STICKY DOORKNOBS

56. Not a bad number.

I like 56. It's a good number. I am not that age yet, which is why I really like it. It represents the one baseball record that will never be broken. And one of the alltime most-colorful Dallas Cowboys wore that number in the 1970s (forget for a moment that Hollywood Henderson would later lose some of his appeal.) 56 is what Heinz 57 was before they found another spice to make it 57, so 56 is good for that reason too.

But most of all -- even more so than because it is a number 10 years more than my age -- 56 represents something called my ejection fraction.

An ejection fraction measures the performance of your heart. For those of you who have had the courage to continue to visit this blog for the last two years or so, you might remember a little episode we endured in '04 and '05 whereby Ye Olde Ticker went somewhat kaput. At its darkest hours, my ejection fraction was 15, as in functioning at only 15 percent. Put another way, 85 percent of the blood my heart pumped in was pooling at the bottom of one of my ventricles and not getting back out into the workforce to do its job. Ony 15 percent of my little corpuscular things were moving product in those dark days.

But after two years of Coreg (a wonder drug ... ask your doctor) I'm back to what my cardio doc calls "the low side of normal," something I have always been, without regard to heart function. Chances are I'll never be completely normal. Hopefully my heart will be again someday.

It's been awhile since I've had some good news to report on the health end, so it's comforting to know that YOT is pulling its weight again.

Now, if we can just find out how come it runs 108 a minute one day and 68 the next, I'd feel even better and more comfortable. Which the health care professionals are working on. They have used some big word called arythmia, I believe. We shall see.

A few more sticky notes to the Lord would be cool, if you don't mind.

Take my WHAT off?

   OK, so, I'm no expert, but let me ask you this: Does it seem right to you that when you are being prepped for a medical procedure where something will be inserted into your neck that you are asked to remove your underwear?

   It just seemed a little weird to me. So I told the nurse she could just forget it.

   "Are you being difficult?" Karen asked me when I refused to step away from my drawers.

    I was just glad there was no paparazzi around. I may not be a former dictator, but I am hot in a pair of Fruit of the Looms. Imagine Barney Fife in his scivvies. I was struggling, having nightmares while awake, about lying on a mobile hospital bed clad only in one of those meaningless, leave-nothing-to-the-imagination cotton wraps that wouldn't fit around a copy of Bill Clinton's autobiography. People would be gettin' out of my way in record time when they saw me bein' wheeled down the hall.

    "No, I'm not being difficult, but I am NOT taking my underwear off for this woman. I don't even know her name."

    The prep nurse chimed in about this time and said, "I promise I won't laugh next time I see you in the mall." The nurse showed me her certification for having completed her CLDP training  ("Comeback Lines For Difficult Patients.")

    "Ma'am," I said, "no disrespect intended, but why do you need me to drop my drawers if you're sticking something in my neck?"

    She finally looked at my chart and relented, admitting she had mistakenly thought I was to have received a catheterization procedure, through the artery in my leg, before finally realizing I was getting a heart biopsy. Through the jugular. The big 5-lane highway of blood in the neck.

    Let me give you one little nugget of advice: You ever get a tube inserted in your neck, tell the hospital staff you weigh 500 pounds so they give you the weight-appropriate sedation. There ain't enough drugs in the world, people, to make you forget the pain of a needle in the neck. Guar-un-teed.

   But hey, it's over, the news was in fact encouraging, and so we move on again to the next phase of my wonderful, only life. The determination was made to not perform a heart biopsy as was earlier thought after the pressure in my lungs was ruled optimum. But the doctor still decided to run some fancy-schmancy tube all the way through my heart and into my lungs to check the pressure, which ain't near as much fun as it sounds. Bottom line: I can breathe easier because the difficulty catching my wind of late was due to being overmedicated on a couple of drugs that relieve my lungs and other parts of my body of fluid. So I am Lasix free and lovin' it. No longer do I have to pee in the middle of important meetings or those particularly compelling episodes of "Oprah."

Who ARE you and why are you in my room?

    My odyssey to Dallas Presbyterian hospital for this little fantasmagorical medical procedure was also my first foray into the high-wire act known as the semi-private room. I shared my room with an older man with a John Deere baseball cap and a pair of bib overalls who when he was being told that he had a new roommate said, "Oh is that what it is?"

