Superman’s Cape is muddy…..

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Last Wednesday, after the Labor Day holiday on Monday, and some technical problems with the water on Tuesday, I swam at the pool where I usually go. It was around noon and for that reason a lady that swims laps like I do, in speed and number, was there. She and I used to swim at the same time but our schedules have changed and I usually don’t see anyone there to swim with. When she showed up I was interested because swimming by oneself is a solitary pursuit.
Swimming is a solitary experience. I use big goggles and I use a snorkel and listen to my mp3 player so I am limited in interaction to others around me. If you happen to have someone swimming in the lane next to you, it becomes a form of entertainment and diversion. Otherwise those blue porcelain diamonds going by are pretty monotonous. Seeing this fellow swimmer again was therefore entertaining and a challenge.
She was swimming such that I was finishing up my workout . I usually swim 50 minutes and she usually swims 30 or so minutes. I swim freestyle and she uses breast stroke and freestyle. She was just starting so she was relatively fresh and moving along pretty well. I like to keep up with fellow swimmers as a motivational tool and so I was trying to keep up with her. She was a bit ahead of me on my last 2 lengths of the pool and I really had to swim hard to make it to the other end of the pool at the same time she did or even better, before. So, I was really digging and pulling thru the last 2 lengths of the pool. I reached the end about the same time she did and really felt it. “IT” was a tight sensation across my anterior chest and front of both arms but, well, I just finished a tough workout so “it” wasn’t that unusual to feel a bit of muscle soreness or tightness.
I got out of the water and proceeded to the car as usual and thought to myself how interesting that I had never had this soreness persist as much as it was today!! Must be getting older and need to pace myself!! By the time I had reached the house, I was fine. No SOB or nausea or radiating pain or an elephant on my chest. Just felt like I had worked out pretty hard.
Rest of the day was un eventful and although I had some “it “soreness, I did all my usual activities. Thursday was band rehearsal, and Friday morning, I proceeded to the pool in the am like normal. I swam my usual 50 minutes and interestingly enough, I didn’t stop or change any of my workout. The soreness seemed to work itself out a little as I swam more. When I got out, I had a little of “it” but nothing really remarkable except that I conveyed to my wife that I must have really busted it on Wed because I was still “sore”. Saturday was football day and I watched grandchildren play soccer and football. After that I loaded the BAND VAN with a little help from my wife and then suffered thru the Ga Vs Notredame game. I did go to bed at halftime when we were ahead!
Sunday morning I arose early, dressed, and proceeded to pick up a couple of band guys and went to the Yellow Daisy Festival and came home around 330. Still no more “it” but I did spend the rest of the day in the lazyboy watching football!!
Monday was occupied with Cabin fever because of the rain and disasters associated with the Hurricane. I usually drive to rehearsal in Clarkston but it was cancelled because the college was closed so I just sat at home and watchd the rain. Tuesday morning I got up and since the pool was open, was going to do my usual Monday workout on Tuesday. I arrived at the pool at 8 am and hopped in. I started swimming and immediately began to feel “it” which wasn’t there before I started. And “it” got worse. I wasn’t hungry for air but I felt a bit winded and after 10 minutes of increasing discomfort, I decided to stop.
Understand that I knew it might be a cardiac event (Im not stupid, I am a doctor) BUT “it” didn’t feel like any of the descriptions of myocardial pain that I had ever come across. I didn’t know, but reason said,”If it is a cardiac event, you are NUTS to ignore it!!!! Chest pain of a cardiac origin is usually described in the texts as crushing substernal pain centered but radiating to either arm or the neck, possibly associated with Shortness of breath and sometimes nausea. Mine was NOT like that. In fact as previously described, it was sort of underwhelming. Pressure, maybe. I come from a family of exercisers. Mom and Dad both had their regimens with Mom it was ballet and with Dad it was Softball, Swimming, YMCA ,Volleyball,and hand ball and finally as he got some mileage on his skeleton it was Jogging. So I have made exercise as part of my life all of my life. So I exercise regularly. I swim 2000 + yards (one nautical mile) three times a week and in the last year I have been riding a tadpole trike on the Silver Comet trail and at the park and local roads. I don’t smoke or drink and never have. My family history does not have any significant cardiovascular disease except my maternal grandfather (incidentally a surgeon) who had a fatal MI, but this was a number of decades ago. So I felt relatively protected from any significant coronary event. I was a bit proud of this. My wife, who was a registered dietitian tried to emphasize the right diet for us, although like most Americans, we would deviate from the plan a good bit. {Good intentions!} So cardiac risk wasn’t in the fore front of my mind.

