Good News ...... and then a Scare!!

This is written in hopes of educating people about the need to be a little more verbal about what is happening to them after a medical procedure.
I spent most of this week preparing for a cardiac catheterization and was feeling pretty good about it. I was not scared or anxious and I slept fine the night before. I had a list of great friends who could provide transport so I felt well supported. I had not made arrangements for anyone to spend the night after the procedure because no one in the medical community had said it would be necessary and I also did not want to ask anyone. I like being alone and I thought I would probably be sleepy.
The catheterization went well. I was given Benadryl and Valium and was awake through the whole thing. There were no blockages and my heart looked very healthy. We were all pleased. I went back to the recovery room and was told I needed to lie still for four hours.
I don’t know if any of this was related but it was all reported to the nurse. First, I had “squiggly light worms” passing in front of my eyes for about ten minutes. I wrote it off as being a side effect of the drugs. Then I had restlessness in my right leg and that was the leg where the cath was put in and I was supposed to keep it quiet. Once they moved me into a different position that went away.
After four hours of little movement I was brought to a sitting position and I asked to see the video of the catheterization. I was able to see the pictures of my heart beating and the contrast die moving through the arteries, strong and clear.
When I stood up, however, things changed. I felt weak in my right leg and when I walked it wanted to drag. I was also listing to the right. It took concentration to keep my gait straight. The nurse saw all of this and I also talked about how it felt like I was dragging my leg. I went into the bathroom to change and that was difficult as my right hand was not consistently in my control. Again, I told the nurse and I said something about it was probably due to the drugs. She did not say anything to contradict me.
Denise picked me up at 4:30 and took me home. I felt like a drunk trying to get in the apartment and, once home, I had trouble pouring a glass of water. Again, I attributed it all to the drugs. I set myself up in bed to watch a movie and then I went to sleep.
It was a restless night. I was up and down and still feeling unsteady. When I got up in the morning I was still being dragged to the right and my hand was not working. I started to be concerned. I called the cardiologist on call and he said that it could be a stroke and I needed to get to the emergency room.
I went into stupid mode. I called my son to come and take me. He lives an hour away and I wanted to take a shower. However, once in the shower I knew I was in danger so finished up as fast as possible and then called the ambulance and called Chris to meet me at the hospital.
The ambulance drivers were very nice and got me to the hospital without a lot of hoopla. They knew I was nervous and when I couldn’t sign my name I became even more so. I was also told that, if it was a stroke, the time period during which they could give me the new drug for strokes had already passed. My symptoms had started on Friday afternoon and the drug needs to be given within six hours. I started to get really mad. I realized that they never should have discharged me with the symptoms I was having.
After a couple of hours in the emergency room with my son and his wife, my symptoms started to improve. I was walking straighter. I was passing the tests and the CT Scan of my brain did not show any evidence of a stroke. The doctor did say, however, that it may have been a TIA - transient ischemic attack (TIA).
From WebMD – “Some people call a transient ischemic attack (TIA) a mini-stroke, because the symptoms are like those of a stroke but do not last long. A TIA happens when blood flow to part of the brain is blocked or reduced, often by a blood clot. After a short time, blood flows again and the symptoms go away.”
By the time I left the ER, I was walking better and could sign my name. I was told to be careful, though, and to rest for the remainder of the day. Chris and Des settled me at home and I spent the rest of the day reclining. Except for a period when I made sure I could still play the cello. I could, not my best, but it was there. I was also able to knit while resting and that was reassuring.
This morning I am back to almost normal. I am a little weak but I think that is from doing nothing for two days. I was told I could drive today so I am going to knitting group and then will take a walk later on tonight, even if it around the parking lot.
On another note – I think the new dopamine enhancer that my naturopath MD gave me is helping reduce my food cravings. I have not had chocolate since Tuesday and I have not killed anyone. I am not obsessing about sugar.
When I talked to my therapist about this last week she discussed the chemical reactions that may cause some people to crave sugar and chocolate more. If we can get the balance just right, it would make a difference. That explains why some people have little need for sweets and chocolate and can make healthy choices. Some of it is how they were brought up, but a lot of it is their chemical balance. I feel hopeful. We also discussed the psychological aspects of the addiction and how to make different choices in how I nurture myself.
I have been making better choices and I want to keep up the momentum even though I am no longer considered to have heart disease and I am not diabetic. I still have the time and the ability to avoid both. And after yesterday’s scare – I know that I do not want to lose my body and my independence. I also know that I need to be a little louder when my body is not working right and a staff member is in a hurry to leave for the long weekend!

