Epiphany Time

Last night I was exercising at the hotel and felt pretty good. I did a little over 20 minutes on the treadmill and then about 300 yards in the pool. 300 doesn't sound like much, but if you are out of shape, it's a painfully long distance.

Tonight I figured on the same thing, or very similar amounts of time. While on the treadmill I sped it up about 0.5mph faster than last night after about 15 minutes. At the 20 minute mark, when I thought I'd be quitting, I decided I wanted to watch the duct taped car on Myth Busters, so I stayed on the treadmill for an extra 10 minutes. And didn't feel like I'd done too much, which is good.

So I changed into my swim suit and hit the pool. About lap 10 of 20 (to get to 300 yards) I started thinking about what my goals need to be in this new health kick. There is the obvious goal of not being back in ICU with a sandbag on my groin holding the sutures down. But that's too obvious. A healthier heart? That's pretty simple. What I needed was some concrete goals that are attainable, but not easily.

I need something to push me, something to make me push myself a little harder when I want to take a day off.

So the longer term goal I came up with, which is an 18 month (from my heart attack) goal is to be down to 185lbs and wearing a 32 waist pant again when I take the wife to Hawaii for our anniversary.

That's about a 55lb weight loss, and 5-6 inches off of my (currently fat) waist. I'm figuring that I should hit that goal earlier than that, so about 3 months should be seeing if I'm capable of sticking with it after I hit the goal.

Shorter term; by this anniversary; I'd like to be down to 210, which is attainable if I keep some diet and exercise discipline. It's about 3/4 of a pound per week of weight loss, which is not a bad target.

As I kept swimming; 15 more laps instead of 10; and while I walked 10 cool down trips around the pool I kept repeating the goals over and over. It wasn't a "convince myself I could do it talk", it was more of the coach drilling the team on how a certain set of plays should work. This is something I know I can do, I just have to drill me on it each day at rehab, or in a hotel gym, or taking a walk with the wife.

I know I want to do it because of that obvious goal up above. And because I really don't want to see "that look" on the wife's face again when I get put in the back of the meat wagon.

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There is Some Good Everywhere

You know, the one thing the last month has me is that you can find some beauty anywhere if you look. Well, anywhere but my 401(k) since every company in it has decided the new health care law is going to require them to take a bath.

For instance, Peoria, Illinois is not my favorite city. I remember seeing it years ago with a dull gray haze hanging over it. They've cleaned it up quite a bit since those days, but the city still suffers from horrible unemployment, and has many areas that could use some sprucing up.

But when you see it from East Peoria across the river, with the sun starting to come down, it looks completely different.


It's my metaphor for the whole heart attack incident. From one angle it sucks; new diet without a lot of my favorite things. Can't really sit around and hammer beers; need to start working out. None of those are things that really make me happy.

Then there is the flip side. I'm here and get to play with my grandson John. Dylan, my daughter's first born will arrive any day now, and I'm going to be able to travel and visit them. I'm not crazy about giving up my morning donuts, but I've got no complaint about the 15 pounds I've given up by not having them.

It's also reminded me how important a lot of folks in my life are to me. After you spend enough time with people you start to take them for granted. Then when you really need them you realize why you've stuck with them for so long; and you are glad they stuck with you.

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New Outlook

It's funny how one ambulance ride can change a guy's outlook on life. 10 Days ago I was still convinced my medical issues this month were caused by a new medication. 9 days ago and a trip to the ER in an ambulance and we figured out that wasn't the problem.

I started thinking about that this morning as I was checking into the doctors office. The nurse noticed my weight was down about 12 lbs from three weeks ago, and my blood pressure was much better.

She hadn't been around this month, so she hadn't seen much of me since my physical. She asked what diet I was on and I told her it's the "I had a heart attack and need to change my life diet".

The nurse laughed and said something I've been saying for a few decades, "eat healthy, exercise often and die anyway". That's as true today as it was last Tuesday, or last month, or when I was 25. The difference is, I think I'll wait a while for the last part of it. And if that means eating healthy and exercising often, so be it.

I quit smoking just before all of the heart issues showed up. I originally did it to save money.

Suddenly knowing that my ticker might quit ticking again, I've found another reason to quit. Before last Wednesday I wanted a smoke about 3 or 4 times a day. Now I really don't care, I forget to put my nicotine patches on but don't get the jitters when someone else lights up.

When I had my physical and my cholesterol and blood pressure were way to high, I had no problem with taking the pills. But changing the diet? Hey, I like traditional cooking with butter and cream. You take the pills so you can do eat that stuff, right.

Now I've got no problem with vegetable broth instead of cream and butter in my mashed potatoes, and making low sodium soups. If it'll keep me out of the ambulance, I'll do it.

