Tuesday, January 12, 2021

I'm ... back?

Good morning, world. Maybe I should write "Hello, World!" since I'm a software guy by trade. Whatever. Perhaps I should write "Hello, World!" because it's shorter, and AT&T won't bring broadband to my neighborhood (per the FCC definition, broadband requires 25mbps download speed and 3mbps upload speed, but AT&T UVerse, the only available option in my neighborhood, doesn't meet the upload speed requirement, so we're technically not provided broadband by way of AT&T UVerse). The sad part: AT&T already has run fiber right past the entrance to our subdivision (years ago) in order to bring fiber to the neighborhood behind us - which has fewer lots than our neighborhood to begin with, and of those, probably less than half are actually constructed upon (compared with our neighborhood which has a much higher construction completion rate), and several of those are not even occupied (last I checked, anyway). So, they brought fiber to a smaller neighborhood with fewer homes and much fewer occupied homes, and left our neighborhood "in the dark" despite a much higher potential sale rate for high speed internet access here. And, they're the only game in town - no cable providers, no Verizon fiber or Google fiber or Verizon home internet via cell... just AT&T UVerse at a max of 25mbps down/1.5mbps up. I've been complaining to AT&T for, literally, almost a decade about it, as have many of the others in my neighborhood, and they just won't do anything, just keep saying "soon" (the last two times I've complained, via chat, with AT&T, they promised it was going to be available within a month... but one of those times was, guess what?, more than a month ago, and it's still not available). Now they're blaming Covid for the slow going, but they've been saying "soon" for way longer than Covid has been an obstacle, and now AT&T is just using that as yet another excuse.

Time for AT&T to actually do something and service their loyal customers (I've been w/ AT&T internet for close to two decades now, and they just don't seem to want to provide good, modern service to my home).

In other news, I had a heart attack last year. To close out 2020, I went to the ER about 2 in the morning on Dec 31 while on vacation in Destin, FL, and was subsequently admitted to the hospital and had a heart catheterization procedure in which they found one of my coronary arteries to be 95% blocked and inserted a stent to open the artery. This was classified as a "mild" heart attack, and fortunately does not seem to have done any real damage to the heart (because it was caught and the artery opened up quickly), for which I'm very glad, and fortunate. It could have been much, much worse. (Unfortunately, at least a portion of the bills will be assigned to my 2020 insurance, but hopefully the majority of the hospital stay will apply to 2021, since I wasn't discharged till 1/1.) Very grateful for the staff, doctors, and medical team at Ascension Sacred Heart Emerald Coast where they were able to prevent any serious issues. Especially the nurse Erica, who was my caregiver throughout the day on 12/31; despite only recently graduating from her nursing program (which neither my wife nor I would have guessed), her care, attention, and bedside manner were phenomenal. Note: all the staff/nurses/doctors at Ascension were very, very good, but Erica went above and beyond, such as when the doc came to explain that I was going to have the heart cath procedure, and the possible outcomes (find nothing, find and open some blockage, find and insert a stent, or find and determine a bypass would be needed, but for which they'd transfer me to Panama City to have that done), after the doc and his team left, during the two minutes before they came back to take me down to the Cardiac OR, Erica made a point to alleviate any anxiety that my wife and I were having (in particular for me, so that I would be calmer going into the procedure, since that could affect how they perceived things and the outcome), and explained things in a clear manner for us and was very reassuring. She was great, even when my dinner came and I was going to have to try to eat a turkey burger with only my left hand (as, having had a heart catheter go through an artery on my right wrist, I was supposed to keep that still until the artery had healed), and she stopped to assemble the sandwich, with recommendations on the condiments to keep it as heart healthy as possible, and then to cut the sandwich to make it easier to handle one-handed (initially she started to cut into bite-sized pieces to eat with a fork, but then we decided I could probably handle half the sandwich one-handed since that cutting wasn't going to plan). We did attempt to nominate her for the Daisy Awards, but only by first name (since I still don't know her last name).

Anyway, if you're going to have a heart attack, Ascension Sacred Heart Emerald Coast is not a bad place to do it.

That said, I don't recommend a heart attack, even a mild one. And if you're wondering, here's what I experienced leading up to it:

The 30th, just before lunchtime, I started having pain in my left shoulder blade area in my back, which I tried to attribute to having played disc golf with my youngest (adult) son and two (young adult) nephews on the 28th, but it was pretty intense pain, and I just didn't feel good. (I kept trying to "pop" it loose by stretching my shoulders toward each other behind me, but it didn't really alleviate the pain any.) Later that day, toward dinner time, I started having pain in the left side of my jaw, which I couldn't really explain, and started to feel a little clammy (skin). I also just "didn't feel right" - not quite nausea, but couldn't really put my finger on it. I ended up going to bed a bit early, as I was tired, and tired of the pain, and thought if I could sleep, it would just all be better in the morning. But I couldn't sleep; no matter how I turned, the pain just wouldn't let me get to sleep. I considered talking to my wife at that point, but it sounded like she was having an enjoyable time with the family playing games (we were on vacation, with my parents and most of my adult children present).

