Thursday, April 26, 2012

Notes written prior to my quadruple bypass surgery

The following notes were posted to my Facebook page prior to my quadruple bypass surgery on April 10, 2012:

March 15 at 11:10pm
Well ... had a stress test and got run through the cat scan plus before and after EKGs ... result: back to the hospital 6 a.m. Wednesday morning for a heart catheterization ... big decisions ahead. Ye olde heart arteries ain't doing so good. But you know ... got "73 years and counting" on the them, including 35 years of smoking, a lot of it in my 20's two packs a day or more.

March 21 at 8:57am
I've had my heart catherization ... and waiting to go home in two hours or so.

March 21 at 2:45pm
Waiting for my ride home in front of St. Barnabas Medical Center.


March 22 at 7:12am
Made it home. Resting in my bed the next day. I see my cardiologist on Friday, tomorrow. Heavy decisions ahead.


March 23 at 11:05pm
Well ... I am going to need several coronary artery bypass grafts. I don't know which technique they will use for certain but my cardiologist, Dr. Fred Aueron, did say they would be cutting through the breastbone so it sounds like open-chest surgery. Dr. Aueron is with The Heart Group at Summit Medical Group, readily referenced on the internet.

He showed me the results of the heart catheterization and went through my basic choices. I simply asked him what would be best for me at my age and in my condition. He's been my cardiologist for the last few years. He knows me, and I know him. I literally trust him with my life, so following his advice was and is the easy part.

Then Dr. Aueron referred me to Dr. Frederic F. Sardari, cardiac surgeon at St. Barnabas Medical Center -- where I will have the surgery. I made an appointment with Dr. Sardari for next Thursday, March 29th. I will get the complete details then. Having the surgery at St. Barnabas allows all my doctors to easily collaborate on my care. They all practice there.

I am sure that I will get a date for the surgery when I meet with Dr. Sadari. I don't know Dr. Sadari, nor have I ever met him. But that's not so unusual in finely tuned specialized medicine. But I don't HAVE to use him, even if I most likely will on Dr. Aueron's recommendation.

One thing to always keep in mind is that the patient can refuse anything in their medical treatment, with the caveat that the patient is rational enough to do so. I have walked off a floor in a hospital, refused to let certain dialysis technicians take care of me, changed doctors, don't allow the same person to try more than twice to draw my blood or stick an intravenous tube into me, and so forth. I even refused to leave a hospital once until the head nurse explained how I should take care of myself after a bout of peritonitis. That was in March or April of 2008. I had to learn all this in the too many trips to hospitals and ERs since I first had acute kidney failure in July, 2002.

It's both sobering and amusing to realize that I could drop dead at any moment from a heart attack, or — what IMHO would be worse — have a debilitating stroke. And then I will be given a date ... and start the countdown. What will be first and foremost on my mind will be thinking about the results right up until I go under on the operating table.

I have already come so close to death twice that I know the drill. But both those times were unexpected, out of the blue occurrences. The first was my acute kidney failure mentioned above. The second was from peritonitis also mentioned above.

This time I will — as I said — counting down to the main event.

March 24 at 12:35am
This is one of the images taken when I had my heart catheretization on Wednesday. I've marked 3 of the trouble spots. — at St Barnabas Medical Center.



March 24 at 11:29am
Went to the South Mountain Reservation this morning with Odin the house dog. I so enjoy my time walking in the reservation that I will be doing a lot of it during the countdown to surgery ... plus the other things that allow me to contemplate the wonderful life I have had to this point ... and, of course, for many more years to come ... if I can just get this pesky heart of mine back into working order. It's worth the risk.

March 27 at 10:07pm
Countdown to the countdown. First countdown is to 1:30 PM this Thursday (day after tomorrow) when I will meet with my "potential/most likely" cardiac surgeon and discuss the intimate details of what I am facing on the operating table ... and when, which will lead to the second countdown.

I don't have much, if any, flexibility on the "what," but I hope to have some on the "when."

If the odds of survival for the bypass — I have chronic kidney disease, too — aren't as good as I want (I want minimal chances of not surviving, of course) then I probably will delay the surgery for as long as it's rational to do so. But I might delay it anyway even if the odds are highly in my favor.

