Archive for the ‘Health and Fitness’ Category

Anesthesia Recovery Often Stressful

Monday, August 7th, 2017

#anesthesia #oxycodone #overdose

John J. Hohn – Writer, Reviewer and Commentator

Anesthesia for major surgery is awesome stuff. Researchers are not entirely sure how it works, and if they are have trouble with it, consider how difficult it might be for the layman to understand it. Scientific American had the best article I could find. It is worth a read. One thing is sure, after all due consideration, anesthesia for major surgery works. The stuff puts you under in a big way. It’s not like sleep, Hamlet. There is no “perhaps to dream.” Everything is turned off. No subconscious calling your attention to some nagging matter. Stories of patients awakening during surgery must be apocryphal. You go out completely.

Recovery from anesthesia is a battle of sorts. The patient is not aware of what is going on. Those at the bedside know, however. Recovery is a roller coaster affair that the anesthesiologist controls with diligence and care. Once the patient wakes up, he may remember somethings that happened during recovery and not others. My wife, for example, said that I was very feisty. That I trashed around quite a bit. She said the anesthesiologist observed that what I doing was as a good thing. I was not aware of my struggle, however. I was not the least anxious. One thing did happen that I remember very clearly.

Why are you here?

I heard my wife ask, “John, why are you here?

“To know, love, and serve God so that I will be happy with Him forever in the next,” I replied.

Sacred Heart Elementary School, Yankton, SD. (No Longer Standing)

My response was right out of the Baltimore catechism. My wife later said that she did not ask me the question. What is more intriguing is my reply. I thought that I actually spoke it. Not so, according to those at bedside, although they did allow that I was mumbling all kinds of gibberish. For me, the assertion of faith was immediately gratifying. I felt a peaceful feeling come over me, a deep contentment. I was seven years old again, in first grade, and Sister Mary Micheline was smiling  at me. Whatever may have been the reason for my feeling of well-being, it clearly came from my subconscious because walking around wide awake I consider myself an agnostic.

For years, I have not been satisfied with the answers that the Church gave me helped me achieve peace of mind. It hasn’t been a matter so much  that I insist I don’t know, but that I want to know more – if that is possible. There is a huge difference between I don’t know and I’d like to know. I really would like to know. I am open to learning more. The brainwashing of my early years, however, really took. Once you have the answers, nobody ponders the questions any more. At some level, apparently, that early programming cannot be overridden or erased. It’s really powerful stuff, so powerful in fact,  it might be better to wait until a child has reached an age of reason before all this stuff is driven home in classroom drills.

A long-lost loved one . . .

All that aside, the patient recovering from anesthesia should not be surprised if some age old memories surface. Perhaps the name of a long-lost love. Whatever. Not to worry. Whatever the patient utters in recovery will probably come out as garbled nonsense.

I was hustled off to the intensive care unit once I regained consciousness. As it turned out, recovery from the anesthesia was probably more difficult than the surgery. I was asked almost immediately to get on my feet and walk, which I did. Coughing, of course, raised a concern among caretakers. The incision that is made all the way through the sternum to lay open the heart has, on rare occasions has come undone – a real nightmare for the surgeon. The patient is cautioned, therefore, to clutch a pillow to the chest when coughing and not to use his arms to get up out of a chair. I wanted to observe these admonitions diligently. However, at one point I was over taken by a paroxysm that was stronger than others. Clutching my pillow to me as if life itself depended it, I felt a slug of sputum moving up my throat. Blaaack! I spit out this ugly gelatinous ball the size of my fist into my urine flask. It was gray with sooty black deposits in it. I was horrified at it and the realization that it had been in my body.

“Look!” I exclaimed to the nurse when she came in, thinking that I had captured something essential to my recovery or at least would further assist in diagnosing my current state of health.

“Oh, good,” The nurse said calmly. “That has to be all of it. Very good.” Okay, I thought.

Pain is subjective. Nurses use this scale of help patients be more clear.

Pain ebbs and wanes during the first two or three days following surgery. Or perhaps the pain is constant but the pain-killers weaken as the hours pass after taking them. In any case. the nurses always asked, and in order to introduce some quantifying measure, they will call for the patient to give a number between 1 and 10. A chart is provided which helps the patient. It depicts cartoon patient faces with 10 looking as if the subject wants to die rather than endure another minute. Whereas 5 or 6 present the character as displeased but not in a panic. It’s a good system, although it depends on every nurse understanding the gradients of the scale. What is a five to one nurse may be a four to the next and even a six to yet another.