Taking the First Steps

This has been somewhat of a stressful week. I tried to maintain my equanimity throughout but there were times I just wanted to scream at the world and ask “Why can’t things move just a little faster when I need them to?” Then I reminded myself that the Universe is not just about me and my issues and I got a grip.

This week was about waiting. Waiting for doctors to make decisions and waiting for people to call with appointments. I was concerned because I have the kind of schedule that creates problems for other people if I have to cancel and this coming week is full of commitments to other people. Having a heart problem right now is very inconvenient. However, I realize that there is never a good time for this.

On Friday afternoon, exactly one week after finding out the results of the imaging stress test, I was called and given an appointment with a cardiologist for June 1. I am also on a waiting list so if there are any cancellations (which the scheduler said would probably happen) I will be called and can go on in. At this point it is expected that after I talk to the cardiologist I will then be scheduled for a catheterization which will lead the way for repair work. The highlight of all this is that the doctor informed me that this is all done under the influence of Versed, the best drug for medical procedures in the known universe. This decreased my anxiety about 80% and I am now sort of actually looking forward to the procedure. I have also been told that the procedure will probably help me feel a lot better than I have in a couple of years. Good news and an excellent reason to be on board.

My primary approach to all this is to remember that I am a part of my medical team. I have a great naturopathic M.D. and a well recommended Primary Care Physician. I also consider my chiropractor a part of my team along with friends, family and co-workers. However, the most important member of my team is Linda. My goal is to participate fully and follow recommendations.

After recovering from giving ten tubes of blood at the lab on Monday morning I was ready to get a move on. I had one relapse day on Wednesday when exhaustion came on but I bounced back. I have made the phone calls, done the yoga, taken the walks and cut out a lot of junk in my diet this week. Okay, there was the baby shower yesterday with the chocolate lava cake and the chocolate mousse tart, oh, and the Pampered Chef party with the chocolate lava cake – but, believe me, things could have been much worse. Much. Oh, so much worse given the stress I was feeling. I also switched to egg substitute to make sure I get less cholesterol and found out it isn’t that bad.

I have been reading Geneen Roth’s book, Women, Food and God, and am taking a closer look at my food issues. According to Geneen, I am a Permitter. I prefer to call it the “fuck its”. When things are stressful and chaotic I get a good case of the “fuck its” and decide that since my world is already in chaos I might as well party and eat as much as I want to. Restrictors are people who, when they feel out of control, try to control their eating through extreme measures. I have alternated between the two but have been primarily in the Permitter mode throughout my life. My parents were Permitters , thus, I was raised a Permitter.

I also obsess about food. What and when my next meal will be takes up a lot of my energy. My therapist and I discussed this and I was supposed to start thinking about what is under all of that and what it is that I am trying not to feel. Before I could get there, though, the supplements that the doctor gave me to increase my dopamine seemed to kick in and I actually forgot to eat a meal. And, I haven’t had the sugar cravings I usually have.

I also took my own advice and increased my yoga and meditation time. I am a big proponent of both for stress reduction but also realize how hard it is to incorporate them into daily life. With all of the season finales of my favorite TV shows this week and next, I needed to step back and remind myself that since I have the ability to choose when I watch those shows I can take out the time to practice my self care. It really is about personal choice. No one is going to do this for me. Even though I am a part of a team, I am the only one who really has the say in the outcome.

Someone mentioned yesterday that even Oprah, who has personal trainers and chefs, continues to struggle with her weight and food issues. I often say that I would love to have someone cook for me and follow me around with a stop watch while I work out but I know the person I am. I could have an excellent heart healthy chef at home but would rebel and be eating a paper bagged wrapped pint of Ben and Jerry’s Brownie Batter Ice Cream in the parking lot of Home Depot if I chose to use that as a way to self medicate. I suspect Oprah has her own version of this.