To be utterly frank, I am not looking forward to the surgery. But I am not depressed ... yet. I surmise there will be a number of "yets" before this is over.

And I've started a "Things to" list. "Before I die" goes unstated, but that's what it is for. I'll share some of it with y'all later. Right now I am going to get some sleep.

One more thing first. My friends tell me I'll be fine and up and at 'em in no time after surgery. I consider that a mental gimmick allowing them to not have to talk about my dying ... which is a reminder that we all die eventually. And if I die in the surgery, I will have at least allowed myself to face it ... even if having to face that prospect irritates me.

March 27 at 10:07pm
OK, coronary artery bypass graft ... aka cabbage ... fear factors: I am over 70 (73) with chronic kidney disease and the resulting high blood pressure, going into multiple bypass surgery.

I was at dialysis earlier and starting looking up the ins and outs, ups and downs ahead of me. (That’s when I attempted the earlier post.) When I read the list of risk factors, and saw mine … I felt a spontaneous spurt of adrenalin , my body’s chemical reaction to fear.

Having lived in Interior Alaska for seven years, I know the feeling … to say nothing of growing up on a small wooded and rural dairy farm with black bears in the forests. Not many bears, but huge in the mind of a child. By the time I got to Alaska I knew how to handle the adrenalin response to fear or other excitement with the element of risk. I push through fear as a barrier and let the adrenaline propel me into compensatory action that keeps me in the adrenaline high.

By learning to deal with adrenalin, I became an adrenalin junkie. The calm suspension of time in my mind with clarity of perception of my surroundings became a desired effect of my travels into the Alaskan bush. For me it didn’t take mountain climbing or wrestling grizzlies. I simply had to take one more step further into an unknown wilderness to feel the effect.

So I knew what was happening when I saw my risk factors for multiple bypass surgery spelled out on the internet in front me and felt the spurt of adrenalin in the face of my fear. I knew I had to do something. Here I was plugged into the dialysis machine and would be for the next three hours or so. FYI my dialysis treatment lasts four-and-a-half hours. I couldn’t go find a friend and share the moment face-to-face, and I wasn’t about to talk about it over the phone. On the phone there would be no way to adequately explore the nuances of my fear and alter its impact. I took out my smart phone and started writing.

Writing has always been a relief valve for my emotions ever since I started writing poetry in high school back in the 1950’s.

Questioning my religion:

Must I because I am afraid
Condemn myself to ages passed
And therein the wisdom of long ago
Lie down and sleep amidst my doubts?
Is there no hope in man alone?


Other poems …

The city
Where men live
But time is the ruler
I hate it.

And …

Herein lies my sudden doubt
imperfect fear
Beyond this day,
this year
The twirl of man's mad carousel
will bind us to its wall,
to travel the cyclic corridors of time,
unheard above the shrieking barkers cry
and the playing of his raucous tune.

All written back in high school.

I didn’t pursue a career as a writer, but I turn to writing when emotion — joy, love, sadness, fear, envy, anger, or (see http://en.wikipedia.org/wiki/List_of_emotions ) — starts to overwhelm me and I am not able to do something positive about it.

I am aware that I am afraid now, and will be right up until the moment I go under the anesthesia for the bypass surgery. I am also irritated—not angry—with the prospect of dying. There is nothing wrong with either reaction. It’s how I deal with the reaction that makes the difference. And the first step is to not deny these emotions and then block them so they build up into panic and anger, wherein I would lose control.

I will see the blankness of “going to sleep” preceding death in my kind of disease. I’ve experienced it twice — once in July of 2002 when my kidneys failed, and once in March-April of 2008 when I caught peritonitis. Death for me is the slow drift into a cotton candy cloud, so blissful that both times I had to fight my way back. Under the anesthesia of major surgery, I won’t be able to do that.