“Any pain tonight,” a nurse asked as she entered the room. I had not seen her before.

“Yes,” I replied. “I’d say about a 4.”

“What can I get for you?” asked. “I have Tylenol, oxycodone, and (a name I didn’t recognize),” as if she was peddling ice cream on the boardwalk

“I don’t know,” I said. “You’re the expert.”

She dropped a tablet or two (I can’t remember) into a paper cup, handed me my water glass, and I downed it all in one big gulp. Thus began the wildest, most terrifying night of my entire life. Instead of the gentle easing into a serene feeling of well-being that usually followed after taking Oxycodone, I had the sensation that the room was beginning to spin. Shadowy figures were coming and going. Some seemed menacing. I didn’t know whether that were hospital staff or not. I didn’t know why they were in the room. Some felt like a menacing presence. But the worst was yet to happen.

I began to lose a sense of myself. I lost touch with my core self. I became like one of Dante‘s characters from the Inferno being blown wildly about by the wind.I had slipped my mooring and was being tossed about in a fearful emotional storm.

A sense of the self . . .

All of my life, whether consciously or not, my perceptions of the world around me registered against the base of my essential self, as if my sensations were the wine and my essential self the goblet keeping all in order. Now the goblet was gone. Only the wine, flowing out of control remained, assaulting my senses like a beleaguered swimmer trying to escape a tsunami. The only thing that was left of the I who I knew myself to be was the fear and the panic that my mind was utterly beyond my control.

I was on a trip. I have heard about trips since college. I have never taken hard drugs. I am very respecting of them and do not feel that, given everything I have been told by those who indulge. they will add anything to the fullness of my life or the joy of living it. “Just think,” my wife observed, “there are people out there who want that experience.” I can’t imagine why.

One friend explained that most of my panic resulted because I did not know what to expect. Could be. He went on to observe that I was among strangers in a unfamiliar setting. Nobody was there to reassure me. Again, could be. Nothing, however, would prompt me to repeat the experience regardless of the conditions. I like who I am. I don’t want to abandon my sense of myself for any reason. Friends know me as a loosey-goosey guy, uninhibited and fun-loving. If anything, one of my biggest problems is weak impulse control. I wish at times I were more uptight. I can think of scores of embarrassing moments that would not have happened if I were. So, if what happened to me is what others are going for in using drugs, I am dismayed. Too bad they can find life itself awesome and marvelous just as it is presented unenhanced to all.

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Recovery from Major Surgery Requires Gumption

Thursday, August 13th, 2015
John J. Hohn, Writer

John J. Hohn, Writer


#by-passsurgery  #heartattack  #convalesces #cardiac

Recovery from major surgery is a drawn out process. Depending on the patient’s age and physical condition, it can take months. The body has absorbed a tremendous shock, especially with highly invasive procedures like coronary bypass surgery, joint replacement, or organ transplant. The patient’s strength is depleted. Muscles that worked just fine prior to surgery are sluggish and weak. Fatigue haunts every waking moment. It can feel like a draining away of the soul.

While philosophers for centuries have labored a definition of the human soul, one this is certain. The soul in all living things is the intangible force that holds the body in a state-of-being called life. The weakness and fatigue that overtakes one during recovery from major surgery depletes the spirit. The lack of vitality is in itself painful. It affects a person emotionally and spiritually.

Of course the implications are a bit ponderous. Vigor inevitably declines with age. Older people are not less soulful for it. The opposite is more often true. Our elders have usually have a more detached perspective on life and are wiser for it. Yet given what is optimal at any age against what is actual can still be a measure of soulfulness. Older folks are often described as sprightly and alert. More soulful, in other words. Against what could be the standard for their age, they weigh in at top form. It’s a relative scale, but the message is clear. Maintaining vitality at optimal levels is caring for the soul just as slothfulness and gluttony disgrace it. The ancients included both in the listing of capital sins for a reason.

