Feeding the Food

Since the bypass, I haven't had the physical prowess to do much in the garden. Dragging the garden hose is too much for my pecs for the most part, I get dizzy squatting, I can't bend or reach as far as usual, and I get tired really quickly.

I slept eight hours last night and took two naps today, to give you some idea what I mean be tiring fast. As I type this I've been up for about 90 minutes and I think I can make it through a movie before going to bed but no guarantees.

Corinna harvested a butt-load of carrots from our front bed yesterday in the rain, and dragging the hose over to start washing them I learned that this was more than I should be doing.

But what I have been able to do is watch YouTube videos about gardening, get caught up on some of that homework I don't normally have time for. Why, I've wondered for a while now, are my bell peppers such runts? They taste great, but what can I do to give them size? I assumed it was the variety of pepper until I noticed a 'California Wonder' stamp on a bell pepper the size of a tackling dummy—California Wonder being the main variety of bells I've grown the past four years or so.

Turns out, apparently, the trick is magnesium sulfate, Epsom salts. And according to some stuff I watched, the yellowing of my cucumber's leaves, that's a magnesium deficiency that can be treated with the same. I'm not sure if there's anything you should avoid putting them on, the bag label recommends it as a fairly general plant food, not sure if there's any hazards I'm missing out on but I'm sure trying me some Epsom salt treatments on my peppers and cukes.

Sexy Squash

So I went out to pollinate our zucchini and summer squash. I'd heard you should do this first thing in the morning, so I made sure to be out in the garden by the crack of noon.

I found a male flower, that was easy (doesn't have a fruit leading up to it, just hangs out on the end of a tendril. The idea is to peel off the outer blossom, then take the flowery penis, and stick it in as many female flowers as possible in hopes of greater squash yields. But all the female flowers were closed up tight, I guess because I didn't listen to that part about first thing in the morning.

It was remarkably like human sexuality: the male part was easy to find and obvious in its workings; the female was difficult to find and uncooperative once found.

Lobsterland Homecoming

Not long after the Revolution* they started talking about sending me home. It seemed soon, I'd gone under the knife Tuesday, they were going to send me home Saturday. But unless they wanted to monitor my sugars and vitals more closely than I could at home, there wasn't that much to be done. I can be uncomfortable at home as easily as at the hospital, plus I don't have to wake up every few hours for vitals checks. And hanging around in hospital is a pretty good way to catch MRSA or one of those other nasties that seem to hang out only in hospitals.

I'd asked my Dad to drive me home because between Corinna not driving much to begin with and suffering that concussion, it seemed prudent. Plus, she drove me after my cardiac catheterization and between her lack of familiarity with my car and my car's tight suspension, the ride felt fast and jerky with one minor injury let alone the full collection.

So of course I had a bunch meds to fill. Some of this stuff I was already on, Lipitor, Zebeta, aspirin. But they also have me on Cardizem CD, Lasix, KDUR, Senokot-S, Miralax, and Percocet. The Wal-Mart pharmacist told me it'd be about a forty minute wait, but I wanted to be home when I finally got home so I copped a squat on a bench there in the pharmacy area and waited. Corinna decided to do some grocery shopping, and my Dad looked around for nothing in particular. Then Corinna decided she couldn't take the noise inside, so she paid for the groceries and went out to wait in the cool afternoon air.

This worried my Dad, because there were dairy products in that cart. Milk, cottage cheese, etc. In his worry, I recognized that this was where I'd gotten my original phobia about dairy products going bad. It took me a long time, as an adult, to realize that the stuff didn't start to go bad before your eyes the minute it was poured into a glass or even set on the counter. I remember freaking out when giving a woman ride one time, in my twenties, because she bought milk at a convenience store and didn't start to drink it until several hours later. Wasn't she worried it would go sour? Or worse? She was completely calm about sipping it through the hot afternoon, even after it was warm. and to take the leftover home to put on her cereal the next morning. I was nauseated at the time.

Of course it probably does shave a few days off the shelf life, but an hour or two outside on a 75ºF day isn't even going to get the process going really. Plus, when dairy does go bad, it's pretty obvious. That milk might start to drift towards yogurt, but it's not as if you're going to accidentally drink and not notice it's sour. Milk doesn't last long in our house anyway, and on the occasion that the last inch or two goes sour, it's a pretty good starter for waffle batter at that point.

