leo_hinterlang

I can’t remember the names of all the people who were involved in this incredible process. All great folks. The janitorial staff that got me a new roll of toilet paper when I asked for it. The great physicians who’s skill and knowledge made it possible for me to have come through this with my heart now in better shape than it was when I went in. The well trained nursing staff who led you to the immediate conclusion that they knew their stuff. The nurses aids were most helpful and professional. But to the guy who shaved me at 5:30 in the morning, John, I’ll be cursing you until this itching goes away.

The heart center at Butler Memorial Hospital is ranked among the top 5 percent in the country, and as the best in the state. You have to work hard to earn that kind of recognition. As an institution and as a group of individuals, I can attest to the fact that this is a hard working enterprise.

I could not help but think to myself, as I enjoyed watching the fireworks on the last night of my stay, how lucky I am to live in a country that encourages people to do their best. In that small group of people that had joined me for a moment of national celebration, were neighbors helping neighbors.

The fireworks ended and everyone dashed back to their duties. But one of them joked that they would be back to my room tomorrow night to do more furniture rearranging. I answered them, “I’m going home tomorrow.” And so I did.

The first morning after the surgery, I was nauseous. I was concerned that people would be coming to visit and so I asked the ICU nurse to call Pam and tell her that only she should come in that day. They gave me a couple of things to help settle my stomach and that did the trick. Pam came in around lunch time and I was glad to have someone to help me keep track of what was being done.

Of particular concern, was my blood sugar levels. I think there were a few miscommunications that led up to my sugar reaching 475 one day in the ICU. Normal sugar should be between 90 and 110 or so. I get readings from 50 to 350 at home and it’s all about how much you eat, how much exercise you get and how much insulin you take. The best thing that’s happened over the 40 years that I’ve been a diabetic is that you can test blood sugar levels quickly and easily these days.

While in the ICU, they use a special IV insulin and monitor it closely. What you don’t want to happen is to have the blood sugars drop too low and cause insulin shock. For me, when it gets too low, I’ve fallen unconscious and begin to sing “I’ll take you home again Kathleen” over and over. It’s not a pretty sight.

In the hospital, they try to standardize everyone to a reasonable lifestyle guideline for eating and sleeping which makes sense. Meals are breakfast, lunch, and dinner with a snack before bedtime. While there is no official bedtime, things start happening at 6:00am and if you’re not awake by 8:00am, they start to bother you.

Well, my lifestyle is difficult to fit into this guideline. When I tried to explain how I take my insulin, I said Lantus 30 twice a day, and Novolog with meals; 15 at breakfast, 15 at dinner, 5 at bedtime, there is no lunch. But since I was in the hospital, there was a lunch and it needed to be covered. They thought that I didn’t take any at lunch and that’s how my blood sugar ended up at 475. Being a diabetic is tough.

Apparently, the hospital doesn’t figure in what you eat or how much. They treat it as a constant as part of the daily routine. My advice, now that I think I know how they do it is to tell them what insulin you would take if you led the ideal lifestyle that the hospital promotes. Don’t tell them what you really do. And they know that people eat irregularly and snack when they shouldn’t. It’s just better to pretend that you always eat lunch and brush and floss and clean under your bed and dust the light fixtures. They like that.

Several times after I was moved out of the ICU to a regular floor, my blood sugar got too low. Sometimes you can tell that it’s too low and take action; eat something. But when you are recovering from surgery and taking pain killers, you are uncertain about how you feel. So you have to test.

Once, my nurse Joyce and I went out in the hall to take a walk. She brought along an oxygen tank because the day before my O2 levels would drop during exercise. When we reached the hall, I noticed that the lights seemed odd somehow; everything was a little too bright. I told her that I thought I was kind of light-headed. She must have seen something in my face because she immediately took me back in the room and tested my blood sugar. It was 56. Nice work there Joyce. I was ready to just keep on going. Some orange juice and crackers brought it back to normal. That’s what’s known as nursing skill.

-- End of Part 4.

Thursday morning came quickly and I had gotten a better night’s sleep. Pam made it for the send off. I was ready.

I was wheeled off the elevator to meet the anesthesiologists who took me into the operating room where I was transferred to the table. In a few minutes they started the sedation and I was out.

The next thing that I remember was coming around in the ICU and finding out that all had gone well. I remember seeing brother Ed and sister Mary Helen in the ICU but Pam says she was there too. I had asked her to give me some reassurance that things were alright because coming out of anesthesia is always disorienting. I don’t remember though.

Now this is where I am going to turn a bit philosophical. Any major surgery, such as this, leaves you in an awful position. There are IV fluids all around you, tubes attached to your lungs and bladder, dressings all over, drainage vessels attached to your chest and legs. You can’t see, you can’t move, you can’t breath, you can’t pee, you can’t poop, you can’t eat, you can’t sleep, you can’t wake up, and you can’t think. It’s completely insane.

There is nothing easy about this at all. You hurt all over and you hate being tied down. Still you continue to play with the buttons on the bed searching for that unique combination that will give you comfort. You are on your back for days in the ICU.