Not to strike too moralistic a note, the message is care for yourself. You’re the only you you’ve got. There’s no new you coming down the line as some kind of scintillating persona that will slide into place like a perfect fitting overcoat. There’s no old you that you will return to at some time in the future. The very idea is an oxymoron. This ain’t no rehearsal, this life. Being oneself implies caring for oneself. Caring implies liking who you are. If don’t like who you are, seek professional help. Good things rarely happen to people who do not like themselves.

Good Physical Condition . . .

The Grim Reaper

The Grim Reaper

But back to anesthesia and recovery from major surgery. Current practice is to get the patient sitting up and walking as soon as possible to prevent blood clots or an embolism. Being in good physical condition going into surgery helps immensely. For one thing, patients are advised not to use their arms rising from a sitting position as it puts a strain on the sutures. Consequently, good leg strength makes rising much easier. The patient who routinely completes a set of deep knee bends or squats will do much better than those who do not. The patient who has does sit-ups or ab crunches will do better also. Good muscle tone speeds healing. The hangover effects of anesthesia and the side effects of pain pills diminish one’s capacity. Thus the degree of overall fitness is a major factor in performing the required tasks in the first 72 hours or more after an operation.

With diminished physical strength and stamina comes the attendant inability to focus sharply on what is happening. As bodily functions come back onto line – urination, bowel movements, and sputum expectoration – the mind slowly comes around. Heart patients, for example, are cautioned against depression. Studies now show that the many nerve channels connecting the heart to the mind have an impact on memory, sensory perception and thought patterns. The patient’s heart is physically manipulated during heart surgery. The impact of this manual intrusion has yet to be measured and understood. But its impact on the patient has been observed and documented. Depression is seen too often to be dismissed.

I, for one, did not experience depression, an old acquaintance of mine. I endured several painful episodes as a young man. I know firsthand how it can distort perception and foul up the thinking process. I resolved long ago to make the opposite choice if presented with a depressing thought or mood swing. All that happened to me, like a flash on a screen, was the image of me holding a gun to my head. It came a went in a nano second. I did not want to  dwell on it or ask myself what it meant. Nothing I recall prompted the image. Nothing in my thoughts triggered it. Over the years, I have grown to respect, and sometimes fear, my imagination. Images pop into mind as if by magic. I don’t need to be in deep sleep to dream. That facility has helped me a writer. It has also made recovery from depression or other self-defeating mindsets all the more difficult. Over the years, I have learned  to intervene aggressively when my imagination wanders off into unhealthy territory.

On the Prowl at All Times . . .

Depression is on the prowl at all times. One of the better ways to fight it is to become physically active. Go for a long, fast walk. Run a couple of miles. Get on the bike or treadmill. But do something! The problem, of course, is the convalescent can’t do any of these things. Instead it takes mental strength and alacrity to defeat it.

Pain is subjective. Nurses use this scale of help patients be more clear.

Pain is subjective. Nurses use this scale of help patients be more clear.

Recovery brings on two kinds of pain. The first is the spike of pain that feels like dagger stuck into a vital area and it can hurt like the devil. This kind of pain can be managed quite effectively with pain pills. The other kind of pain is a heavy dullness that invades the body and weighs down every limb. It is the pain of Sisyphus, the Greek mythological figure who is doomed to roll a monstrous boulder up the steep incline only to have it roll back on him as soon as he nears the peak. The pain of Sisyphus is in a patient’s first attempt to sit. In the first short walk in the corridor and many similar walks to be repeated day after day until strength is reestablished in the body. The pain of Sisyphus cannot be wished away. Like the boulder it rolls back over one every night and waits to burden the subject the next day almost as severely as the first.

A morning shower is exhausting the first few days in recovery from major surgery. For a couple of weeks my day began with breakfast, a shower, and then a nap because those two mundane activities exhausted me. The fatigued patient is the host depression seeks. With no reserve, let alone the mental discipline, to fight it off, depression gains easy access. Further, the mind is awakening to the thought that the grim reaper is at hand. Death feels more realistic. Denial just doesn’t work as it may have in the past. Fear, or at least an anxiousness, takes over serving as advance scouts for depression. Anxiety predisposes the patient to an onset of futility and a sense that life is not going to work out to be much after all. Time is running out on the some days when this or that would be achieved. Unfinished business and unresolved conflicts with loved ones stack up as indictments. They will stand as they are forever. It’s useless to plead understanding and forgiveness. No reprieve.