By the time my prescriptions where filled, I was too worn down to question the quantity of Miralax in the bag. Three 527 gram jars, almost 3-1/2 pounds of laxative. My Percocet script is only 30 tabs, and at the rate I've needed them, they'll be gone in a few short days. Even with a cat that needs the laxative, I think I'm sitting on at least a two year supply.

Dad wondered where Corinna had gotten to at one point, and I said she was probably out in front, stretched out on a bench sleeping with her grocery bags spread out in front of her like a homeless person. Then I remembered we were supposed to pick up a bathroom scale so I could monitor myself against sudden weight gains that might indicate complications, and also to grab a thermometer so I could check my temperature—same reason.

I went to find these things, and got completely gassed walking before I found the scales. Meanwhile my Dad was calling me trying to figure out where I'd gone, and Corinna was trying to text me. Her text ring tone on my phone is James Brown I Feel Good, so while I was trying to tell my Dad where I was in the store, I was hearing James Brown scream and shout in my ear and couldn't find a way to make it stop. I finally gave up, bought family-sized bag of pharmaceuticals and went to the car where nobody was to be seen. There was a courtesy wheel chair abandoned between the cars, so I sat in it and waited. Eventually they turned up, loaded up the car and on we went to home. Dad had gotten the scale himself after finding Corinna stretched out on a bench like a homeless person, a package of toilet paper for a pillow.

I'm not sure I've ever been so exhausted in my life.

Getting my nest set up here hat home took a good deal of time and trouble, or so it felt. More remarkable than the pain of post-op is the exhaustion. I can slowly do much of what I normally would, but when I'm done it's nappy time. And actually there's a lot I can't do. I'm on a ten pound lift limit and I certainly don't have a full range of motion with my arms and neck.

Once I finally did get settled, I think I slept about 12 out of the next 14 hours. Over the past two days I've been cobbling together these posts. Jello and Zippy have helped some, Jello pinned me down for a good nine hours the second night I was home.

*The Revolution is a bit of TMI: they kept giving me laxatives and stool softeners to counter the constipating effect of the drugs, and it had finally worked. When they asked me if I'd had a bowel movement, Corinna offered that it was more like a revolution.

Cardiothoracic Resort Vacation

After doing everything I could come up with to avoid it, it was finally time for my open heart coronary bypass surgery. Well, except according to one person, I could just put some kind of chelation suppositories up my butt instead, and I have to admit I didn't give that a full and thorough hearing. I also have friends who think they're really going to get to the bottom of what's going on at Area 51 and expose it to the world, which is all good fun at a cocktail party but nothing I'd want to hang life and death decisions on.

So they got is there at the ass-crack of dawn all ready to rock and roll last Tuesday. Monday morning was spent getting registered, tested, inspected, educated and so on as far as surgery prep. That idea I had to shave my chest in advance, I found out Monday they would have canceled the surgery because they don't trust my razor and whatnot to be sanitary and nick-free. They gave me a special cleanser for in the shower both the night before and morning off the surgery, and so on.

There were some German Brethren hanging out in the lobby where my family was camped out to see me off across the River Styx. They create a bit of an Amish impression, though not quite as extreme in dress. Turns out my future neighbor was their relative, an older guy who'd been in for a couple of weeks to have the same operation as me plus maybe some more. In recovery, I'd be able to hear them sing hymns from the other room periodically, and see members of the family come and go. What makes their dress striking, I think, besides its 19th Century feel and long beards, is little boys and girls dress like miniatures of the adults, same dress, same bonnet, same pants, same suspenders. It's the effect of a mother wearing the bear midriff look of her daughter down to the jewelry and eye makeup except from the other direction and starting in Victorian times.

Corinna and I joke that we're half Amish, what with our TV-less home and doing so much cycling for transportation, but these folks were the real thing (not actually Amish but an Anabaptist theological cousin to them). Me, with my purple mohawk and goatee, I was getting at least as many long looks as they were, but I suppose the impulses and ethics behind my appearance were quite a bit different.

We had quite a wait which surprised me. The trains seem to run on time with Mid-America Cardiology, and with KU Med in general, from what I've experienced so far. I was supposed to be first case, too, so there shouldn't be much way for the doctor to get backed up. Except, it turns out, when someone comes in the ER feet first and needs emergency heart surgery.