  OK, this is gonna work out just fine. The guy pulled the curtain between the beds before I even got inside the room. His was the bed closer to the window. I was closer to the bathroom. He kept the TV tuned to "Law and Order" reruns all ... night ... long. It was kinda like being at home.

    Do you know how surreal it is when you are watching television and a stranger walks in front of your bed on his way to the bathroom? That'll snap you right out of a nap.

   Turns out the guy was nice enough (when he was discharged and learned he wouldn't have to be with "problem-patient" roommate any more). He was a farmer from the country who was a REAL heart patient; the kind who was a heart attack veteran who had apparently run out of his nitroglycerin. I see this guy, I'm thinking: I'm not a heart patient, I just play one on my blog.

    Long story short: I got to keep my shorts on, had my lungs examined and the doctor told me I could go hiking with The Boy again ... provided I didn't do too much. Which is great news unless my body tells me to knock it off when I'm four miles down the trail in the Chisos Mountains and there's no way to get in touch with a mountain lion, much less a doctor or a nurse who wants my underwear. But the hiking gig is back on the calendar. And I couldn't be happier. Even if the doctors still don't know quite what's wrong with me.

You're gonna put WHAT in WHERE?

OK, so I thought the jugular vein was used JUST for carrying blood from head to heart? Nobody ever told me -- until today -- that it could be used as something like a ship canal or a human version of I-20. But Dr. Huong, a congestive heart failure specialist who has been assigned my ticker, tells me the jugular is also good to carry things like threads that contain on the end of them little tiny grabbers that are used to pinch off a small (hopefully) piece of the heart so it can be sent to the lab for analysis.

Say what?

Let me put it in a laid-up man's terms: It's called a myocardial biopsy. A fancy name for, well, for running a thread through the jugular so a little tiny grabber can snatch a piece of my heart for the lab. My luck, the grabber will drop the piece of the heart half way out and have to go get another one. My biopsy is scheduled for Wednesday morning. This week. So you'll pardon the shakiness in my writing. And you can consider this my doctor's excuse if I am unable to render a few of you hysterical with laughter (whatever) as I try to do every other day in this space.

Oh, and here's perhaps the best news: I get to undergo this little procedure without benefit of sedation. No drugs, either. Apparently sedatives mess with the beating of the heart, and we don't want that. Actually, it's the doctor who doesn't want that. I'd just as soon be stoned and totally incoherent if you don't mind my saying.

"So," my 16-year-old daughter asked her mother the other day, "dad's having an autopsy on his heart?" God love 'er. No, thank God not yet.

Karen replied, "No, not an autopsy, a biopsy."

To which our daughter said, "Oh well, they're both opsies."

Ahh, to be young and have a decent ticker and a good sense of humor again.

So, now you know the latest. The umpteenth chapter in this sadsack circulatory saga. Another day, another procedure. And yet more money to Dallas Presbyterian.

I asked the doctor in our telephone visit today about the complications and the first one would be bleeding. Oh really? Bleeding. You insert something into the largest vein in your body and I guess you're gonna get that.

"Lung puncture is possible," she added. "And although rare, heart puncture. In the highly unlikely event that were to occur, it could lead to emergency heart surgery." She sounded a lot like a flight attendant telling me to grab the oxygen mask in the unlikely event of a drop in cabin pressure.

And there I was sitting at a Subway trying to enjoy a fat free tuna sandwich which is hard enough to do when a stranger is NOT on the other end of the phone telling me how they are going to insert a thread into my jugular as calmly as if she were planning an evening of needlepoint and a discussion of "Jane Eyre."

But I am being told by so very many thoughtful and caring friends and family members that everything will be just fine. And so it will be, right? I mean, what are the options, right? Well ... not fine comes immediately to mind.

But in the meantime, don't forget about coming back here later this week when I can write again. I promise no sick jokes. Just bad ones like always. But don't go away.

Oh, and somebody record "Lost" for me, will ya? I may miss it this week. And a prayer or two may be helpful.

So excuse me for now while I practice counting backward from 100 just in case I can convince them to change their mind about the Valium. I figure if I shake enough and cry a little that may actually do the trick.

See ya later.

