Boswell

I've had a pretty poor perception of Boswell Hospital for some years, mostly because my dad died in that hospital. Did anyone or anything at Boswell contribute to his death? I can't say for sure in a legal sense, but I do know that he had surgery in Boswell and then died a few days later, and whether there's any actual culpability or not, that's not the kind of thing you forgive readily.

But having said that, I have to say that the care I received from Boswell was first-rate and I find that I just can't hold a grudge against the hospital any more.

Actually, every part of the health care chain seemed to work extremely well, from the EMS crew to the Del Webb ER to the Boswell CV/SICU. Looking back on it, I have only one real complaint, that being that the barf bags were entirely inadequate to the task at hand and need serious enlarging.

Now it's up to me whether any of this bypassing and grafting means anything in the long run. I smoked for about 25 years prior to my heart attack, and always swore that I'd quit smoking when I noticed smoking affecting my health. I was always pretty heavy, and swore I'd lose weight and start exercising when I noticed health problems. Well, a heart attack and bypass surgery are pretty hard to miss as "health problems", so what I do propose to do about it now?

I haven't smoked since the morning of July 4th, and at this remove, the idea of copping a cigarette while having an actual heart attack seems pretty foolish, but there I was... I quit cold turkey, though being in a morphine and anesthetic haze for a day or two spared me the worse of the physical withdrawal symptoms. Now I just have the residual habit to deal with, the habit of wanting to smoke. Some days are better than others, but I'm now on Day 25 without a cigarette and I think I'm past the worst. I just keep reminding myself of how I felt on the side of the highway waiting for the ambulance to arrive.

More Catching Up

So where am I in my story? It's the evening of July fifth, I guess. My breathing tube it out and I've got an immense dressing on the front of my chest, and my right leg is wrapped up in so many Ace bandages I look like I'm trying out for a bit part in a movie about mummies. Sitting up felt better than lying down, at least for me. I found that sitting up in the chair and leaning over the mobile shelf unit actually felt better than lying down, and the nurses seemed just as happy to let me sit up. It was hard to actually get up, but once I was up and sitting, things seemed fine.

I was living in Tube City: catheter, two chest tubes, IVs in my arms, A-line in my wrist, IVs in my neck... Given this kind of limited mobility, I could either sit up or lie down, and sitting up felt better. My wife brought me a Harry Potter book to read, and my brother brought in some magazines, but I couldn't really read any of them. I was so zoned on anesthetic or morphine that I couldn't concentrate hard enough to read; I'd just look at the words for a few minutes before going under. I remember wanting to stay awake to talk to my visitors (because I quickly learned that when one is in the ICU, visitors are golden) but I just couldn't do it.

My normal pre-op breathing volume as measured by the spirometer was just under three liters. When I first tried to use the spirometer in the ICU, I could barely manage a half a wheezing liter. Gah! Why is that? Does the body decay that rapidly in surgery? Was my chest simply too sore and swollen for me to breath effectively? Were my lungs full of junk?

The next day I could get about a liter, and the nurses got me up and made me walk about the nurse's station. That was hard. My leg hurt, my chest hurt, and I was so completely out of breath I had to pause every eight or ten feet to rest for a few seconds. What a shabby performance! Still, at least I was up and walking around, and I passed rooms and saw people who weren't even doing as well as I was.

The first meal I remember was breakfast the day after the surgery, on the Sixth. I don't remember what I had, I just remember having breakfast in the abstract. I finished the fruit cup and the cup of coffee and the apple juice, but I don't think I touched much else. I wasn't very hungry at lunch either. It was some kind of sliced beef thing served with a roll, and Jean ended up eating most of it. (I would end up losing about 25 pounds during my hospital stay, though I have to be fair to Boswell and say that the food actually was pretty good. If I didn't eat much, it was because I just flat wasn't hungry, not because the foot was unpalatable.)

The next day was better. I managed to make five laps around the nurse's station, including a side trip down the hall to look out the window at the bushes and grass outside. I was up to a liter and a half on the spirometer, and the tubes were slowly coming out. I found the process of removing the chest tubes and the neck IVs exquisitely uncomfortable, especially since it turned out the neck IVs went all the way into my heart! But they hadn't taken the catheter out yet, because they were concerned about my blood pressure and were keeping me on diruetics, and they didn't want to force me to jump out of bed every twenty minutes to pee. So I sat, watched TV, chatted with my visitors, drained into my urine bag, and drooled every time they gave me morphine.