When they finally took me back, got me changed and so on, they got to doing that shave job I was supposed to leave to the professionals. I'm ticklish, esepcially my legs and butt, but really everywhere on my body. Always have been. And these trimmers vibrated. And they were trying to deforest a zone from my clavicle to my ankles. It was ugly.

I suggested that since it's hard to tickle yourself, maybe they could hand me the trimmers for the trickier regions of my body, but the one doing the trimming didn't think she was allowed to do that. I guess I should have snatched them from her and just done it myself, but instead I focused on not jumping off the table as those trimmers came at me again and again. They acted like nobody had squealed and squirmed as much as me, ever, but I don't believe it. My oldest daughter is at least as ticklish as me, so I know I'm not some singularity. They've had others, I'm sure, and told them they were the record setters for screaming like a girl and giggling with tears in their eyes.

I think next time, I'll have to insist on anesthetic before shaving, no joke.

From there was the nerve-racking wait to go in to the OR. The 'love you's' and 'see you in a bits' from my family and I was off. My Dad said, 'Welcome to the club.' He's a bypass patient as is my uncle. Both my grandfathers died of heart disease before unpleasant procedures to extend life had been developed. In case I want to whine about what I have to go through, there's that.

I came to, I guess, with the tubes still in my throat and chest, not able to talk. Unable to communicate discomfort. I guess I squeezed Corinna's hand though I have no memory of this. By the time the tubes came out, about ten at night I think, my family was long gone. I didn't remember the post-visit so I thought they'd waited around all day for nothing and got sent away, I can't remember the complication that delayed my breathing tube coming out. I was allowed Sprite and oxycodone, I think the first time I've had that particular painkiller. I'm pretty impressed with it, gets the majority of the pain without making me feel high or dopey. Which surprises me, given its reputation as a street drug, but they told me if you have actual pain, the receptors for that get the drug and the euphoria thing doesn't happen.

Before my transition from ICU, they wanted my chest tubes out. In the process of pulling them I got a huge cramp in the wall of my chest that went basically from the shoulder to the diaphragm over the left half of my body. They'd been asking me to rate my pain on a ten point scale but that one was a twelve, minimum. They left in a couple of pace-making wires hooked to a box. "This is not the nurse call box!" one nurse told me as she tucked the pace box into a side of the bed.

Food was served as room service when I got up to the CTP recovery room I was in the rest of the time. Cardiac, low-sodium menu, but you could pick from quite a bit of stuff and Corinna was able to add a guest tray for six bucks. The room was fashioned as a suite, hotellish, with a desk and settee, several chairs and so on. Corinna commented more than once that it seemed posh, and I kept thinking what a lousy theme resort.

After my finger a couple of years ago, I was braced for a lot of post-op pain. That pain was intense, so I was surprised when my chest and arm (where they harvested my radial artery) weren't as bad as that. Not nothing, mind you, I'm still eating oxy to keep it at bay, but there must be more nerves in the finger or my finger surgeon must have been a clod.

They gave me devices for breathing exercises and sent in respiratory therapists to help me use them. I say the pain isn't as intense as my finger was, but you breath all the time, and getting your sternum split makes that breathing pretty damned uncomfortable. They also set me up with a Heart Hugger, a harness I wear to clutch closed when I cough or move in ways that strain my sternum while it's healing.

The first night out of ICU, I was awakened hourly to check my vitals, blood sugar, etc. I was on an insulin drip, SOP I'm told because the stress of heart surgery sends everyone's blood sugar out of control and that hampers healing.

Corinna didn't spend the night that night, but she did visit. She hadn't figured out the settee so she started arranging chairs to ice her head (she's been fighting back from a nasty concussion), and of course I doubted she could get the chairs arranged and get in there that way. So she proved me wrong.

When my nephew visited Friday, my brother warned me not to show him my full scars. 'He still worries about this scar,' he said, showing me his laproscopic hernia operation scar, perhaps 3/16" long. I've had cat scratches more impressive looking than that scar, and here I am with the marks from three IVs, including one in the throat, plus an eight in zipper on my arm, one of similar length on my breastbone and a couple of wires sticking out my belly. My nephew is three, so this is a freakshow.