Even days later when you still have to do things that are seemingly impossible to imagine, it’s all tough. Get out of bed, walk the halls, eat all your food, don’t drink too much fluid, pee in this container, make a bowel movement. Someone really needs to add some things to the recovery process that are easy to do. Smile at the nurse, blink your eyes, point to your nose. Just a little balance would be a good idea.

There is only one way to survive such an ordeal without losing your mind; drugs. Morphine and percocet do the trick. The pain in your back, shoulders, and neck just melt away. It makes the whole thing more bearable and that’s how it works. Don’t hesitate to take what they offer in the hospital to relieve pain. It’s the only way.

This happens day after day to all sorts of people with all sorts of problems and yet as tough as it is, people endure and come through it in relatively good shape. I consider myself to be average tough at age 57 and many others older than I are able to do this as well. I find the whole thing to be incredible.

When I asked one Doctor how so many people can go through this, he said that in many cases there is no alternative.

-- End of Part 3.

A heart bypass operation involves making a graft around damaged blood vessels by going around the blockages. The vessels that they use are your own taken from another part of your body, generally the legs. When I asked if any of the heart muscle itself had been damaged due to a lack of blood flow, the Doctor explained that the demand for blood from the heart had developed alternate routes for blood flow but these are not good connections.

He also explained that this would be a triple bypass in that all parts of the heart were affected. Quad and quintuple bypass sounds like a bigger deal but once you’re into a triple, the risks are about the same. A quad and quintuple are added for smaller vessels that also feed the heart but are not as essential.

I apologize to the nit-pickers for my medical knowledge is much like that of an ameba, which I also don’t understand and am not sure how to spell.

Wednesday, June 29, a man in scrubs woke me at 5:30am to give me the shave which is extensive. From the chest to your feet, everything must go. I had spent my whole life growing that hair and I knew that it would itch when it decided to grow back and it does. I always thought that shaving your deal would be more comfortable and clean but it’s not.

The night before I was scrubbed down with the orange soap which was okay just to get everything clean for surgery. I was still recovering from the heart catheterization and had long lost any sense of human dignity.

Early that afternoon, I was outside the operating room with Pam and Jim and Mary Helen being prepared for surgery. I wasn’t scared but I was nervous, and hungry. One of the assistant surgeons came in and announced that they had an emergency surgery and that I would have to wait till tomorrow morning. I wasn’t all that disappointed but I didn’t want to have to go through this all over again. Besides, I was hungry.

Jim left to go to work. Kathy was waiting back in my room which I was supposed to be finished with because after surgery you end up in the ICU. I ate lunch. Pam and Mary Helen and Kathy visited while I took a nap. Later, I watched the ballgame and got myself set for the next morning. Would they shave me again? No. Would I need to be scrubbed down again? No.

-- End of Part 2.

On the evening of the Fourth of July, as the sun was disappearing behind the hills around the city of Butler, PA, a small group of nurses and aids gathered to watch the fireworks from my room which has the only westward facing window in the new section of the hospital. We had a good vantage point for the display that was being done from Pullman Park, a ball field near the center of the city. As it began, one of the nurses aids said that we needed to have some ice cream to eat while we watched. Someone else said, “Well, there’s ice cream out on the cart in the hall.”

We all settled in to “ohh and ahh” at the fireworks with our ice cream now firmly in our collective grasp. I said, “Man, all we need now is some more percocet and some Ina Gadda da Vida music playing and we’ll be all set.” They laughed.

I felt good about sharing my corner hospital room with this small communal group. These were the people who had done their best to assist me in getting through the trauma of open heart surgery in the past few days. I had accused some of them of attending the “lecture” on customer service which they admitted was true. They know that in a free market, I could have gone to any number of good hospitals to have my heart bypass done. For my case, the lecture paid off. I was suitably impressed.

On June 22, I had been scheduled for a routine stress test as recommended by the kidney transplant team at Allegheny General. The test got me very winded and I had to ask them to stop. The Doctor said that he could see some problems on his EKG monitor during the test and so he sent me to a cardiology group to have a heart catheterization done. This would show them how things stood and perhaps they could fix it with stents and a roto-rooter.

They let me go for the weekend but by Monday morning Pam was taking phone calls from the cardiologists. So on Tuesday I was taken to an outpatient area at Butler Hospital for the heart cath procedure. They found blockages in the blood vessels to the heart that would require bypass surgery. There was no hesitation. They got me a room and it was set up for the next day.

-- End of Part 1.

Who should be my friend? In the world today, it seems that this may be a thing to ponder. What is it about a person that makes them worthy or at least a valid applicant for my friendship? Surely it’s more than just the sharing of common experiences and ancestry. There’s more to it than just living a portion of one’s life in the same place, the same neighborhood, or even the same household. There are many things that together make up a suitable bond between individuals that may lead to an everlasting friendship. And yet, the question has been asked; who should be my friend.

But perhaps it might be better to ask who should not be my friend. What constitutes the attributes that would exclude one from taking an active role in the activities that make up my life? Well, first off, they would need to be ugly. Not just dog ugly but truly bump into a pole, feature depleted bad looking. I mean they would have to be so ugly that if I owned a camel that had a face that bad, I’d shave his rear and make him walk backwards. I can think of very few people that qualify for this category but it seems obvious to me that this would surely be a solid reason to not want to be friends with them.