- jp

Top 10 Things That Stink About Having Heart Disease

10. Not enough energy to stay awake until "Oprah" just so you can fall asleep watching "Oprah."

9. And you thought walking and talking at the same time was just a problem for clumsy people!

8. Always getting beta blockers confused with Viagra. Heart doesn't know whether to beat slow or fast.

7. Cheetos on banned food list ... no more unsightly orange fingers (Also on "Top 10 Good Things About Heart Disease" list).

6. Brother insists it's punishment for being a Democrat.

5. Five-day stay in Sahara with no water only slightly more bearable than hearing three words: "Limit Fluid Intake."

4. The phrase, "Oh, you have such a big heart" ... not really such a good thing anymore.

3. Heart works at only 20 percent  ... parties other 80 percent of the time!

2. When doctor says "Let's you and me have a little heart to heart" ... RUN!

1. No more beer or Mexican food? Who needs a heart, anyway?

10. Not enough energy to stay awake until "Oprah" just so you can fall asleep watching "Oprah."

9. And you thought walking and talking at the same time was just a problem for clumsy people!

8. Always getting beta blockers confused with Viagra. Heart doesn't know whether to beat slow or fast.

7. Cheetos on banned food list ... no more unsightly orange fingers (Also on "Top 10 Good Things About Heart Disease" list).

6. Brother insists it's punishment for being a Democrat.

5. Five-day stay in Sahara with no water only slightly more bearable than hearing three words: "Limit Fluid Intake."

4. The phrase, "Oh, you have such a big heart" ... not really such a good thing anymore.

3. Heart works at only 20 percent  ... parties other 80 percent of the time!

2. When doctor says "Let's you and me have a little heart to heart" ... RUN!

1. No more beer or Mexican food? Who needs a heart, anyway?

We interrupt our regularly scheduled life

    I guess it is the planning that will have to be put by the wayside that is perhaps most discouraging. I had a weekend in June circled. The Boy and I were going to go hiking. The Window Trail. A simple, 3 or 4 mile out-and-back walk to a spectacular view in Big Bend. Bit of an elevation change, but nothing too difficult. I was really looking forward to it. And then the phone rang last Friday at 6 o'clock. I just shouldn't have answered it.

    "Your heart function is back down to 30 percent. We're not sure why."

    Dr. Harper's news was upsetting but not entirely unexpected. Deep breaths have again been more a luxury than something taken for granted, ala the Summer of '04, for the last few weeks. Not as rampant as the Summer of '04, but there is noticably more laboring in the breath-catching process once again.

   We had thought, doctor included, that the cardiomyopathy that I had/have was/is a viral infection and fully reversible. In fact, it had acted like it had packed up and gone for the last three months. But alas, it came a' callin' again about a month ago.

    So we sit and play the waiting game again. And while we do that, we try the best we can to handle the discouragement that comes with a Permanently Altered Lifestyle.

    You may recall reading some time back that everything was quite peachy upon my furlough from Dallas Presbyterian in January. And things have been really remarkable. Karen and I have been walking, eating healtier, living better. And then April came and with it two baseball games a week and Boy Scouts and all the other things you do when you're the parents of young 'uns. And with the raging evening schedule that spring brings, we see ourselves in drive-thrus more often (Mexican, don'tcha know) and with little or no time to walk. And when the breath-catching became more difficult, I figured it was just attributable to that Americana way of livin'.

   But Doc Harper said no. It was not that. In fact he's not sure why my heart has become troublesome again. Acting up like a darn 2-year-old when no one's looking. Sticking its fingers in the cake icing hoping to get away with it. Yessir, that's my heart.

    But we make the best of it, right? A doctor gives you news you don't want to hear, you really only have two options: Whine, or get on with it. So I try not to whine because it's really quite unbecoming -- which is one of the nice things about having a major health problem -- you quit complaining because you're just happy to be alive and you know your problems are really quite small, and you are just thankful you're not as bad as the next guy who is sure to share his sob story that's "You-think-that's-bad" worse than yours.

    And I try to tell The Boy "We'll hike. Sometime. Don't you worry. It may have to be a peaceful (boring) walk on flat land through a flower garden (what kinda fun is that to a Tenderfoot Scout like The Boy, huh?). But we'll do it. I promise." And I try my best to buy into it myself.