Turns out he never even noticed my scars, just the purple hair. He wanted to see the dragons on my phone (Fort Conquer), wanted to play Fruit Ninja on Corinna's phone, wanted to explore the rest of the cardiothoracic surgery floor, but never even asked about the wounds that showed on me.

All the while these things are transpiring, I'm getting used to the constant monitoring. Peeing in a measuring thing so they can see how much I'm letting off, that sort of thing. They keep asking me if I've had a bowel movement and no, just a lot of farts. Almost from the first I came out of anesthesia and they say this is good, means things are processing at least. But they keep bringing me meds that include 'stool softener' in the list. Anesthesia and pain meds constipate, they explain, and you don't want to get backed up. They added the stuff we have to give our mighty hunter, Jello, Miralax. They hint that suppositories are in the arsenal if I can't produce.

When it finally happened, they asked if I'd had a bowl movement and Corinna said, 'More like a revolution!'

War Paint

I really didn't have time for this foolish transmogrification. I have my kids this weekend, the Poet Laureate is recovering from a nasty concussion, the garden needs daily harvesting at this point, and my bimonthly freelance project is this weekend—and since I'm going under the knife first thing Tuesday, my deadline on that project is moved up from the usual and in a very firm way.

But I really wanted to do this. I've wanted a purple mohawk ever since Halloween of 2009 when I had one for a whole weekend. I half-assed it then, just did Manic Panic without peroxiding the color out of my hair first. I'm blond, so it should work right?

Turns out, you have to get a few shades paler than Anna Nicole Smith before the bright color really takes. But whatever, it was for a weekend, right? My boss doesn't even like me wearing Hawaiian shirts to work, so you can imagine how well a purple Mohawk and goatee would go over.

So this time, I decided to do it right. Or righter, anyway. I'm off work for four to six weeks to recuperate from my triple bypass surgery. My hair grows fast, there's enough time to grow the funk out a bit and then do a buzz cut, or maybe peroxide it back to a damaged pseudo-blond for my return to work.

So I tried Splat, it comes with the bleaching stuff as well as the color. Man's Refrigerator Syndrome kept me from finding the four year old jar of Manic Panic in the medicine chest, it was hidden in plain site and I looked for it three or four times.

I stained my skin quite a bit, both under the hair in places on my beard and scalp, and on my neck, chest, and hands (the gloves that came with the kit were truly sorry excuses for gloves and I failed to find anything better in the house—I used to keep a box of nitrile gloves for working with epoxy on my rockets, but Mo made balloons out of them long ago).

But I was going for a punk rock thing, and what is more punk rock than a little DIY learning curve showing? I think I'll do this every time I'm getting ready for open heart surgery, a sort of purification ritual.

Corinna really liked the peroxide look, actually, and suggested I stop there rather than add the purple. It was good advice, and I think I might go to that when I turn back into a civilian. Seems like the peroxide look is mainstream enough these days, and it does keep the gray hair from showing.

From the Jaws of Victory

I was so stoked when I got an appointment with the doc over at KU who does the MICS, minimally invasive cardiac surgery. Actually, they seem fond of calling it robot surgery because the thing that lets them go in between the ribs instead of splitting the breast plate is, basically, a robot.

This is not your Daddy's bypass surgery. The incision is 5 to 7 centimeters, between two ribs. It's still major surgery, coronary bypass and all that, but the recovery time is much quicker and you still get the benefits, in my case of that mammary artery to LAD graft, the best patency in the arsenal. They have theories but don't entirely know why, but that mammary artery just doesn't get clogged up.

The idea was do that, then go in and stent the diagonal and left circumflex blockages. I'd be back on the bike sooner rather than later, I'd still be a virgin chest if they needed to do bypass surgery again 20 years later (I'm only 43).

Turns out, my LAD goes below the surface of the heart for a good stretch, including into the grafting spot. So while I'm a perfect candidate for this operation in so many ways, it turns out I'm not a candidate at all. The doc didn't say it was a bad idea, he said, 'I won't try to do it.' The danger, since he can't feel for the grafting spot on the LAD, is he'd end up puncturing the wall of the heart with his robot, then have to split me open anyway to do emergency repair work on the heart in addition to the bypass work.

