CABG: Recovery (Year One + a few yearly addendums)


CABG Chronicles, December 9, 2018

Five Year Anniversary. First recovery addendum.

I’ll keep it as brief as is possible for a loquacious geezer like me.

Five years into recovery…and still ticking. That’s not bad. Five years ago today I did a John Elroy Sanford. Who? Redd Foxx. It’s the big one, folks. (Old guys remember Redd and his nasty jokes. For those of you who are wondering, Google the name. Anyway, unlike Redd, I didn’t expire in front of the audience. 

Five years in, I’m still walking three to five miles several times each week. I’m about to return to bicycling, I miss riding and the motorcycle doesn’t do for mister heart what the bicycle does. I lift weights two or three times each week.

Simple routine: warm up: 10 reps of cleaning a 40 pound bar from ankle level to waist to chest then over head, down behind head, back up over head, down to neck, waist then to ankle. That’s followed by five arm sets. Each set is standing curls, increasing weights with each set, followed by triceps press downs or other equivalent triceps exercise such as reverse dumbbell raises.

On to chest. Flat bench presses, four sets. The bench presses are with cascading weight levels alternated with standing dumbbell raises for deltoids or other equivalents. I’ve been really cautious on the bench, starting with 100 pounds for 14 reps warmup. Adding an occasional bump, I’m now benching 180 for four reps occasionally (when I feel the urge…). 

Weights end with overhead wide bar pulldowns (on a pulley machine) for the lats closing with 25 reps of ab bends on a Nautilus machine. I’m fortunate to have my own gym in the basement. It makes resistance training much more convenient.

Last note (there are other posts in my regular web log regarding health and recovery): If you read the following posts on my first year of recovery, you’ll see a reference to weighing 170 pounds. Part way through year four I was tipping the scales at 177.6. That’s nekkid, following ablutions. It was weigh, way, way too much. Without going into the specifics–my actual program for reducing weight will be covered on a separate blog page–I cut back to the high 150’s, usually around 158 or 159. 

All this has resulted in having to accumulate a new wardrobe. Expensive? Yeah, but buying clothes is greatly facilitated by frequenting eBay. Not everything fits but I don’t pay much, either. Trendy clothes? Sometimes, but an old fart tries new things. They don’t all work.

No matter, I’m still alive. I look forward to new challenges. Better watch out, Jennifer Aniston. 

 

CABG Chronicles, December 14, 2014

One Year

Twelve months after having a heart attack, “Ah’m stil heah,” as one might say in Alabama.

Observations (salient or not): The past year has, in most ways, been much easier than I thought it would be. There are two categories in recovery: what I expected and what I didn’t. (Yeah, I know, there are two types of people. Those who believe there are two types of people and those who don’t.)

Begin with the expected. I was told by doctors, nurses and the comic book provided me by University Medical Center to anticipate times of depression. I did experience some depression–a heart attack, expensive surgery, tons of bills and the Promethian task of recovering what I could in the aftermath of my 2013 Christmas present would tend to depress most sane people and even those (like me) who aren’t quite so sane–but not as severe as I expected. Insurance covered almost everything. Recovery started slowly but began almost from the moment I was sewn back together.

My chest was sore after surgery. That wasn’t a surprise. Coughing was painful, again not too surprising. Walking was…OK…the first few days and quickly became a task I anticipated with a sense of pleasure. At first I wore an HRM–heart rate monitor–on every walk. My primary care physician and my cardiologist both warned me to stay under 130 beats per minute. In April I went through a stress test (monitored by the cardiologist) after which he cleared me to not worry about my heart rate. The effects of Coreg (generic carvedilol) keep my heart rate down under 130 anyway.

Mentally, I floundered for the first couple of months. Names did not come back quickly. (Branch Rickey is quoted as saying “First you forget the names then the faces; later you forget to zip up your fly then you forget to unzip…”) My reading retention was poor. Mental acuity began to improve around the third month. Now, as best as I can tell, I’m about as bright as I ever was. That’s not saying too much but it’s an improvement on what I had in early January when I first came home.

The unexpected: After six months, I began very gingerly to lift weights. I was curling two five pound dumbbells, bench pressing just the Olympic bar itself (50 pounds) and so on. A year after the heart attack, I’m curling a pair of 30 pound dumbbells for six reps (15 lbs. for 12 reps, 20 for 10, 25 for 8 then 30 for 6…) and bench pressing 177 (again, cascading the weights  up to 177) and so on. I weighed 158 when I returned home. I’m up to 170 with only a one inch waist increase.

