Strolling Amok

Quiet Miracles

I suspect that it’s normal to compare current medical knowledge in relation to that of the past, and when that takes place, the new knowledge always seems to shine. I mean, we’re so much smarter now, aren’t we? Not like those stupid and superstitious fools who once practiced medical philosophy instead of medical science. Those are the inferences I detect whenever I hear the same old refrains. For example, it’s always popular to deride the medical practices of centuries ago by citing the practice of bleeding with leeches. That’s often used as a cudgel in arguments, even though bloodletting is still used today as a corrective measure for iron overload, a condition which most commonly results from a genetic mutation in people of Celtic, English, and Scandinavian descent. It has been proposed that the relatively high numbers of people with this mutation in those groups came about from the mutation being a helpful factor in surviving the plagues. On the downside, this genetic predisposition to iron overload also popularizes cardiomyopathy (heart failure and the like), arthritis, cirrhosis of the liver, and diabetes along with it. Whenever someone with iron overload came into play, the ancient practice of bloodletting suddenly validated the procedure, and it usually needed to be done on a regular basis. Unfortunately, since that benefit only applied to a mysterious subset of people, and a knowledge of why it helped was limited to preexisting philosophy and deductive reasoning based on observation, it appeared to simply validate bloodletting as worth a shot for anyone suffering from anything. The only problem was that they could only theorize about why it worked, and in whom.

Perhaps, as we get older and more exposed to modern medical practices and philosophies, it’s normal to begin to detect some cracks in the seamless veneer of modern Medical Science. I think we’re still in the medical Dark Ages, but I say that because modern doctors seldom focus on enhancing the body’s abilities to protect and heal itself. Instead, they divide up the body into different areas of practice, and focus more on suppressing symptoms with brute force chemicals. As long as they treat the problem within their own little area of chosen responsibility, they’re happy to treat them using methods that are likely to cause other problems over time, problems which will fall within some other doctor’s specialty. Collateral damage is acceptable, however regrettably. The only loser in this scenario is the patient. Diagnostic procedures and prescriptions that are expected to be taken for the rest of one’s life are often a good example of this, since many of them are likely to damage the kidneys, liver, or some other organ.  In my view, there seems to be very little interest in going past the symptom to figure out what’s actually causing the symptom, what’s behind it, and addressing that. Today’s assumption is that the human body simply goes out of whack for no reason, and that there is no causative factor other than innate defects or genetics, perhaps. The recent virtual explosion in serious ailments among people (particularly children) in developed countries, especially the U.S., betrays that dogma. It may be that one day, Medical Science will edge away from the philosophy that merely suppressing symptoms is the path to victory over diseases.

I could go on forever, but I will cut this particular rant short to shift over to my own medical circumstances. After all, it’s all about me, isn’t it? This is a personal blog, after all, so here we go.

I’ve had the symptoms of something wrong with my ability to cope with hard physical work for decades, ending in the year 2000 with the diagnosis of a classic heart murmur causing a moderate swelling of the heart (called congestive heart failure) since my heart had to struggle with the poorer pumping efficiency for so long. Add in large amounts of long-term stress beforehand, which accelerates the “disease”. In mid-2016, I had the heart valve and an aneurysm repaired, and the latter meant that I’d have to be opened up old school-style with the medical version of a Saws-All to cut through the sternum for access. Judging from the faint mist of blood I found on my lower jaw and neck afterward, they started at the bottom. My mental image of the procedure was having the strongest nurse of the bunch get one leg up over the table to catch the heel of her jackboot on one side of the cut, and yank the other side open with both arms, allowing the surgeon full access. He’d told me earlier that they spread the ribs apart about a foot, showing me with his hands. I was impressed, though to me it was more disconcerting than the fact that they have to stop your heart and get the job done within a set timetable, otherwise you’re unlikely to wake up afterward. Due to the traumatic nature of that procedure on the body, this isn’t the kind of operation that you do early as a preemptive move. The risks are too significant.

But my surgery went quickly, which I attribute to my inherently compliant and orderly nature in all things. If it weren’t for the sensation of coming out of the anesthesia too early, with the feeling that I’d been hit with a cannonball in my chest, I’d never have known anything but just waking up later in recovery. I naturally don’t know if that was the case, but it was similar to having a nightmare where you’re trying to scream but are too far out of it to hear yourself do any more than groan groggily. That only lasted for maybe a minute, and I presume that they dosed me again. No mention of such a thing was made later, and I certainly wasn’t going to ask. I made it through, and that was enough.