I also have one other member of my team. My cat, Boo. She does yoga with me and she has a wonderful way of helping me de-stress. When I am tired and need to stay put for a few, I will lie down on the couch. Boo will jump up and lie down right on my heart center and purr at the loudest decibel she can produce. I can actually feel it right through to my spine. She will do this for ten to fifteen minutes and I will feel like I have gone through an extensive Reiki or other type of energy session. She also does yoga with me. Really, she does! Here are pictures!

Finally, I can’t say enough about laughter and music. I can’t imagine my life without belly laughs with friends and good music. I am fortunate to experience both daily.oweveHo

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The Start of a New Journey to Wellness

Things have certainly gotten interesting around here. I don’t like to think of myself as getting old but my body is reminding me every day that it needs my attention.

Over the past few months I have gone on a rant about the lack of good medical care in my life. I wasn’t feeling listened to and felt some complaints were being disregarded. All of that has come to an end. I had some second thoughts about writing about all this, but it might help someone else once they read about my experiences.

On Tuesday morning of this week I spent three hours with a wonderful naturopathic MD here in Concord. I had waited seven months for this appointment and it was well worth it. She listened and responded to every symptom and concern I had and dug deeper when she sensed I was minimizing or trying to skim over certain issues. By the end of the three hours she had come up with a preliminary plan.

First of all – MODERATO has to be my new motto. I have a tendency to do a lot, then I have to crash. This even includes exercise. My pattern is to go out for a three mile walk and then need to rest for three days because everything hurts. I also work hard, travel a lot and then wonder why I am exhausted by the end of the week. MODERATO!!

She also validated that mindfulness meditation and yoga is excellent and should be a part of my daily routine.

Then we moved into new territory. Here is what I learned about medication for depression and anxiety. I have been taking Celexa for a few years and it helps with anxiety. Without it, I am bouncing off the walls, can’t sleep, and ruminate over everything from the Viet Nam War to oil spills. However, even with the Celexa I have some low grade depression that just never lightens up. Even when I am having a good day I can still feel blue.

The doctor explained to me that the Celexa only regulates Serotonin and Gaba and helps to decrease anxiety, but that it lacks the dopamine and nor-epinephrine which are needed to relieve depression. She said that from what I was telling her she could tell I needed something to increase dopamine. She explained this all in a way that I understood. I know from my research on the effects of trauma that the brain can use up dopamine and have difficulty producing more when a person has been under prolonged stress. She has given me a supplement that will work to increase the dopamine and I hope to feel some improvement by the end of the week. She is also going to help me get a good deal on a light box before winter sets in. I do feel more depressed from November to March so a light would be very helpful.

She also gave me information on some inserts for my shoes to help with plantar fascia.
The most important thing she did, though, was take my complaints about fatigue and general overall exhaustion seriously. She looked at my family’s medical history and asked me about heart disease and when I talked about having times when I felt some pressure in my chest she did not allow me to minimize it. She took it all seriously and had an EKG done. She explained to me that women do not feel chest pain in the same way that men do. She said that women are more likely to feel pressure. I told her that I usually felt it after going up these damn New England stairs (there are ladders in ships that are less steep) and it went away after a minute or so. Very calmly, she explained that is exactly a symptom of a possible blockage in an artery and that she wanted to have an imagining stress test done. She was so calm and yet concerned, that I knew it was necessary but I was not anxious.

I left her office after having an EKG. I had a plan, orders for a lot of blood work, a kit to submit saliva and urine samples, and the promise that the nurse would get back to me with an appointment for the stress test.
Over the next 24 hours my schedule opened up and the diagnostic center was able to get me in to have the test over two days. I stopped drinking caffeine and eating chocolate (yes, Boo is still alive, but it is a damn good thing I live alone and had the Chris Botti concert to attend on Thursday evening) and didn’t eat after midnight before the test. On Thursday morning I was injected with a radioactive dye, swaddled in a blanket and was allowed to take a 20 minute nap under a gamma scanner. It took pictures of my heart while it was in normal mode. The next day I was hooked up to an EKG machine while walking on the treadmill. As soon as my heart rate reached the targeted heart rate of 142 (220-my age X 85%), they injected me with the radioactive dye again, had me walk another minute and then I was allowed to rest and have a few sips of water. After about 20 minutes I was able to take another nap under the gamma camera. For some reason the pictures didn’t download onto their computer, so I was given time for a second nap. Not a problem. Afterward, they unhooked me and let me go. I left , went into the Starbucks on the second floor of the hospital, got a chai latte and went home feeling that all went pretty well. I hadn’t felt any problems during the stress test and I was convinced I had passed with flying colors. My denial was even working so well that I convinced myself that since I hadn’t felt any effects from not eating breakfast that my blood sugar must be stable and that I didn’t need to worry about the glucose tolerance test coming up this Monday.

