Tuesdays with PHTony

Syncope

2010-06-16T15:58:00.004-04:00

Syncope (pronounced SINK-uh-pee) may be the most medically accurate term that's described me since I fell ill. Because that's exactly what I did last night after passing out. I was watching a movie late at night with Oreo when I noticed a little bug scurrying across the floor. Maybe it was the adrenaline from watching the movie, but I arose quickly to dispose of the beast just barely catching it's hindside. It dashed under the couch in an attempt at escape. I quickly bent over to get it & noticed it had stopped just out of arms reach. Thinking I would grab the fly swatter to extradite the thing, I quickly arose so I could get back before it chose to move.

It was at this point that my heart spoke to me: "You mean to tell me you want to quickly stand up, quickly bend over, and then quickly stand up again? You must be kidding". I knew too late that I'd made a mistake & attempted to sit down on a chair before leaving the world of the conscious. I then sank-and-peed. Let's be honest, dignity is but a word when it comes to being ill. Bug 1 - Tony 0.

You've all seen any random movie where someone is swimming frantically upwards trying to reach air before their lungs explode and the moment of jubilation when they catch that all important breath. Well that was how I woke up, gasping for air. I was slouched on the floor with my head leaning against the couch. My vision was blurry and I had absolutely no energy to move myself. I was able to lean to a sitting position and that's when I noticed my sink-uh-pee. Oreo was gone and I couldn't stand up. I was hot and had difficulty breathing. Looking at the clock, I guesstimated (yea I made that spelling up) that I'd been out 10-15 minutes. I reached over to Oreo's water bowl and dabbed some on my forehead. I then began to yell for Gail (my wife). It took a couple minutes for me to get her attention. She came & attended my immediate need of a cold rag and some pillows so I could lay back down on the floor. Should she call 911? I don't know; give me a couple minutes to see if my dizziness passes. But the cold rag and pillows wasn't going to cut it this time. She called.

Funny are the thoughts that run through your head when abnormal cicumstances happen to you. Gail (other than obviously being worried for me) was worried the sirens would scare Oreo. I just hoped they didn't wake the neighbors (it was about 4 AM). The ambulance arrived in storied fashion and rescue personnel filled my living room. The first thing they wanted to do: talk. I suppose it was to ascertain my state of consciousness but I was hardly ready to have a fulfilling conversation. What happened? I sink-uh-peed. How do you feel? Warm, wet, nauseous, and dizzy. Ok now time to check my pulse and blood pressure. Ok, I think we need to get you to the hospital. What so soon? But we just started! Well that's what she'd recommend. Try to sit up and see how you feel. I sat up. Yea, I think the hospital would be good.

Riding the stretcher was cool. I was strapped on like in the movies and wheeled over all sorts of obstacles on the way to the ambulance. I looked for any sign of my neighbors to give them a triumphant thumbs up but no one was in sight. I guess the crowds you see in the movies are just a Hollywood thing. They lifted me into a refrigerated truck (also called an ambulance). After being strapped in, we were on our way. I want to say my rescue attendant was attractive but every time I tried to focus I grew nausous looking at her upside down face, so I just closed my eyes and listened. When you have your eyes closed it's like you become a third party at that point. I was privy to the conversation between the hospital and the ambulance personnel. "We have a 45 year old male...". Wait, I'm only 41! Too fatigued to talk, I simply held up my fingers to give her the correct number. I don't think she noticed b/c she was still talking to the hospital over the radio. "We're going to start an IV at this time...". Oh great. Of course with the truck bouncing all over the place, cords flew here and there even hitting me in the face and the first attempt failed. "Are you on blood thinner"? Ah they must have had trouble stopping the bleeding. As a matter of fact I am. Attempt number two was successful but hurt something awful. I really should be used to all the sticking by now.

After being whisked straight to a room I think to myself, wow this is service! No waiting room for me! Three nurses swoop in and begin the process: move to a bed, remove clothing, adorn beautiful hospital gown, IV, check temperature, attach oximeter, attach sticky pads to chest for monitors...really that many? After that it was the norm, chest x-ray, blood work, monitor vitals, can I get a pillow? Doctor visits a couple times, checks results, more monitoring...diagnosis SINK-uh-pee. "Will I be here long enough for first breakfast"? Ok to release, be sure to contact your doctor (seeing him Friday as scheduled anyway so sure), seek immediate medical attention if you have any of the following, yada yada.

But this story isn't about a hospital visit (well maybe some of it is). There is a score to settle. I get home. First thing, shower off the SINK-uh-pee...and when I step out of the shower that's when he reappeared. The BUG. Mr. I'm Faster Than You. "Yea I made it all the way from the living room to your bathroom because I knew you'd be here after your unfortunate accident. I saw the whole thing! Catch me if you can"! He darts under the shower rug. I may be many things but stupid is not one of them. I immediately call for reinforcements. "GAIL"! Being on alert status, she comes quickly. "He ran under the rug; I don't want to bend over again". She removes the rug and catches Mr. I'm Faster Than You and that's that. Bug-1 Gail-1 Tony-0.

True story, the End.

Tap, tap; is this thing on?

