A Poke in the Ribs

So yesterday I visited the cardiologist and he told me he wanted me to wait a few weeks after I finished antibiotics before talking about surgery. I get it. Letting my body adjust to life without infection or antibiotics makes a lot of sense. But I am sick of living my life on egg shells and I am sick of being on hold until I have the surgery done. Honestly, I just want to do it and get it over with and move on. I am frustrated.

My friend Randi advised me to think about the time before surgery as training for surgery...a time to get my body in the best possible shape to weather the surgery and recover as fast as possible. She, of course, has a good point and the whole training angle almost gives me enough to keep me going for the next 6 weeks...almost. And sure I've got half a dozen writing projects to keep me amused, too. Still, I am having a hard time with this schedule.

Yesterday in my frustration I posted that I declared myself no longer sick. The cardiologist didn't exactly say it that way, but he said I could do any normal activity I felt comfortable doing. Surprisingly, 30-mile bike rides apparently don't qualify as normal activity. I declared I would drink coffee (in moderation), go on short bike rides, and forget about having surgery. Now any of you who have followed my adventures since I started trying to lose weight and get into cycling should have noticed a pattern. When it comes to pushing my body, I am not particularly patient and I often make rather rash decisions. Usually I pay for that with sore muscles, difficult bike rides, or some other short-term physical set back. You think I'd might learn something.

So yesterday I delcared myself no longer sick, and therefore able to do normal things. Today I got a subtle poke in the ribs from the powers that be. Today I woke up with a scratchy throat and runny nose. I have a cold. It isn't a bad one, and it doesn't pose any threat to my overall health. Still, I feel a little...well, sick.  So much for my declaration!

This past weekend I missed a Busk at the Creek Indian ceremonial grounds I attend because I couldn't travel. At previous Busks, the ceremonial leadership has admonished those attending to be aware, listen, and pay attention to what is going on around them. We tend to miss some really important stuff about ourselves, our relationships, and the world around us because we are so disconnected, so diverted by technology.

This cold is a reminder of that important lesson from the grounds. I know there were people there this weekend concerned about my health and they did things in the sacred space of the grounds to harness power to help me. Whether you or I or anyone else sees my cold as just another random and meaningless event in a random universe or something else really doesn't matter much. I think I should listen to the message that it sends to me.

So maybe I am not really sick, but that doesn't mean I should be stupid (I tell myself as I tell you). As Randi says, this is my time to get ready for what surgery will do to me. Frustrated or not, I need to be a little smarter about my body than I usually am.

But that doesn't mean you won't see me coasting around on my bike along the mean streets of Shandon now and again.

My Spa Days: Pudding, V-Tach, and Billy the Exterminator

I recently spent 8 lovely days in a restful spa called Providence Hospital. Now usually going to the hospital has negative connotations. Sure, you’re injured or seriously sick and that is never a good thing. Sure, hospitals are filled with sick people and the germs they propagate. Who really wants to go to the hospital? Well, no one in their right mind. Since returning home and feeling a bit better, I’ve had the chance to reflect on the good and bad points of being in the hospital. Let’s just forget for the moment why I was in, because that is not a good point.

The Good

The Service

In the hospital the service is pretty good. If you need something, you have a button you can push and a friendly voice asks what you need. Clean towels, a new gown, snacks, explanations as to why your heart is beating erratically? Just ask and it is yours in short order.  Here at home no one waits on me…I am the waiter, not the waited upon (a role I realize I have created and continued through my own agency). Also, in the hospital food comes at regular, predictable intervals…already prepared! And, it comes with a menu so you know what you’ll be eating at the next meal…and there are even choices! It’s like magic or Star Trek where they have those things that make food appear instantly. Here at home, food does not appear…it is made…usually by me. In the hospital meals come with salads or soup, include meat and a starch and vegetables, and finish with dessert. Meals at home do not have all that. Eating is one of my favorite hobbies…and I’ll admit that the food was pretty good. Honestly, it was nice being served.

Peace and Quiet

It was pretty peaceful in the hospital. Of sure, people came in and out at both regular and random intervals to do things from taking my vitals to borrowing some blood to emptying my pee bottle. In between those visits, it was just me. I watched some TV, enjoyed the free Wi-Fi, even read the paper a bit. There were no kids dashing through the room or fighting or wanting something…no yelling or crying or complaining. Comparatively speaking, it was pretty peaceful…as it should be if healing is the goal.

