(Cole and yours truly at his 5th birthday party circa 2007)
Again I lead with that quote from A Tale of Two Cities, “It was the best of times, and it was the worst of times”!
That phrase has such an apropos feeling and meaning to me these days. The reason why it resonates with me is because my adult life has truly been some of the best of times in my life, as well as some most trying and troubling times in my life.
How else could I describe the last forty six years, since college graduation? How could a poor boy from Fresno, CA, have such great experiences during his working career? (That is fodder for another story yet to come.)
More importantly, I am now dealing with the culmination of what has gone on for the last thirteen years. Back in 2006 I began to develop blood pressure issues, as well as discovering that I had a heart murmur. After several tests to figure out why I have a murmur, it was discovered that I have a bicuspid aortic valve that would have to replaced in due time, something that I was obviously born with back in 1951.
Well, that due time for replacement has now arrived! My cardiologist relayed that information to me back in May, before I left the heat for the cool Oregon Coast for the summer months. She told me that when I returned back home at the end of the summer it would be time to start getting prepared for this open heart surgery. So during the summer I began scouring my winter schedule to see when would be the ideal time to devote to the open heart surgery and the requisite recovery time.
I decided that I would try to schedule this surgery to happen shortly after the end of the NASCAR racing season, I run a fantasy league and also do some photography work at the West Coast venues, as well. So after mulling over the schedule and the time off between the 2020 start up, I decided that I would try to get on the schedule for a surgery around November 21st. So my surgeon worked with me and I got on the surgery schedule for the afore mentioned date. Everything was rolling right along swimmingly until I arrived at the hospital the day previous to the surgery to do the pre-op blood work, etc. After I got to the hotel that afternoon upon completion of that blood work I received a phone call from my surgeon’s office stating that the surgery was cancelled due to a perceived infection found in my blood work.
My family was all there, checked into the hotel, and now it was not going to happen. I had plenty of time to get all prepared, to get my heart and mind ready for this monumental event in my life. I had many “talks with myself” in the four months leading up to the surgery date. And once I arrived in San Diego I had finally gotten my head right for the open heart surgery, or so I thought!
Can we say total letdown?
Thursday morning it was time to load up the car and return back to Yuma. Friday I got in to see my primary physician to review the surgeon’s blood work, get prescribed some high powered antibiotics, and get established on them ASAP in order to get back on the surgery schedule ASAP.
I have now competed the required blood work to make sure that the infection has vacated this ol body! Now the surgery is scheduled for Dec 17th.
With the new surgery date comes the emotional rollercoaster that plagued me leading up to the previous surgery date. Even though this surgery, aortic valve replacement, has become a very common surgery performed at the prestigious hospitals, it still contains risks. Those risks are stroke, heart attack, and possibly death during the surgery!
Try dealing with that thought and signing the document that you understand the risks of this surgery! That will put a huge lump in your throat and an uneasy feeling in the pit of your stomach!
Once again , with all the pre-op things checked off it is time to search all of of drawers thoroughly to find my “Big Boy Panties”. Then I need to run them though the washer and dryer, pull those bad boys on, and be prepared to wither the revival of the emotional rollercoaster that I know will be coming to visit me from time to tome over the next ten days! There may be more to come prior to my surgery, or the next installment may be during my long recovery period. It just depends on how creative I feel both before and after this surgery.
It was the best of times, and it was the worst of times! Isn’t that how The Tale of Two Cities begins? Well it is very apropos in my tale as well.
It was the Spring of 2006, I was 55 years old, when my life took a hard left turn, quite unexpectedly. I was taking my bi-annual FAA physical when the doctor was listening to my heart and suddenly looked up at me and asked me a question, that appeared quite out of the blue!
The doctor asked me “how long have you had this heart murmur?” I was completely stunned by his question. My eloquent retort to the doctor went something like this. “What murmur, I don’t have no stinkin’ murmur”!
The doctor then sat down beside me and explained what a heart murmur was and that, yes indeed, you do have a heart murmur. He then explained to me what to listen for through his stethoscope as he positioned that on my ears and over my heart.
I heard just exactly what he had heard! I did in fact have a murmur at 55 years old. How could that be? How could this just now show up? I have physicals yearly for twenty years, and for the last ten years a physical every six months.
In addition to the heart murmur, the doctor had detected that my blood pressure was creeping up. He suggested that I see my doctor regarding all this news. I was getting ready to move back to my hometown, Fresno, in just a few weeks so I thought that once I was all moved in I would contact a cardiologist. I decided I would make an appointment with the cardiologist that saved my older brother’s life a decade previous.
I was caught completely off guard. My first 55 years had been a cake walk.
Now, all of the sudden, “Houston we have a problem!”
After getting into to see Dr. John Nelson, he began to prescribe some medication that he thought would get my blood pressure down. Then he got down to brass tacks to try to find what the cause of my heart murmur to be. After an echocardiogram the doctor was beginning to get a feel for the culprit. Dr Nelson told me that the echo seems to point to a bicuspid aortic valve as the problem, but it wasn’t conclusive. He wanted for me to have and angiogram and that would help to flush out the answer. I had heard about that procedure and that you are awake when it is performed. My answer was “no Happy Valley, no angiogram!”