A Spirit Less Willing . . .

So it is that recovery from major surgery requires gumption and commitment when the spirit is less willing. The worst thing a patient can do is surrender to the fatigue, the weight of Sisyphus, and not try. ”Do everything they tell you,” a friend of mine who had gone through bypass surgery wrote. “There’s no easy way.” I took his advice. I may have fudged a little bit this day or that, but I set goals for myself. At first, I wanted to walk to my neighbor’s house and back, a distance of about 150 yards. Once I achieved that, I set a new destination and continued until in a short while I could walk for 25 to 30 minutes without getting so tired that I needed to stop. I plan to keep challenging myself.

Hospitals want to send patients home as soon as possible. I was discharged three days after my surgery. I welcomed being back at home but found breathing was too difficult if I took to my bed. My recliner allowed me to sit somewhat upright, as I had in the hospital, and comfortable enough to drift off. After a couple of weeks, I found that I could spend half the night in bed and half the night in the recliner. Again, challenging myself to get back to normal as soon as possible helped me move along. I came off pain pills as quickly as I could, within a day or two or returning home.

August 4 marked the third month anniversary for my triple bypass. My recovery from major surgery is nearly complete. I spend the entire night in my bed. I walk at least twenty minutes every day, sometimes twice, and have begun my workouts at the gym using lighter weights – all with the mind of trying to get back to as healthy as I can be at age 76. Knowing others have survived for fifteen, twenty or even more years after bypass surgery spurs me on. I want my body to be strong. I want my spirit to be strong. I want to be a wise, loving, productive, thoughtful senior and I am happiest when I am doing things that serve those goals.

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Coronary Bypass Surgery Commonplace and Life Extending for Many.

Wednesday, August 5th, 2015
John J. Hohn, Writer

John J. Hohn, Writer

Coronary bypass surgery has been around for more than 50 years. Yet to the patient, most of whom experience the procedure only once, undergoing the operation can give rise to anxiety. The survival rate is actually very high. Less than 5 percent mortality in the first thirty days and less than 8 percent in the twelve months following. Survival rates increase slightly with age and depend in large part upon the general health of the patient going into the operation.

I can’t say that I was anxious at first. Astonished would be more to the point. I thought that with my diet and aerobic workouts, I was invulnerable. As reality settled in, my feelings changed. If I was anxious at all, I feared pain. I’ve never liked pain. I’ve avoided it all of my life. I hoped that the repairs to my ticker could be performed using the newer less invasive techniques. The thought of sawing through my sternum and spreading rib cage to access to the chest bordered on terrifying for me.

I had been on a been on a blood thinner (clopidogrel) since I had three stents inserted into my coronary arteries almost five years earlier. Consequently, I was hospitalized on a monitor (my left descending artery was 90% blocked) for four days before the operation. During that time, my blood was checked every four hours to see if the effects of the blood thinner had worn off and it was safe to operate. The frequent blood tests were a serious annoyance. My guess is even the janitor on the floor knew that it would take at least 48 hours for the effect of the blood thinner to wear off in a six-foot-two-inch male weighing 210 pounds. But no! Every hour hours, beginning right after admission. Forget what would be reasonable. It helps run up the lab bill, after all. The markup on lab procedures is probably several hundred times. But the wait gave me plenty of time to stew about my chances and my future.

When it came to not surviving, I knew only that I did not want to leave. That sounds a bit silly, but dying didn’t really bother me. I embraced my mortality years ago. Most writers do. It’s all but forced upon them. I didn’t want to leave my wife and children. I wanted to hang around and enjoy loving them and time with them. I didn’t want them to grieve. As a consolation to myself, I decided quite calmly that I had lived a good life. It was certainly exciting, perhaps more at times than I would have wished. But I was completely comfortable with the realization that I was not an evil man. A fool, yes! But evil, no. I never deliberated set out to hurt anyone or deprive anyone of anything he or she needed. I made a few mistakes. Some of them quite serious. (Don’t ask.) But mistakes are not as important as how one recovers from them. I felt, all in all, if I was on the threshold of departure from this life, I could make my good-byes with a degree of satisfaction that my life was a successful one, especially given then last 35 years, or roughly half.