Eventually they managed to get my blood pressure regularized and they took the catheter out, and then it was off to Telemetry, freeing up my bed in the ICU. Telemetry was pretty nice. It's not as busy as the ICU and you have more spare time. In my case I had a double room to myself and I flitted from chair to chair until I found the most comfortable spot - the commode chair, as it happened. I also stood in front of the window and looked out a lot, because even standing was more comfortable than lying down.

And then, the next morning, a nurse helped me take a shower and I changed into pajamas that my wife brought up from home, and they cut me loose. My mom picked me up and drove me home, and by about noon on the eighth I was safely in my own bed, having just seen first-hand what $95,000 worth of medical treatment looks like.

Catching Up

I haven't posted anything for a while - most of July, actually, but there's a halfway decent reason for that.

I had a heart attack on the morning of July 4th. Opinion varies on how serious it was, but at the very minimum, I hew to the line that there's no such thing as a minor heart attack.

Oh heck, let's do the whole chronology, shall we?

It turned out that I'd been experiencing angina for a couple of weeks but didn't know what it was, or perhaps didn't want to know what it was. On the night of the third the angina was pretty intense, but again I either didn't realize what it was, or chose to pretend I wasn't having some kind of heart problem. Most of the time the ache would be gone in the morning, but on the morning of the fourth the pain was worse. Much worse. It actually woke me up at about five or six in the morning, and I knew it wasn't a muscle thing any more.

Nevertheless, I took a shower and put on clean clothes, and hoped for the best. The pain was fairly bad and it radiated all the way down to my left wrist, and then I got nauseated and threw up like a firehose. That was the final straw. Jean came out of the office to see what was wrong, I told her I had chest and arm pain, and she said "Hospital."

We started to drive to the hospital because we live out in the sticks, but as we drove Jean called 911 and found that there's actually an ambulance stationed in Wittmann! They advised us to pull off and wait, so that's what we did, stopping at milepost 130 of US Highway 60. The pain by then was becoming quite quite unbearable - on the hallowed 0 to 10 scale, we were approaching a Spinal Tap-esque 11, and the continued vomiting didn't help either. I actually thought I was dying and would have to be scraped up off the side of the highway like roadkill...

The ambulance arrived, and they gave me oxygen, nitroglycerine and morphine on the way to Del Webb Hospital. This treatment cut the pain level in half and removed the sense of impending death, so by the time I got into the ER at Del Webb I didn't feel too bad. I still had chest pain and had picked up a dandy nitroglycerine headache, but things seemed to be improving.

The Del Webb ER staff treated me further, including injecting some clot-busting medication into my abdomen and fitting me with IV nitroglycerine. Soon the chest and arm pain were gone, but I felt like I had a strand of barbed wire twisted around my head. Cripes does nitroglycerine give one headaches!

Then it was off to the Cath Lab. The Cath Lab is kind of an intense experience. You're sedated, but not out. It's about like napping through a TV show; sometimes you hear things from the TV show and sometimes you don't. I remember feeling the bright, warm flashes in my chest as they released the dye (and I remember being astonished at how rapidly the blood seemed to flow outward). I remember a lot of pressure and manipulation in my right groin. And most of all, I remember the cardiologist suddenly saying "This man needs to be in the ICU immediately."

Oh shit!

Suddenly I was wide awake and felt everything they did to me in the Cath Lab. Wide awake and scared. Presently they plugged the hole in my femoral artery and wheeled me back to the ER. What ensued was a medical blitzkrieg - I suddenly had no end of top-shelf medical types in my little ER room, telling me what they'd found and laying out my options. At least three and perhaps five blockages in my coronary arteries, one of them about 95% blocked. A pattern of enzymes that suggested that I'd had a heart attack but that the clot-busting drugs had successfully ended the MI.

So it was decided that I would be transported to Boswell for emergency coronary bypass surgery the next day. As I waited to be moved, I became hugely nauseated. I'm not sure why, if it was a reaction to drugs or stress or dye or the Cath Lab or what, but I threw up in the ER, I threw up in the ambulance, and I threw up in the ICU at Boswell. The barf bags were completely inadequate, by the way, being far too small for the job at hand, so I ended up throwing up on myself a fair amount.