2009-08-02T00:42:00.002-04:00

Today was the day. It had been ten months since my last visit. The heat of the day would only make it harder. Always harder when hotter, at least that's what they kept telling me. My gear was packed and I was ready to venture outside. The summer heat showed no mercy as I opened my truck door. A thin line of dust covered my dash, seemingly melted into place and as innocent as fallen snow. My first act was to crank up the AC, then dive for cover as the explosion of dust from the unused vents covered the exact spot I would have been. Another crisis averted for the moment. The heat eventually gave way to pulses of cool air breezing past my face and feet. Ahhhh, one of life's little pleasures for sure. The seat hugged my body as if it had known all along that I would need the correct mixture of incline and distance. Familiarity took over; I smiled and let myself release some stress with long breaths. Maybe today would turn out OK after all.

The drive was pleasant. The motion of life I had left behind was twice as fast as I had remembered. So many people...so many places to go...seemingly so little time. I eventually found a break in the traffic and accelerated to the appropriate speed. Things zipped by so fast; signs, cars, fences, faces. I was on some kind of rollercoaster ride, everything flashed into and out of focus as if it was never really there; like I had simply imagined it. Once I felt comfortable with the racing stream of cars I dared to look down at the speedometer; life was blazing by at a head-spinning 45 miles per hour. I smiled at my self-imposed fears and began to enjoy the scenery as I drove. I had forgotten this world actually existed. Life pre-PH; where people were always in a hurry. Things had to get done, and they had to get done fast.

I arrived at my destination wondering what news the check-up would give. I had the same doubts that plagued my mind every visit. Had I waited too long for the check-up? Would there be some problem they could have fixed if only they had caught it in time? Why did I always procrastinate? Why did I always dread the necessary? Should I have brought my wife in case I heard the worst and needed support? Time would give the answers I guess.

The wait wasn't terribly long. "Mr. Martin"? The scowl on the attendants face didn't fortell good news. "Yes", I responded. An eternity passed as the attendant looked at the computer screen and typed furiously and then again as if he had not gotten the correct answer he was looking for. "It seems....everything checked out". I visibly relaxed at the news. "Will this be debit or credit?", he asked. "Debit please", I responded. Life would go on it seems.

A multitude of thoughts crossed my mind on the way home, not the least of which was why they quit putting inspection stickers on windshields after a state inspection. Perhaps it's so you'll alway worry about whether you've waited too long for your check-up. I guess I'll never know.

Short Update

2009-03-24T06:22:00.002-04:00

Time to catch you guys up.

Life in these parts has been a real ho-hum time. A lot of nothing going on. Had my echo - no change. Took my dose of 6MW - scored a 474! The doc was pretty happy to see that, so happy in fact he doubled my Revatio...huh? Seems he wants to see just how much better he can get me, kinda like he's building the Six Million Dollar Man (in pharmacy costs - chuckle). The additional Revatio has me feeling pretty good but I'm gettin a stuffy nose again. Hopefully that will pass as my body adapts to the new dose. I know, as side effects go I have it made compared to most others.

You know a part of this whole gig that I underestimated was depression. It's not like I lay in bed crying or anything (like I used to) but the extreme loneliness of being home by myself all day while Gail is workin is pretty craptastic to say the least. Sometimes I can fool it by reading a book or watching a movie but that's no substitute from the social time I used to get from co-workers, golf buddies, and guys night out. The thing is, going out takes so much effort that I'm exhausted by the time I get anywhere. Some days I envision cleaning a room and actually get as far as the first item - ha. Well at least I have Oreo to keep me company.

Well that's it for me. Same ole, same ole. I hope you guys are doing well. As for me, I need to buckle down & start taxes...yippee!

Take care,

Short Update

2009-02-09T05:23:00.004-05:00

Hi fellow PH'rs,

I know I've been slackadaisical (don't spell check that :-) since the holidays and I don't really have a good excuse. I've kinda felt like that ornamental piece sitting in your den. What's it for? I don't know. What's it do? Nothing much. Why'd you buy it? Because I likey the knick-knacks. Well you get the idea; I'm just here. February looks to be an interesting month. I have an echo on Wednesday and a 6MW the following week. Nothing has changed functionally but I gather that the King's looking for some reason to get me on the inhaler. I know that is cake compared to what most of you are going through but it's an extra co-pay for me & does require a tad more maintenance. His intentions are good; he wants to get me a bit more functional. Like TW & his remodulin, I fought it off last time. I'm not goin to lose any sleep on it this time though. What will be will be.

I need to get my butt in chat to give the newbies the same support I got when I met you guys...but I'll probably just turn it into a jokefest. I can't seem to take things so seriously. It's like there is a smile in everything I see; life is funny, people are funny. If it doesn't make you cry then it should make you laugh kinda attitude. Life can also be suffering and once you realize that then you understand that all the worrying is well...funny. A movie quote I just love from The 13th Warrior: " Fear profits a man nothing". And so it is with me. I used to be the worry-type; everything had to be perfect. If it wasn't, then there was another cup of stress to go with my morning yogurt. Now-a-days...it's more like a cup of oh that's nice, followed by comical sarcasm.

It's tax time. That's going to be loads of fun. Sick pay, SSD benefits, work disability, stimulus check, 401K, do I file jointly as per norm or figure out if we can save by me filing separately. Fun...lots of it.

Family is doing well. Oreo is as spoiled as ever. Gail is doing well; she has a decent set of kids this year (teacher). I wish I could do more around the house to help her out. I kind of feel like Fred Sanford while Lamont does all the work.

So of all the foods to get a recall: peanut butter? Are you serious? That's a staple in my diet. No one ever had an urge for a banana and jelly sandwich.