Lights  out . . .

For a man who lives by his imagination, I had no idea what I was going to experience. My last hospitalization for surgery was minor when I had the stents implanted as I mention earlier. This time, I was rolled into the operating room, a huge, overwhelming gray and white space. Several humans were milling about in light green surgical suits. I had to scrunch a little to get onto the operating table.

Coronary Bypass Surgery  Illustration

Coronary Bypass Surgery Illustration

Then. blam! Lights out. I am guessing that the anesthesia for coronary bypass surgery takes the patient about as far under as one dare go. I jokingly said that the anesthesiologist has a “death meter” that must be watched as the needle hovers precariously above zero. After all, my heart was going to be stopped. A machine was going to breathe for me. So. I ceased to exist as I know myself. I would like to write that it was pleasant, but it wasn’t! It wasn’t anything. I continued to exist with no awareness of myself and life around me. If death is like that, I’m thinking it’s not to be feared.

Waking up, however, is another matter. My wife and stepson were at my bedside side with the anesthesiologist and a nurse. Apparently, I struggled and thrashed around for a couple of hours or more. I’d give thumbs up and nodded when asked, but I do not remember anything. At one point, in the darkness, I heard my wife’s dear voice, “John? Why are you here?”

“To know, to love and to serve God,” I responded with great pride that the answer felt so right and came to me so readily. (Never underestimate the power of early catechism lessons.) It was a response that I respect to this day and one that I still question because I really want the answer to be an honest one. As it stands, it may be something learned and recited by rote. On the other hand, I felt an innocence flow through me in making the reply. I felt like a babe being lifted dripping naked from the bath. My response was mumbled. Nobody understood what I tried to say. The borderline between consciousness and stupor bends and sways at this point in overcoming the anesthesia. Taking it seriously, I do love God. I intend to serve God in all that I do. (I can’t imagine deliberately undertaking to not serve God.) The heart of the matter for me is knowing or striving to know God. Lots of pretend, sometimes ludicrous knowledge clutters the path.

Suddenly, I am aware. Alive! The people in the room appear as silhouettes. “I love you guys,” I proclaimed in my joy at being awake. The fact that I only knew two people present concerned me not in the least. I was in a recovery room in the intensive care unit (ICU). I was comfortable but groggy, drifting in and out of consciousness, so much so that I remember very little of the day.

Extremely Depleting . . .

When the next day rolled around, I was more myself. I was immediately challenged to stand up which was a struggle. I began to realize how much the body gives up enduring major surgery. It is extremely depleting. The nurse was impressed with my leg strength, given my age. Why not? I had been working out regularly for 40 years, but I felt horribly weak. Later, when I was asked to walk,

Interveneous Insert = I Needed Two.

Intravenous Insert = I Needed Two.

every step required effort. I tired very quickly. The heck with my heart – what had been done to the rest of my body? Apparently, experience proves that patients who get back on their feet immediately, recover much faster, and thus the effort to get one out of bed and strolling about even if it requires assistance.

All of my systems were coming back onto line. I could not get to the bathroom on my own, but I had a bottle. I hacked up a lifetime-best slug of sputum from my lungs. “Oh good!” my nurse exclaimed when I told her about it. “Everything’s working.” My appetite returned. I had not eaten for two days. I ordered lunch, but before it arrived, I was told that I was doing so well that I was going to be moved out of ICU into a coronary care area. The lunch was directed to my new room The nurses in ICU, however, did not want me to be transferred until they had two working intravenous inserts (IV’s) established.

My arms looked like the no-man’s land of a World War I battlefield. Blood had been taken from the back of my hands up to my elbow on both arms. My fatty arms. I don’t have rope veins on the surface al a gym rats everywhere. They could not find a place to insert the new IV. I kept telling them to try above my elbow. But no, they’d rather not. Finally a doctor was called and she found a place using a sonogram locator. Guess where. Above my elbow. Lunch hour was long gone. It was 4:00 pm.