    And I decide not to whine because I know I am fortunate because I have a family who cares, a mom and a dad and a sister and a brother who I love and who call constantly hoping the news is better. And a wife without whom I would simply not be able to make it. A wife who has saved me more times than I can count. So, except for the hiking part, the not being able to walk up mountains in the middle of nowhere part, I really am a lucky guy. My heart may not be coming along for the ride entirely, but my head's got it figured out. And I'm thankful for that, too.

   So, we sit and wait and I will drive to Dallas again and again to see a great doctor who will one day get to the bottom of what's going on. And until then, life will go on.

   Oh, and ... your prayers would make it easier.

Open Out Back

   I get to expand my wardrobe this month, and I gotta tell ya I'm pretty excited about it: I'm getting one of those thin cotton hospital robes with the flimsy tie in back that shows pretty much everything you had hoped no one would ever see. You can't buy them in stores (except really weird and kinky ones), but you can pick one up off a cart as you walk by with your IV tray.
   Karen and I went to see a heart specialist in Dallas in December, and after chatting with him for over an hour the decision was made to spend a week in sunny, balmy Dallas for an unexpected vacation, so that a series of tests can be performed to determine exactly what is ailing my lazy ticker. (I have been told that referring to it as a lazy ticker is not altogether accurate, but if it beats at only 20 percent of its required rate and it makes me tired all the time, if I want to call it lazy, I'm gonna call it lazy.)
    The heart specialist is Dr. John Harper, a cardiologist with the North Texas Heart Institute who was recognized as a "Texas Super Doctor" in the November 2004 issue of Texas Monthly (the same issue that featured Mexican food as the cover story, ironic since Doc Harper said I would soon have to give up Mexican food which will frankly be harder than giving up beer).
    It's hard to understand how come a hospital visit is deemed preferable when you really don't feel all that bad day in and day out. Sure, I almost passed out when I walked up a 30-foot incline to go innertubing (just once) this weekend. And sure, fatigue continues at a really tiring daily clip. I wish I could crawl in bed with the covers pulled up to my chin and a feather pillow frumped up outside each ear. But I guess everybody secretly wishes they had no responsibility and could just find a nice warm bed somewhere. That feeling comes most every day for me, sometimes at Noon, sometimes not until 2 or 3. Some days I find myself sleeping at 5:30, just a few minutes after hitting the door after work. Other days I luck out and my family can have bits and pieces of me until 8 or 8:30. If I'm REALLY lucky, I last till 9.
   (And let me just say one thing right here: This blog phenomenon really baffles me. Why ever would anyone be the least bit interested that someone else is tired every day? ... I have a friend who is a veteran blogger who tells me that other people actually do care about minute details like that and in fact that's one reason why blogs are such a phenomenon in the first place. Weird. I don't get it. Somebody explain this to me, please ...)
   So, a series of tests will be run at this hospital, including some stress tests, heart monitoring, medication monitoring ... you know, all that stuff old people have to endure. And, oh, let's not forget The Biggy: a heart catheterization, at which point a small camera will supposedly be inserted into an artery and head toward the heart to take a few pictures.
    I have decided to pay the extra bucks to the hospital so that when the camera is inside of me, I'll also have them send with it a very small director, producer and a few really tiny actors so they can produce an entire primetime soap opera actually shot inside my arteries. I've yet to come up with a name for the finished product -- which I'm told will unfortunately air opposite "Desperate Housewives," dooming it to an early demise -- but I know a title will come to me when I am heavily sedated from the massive doses of drugs I hope to receive during the procedure.
    And, by the by, to add star power to the picture being shot inside my heart, I am currently in contract negotiations with the Grinch in attempts to get his heart to play my heart's stunt double since the Grinch's "grew three sizes that day."
   Film at 11 ... and more later.

