Follow-Up to CT Scan; NaNoWriMo

I’m home from work today, because of the Veterans’ Day holiday.  When last we spoke, I was dreading an appointment at the Ross Heart Hospital, since it has been six months since I learned about my thoracic aortic aneurysm.  I had all kinds of worst-case scenarios playing in my head as I made my way to the Ohio State campus.

One of these days I’ll learn about the futility of worrying.  I had the CT scan.  The cardiovascular surgeon and the radiologist read it, and it turns out I don’t have to have a scan again until next year.  (I found it amusing that The New York Review of Books sent me a checkbook-sized datebook/appointment diary for 2014 as a gift for buying a subscription.  I christened it by turning straight to December 14 and writing, “CT scan, Ross Heart Hospital, 9 a.m.”  I still have not filled in the contact information in the front cover!)

The news is not all worry-free, however.  Dr. Whitson, the cardiovascular surgeon, mentioned that he was going to refer me to a cardiologist, because I told him about how I have pain that comes and goes in the left side of my chest, all the way up to my shoulder and sometimes into my humerus.  (None of these twinges have lasted long enough to justify a trip to the emergency room–especially when I’m paying off Riverside Methodist Hospital in $50 monthly installments for my trip last May, the parts that insurance would not cover.)  The pain lasts no more than four or five minutes, but during that time, it feels like that side of my chest is full of broken glass.

A day or two after the appointment, the cardiologist’s aide called me up and told me about the appointment on December 11 at 7:45 a.m.  She may have tipped her hand a little too much, since she mentioned the trip may involve a cardiac catheterization.  I had a co-worker once who hung a sign above her desk that said Eat a live toad before breakfast, and nothing worse can happen the rest of the day.  I guess the same is true for starting the day by having a needle jabbed up your groin.

I’m writing this in haste, because I need to leave the house not too long after 1 for my monthly appointment at Optima Behavioral Health Care, meeting with my nurse practitioner for medication monitoring.  This is a time-consuming event, not because of the appointment (which seldom lasts longer than 10 or 15 minutes), but because of the travel time involved, going way out to the borders of East Columbus, out by Mount Carmel East Hospital.  So my goal is to have this entry safely in cyberspace before I head out to the bus stop.

We’re in the 11th day of NaNoWriMo, the much-anticipated and -dreaded (by me, and by all other participants) monthly writing contest.  As of last night, I stand at 16,541 words, which is about one-third of the way there.  I took the laptop to Kafé Kerouac and wrote there two or three nights, but I also goofed off one or two nights, more out of depression than laziness.  I couldn’t seem to summon the energy to do anything more than watch DVDs of the third season of The O.C.

The subject I tackle this year is–NaNoWriMo.  I gave it a different name, 50 K in Thirty Days, and it is semi-autobiographical through several characters.  One character is a single father who is attempting to tackle the contest along with his teenage daughter.  (The major change from my situation is that the father is a widower, not separated, as I am.  Another is that his daughter is a lesbian, while Susie is bisexual.)

I go through the same scenario every night.  The first few pages are like torture, but then I gradually pick up speed.  NaNoWriMo keeps reminding its participants that the name of the game is quantity, not quality, so there are times when I write prose that I’ll marvel over, and there are times when I’m veering very close to word salad.  By the time I have reached my quota, there are times when I want to keep on going, but at the same time the mental and physical exhaustion have reached their peak.  I’m quite fond of a Louis L’Amour anecdote: “One day I was speeding along at the typewriter, and my daughter–who was a child at the time–asked me, ‘Daddy, why are you writing so fast?’  And I replied, ‘Because I want to see how the story comes out.'”  That’s the way this project stands at the moment.  Ask me how this story will resolve itself, I cannot tell you.  (I am not a big fan of Louis L’Amour–the Old West has never held my interest, although I do respect the fact that the man meticulously did his homework when he wrote his books, consulting newspapers, letters, diaries, and memoirs of actual pioneers and cowboys.)

Ross Heart Hospital, on W. 10th Ave. in Columbus.

Time Bomb?

Before I launch into this entry, I want to inform my readership that Susie and company landed safely in Bucharest about 7:05 this morning Columbus time (2:05 p.m. in Bucharest).  I was planning to post during the night, but my attention would have been divided.  I sat in the living room with either Cat Stevens or Seals and Crofts playing on the turntable, and watched this site to track the progress of her Finnair flight from Helsinki to Warsaw.  I read a little, but could not stay focused.  I did attempt to write in my diary, but only got as far as taking the thick red and green book out of my knapsack and clicking the ballpoint pen.

When I neglect the blog for an extended period of time, there is often quite a bit of news to relay.  The front-page item in our household has been Susie’s trip, and yesterday, I did not want to steal any of her thunder, so I focused exclusively on that.  I have some significant news of my own, and news that is quite worrisome: I am now the proud owner of a thoracic aortic aneurysm.