I am struck by the standard cultural reaction of my friends, “You’ll be all right!” They are trying to cheer me up, to help keep me from descending into depression, I am sure … or maybe to keep themselves from becoming depressed also. Actually I like it in a general sense because then I don’t have to explain the nuances of my mind. I can write about them instead, and fear becomes elevator music, always there but mostly subconscious … and easily tuned out by other thoughts.

http://en.wikipedia.org/wiki/List_of_emotions


March 30 at 4:38am
It's going to be quadruple coronary artery bypass graft -- CABG, aka "cabbage" (but I already told you that, didn't I) -- on the morning of April 10th. My surgeon-to-be, Dr. Frederic F. Sardari, said sooner is better than later with at least 90% blockage in some of them. He also said there may be more than four. He wouldn't know for sure until he was in there. That got my attention.

Yesterday was emotionally like bobbing in a small boat all by myself on the waves of the Pacific Ocean, up and down, up and down -- but not a roller coaster . I started out thinking of not having the surgery. That was a relief until I thought of the possible consequences of not having the surgery … heart attack, stroke, reduced mobility.

I went back and forth (up and down) until I talked with Dr. Sardari ...

I have to get ready to go to dialysis ...

March 30 at 5:44am
By the way (aaaaaaaaaaaah, such a casual beginning ... ) I sent the following to a couple of friends last Tuesday, March 27th:

As a friend of mine once said, "It's been a grand adventure." I would add, "It wouldn't be worth it if it wasn't."

Things that come to mind are:

Sinatra's "I Did It My Way"
(Link to lyrics.)

And now, the end is near;
And so I face the final curtain.
My friend, I'll say it clear,
I'll state my case, of which I'm certain.

I've lived a life that's full.
I've traveled each and ev'ry highway;
But more, much more than this,
I did it my way.

Regrets, I've had a few;
But then again, too few to mention.
I did what I had to do
And saw it through without exemption.

I planned each charted course;
Each careful step along the byway,
But more, much more than this,
I did it my way.

...




But that's a wee bit ho hum for a male in this culture. A little more thoughtful, and me, is a poem I memorized for a high school English class and has stuck with me ever since:

Gray's "Elegy Written In A Country Churchyard" http://www.blupete.com/Literature/Poetry/Elegy.htm

The curfew tolls the knell of parting day,
The lowing herd winds slowly o'er the lea,
The ploughman homeward plods his weary way,
And leaves the world to darkness and to me.

...


And then there is the Bible. Being a Humanist raised as a Fundamentalist Evangelical Baptist, I appreciate the words from Ecclesiastes Chapter 3: http://www.blueletterbible.org/Bible.cfm?b=Ecc&c=3&t=KJV#1

To every [thing there is] a season,
and a time to every purpose under the heaven:
A time to be born, and a time to die;
a time to plant, and a time to pluck up [that which is] planted;

...


[End of sent material]

Maybe a little too maudlin ... my gawd, how often do I get to use "maudlin?" In any case, I really, really like "Elegy Written In A Country Churchyard." I plan to bring a copy along with me on April 10th when I go in for surgery. I'll read it while I am waiting to be taken into the operating room.

Oh, and a caveat about "I Did It My Way" ...

"Regrets, I've had a few;
But then again, too few to mention.
I did what I had to do"

is spot on ...

"And saw it through without exemption."

is not.

I have a propensity to move on to the next thing before finishing the first thing. But I don't regret it.

Now, brush my teeth and off to dialysis ...

And ... I have to try to get another appointment with my urologist to see how my prostate cancer is doing ... I cancelled my appointment with him when this heart stuff started with a trip to the ER. (The cancer is in remission ... at least according to my last checkup. I am taking hormone treatment.)

March 31 at 9:11am
I have been having long talks with friends about cabbage aka coronary artery bypass grafts. If you've been reading my posts then you know I will be having at least four of them (quadruple bypass) on April 10th—a week from Tuesday. The countdown is underway to leaving for the hospital—St. Barnabas Medical Center—at 5am that morning. I have to be there by 5:30am and the surgery is scheduled for 7am.

From this point on, I anticipate the biggest stressful impact will be when they give me the anesthesia and I lose consciousness. Let's face reality. There is a chance that I won't wake up. That I will die there on the operating table. In my conversations with my friends this is avoided, but this is the elephant named Denial in the room.

I want to learn how to think rationally about my death. Death is the last great adventure. I want to see it coming, to validate my sense of self. It's hard to explain. And it would have upset me to no end to have the end of my consciousness be the drift into unconscious from the anesthesia ... and that be it ... if I had not prepared myself like this beforehand. Funny how the (my) mind works.