I had a great Friday. I spent it working on the novel and taking some time off of work. I was just settling down to a plate of scrambled eggs with feta and spinach (there is irony here) when the doctor called.

I don’t have much experience with doctors calling me. In fact, my last PCP’s office told me that the doctors do not make phone calls, the nurses do. So when I heard the doctor on the phone I knew something was up. She said, “How are you?” I said, “You tell me!”

She explained that the tests show that I have signs of Coronary Artery Disease. Fuck NO!!! But she also explained it was good because it had been found and that there were steps to take care of it and I was already doing some things I needed to do. She said she will be conferring with my new PCP and they will be setting me up with a cardiologist ($$$$$$$$$$$$$$$$$$$$$$$) and I will probably need to have a catheterization. Whew!!! – they won’t be cracking my sternum open like a lobster. PLEASE!! - I will do anything – but not that!!! She also said that she was calling in a prescription for nitroglycerin (oh, damn, I have to carry that stuff around with me all the time and I can barely remember my car keys) and that I needed to start taking an aspirin a day – for the rest of my life!

She was wonderful. She asked me how I was, she let me know she was available to talk to me any time and that she really felt that this was a good thing to have found now. She explained what to do when I felt pressure, when to take the nitro, when to call 911, and asked how I was going to spend the weekend. She also reiterated how heart symptoms are different for women and to not take the absence of pain as a sign that everything is okay. She urged me to do my normal activities, take walks and do yoga. No hills or mountains, though.

I spent the evening in a fog and near tears. I called my friend, Barbara, and she gave me a great pep talk. I had thought of canceling out on a yarn shopping trip but decided I was going to have fun. But I also experienced a lot of anger because I have been complaining to various medical professionals about these symptoms for at least three years and have not been taken seriously. Then I let it go. I realize that everything comes at the right time and now I have a doctor who is listening and taking me seriously. She said that this explains my exhaustion and the catheterization should be able to help.

Yesterday evening I remembered that I have an aunt who has been living with heart disease for probably thirty years so I know this doesn’t mean I am going to die any time soon. That was reassuring. However, having my chest cracked open with rib spreaders frightens me even more than death, so I will do everything I can to avoid that.

This morning I talked to my nurse friend, Darcy. She knows me well to know that I could be on the floor and out of breath and still questioning whether or not I should call 911. Darcy made me agree that if I felt like I should take a nitro to give her a call and she will use her nurse voice to convince me of what I should do.

I am definitely blessed in the friends department.

I also have a cat that likes to give me Kitty Reiki. She lies down on my chest and purrs so loud that I can feel the vibration go all the way to my heart center. I know that has to be healing.
I am going to continue to post on this journey. It helps me to process and I also hope it will help someone else down the line. As of right now, I feel pretty good because I think I have good medical, friend and family support and all will be well.

Writing, April, and Purple Hi-Tops

I started the first draft of this post while sitting in my rocking chair on my deck. It is a warm and sunny day and I rested my feet on a footstool my parents had made years ago. Boo came out with me and did not have to be banished for trying to jump between the rails. If I had seen her put her head through she would have been swiftly escorted back indoors, but she decided to go back in on her own instead.

For the past few weeks I have been experiencing a serious case of writer’s block. I couldn't work on the novel and it was a struggle to open the Word file on the computer. I was beginning to think that the only way I could write anything would be if I found a cabin in the woods without internet service. I would then be able to write without the distractions of email and Facebook. I became jealous of writers who spoke of their writing cabins. Isabel Allende writes in a little house on her property from 9 a.m. to 7 p.m. six days a week and begins a new novel every January. I, on the other hand, write for a few hours on occasional weekends. I do not have a writing practice. I have writing hiccups. That needs to change.