He didn’t like my response. So he sat back down and mulled over another plan. He asked me would I be interested in getting a 64-Slice? After he explained that it was non intrusive and that it was, in effect, a very strong xray, a Cat Scan type of procedure. At that time it was very leading edge. He would like to get me into this new test program in San Francisco that was cutting edge at the time and give him a better look at my aortic valve via that scan. He was pretty sure that my insurance would not cover the expense, but that he could get me enrolled for free,
I agreed that if it wasn’t going to cost me a thing, and that there was no adverse conditions or pain, I would do it.
It took several weeks to get my schedule and the facility’s schedule worked out. But, we made it work and soon I was off to downtown San Francisco for my 64-Slice.
It was a very simple, interesting, and basically a non-invasive procedure. It was like an enhanced x-ray with contrast. That was a very important piece of the puzzle to gather in order to make the proper diagnosis for me.
Having gathered the info from the 64-Slice, there was just one more test or piece of evidence required to nail down the reason for the murmur. Dr. Nelson suggested that I have a TEE (Transesophageal echocardiogram). I agreed to have that procedure at the hospital with Dr. Sandhu (you may hear more about this doctor later in this series, he was a trip)! I found out that the aortic valve lies right next to your esophagus, and this procedure allows a very up close and personal look at the aortic valve.
In a few days following the TEE Dr. Nelson concluded that I have a bicuspid aortic valve (two folds or flaps), normally the aortic valve is tricuspid or three fold or flaps. My bicuspid aortic valve is genetic. As Lady Gaga sang, “I was Born That Way”! It is genetic, in that, I received this from either my mom’s genes or my dad’s genes!
The results of the TEE gave Dr. Nelson the vital piece of knowledge to fully understand and diagnose what was to come down the road!
Now realize that this all happened in the time frame of late 2006 and the Spring of 2007.
What lies ahead for me will be eye opening and life changing!
This post will the first part of a several part series that I am in the process of writing to bring you up to date as to what is currently happening to me……… open heart surgery in the next six weeks.
Every time that I make a trip to Fresno lately to visit with my two sons and my two grandkids, while staying with my eldest son Jason, we (Jason and I) strike off on one of his famous or infamous day trips! This visit to Fresno was no exception to what has now become the rule.
Last Saturday we rose up early and got things together, packed up what we thought was necessary for our 2 1/2 hour drive over to Carmel-By-The-Sea for an afternoon of sightseeing. This particular trip, Jason explained to me, would be specifically pointed towards visiting many of the art galleries that are there.
Now it is at this point that I must do some “splainin”!
First and foremost, for those that know me well know that there is not one single artistic bone located anywhere in, on, nor around the physical composition that makes up my being! I may appreciate some art, but I am not anywhere close to being an art critique nor, an art connoisseur by any stretch of the imagination!
I may have the art or gift of gab, or as one of my dearly departed college friends, Jerry Noblett, so aptly put it back during one of our shared college classes, and I will paraphrase it for you. When he saw the A that I received for one of our essay tests in Business Law and his B, his response was something that I have never forgotten.
Jerry’s explanation was something like “Leon you are so full of BS that you just BS’ed your way into that A! I can’t believe that we said the same thing in our essay answers, but you really greased him up with your BS!” Eureka, I think that we have a winner!
I have digressed, but I think that you get my point about my art knowledge!
Anyway, we arrived at Carmel around 10:30 am on Saturday. By the time we found a place to park his car it was about 11 am.
As we began our stroll around Carmel-By-The-Sea our first stop was to try to find a place to eat, since breakfast was wearing very thin with both of us. After all, it was going take a lot of calorie intact to fuel our walk around Carmel! After a few Google searches and reading of a few menus, Jason mentioned that he knew a good little Italian restaurant, Pepe’s Little Napoli Bistro Italiano on the corner of Delores and 7th. So we headed over to scope it out and decided this was the place for lunch.
Lunch was outstanding and very affordable for Carmel! We each ordered up differing pizzas with an appetizer of their “World Famous” garlic bread. It all was very tasty, and I would suggest this place if you are ever in town.
When lunch was finished we sat out on our mission of visiting as many art galleries as we could Saturday. There was a lot of people out and about walking up and down the sidewalks of Carmel. It couldn’t have been a more perfect afternoon, clear, sunny, and temps in the mid 60’s, HELLO!
So my tour guide, read Jason The Latent Tie Dye Hippie and All Around Edgy Dude, takes out his handy dandy cell and directs us to our first art gallery. As we walked in and began to look around at the collection hanging on the walls of the gallery the owner/manager/curator greeted us and welcomed us into the establishment. Within the first few sentences the question was asked, “are you an artist?” Now this person surely must have been kidding when she asked that question!
