tiring day."

Along with the Good News, the good news is that since I started on the iron supplements this morning (and a wonderful medium rare steak tonight), many of the symptoms have been alleviating.

Tired of Visiting E/Rs

I have been having some unexplained shortness of breath problems since at least May when a 1.2 mile walk to the convention center where the NRA Annual Meeting was held left me struggling to keep up with an NRA employee wearing high heels.  Last night, the "overly demanding" exercise was 90 minutes of doing the couch potato.  Many of the symptoms were those from before my aortic valve replacement; I spent several sleepless hours deciding whether the post-operative pain of going through that again was worse than calling it a life, and moving on.  Thinking through the effects on my wife, kids, and gun rights, I decided that it was worth it.  (Or perhaps doing the slightly riskier transarterial valve replacement (TAVR), which does not require cutting you open.)

This morning, the shortness of breath problem woke me up.  Walking to the kitchen to prepare breakfast not only exhausted me but produced upper left chest pain.  Nitroglycerin pills solved the pain, so we set out for the St. Al's E/R.  The very concerned, engaged, communicative (can I think of some more positive adjectives?) doctor found an EKG no worse than my last post-myocardial infarct EKG. 

Dying heart muscle produces a protein called troponin in the blood.  Even three hours later, there was none in my blood, so he ruled out a heart attack as the cause.

What he did notice was anemia.  Many symptoms of anemia mirror a heart attack because insufficient oxygen in your blood causes the same problems as the loss of blood flow to the heart; nitroglycerin essentially explodes the arteries open, improving flow of whatever oxyhemoglobin actually is present.  The E/R doctor also thinks my recent hernia repair surgery might have lowered my hemocrit levels, which can take 60 days to recover.  He pushed a previously scheduled cardiologist appointment up from August 9th to tomorrow. 

This Whole E/R Thing is Getting Old

I have been having shortness of breath issues for some months now, including after 90 minutes being a couch potato last night.    This morning walking to the kitchen was too intense, and I was having upper left chest pain.  Nitroglycerin took the pain away,  so to the E/R.  The EKG was normal; the treponin level indicated no heart muscle death,  but I am anemic and the incredibly concerned and engaged E/R doctor thought these might be symptoms of that.   Unsurprisingly, the reduced oxygenation of the blood has many similarities to a heart attack.   He is having my cardiologist jump me in queue for an appointment and having me increase my iron intake.

This anemia might be a product of the hernia surgery,  but when I was in Dallas in May,  a 1.2 mile walk left me utterly overwhelmed,  so I think at most the hernia surgery tipped me over the edge.