Locating the right place for the IV took so long that my lunch was returned to the kitchen. I was starving. I told the nurse on the floor to which I was transferred that I needed something eat. She insisted on completing a questionnaire on a monitor in the room that repeated all the questions I had been asked every day for six days. What good, I thought, was a system if it didn’t retain the answers from one day to the next? When the nurse left saying nothing about my lunch, I called my wife and asked her to bring me a peanut butter-and-jelly sandwich from home. We live five minutes from the hospital. It seemed the only way.  I really did not, as I feared, experience much physical pain. The only pain I experienced during for my entire stay was hunger in the face of indifference toward it and multiple attempts at inserting an IV. But there is more to my story . . .

To be Continued . . .

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Widow Maker — The Left Main Coronary Artery

Friday, June 12th, 2015
John J. Hohn, Writer

John J. Hohn, Writer

#heartattack #widowmake #coronary

Widow Maker. That’s what they call it – the widow maker. The left main coronary artery. “They’d never have been able to resuscitate you,” my friend Bruce Walley said, as he viewed the video of the angiogram. Bruce would know. He’s a retired heart surgeon. The artery was 90% blocked. I had been running around all over the southeast at huge risk to my survival. His word, and the fact that I went directly onto a monitor and into the hospital cardiac care unit told me I had been taking huge risks. I had no idea of perilous my condition was.

I’ve known for years that I had high cholesterol – stratospheric – in the mid-300 range. I also found out early that I could not tolerate statins. Lipitor, Mevacor, Crestor Zetia, etc. I tried them all. At one point, in fact, I signed up with the lipid clinic. Under a doctor’s direction, I started taking massive dosages of statins. My cholesterol totals were checked twice a month. Finally, my total LDL and HDL combined total dropped to less than the magic total of 150. Then one night, as I was getting out of my chair, a bolt of pain in my left leg dropped me to the floor. It felt as though a rod had been driven down my thigh from my buttocks to my knee. It was the worst pain I had ever felt. It hurt to lie still. It hurt to move. My wife was aghast. Call 911?

Cure Worse than the Affliction . . .

Then, after what seemed like minutes, the pain subsided. Instinctively I knew it was a reaction to the medicines I was taking. I stopped altogether. The cure was worse than the affliction. I dropped out of the clinic and began doing my own research. I found, for example, that the statistical viability of venerable Framingham Study weakened once subjects passed their 70 birthday, a milepost six years back in my review mirror. So many other factors entered into considering the mortality rates in the eight decade that high cholesterol shared its grim reaper status with a host of other diseases and physical anomalies. I found experts did not agree that high cholesterol was a problem. Of course I had a vested interest in believing I was not threatened by the waxy buildup in my arteries. Some authors even made a case against the pharmaceutical industry for pushing statins onto medical providers who were too busy or too tired to do their own research.

I found that my wife and I were doing a lot of the right things. I had been a regular at the gym for over thirty years. I did my cardio. Three times a week, I got my heart rate up to 80% of its max for a sustained 20 minutes or more. I was not overweight. We rarely ate red meats. We avoided sugars and sweets.  I abstained from soft drinks. We avoided hydrogenated oils and fats, high fructose corn syrup (or as has been allowed, simply “corn syrup). I started taking daily doses of Omega-3, niacin, Co-Q10, clopidegrel, coated aspirin. Every meal I sat down to a mini chemistry set in front of me. My ratio of HDL to LDL was right where it needed to be. Vegetarian, vegan, low-carb diets all had advocates, many of whom contradicted the research of those with a differing view. I decided that nutritionists shared a position with economists – if they were lined up head-to-foot around the equator, they would all, nevertheless, wind up pointing in different directiosn.

One thing is certain. No one can trust the rulings and proclamations of the Food and Drug Administration. Lobbyists hammer away at our congressional representatives, venial humans like the rest of us who are no brighter, no more enlightened, and perhaps more greedy and narcissistic than the rest of us. Money in the billions is made available to sway legislation and policy formation. The FDA does not have the best interests of the nation’s health in mind any more that the SEC seeks to protect the average investor from the scams and crooked dealings of the big banks and brokerage firms. .

In May, 2010, my cardiologist detected an anomaly in the results of my stress EKG. “It’s up to you,” he counseled my wife and me. “If it were me, I would have the procedure. Then we will know what we are talking about.”

Moving Confidently Ahead with Our Lives . . .