I've been reading some really good books, going through the stack I got for Christmas. I like to write but I love to read.

Weird event: Last three times I've been to the pharmacist, three different people greeted me by name. I must really be a regular. That's nice (see above).

Well, I've checked my calendar today and I've got some sleep and slack to get done. You guys take care. You can always reach me at phtony06@gmail.com if you ever feel the need to fratenize. Give me a day or three to get back to you; I'm a very busy man.

Thanks for reading & I hope you all are feeling great :-)

Tony

Let the Good Times Roll

2008-12-30T17:19:00.003-05:00

I've been feeling better than average of late and I'm afraid to change any routines so that I don't jinx my luck. Maybe it's the fact that Gail hasn't had to be at work and I get an extra portion of TLC (not to mention one extra cooked meal per day - ha). I've been trapped inside on cold days as my neighbor heats his house with wood. So whenever I step out, I get an immediate breath of wood smoke (ironically I used to love that smell). I don't fault the circumstance; it is what it is. It does make trips in the truck that much more enjoyable as I can get away, letting the air flow through my hair as I stick my head outside the window while driving down the road (OK not really but that's what Oreo does). Life's small pleasures...gotta love 'em.

I got a couple of neat presents for Christmas that help me monitor my stats. The first is a heart rate wrist monitor. It has a couple of really cool features one of which is downloading the saved information to the computer. I also got an oximeter. Measurements so far have been:

Sat: BP: 119/77 O2: 97

Sun: BP: 103/65 O2: 93

Mon: BP: 123/72 O2: 95

Tue: BP: 106/61 O2: 94

I've been taking the measurements after I get up in the morning just after taking my meds and before breakfast (or lunch depending on the time of day :-). I'm know that you get different readings at different times of day, at different levels of activity and so forth. I plan to look for trends more than focus on any single reading. I also plan on taking the two items to my next doctor's visit to see how accurate they really are. Worse case scenario is that it's fun to keep track of this stuff.

I was in a true state of depression the day that Dallas got trounced by the Eagles. A couple of other issues had me feelin' down. Isn't it funny how we can tie our emotions to the success or failure of a sports team that we are no part of? As with most things though, I awoke to a new day with a new smile. It wasn't a total loss after all; I had won my fantasy football season championship and $100 prize to go with it. Woot.

Judging from the blogs I've read it seems everyone had a nice Christmas. I hope that continues through the new year as well. This is one of my favorite times of year. I love watching other people put aside their differences and sharing an all around feel-good moment. If only we could be that way year-round.

I don't think I truly have any New Year's resolutions this year. Maybe that's a final sign of my acceptance as to what this is or maybe it's a sign of contentment. I don't know. Either way I don't see any major lifestyle changes unless my health takes a turn for the worse. Perhaps I could clean the house more often...lol.

Well, I'm gonna head out. Take care all and have a great week!

Pack Leader Names Important Cabinet Post

2008-12-23T12:35:00.005-05:00

Dad-daddie was too tired to write this week, so he asked me to take over for him. We had a large amount of invasions this week so I was named official Secreterrier of De Fence. Mom-mommie didn't have to go to works so I had dubble guard dog duties. The mailmens were outta hand this week as they consistently attack the house with packages. I wo-man my perch in the picture window so I can see them coming a mile away. They won't sneak past me! After I wake up Dad-daddie with a resounding RAWR, I sniffle the packages to make sure no goodies sneak by me. Then I shake my tail-feather at the mailmens to let them know they are free to go. Apparently this is that time of year when Dad-daddie and Mom-mommie need me to shred all the wrappin papers that hide my toys. It's a good thing because my toy bin was gettin empty. Mom-mommie can almost step over it now. Sometimes I have so much fun, I can't tell the paper from the toy. When I rip off the paper and toss it into the air, they call it makin snow. I make good snow! It sounds like I got the raw end of the bone but I'm coming out ahead with the xtra duties. I get xtra rib bones to gobble. If only I could get Dad-daddie to share his negg-nogg.

Well, Mom-mommie looks like she may be layin down to watch televisions so I gotta go crawl under the covers and get some sleepytime. You never know when the next attack may come and I have to be well-rested.

Merry Christmases to all!

Oreo

Twas the Week Before Christmas

2008-12-16T10:37:00.008-05:00

Twas the week before Christmas and all through the city,

The shopping deadline was near and I was not done; what a pity.

My cannula was hung on my ears with care,

In hopes that O2 goodness soon would be there.

The traffic was daunting and the singers were harking,

I laughed at the madness and pulled into my favorite handicap parking.

The store was lit like the sun in the sky,

Of course I had the medical side effect: spots in my eyes.

The shoppers were scurrying, this way and that.

But they made way for me as I wore my SOB hat.

I had just begun shopping when I heard such a clatter,

I peaked into an aisle to see what was the matter.

Away down the isle I flew like a turtle,

A stack of unshelved products in the way, just a hurdle.

I landed without grace, dignity, or honor,

You see I face planted into the butt of a reindeer called Donner.

Off Dasher, off Dancer, off Prancer, off Vixen,

The holiday decoration sure needed fixin.

I came to my senses, my cannula askew,

How to save face? What to do?

I needn't have worried, my honor intact,

I looked down the isle; the situation was jacked.

Two couples were arguing over the last toy on a shelf,

Their kids were dressed up as an angel and elf.

The boy with long ears, the girl with her wings,

They smiled at each other as their parents argued over things.