When looking at this duo one could see an elderly gentleman, a child of the 60’s, yours truly, dressed in a pair of cargo pants, long sleeved Daytona Speedway T-Shirt and a jacket from Gold Beach, Oregon. I must say that I was looking very nondescript, but very cool I might add, that day. I kind of blended into the nondescript, but cool, crowd! However, standing next to me was a much younger, bearded 40-something man, who had just swapped out his Birkenstocks for a pair of hiking boots before we left his car, wearing a pair of cargo pants and a self designed and styled Tie Dye hoodie sweatshirt.
Isn’t it quite obvious who may be the artistic person and who isn’t?
So when that question was asked I would just stick my finger out and point to the bearded 40-something person with the Tie Dye hoodie accompanying me and let them know that it wasn’t me that was an artist! But to a tee, everyone of the people that we talked to in these art galleries was very friendly, courteous, and very engaging. Many of the galleries were very interesting and entertaining for this old non-artist dude. But there were about four or five galleries out of the thirteen that we visited Saturday that really captured my attention.
The Dr. Sues art gallery was really cool! Charles Schultz granted a license to a gentleman that had worked with him over the years to continue with Schultz’ work. The only stipulation was that this gentleman could not duplicate his work. He could use all of the characters but had to use the characters differently than Shultz had done. That gallery was cool and really brought me back to some of my youth with Linus, Lucy, Charley Brown and many, many more Shultz characters! Again, the gallery owner gave us a little history lesson on this gallery, the works that were being shown and he was very friendly, as well.
We entered another gallery that was full of paintings that were focused on the pop culture of the last 50 years. There were many great paintings that took me back in time in this gallery. However, there was one painting that struck me in a most unusual way. It was kind of freaky!
As I turned the corner and entered another room in the gallery I was struck by this piece that was full of images of The Beatles. Some likenesses from the Magical Mystery Tour album, some from the Abbey Road album and some from Sgt. Peppers. As I gazed upon this painting, all of the sudden inside my head there was the music of George Harrison playing. The song playing was “While My Guitar Gently Weeps”! It was just freaky crazy, my friend!
Down the street and around the corner there were two galleries that were full of bronze sculptures. The first gallery, The Bennet Gallery, was all the works of the twin Bennet brothers and some of their children’s work. It was very fascinating to look at all the various pieces on display. Again, talking to the curator/manager/owner of this gallery, and answering the repeated question as to which one of us was an artist, led to a very pleasant surprise! After talking to this lady for quite sometime, she revealed that one of the twin brothers was her late husband and that her daughter was also one of the producers of these bronze images!
Later in the afternoon we entered another gallery featuring more bronze sculptures. The lady in charge took us around and explained many of the show pieces on display. She fired up a video showing the artist at work with his models, etc. She seemed very knowledgable. And after answering “the question of the day” once again, she and Jason connected, as he did with every single person that we talked with on Saturday. So as the conversation led itself to the question, Jason asked her how she knew so much about the artist and his works. She confessed that the reason that she knew so much about the artist was that it was her father!
We actually visited 13 of the 70-plus art galleries in Carmel on Saturday.
As the sun was getting low on the horizon, our feet and legs were getting tired, this 66 year old body was starting to feel fatigued, as we were walking back to the car I peered though the glass at one last shop. It sparked my interest and in turn I got Jason’s attention. I said to him let’s go into just one more. He looked at me sort of incredulously, like he couldn’t believe that I was really interested in going into another art gallery! I repeated what I said and he concurred.
Once inside he figured out my interest. I was busted! It was a gallery of race cars and airplanes! I was in my element, race cars and airplanes. I really thought that I had died and gone to Heaven!
The quality of the paintings were unbelievable. The attention to detail was second to none. It was so meticulous that it appeared photographic like in detail! I learned that this artist was an engineer by trade. He had worked in the auto industry designing automotive stuff. His education, training, and background definitely came through in his attention to automotive detail, as well as aviation detail!
There was a painting of Michael Schumaker in his Ferrari, Mario Andretti in Formula 5000 car, Jim Clark in the Lotus that he brought to the Indy 500 in 1963, Ayrton Senna in his McLaren, a two ship of F-14 Tomcats orbiting over the USS Arizona in Pearl Harbor with the point of view from a third aircraft in the formation, as well as many more fantastic paintings too many to mention!
Once again the gallery person was eager to engage both of us in conversation. She was eager to explain the art work, give us background about the artist and answer our questions. Once I got my fill of this gallery it was time to find Jay’s car and head over to the beach for a few minutes before we pack up and return to the valley.
The navigator, aka My Latent Tie Dye Hippie and All Around Edgy Dude, got us over to the beach just south of Pebble Beach Gold Club to check out the Pacific Ocean, the dropping sun, and the sandy beach. It was a beautiful ending to a really fun day in this magical Central California Coast town!
Now for the 2 1/2 hour drive back to Fresno. Jason and I talked about many things and that made the time go by very fast.
However, once we got back to his apartment and I began to unwind, I knew it was time for this old man to hit the rack. As I slipped into bed and was laying there waiting to fall asleep, there were many thoughts that ran through my brain.
