Saturday, August 19, 2017

All clear: Getting good news on an otherwise ordinary Friday

Fridays are usually pretty tame at work. But I wasn't really looking forward to the meeting with my doctor late in the afternoon.

You see, no matter what the occasion, I approach it like there will be bad news. If it comes, I'm prepared. If it's good news, I'm even more happy about it. It makes for a pretty weird personality, I know.

I had double pulmonary embolism back in February. Mortality rate for such an occurrence range between 30 and 75 percent, depending on which website you're looking at. For the record, I looked at all of them when I was in ICU.

For the millions who don't read my blog, I made a quick initial recovery and was discharged three days early.

Marching orders
The first order of business was seeing my new doc. For the first time, I have a doctor I really like. I will say, however, that she tends to operate on the way safe side of medicine. More about that in a bit.

The first thing she told me? "I'm going to be your new best friend." Cool.

I'd be in every two weeks for updates. The first order of business was a blood test to make sure the blood thinners were working. She also told me to start walking for exercise. Ten minutes a day, no hills.

When she told me I could only drink one beer a week, I bristled. She said, "It's either that or dying," she said.

"That's no way to live, Doc," I said, contemplating life without what Ben Franklin called "proof that God loves us and wants us to be happy. The Eliquis website says I can have two a day.

Dr. Toney explained that because alcohol thins the blood, if I had a couple of beers on a day in which the blood thinner was working very well and was in a car wreck that caused internal bleeding, I would bleed out before anyone could help me. My contention is that a long-shot confluence of events involving physiology and bad timing on the road would have to occur.

When we got the results, Dr. Toney was amazed. I could increase walking time to 20 minutes and come back in six weeks. And she scheduled my first appointment with a wellness coach named Tiffany. Of course her name is Tiffany. What else could it be? Rain... Heather... Sienna...

Anyway, she's fantastic, too. We meet every two to three weeks. She's both a sounding board and information source. Most of all, she serves as a point of accountability for me. These two, along with a slick little piece of technology, bear a great deal of the credit for my success.

The losing battle
Fitbit kind of changed the approach. Gamification works for me. Seeing the stars pop up and turn green drives me on a daily basis. I use the app to track calories and macronutrients. (There's a sentence I never thought I'd write. Or say.)

In the past, I've had success at the gym. I improved cardio output and packed on muscle, but I didn't lose a lot of weight. And that was simply because I didn't change my attitude about food.

But that was then and this is now.

One one of my sessions with Tiffany, she actually told me to eat more. As a fat guy, I've never been told that. Her concern is that if I'm not eating enough, my body will go into survival mode and the weight will shed more slowly.

And it's not like I'm starving myself. I get plenty to eat and I'm not depriving myself of much.

Over time, I've been able to increase physical therapy from 20 to 40 minutes, then to 60 a day. I wasn't cleared to swim or lift weights, though, till we were sure my lungs are clear of clots. I've been walking an hour a day, six days a week. It's therapeutic for the mind as well as the body. Way more beneficial than I ever thought. And it doesn't cost a thing, except a new pair of shoes.

I've also started meditating. (Yet another sentence I never thought I'd say.) No, I'm not turning into a hippie transcendentalist or anything of the sort. I started doing deep breathing exercises to help my lungs and realized I felt more focused. I don't do it every day, but I think I should.

The results
I just got the results from my six-month follow-up CT scan. The lungs are completely clear. My heart is in good shape. Dr. Toney said she was glad the pulmonary embolism happened when it did because something even more dire could have taken me out.

In six months, I've lost 56 pounds. My blood pressure is down to normal levels, about 130/70. Twenty more pounds, Doc said, and I'll probably come off the blood pressure medication. My oxygen level hangs around 96 percent. And my resting heart rate is in the mid 60s.

The most important thing I'd like to get across is this: If I can do it, anyone can. Yes, It's a lifestyle change. And it's not that hard. Yes, it takes a little time, but it's worth it. I feel so much better. And I'm not planning on quitting any time soon. I know I've still got a ways to go.

The biggest challenge is to just get started. Don't let a major event be the catalyst. I took small steps out of necessity, but with physical restrictions lifted, more options are available. And I'll keep walking, too. It's what got me started, after all.

Wednesday, February 15, 2017

An Ordinary Weekend with Morphine

Just wanted to let y'all know what happened to me over the weekend, now that I'm out of the woods. 

For a few days, I'd had what I thought was a chest cold and I'd been diagnosed with a sinus infection on Thursday. On Saturday morning before Ashley and I ran weekly errands, I took a shower and broke loose some mucus and I couldn't catch my breath for several minutes. I wanted to make sure I didn't have pneumonia or was having a panic attack or, worse yet, one of the heart kind, so
I went to the ER.

My oxygen level was 86, blood pressure 190/105 and heart rate was over 150. They did a chest Xray and EKG. They gave me a double breathing treatment and put me on a bi-pap. If you don't know what that is, they put a mask on your face and it forces air into your mouth and nose, even if you're not ready to have that air. They didn't like the results of the chest film and EKG, so I had a CT scan.

I've never been claustrophobic until two years ago when I had an MRI - a process I equated to test-driving a coffin - and this looked roughly the same. The tech assured me that my head would be out. Until she slid me in and realized I'm so tall. I had to move down farther on the slide an my head was indeed going in. The nice respiratory tech, a stocky guy named Joseph, talked me through the procedure. I think he may have even held my hand, but I can't be sure.