The adults had faces full of anger and stress,

Who better than I to help them out of this mess?

So I headed their way with a smile full of charm,

I would do a good deed; what's the harm?

I forgot to mention that I'd dressed up as well,

My costume was laden with holly and bells.

I interrupted the couple, their behavior outrageous,

I gave them a smile I hoped would be contagious.

I commented on why I loved Christmas, all remembrance and giving.

How much I loved Christmas when my parents were living.

I looked at the children, quite content in their glee.

Then back at the parents with a nod and a plea.

The parents made up, their tiff didn't last.

Saved by the ghost of my Christmas past.

They replaced the last toy and looked for another,

Something else that would satisfy sister and brother.

I felt quite happy and proud of myself,

Knowing that Oreo would enjoy...the last toy on the shelf.

If I Had to Teach the Alphabet

2008-12-08T02:51:00.030-05:00

I was laying in bed night before last wondering what I'd write about this week. Unlike some, I allow my mind to wander to strange places. I just make sure I give it a slice of bread so it can make a bread crumb trail to find it's way back. Like a lost dog, it always seems to know the way home. Here's what it found this week:

A - A is not for apple; you'll probably end up choosing the Doritos anyway. A is for attitude. Bad things happen in this life; in many ways it is not fair. How you let it affect you is up to you. If you have the right attitude, then things will always fall into the proper perspective. If you have a bad attitude, then life's burdens will magnify exponentially. Pass the apples please.

B - B is for book. Put down the remote or Playstation long enough to open one. I taught myself how to change the carburetor on my first car by reading one. I learned how to build computers by reading one. I caught clues to life mysteries by reading several. I finally learned how to control stress by reading one. I escape into the mind of the author when I read one. You'd be surprised at how fulfilling that can be.

C - C is for consequence. Life is a sum of decisions that you make. Take the time to think things through before you make them. The world is full of "if I'd only known then what I know now" cliches.

D - D is for diversity. There is no one way things are supposed to be. People are created differently; respect them for it and lose the "if it's not like me.." biases.

D - OK, we have a tie here. D is also for desire. When we have feelings of regret and stress, it is because we desired something we didn't get. If you let this grow too much, you will end up in a cyclical pattern of disappointment. As Sheryl Crow sings: "It's not having what you want, it's wanting what you've got".

E - E is for education. Education is the single greatest tool to protecting yourself against life's hardships. Whether it's learning to cultivate your mind, body, or soul; education will allow you to make informed decisions, many of which could permanently change your life.

F - F is for friendship. Friendship is a lot like marriage in that it's a two-way street. If you stop maintaining your side, then potholes will eventually make passage impossible.

G - G is for good. When in doubt, do the thing that makes your conscience feel good. Even if it goes against the flow, you'll be able to live with yourself later.

H - H is for happiness. I can find no other single word that would describe my goal in life. Do what makes you smile. Just make sure it's legal.

I - I is not for igloo. Why teach someone a word they'll use maybe 5 times the rest of their life. I is for ignorance. Ignorance is one of the top maladies of our lifetime. If you don't know enough about something then see "E" above.

J - J is for judgement. Use good judgment when making decisions, and don't judge others based on your biases.

K - K is for kindness. A little goes a long way. If you're kind to people you build friendship capital. You may receive kindness in return; you may not. But odds are you won't receive a slap in the face either.

L - L is for listen. This means you take the time to actually ingest what people are saying. If you're formulating your response before they finish (or rudely talking over them) then you're not listening, in which case it's a one-way conversation.

M - M is for manners. Using manners is a lost art. Say please, thank you and you're welcome. Say yes mame and no sir.

N - N is for nurture. Bring something to life, and then help it grow.

O - O is for observe. Watching how things and people live and interact can be a very pleasant activity. You may even learn a thing or two.

P - P is for pulmonary hypertension. We have to get the word out someway don't we?

Q - Q is for quiet. Step out into the forest or on a riverbank and quiet your mind of all of civilization's noises. It's true therapy.

R - R is for responsibility. A powerful word, responsibility is a noun you want associated with your name. Responsible people get rewarded, become role models, and are respected for their trustworthiness.

S - S is for sex. You'll probably end up having it at some point in your life. Have it responsibly and with someone you spend quality time with.

T - T is for teach. Want to rid the word of ignorance? Take the time to explain something to someone who could benefit from it. Making people around you smarter will only improve your life. (I'll go first, T is for two is for too is for to. Learn the difference).

U - U is not for um. If you don't know what you're saying, then pause long enough to think it over. Don't worry, we'll wait. U is for useful, as in make yourself useful. You don't have to wait to be asked to do something beneficial for another.

V - V is for vision. Learn to see things as they could be, and then make it so.

W - W is for wisdom. One of my favorite words, wisdom is the sum of intelligence and experience. It could also be described as the sum of knowledge and common sense. Strive to be wise, not a wise-ass.

X - X is for xenial. Also know as being hospitable. Scroll up to see friendship capital.

Y - Y is for youth. You only get one. Make sure you enjoy it. If you're in an abusive situation, seek help.

Z - Z is for z's, as in time to get some. Everyone take care.

Sleep the best medicine?