Things then seemed to be going well until a month later, when a fever and fainting spell threw an alarm that a heart-specific infection might be present, and if so, that would be a life-shortening event. “Get to the ER right now!” I was told. So I was tested and observed for a week, and blood tests showed nothing bad after an infectious diseases specialist showed up and did his thing. What they didn’t tell me was that the plastic ring they insert to reshape the wonky valve is (and always will be) a handy landing and breeding spot for any bacteria in the bloodstream, but I assume that it’s better not to be informed of that while you’re wiped out in a hospital bed. They finally booted me out with a nondescript catch-all prognosis that amounts to being a simple reaction to the surgery which occurs maybe 30% of the time.

Physically though, that reaction set me back to Square One for recovery, and the pace of improvement after that switched to being glacial. I returned from Indiana to my home state for a follow-up with my own cardiologist at the two-month mark, and her assessment of my 25-30% heart pumping efficiency was that the surgery apparently took place too late to do any good – thus the heart failure would proceed normally even with the repaired valve working well. See, this type of operation pretty much trashes efficiency all by itself, but the scheme is that the heart will gradually recover in a three-month window of healing and get back to a level higher than it was pre-surgery. Nobody tells you any of that beforehand of course, but below 30% is a “danger zone” where, among other complications, spontaneous cardiac arrest is quite possible. My cardiologist pleaded with me to not attempt the long trek to Arizona, and gave me one Rx that would help lower my blood pressure. When I told her that camping in Illinois over the winter was not a realistic option (my Four Wheel pop-up truck camper is in no way a cold-weather rig), looked at me sorrowfully, as if this might be the last time she’d ever see me alive. Before beginning the trip, I called my surgeon’s staff, told them of my cardiologist’s fare-thee-well, and was told “Recovery from this is a slow process. You have to give it time!” Now, this guy has been around the track a few laps, and I decided to bet on his side. He’s not exactly fresh out of med school.

But I did make it to Arizona and, as recommended, found a cardio specialist in Phoenix who was qualified to do the needed follow-up tests. That’s a three-hour drive from Wellton, but hey, I’m worth it and Medicare plus my add-on insurance was picking up the tab for all this. I don’t know if you can imagine the joy of my Inner Scotsman in seeing invoices that would buy a very nice home, and then seeing “Patient Payment Due: $0.00” again and again. Hoot mon! Nirvana. I mean, does it get any better than this?

This cardiologist, an “electrophysiologist”, also recited the three-month healing window, came up with the same dismal pumping efficiency percentage, noted the electrical problems that accompanied the basic issue, and highly recommended a type of pacemaker that would jump-start my heart in the sizable odds that it would simply stall out while I was asleep. I declined that, feeling that there are certainly worse ways to go, and that although I really enjoy my new-to-me lifestyle of marauding, that I had nearly completed my personal purposes and goals here. Truth to tell, now and then, I get almost impatient for what I know lies ahead of me, but to fully understand that, you’d have to saw your way through my The Nature of God blog post series in which God drags me kicking and screaming into faith in Him. I later found that there are groups of people wearing this type of pacemaker who meet regularly to try to deal with the psychological trauma of the electrical jolt those things put out. It’s like getting hit with the paddles on a regular basis. I can imagine that’s a nightmarish way to wake up. BOOM! Nobody told me about that, either.

Before I finally left Arizona in the Spring, the irregular electrical issues had resolved themselves, and the cardio had me more solidly on two prescriptions that lower both blood pressure and heart rate. I was told that further gains in pumping efficiency outside of that long-gone three-month window were unrealistic and simply not going to happen. His goal was merely to lessen strain on the heart and thus slow the rate of deterioration, since the later stages of heart failure are best put off as long as possible. Nothing else could be done. In a sense these meds would give it a chance to heal, though further actual recovery was wishful thinking. I internally disagreed and felt that the God who so convinced me of His existence and character was fully able to do with me as He chose. I had given Him that right long ago. Anything after that is Bonus Time in more ways than one.

Touring the country was arduous at times, since I’m supposed to walk or otherwise exercise each day. It seemed to take forever (as in right now, over a year after the relapse) to get back up to a mere two miles on level ground. At some point, the hammer drops and you are on emergency reserve. Those heart meds felt too effective because, sitting or walking, my heart was always too little, too late. You’re always too tired to do anything, and walks at 6,000′-9000′ elevation topped out at a quarter-mile, round trip, feeling much like a death march from the start. Oxygen levels in the bloodstream were way low, and one of the meds was acting as a depressant as well. That’s fun, isn’t it? Not much. You know something is amiss when it seems like unpacking a videocam is just too much to bother with.