Sometime after she came to bed, and got to sleep, I eventually decided to wake her; it was around 1AM, and I was starting to have a little bit of discomfort or pain in my chest (sort of circling around the center). It took a while for her to fully wake and understand what I was talking about, and we discussed it for a while. When she mentioned going to the front desk and checking if they had any medical facilities on campus of the condo, or if they could tell us where a hospital was, and I mentioned that the hospital was 12 miles down the road, she realized, from the fact that I'd already searched out where the hospital was, that we needed to go. I mostly still didn't want to, as I'd been to an ER previously a few years back for some back/chest pains, and it wasn't anything they could really identify and it was just a huge medical bill (we have a very high deductible insurance plan, thanks ACA). But she wouldn't let me talk her out of going to the ER, even as we approached the parking area, for which I'm very glad now.

FYI, if you feel signs that may be related to a heart attack, go ahead and go to the ER. Better to pay for confirmation that it's not a heart attack than not to pay for emergent medical services that could, literally, save your life. Had I not gone, I probably wouldn't be writing this today.

Once at the ER, they hooked up an ECG and drew some blood. The ECG was normal, and I thought it was just going to be another "waste of money," but soon they came back with four chewable baby aspirin, and I realized that probably this wasn't going to be the same as last time. They came back a little bit later and said that the troponin enzymes were a bit elevated, indicating something was going on, and they were going to put a nitro patch on my chest and then (after a Covid test, which came back negative) admit me to the hospital for an echocardiogram and more monitoring.

The troponin levels at the ER blood draw (circa 2:30am) were 0.05 (we were later told by a nurse friend that normal is 0.001 or lower; troponin is one of the enzymes that indicates cardiac distress, whether it's damage to the heart muscle or just some other stressors on the heart). At the 7am blood draw the levels had risen to 1.89, and they did the echocardiogram around 8 or 8:30. While the lady was doing that, she kept checking one area, it seemed, and then asked, "have you had anything to eat or drink since last night?" which was a telling sign. She wouldn't discuss what she saw (indicating the doctor would have to do that), but we knew something was up. The 11am blood draw saw the troponin levels at 3.25 (note: major heart attack is still a much higher level, in the hundreds, but clearly this was a trend in the wrong direction), and about the time we got that info (I don't recall if it was before or after), the doc came in and started talking about the heart cath they were going to do to find out what was going on. At that point (I think) we got confirmation that a heart attack was in progress.

I remember going to the cardiac OR, moving over to the surgical table, them taping my right hand to something (to keep it still; for the heart catheterization, they go in either through an artery in the wrist or an artery in the groin, the wrist being preferred if they can get it that way, but they prep for both), the prep for the procedure, and the insertion of the catheter at least a couple of inches into the artery. You're awake for the procedure (at least that's my understanding), but with one of the drugs that makes you not remember it after, and so the next memory that I have is back in the hospital bed in the room I was in before heading to the cardiac OR. With a cool pressure bracelet on my right wrist, which is clear for viewing the catheter insertion point, and pumped up with air to apply pressure. They slowly, in steps over several hours, remove air from the pressure bracelet and observe the catheter insertion point to make sure it's not bleeding (internally or externally, since it's a high-pressure artery, unlike the low-pressure veins used for drawing blood). If it doesn't close and heal on its own, your hospital stay gets a lot longer. As for me, everything seemed to go according to plan, and less than 24 hours after having the stent inserted I was discharged from the hospital into an overcast, grey, rainy day, a day that I was extremely happy to see. We went back to the condo (it was actually the last day of our stay, and my dad had arranged for late checkout), then back toward home, stopping at my parents' place in Pensacola to watch the Alabama/Notre Dame CFP semifinal. They had chili; I skipped that and had some chicken pasta stuff leftover from the condo instead, and then we headed home after the game. Fortunately our youngest son had travelled with us, and was able to drive back from Destin to Pensacola and then home. I wasn't allowed to drive (because of the non-use of my right hand, not to mention the heart attack and the meds I was now taking), and my wife was exhausted from the ordeal (neither of us had a lot of sleep from getting up Wednesday the 30th until we got in bed the evening of Friday the 1st). I guess kids are good for something! 😄

Since then we've had a lot of life changes going on. I've been to my primary care physician and to a cardiologist (who said he didn't see any real signs of damage to the heart because they got things opened up so quickly in Destin), and will be getting in touch with cardiac rehab to follow up with a monitored exercise program to strengthen my cardiovascular system. And maybe lose some weight. I've already lost about 10 pounds since the heart attack (note: not a recommended weight loss program), and we're starting to eat much healthier, both in portion sizes and content. The DASH diet (Dietary Approaches to Stop Hypertension) was one of the first recommendations by the doctor at Sacred Heart, and it's what we've started with. Mediterranean diet is the second recommendation (she also mentioned a plant-based diet, but said it's not something she personally could adhere to, and neither can I!), and we'll probably try to look at that at some point, but first things first: reduction of the sodium, fat (especially the saturated variety), and cholesterol intake, by way of what we can glean from the DASH diet. So far, I'm coping well with the new diet plan, although it's a lot more work for my wife to prepare meals in this fashion. I also have more follow ups scheduled with my primary care physician (and another follow up with the cardiologist in about 4-5 months). He adjusted some of the medicines initially prescribed at the hospital (the blood pressure one) to try to alleviate some of the fatigue that it may be causing.

Life is different now. But hopefully different in a good way, as this seems to have been a wake-up call (I was already planning to improve my diet & exercise this year, but now it's much more urgent and mandatory that I do so, and I have more motivation from various perspectives). Hopefully this may be a cautionary tale to you, as well: don't ignore the signs, and take care of yourself. I thought I would make 50 years of age before dealing with this level of medical issue... but you really never know.

So, until next time... a topato!

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