My significant other walks with me three or four times a week, usually for five miles, sometimes for more.

OK, the bills have been paid, my physical recovery is going better than I expected and mentally I’m almost as bright as the cat. (Hey, he’s a smart cat.) Now for the second year.

 

CABG Chronicles, October 08, 2014

Ten Months

As the man said after jumping off the observation deck at the top of the Empire State Building when he passed the halfway point on his journey toward the ground, “Well, so far, so good.” Eyup. It’s been ten months since I sprawled out on the floor of my office and…so far, so good.

I’ve modified my exercise routine. Instead of five or six days of walking seven miles each week, I’ve settled into a routine of four walking days, two of which I also lift weights in the afternoon. My lifting routine is simple: curls, arm rises and neck harness on one day; overhead dumbbell presses, bench presses, lat pulldowns and incline presses on the other day. Unlike routines in the past, I’m not going for totals. I pyramid my bench presses starting with eight warmups with 100 pounds then sets of six, four and two going up ten pounds each set.

It ain’t much but better than having my ashes sprinkled in the back yard.

Goals: yes. I’ll stay with the hundred for warmups, at least for the next few months, but go up on the succeeding sets. I’d like to see two reps with two hundred but that’s not necessary as long as I’m getting stronger with each workout.

For those of you who arrived here after I did, it’s not as bad as you expect.

 

CABG Chronicles, Aug 23, 2014

Another Month in the Can

My eighth month after surgery was spent on my feet lugging a three-pound camera, a three-lens, batteries, memory cards, and a backup camera and lens which added another four pounds to the load. I photographed a wedding and reception; much better than being stretched out on an operating table with the surgeon attaching new fuel lines to my pumper.

Problems? None with the fuel lines or the pump. No shortness of breath, no pains…which is to be expected since most days I walk an hour and a half without problems.

Reflections? Yes, I suppose. The operation was not on my agenda at the time but neither was croaking on the floor like a big pile of cat puke. Might have been nice to have the CABG without the ticker burping but that’s not what happened. So it goes.

I’m happy to be alive, taking pictures of other living creatures.

 

CABG Chronicles, July 23, 2014

Seven Month Anniversary

Been seven months since the bone butchers hacksawed my chest open then spread my ribcage like Lindsay Lohan at a lesbo cocaine party just so they could get in to the pumper and replace some corroded fuel lines. I feel much better but I do have some observations.

1. I discussed moving back to Phoenix, taking advantage of the art scene, neat restaurants, being around a vibrant community. In retrospect, that would not be a good decision for me or likely anyone else who had a heart attack. Sure, there are lots of folks in Feenix who have cardiovascular disease but it’s rather like a non-swimmer who fears water choosing to live on a sailboat in the Pacific. If something goes wrong…

Monday we were in Tucson for a shopping day. Temperatures peaked around 105. That was still bicycle riding weather for me just a couple of years ago. Not now. Combination of the added stress to my ticker (not a good idea) and the effects of Carvedilol, a generic form of the beta blocker Coreg, causes high heat to have an extreme effect on the old guy. I wasn’t falling down or passing out and my pump wasn’t too strained but my energy level was that of an old battery left outside for a couple of years. I was flat. Supposed to be up around 112-113 in Phoenix today. I don’t want to be there.

2. Coffee (and other caffeinated drinks) aren’t good for me when the temperatures are high. I usually have one double shot of espresso in the AM. That’s my limit for the day. On Monday I treated myself to an iced-coffee midway through the afternoon. The cold Joe didn’t have its one time “pick me up” effect. Instead, the caffeine left me even more depleted than I was before drinking it. A nice, sparkling water would have been a much better choice. Hopefully I’ll remember that in the future.

3. Humidity is also a depleting factor. Normally humidity isn’t much of a consideration here in Arid-zona but it’s monsoon time and the sky was littered with clouds on Monday. Humidity combined with high temperatures do not a happy heart attack survivor make. I was OK, not great but OK. By the time we arrived back home in the late afternoon (home being 5280 feet elevation and temperatures usually 10 to 15 degrees cooler than Tucson), I was fine. I unloaded a couple hundred pounds of gelt from the stores and was ready for dinner.