2008-12-03T11:39:00.002-05:00

OK, I know I missed yesterday. But I have a good excuse. You see, I was asleep. Not just at night, not just in the morning, not just in the afternoon, but all day. It happens rarely but when it does, I feel like a new person the next day. Weird thing was, I slept most of the day Monday too. I feel like a million bucks! I wish I could bottle this & break it out when the going gets rough. I felt pretty lousy all weekend so I guess I was due you could say. Anyway, that's what happened. :-)

Thanksgiving came & went; Dallas won, no food comas, plenty of goodies all the way around topped off with a swig from the eggnog carton. Wife doesn't drink it so I can drink from the carton (a man's innate desire by the way). I had a good time reading all the blogs & what everyone was thankful for. In a weird kind of way, I'm thankful for having PH. It's helped to slow me down so I could enjoy the pleasures of my life and virtually eliminate stress. It's helped me understand what's really important in life (I sorta knew all along but was too busy to notice/appreciate it). It's helped me to pay more attention to my body and mind. It's helped me to spend more time with my family and my dog. It's helped me to be able to sleep anytime I want to (oh yea, we covered that already, lol). It's helped me to meet new people in a virtual world that have a lot of class and character. It's helped me to appreciate what I have rather than worry about what I don't. It's helped me to catch up on my reading. It's helped me to get better parking spots at the store. It's helped me retire my huge set of neckties that choked me everyday. It's helped me appreciate the days I feel well. It's helped me appreciate the job that our healthcare workers are doing. It's helped me learn how to make spicy chili...it was a PH chat thing. It's helped me to better understand how my mother, father, stepmother, and grandfathers felt when they didn't look well. It's helped me and I am thankful.

Now that doesn't mean I'm glad I have PH. But someday when the cure comes along (hopefully in our lifetime), I will have a better understanding of what really matters in life & won't let corporate pressures stress me out. I would get a job either writing or teaching, or something PC related (other than working accounts, claims, and files). Wonder if I could make a living playing Scrabble, lol.

Well anyway, that's my offering for today. I know it's a weak effort but I have an appointment with the CPAP this afternoon. It's a medication after all. Three doses a day at three or more hours per dose. Does a body good.

Cheers,

Tony

What Really Mighta Happened at Plymouth Rock

2008-11-25T13:14:00.012-05:00

"Land ahoy!" cried the lookout in the crow's nest of the constricted blood vessel. The boat's passengers began to strain their eyes for sight of their salvation. Pillgremlins, they were called. They had sailed all the way across the ocean in hopes of escaping their constrictive oppressors. The journey had been long and weary; the vessel had taken on some water retention so many of the Pillgremlins had become bloated and therefore welcomed the sight of dry land, an outhouse, or even a tree.

"Launch the life boats my sick mates" yelled the captain. The crew wasted no time in lowering the boats for the Pillgremlins. Reaching shore, the captain pronounced "I shall name this place Chevy Hard Rock Cafe."

"Doesn't that sound a bit commercial captain?" asked one of the Pillgremlins. "I'm kind of partial to Plymouths."

"Yes, perhaps it does. Plymouth Rock it shall be then. Now someone gather firewood, my blood thinner is making me shiver."

And so the Pillgremlins began settling in, some gathering firewood while others made shelters. Autumn had begun to take the land, leaves changed their colors and fell to the ground.

"What shall we do for food captain?" asked the cook.

"Well normally I just ask the wife to make something but since she didn't make the trip, I'll send out four hunters."

Three days later on the brink of starvation, the hunters returned. "What did you find?" asked the captain. The first hunter replied "Foul."

"Fowl, excellent!" exclaimed the captain.

"No, foul as in f-o-u-l. I found this vegetable that looks like corn, but it's all black and red. Well beggars can't be choosers. I suppose we could have some maize-on-the-cob."

"And what did you find?" asked the captain of the second hunter.

"I found leafy greens." replied the second.

"Bah!" cried the captain. "You know we can't have those in abundance. I don't want to increase my coumadin dose. What of the third hunter then?"

"I found a fruitcake captain!" proclaimed the third hunter. "But it tastes kind of old."

The captain plants his face in his palm. "Are we destined to starve? Save the fruitcake until Christmas; it might be better by then."

"All is not lost captain." stated the fourth hunter. "For I have found a turducken!"

"Rejoice!" yelled the captain. "You have done very well hunter. How did you come by such a tasty feast?"

"Twas the natives sir. They have invited us to their fall festival."

"Excellent." cried the captain. "Let us meet our gracious hosts."

The Pillgremlins journeyed to the camp of the natives and it was there that they met their leader.

"Greetings, my name is Squanto and this is my blood lab technician Pokeehauntus. You must be the Lone Rangers?"

"I am Agent Smith, agent John Smith." replied the captain. "We thank you for your hospitality in our time of need. I was beginning to think I'd have to eat the fruitcake."

So the natives and the Pillgremlins went on to survive together for many centuries thereafter. And that's what really mighta happened at Plymouth Rock.

PH Awareness Month - The Rest of the Story

2008-11-18T11:10:00.001-05:00

November has been dubbed PH awareness month and if you're a regular reader of this blog, then you no doubt have found the blogs that are doing an outstanding job of defining the disease. Also if you're a regular reader, then you know I do things a bit differently and to that end I give you this week's offering.

It started out like any normal hiking trip. The plan was to navigate a little over 10 miles of the Uwharrie Mountains ending at my campsite in time to cook dinner and possibly read a chapter or two of a good book. I was no novice of day hikes and had a 15-miler to my credit the season before. I had checked and rechecked my gear, attempting to utilize efficiency and limit the amount of weight so I could make good time. The only thing that weighed much was the water I was carrying. I decided to err on the side of caution and grabbed two extra bottles to go with my Camelbak backpack. This section of the Uwharries was new to me but I had no worries. I had studied the map, memorized routes to take at trail crossings, and even checked elevation changes. The forecast was for clear skies and an overnight low in the 40's. The weather was briskly cool but I knew the hiking would more than warm me up.