Secondly, a person who has an arrow in his chest might be left off my list. This would be a constant annoyance that I could live without. No people with arrows, in fact anywhere on their person would be a good rule.

No people who require that they always get the last word. Jeez, I hate that. If you don’t care, fine. Let them be your friend. Anyone who likes to talk about stuff that makes you feel like you want to throw up, excluda mundo. Other candidates include gypsies, tramps and thieves, and the hopelessly tired.

While I don’t think that this is an exhaustive set of exclusionary criteria, I do think that we’ve developed some good benchmarks. The main thing to remember is that friends are a dime a dozen and it might just be a good idea to toss a few over the side. Most people want to be your friend and they don’t even know why. Go ahead, ask them. Why do you want to be my friend? Most people will just look at you funny and then begin a frantic search for their coffee cup.

The Pittsburgh Steelers have lost the Super Bowl to the Green Bay Packers 25 to 31. It was a good game that boiled down to turnovers. Our team blew the big game, yet we still hold them in high regard. Why is this? Why are Steeler fans not more upset about losing the game that would have given us the seventh Super Bowl trophy since it’s inception?

Some would venture that it’s only a game. That’s true, but even more to the point, it is for our amusement and not to be taken too seriously. Because as Bill Murray once said, “It just doesn’t matter!”

Oh, but it is a sport you might interject. It involves athleticism, skill, endurance, conditioning, strategy, adaptation, and all over a brand of behavior that is not at all natural in origin. All sports are like this only some tend toward simpler achievements and more natural abilities; running, swimming, jumping. So it is a game, involving sports, with strange rules and judges who determine if the rules are being followed, that is watched by people across the country and that just doesn’t matter. That’s what football is.

Then there is the element of a team sport in which a group of individuals that represent a particular geographical region is placed in competition with another such group. Now we’re talking about the honor and integrity of an entire segment of society sliced up into zones of heterogeneous football fanaticism, and that’s where we come in. Cultural migration takes place and soon there develops a Steeler Nation, unbounded in its zeal for victory and uncompromising in its lust for high achievement, that just doesn’t matter. What great fun it all is.

The truth is that we love the Steelers. Sure, the individuals change and the years go by. But the Steelers are a part of what makes us who we are. I recall how my father would moan while sitting in front of the television set, just as I did tonight, and complain about Terry Bradshaw back in the 70’s because when he first showed up, he was awful. He improved a bit over time.

The Steelers are a point of convergence, one generation to the next. In our short lives, we need that kind of linkage. We guard that bond with the past and protect that loyalty as we pass it on to future generations of Steeler fans. That’s why we love the Steelers.

Well, the Steelers are in another Super Bowl. After going 12 and 4 in the regular season, and then beating the Ravens and the Jets in the playoffs, their opponent for the big game is the Green Bay Packers. My prediction based on strictly objective criteria is a complete fabrication but I'm going with it anyway. Steelers 30, Packers 21.

I am posting this entry in Live Journal as a test to see if it will cross-post it to Facebook via a new feature. My blog began in 2005 and I am attempting to keep it more up to date. Facebook looks like fun and I intend to use it for jibber jabber while my blog is more of a journal about whatever I feel like writting about. We shall see.

I know that Christmas is past but I think I should note my feelings about the holidays at this point in my life. First of all, Christmas for me is a mental journey back to my childhood when it seemed that the only real problems were about how to keep your brothers from destroying all the things that you held in high regard. That’s right. Even at a young age, I had developed a sense of values for both things and attitudes which have changed somewhat since then but which I often return to when I find myself in a struggle.

Eventually you learn that the “things” that you value are subject to variables such as income and ability so that their worth tends to waiver in a fairly predictable way. But the “attitudes” you grow up with stay with you as long as you still view them as true and useful. In other words, you can count on certain principles of behavior as a guide to the obstacles that you encounter in your life. I find that Christmas reminds me of the notion that my upbringing was very good and a solid background for navigating through the ups and downs.

Back in early December, I wasn’t sure that I wanted to do all the work that goes into decorating for Christmas. I even remember saying that it doesn’t do anything for me. But I was wrong. It is absolute, pure magic. The whole thing. God’s great mercy showed up in a stable that night. He should have turned His back and said whoa, that human being thing didn’t work out so well, and moved on to something else, in another part of the Universe. But no. Instead He didn’t give up on us. That’s remarkable. The Christmas tree in this house takes me back through the years to remind me, once again, of that great truth. Sure, it’s just a decoration with lights and beads and shiny objects and plastic shepherds and a manger scene. But it commemorates the most important event in the history of the world.

In the past few weeks, in the early morning hours, I will sit in the living room and look at the tree and the manger scene underneath and watch as the new sunlight shines off the appropriately dense strands of tinsel and wonder at how marvelous it all is. It’s the same living room, the same decorations, the same stable and I’m just slightly older. But it’s the same me.