Then there was the linked article (see link below) on The New York Times OpEd page this morning ... and I would recommend it to all adults. It's never too early to have a clear advance directive aka living will. I am updating mine this weekend. My living will directs my caregivers to not continue to medicate me if I am in severe pain whose cause is incurable or my brain is not functioning at a level needed to provide me with a rational life by normal and customary standards. The one thing I will not sign is a "Do not resuscitate" directive. That is far too much leeway to give anyone and especially anyone not a personal and trusted friend—including relatives.

Link to NY Times "Taking Responsibility for Death"


But really. I am being a bit melodramatic. I trust my cardiologist, Dr. Fred Aueron.

Link to Dr. Fred Aueron


Dr. Aueron referred me to one of the best cardiac surgeons around here, Dr. Frederick Sardari—and seeing how this is the New York City Metropolitan Area, that says a lot.

Link to Dr. Frederick Sardari


I am going to one of the best medical centers for this surgery—St. Barnabas. I have been to their ER and on their hospital floors enough times for various reasons to know it is a superior medical facility ... and I have been in enough of them to know the difference. It's my preferred choice.

Link to St. Barnabas Medical Center


The fact of the matter is that the chance of the surgery not being successful is minimal. I have gone over my significant risk factors with Dr. Sardari, over 70 years of age, on dialysis, afib. There is nothing unusual in them for him. And with 90%+ blockage in the blocked arteries--and not getting any better, it is only a matter of time (like anytime) before I suffer a heart attack.

Having addressed my concerns, my fears are like elevator music ... ubiquitous but easily pushed out of conscious awareness by practically any other thought. I really do love that metaphor.

April 3 at 9:30am
Yesterday I had a long talk with a friend. She asked me if I was afraid facing multiple bypass surgery. I again used my "it's like elevator music" phrase, there but easily dismissed. On the other hand it always comes back.

I feel the stress of the nagging fear. I forget things more easily. Later yesterday I forgot to go visit an even closer friend whom I had told I would be coming over around 4:30 PM. She called around ten after five and left a message asking if I was OK. When I called back around six, she graciously said she understood.

There are other symptoms of stress. I worry about the things I will leave undone. Should I file my tax returns or extensions? Which bills should I pay ahead of time? I'm going to file my tax return and pay all my bills ahead through to the middle of May ... at least that is what I plan now.

And filing all my miscellaneous paperwork ... and leaving names and phone numbers ... and account numbers, ID names, and passwords ...

I am not going to get it all done ... and I am stressed about it.

I am not ready for this ... but I can't admit THAT, now can I?

No I am not going to have some kind of a breakdown. I learned a long time ago that keeping feelings stuffed inside me causes me to go off the rails ... which for me was using alcohol to dampen the stress. It worked ... up to a point.

Now I write about it. And being able to write to a "public" audience helps beyond the words ... and it really doesn't matter if anyone reads what I write. The simple fact that it can be read by family, friends, and strangers ... and that I am committed to being as honest as I can be without compromising someone else's privacy. And written in first person it means it is utterly subjective.

April 3 at 10:03am
Last night I had a dream straight out of my fundamentalist evangelical Baptist upbringing. A "spiritual presence" was exhorting me to turn back to the spiritual life of my childhood, to let the saving power of faith in Jesus Christ as Son of God envelope me in His love.

That was heavy. It felt so real it disturbed me enough that I questioned my current course with humanism ... briefly. And it lingers. I better understand the Jesuit motto "Give me a child until he is seven and I will give you the man."

If I had been raised as a Buddhist then last night I probably would have dreamed about the Buddhism of my childhood.

It is moments like this that I gain insight into the power of my subconscious. And I benefit—reduce stress—from drawing the subconscious influences into conscious awareness in order to neutralize their effect, at least to some degree.

And then there are those subconscious influences that were formed in the consciousness of my early childhood, influences that are felt as they emerge from my preconscious mind but do not come forward into the conscious mind as a gestalt, they can never take on a mental form of awareness other than the feeling of its influence. An example is if I had been attacked as a baby by a dog. Later in life I might feel the fear of dogs, but not be able to "remember" the reason for my fear." If any of that makes sense. (I hope I used all the psychology terms correctly.)

