Friday, July 12, 2013

starting to feel like we own the place

We're two days out from my latest round trip to Regions Hospital.  This last visit came this past Wednesday when Miz Susan and I put in full days of work, arriving at 7 AM and getting thrown out at about 3 in the afternoon.  I'm starting to wonder how many more punches on our card in the ramp we need to deserve our own rock star parking spot.  I guess that we really don't want to know.

The adventure started about 5 weeks ago.  I received calls from the Heart Center to tell me that the remote monitor which watches over me while I sleep had picked up distress calls from my pacemaker which indicated abnormal rhythms.  What else is new?  That seems to be about all I have.

I learned during a quick trip down there that I was experiencing atrial flutter and that I was in need of an atreal flutter ablation.  Who was I to argue?  It turns out that my ticker was churning out rapid and weak compressions in its upper chamber and that that this was something to be avoided.  And that the crack staff at the Heart Center had just the procedure for me.  An atreal flutter ablation.

There were a few preliminary steps which I needed to take before the real fun could begin.  One was to dispense with taking my baby aspirin in the morning and instead start taking little red martial-arts-throwing- star-shaped tablets of something called Xarelto.  They loaded me up with nearly a month's worth of free samples and sent me home with orders to come back on July 10th and to get a pre-op physical scheduled.  One of the attending physicians neatly ducked my question about the cost of a refill of Xarelto when the free ones ran out.  Smart guy.  The refill set me back $175 when it came time to do that.  And that was discounted on the Walgreen's prescription plan for the overmedicated and under-insured.  You may have seen Xarelto's ads on national TV.

I hate getting physicals.  Pre-op, annual, army induction (as if I'd know): you name it, I hate it.  I take terrible care of myself.  I don't test my blood sugars regularly.  OK, I don't test my blood sugars at all.  I can't lose the weight that my doctor tells me to lose, not to save my life.  Literally.  I eat and drink all manner of things which provide instant gratification but which are irreparably bad me.  I'm wracked with guilt before I go into a physical and I'm wracked with guilt during a physical as I lie to Dr. Mahmoud about how I'll try to do better.  These are not good experiences for me.

Dr. Mahmoud, my family practitioner, is an adorable Pakistani who undoubtedly sees through my lies every time I trot them out.  She probably rolls her eyes and takes a deep breath before coming into the examining room to see me and she probably leans back against the door, rolls her eyes and breathes a deep sigh of relief after she's left the examining room.  I don't wish her any harm; I'm just a bad patient.

I got off lucky this time.  My blood pressure decided to come down out of the stratosphere and I've unexpectedly and unaccountably lost some weight.  I called this minor weight loss to her attention and said that I was disappointed that she hadn't congratulated me on it.  She responded by saying, "David, I think you're doing very well."  While looking forward to that deep sigh of relief she was just waiting to release.

I'd scheduled the pre-op physical just a day before the ablation procedure so I didn't have a whole lot of time to rest on my laurels.  Really, what would have been the point in getting that scheduled any earlier?  My only regret is that I had to suffer through two straight mornings of not having eaten anything since dinners the nights before.

At any rate, Wednesday morning came way too early, especially for Miz Susan who is not used to being up at 5:30 in the AM.  We managed to get out of the house only two minutes behind schedule and were actually walking into the hospital at 5 minutes before 7.  I absolutely love I-94 eastbound for getting us down to Regions hospital in a hurry.

We checked me in and I was whisked away to my prep room, stat (yeah, I've seen ER).  Where I was visited by half the staff of the hospital for various lectures, pokings, monitorings, forms-signings and donning of hospital attire.  We won't go into that any further.  A bright spot of that stop on the tour of the hospital was the appearance of Alison's and Liz's friend and erstwhile coworker and roommate Andrea.  She cheerfully informed us that she was working the recovery end of the operating room and that she might be my nurse if I survived my time on the table.  I've heard since that she was impressed by my imaginative use of various profanities but she must have been thinking of somebody else.

I remember Miz Susan being dragged away from me and then going for a long and winding ride on my gurney to the operating room.  I remember that it was cold in there and that they offered to turn up the heat if I wanted them to.  I don't think they were serious.  I remember that all the nurses and techs were making jokes, mostly at my expense.  And I remember somebody telling me that they were going to start giving me some medicine to help me relax.  Fade to black.

When I came to, my right arm was aching and throbbing.  This had nothing to do with the procedure (which consisted of threading a line up a vein from the groin to the heart, determining the location of the nerve which was causing the flutter, and then zapping it dead with a laser or an electrical charge or some appropriately harsh words), my right arm always aches and throbs when I've been sleeping. An old softball injury, perhaps.

The damn arm hurt like hell and I started squirming to get it into a more comfortable position.  This must have been one of the things that I had been lectured not to do because several voices at once told me to hold the f--- still.  When I complained that my arm hurt, they cranked up the relaxation medicine and put me under again.

Sooner or later, I was transferred from the operating table back to my gurney and from there to the recovery room.  Where we found out that Andrea was going to be my nurse and that her coworker who covered for her during lunch was an old friend whom I hadn't seen for 8-10 years.  Alison's former supervisor came and introduced herself to Susan and told her how much Alison was missed.  We ran into quite a few people who spoke fondly of Alison.  We felt like we owned the place.

All good things, including this one, do have to end and we got discharged with a minimum of formalities.  We were home for naps by 3:30.  We still had to pay 8 bucks to get out of the parking ramp.  I'm torn between staying healthy and getting that frequent visitor rock star parking spot.

I pictured this procedure as pretty garden variety medicine by today's standards though it remains a complete mystery to Susan and me.  I asked the nurses in the OR about this and, in between jokes at my expense,  they said they were doing five ablations on that Wednesday alone and that our surgeon performs several hundred a year.  This was a time when, even if we didn't understand the magic that was being performed, we needed to put our faith in the expertise of the experts and go all in.  It worked out well that we did.  I'm happy to be here to tell the tale.