Endless Pudding

Yeah, endless pudding. Anytime I wanted pudding—morning, noon, or night—some would appear…usually more than one cup at a time, too. I forgot how great pudding is. I love pudding.

Cable TV

We don’t have cable TV at home, we gave it up because there is nothing but junk on. In the hospital I got to watch all that useless stuff we gave up…like football games and reality TV. Would you believe there are two different reality TV shows featuring towing companies? And they are both great! It is amazing how much satisfaction you can get watching rich people get their cars towed. There is also lots of cussing and fighting, too. TV that is very good for convalescing. And don’t even get me going on Billy the Exterminator…great stuff!

The Bad

Sure with all the great reasons to go to the hospital, there are some bad things about being there…and let’s still forget why I went there in the first place.

That Bed

First of all, it’s a really narrow bed so you can’t spread out or roll over. I discovered that rolling on to my left side sent me into v-tach (fast irregular heartbeat that can lead to oxygen deprivation), so after that I pretty much just slept on my back as a matter of self-preservation.

Sure the bed has those nifty features that let you raise it up or lower it, raise your feet or head, etc. Those are only useful in limited circumstances: when someone wants to take some blood from you or take your vitals; to facilitate reality TV watching; to entertain your kids when they visit. The worst thing about the bed, well there are two bad things about it. One is that it has a plastic liner under the sheets…nothing says sweaty sleeping like a plastic liner. The other is that the bed automatically made adjustments—puffing one area up and then letting it down. It did it all the time, day and night. That took some getting used to. Maybe if I had been in the Navy and was used to sleeping on a moving target it would have been an easier adjustment. I assume that was to keep me from getting bed sores—clever but really, really annoying. I should really talk to the management about those beds so my next stay is more comfortable.

Peeing in a Bottle

When you’re hooked up to an IV stand that is plugged into the wall, you have no choice but to pee in a bottle. It is hard to maintain your dignity when you have to pee in a bottle, but I found a way that worked for me. I stood up and faced the wall as if I was just peeing in the bushes…you know, just another  Friday night out with the guys. (Remind me to tell the story of getting roughed up because some frat boys caught me peeing in THEIR bushes when I was in college.) In the hospital I got pretty good at peeing in a bottle and could do it all one-handed. That did get old though, so I started unplugging my automatic monitoring IV stand from the wall and walking it to the bathroom with me. It was awkward and took a lot of furniture moving, but I had the time to work it out.

After a while I realized the nurses, who would come in to empty my pee bottle, were using it to keep track of how much I peed. When I stopped using the bottle I was peppered with questions every few hours about how many times I had peed. That was a dignity sapper.

No Privacy

People did come and go from my room at all hours of the day and night. Sure, they would knock before they came in, but the lag between knock and entry barely left time to inform someone that I was busy peeing in my bottle. Honestly, that really wasn’t very different from being home. My kids are pretty much on top of me whenever I am home and they, especially my son, will follow me anywhere and talk to me while I do absolutely anything.

4am Wake-up

They took my vital signs every 4 hours and the first one of the morning started at 4am. Often that was followed up by someone taking blood, doing an EKG, or dispensing medicine. Not long after the doctors would make their appearance to speak to me in their vague and non-committal ways. So effectively, I woke up every day at 4am. Sure, I might grab a cat nap between vitals and the EKG, but it left me no choice but to have an afternoon nap…which left me watching reality TV until the midnight vitals check, only to be awakened at 4am to start it all over again.

Collateral Damage

I was in the hospital for 8 days…not an eternity but long enough to form some habits.

Pudding

I am thoroughly addicted to pudding. I’ve gone through I don’t know how many tubs of Kozy Shack pudding since I’ve come home. I love it, I love it, I can’t stop.