So I did my best to worm out of it but I'm getting a bypass operation very similar to Daddy's. They'll use my radial artery for the grafting material instead of the veins in my legs, and since I have a nickel allergy they'll have to hook my sternum back up with titanium instead of stainless, but I'm getting more or less the same surgery my Dad had eleven years ago. My uncle who built me Lilith had it, too. My grandfather son both sides of the family would have had it except they died of heart disease back when the only thing to be done for it was nitroglycerin and not overdoing it.

On the one hand, this is going to be a big bowl of suck. It'll probably be November before I'm back on my bike, I'll probably miss over a month of work (and I'm a one-man department, so that's no small beer in itself). I guess I should be grateful that they can do all they're going to do with me, my grandfathers didn't get that option.

Word Up

This was billed as a spoken word poetry event, and there was plenty of that on offer, but it wasn't just spoken word.

It actually ended up being more like a warm up for the Fringe Festival, hosted by our friend Sarah.

I had a lot of fun trying to shoot the gypsy dancers, about burned up the shutter on my D7000 trying. Here are a few of the better examples I got, battling flourescent lights, not that much light, and trying to capture their faces sharp with a a narrow depth of field and some blur on the action of their skirts which flowed and swayed violently.

I managed to get a shot of Sarah modeling the Connect Power t-shirt. She never, and I mean never wears t-shirts as far as I can tell. Kind of like me with my Hawaiian shirts except her wardrobe has more variety.

A Funny Thing Happened on the Way to Cardiothoracic Surgery

So I had my appointment today at KU, Mid-America Cardiology. This was for a second opinion about my scheduled triple bypass to be done this coming Tuesday. I was pretty well resigned to the bypass, but I was frustrated that there didn't seem to be a better way. The interventionist who did my cath didn't think you could stent my blockages, and when I asked the cardiothoracic surgeon about a hybrid approach where you bypassed the LAD with a more minimally invasive procedure (MICS, I'd read about that online) and then stented the rest, he launched into a dog and pony show about how in my situation his fix was the fix.

I'm sure he's a very competent, experienced surgeon, but I needed to hear this story from someone independent. That old cliché about how when you're a hammer everything looks like a nail, well, he's a cardiothoracic surgeon.

So today's visit was with an interventionist, and he's another kind of hammer or maybe he's the screwdriver who's bound to see everything as if it were a screw. He told me the bypass by open heart was an entirely reasonable approach, he knew of the surgeon and thought well of him, that I'd be in good hands.

He also thought he could stent my blockages, and told me how you overcome the difficulties of bifurcations and whatnot. He also told me the percentages as far as the likelihood I'll be back for more in a few years, which isn't insignificant when you open up three or four blockages. So the bypass is more for-sure, but also much more invasive. I'm young enough to be a likely candidate for a second bypass later, so that's a reason against open heart, but there's a significant chance with just stents I'll be back for more stents or bypass again in two or three years.

In other words, nothing is perfect and I have options. Then he said there's a third option, a sort of hybrid where they'd do a bypass, hook my mammary artery to the LAD with a robot that goes in between the ribs, minimally invasive bypass, MICS; then after I've healed a bit from that, go in and stent me up everywhere else.

I was on guard against hearing just what I wanted to hear, but I wasn't prepared to have the second cardiologist actually propose my own idea.

Turns out the MICS thing is pretty new, so the drawback is there's not a lot of long range data for this method of bypass. The bypass itself is nothing new, the doc said he'd seen patients thirty years out that still had great results with that, but doing it by remote without splitting the sternum is only a few years old. But I'd get the benefits of the mammary artery bypsss to my LAD, likely a lifetime fix, but with a shorter recovery time. Stent the rest and with a little luck, if I'm careful about meds, diet and exercise, there's a good chance I could keep my sternum intact many years to come.

To Bypass or Not to Bypass?

My heart is all stopped up.

My brother in law sends me stuff via Facebook about how chelation therapy will fix me right up, just stick a big 'ol suppository up my but and problem solved. Which is a fine theory if I hadn't also heard for years that this exact same nonsense would cure my daughter's autism.

What I've been holding out hope for is stents. I have three blockages, all in that 90% range, but two are up front, the other in the back. The back one is supposedly too long to stent, but a doc friend of mine (internal med, not a cardiologist) says he's seen them 'full metal jacket' things with a series of stents. I already have one in my LAD from a heart attack 11 years ago, that LAD is part of the problem again (I've heard it's nicknamed the 'widowmaker').

