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Pill Box
Officially an old man now.
As I am gathering my stuff to leave the cardiac ward, Philitrina, my afternoon nurse, gives me one additional bit of advice: Do not ignore the warning about not lifting more than 10 pounds and not driving for a week. Because, she says, you can bleed to death in three minutes from a severed femoral artery. That's the one they cut open in my groin to thread a balloon into my right coronary artery and mash the fatty, 95% blockage that awarded me with a heart attack Nov. 8. If the suture were to pop, I wouldn't really have three minutes, and it's hard to call 911 when you're trying to get a grip on a slippery bit of organic tubing through the half-inch incision the doctors have made.

Yep. I had a heart attack. And I'm not 100 percent recovered. But just 12 days after my 28-hour-stay in Kaiser Permanente's cardiology facility in Santa Clara, California, I am much better off than I was before the attack.

For one thing, I've got a state-of-the-art drug-eluting stent designed to keep that artery from getting blocked again as it repairs itself. Consequently, the blood flow through that crucial conduit is now as good as it's been in probably a decade. Patients with bare-metal stents—they look as if made of tiny chicken wire—have at least a 25 percent chance of restenosis—reclosing—of the same artery within a year. For DES stent recipients, the chance is more like 5 percent.

Since the stent was installed in the artery that feeds the right side of the heart, it means my lungs are now getting the oxygenated blood they previously weren't. Already, I can walk without getting winded, a frailty that had gotten worse over the past few years but that doctors previously diagnosed as apparent lung damage from two pulmonary embolisms that flatlined me nine-and-a-half years ago. Why they didn't trace that problem to possible arterial blockage until my heart revolted is not a matter I'm ready to take up with them yet.  

What was I doing when it happened? Summarizing the damned monthly jobs report from the Bureau of Labor Statistics. Having never had a heart attack previously, the symptoms didn't immediately make clear what was going on. I just felt crappy and tired. So I tried to sleep it off for a couple of hours. But then the pain started. Actually, it was just discomfort, a kind of strong pressure in the left side of my chest right through to my scapula. But it was obvious now what was going on.

That's when I called 911.

EMTs from the local fire station arrived within minutes.  Everything about me screamed heart attack even though my blood pressure was not overly high, and they called for an ambulance. On the ride to the Emergency Room, they fed me aspirin, nitroglycerin and an anti-nausea pill. At the hospital, a shot of morphine followed by a shot of hydromorphone (Dilaudid—10 times stronger than morphine) got rid of the unpleasant sensations in my chest. They took an X-ray right in the room, and the doctor soon told me that the electro-cardiogram showed that I was having a heart attack.

Wait, I said. I thought I had had a heart attack. Still going on, he said. My friend navajo, who acted as my advocate throughout this procedure (and later my ride home), had by now arrived, giving me some relief over concern that, drugged as I was, I might not fully consider everything that was being explained to me.

Since I was stable and now comfortable—flying actually, since Dilaudid really works—they transferred me from the ER to the Santa Clara facility where the angioplasty and stent installation were carried out. But, first, I had another ambulance ride, 30 minutes of hell.

You would think that in a potentially life-threatening situation, one could evade right-wing political jackassery for a few minutes. But no. I made the mistake of honestly replying to a question about my job writing for Daily Kos, which spurred one of the three paramedics transporting me to go into a rant about Obamacare. A key complaint: "Lazy" people with "14 kids and no job" can now get health coverage "for free." Taxes are going up as a result and people are losing their insurance, blah-de-blah-blah for most of the ride. The other two EMTs were almost completely silent. I didn't get a chance to ask if they're a team.

Once in the cardiac ward, I was immediately prepped for the angioplasty, which was undertaken with light sedation. If the television screens monitoring the procedure had been cocked a little more my direction, I could have watched the whole thing. Ninety minutes later, I was back in my room.

I slept well. And the next day, after everything checked out, I was back in my apartment before dark, thanks to my chauffeur.

I was lucky in more ways than simply not croaking. Because I'm on Medicare—I'll be 67 in eight days—a $50,000 procedure cost me a $250 co-pay plus discount drugs. Another one of those government programs that my ambulance bête noire probably thinks should be done away with.

Doctor's orders: "aggressive life-style modification." That means diet and exercise and five pills a day (plus vitamin supplements). Those drugs include daily aspirin for life, plavix for a year to help keep my blood's platelets from sticking to the stent and plugging up that artery again, as well as blood-pressure and chloresterol medicine for at least a month. Also, just in case, I have teensy tablets of nitroglycerin for serious chest pain.

What I eat isn't the problem. Portion control is. As that artery clogged up, I exercised less and less since I couldn't seem to improve my stamina, this being complicated by the fact that I was adding pounds. Before the embolisms, I was in decent shape, having been a serious high-school athlete and having practiced martial arts intensively until well into my 50s when I decided getting hit in the head by 20-year-olds was probably not such a great idea at my age even with protective gear. Overeating and drifting into an ever-more sedentary life-style put me at high risk for what happened.

But, already, I can tell a huge positive difference when I walk, and once cleared by my doctor in a couple of weeks, I plan to undertake an incremental exercise program.  

All of which is to say that you're not going to get rid of me that easily.

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