Wednesday, March 4, 2009

The Winter Breaks 2009

The Winter Breaks

Some of you may remember that I experienced three sudden hospitalizations a year ago. The first stretch, lasting nine days, occurred after I nearly died--twice. The second near death experience happened whilst flunking my stress test at the U. Go home? They had a room—good grief! They committed me. Just like that. There go the errands.

Then they sent me to the cath lab, where they feed a catheter from a groin artery all the way up and through and around the heart. Afterwards they assign a tech to stand by your gurney and press down with all their might on the “wound” (the hole they just bored) so you don’t lose blood. I was heart-cathed, MRI-ed, CT-scanned, X-rayed, heart-cathed again, during which I was outfitted with one arterial stent, at a cost of, yes, blood. (The gurney guy must not have had his heart in his job.) Two pints of O-neg transfused and the cardios figure maybe I’m cured.

The stent wasn’t, strictly speaking, warranted according to protocol since the artery, first measured 30% occluded, revised upward to 50% after another scan, eventually bumped up to 70% based on I don’t know what. But even 70% doesn’t meet the criteria, and the other arteries were clear. But stents are what cardios do. They did it—job well done. Clean bill of health. Pack up your rubberized bed socks, plastic basin, puke tray, and toiletries.

“Not so fast.” On come the electro-physiologists, cardiologists with an additional residency in the heart itself and its beatings. They observed that my heart was going whacka-whacka, accounting for all the instances of severe chest pain and shortness of breath. Down I went to get my heart ablated. Ablation is cautery of places in the heart muscle tissue that are wildly arrhythmic, ending the patient’s v-tach (ventricular tachycardia) and associated medical crises, thus freeing the patient. Libre comme les oiseaux! Not exactly. I emerged from surgery with a stiff, metallic, electronic playing card under my flesh between my tit and left shoulder. This is an ICD (implanted cardioverter defibrillator), a device that acts like a pacemaker (regulator) and if that doesn’t work you get zapped. Think about those medical TV shows where they bring in those paddles and say, “stand back!” ZAP! And the body bounces up off the bed. That's the power in my device, within my flesh.

The interesting thing about the ICD is that its bearers have something like a community thing going, thanks to the manufacturers who spring for these bonding events: meetings, parties, annual picnic. The Christmas party was a lavish spread. I digress.

I got the ICD, I’m told, because too much of my heart needed cauterizing. It made no sense with an ICD available.

So with stent, ICD, and an array of cardio meds with unpronounceable names, I exited the Umich Hilton after nine days, nine days of: watching endless judge shows, Bridezillas, reruns of Monk, and How It’s Made: curling pucks, cricket bats, inner spring mattresses, Hokey sweepers; roommates like the bellowing Alzhie, Seraphina, and the woman whose husband yelled his belligerence at every staffer crossing the room threshold; and bands of baby docs, nurses, more docs, more nurses, people with hospital ID and indefinite job description, all looking down upon me quizzically, then asking oh-so-delicately if they could “just…take…a…little…peak…at your, um, groin…area?” (I wonder has anyone said no. Or hell, no! I wonder whether someone could be in such denial about the way of hospitals and their identities as technical organisms to feel any delicacy at all. Many things are mystifying though.

Peace in the valley. Not quite. A week later, feeling clearly dreadful, I had no choice but to return. The diagnosis this time: acute renal failure. How do you like that? One of the unpronounceable meds was apparently shutting my kidneys down. But that was just overnight, sort of like a sleepover.

Things went more or less OK, if brisk walks around New Orleans were an inidcator, notwithstanding periodic angina, but I had my granny pills (sub-lingual nitro-glycerine) and I felt good. I started cardio rehab in mid-April, progressing well, but then I got zapped. One of the elists calls ICD folk joeys until they get “fibbed,” thus morphed into a kangaroo. Pleased to meet you. I had a no good, very bad v-tach episode, between the parking lot at work and my office. I was dying all along the way. Heart wild, brain flooded with explosive special effects. Then my trusty ICD rose to the occasion as I sat on a chair near the elevator I’d made it into, not dead. ZAP, and I was good to go, a full-fledged ‘roo.

This information was fed from my bedside monitor through the phone lines to the ICD clinic, whose staff were concerned. At the same time the angina remained and my QT interval was squeehunkie, so it was decided, while I was at the cardio rehab clinic getting ready to aerobicize in my cross trainers, shorts, and jogbra, to ambulance me back to the U for another stay to sort my treatment regimen out. This was the second to last week of the semester; I stayed six days, getting out just in time for finals week.