But the interventionist who worked on me a week ago Monday pronounced me beyond intervention and sent me to a cardiothoracic surgeon for a triple bypass. About as invasive as surgery gets, and a long recovery period. Months before I can be back to riding my bike to and from work, tending to our two dozen garden beds, etc. Weeks out of work, not good either.

The surgeon seems capable and what he's telling me makes sense, but this still starts roughly like field dressing a deer. So while I'm scheduled to go under the knife next Tuesday, I also have a Friday afternoon appointment with an interventionist at a different cardiology group, one that's supposedly the best in the city. I don't know who ranks these things or by what criteria, but supposedly top 100 in the country.

And after reviewing a CD of my scans from the other chop shop, this interventionist thinks stenting might be possible. I'm all ears.

If there's anything innovative going on, that's probably where it's happening. Even if I still end up having the bypass surgery I might prefer to have it there. Plus the place is half way between work and home, so I will probably pursue my after care and follow up there no matter what.

The only thing I worry about here is getting someone who tells me what I want to hear (that I don't need a bypass) but it turning out that the bypass is my best option. If you are a hammer, everything looks like a nail, so I suspect an interventionist is vulnerable to a bias that stents and balloon angioplasty are awesome, and a cardiothoracic surgeon is likely just as apt to think bypass surgery is the thing. Which one is likely to see me become a senior citizen (I'm 43 now)?

Duly Posted

Tomatosaurus Rex. Pre-Op

I've been tying my tomatoes the way I used to, as if they were plotting to get away.

I have 36 plants out this year, only one duplicate so 35 varieties. I'm about to go under the knife, probably in the next week or so, for triple bypass open heart surgery. So I want to get these plants as under control as possible before they gut me like a tomato-raiding squirrel.

I'm amazed at the plants, though, they're easily five feet tall a lot of them, and even the runts are three or four times as big as they were a month or so ago.

Living History vs. Disney

So when we death-marched my kiddos up to Shoal Creek awhile back, Em got interested and volunteered.

It's strictly first Saturdays, once a month, but so far it's what she's found int he way of summer job opportunities.

I drove her up there this morning, which meant I didn't get to sleep in, but it did mean I got to take in a movie. Driving all the way to Liberty, it didn't make sense to drive home and then back out & home again.

I'm not super familiar with North of the River, the Other Johnson County. But Corinna used to live up there and she told me the Dickenson Theater up off 152 had $5 early movies, so I went to see The Lone Ranger.

I wasn't 100% on this, we went to World War Z after my cardiocath last Monday and realized we should have done Man of Steel or Monster University instead.

But Johnny Depp, Brookheimer, Helena Bonham-Carter, I thought, well...

I should have seen the large warning sign that read 'Disney' and stayed away. It's not that it wasn't entertaining, but it wasn't what it could have been.

Disney violence just doesn't work. They have a guy eat someone's heart but they wouldn't want to gross you out so they don't show it. Then, there's a train chase scene (way too long and complicated) where you know no principal characters are in any danger. If Tonto and the Lone Ranger can't be killed, there ain't much suspense no matter the improbable situations they might find themselves in.

For that matter (spoiler alert, if you're planning to see this anyway you might want to skip ahead), how can they be on the trains racing toward the bridge that's about to blow up and simultaneously be at the bottom of that bridge setting charges and lighting a fuse to blow the bridge?

So yeah, plot holes you could drive a train through.

After, I went and found Em being the school marm at the living history museum. It's a cool setup, including some tombstones that really spoke to me. I'm feeling all sorry for myself as a slow-walk around a place like this that I have to have triple bypass surgery soon, but look at the people who died at 37, 39, folks who didn't even make it as far as me.

For that matter, I would have died as a baby back then, had the croup when I was one. Not to mention the heart attack at 32, that would have been the end of the show if the croup hadn't snuffed me out.

I was passing by the Marshall's office when I heard some of the reenactors planning their next move. "What do you want to do next, Bob? Rob the bank or the store?" The response was, "Whatever you want to do."

A pseudo bloodbath ensued, lots of smoke and booms.