I even bought an American Heart Association cookbook, and one from Readers Digest for low sodium cooking.

And, as soon as I get the okay from the cardiologist, and my disability check from work; I plan on joining the park district gym. They've got some great cardio equipment in there, and it's only 5 blocks from the house.

I'm sure some of this new found health kick will wear off in a while. I'm not sure how long until I want to cook with cream again, but hopefully when I do too my wife will remind me of how she was feeling last Wednesday; as we sat at a gas station with 4 paramedics crawling through my truck to get me out and into the ambulance. I never want to put her through anything like it again.

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Failing Me

My personal version of Nationalized Health Care, the VA, has failed me; surprise.

I noted on the 8th that they'd be testing me quite a bit. I had a cardiac stress test that week, which I failed, and a pulmonary function which was good, and an echo test, which was also good. So, the following Monday an imaging stress test was done. Radioactive isotopes were pumped into my blood, I ran a treadmill, and then had pictures of my heart taken.

This is where the system failed. I failed the test; bad enough to cause a couple of doctors a lot of concern; but not enough to get anyone to pick up a phone and call me. I was scheduled for a visit on Thursday, so they planned on telling me then, evidently.

The problem is, I had a heart attack (luckily mild) Wednesday night. Thursday I was feeling well enough to call the VA, and notify them I'd be unable to attend my appointment, I was in the hospital due to the above mentioned heart attack, and was going to be taken for a catheterization shortly.

Six hours later (the same person) called back and asked my wife why I missed my appointment, and told her it was really important I see a the cardiologist, there were problems with my stress test. While I know the Internet isn't censored, I'll avoid posting the wife's response out of respect for any nuns who might read this.

Friday, shortly before the cardiologist who performed part of my procedure came to see me; the attending physician who treated me 2 weeks earlier at the VA called. She'd been doing follow up reviews, saw my stress test, and realized I hadn't been to cardiology (there). So she wanted to let me know it was urgent I saw a the cardiologist. I explained what had transpired over the last 36 hours, and assured her, I'd seen one, just not on my terms.

Here's why the VA failed in this episode, and why my government run health care has failed so often in 30 years. The Bureaucracy of the system is the issue. Most doctors other than GP's don't make decisions on their own.

As was my case a cardiology fellow did the (2nd) stress test, and dicated it. But he didn't call me, instead, he sent the dication to a secretary for transcription. It's not her job (nor should it be) to call patients back, so she didn't. The head of cardiology has to review the transcript in a record, and approve of any recommendations. He did, but he didn't notify me, why bother, I'd be in the next day for an appointment. Unless of course I had a heart attack.

Contrast that to how most "regular health care works". The cardiologist orders a stress test, in the case of my first one I failed. At that point most civilian cardiologists immediately admit you, and order the follow up imaging stress test. This is especially true in cases like mine with a family history and basically every bad marker for heart disease.

Then they run the next test and keep you until they have read the images and decide what it says. In my case, it would have dictated an immediate catheterization, so at that point a number of meds would have been started, and I'd have been doing nothing that could cause any stress on my heart until I was on the table getting fixed.

So instead of going from the 5th, when I was first admitted to the hospital for observation, to the 18th when I had the procedure, I probably would have been completely through the test battery and "fixed" by the 10th or 12th. Six days and 1 heart attack sooner.

This isn't to say there is nothing right with either the VA, or the Military Treatment Facility I go to for my primary care. For general care, and preventive medicine they are pretty good. My annual physical this year found that my blood pressure was getting back out of control, and that my cholesterol had jumped back up too high. It actually started the ball rolling on some of this stuff.

But once they get out of that area to specialty care, the wheels fall off. The same physical couldn't find the problem with one of my hands, so off I go to a specialist. Except there's exactly one in a hundred mile radius that will accept the government reimbursement rate to treat it. He's booked until late April. I guess another 2 months (my physical was late February) isn't long to wait.

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Testing, Testing, They'll be Testing Me!

I know I haven't been posting much, but might change this week, since I'm not at work at all.

I wish it were a vacation, but instead it's a week of sick leave. I started some new medication week back, and had some less than wonderful reactions to it. I called the doctor, he called the ER, and I got to spend a night in the critical care ward at the VA hospital, trying to figure out if I had a heart attack, an asthma attack, or just a weird, and rare, reaction to the medication.

Now, for safety's sake, I'm sidelined for a week, and waiting for a new battery of tests to (hopefully) determine exactly what the hell happened.

Luckily, the Prez hasn't gotten his way with health care yet, so they don't have to go with the "best guess" method of treatment, they can actually do all the tests.

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