I thought about some of the things that I did with my dad in his later years. I thought about bringing my parents to NYC for their first time and giving them “the grand tour of NYC”, which included taking them to Broadway for a show. I thought about the only time that my dad ever went flying with me. There were many more thoughts and memories of my dad that flashed through my brain before I fell asleep.
Those memories are priceless and aren’t for sale!
I wonder someday, when Jason reaches my age, if he will look back on our “day trip to Carmel”, or our other day trips, or maybe his trip out to Honolulu with me flying the B-767 with the same fond memories? I surely hope so.
TIL NEXT TIME MY FRIEND, ROGER, WILCO, OVER AND OUT!
On January 5. 2011 I received a phone call from United Airlines Medical Department that my request for a medical retirement had been approved. United Airlines had no choice because The FAA had grounded me back on July 9, 2010 in light of the cardiac ablation procedure that was performed on me to try to regulate my heart’s rhythm.
I have had 24 hours to reflect upon the reality and gravity of the news. I have had time to ponder, evaluate, and relive some of the 37 years of flying memories that my career spanned. Over the coming days, weeks, and yes months I thought that I would put some of those memories to paper and share them with you the readers, my friends, and family.
Although the end to my flying career didn’t end in the manner that I had envisioned, nevertheless, my 37 year aviation career has reached its sunset. I will miss my flying buddies from Eastern Air Lines and United Airlines, but I will not miss all the behind the scenes, contract negotiations , bickering, feuding, and company BS that accompanied the job.
So I will leave you with a song that probably sums up my aviation career, and most likely my life as well. It is a classic song that Paul Anka wrote and “old blue eyes” sang so eloquently, “My way”!
Check out this classic Frank Sinatra video. Nobody can do it like Frankie did it!!
With all the required preparation complete, Tuesday was the the day to launch out of Yuma with my brother, Jim, for our second adventurous trek to the 2010 Chase “wild card race”, Talladega Superspeedway, in Talladega, AL. The plan was to fly to LAX Tuesday, grab a hotel, then launch out of LAX early Wednesday morning flying to Denver, then on to Atlanta, GA. Once we got to ATL, we would grab a hotel room, get a good nights sleep, get up Thursday morning, rent a car, drive over to Anniston, AL, about 1 1/2 hr drove, and set up camp at our hotel for what is billed this year as the “Hallodega” race weekend.
Well, Tuesday was our shortest day, flying from Yuma,AZ to LAX. That first segment went off without a single hitch. We got to our LAX hotel, checked in, and got a good nights sleep, knowing that we were getting up early at 5am for our next segment of travel, LAX-DEN-ATL.
Day 2, Wednesday, started out early with a wake up call at 5am. we hopped on the 6am hotel bus back to the airport. Security went swimmingly well with almost no line whatsoever at the security checkpoint. Both Jim and I were hungry for something small in order to get our morning medications down. So we stopped at the gourmet restaurant of Mickey D’s, we knew that we would have a couple of hours at Denver with much better eating choices at the Mile High airport.
As it turned out there were plenty of seats available on the Denver flight, therefore, Jim and I had a whole row to our selves. Once we got into our seats, settled down and buckled in, the B-767 pushed back, started up the engines, and taxied out for takeoff on runway 25R at LAX.
The 1:47 flight went by very quickly, added by a couple of a cat naps along the way! On the descent, my thoughts turned to the layover time and the ability to get some better food at the Denver airport vs. LAX! As we settled into a seat in the food court, I decided to look quickly at the departure screens to determine how far our walk would be to our departure gate. To my total and utter dismay, I noticed that our flight to ATL had just been cancelled! There was only one more flight to ATL and that was going to be in 6 hours. Not only was it going to be a 6 hour wait, there would be more passengers there than seats available on the airplane! Since we were standby passengers, it wasn’t looking very good for us to get to ATL Wednesday night.
What a bummer!
With some quick mental gymnastics, I tried to look for a quick and reasonable alternate plan. I saw that the Birmingham flight was running about 1:30 minutes late and it was scheduled to depart now in about 20 minutes. Quickly I called Karen, got her working on listing the both of us on that Birmingham flight, cancelling our room in ATL that night, trying to get us a hotel room in Anniston, AL, and reserving a rental car in Birmingham, as well! Those were going to be some daunting tasks to be done rapidly.
The first task was accomplished quickly and we were able to get onboard the flight to Birmingham. The rest of those tasks would be accomplished while the two of us were airborne to Birmingham. Now I had to wait until I landed in Birmingham to see if the other requests were able to be fulfilled, the rental car availability, hotel room, cancelling the room in ATL, etc.
Once we landed in Birmingham, I thought of one more problem that I failed to address before we got on the plane to Birmingham. Our bags were going to ATL and we were now in Birmingham, AL, 125 miles away from ATL.
OOPPSS! The only way to get our bags was to drive to ATL airport and pick up the bags once they arrived there. Well first things first, we have to see if we have a rental car reserved in BHM. I turned on my phone to find that there was a voice mail from Karen saying that there is reservation at Enterprise, the hotel room in ATL was cancelled, and that I would have to get the hotel room in Oxford/Anniston myself, but there were rooms available.