Billy the Exterminator

I am also thoroughly addicted to a reality TV show called Billy the Exterminator. He works for a company called Vexcon in Shreveport that specializes in getting rid of all kinds of things from gators to bobcats to roaches. But Billy is no ordinary guy. He knows more ways to get rid of pests than anyone on earth, and he’s got a unique look. He has spiked hair and wears black leather everything with spikes all over it. He’s the McGuiver/Billy Idol of exterminators. Since coming home (where there is no cable TV) I’ve found that Billy the Exterminator is available on Hulu…just season 2 for now. My daughter and wife are now thoroughly hooked too. Billy’s even got his own online store where you can buy leather gear with spikes and chains. If you are looking for a birthday gift for me (October 5)…

4am Wake-up

Since coming home I’ve found that I wake up early. Sure, taking a 3-hour nap in the afternoon is going to shorten a night’s sleep, but oddly enough I keep waking up somewhere between 4 and 6 am. No one is poking me, squeezing me, or sticking a thermometer in my mouth…yet I wake up. I was up at 4 this morning and am trying hard to avoid an afternoon nap just so I sleep through the night. I am really looking forward to getting this all fixed up so I can go back to a more normal routine…only 3 months to go!

All in all I have no real complaints about my stay in the hospital. Really, I did miss my family and the hubbub a lot. But, it was nice to rest and be served. I have a new appreciation for nurses and nursing techs. They work hard and work around the clock…and every single one I came into contact with was nice and upbeat. I found the simmering class conflict between doctors and everyone else to be really interesting, but that is another story.

What a long strange trip it's been

I rip that off directly from the great American poets the Grateful Dead, and use it because it is apropos of my summer. It has been a long and not so good summer, mostly because I was sick during most of it. I now know that I have bacterial endocarditis and that I got it when a tooth extraction back in May let loose bacteria into my bloodstream. Those bacteria found the defective aortic valve in my heart and set to work.

The first impact was a fever and fatigue about 5 days after the extraction. I got the tooth pulled on a Monday and Tuesday I went to Cartersville, GA to co-direct a dig on an interesting and large prehistoric feature located just west of the Etowah Indian Mounds site. I took my bike up there because one of the goals I set for myself at the beginning of the year was to ride in three states other than SC. It was hot and running a dig is always tiring and stressful. One morning I went for a 30-mile ride. It was a great ride, maybe one of the best I’d done. The countryside was beautiful, I saw a lot of wildlife and it just felt good to propel myself. A day later we ended the dig—without finding any conclusive answers—and the following day I got a fever, chills, headache, and fatigue. Thinking this was related to the tooth, I called my dentist and that Monday he gave me some antibiotics. I felt better in a couple of days.

Jump forward about 10 days. My wife was gone to Atlanta for a few weeks on a photo shoot. I took my kids to a local park, asked the moms to watch them and jumped on my bike for another ride. I only went 25 miles and really felt like crap—no juice. Two days later I got a new fever with chills, etc. I called my dentist—on his way to the beach—and he (somewhat reluctantly) called in a second prescription for antibiotics. In a few days I felt better…but I began to wonder if these problems weren’t related to the physical exertion of riding my bike.

A week or so later my wife came back home and I was ready to get back to training. I set up a very full schedule (5 nights in 6 days) of valet parking (one of my side occupations) and planned a ride in there, too. I took the ride on a Tuesday—after a couple of valet nights—and barely finished the ride. I was exhausted, no energy. It was such a terrible ride that I didn’t even want to think about riding again for days. A funny thing happened; a few days later I had the fever and all again. On July 5^th I went to a “real” doctor…OK a “doc-in-a-box.” He did some tests, confirmed I had an infection and prescribed me a long course of antibiotics. He didn’t have any answers, but suggested a variety of things. A few days later, I felt OK again, but I decided not to ride my bike until after I had finished this course of antibiotics. I was sure riding my bike was somehow triggering this.

Near the end of that two-week course, we went to visit my parents in southern VA. I brought my bike because I had been having troubles with the derailleur and wanted to work on it with my Dad. I also wanted to take it with us because from my parents’ house we were heading to the Shenandoah Valley to visit my sister-in-law. It sounded like a beautiful place to ride…and I was really jonesing to ride. The day after I finished my antibiotics I worked on my bike and then took it out for a measly 12-mile ride. There was a nasty hill in it and my shifting problems weren’t fixed, so the ride was a lot harder than it should have been. Two days later while in the Shenandoah Valley, the fever returned. We drove home the next day and the day after that I visited the “doc-in-the-box” again.  The PA I saw this time mentioned to me that I had a heart murmur. I asked if it was related to my fever and she said she didn’t know. She prescribed a course of antibiotics focused on tick-borne diseases like Lyme’s Disease or Rocky Mountain spotted fever and ordered some more tests. This time I did not feel better after a couple of days.