The first couple miles of the trail went very smoothly. The forest had been ravaged the previous year by a forest fire and although it was recovering, there was no dense vegetation to go through. There was no animal activity, other than birds. After taking a couple of snapshots of the devastation, I headed back down the trail. The next section of woods was unaffected by the previous year's fire, but it had been hit by hurricane winds and there was deadfall everywhere. There was some evidence that caretakers had begun to clear the trail, but some of the trail was still blocked by massive trees. I rarely liked to hike off-trail because of the harmful effect it can have on the plant life, but I had little choice. At some points in the trail I could hop up and over the fallen trees, taking care not to step on a copperhead or rattlesnake on the other side. But the going was slower than I had anticipated and the constant deviation required additional energy. I drank more often.

After topping a ridge I decided to break for lunch. My energy level had dropped and I was taking in more water than I had ever before. The area ahead seemed to be unaffected by either the fire or the hurricane. The vegetation was thick. So lunchtime it was. I broke out my trail food favorites: peanut butter and jelly sandwich, salted peanuts, and canned peaches for dessert. I topped it off with some more water and made for the next ridge.

While the wildlife had awakened in the previous section of trail, this section was abuzz with the sounds of the forest. I could hear frogs, birds, squirrels, and chipmunks chatting everywhere. Evidently the cool nights had yet to extinguish the insect life as mosquitoes, horse flies, dragon flies, and locusts flurried about. The sound of the locusts alone was almost deafening. I continued to hike, enjoying the change of scenery and sound. Eventually I reached a point in the trail that had obviously not been maintained in a long while. The vegetation was so thick I could not see the forest floor. The parts of the forest around the trail was even thicker. I decided to take another break to review my options, besides I needed the rest. I could turn around and go back but I was more than half way and that might have me reach the campsite later than desired knowing that I had to traverse the deadfall again. The other option, of course, was to go forward hoping that the vegetation would thin out and I wouldn't get lost. After checking the map and my water supply, I decided to go forward. I needed to reach my reserves sooner than later. As I mentioned the vegetation was so thick I couldn't see the forest floor. So I had to rely on trail markings on the trees as navigation points. I had made some decent progress through the maze when I heard it, the sound of a rattlesnake. Being a cautionary type of guy, I listened to various rattlesnakes on the internet so I would be able to recognize their tell-tell sound out in the wild. I was 90% sure that I was within close enough range of one for it to emit it's defensive rattle. Normally I would follow a brief shot of excitement with a move in the other direction, but with the deafening sounds of the locusts I couldn't tell which direction the rattlesnake was. I did know that if it was rattling, then I was too close.

Wikipedia describes the fight or flight response as the biological response of animals to acute stress. The rattlesnake was stressed due to my proximity and chose to rattle thereby warning me I would have a fight on my hands should I choose to advance. I suffered no such gallantry. I broke into a hectic run through the underbrush, crashing through the portion that I assumed to be the trail ahead. I'm not sure how long I ran, but I ran until I was out of breath. The good news was that I no longer heard the sounds of the snake and being of sound mind and body I also checked that it didn't have any illusions of chasing me down the trail. I had also managed to escape the dense underbrush. After taking at least five minutes to recover, I noticed that I was no longer on the trail. My flight had taken me to an open area of the forest but there was no trail in sight. I would have to double back in order to find the trail. I decided that being lost without a snake was better than knowing where I was with one, so I traveled the perimeter of the vegetation until I saw a trail marking on a tree. Soon thereafter, I found the trail. Knowing it was a good time to regroup, I checked the map and had some more water. The highest elevation of the hike was just over two more ridges. By the time I reached the second ridge, I was completely exhausted. I began to take more breaks and drink more water. I ate the last of my snacks, even my emergency food.

When I topped the ridge, I expected to see the trail head up on a series of switchbacks (zigzag pattern of trail that allows for easier hiking up steep inclines). Instead I found a rock ridge, the trail went straight up! I would have to climb up a rock face in order to continue and believe me there was no turning back after what I'd been through. As I climbed all I could think about was how snakes loved to warm themselves on sunny rocks. Each time I pulled myself over a rock I expected to be face to face with one of the cold-blooded reptiles. As luck would have it, all I encountered was a disinterested salamander. By the time I reached the summit, I was spent. I dropped to a knee to recover my breath yet again and drink some more water. I was met with the slurping sound of an empty container. Great! I was out of food, breath, and now water. It took me 30 minutes to recover from my ascent. I noticed the sun was much lower than I had expected it to be at this point in the hike. After checking the map and my watch, I realized I was way behind schedule. Even allowing for elevation change, I had alloted plenty of time to finish the trail and have dinner before nightfall. What had changed? It was then that I realized I had taken far more rest breaks than I normally do. The breaks had become more frequent throughout the hike and had lasted longer than normal.

The enthusiast in me wouldn't give up. Even though I hadn't brought my water filter, I could drink from the streams if it became necessary. And I knew enough woods craft to make a lean-to if I had to spend the night in the forest. But I wanted these to be a last resort, so I got up. I got up and I trudged ahead. The hike would hold no more surprises for me. I labored into my campsite a full hour after nightfall. I was too tired to cook, so I grabbed some warm gatorade and a candy bar for dinner. I put up my tent and crawled into my sleeping bag zipping it almost all the way up. I had survived my hike, but it would be my last.