5. Mountain High, Valley Low

     A lot of people made resolutions this week. Mine have been made for me. No drinking, no fat food, no salt. Nothing. If it tastes good, it's pretty much out.
    So I am forced to make another set of goals for 2005, a year in which I'm frankly not sure of the ending. But I'm going to try to at least be a kinder and better husband and father, and to learn to pray better. I'm not a good pray-er. Never have been. It's always been somewhat of a weakness and I really can't tell you why other than it might have something to do with a stark inability to concentrate for long periods of time.
    Lord, bless my family ... oh yeah, I have a brochure design due today; help my mother to feel better ... can't forget to take The Boy to Scouts tonight; give me more patience ... and oh yeah, have a story for the newspaper due this afternoon.
    I am honestly probably not unlike a lot of other people, but that makes it no easier. The world could use more prayer and more pray-ers, and frankly it could probably use alot more people who know how to pray. I have a few favorites that I take along in my wallet if ever called upon to pray in public which I would refer to once I am done throwing up.
    Back onto the beaten track: There's another goal I have for 2005: Three, actually: to go innertubing, to hike the south rim of the Chisos Mountains in Big Bend National Park and to climb to the top of Capitan Mountain in central New Mexico. When our family visited Cloudcroft, NM, this weekend, I could see Capitan lurking in the distance -- "You can't do me," it seemed to be saying condescendingly.
    Inachieveable goals? Absolutely. With my little heart issue, which is more accurately described as a big, lazy heart issue, I can do little more than dream. Which is what I will do for the time being, on the chance I will somehow shake this.

4. Club Meds

    When my mom and dad celebrated their 50th wedding anniversary in 1997, I joked that it was a fallacy that old people never had anything to do together: every Sunday mom and dad sit at the kitchen table and fill their pill bottles. Now, THAT'S entertainment.
    Sometimes in a cruel way, jokes can come back to bite you in the behind.
    My lovely dance with DCM has given me the opportunity to spend a piece of my Sunday afternoons filling MY pill box and I feel positively ancient because of it. Everyone knows not to bother me while I am counting the days and placing the proper pills in the morning and evening boxes. I frankly don't know how people with Adult ADD could manage restocking their pill box every week it can be so confusing. It's no wonder older Americans get easily confused: it's because they spend all their mental energy filling their pill boxes every week. And no, I'm not joking. You try putting in tons of medications in boxes every week, certain pills going in a morning box, certain ones going in an evening box and see if it's easy.
    Seven pills a day? Who ever heard of such a thing? Medicine is the only thing I take more of than naps these days and frankly it sucks. And let me add one thing here. The word "sucks" was a word we never used to use in our house, but it works so well when you have a heart condition. It sucks to have a heart condition. It sucks to take seven pills a day. It sucks to have your days significantly shortened because you fall asleep during the early evening most every night.
    So, for all you medical types out there, let's review the ever-expanding pharmacy I put in my body every day. For the laymen among us, I have provided additional insight into the medications and what they do.
    Potassium. One a day. Replaces potassium I supposedly lose every day since I am prohibited from salt. I don't ever remember having potassium on a regular basis but apparently my body will miss it anyway.
    Furosomide. I frankly don't know if that's how it's spelled or not. All I know is it is a diuretic, like coffee. Except not like coffee because it doesn't give me vim OR vigor. It only makes you pee. In fact, when the doctor gave it to me, he said it would be necessary for me to limit my fluid intake to the ridiculously low 48 ounces a day so the diuretic could work better. Which really confuses me so much I don't want to know how that works.
   Metaprolol, Lisinopril and Lanoxin. One's an ace inhibitor, the others are beta blockers, Beta blockers work wonders. Suffice it to bring up a "Seinfeld" quote. As George Castanza said," "I WAS IN THE POOL!"
   The number of prescriptions heart patients have to take is really ridiculous. And let me just point out, I refuse to call them meds or scrips or anything that sounds like I'm some patient on "ER." No, this is real life. For proof of that, just watch me call the automated pharmacy on the phone every couple of Sundays. I am actually on a first-name basis with the computer-generated pharmacist. I no longer have to enter the last four digits of my phone number to verify my existence. The computer now recognizes my under-the-breath mutterings and just patches me right through these days.

3. Shadow dancing (not that dancing is allowed)

    You know it may not be the best day of your life when you hear your doctor say, "There's a shadow on your x-ray."

    I sat for a moment, trying to take it all in. Trying to determine on my own what it all meant. How it would affect my life; the time I have left; my day to day activities. I looked at the doctor.

   "So, I should call and cancel today's tee time, I guess?"

    The shadow was, and remains, an enlarged heart. The heart gets liberal in size because the blood likes to hang around long past its welcome. With it pumping out just 20-25 percent, blood loiters in the bottom of a ventricle and makes the heart grow beyond its normal size. That makes one seriously short of breath, tired and somehwat cranky. Now, this definition would likely never make it in the Journal of the American Medical Association, but it works for me and maybe other laymen.

