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.)


This is One of Those Memorable Birthdays

I started my life on April 29, 1963 at a hospital (St. Joseph’s in Parkersburg, W.Va.).  I turned 47 today, and I started this birthday in a hospital.  From 10:30 last night to mid-afternoon today, I was at the hospital while the doctors, nurses, and technicians were trying to figure out the cause of my chest pain and shortness of breath (It said “SOB” on my chart, and I’m sure many people who have met me over the years will second that!).

The chest tightness and shortness of breath happened during my last hour and a half at work, but I managed to conceal it from my co-workers.  When I left work, I debated heading straight for the hospital, but I’ve had these symptoms before, and they’ve always quickly passed, so I decided to let it ride for awhile.

I let it ride until about 10:30, when the pain, the shortness of breath, and the tightness were all impossible to ignore.  I called Pat, and he took me over to Riverside Methodist Hospital, site of Steph’s 1999 heart procedure.  Fortunately, it was a pretty quiet night in the E.R., so they took me back almost right away.

Pat stayed with me until I was assigned to a room.  The nurses drew blood, I had two enzyme series, and the nurse kept giving me nitroglycerin tablets to lessen the pain in my chest.  The tablets did bring down the pain, but the flush of heat and the shortness of breath almost cancelled any benefit.  It’s probably the closest a male can come to hot flashes.

The E.R. doc who came in took down the pertinent information I gave him, and his grimness made me worry. “I’m not liking what you’re telling me,” he said.  He specifically asked about family history of heart disease, and  I told him my father and his father both died of heart attacks, and the doctor was especially concerned that my grandfather had died at 52, a comparatively young age.

The nurse added morphine to my IV, as an added measure for pain reduction, and told me in the morning they’d be giving me a stress test.  I should have been happy they weren’t ordering a cardiac catheterization.  Steph has had several, but even without her first-hand knowledge, I can’t imagine having a needle jabbed up your groin is all that pleasant.

The hospital gave me two birthday presents (not counting the morphine!).  One was a very nice bracelet, and the other was a Mylar balloon that said Happy Birthday!.  This is a picture of the bracelet:

I decided that whenever I received a hospital bracelet, I’d staple it to a page in my diary.  This current volume has more than its share, in between my CT scan in December, the chest X ray at Mount Carmel West Hospital, the gallbladder surgery, and now this.

The CT scan was better than the one I had in December, especially since it didn’t entail drinking any barium beforehand.  I still rolled my eyes when I was lying on that moving table listening to the machine tell me, “Take a deep breath.  Now hold it.”  I was thinking all the while, If I could do that, I wouldn’t be here.

Pat left once I was settled, after calling Steph to let her know my situation.  I was in and out of sleep until morning.  I think I fell asleep to the National Weather Service radar.

There was lots of waiting before the stress test, which was fine with me, because I’ve had them before, and they aren’t pleasant, especially for a non-athlete like myself.  In the meantime, a technician injected me with a radioactive isotope (good thing my days of fathering children are long over!) and I had a gamma camera scan, which took awhile.  I was able to lie still during it; I was so exhausted that I must have gone to sleep during it.

And then it was time for the stress test.  I had to stay on the treadmill, at (allegedly) a walking pace, until my heart rate was 150 beats per minute.  This took about 10 minutes, with the treadmill’s speed and incline steadily increasing.  I wasn’t supposed to run, just take long strides.  All the while, I kept thinking of the closing credits of The Jetsons, with hapless George Jetson trapped on the dog-walker and shouting, “Jane!  Stop this crazy thing!”  The nurse and the technician kept telling me how well I was doing, but I thought I was going to collapse at any second.  I was so exhausted I definitely did fall asleep during the second gamma camera scan.

The doctor finally discharged me in mid-afternoon.  Nothing wrong with my heart and lungs, but they were still clueless as to the cause of the pain.  He wrote me a Vicodin prescription for the pain, so I’m ready in case it returns.  The ultimate diagnosis was Chest pain–pleural.

So, I’ve been in bed most of the evening since I returned home.  (I came home via the Goodwill thrift store, where I treated myself to a new–to me–pair of tennis shoes and a T-shirt advertising The Florentine, an Italian restaurant that truly made living on the West Side more pleasant.)  Susie visited me with her present and a cake, but mostly I was in and out of sleep.  I do plan on working in the morning, although I will bring Vicodin along with me just in case the pain returns.

I chuckled when I thought about being in Lafayette Park in Washington last month, taking my dose of codeine-laden cough medicine by drinking it straight out of the bottle.  I was worried a police officer would see it and arrest me.  (My psychologist pointed out that I was hardly the first person to take opiates in Lafayette Park.)