I learned this news totally by accident, and am wondering when it first started to develop.  Two weeks ago, on a Friday night, I went straight from work to the emergency room at Riverside Methodist Hospital.  (Susie was away for the weekend at a Senior High Youth Con at the Unitarian Universalist Church in Akron, so I did not have to worry her.)  Throughout the day, I had a sharp, almost electric pain in the right side of my chest, which spread up into my throat and jaw, and constricted my chest so much that I would go into spasms of dry coughing every time I drew a deep breath.  I was not worried about it being anything cardiac, since it was on the wrong side of the chest.  All I knew was that I was in pain, and had no idea why.

I won’t reel off all the procedures and conversations I had in the six or seven hours I was in the emergency room.  I came early Friday evening, so I was there well ahead of the Knife and Gun Club activities.  They put me on a Dilaudid drip, drew blood, and hooked me up to a heart monitor.  (I now can understand how someone could develop a Dilaudid habit, by the way.)

The emergency room doctor ordered a CT scan, because he was suspecting that I had a blood clot in my lung.  I have had CT scans before, but I will never get used to the feeling when they inject the dye.  It only lasts about 15-20 seconds, but it feels like they’re shooting you full of hot water.  For a brief terrible moment, I thought I was going to mess myself, but the technicians reassured me that was a normal feeling.

The doctor and nurse came to my cubicle three or four hours later (I spent most of the evening lying there watching reruns of Law and Order: Special Victims Unit on USA Network) with the diagnosis.  The pain in my chest was an inflamed muscle.  He was prescribing hydrocodone and Naproxen, a painkiller and an anti-inflammatory, respectively.  Then he said, “But…”

That’s never a good thing to hear from a doctor.  He followed up, after pausing for dramatic effect.  When he read the CT scan, he found that I have a thoracic aortic aneurysm.  It was totally unrelated to muscle inflammation.  The aorta is the largest artery in the body, and the aneurysm is analogous to a knot tied in a garden hose.

Apparently, this is what I have.  Look for me to be Centerfold of the Month in the next New England Journal of Medicine.

From my own research, I have learned that when the aneurysm is dilated 6.0, surgery becomes almost immediately necessary.  (Mine is 4.2, which is 70% of that.)  Steph pointed out that had it been urgent, they would have admitted me to the Cardiac Care Unit immediately.  Cynically, she brought up the fact that my insurance is good enough that they would not have hesitated to operate, since United Healthcare would be sure to foot the bill.

I followed the emergency room doctor’s advice, and saw my general practitioner about a week later (as soon as I could schedule an appointment.)  I faxed her all the paperwork from the E.R. (including the printout for my EKG), and the following day Susie dropped off the two disks of my CT scan.  The doctor renewed my Naproxen prescription, but not the hydrocodone (since it is a narcotic).  She said that she was not a radiologist or cardiologist, so she could not look at the disk.  (I tried to look at it, but apparently do not have the software necessary to play it.)

So what’s happening now?  First, I am going on record as saying I am not letting this condition turn me into an invalid.  I’ve been going to work, walking (although I am just getting over an unrelated pain in my left foot, probably because I’ve been wearing a shoe that is too old), and will be on the trike this weekend.  I worked at the bookstore after the diagnosis, which entailed 2½ hours at a time on my feet.  Again, I come back to Abraham Lincoln’s attitude toward assassination, at a time when he had a file of 80 threatening letters in his desk:  “If I am killed, I can die but once; but to live in constant dread of it, is to die over and over again.”  I have kidded my supervisor (who is an R.N.) that if she assigns me a task I don’t like, I’ll do the “I’m comin’, Elizabeth” routine Redd Foxx made popular in Sanford and Son.  She told me never to joke about that.

I have an appointment with a vascular surgeon at the OSU Ross Heart Hospital on Monday afternoon, to be followed by a stress test.  I’m not sure if it’ll be a treadmill test, or by IV stimulation.  (Neither one sounds like much fun.  I have had the treadmill test, and do not have fond memories of it.)  I mailed the disk of the CT scan to the doctor earlier this week, and hopefully he’ll have looked at it by Monday.

Oddly enough, I don’t meet the usual characteristics of the typical thoracic aneurysm patient.  I do not have high blood pressure, and I have never been a smoker.  I do not have any connective-tissue diseases, such as Ehrlers-Danlos syndrome or Marfan’s.  I am well aware that my cholesterol and triglyceride levels resemble zip codes, a byproduct of loving the fare at the Blue Danube Restaurant, I am sure.  My weight surely does not help, and the genetic factor worried my E.R. doctor–my dad died (aged 70) of congestive heart failure, and his father died of a heart attack at the age of 52, two years older than I am now.  My mother had a heart attack in her 60s, but made a full recovery.  Also, abdominal aortic aneurysms are far more common.

As a departure from this gloom and doom, I want to share with you the current view from where Susie is right now.  (I received a text message from her this morning, saying I had forgotten to give her the PIN number to the pre-paid Visa card I sent with her.  I replied, and told her that if it didn’t work, I’d go to Western Union and send her money that way.)

So, I leave you with this picture from Romania:

Photo by Ben Iten of the southern Carpathian Mountains.  (Susie took her Nikon digital camera with her, with a memory card capable of holding about 1600 pictures, but we won’t see those until she returns to the States.)