    So once we determined the heart was too big, a series of tests followed; all the tests performed confirmed those tests performed in the early going, last September. As October came in, my heart remained large and low performing and I grew quite tired of technicians spreading jelly on my chest to see if things had changed. I don't know how pregnant women do it ... let those techie people spread sticky goo on their stomach when they're pregnant. An EKG is a lot like a sonogram, except you rarely find a growing fetus in that part of the body.

    Especially in male heart patients.

    After the fact had been established that DCM and I would be close friends, there were certainly new life-altering guidelines that had to be followed ... immediately, if not sooner, which of course did nothing for my comfort level.

  First, no salt. As in no pretzels, no chips or Tostitos or nothin'.  Secondly, "Limit your fluid intake," the doc said. Of course, whenever you are told this, you become instantly thirsty for, like, 24 hours a day.  And finally, no alcohol. Apparently, I wasn't even supposed to smell alcohol on someone else's breath. In summation, pretty much anything that goes good with a football game is off limits. Frankly, I'm surprised I'm allowed to watch football. Football would likely be off-limits, too, if I followed a team other than the Cowboys.

    Salt is pretty much what food is all about in West Texas. We shower our tortilla chips with it before we dip them into salsa that is likely loaded, as well. If we opt for BBQ, I'm guessing that's not exactly heart friendly fare either.

    Oh, and fluids are mostly out, or they will limit the effectiveness of the powerful diuretics. Roughly, I am permitted to take in about 48 ounces a day, the equivalent of four cans of soda. Which is about right since it takes about that much to down the legion of pills I am forced to take day and night.

  Welcome to my nightmare.

  Diuretecs, if you haven't heard, make you pee so that you cn get rid of what little fluid you have. Diuretics' main job is to constantly interrupt really good dreams. In fact, I had a dream the other night. I was falling from a tall building. In the middle of being rescued by Elastigirl, I looked up at her and said, "Hold on a sec, gotta go pee. And the I have to stand around and see if I need to jiggle the handle because we can't have a toilet running in the middle of bein' saved."

2. You Take My Breath Away

In the 40 some odd years I've lived and played here, I've never really paid much attention to my heart. It always seemed to work just fine for me, thank you for very much, so like most people, I suppose I neglected it and even took it for granted. If I woke up in the morning and got out of bed, I didn't think of my heart because I just assumed it must be beating. When I went to work in the morning, I never gave the ticker much individualized attention. Too busy listening to talk radio, which oddly enough always seemed to increase the heart rate but was never actually detrimental to how it functioned. As much as talk radio seemed to get the heart working quicker, there never seemed any danger that the heart may one day just stop. Never thought much about the heart at lunch, dinner or bedtime either. Too many appointments, too many family things to do. As Willie Nelson sings in the Christmas song, "Pretty Paper," Cant stop now, much too busy.

But I guess it was one day in June of 2004. My wife, Karen, and I were in the Smoky Mountains for our 20th wedding anniversary, and I vaguely remember not being able to catch my breath one day. I thought it might be the thought of the hot tub on the back porch of the cabin (www.cobblynob.com) for which we were paying a nice but reasonable chunk of change during the vacation. The hot tub seemed to be calling out for me. It overlooked the mountains which I have always been nuts about, and the more time I spent in the hot tub, the happier my vacation would be. For what little time remained that I spent thinking about why I was short of breath I gave thought that it might be stress. Whatever it was, it went away, and I continued to think about the hot tub on the back porch. Hot tubs are like talk radio -- they're good at taking the ticker for a nice little ride.

We had a good vacation. Tennessee is the volunteer state, but if it's not already, it really should be the official home of fried food. Because that's all they have there. Everything's fried. I think somewhere in some saloon somewhere, they may even fry their moonshine. Or get fried because of moonshine, I don't know which.

But there is a link. Because as you well know, Tennessee is famous for both hootch and Fry Daddies.

But the heart. I've gotten off the heart. The shortness of breath went away in Tennessee, and it stayed away for several weeks thereafter, or at least I didn't feel it or sense it any longer. I was back abusing it, listening to talk radio and harboring thoughts of a hot tub 1,100 miles away.

But August came, the summer vacation season ended and so did life I had lived it and enjoyed it for as long as I'd been here.