When I showed up at the Enterprise Car rental desk at BHM and talked to the person behind the desk, I found out that there was no reservation in the computer, additionally, that they didn’t have any available cars! Big Bummer dude! I tried call Karen, but she was hanging out with her girlfriends at a casino in town playing bingo. So I left a voice mail on her phone and decided that Jim would start at one end of the car rental area and I at the other end and just checking to see if there was a way to rent a car. It wasn’t looking very favorable when Karen returned my call. She had the confirmation number, I gave that number to the Enterprise dude behind the desk, and his reply made my heart sink.
The reservation was for the following day!
What do I do now? I’m in BHM with what looks like now way to leave! Nevertheless, within a couple of minutes the Enterprise dude had me hooked up with a sardine can for a rental car, but a rental car nonetheless! Now we have to decide what our approach would be for a hotel room.
The decision was to approach the hotel that we have reservations with for Thursday-Sunday to see if they had a room for the additional night of Wednesday. Using the now world famous Hammack charm, Jim and myself was not only able to requisition a room at our hotel for Wednesday, but got two queen beds to boot!
We have successfully dodges almost all the bullets that were shot our way…….so far. Now we have one last obstacle in our way, getting our luggage at the Atlanta airport. We are feeling soooo good now, what could possibly go wrong now?
We depart Oxford/Anniston, AL headed for Atlanta 93 miles away. With a phone call I was reassured that the DEN-ATL flight was landing at 10:29pm. ATL is in the Eastern time zone and because the drive was about 1:30, we left Oxford at 7:30pm trying to time our arrival at ATL. We arrived at ATL at approximately 10:10pm, parked the car, walked into the terminal, and was reaffirmed by the TV monitors that the plane was scheduled to land at 10:29pm. Now the only question to be answered is, did our bags make this flight?
So the brothers Hammack hung out at Carousel #5 patiently waiting for the bags to come up the conveyor belt and plop down on the circular belt that takes the bags around and around. Thirty minutes no bags, forty five minutes no bags, where could the bags be? More questions and less answers as the time rolls on!
While waiting so patiently, we struck up a conversation with two wome that were waiting for someone off of that same flight. We found out that because of all the weather in the area earlier in the evening, there was a backlog of flights arriving into the ATL airport, forming a logjam on the taxiways, and thus the planes were unable to get to the gates, causing excessively long delays.
Nevertheless, we waited patiently by Carousel #5 for our bags. Now it is one hour, an hour and fifteen, on hour and a half, still now bags! The patience has now turned frustration, cynicism, and even a small bit of anger. Finally at the one hour forty five minute mark, the bags start to fool off the conveyor belt! Jim’s bag was the second one to come up the chute, hooray! Now mine should follow shortly.
Not so fast pilgrim! We waited and waited, it was an additional ten minutes before my bag came ambling up the chute. Hip, hip hooray our evening was a success! It is only now 11:50pm Wednesday night.
Now we have the 1:30 drive back the Oxford/Anniston,AL, initially in a driving down pouring rain storm. Our final arrival time to end our day was 1:15am Thursday morning! If you were counting that was 18:30 minutes after we started our day back in LA!
That my friends, was how my Wednesday went this week on the trek to Talladega!
Well, looking back on all the segments of my life, there have been many questions that have been asked of me. Questions like how do you like your steak? Would like paper or plastic? Is this cash or charge? Would this be credit or debit? Would you like cheese on that? Would you like that super-sized (my answer to that was always of course)? Are you married or single? Do you have any children? Are you a Republican or Democrat? Are you conservative or liberal? These questions get asked of most everyone very frequently, but not mechanical or tissue?
Well, now I have to really start thinking about how to answer what quite possibly might be the single most important question for my future.
Would you liketissue or mechanical, Captain Blowdri?
This mechanical aorta valve will last forever. However the the patient must take coumadin for the rest of his/her life. There are some really serious possible side effects from prolonged use of this drug:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); back, side, muscle, joint, or stomach pain; black, tarry, or bloody stools; blood in the urine (pink or brown urine); bloody or coffee ground-like vomit; chest pain; decreased urination; dizziness; fainting; fever; numbness or tingling; pain, unusual color, or temperature change in any area of the body; pale skin; purple, dark, or painful toes; shortness of breath; skin sores or ulcers; stroke symptoms (eg, confusion, slurred speech, vision problems, one-sided weakness); sudden severe pain in your legs, feet, or toes; trouble swallowing; unexplained swelling; unusual bruising or bleeding (eg, nosebleed, unusual bleeding from gums, increased bleeding from cuts, increased menstrual or vaginal bleeding, coughing up blood, bleeding at the injection site); unusual headache or weakness; unusual pain, swelling, or discomfort; wounds or sores that do not heal properly; yellowing of the skin or eyes.