On my next trip to the primary care physician I mentioned my hike and how my breathlessness had contributed to my situation. We both thought it was my asthma, asthma and dehydration. So he prescribed Advair to go along with the inhaler I had always used. That was the fall of 2005. One year before I would be diagnosed with stage IV pulmonary hypertension.

As Paul Harvey would say, "And now you know...the rest of the story."

I Don't Speaka Tha Language

2008-11-11T12:52:00.013-05:00

I've always been a big believer in picking up a dictionary if you didn't know what a word meant. Too many times, we see people ask someone else for a definition only to forget what it was a day later. When I got a copy of my latest echo exam, I knew immediately that it was going to be hard to practice what I preached. It seems that medical language is something more than a joke uttered about some drug ending in 'pril, 'pro, or 'prin. Before getting PH, I used to laugh at the medicine prescriptions on the way to the pharmacist, as there was no way they would be able to decipher the chicken scratch and give me the right medicine. But it turns out that doctors, nurses, and pharmacists do speak a different language, something called medspeak.

Medspeak started out as a way for village medicine men to communicate with their fellow shaman without upsetting the village leader, or for that matter the village idiot. If a village person became agitated or distraught, the medicine man would prescribe something called the chilquitadukadukapril. That was later dumbed down to chill pill. The tradition has lasted until this day.

Getting back to the echo results, I see some recognizable words like ventricle, valve, and doppler. But it wasn't the weather that was being measured here. Evidently there is some tomfoolery going on in my right ventricle and right atrium. The shaman was back muttering something about tricuspidaorticmitralscleroticregurgitation. This was definitely something beyond my understanding & also that of Merriam-Webster. It was time to take a closer look.

Left Ventricle: Normal in size - left ventricular ejection fraction is normal (sounds like a math problem on a genius edition of Jeopardy) - transmitral spectral Doppler flow pattern is suggestive of impaired LV relaxation (OK, rest & relaxation can't be all bad) - flattened septum consistent with RV pressure overload (I don't even own a RV)

Right Ventricle: severely dilated (I promise I didn't smoke anything) - systolic function moderately reduced

Atria: left side is normal - right atrium is severely dilated (again with the implications - geesh)

Mitral Valve: normal - no significant stenosis - trace mitral regurgitation (I don't recall having thrown up recently)

Tricuspid Valve: normal - moderate to severe tricuspid regurgitation - right ventricular systolic pressure is elevated at>60mmHg (OK this sounds kinda serious, but is greater than 60, 61 or 90? All this medspeak and no specifics)?

Aortic Valve: is trileaflet - mildly sclerotic - no aortic stenosis - no aortic regurgitation (Great...mildly erotic leaflets that don't make you throw up)

Pulmonic Value: not well visualized (maybe because they were the ones smoking drugs & had the dilated eyes, not me)

Pericardium/Pleural: no pericadial effusion (evidently, they weren't invited to the party)

The echo goes on to list a number of measurements and calculations, some of which surely could tell you how long the man has lived on the moon. I knew I should've manned up & paid the cardiologist $50 for the Medspeak-English Dictionary. I see the Lung Shaman next week. He better have answers or I might have to break out the voodoo doll.

Yes We Can

2008-11-05T10:54:00.004-05:00

Last night I heard glass ceilings shatter all across America; I felt a burden lifted from my shoulders; I sensed a change in the fundamental attitudes that have kept us pinned in the roles we were born into; I saw several American iconic figures brought to tears; I tasted tears of my own as I saw history in the making; I thought that my lifelong desire to see good overcome everything that would keep good from victory had finally come to pass, and I breathed without labor for the first time in two years.

Now that I know we can; I hope to live long enough to see that we did.

Foliage Wars

2008-11-04T09:57:00.012-05:00

This week has seen a rise in physical activity if for no other reason than getting up to answer all the robo calls from political hopefuls. (It seems an unpublished phone number is no obstacle to those who want to take advantage of the politically uneducated). I took advantage of a feel good day to cut the grass for the last time this season and in the process blow all the fallen leaves to the wood's edge. My wife has this thing about leaves. I guess you might call it a pet peeve. To me, a yard full of fallen leaves is but a sign of the season. To her it's like having a sink full of unwashed dishes. The siege towers that gave us a measure of shade and privacy in the summer now spew forth a profusion of optical debris. And when the foliage flies, she declares war. She will spend an entire afternoon raking leaves, bagging them up, and dragging them to the curb for removal. She has already blown up the leaf blower we bought just 3 years ago. Now I have been recruited to help in the fight, an army of two if you will. By riding the mower, I can theoretically help stem the tide of the enemy. I think for a moment about using gas prices as an excuse but the serious look in her eye tells me that I'm better served to save that for a winnable argument down the road. So the choices before me are to buy a leaf catcher for the riding mower, detach the side guard so I can mulch, or leave things as they are and just blow the leaves back to the forest's edge. I choose the latter. Catching the leaves and leaving them at the curb to be hauled off seems akin to sending your child off to military school. Mulching them up may have a nutritious effect on the yard but I'm not crazy about having small oaks sprout up everywhere. At least by blowing them aside they're still part of the landscape. Sure the squirrels have to dig a little more for their nuts but Oreo appreciates having a bed of leaves to do her business. I know you think I'm stretching a bit for justification but lets not forget the PH implications. The only thing I know for sure is: I won't frown any more when I see a youngling clean their room by pushing everything under the bed.