Once they gave me something for the nausea, I felt pretty good. Good enough to go home, actually, but that wasn't how it was going to play. I spent the rest of the day being prepped. They ran an ultrasound on my legs to locate choice vein segments. They shaved my chest and leg. They kept pumping me full of drugs. They wouldn't let me eat or drink.

So at about 10:00 the next morning off I went. They'd given me a sedative so I didn't feel too anxious, but it's still a bit scary, being wheeled off to a procedure that has a small but non-zero possibility of stroke or death. I remember thinking that I wished the doctors had given my family some of the same sedative; I was scared, sure, but they looked more scared than I felt.

I remember nothing of surgery. The last thing I remember was being lowered onto the operating table, which to my surprise had a raised rim around the outside, like a drip pan. I was tempted to make a joke about making my own gravy but the next thing I knew, someone was telling me to cough. I kept trying but my throat hurt, and every now and then there would be a terrible wet sucking sound. Then I heard a voice say "He initiated five times" and then they were pulling some horrible corrugated thing out of my throat. I coughed, or did they vacuum me out? I don't remember.

I came to some time later when a couple of nurses were trying to get me out of bed. I was awake, sort of, and hurt, sort of, but looking back on it, I was drifting along under a nice overcast of morphine...

This is getting long, isn't it? To be continued!

Anniversary

It just struck me that this is my one-year blogging anniversary, more or less. Whee!

I haven't written much lately because I haven't really had the inclination. June wasn't a great month and I just didn't think there was any need to diddle my navel on a blog; navel-gazing is something best done in a swimming pool with a glass of wine, I think.

The Bad News

The bad news is that I am unemployed. At 27 years with the same company, I'm out on the sidewalk with my box of desk junk. I'm not going to say much about this until I've had time to think, explore my options, and find another job.

The Good News

The good news is that I don't miss my old job - the company had gone out of its way in the last year in particular to equip itself with square wheels and I don't miss the shaking. More good news is that jobs appear to be fairly thick on the ground, and my "secret network" seems to be working in my favor. And another piece of good news is that the box scraper I ordered arrived, and it works like gangbusters.

The Google Effect

This morning I did a search on Goggle for Ty Murray, a great rodeo rider and a man who often seems to be labeled the "King of Cowboys". I ran the search mostly because Ty and I both grew up in Phoenix and I was curious to see where he had gone to school and if he had ever competed out where I lived, south of Cashion.

But that's not what I'm writing about. As I was exploring the various links Google coughed up, I found one that led to a website operated by a group opposed to animal abuse and cruelty, and that in turn led to this group's allegations of massive, slope-browed, knuckle-dragging, gibbering cruelty at rodeos.

That's the Google Effect. You look for one thing, and end up somewhere entirely different.

I'm not here to defend Ty Murray, and I'm sure he neither wants nor needs me to even try. Nor am I here to defend rodeo in general, as it is my general policy to not go out of my way to defend any organization that has its own lawyers and PR firm.

But come on - when looking at professional bull riding, does the phrase "cruelty to animals" even mean anything? People should be more worried about "cruelty to cowboys". Just ask Valdiron de la Oliveira (among a great many others), or consult this link:

http://www.health.state.ok.us/Program/injury/updates/bullcns.html

There are legitimate cases of animal cruelty, no doubt, and things like canned hunts and dog-fights are utterly reprehensible. But if putting a 150-pound cowboy on the back of a 2000-pound bull qualifies as cruelty, then having to put up with self-righteous vegetarian propaganda also qualifies as cruelty.

The anti-cruelty group apparently invites cowboys to be zapped by cattle prods, and notes with snooty self-righteousness that none of the cowboys ever take them up on that offer. They should have been around when I was a teenager, because I'd estimate we spent at least five percent of our time chasing each other around with the cattle prod (we only had one, and the Holder of the Prod was king). Is the cattle prod unpleasant? Sure - and it'll motivate you to move along, no question about that. But I'd still rather take a zap from a cattle prod than eat asparagus, for whatever that's worth to you.