 

CABG Chronicles, July 19, 2014

Walked 500 miles today, bench pressed 500 pounds…

Well, not really. My average daily stroll stays around e miles most days. It’s not that I’m out of strength at that distance…but Arizona’s monsoon season is upon us like stink on fresh poop. It’s both hot and humid and the combination does have an effect on me. So, the big walk, usually in the morning, stays at around 8000 paces on my pedometer then I do a couple of additional 2000 step jaunts later in the day. Adding up the walking around the house and in the yard, I reach 16000 most days.

That ain’t what I did back in You Ess Armee days but it’s not bad for an old man who had his chest cut open just seven months ago.

My reading includes Mayo and Harvard medical web material. One of the studies that I find fascinating indicates aerobic exercise is more important–much more important–for heart attack survivors than is strength training. I suppose that’s logical but on the third hand, without maintaining muscle tone, there are other problems lurking around the corning. Or, to be more accurate, on the floor.

Falling down…

Help…I’ve fallen and I can’t get up… 

Remember those horrible TV ads? I don’t know if they’re still around, haven’t watched real TV in many, many years, but the fear of falling is still there. Yes, fear of falling, not fear of flying as in Erica Jong’s book. I suppose there is a connection. Fall down, get fucked…up.

I try to practice standing on one foot then the other, closing my eyes while balancing on one foot…and I’m getting better. Maybe someday soon I can raise both legs into the air. I also work on lowering myself to the floor without using my hands then rising back up, again without using my hands. Five times of doing this several times each day seems to strengthen my legs and improve balance.

Ain’t getting old grand?

Still, it seems to beat the alternative (which I came quite close to experiencing last December 9th).

 

CABG Chronicles, July 9, 2014

STILL TICKING AFTER SEVEN MONTHS

Just seven months ago, December 9, 2013, my heart stopped. Not for just a few seconds, either. I was code blue when the paramedics arrived and, in order to save my miserable existence, I was resuscitated. Far fucking out. By the way, not just once did I flat line but twice. I know I’ve written about the experience in the posts on my main web log but part of recovery from CABG is understanding what happened to me.

The other part is doing something to avoid having a recurrence of the episode, at least not for many years. After all, when it’s time to go, if I just close my eyes and wander into darkness isn’t painful. I’m just not ready to do it again, not yet.

Today, my significant other and I walked about four and a half miles at a brisk pace. Weather was fine, temperatures have dropped several degrees since the arrival of the monsoonal moisture, so the jaunt was pleasant. My legs are getting stronger with each trek…and so is my heart, though a daily dose of statin, carvedilol and lisinopril all have a part in keeping me off the floor along with maintaining a healthy diet, etc., etc…

Shame that my brain doesn’t exhibit quite the growth that other body parts do. I find myself wondering about the aftermath of the induced coma, a medical procedure performed at Carondelet Medical Center in Tucson. How much damage was done to my brain? My memory seems fine…except for the couple days before the heart attack and the week afterward. Likely that will never come back. Still, would I know if I were missing important processes?

This all reminds me of the science fiction tale Algernon, about a mouse that took smart pills. The smarts didn’t last, but likely the mouse wasn’t aware of the difference.

 

CABG Chronicles, July 1, 2014

SWIMMING IN DENIAL

When I attended my first few AA meetings–that’s Alcoholics Anonymous, just in case anyone wonders what the acronym signifies–I laughed at the phrase “swimming in denial,” referring, of course, to human beings and their our tendency to turn away from awkward or uncomfortable truths. Yes, I should acknowledge some passing connection to the human race although the more I know about people, the better I like our cat. There were other clichés that I was hearing for the first time at an AA meeting. Alcoholism is the only disease that tells us we don’t have it. That assumption is, unfortunately, demonstrably wrong. Most of us deny anything we don’t want to own, including debt, illness, bad marriages or relationships or auto problems that we steadfastly cover with inexpensive snake oil remedies that we know won’t cure the problem.

That brings me to the person my significant other and I encountered at the mall a few weeks ago. (If you think this story is written about you, you’re probably correct.)