News you probably can't use...

2008-10-28T08:44:00.012-04:00

I watched The Bucket List. I know the normal person would say big deal but for me it was a hard thing to do. I ordered it from Netflix because my wife wanted to see it and I did too...at some point. It lay next to my TV for almost 3 months (now part of that was out of sight/out of mind thing). As I watched the movie, I naturally gravitated to thoughts of how it related to me and whether I might have any sort of interest in a bucket list of my own. I came to the conclusion that I don't. For me ultimate happiness is being with my family, delving into a good book, sleeping in on cold mornings, playing with Oreo, getting engrossed in a good movie, eating a hot bowl of spaghetti, and playing on my PC. There are other things that would make the list of course. But those belong to another life, a life without PH. I'd give the movie 3.5 out of 5 stars, mostly because of the actors and the relevance of the situation. I enjoyed the way that the two characters were able to change each other's life in a positive way. I won't give away anything else in case you haven't seen it, but it's certainly worth a look.

In other news: I voted early this year for the first time ever. With each day being a crapshoot on how I will feel, I decided to get out on a good day. The lines had already formed even though I was there before the polls opened. Standing in line was a bit tough; it reminded me of how I felt at the end of the day when I was working. I guess it was about an hour's wait. I had to muster a little manliness in order not to look like I needed a chair. My decline in stamina was a little shocking considering the "athlete" I had once been. I wore my O2 in a Camelbak backpack, trimmed for it's new course of duty. Overall I felt OK afterwards; just don't ask me to do it everyday, ha ha.

In weird news: It appears I was right all along. I always knew that holding it in seemed unnatural. http://www.medicalnewstoday.com/articles/126730.php Now I have a good excuse for my wife :-).

Medically, I have my LFT & coumadin check on Friday. I still haven't heard anything new from the King as to the echo results. I did receive a letter today in the mail from my health insurance that my "prescription" for Ventavis was approved. The PH people really jumped the gun on this one. I almost don't know how to respond when I see them next. I don't want to put up too big of a stink in case I need this somewhere down the road, but I am going to have a pointed conversation and get some answers so I can get this off my chest.

Birthday and holidays coming up in the next couple of months. My wife brought to my attention a new tech gadget called Kindle. You can check it out at Amazon. It's a bit pricey at the moment but for someone who likes to read, it looks really cool. She & I do gifts a little different than most; we pick out what we want & the other person buys it. We do share one surprise gift to stay with the spirit of gift giving. I'm not sure yet if this beats out an oximeter & a wrist wrap BP/pulse reader. (Sense my sarcasm). We'll see what happens.

Other than that not much going on. I did a little off the wall writing but it wasn't finished so it didn't make this week's blog deadline, maybe next week. I was also pleased to see that Mason and Mack made it home from the hospital. I hope they get settled back in with a little more comfort.

Well, time to visit the pharmacist. See you guys next week.

The Chicken or the Egg

2008-10-21T07:50:00.004-04:00

I got a package in the mail a few weeks ago, of significant size and implied importance. It momentarily reminded me of being back at work when packages I received were always significant and my responsive action of financial implication. This package turned out to be no different.

"Dear PHTony,

Your prescription for Ventavis (Iloprost) comes with helpful this and some more helpful that. This program is brought to you from ------ Pharmaceuticals (wasn't that the same company in The Fugitive ?). As your doctor explained..."

OK I know I'm a bit forgetful now a days, but I don't recall any explaining and certainly don't recall a new prescription. The King & I have only agreed that this would be the next step should I suffer any degradation. As a matter of fact, my last visit ended with an appointment for an echo & my appointment two weeks ago was to go over the results.

The next morning I awaken to the cursed sound of our telephone. I get up to answer (which isn't really a quick process anymore) but can't reach the phone in time. The message was left by the King's assistant. Time to call back and shine some light on the prior day's mail. Well it turns out that Devlin Macgregor....um I mean ---- Pharmaceuticals has a rep in their office right now who would be willing to demonstrate their product if I would just hop, skip, and jump across town to their office. Apparently an egg had hatched before we even saw the chicken. I'm sure the King's court has nothing but my best interest in mind...um OK I'm not convinced.

I politely (I think) tell them that I'll have to pass. After all, aren't we missing a certain KEY part of this equation (the part where we review the echo results, then I actually get counseled by the King & then get prescribed a medication). We don't even know the results of the echo yet, and there hasn't been any decrease in cardio function. Doesn't the chicken come first?

Update: I went to the King's follow up appointment to discuss the echo results, only they didn't have the results (good thing my co-pay's only $50...). Being a straight-A student of hindsight, I had a good book to keep me company while I waited for the results to be faxed over. While we wait, I grill him on the chicken/egg issue. After witnessing his apology I kinda felt sorry for the guy. It's obvious that neither the chicken nor the egg come first; it's the carton...

The King receives the results but unfortunately they were coded in chicken scratch. The King can't decipher the numbers and I can't tell a chicken from an egg. So he tells me he'll call the Ricola guy (you know, the guy that gives the echo :-) and call me back. That was almost two weeks ago. I don't know how this is going to turn out, but Ole McDonald has some explaining to do.