April 4 at 10:55am
OK, yesterday I saw my nuerologist, Dr. Joseph Sobelman, (grrrrrrrrreat doctor by the way, intelligent, good sense of humor, superior people skills, AND knowledgeable and experienced). I asked him to check on me after surgery. I do not want to experience my "restless leg/body" symptoms while lying flat on my back in the hospital. He assured me he would take care of me, as I knew he would. I just wanted to hear him say it for my own peace of mind.

After seeing Dr. Sobelman I went to St. Barnabas Medical Center for pre-admission tests -- bloodwork, pulmonary, x-rays(2). Everything is still on track for the morning of April 10th.

This afternoon I go see my urologist, D. John Siegal at Summit Medical. He's another great doctor.I had a 3-month checkup on keeping my prostate cancer in remission that I had to cancel when all this heart stuff started last month. You know, I look forward to my appointments with all my doctors. If I don't I go elsewhere.

I stop taking my blood thinner and I will start swabbing antibacterial ointment into my nostrils tomorrow -- five days before surgery.

Tomorrow afternoon I go see my cardiologist, Dr. Fred Aueron, for his review before the surgey. I have mentoned him before. Everything I wrote about Dr. Sobleman above is also true of Dr. Aueron. AND Dr. Aueron referred me to Dr. Sobelman. They are both brilliant.

Then on the afternoon of Monday, April 9th, I will go back to St. Barnabas for more bloodwork. They will check my INR to make sure my blood will clot and I won't bleed to death during surgery.

The night before and again the next morning on the day of the surgery, I will shower and then wipe myself all over with six sterilizing cloths each time -- one cloth for each of six different areas of my body.

April 5 at 6:14am
Yesterday afternoon I went to see my urologist, Dr. John Siegel and another great doctor, at Summit Medical Group in Berkeley Heights (New Jersey, of course). I had cancelled my "every 3 months +/-" checkup with him because of the recent cardiac episode that sent me to the St. Barnabas Emergency Room. I wanted to catch up with him because my urologist keeps an eye on my prostate.

I was diagnosed with prostate cancer back in August, 2002, when I was in Fairbanks Memorial Hospital because of acute kidney failure. With surgery and followup -- and continuing -- hormone treatment, the cancer has been in remission. My prostate was not entirely removed because it was too large (and the cause of my kidney failure), so I am at perpetual risk for the cancer's return.

Dr. Siegel will see me at 6 AM on Tuesday (April 10th) at St. Barnabas (I arrive at 5:30 AM) to insert the catheter needed for the surgery starting at 7 AM. The fact that he will come and do it enlarges my comfort zone. On the other hand, the surgical team would do it while I am sedated in the operating room ahead of the surgery.

Seeing Dr. Siegel will have a calming effect. It's like the TV commercial that says "you are in good hands." My whole "team" of doctors reduces the stress of my countdown to quadruple (at least) coronary artery bypass graft (aka CABG or "cabbage") surgery to elevator music -- stress that is not to be denied, but not to be listened to too intently either.

And that -- my doctors reducing my stress level -- is a direct benefit of being a senior citizen here in the USA, and then specifically living in a large and affluent (not me) metropolitan area with the great doctors that an area like this attracts. The fact that it is the New York City metropolitan area means we are in the top tier of the medical pecking order. I have Medicare and Medigap from Blue Cross and Blue Shield, and I have never had a problem finding a superior physician to treat me. In fact, my insurance once documented isn't questioned. And there is no significant wait for getting things done, like I hear about in other countries with a more "socialized" form of medical care. I am having my cardiac bypass just about as soon as possible (outside of an emergency) considering the steps I have to take to prepare.

Let me be politically philosophical for a smidgen. When House Speaker Tip O'Neill famously said "All politics is local," he put to words one of the great truths of democracy. And as a senior citizen my medical care is about as "local" as it gets. And I vote.