They didn't mess around waiting for the results and the ER doc went down to see for himself. Within a few minutes, he came back to deliver the news. I had thrown blood clots into both lungs. Said another way: double pulmonary embolisms. The way he described it, the clots hit my heart and it ejected them into my lungs. The clots may have thrown at two different times. In retrospect, it makes sense now.

Let me back up. My office is on the lower part of the Cerner campus and I had a meeting in the main building, which is up a hill that is roughly the equivalent of climbing five flights of stairs. It was the second time I'd done the climb that week, and it really hurt. Both times. I'd also had meetings at another campus earlier in the week and the parking lot is up a good sized hill, roughly the same kind of climb.

I chalked it up to a chest cold and I'd been diagnosed with a sinus infection. Turns out, it was because of severely diminished lung capacity. Thankfully, my heart was strong enough the clots didn't become lodged, or the outcome would've been much different and you'd be reading this in a different platform. 

They told us there were "many" clots on both sides. I was disappointed I didn't set the record for number of pulmonary embolisms; you know me, always competitive. 

They gave me morphine to help my lungs relax enough to breathe. I didn't feel it and didn't feel any effect on my breathing.

They moved me to the Cardiac ICU. Let me say, ICU is scary enough. Being told you're going to CICU is a nut punch. As I transferred from the uncomfortable gurney to a one-size-fits-most hospital bed, 10 people surrounded me and very quickly and efficiently told me their names and how they would be torturing me over the next few minutes. 

IVs went in, monitors were stuck on my chest, without shaving, a situation that became a nuisance later, and eventually I looked like a very badly wired home entertainment system circa 1989. 

I was put on a heparin-steady drip to thin my blood and six liters of oxygen per hour. My nurse came in to introduce herself. Tresa expected me to pee laying down into a jug, which angled up, but for me this seemed like a logistical impossibility. I wanted to stand to pee, but she said she's seen patients with blood clots who stand up have the clots move on them. I asked how often it happened and she said it had only happened once in her10 years as an ICU nurse. So I explained a little about probability and we reached an understanding.

My next nurse was in her mid 60s named Peggy. She offered me morphine every time she came in. Kinda like a grandmother with a plate of homemade shortbread, but with painkillers. Ashley went home at 2 a.m. when she was convinced Peggy wasn't trying to hop me up on opiates. Eventually I took the morphine because I wouldn't go to sleep. Mostly because I had a rotation of people coming in for blood draws and breathing treatments every four hours and they couldn't get on the same schedule. And also because I was convinced that I didn't want people talking about how I "went peacefully in my sleep." 

Anyway, that morphine was a donkey punch. Peggy talked me through it like some whacky LSD monitor from the 60s. After about five minutes, it passed and I dozed off for a couple of hours. They started stair-stepping my O2 down and I responded well to the heparin. 

The next two days were a blur of poking and prodding in CICU, where I had to stay because they didn't have a room for me. Although I was taken off critical care at 4:00 Sunday, I think merely out of habit, they kept treating me like one of the really sick people on the floor, complete with the revolving door of techs putting needles in my arm and breathing treatments. Tresa returned, followed by Brie, the night CICU nurse. A floater nurse named Erin took care of me Monday, and she didn't let me move around much at all.

Monday afternoon, a sonogram showed I still have one small clot in my right calf, but the blood thinner will take care of that little jihadi zealot.

I was happy to see Brie return if only so I could pee in the stainless steel prison toilet under the sink, like any normal prisoner. She informed by that I would move to another room Monday night - one with a shower and toilet. I could even change from the very fashionable (and revealing) hospital gown into regular clothes. I was off oxygen and heparin, so I was no longer considered a fall risk, but the nurse still put me on a bed alarm. However, she neglected to tell me. So when I got up to change clothes, it went off and I almost had a heart attack.  

I was settled in time to watch the KU-West Virginia game and almost have another heart attack. Because I was no longer wired in, I got to sleep on my side for the first time and slept like a rock. The nurse and nurses assistant kept unneeded torture practitioners away from me and pokes and prods to an absolute minimum.

Doc came to see me about noon and said I was being discharged. She also said when she saw me Saturday, she didn't expect me to be leaving until Friday and that she didn't expect me to leave without an oxygen tank. 

I'll be on blood thinners for six months and the doc will reevaluate. Given the Griggs family's genetic predisposition to sludgy blood, it may be a rest of my life proposition. I'm also on a low level blood pressure med, which should come as a shock to no one. 

I started off this adventure thinking I was going to die and then transitioned to thinking that I could have died. Both are dark places to go. (I blame the lingering effects of Mother Morphine.)

But I didn't leave the mortal coil because I've got some shit left undone. I was already making some changes to my diet and exercise habits, in large part to working for a health care company that really focuses on it, but also because I need to. This episode will just accelerate my program. 

And I promise I won't become one of those dbags who gets all militant about being healthy because I hate hypocrisy.

I would've written this while I was in the hospital, but you can't joke about this stuff when you're getting your blood pressure taken every 15 minutes and have to poop in a bucket. Did I forget that part? Oh well... Perhaps that is as story for another time.