A couple of weeks ago, my writing group, the Misplace Modifiers, got together for our monthly meeting. There are five of us and not a one had produced anything in the past month. I did share that I had managed to get a post done to my work blog and had written a five page report for my performance appraisal. They were not impressed as that did not count toward being critiqued by the group.

Denise brought some writing exercises and after praising Sally for having received her contract from a publisher who is going to put her dissertation in print we started to write. I discovered something. I like hand writing. I like to have my thoughts flow from me to pen to paper. I like to scribble a first draft in my own, unreadable to anyone but me, shorthand. I like the flow of it. I decided to cut out the middle man – my computer – and get back to basics. I remembered that I also have preferred writing implements. I like 8 ½ x 11 spiral bound note books with the spiral on top and roller ball ink pens. At Staples yesterday, I found the last two spiral notebooks with the spiral on top and they were only 50 cents. It was kismet. Or karma. Or just plain luck and timing on my part.

So my deck is now my designated writing area. I am not tempted to check my email or stalk ex-boyfriends on Facebook. I don’t have to write at the place where I pay my bills. I now have a writing sanctuary where I can also read and meditate while listening to the birds and watching the chipmunks skitter through the fallen branches and leaves.

Let the writing commence.

April was an exciting month from the very first day when I had the opportunity to speak to a Women’s Studies class at the University of New Hampshire in Durham. It was one of the first warm days of spring and it felt good to be on a college campus. Groups and couples were sitting on the grass and brick walls and music was playing from dorm windows. I felt guilty for keeping students away from the outdoors on such a beautiful day but I thoroughly enjoyed the opportunity to talk to such a young and interested group of women. It was also the day that I discovered that there are at least four ice cream stands on the route between Concord and Durham. I hope that I do not make that drive too often.

April 2 was my 54^th birthday. I have no trouble telling my age since it is really only a number. I managed to celebrate over two days – maybe even throughout the month. On the second, I spent the morning visiting my ex (vs. “old”) housemate, Kat, and her brood of felines. I wanted to visit Lucy (see my last post) and check in with the rest of the cats and the beavers out back in the pond. Afterward, I visited Kristen (another ex-housemate) and her eight month old son, Augustine in Peterborough. We sat outside and watched him play on a blanket. It was so peaceful.

The next day I got my best birthday present. My son and his wife have been making noises for a couple of years about moving away from New Hampshire because of the economy and the weather (neither of which I really feel are better anywhere else). This had been causing me a great amount of angst and had put me into a pretty bad depression a little over a year ago. Now I can rest easy. Chris told me that they will all be moving just a few miles away from where they are now into a house that his father has bought and which Chris and Des will be renting to own. It is a ten year commitment for them which means I can rest easy.

The following week I spent at the Self and Family Conference in Santa Fe, NM. This was the best conference I have ever attended. There were speakers on integrative health care, trauma, and substance abuse. I even had lunch with Stephanie Covington, author of A Women’s Way Through the Twelve Steps, whom I consider the leader in my field of women, substance abuse and trauma. She was helpful in validating what I do and helping me clarify some issues. The icing on the cake for that week was being able to rent a car and drive up to Taos. I didn’t get to see much of Taos on that afternoon, but the taste I had left me wanting more.

Another big event during the month was getting my purple Chuck Taylor Converse hi-tops. Remember that I said that my age was just a number. This was proof. I had gotten it in my head a couple of months ago that I just had to have a pair of purple hi-tops. They are a very necessary part of my wardrobe and I wear them with great pride and comfort.

The rest of the month was a blur. I spent two days in Atlanta, GA where I presented a workshop at the Ending Violence Against Women conference and also did a six hour training with child protective service workers here in NH. I also did a lot of driving trying to spread the knowledge I gained at the Santa Fe conference.

I have been in my job for a full year now and still love it. I have been in New Hampshire for almost five years and have come to love it more each year – even when it snows on Wednesday and is 80 degrees on Saturday. I am very grateful to have the life I have here and - for my new writing space.