My recent return to my cardio specialist elicited little sympathy for my whining about the meds being too effective and too depressing. Thus is ever the case. He was happy with the blood pressure reading in his office, which is always higher than “real life” readings sitting on my can in the Defiant. It was within the window he wanted to see, and he discounted my home readings that mostly hovered a gnat’s whisker above what he considered to be at the bottom of the window. You don’t want to go below 100 systolic when awake, since that puts you at risk of a train of difficulties. So he was thrilled until I showed him one reading of 89, and before he called for another pumping efficiency test, he once again tried hard to talk me into his pacemaker remedy, pointing out that he was having to dance a fine line between lowering blood pressure to save the heart, and yet not backing off the meds so much that it would get high enough to accelerate deterioration. I needed a fail-safe to protect me at the bottom end.

Surprise. The efficiency test showed that my heart was now up to a solid 40% efficiency which, given the results of his hundreds of other similar patients, surprised and dare I say, impressed him. “This is unusual but very good,” he said, “You can forget about the pacemaker. You don’t need it. And we should cut the dosage of this one in half, and see where you are in a couple of months on blood pressure. We need to find the best dosage before you disappear until next Fall.” In two months, he would hope to find no more dangerously low readings, and no more high ones, at least in his office where I might suffer the stress of accidentally viewing an invoice on someone’s desk. I think that the sonar-like test he did bills at something like $3,500. I don’t even like to be around that. Gives me the willies.

So my surgeon in Indy was right. You don’t technically kill someone, practice your sewing skills and goosh their heart with both hands for an hour or so, then button up and then expect them to walk it off in a few months, particularly after a serious setback. For all I know, maybe the surgery was too late, and I may or may not ever recover more. After all, I am now past even his expected window of healing. But I’m back to where I was maybe 8-10 years ago with that failing valve, and that’s a good thing. That’s fully functional, with limitations. That’s what I need right now, for now. I’m pleased.

I think it’s important to point out that I do not attach this efficiency gain miracle to my faith, as in, “God must be good because he overcame the expected deterioration.” That would mean that I’d consider Him to be bad if He had let things go on their inevitable path this year. What tends to break that linkage is trust. When you trust in Him, you trust in the outcome, not in your own interpretation of the outcome being “good” or “bad”. We can’t see that far. Bad things do happen, as do great disappointments, but the danger lies in our viewing them with our own myopic vision and our own understanding. As far as I can recall, I never prayed for healing from this, just for His will to be actively accomplished either way. Call it a very pleasant surprise. He has been aware of my hope, which was simply to either show or confirm to this doctor that there is something active in this world which conforms neither to modern thought nor modern practices. Now and then, it defies the odds. It’s an intervention, of sorts. Not everything is up to us, nor to fate. For me, this is mighty good news, and cutting the one Rx in half has already taken a good whack out of its depressive effects. Don’t think I’m not enjoying that little perk! Enthusiasm is not something you want to do without for a long time.

He apparently knew what He was talking about.

On my end, I’m working hard to explore ways of reducing blood pressure which center more on cause than on hammering the symptom itself with prescription drugs. After all, I now know the new window that I need to maintain, and I’m on minimal dosages of these prescription meds because in more recent years, my blood pressure never really qualified as high anyway. The damage was done in my “former lifestyle”. They’re now used because my heart can now benefit from pressures a little lower than what’s “normal”. I’d like to avoid the various side effects and unseen potential side effects of modern chemistry and, armed with the new target window, I strongly suspect that I can keep within it by taking a different and less problematic tack.

Yes, one piece of the miracle is the parted waters, but to me, the other piece of the miracle is having the faith and courage to walk the path and not turn back. That’s trust, in my book. Not so easy either, in my book.

My goal is to show up here next November meeting those targets, but without the drugs. That would further surprise the doctor (and myself), but should I fail before I get back here, I can always fall back to them if needed. That’s the thing about drugs – if a patient shows no indication that they are needed, then continuing to prescribe them would only be counterproductive, if not harmful. For the next two months however, it’s business as usual in order to get that “backup” dosage more correct. My other goal is to drop a good ten pounds accumulated during my lethargy-enforced sedentary lifestyle, but that’s a practical goal because I’m too cheap to go out and replace perfectly good vintage clothing! No further explanation needed, I assume. Part of that is also the internal result of repeated doses of antibiotics and dyes, which raised havoc with my gizzard. (And don’t offer to tell me the “quickest way to lose 10 pounds of ugly fat”. I heard that one when I was 12!)

Drat. Any time there comes a day when you have to get serious about something that might possibly involve some willpower or denial of something tasty but deleterious, it comes down to the hard question.