My intimate relationship with the cardiology establishment continues but I have most of my life back. I’m doing well. So this past week, winter break, I felt a comic flirtation with the memory of the previous winter break, the first hospitalization, that last week of February, 2008. Would I make it through without hospitalization? Of course. Silly. Could I be cursed? Doomed to a re-peat? Nah. Kind of whimsical to speculate, eh? But creepy anyhow. And creepy it was.

On Thursday afternoon of winter break we were visited by a stray cat I had come to call HLB, the horny little bastard. Our cat, Cookie, dumped on our property as an eight week old kitten in September, had been kept indoors since then so we had postponed spaying her. Once HLB got a whiff of Cookie in heat, he came around. A lot. Mewing quietly. Earnestly staring in through the window. Rolling around on the deck. He’d circle the house, yowling his unrequited angst. So on that Thursday, February 26, 2009, on one loop I went out and keeteekeeteed him and he came over. HLB is one big lug. At least 12 pounds, ergo fed, perhaps owned. But his coat was a bit matted and at his neck I could see vestiges of an embedded collar. Collar gone, neck shorn and possibly stitched. I leaned over and he seemed to welcome my chin rub till I got too close to the wound. Lightening fast, he bit and scratched me deep into my thumb. OK, so I wanted to see the neck scar plus I thought I could see if he had balls. My fault all around. One doc would call it a provoked attack. Jean, Cat Provocateur.

I went inside to wash my thumb well, slather it with antibiotic ointment, then bandage.But my thumb grew to the size of a very large fig. I’ve had plenty of bites and scratches, but this time they were so very painful I couldn’t sleep. NSAIDs didn’t help at all. In the morning the thumb was purple, red, green, with a bit of yellow and it continued to hurt like hell. I know what you were thinking. Why didn’t she go to the ER? Gosh. An Irish nurse’s daughter, it was chin up, others have it worse. Others go to the ER. I knew though that a trip to the vet to buy meds would resolve this stalemate. Vets and techs know their bites and scratches; they’d tell me what to do. And they said to go to the ER, right away! It’s happened. Winter break and I’m back at the U, by way of Saline Hospital ER. I was stablized at Saline and given the most wonderful pain killer, dilaudid , through IV. (Trust me. If you’re offered dilaudid, take it.) And the ambulance took me away. Suddenly it’s déjà vu. My reflections from last year (above) suffice for this new visit, where I was reduced again to this pathetic, redundant humanoik in my pitiful gown.

Though I never was lanced or punctured, except for the IV and the one puncture did it all. But I was violated. Hospitalization is a drag but becomes a locus of sheer desperation when one is violated. IVs violate but can be endured and forgotten as long as it doesn’t take three people to each give it a try: stab, (“let me try”)stab, “that vein’s real floppy”) stab. But the major abdominal surgery to give surgical birth to my son was violating. The stent was violating. The ICD implantation was violating. Nothing this time was apt to violate, except for one thing. A PA raised the option of rabies vaccine. And I, quite sure HLB was NOT rabid, agreed. I had a bad feeling from the start. Then I was told I’d be getting six injections, one the vaccine, the other five gamma globulin. It was these that were nothing but violent. Fortunately, two nurses did them in pairs: stab, stab, stab--arms, hips, and buttocks.

More shots, the ordinary kind, await, but the gamma glubulin shots have left me shaken, agitated, fearful, weepy, and enraged! I’m thinking of Mr.Belvedere, a home remodeler in Detroit who did his own TV comercials in a plodding, sadsack monotone: “We—do—good—work.” I remember reading that the lethargic Mr. Belvedere had sets of dishes in his basement and when he was filled with rage, would go down and smash plates, and cups, and saucers against the wall till his madness dissipated. Me? I’d prefer dilaudid. But it’s about realizing that my body is penetrable, rippable, puncturable, sliceable, could even be smashed to smithereens. And here I am expecting my molecules to cohere. As they do all the time. As they show little inclination not to. I think there’s a word in chemistry to explain the tendency of people not to come apart. But there you are, violated, your faith in your body’s integrity dashed for good. Like Warren Zevon’s hockey goon from Windsor would say, “I just want to hit somebody!”

Meanwhile, my injury had to be reported to Monroe County Animal Control, which requires us to trap HLB next time we see him so he can be hauled off and euthanized. Not so fast. I don’t want them to cut his head off and send it to Lansing. Especially since I tried to look at his nuts. I mean. Give him a break. He was only protecting himself. And for this he should lose his head, not to mention body integrity? Cookie will be spayed. Her heat is over. Peace in the valley. Till next break?

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