Now in my mind President Obama really screwed up with the mandate ... not because everyone is obligated to buy insurance, but because insurance companies get a captive "audience" of new customers paying the high cost of their administrative overhead ... rather than offering a public option (like Medicare) as a competitive choice ... which IMHO would have the effect of reducing the overall cost of medical care—relative to "Obamacare". Whereas reducing the overall cost of medical care by slashing Medicare costs unrealistically—as the 2010 election proved—comes with a political death sentence for politicians ... as well as a real one for senior citizens.

And ANYBODY who thinks even for a second that a small centralized group of health care gurus can set SOPs (standard operating procedures) at the local level for this diverse nation -- even with a public option—has to be out of their everlovin' mind—unless the SOPs are on some sort of multi-dimensional set of sliding scales both in cost and care. There are so many factors that come into play ... like the ability to travel, to a top-tier medical facility, factoring in cost, time, and health status. We cannot have equal access to quality medical care—or quality anything for that matter (like going to The Met [either one] )—even in a fair society if we treasure freedom as the highest good.

Like for me. I could have stayed in Interior Alaska and probably been dead by now. I chose to move to New Jersey, where because of economic factors mostly (I am NOT wealthy), I have a different set of restrictions to deal with. But I am alive in the face of chronic kidney disease, prostate cancer (in remission), and heart problems (most heart problems—except for afib—to be fixed on Tuesday, April 10th).

April 6 at 4:03am
Trying to catch the ambiance of the South Mountain Reservation just before the buds of spring arrive, once again altering the forest until the fall—when it changes yet again in the repetitive cycle of the seasons.


April 6 at 5:12am
Went back to see my cardiologist, Dr. Fred Aueron, yesterday for my final checkup with him before surgery. I'm good to go. He told me that I would do just fine. That, of course, comes with standard caveats. Between him and Dr. Sardari—my cardiac surgeon—I know the risks ... and the inevitable if I don't have the surgery.

I am feeling better about the surgery. Talking with my doctors has eased the stress, lowered the volume and slowed the beat of the elevator music.

I respect my core set of doctors because of my having spent time with them over the past few years acquiring that respect and the growing confidence in their ability. Believe me, I know what it is like—emotionally—when I don't have a clue about the doctor who is going to operate on me, or perform any procedure that involves sufficient risk. It has happened infrequently, because I insist on knowing at least as much as is necessary to reassure me about that doctor whenever there is time and opportunity to do so, which is usually the case. To be specific, getting peritonitis when I was being set up for peritoneal dialysis focused my attention on these issues.

I now take the fact seriously that I am ultimately in charge of my medical care ... which for me means that I must do my homework—whenever time allows—on what is going to be done to me and who is going to do it. Because I will never be able to know as much about it as my doctors, I had at least better be sure the particular doctor knows what he or she is doing and is good at it.

Which brings me to some advice for Senior Citizens (or those responsible for their medical care). If at all possible get to know your primary care physician (PCP) at least. If you can't develop a relationship of respect and trust with that doctor, then—if possible—look for another doctor to be your PCP. Be proactive in your own medical care.

April 7 at 9:55am
Had another long with a close friend last night—different friend. I told her about BK and I talking about dying and how it is important for me to be aware without morbid fear of the possibility of dying as a result of the surgery.

There are things I would regret not having done if I die. Which may sound strange but it has to do with my own peace of mind as I am wheeled into the operating room, moved onto the operating table, and given the anesthesia. Been there done that. In fact the last time I was operated on I was so able to anticipate what came next that the nurse remarked with dry humor that it was not a good sign that I was so familiar with procedures in an operating room.

With the anesthesia the nurse will ask me to count to ten. I will start counting silently and I will either wake up or I won't. Quadruple bypass surgery is not entirely without risk. The odds are vastly in favor of my waking up, so I don't want some nagging concern about unfinished business in the face of an unlikely event to be rattling around in my mind as the anesthesia puts me under. I want to know that I have done everything I could have to make the transition as easy as possible on my family and friends in the time I had available. (Is that enough caveats?)

Note: There wasn't any counting this time. They put intravenous tube (or was it into an artery?) into my right arm and before I even thought about it I was waking up in the recovery room.