The procedure to be considered was an angiogram. We consented to it and it revealed that I had minor blockages of three coronary arteries. The left main – the widow-maker – was not among them. Two short hospitalizations and I walked back into my life ready to begin my aerobic workouts and my exasperating golf game without a hitch. The results seemed to substantiate that I was on the right track, that what I was doing as far as exercise and diet were concerned was working. We moved confidently ahead with our lives, proactively seeking a healthy, happy lifestyle. Our long term aspirations led us to decide that, for all the attractions of our current residence, we felt we would be happier moving back to Winston-Salem, the town we had lived in for more than 30 years. We bought a house and moved.

Major Coronary Heart Arteries. The Widow Make is upper right.

Major Coronary Heart Arteries. The Widow Make is upper right.

The move, of course, meant that I needed to gain entry into the medical care provider system in my new community. My cardiologist in Wilmington had sent me on my way in December, 2015, after checking my EKG and a routine physical. “You look great. Keep it up,” he announced cheerfully. My new physicians were more thorough. But, in fairness, even they seemed convinced by my general healthy appearance, my diet and workout regimen that nothing could be too seriously wrong. I enthusiastically affirmed everything they said that was positive. But slowly things began to breakdown.

The results of a new stress test were positive (in medical terms “positive” means “bad.”) “There’s trouble with the early part of your heartbeat,” my cardiologist observed. He prescribed Isorsorbide, a blood vessel dilator, and somewhat more alarming, an emergency supply of nitro tablets to be taken if I experienced chest pains again  (see my previous article). An angiogram was scheduled and the full scope of my troubles became apparent. In five years, my left main coronary artery – the widow-maker – was 90 percent blocked. I had been hoping that another stent or two would solve the problem. “It would only make it worse,” my cardiologist reported. If not stents, then perhaps the newer non-invasive heart surgery procedures would spare me the horror of having my sternum cut from my clavicle to my diaphragm, pried apart, and all manner of other fantastic manipulations of my vitals. But it was the only way. I was rushed to the hospital.

It’s Not My Time . . .

“This is not my time,” I confided in my good friend. “I just don’t feel that I am through with my life yet.”

“I don’t think that it is your time either,” she replied, a survivor of not one but two open heart surgeries. I took some comfort in recognizing the open heart surgeries were no longer experimental. They had been around since the 1960’s and what once was considered pioneering surgery had become routine.

Even so, I thought, I have lived a good life. I can’t change my past. What is done is done. I had deliberately set out to atone for my most regrets. There are so many foolish things in my past that cause me to cringe to this day when I recall them. But they were not evil acts. I am a foolish man. I know that. Yet given that, I have been thoughtful about my beliefs and my faith. I have wanted my beliefs to be reasonable. Once reason is abandoned in the name of religion or any belief system, a threshold is crossed in man’s intellectual makeup that makes anything possible, be it Charlie Brown’s Great Pumpkin or the notion that every human soul enters life unacceptable in the eyes of the Almighty because the child inherits a sin from an illiterate savage human ancestor.

I don’t know if I pray any more. Certainly not in the traditional sense which often is nothing more than repeating a composed piece from memory. But I  find I am thankful for the life I have lived. Of course, I would have chosen to avoid the pain of divorce, of parting with my children, and of bearing with financial failure at the height of my earning years. Thorns among the roses. I want to learn more. I want to become wiser and more understanding. Perhaps I can write something better than anything I have composed so far. But when a summing up takes place and the end is a tangible possibility, my first and nearly overwhelming utterance is that I am thankful. I have loved as well as I was capable at the time. I have enjoyed the love of so many. My life, up until the time the anesthesiologist turned out the lights, was a success.

I have so little that I would ask for by way of any supplication. In fact, I may not believe in prayers of supplication. They may relieve stress at the time of crisis but the record on them being answered is not encouraging. Hind sight shapes the answers. There is no control group data – the outcome for others suffering the same crisis but choosing not to pray.

I believe in praise and thanksgiving. I do not know my Creator well. I know dishonesty and cruelty when I see it. There is too much of both in the world. I believe in truth. I believe we are drawn to beauty because it reflects the Divine. I believe nature strives, if often extravagantly, for perfection and sometimes overshoots the mark. Beyond that, I will continue to search and sing songs of praise and thanksgiving.


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