Additionally the following may occur:
Fatal or nonfatal hemorrhage from any tissue or organ. This is a consequence of the anticoagulant effect. The signs, symptoms, and severity will vary according to the location and degree or extent of the bleeding. Hemorrhagic complications may present as paralysis; paresthesia; headache, chest, abdomen, joint, muscle or other pain; dizziness; shortness of breath, difficult breathing or swallowing; unexplained swelling; weakness; hypotension; or unexplained shock. Therefore, the possibility of hemorrhage should be considered in evaluating the condition of any anticoagulated patient with complaints which do not indicate an obvious diagnosis. Bleeding during anticoagulant therapy does not always correlate with PT/INR.
Bleeding which occurs when the PT/INR is within the therapeutic range warrants diagnostic investigation since it may unmask a previously unsuspected lesion, eg, tumor, ulcer, etc.
Necrosis of skin and other tissues.
Adverse reactions reported infrequently include: hypersensitivity/allergic reactions, including anaphylactic reactions, systemic cholesterol microembolization, purple toes syndrome, hepatitis, cholestatic hepatic injury, jaundice, elevated liver enzymes, hypotension, vasculitis, edema, anemia, pallor, fever, rash, dermatitis, including bullous eruptions, urticaria, angina syndrome, chest pain, abdominal pain including cramping, flatulence/bloating, fatigue, lethargy, malaise, asthenia, nausea, vomiting, diarrhea, pain, headache, dizziness, loss of consciousness, syncope, coma, taste perversion, pruritus, alopecia, cold intolerance, and paresthesia including feeling cold and chills.
Rare events of tracheal or tracheobronchial calcification have been reported in association with long-term warfarin therapy. The clinical significance of this event is unknown.
Priapism has been associated with anticoagulant administration; however, a causal relationship has not been established.
Let me just add that if I were to “suffer” from priapism I could start a whole new professional acting career and make a ton of money down in the San Fernando Valley!! (I understand that the adult film industry, just like the United States Marine Corps, is always looking for a few good men!!!)
Now my other choice for aortic valve replacement is a tissue valve. The tissue replacement may come from the patient, from a pig, or from a cow. Life expectancy of the tissue replacement valve is approximately 10 years. Therefore, at my present age, 59, there is a possibility that I might have to endure two of these surgeries, when the decision to replace my aorta arrives !
Now having researched these two options still doesn’t make the decision very easy.
Let me review these choices:
If, when the time comes, I select a tissue replacement from either a pig or a cow there are some serious humanitarian concerns. What are the ramifications to society for consuming either a very finely grilled prime rib, rib eye, T-bone, porterhouse, an In-N-Out burger, or some really great pork chops? Would that be a tabu thing to do in our society? Would I be considered a cannibal? These are questions that I want the surgeon to clear up before I ever have to make this particular decision!
Similarly, if the decision is made to have the mechanical valve relacement, and I was confronted with the dreaded side effect of priapism, would I be considered an outcast if I decided to capitalize on that “misfortune” and move to the San Fernando Valley to start my film career?
What is your view? I need your help! Is it mechanical or tissue?
Well Friday night,“the night from hell”, ended and transitioned into Saturday morning, the day I hoped to be checking out of this facility!
As the Sun started coming up over the horizon, the room activity increased with every minute. First up on the agenda was take my blood pressure, pulse, temperature, and of course whip those sheets back and check out the ol groin and pubic region for a bruising check! Everything must have delighted the new morning nurse, ’cause she too busted out into some tee-hee-hee’s and giggles! I didn’t know that looking at a bruise could be so humorous.
Once the new nurse gathered up her composure, she left my room and returned with breakfast. I had forgotten just how unappealing hospital food could be until my tray was presented to me for my edification. I will attempt to adequately describe the culinary delight to the best of my ability.
First off, the centerpiece of this breakfast was a heaping mound of egg-like material. It appeared that the eggs were just barely cooked enough to coagulate into this mound. Now my family will attest that I don’t eat eggs unless they are cooked for a while, like well done…PERIOD! Looking at this yellowish globular mound almost turned my stomach! The sidekicks to the eggs was a bowl of cream of rice, which was very tasty, toast, orange juice, and two sausage links that were the consistency of glue when eaten. Those two little dudes stuck to the enamel of my teeth, and hugged the base of my tongue like criminals avoiding a police manhunt! Yummy was not the words that came to my mind after attempting to eat my breakfast!
The next few hours were spent awaiting the doctor’s arrival for a last minute check over and a release to go home. That waiting period took until approximately 1:30pm. At that time my surgeon, the Electro-Physiologist, strolled into my room totally apologetic about not getting to my room much earlier in the morning. He said that he was filling in for 53 doctors in Fresno that day!
Once he gave me the “once over”, he signed the release orders. Now all that was left was to get to get the IV needle out of my left forearm, go over all the releasing documents, and oh yeah removing that pesky little catheter that is still up into my bladder! I can only imagine how thrilling this procedure is going to be for me!! Yippe yo ki yeah get along little doggy!!
Now my nurse was a very nice young women, somewhat younger than the age of my two sons. I am thinking to myself, this is not going to be a huge ball of fun. More importantly, I am not sure what the procedure for my catheter removal is going to include, but I am reasonably sure it involves “hands on” maneuvers here!!