By the way, BK is one of my few closest friends—whom I can count on my fingers and have several to spare—who has far outlived his doctors' predictions. Several years back—like twelve—he was told he had six months to live. With severe COPD, he's on oxygen 24/7 and some days he can't move from his bed, but he welds, maintains his cabin, rides a tricycle motorcycle in the summer, ties flies in winter and goes fly fishing in summer ... AND he lives in Interior Alaska year-round. When I am beginning to feel sorry for myself, I think about BK. What excuse do I have for complaining? I mean, really?

April 9 at 3:23pm
Back at St. Barnabas for bloodwork on the day before surgery. Because of the condition of my heart and its arteries I have had to be on blood thinners (non-aspirin) for the past couple of years. This was to help protect me from clotting in my narrowing heart arteries and a stroke or heart attack … is how I understand it. So the countdown continues … less than 17 hours.

April 9 at 7:10pm
I found a Advanced Directive and filled it in to be in force until I revoke it. Now, on the eve of my surgery, I have to find a couple of witnesses. Actually, I have one ... and I should be able to get the second one without any trouble.

Click here to download the Advanced Directive from Oregon that I used.


Anyway, I still have a few too many loose ends to wrap up ... but what gets done will get done. The rest can wait until I regain consciousness ... and recover a tad.

One of things that I am aware of, is that the stress of fear's elevator music drives me to keep busy on being busy ... it's a common reaction ... and I still remember how a young mother was convicted in the State of Washington for what seemed to be callous disregard for her baby who had just been scalded to death. The mother was doing laundry when aid arrived. She later told the investigators that her two year old had tried to give the baby a bath, but the mother was blamed because of her seeming indifference ... what I know is a mental defense against overwhelming stress. If the mother had done it, she most likely would have had a better story and a more convincing demeanor.

Just remember, folks, there is no real justice for the vast majority of us who work for a living.

April 9 at 7:21pm
By the way, St. Barnabas called in the late afternoon. I am good to go tomorrow morning ... get there before 5:30am ... cabbage starting at 7:00 ... "cabbage" like I keep reminding myself (and the rest of you) stands for "coronary artery bypass graft" or CABG. Just in case you missed it (how could you?) I'm going to have at least four ... but repeating myself must get a little tiring, don't you think? On the other hand, my cardiac surgeon said quadruple bypass was impressive ...

It definitely has my attention ... can't you tell?

April 10 at 6:10am
Checked in at St. Barnabas for my surgery.


Addendum
That's the end of my "Notes written prior to my quadruple bypass surgery." I'll start working on Notes from my stay in the hospital following surgery, first in the CTICU—Cardiothoracic Intensive Care Unit, Unit 2500 at St. Barnabas Medical Center. Then in Step Down— one step down from CTICU, Unit 2400. I was sent home on Thursday afternoon, April 19th, from Step Down.

Tuesday, April 24, 2012

12 Days After Quadruple Bypass Surgery: "Cookin' in the Kitchen"

As I promised some of my friends, here is a quick & flakey video showing how I recovering from my quadruple bypass operation at St. Barnabas Medical Center in Livingston, New Jersey, on the morning of Tuesday, April 10, 2012. This video is about me "cookin' in the kitchen" on the evening of Sunday, April 22nd. I didn't take the time to perfect it. I just wanted it out so my friends could see how well I am doing. By the way, Dr. Frederick Sardari, M.D., was my Cardiothoracic Surgeon, and Dr. Fred Aueron of Summit Medical Group is my Cardiologist. You can get more information here in past and future posts.

Note: The best way to view the video is to click on this link: http://vimeo.com/40960464

Saturday, April 21, 2012

Photos from CTICU at SBMC 4/12-4/13/2012

Here I am in the CardioThoratic Intensive Care Unit (CTICU)aka Unit 2500 at St. Barnabas Medical Center in Livingston, New Jersey, on the 2nd and 3rd post-op days following quadruple Coronary Artery Bypass Graft (CABG or "cabbage") surgery starting at 7:00 AM Tuesday, April 10, 2012.

Thursday, April 12th


Having dialysis while in bed.



Friday, April 13th


After which they told me cameras were not allowed in the CTICU ... Pretty impressive set of medical equipment, don't you think?!