I shall refer to the individual in question as an oaf, OAF being an acronym for Old Army Friend. Oaf’s been visiting physicians at the VA for a variety of symptoms including shortness of breath, pain in the chest and arms, lack of energy…you get the idea. VA says he need to monitor the symptoms and let them know if any of his problems get worse. Oaf and I discussed my ailments that culminated in myocardial infarction, resuscitation and CABG. He was quite clear that–although he’s had a couple of stents installed and has been diagnosed with arterial blockages and a leaky valve–none of what happened to me could possibly be in his future.

If my problems get serious, I’ll call the doctor, Oaf told me.

What if you’re lying in the center of the room staring at the ceiling and no one else is home? I asked.

That isn’t very likely, was the answer.

This from a man who can’t walk from one end of a tiny, rural mall to the other without taking at least one rest break, whose coloring is reminiscent of a flight line vehicle that’s been out in the sun for twenty years.

Who…to be quite truthful…reminds me of: me.

Why, after I began feeling short of breath, when I experienced pain in my arms after exertion, why did I not tell my doctor?

I suppose the answer is simple. Why did I not consider the possibility that I was drinking too much when (fill in this space with whatever funny, horrible, frightening, disgusting, pathetic anecdote seems appropriate)? Why did my ex-girlfriend not but the brakes on her spending when she had maxed out all her credit cards? Had she exercised fiscal restraint, she might not have had to date guys like me who only wanted her for her open thighs and soft breasts.

Swimming in denial.

 

CABG Chronicles, June 28, 2014

RUN DOWN STORES AND OLD MEN OFTEN NEED RECOVERY

Significant Other and I went to what purports to be a mall yesterday. Purports to be a mall? Yes, about half an hour away from where we live exists an indoor shopping area that once hoped to compete with big city shopping malls. After all, it’s a covered area, has a couple of anchor stores…a food court and air conditioning. When first it opened, I suppose high hopes were part of the construction project. Now…the two anchor stores have that stale aroma of merchant morbidity. One of the anchors, Sears, has been in a long, agonizing decline for many years. Sears reminds me of a tubercular female from the 1800’s, what people of that time referred to as a consumptive, a frail woman slowly fading into her grave.

The other main store (one which specializes in matronly women’s wear) should change its name to Frumpy’s. The two anchor stores are separated by a corridor lined with video game arcades, cheap outlets and nail shops owned by Asian ladies who haven’t quite learned to speak English. Oh, there’s a food court, too, but only two of the fast food outlets have managed to keep a heartbeat going for more than a few months.

A mall? More aptly we could call the place a small.

Which brings me to the point of this post. Many of the food court tables are usually occupied by “older” people. Not older shoppers, that would imply people who either had spent or intend to spend more money after gumming their servings of fast fuel. These diners want a cheap sandwich then they can stroll the air-conditioned area away from Arizona’s searing summer heat. Dollars are wallet barnacles, not easily detached from their back pocket hideaway.

I have eavesdropped conversations and overheard familiar terms such as cardiologist, meds, hospital, bypass, valve replacement, heart attack, chemo…so, many of the diners are as ravaged as the mall itself. Who will shut down first: granddad, grandma or Sears?

Still and all, the mall does provide a respite from the hundred degree day waiting outside. A walk from one end of the small to the other then a loop around the outside area through the parking lot increases the step count on my pedometer by more than 2000, allows me to synthesize some vitamin D and provides chair and table during my rest time. One circuit before a cheap eat followed by another lap and a stop for a scoop of low fat frozen yogurt then the final loop returning to the car adds 6000 steps, a significant portion of my daily goal of recording a minimum of 10,000 strides for at least six days each week. (FYI: 10,000 steps x 2 feet @ step = 20,000 feet. Most days I tote up 12 or 13K. My weakly weekly sum is between 25 and 30 miles which I consider not too shabby for an old person who needs reupholstered. Rather, make that recovered.

Then, a few days ago, significant other ‘n myself encountered a couple we know, a man and woman about our ages. I’ll tell you the husband’s story someday soon, that is if the river don’t rise and my ticker don’t blow like a 283 CI Chevy V8 wound out to 8,000 rpm. After all, I’m one of the old farts, too. I can spin tales about my CABG with the best of ’em.

 

CABG Chronicles, June 25, 2014

WHY ME? WHAT DID I DO WRONG?

OK, time for something new.