Now I must digress. Just as a side note here, the only women that have ever touched me where this nurse was about to grab on to, drunk or sober, were women with which I have had an intimate relationship. However my friends, I have now entered into an area whereby I have become totally unnerved, and completely uncomfortable!
Can someone please help me! Can I have an AMEN?
Now that the time has come for that catheter to be removed, I am very nervous and extremely uncomfortable. I ask her a couple of questions and I am feeling like it is time to “fish or cut the bait.” So she soothes my anxiety with some small talk, she says to take a big breath in and then exhale, she will remove the catheter on the exhalation. So I followed her instructions, and out comes the catheter with a burning sensation!
Following the catheter removal, my nurse departs my room and gives me some “privacy” to get dressed. I am thinking that this is a very odd situation. She just was in a position to not only see all of me, but to grab a “handful”, in my case that Saturday morning it was a very little handful, and remove the catheter. Now she gives me some privacy to get dressed. I am thinking that there has to be some irony in that scene!!
I get dressed and then hop into my classic, low tech, hallway cruiser and transporter. Some of you may know it by its name in the previous century, the wheelchair. Down the halls, into the elevator and out the front door to my waiting transportation to my sister’s house for some badly need sleep and recuperation!
I am checking out and heading out of here!
As the Sun sets in the west, I am taking off to new destinations.
In Part 3, I left you with this thought; “You can NEVER rest in the hospital.”
Let me explore and expound upon this thought.
From the moment that I arrived back into my room, there were nurses coming and going about every 20 minutes, They would come in and take my temperature, take my pulse, check my left groin, monitor the bruising that occurred there, check my catheter, and dump the fluid out of it as needed.
Now most of those activities are ok. However, when the nurses check your catheter tube and its connections, that is somewhat degrading. More emphatically, when they pull down the sheets and check the bruising that is in you left groin and pubic region, embarrassment doesn’t really cover the feeling very well. Moreover, when the nurse is trying very hard not “to bust a gut” and break out laughing, demoralized comes close to how you feel! I know it is only the hospital, it shouldn’t bother you. Oh yeah, right I forgot!
Anyway, I digress. After four hours in surgery and three hours in the recovery room, I get to my room and all I want to do is grab some much needed sleep. My family leaves my room about 9 pm, I am thinking that now I can get some rest and sleep this long day off. I am not prescribed any pain medication everything in my mind tells me that with the door closed I can really get some good sleep!
Oh contrare my friend!
From 9 pm Friday night until 1:20 am Saturday morning the nurses were in my room every 20 minutes taking my blood pressure, temperature, and checking right and left groin and pubic region, keeping a close watch on the spreading bruise that I have there! From 1:20 am until 3 am I was able to sleep uninterrupted, one whole hour and forty minutes!
The calm and quietness of my room ended at 3 am when the phlebotomist comes into my room, flips on the light switch, and announces that she has to draw some blood. At 3 am they have to draw some of my blood, you really got to be sh#%!ing me? “Why 3 am, couldn’t this wait for a more civilized time, like say 7 or 8 am”, I inquired? “No doctor’s orders,” was the response! Dude!!! So out comes the foot long needle and she drew out, what seemed to be, a gallon of my beloved blood!
Now that this ordeal is over, surely I can sleep the rest of the morning? Yeah right! As the “Dracula Nurse” was leaving, in came the morning nurse to take my blood pressure, pulse, temperature, and she pulls back the covers to get a better look at the old groin and pubic area to check the status of my bruising again. Dude !!
It is now about 3:30 am and this old boy is getting very tired of my hospital care! I hoping that this is the last interruption so that I can at least get a couple of hours sleep before the sun rises. Wrong, wrong, wrong, wrong, I was oh so wrong! At 5 am the nurse once again enters the room and turns on the high intensity lights for another round of……..blood pressure, pulse, temperature, additionally she gave me a pneumonia shot, and of course checking out my groin and pubic region for bruising!!
I was starting to feel paranoid. I think that the word was out and all the nursing staff had to cop a view!! For sure I knew something was up when the nurses started bringing a magnifying glass with them when they entered my room! Dude!!
Well so much for sleeping at night in the hospital. There was nonstop interruptions throughout the night in my room! The high intensity lights in my room felt like searchlights each and every time the light switch was turned on!
It was truly the “Night From Hell”!
Stay tuned for checking out and going to my sister’s house in Part 5..
It was with Lynard Skynard’s “Free Bird” and this last thought that I ended the last article, Part 2:
The last thing that I remember were these words from the stereo system:
If I leave here tomorrow
Would you still remember me?
For I must be traveling on, now
‘Cause there’s too many places
I’ve got to see……….
Off to Happy Valley, USA I went……………………
“Mr. Hammack, wake up, wake up, the surgery is over!”
As rum-dumb and as groggy from all the anesthesia as I was, that was even better music to me ears than Lynard Skynard was to me some 4 1/2 hours previously! The unknown was over. None of the possible “side affects” seemed to have happened to me! I can hear, I think that I can somehow slur an answer out. So maybe no heart attack, looks like no stroke happened, and I am definitely alive!