So, begrudgingly, I got out of the pool and went to the car and drove home. Felt pretty good. “It” had gotten better in the ride home but had not gone away. So I called my MD and took a shower and left a message as to what to do.
Upon occasion in life, we get the feeling that we are immune to the risks and problems of “normal” people because if we actually immersed ourselves in the trouble of others and worried about that being an outcome for us, we would be immensely burdened. So, ignorance or acceptance of some risk and being a bit pragmatic is necessary to survive life in general. That doesn’t not imply that we should completely disregard choices and risky behavior, but just that we should acknowledge it for what it is and do our best to continue on, knowing that Superman occasionally got some mud on his cape Im sure!!
I live across the street from my doctor’s home and my office used to be across the street from his office. So we are friends. His wife and all of us are all neighbors. He came to practice about the same time I came to town so we are also professional compadres. He is a direct sort of person who calls it like he sees it and does not mince words if they are needed to be delivered directly. He is also one of the last great family doctors. I had fixed his daughters ACL when she tore it and, suffice it to say, we got along well. But he knows that I am a strong willed person and deals with that well.
I went to his office and they ran an EKG and there were some slight changes in the inferior leads from May and so we drew some “Markers” (specifically troponin etc) and he gave me the tubes and sent me to the lab at the hospital to Betty Sue and told me to go on home and if there were anything there, he would call me. Because I used to use this hospital and knew a lot of the folks there, he gave me the tubes and said take them to Betty Sue in the lab. I coached Betty Sue’s boy in baseball and my partner and I fixed her supracondylar elbow fracture when she “powdered it” in a fall. So Betty Sue is my friend.
Sure enough, I got a phone call within the hour and he said the troponin level was up and that I needed to be evaluated by Cardiology at the hospital. So I left my socks and went to the ED.
I was admitted by Donna, a dear friend from our old hospital days and worked up by a really competently appearing ER doc. My nurse, Ellen, I had almost hired to work for me in the mid 90’s so she and I hit it off well. More enzymes, more EKG, more blood (a process that was to continue through my hospitalization) IV fluids, heparin and admission to the “Telemetry Unit”. I was put in room 305 which was a room I was familiar with because the orthopedic patients used to all be on the 3rd floor. I was taken up to the room by Keith who was an old EMT buddy from way back so I was well taken care of.
All of the rooms in this hospital in the section I was housed were built as double occupancy rooms so that if the hospital needed to increase the number of beds, they could just roll another bed in. Some of the rooms on other floors were double occupancy, but orthopedic rooms and telemetry were almost always private. So I felt right at home. Familiar smells and sights were present. All my old nursing buddies were now supervisors and would pop in upon occasion and we would tell stories. So I was not alone. Also, the younger nurses I could identify with because of my years of teaching at KSU in the nursing program.
Entering the hospital these days, you are confronted with a tiered care environment. Starts with the Hospitalist who does what the Cardiologist says, and his PA, followed by the Supervisor Nurse and the Charge Nurse and the floor nurse and the nurse tech and so on….. So although it works well, it does not appear to be doing so !! LOL!!
The hospitalist came in and gave me another H & P eval (one of about 4 that I got with all the usual questions, (“do you smoke, drink, use recreational drugs…….”)and we decided that with all the evidence so far and a troponin level that was up, why would we NOT do a cath to see what was cooking.
Thru all this, I still had “it” but was in no way uncomfortable. They scheduled my cath for in the morning.
The telemetry area is not a place to rest. They were trying to “keep me alive” so the monitoring of vital signs and output and lab work etc. is there job. And they did it well, but left little time for sleep. In addition, although those hospital beds are infinitely adjustable, they still aren’t just like home

I sent my wife home at about 8pm thinking I could get some rest. Nope. Not in this unit. The freaking alarms that went off every time I moved, the electrodes on my chest , the IVF in my arm, and the ever present seemingly q2hr vital signs kept me from enjoying any significant rest. And there is nothing on TV on TUESDAY NIGHT!
The worst thing thru the night was the fluids. I have a touch of prostatic hypertrophy but it is well controlled with meds (which I didn’t have) and by not drinking much after 730pm. Here, they were pouring IVF into me with heparin at 100cc per hour, so the urinal and I became great friends!! !! I was using the urinal every 60 minutes or so.
Thankfully, with coming of 8 am the next day, things began to happen. More blood, Chest xray ,then a portable Echo cardiogram(where she really worked over my chest wall with that probe!!!) The Cardiologist came in, and after a brief conversation, we arrived at the conclusion that he would do a PCI thru my WRIST!!! OMG, the radial artery. No concerns about hematomas and hours of immobility from a femoral artery stick etc.
So, after a while they wheeled me down to the Cath lab. The Cath nurses were an efficient team and had a lot of experience and were the “A Team” in my mind. Not a moment or movement or instruction was wasted. I usually get very sick with any narcotics so they gave me only 1mg of Versed and it just relaxed me so I could get comfortable. The PCI (percutaneous cardiac intervention) itself was completely painless with only a couple of brief moments (less than a second) of arm burning then it was gone and I listened and watched the efficient machine of the Cardiologist and his team doing their job. Then it was over. Bam. A balloon and a stent on a 99% lesion RCA and it was fixed.
Immediately after the procedure, “it” pain was gone. And then I realized that I really had experienced some chest tightness, by the fact that I didn’t have it anymore!!!!
The rest of my visit there was very uneventful, which included another night of peeing every hour and no rest and crappy cable TV with alarms going off all the time with any movement, BUT, I felt great!!
Went home the next day on 4 meds which will be tapered in about 4 weeks to two….but I feel MAVELOUS!!
So, what is the big deal? Well, I really don’t want to tell this story ten thousand times over and over again. The talking points are this:
1. Nobody is invincible (ask Dr Fick….google it)
2. Listen to what your body is telling you
3. Pride in your education and abilities do NOT trump events as they occur.
4. Good friends are always good friends
5. People in health care are irreplaceable by any “system” on earth
6. Technology is amazing
7. Even if you don’t think it could happen to you, it can
8. Exercise and living “correctly” don’t prevent cardiac disease but it can make it easier to treat when it does happen and prevent permanent cardiac muscle damage, so do it anyway!!
9. God is Good. All the time. Thank you!!

 

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About sjonesjrmd

Orthopedic Surgeon by training, a Jazz player since the 4th grade, Dr Jones is now retired and playing around north Georgia.
This entry was posted in Health and wellness, Humor. Bookmark the permalink.

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