Until slipping out of my office chair and falling on the floor just a few minutes from meeting the Great Fool Taker, my definition of cabbage was a vegetable consumed either raw or cooked that could be found in a variety of colors and was a component of recipes ranging from slaw to sandwiches. That’s changed, as you’ll discover if you read Part I through Part VI of The CABG Chronicle posts. Click on heart and other vital parts in the index to your right to access the chronicles.

I’ll begin this separate compendium–a page of posts which deal with recovery, the aftermath of CABG–with observations on what life was like before my myocardial infarction.

At the time of my heart attack, I was not overweight. I had embarked on a regimen of bicycling in 2005 after a few years of not riding. By 2007, I was riding about four or five days each week for 15 or 20 miles each session. I had reduced my load of fat by about 35 or 40 pounds. This routine continued until fall of 2012 when I began to falter not out of lack of desire but because of increasing difficulty in completing each ride. I’ve been a vegetarian for eight years but for most of my life, my diet ranged from horrible to almost admirable and back again. French-fried potatoes and hamburgers graced my plate more often than kale and brown rice before I went to veggie route. I don’t drink alcohol and haven’t since 1984. Prior to ’84, I drank moderately to excessively beginning in my teenage years. Same for illicit (and licit) drugs. I quit in ’84. No tobacco, either, but before I quit for the last time in 1980, I’d smoked pipes and cigars since my mid-teens. The attaboys were there but so were the aw shits. Each aw shit deducts five attaboys. Truthfully, my cleanup was too little too late, at least by itself.

To make matters worse, I did not visit a doctor for anything other than FAA flight physicals. A more thorough examination might have revealed problems. I hadn’t had a blood workup since the mid-80s, at which time my lipids were within acceptable range. Would prescriptions have cleared up the arterial blockage? I don’t know. I didn’t pursue that avenue. I’ve never been fond of spending time in a doctor’s office and believed that anyone who could ride a mountain bicycle 25 miles in mile-high elevation on rough, dirt trails didn’t need to be concerned with heart disease.

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To your left is a photo of me taken in 1993. I was arranging reflectors for a motorcycle photo shoot about halfway between Safford, Arizona, and I-10 outside Willcox. Yeah, there’s a belly there but I was feeling quite healthy back twenty years before the big banger. About a year before my cardiac event–Isn’t that a wonderful term? Sounds like something scheduled at an auditorium–I had a spate of shortness of breath while out on a bicycle ride. I still completed the ride but soon my bicycling route was reduced in length then eventually I eliminated riding. I’m getting old is a really lame excuse for what occurred but that’s what I told myself. There were other signs, too. When significant other and I made our trips north to Tucson about twice each month for shopping days, unloading the car when we arrived home was becoming a real trial. By the time I’d lugged in numerous sacks of groceries and a couple of heavy coolers, I was done. Wiped out. Exhausted. I hurt all over.

I still lifted weights, even increasing my number of workout days because I wasn’t spinning the bicycle spokes…but my system protested more and more frequently and more vociferously. Why the hell didn’t I go to the doctor? Maybe…not absolutely guaranteed but maybe…had I told my primary care physician what was taking place, this story might be different. Likely he would have, at a minimum, scheduled a stress test and a blood workup. Maybe an echocardiogram, too. I’ll go so far as to say probably if the tests had been run, my arterial blockages would have been detected. What then? More tests. Possibly a couple of stents, maybe a suggestion that I go under the dreaded blade for CABG.  Probably I would not have keeled over in my office. I probably would not have had a heart attack on Monday, December 9, 2013.

No matter, I didn’t tell my doctor about my problems. In fact, since I quit flying commercially in 2000 then sold my airplane in early 2001, I wasn’t getting flight physicals on a yearly basis. I was on my own. Telling the doctor was up to me and I was swimming stroke after stroke up a giant river known as denial. Without really articulating my reasons at the time, I was unwilling to chance becoming…whatever…I might be if I had heart disease. Maybe I preferred taking a chance on becoming a fatality. I never really asked myself the hard questions.

Hint: if you recognize yourself in what I’ve just written, it’s probably a good idea not to do what I did.

Why am I writing this drivel? If for no other reason, to help myself comprehend what happened and why. If someone else benefits from any of my experiences, that’s great. If not, at least I’m delving into my own condition and learning about the process that caused me to go Code Blue twice within a few hours. Two times I had to be resuscitated. I was that close.

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