At this point I decided I needed to see a real doctor, so I tried to make an appointment with my wife’s internist. He was on vacation and wouldn’t be available for two weeks. I took the first available appointment in the practice for the following week. I saw the doctor and he puzzled over my case. He ordered some tests, including an echocardiogram. He suggested that my heart murmur might have something to do with my problems, but didn’t elaborate or commit. Then he said, I will see you in two weeks—he went on vacation. At this point, I had been through a week or so of daily fevers and chills and complete exhaustion. I suffered through another week of that and then got the echocardiogram done…the results wouldn’t be available for a week, just about the same time my doctor was coming back. I was pretty distressed at this point because I really didn’t want to face another full week of sweating, freezing, and feeling horrible and I was becoming increasingly scared that something very serious was wrong with me.

At the same time that this last fever started, while I was in Virginia, I also noticed a spot blocking my vision in my right eye…it didn’t go away. When we returned home in addition to seeing the doc-in-a-box I also saw an eye doctor. He said I ruptured a blood vessel in my eye and wanted me to see a retina specialist to make sure there was no permanent damage. A few days later I saw the retina doctor. He confirmed the ruptured vessel, said there would be no permanent damage, and scheduled a follow-up visit for about 10 days later. At my follow-up visit, the retina doc and his nurse started quizzing me about the persistent fevers. I told him my story. He looked at me and said, it sounds like you have endocarditis. He got a stethoscope—my eye doctor—and listened to my heart. He immediately called a cardiologist and two hours later I was in his office. Four hours later he admitted me to the hospital.

In the hospital it was confirmed that I have endocarditis, that my heart valve is damaged, and that I need surgery to replace it. Here I sit today talking iv antibiotics at home waiting to clear up the infection so I can have open heart surgery. Me, a healthy guy only 45 years old—heart surgery. Crazy! The fact that my eye doctor recognized my problem and got me on the path to treatment—crazy! The fact that I kept going on long bike rides and spending my evenings in 100 degree weather chasing cars while my heart was struggling to function—crazy and scary! I was actually beginning to wonder if my body just couldn’t handle the physical strain I was putting on it between my various jobs and bike riding. I was beginning to think I’d have to give up cycling before I really got to see what I could do. It was such a relief to finally know what was wrong with me that I was actually happy to hear I had a heart infection and needed surgery—crazy!

So, it’s been a long strange trip and I’ve got another one to take—recovery from heart surgery will take 2 months, maybe more. If I am lucky, I’ll get on my bike again in November and if I am lucky I might be able to do long, hard rides before the turn of the New Year. The upside? Well, my heart has enlarged so that it can keep pumping enough blood to my body despite the backwash across my leaky valve. When my new valve is in place and the backwash stops my heart will have an increased capacity. In cycling, more blood is more oxygen to the muscles and that means being able to ride longer and faster. My body will work better than it does now!

This whole experience has caused me to reflect …and I haven’t even gotten to the scary part yet (where they crack me open like a lobster, stop my heart, and tinker with it). I spend too much time and energy doing things because I feel like I have to (usually chasing the all-mighty dollar) instead of doing things that I want to do. When my life ends I want to think I’ve done the best I can for my family, but I want to feel like I allowed myself to live my life, too. I think of my friend Ed. He has a pretty demanding job and manages a pretty full family life, but he always makes time to take his kayak to the ocean, take his kids fishing, go for a run, paddle his wife or friends around to see dolphins swimming, etc. I need to get a little more living out of my life before I can’t anymore. Thanks for reminding me, Ed.

Another upside to this whole business? My course of antibiotics at home—when I am supposed to be recovering from the infection and getting strong enough for surgery—comes right during the final grand tour of the professional cycling season—Vuelta a Espana (Tour of Spain)—which also overlaps with the inaugural running of the USA Pro Cycling Challenge in Colorado. So I have every excuse and all the time in the world to sit on my ass and watch cycling for several hours a day for the next three weeks! Oh yeah, and finish that grant proposal, finish editing that book, and finish that paper I promised months ago.