As they rolled me out of that daunting surgery room, one of the surgical nurses told me that we will be rolling by my family and that they would stop briefly so I could say “hi” to them. Yeah, right, like I could be coherent after being under the influence of “the good stuff” for more than 4 hours! However, I do remember stopping briefly at the waiting room, seeing adults that closely resembled my family, muttering brilliant verbiage that probably was totally undecipherable, but nevertheless undeniably brilliant!
Once in the recovery room, I could tell that there was some concern over my lack of recovery. The recovery room nurse was hovering over my left leg, applying pressure to my groin area, and expressing concern that the bleeding will not stop there! He was also making calls to the surgery room or the cardiac floor for assistance. It was slow in coming, in fact I was in the recovery room for over three hours. The normal recovery time is about an hour.
Needless to say, the stress that my family and friends were feeling was tremendous. There were starting to be some frayed nerves precipitated from the lack of communication between the recovery room and the family waiting room. Among my family and friends, there was this overwhelming felling that something was something definitely wrong, because I was so long in the recovery room.
On the other hand, I was horizontal in recovery kind of stuck in a holding pattern, like I was arriving at JFK, ATL, SFO, or ORD (Chicago)! And on top of it all, I didn’t really didn’t give a dang! After all, I was still rocking in my head to some goooood Lynard Skynard that led me down the path to Happy Valley, USA! Surely nothing could be going wrong. Nevertheless, there was concern in the recovery room over my left groin bleeding.
After more than three hours in the recovery room, the nurses were able to get the bleeding in my left groin stopped, and with that accomplished I got to go to my hospital room. Now the time is about 8pm Friday evening, 12 hours after I first signed into the hospital! To say that this has turned into a very long day is a gross understatement to say the least!
As my family and friends assembled one at a time into my room there was noticed a collective sigh of relief that this procedure was now over for them, as well. They could see for themselves that I had made it through a very long, arduous, and intricate surgery, in turn making their Friday a very long and anxious ordeal!
From my standpoint, it was a welcomed relief to be back in my hospital room, seeing my family and friends, knowing that all of the worst was behind me. However, for those of you who have stays in the hospital for any length of time, arriving back in your room is only the beginning of what is in store for the patient! You can NEVER rest in the hospital.
Stay tuned for the “Friday night from Hell”, and Part 4!
For those of you who are have a difficult time comprehending the concept of having a “helmet fire”, I will try to help you understand that concept of feeling. A “helmet fire” has no conscience or internal clock, it can happen at any time, at any place! But my “helmet fire” was occurring on the gurney, on the L-O-N-G hallway to the elevators. It was happening as I was leaving my family and friends for, what I perceived, could be the very last time! The fear of the unknown that lay ahead of me at the end of the gurney ride, the thought that something could happen during the four hour procedure of probing my heart, a heart attack, a stroke, and the worse side effect of this procedure……death, was causing my emotions and my intellectual thoughts to call each other out and begin an “old fashioned, blue collar, bar fight” inside my head! It was totally out of control! That my friends, is just one example of what a “helmet fire” might be or feel like inside your brain!
However, by the time I had gotten into the surgery room, the “helmet fire police” had arrived inside my heard and arrested all those involved in the “helmet fire” and carted them off in the “paddywagon”! But now the fear of the unknown had taken over and things got real serious. The surgery nurses, both men, had arrived in the room. Their first point of business was to gather up all the patches, probes, and the electrical connectors that was going to be used in this highly computerized and electrical exploration expedition into the sanctuary I call my heart.
It took them more than 30 minutes to put the required patches on my chest and back in the appropriate places, place the probes in the designated areas fore and aft, and then attach all the wires that would provide the vital information to the many computer screens that were above the surgery table. During this “hook up” process the nurses obviously noticed that I was shaking in my boots, even though the only thing that I had on was that “designer gown” I described in Part 1.
One of them asked me what kind of music that I like. I replied that my music runs the gamut from Alabama, ZZ Top, Merle Haggard, The Beatles, The Eagles, Lynard Skynard, Brad Paisley, and many points in between! “My music tastes might be called eclectic”, I added! He replied that I would most likely enjoy what he was cranking up. Well he was right, over the speakers came a little southern rock band from Jacksonville, FL that you all may have heard over the years…….Lynard Skynard singing “Sweet Home Alabama” followed up by “What’s Your Name, Little Girl”!
As this long, painstaking pre-surgery procedure was culminating and the team was ready to rock and roll, my doctor strolled in and greeted me with this phrase, “Good morning Captain how are you doing? We are ready, how about you?” I replied, obviously in a apprehensive sort of way, that I was indeed ready to get this over. The anesthesiologist had taken up his position next to my right arm, briefed me on what to expect, and set a mask on my face with the consoling words that this will start to relax you now, Captain. He was right I could feel the soothing affects of the anesthesia, along with Lynard Skynard’s tune “Free Byrd”, I was fading.
The last thing that I remember were these words from the stereo system:
If I leave here tomorrow
Would you still remember me?
For I must be traveling on, now
‘Cause there’s too many places
I’ve got to see