Needles, Part Two

After my A-fib episode I went on Coumadin. It's a blood thinner, as has been discussed here previously ad nauseum. What we haven't discussed is Lovenox. Lovenox is another blood thinner that is sometimes prescribed in tandem with Coumadin to prevent blood clots in the leg known as Deep Vein Thrombosis, or D.V.T. It is injected subcutaneously (under the skin, not in the muscle). Nobody ever explained to me why I had to be on two different blood thinners, but I would venture to guess that they wanted to make very sure that I didn't stroke out on their watch and ruin their day. Of course at this point I was a veritable expert at the art of self-injection, having been stabbing myself in the belly for a month or so with Insulin-filled syringes. I was not, however, prepared for Lovenox. Insulin syringes come empty and you fill them with Insulin from a small vial. The amount you inject depends on what your blood sugar is, but even if it's quite high, you only use a teensy, tiny drop. That and the fact that the actual needle part of the syringe is very short and also coated with some kind of Teflon-y substance makes the procedure pretty close to painless. In fact, pricking your finger for blood for the glucose monitor hurts more than the actual shot. Lovenox, however, is nasty. It comes pre-loaded in the syringe, and there's a lot of it. The needle is quite long and it takes some time until the entire does is injected. All this was a turn-off, but when I read side of the box in which the syringes came, I almost lost my lunch. In language probably intended to be too sophisticated for the average user (which obviously doesn't include yours truly), it explains that Lovenox is made from "porcine intestinal mucosa". Hmmm. Let's see. Porcine refers to animals of the porcine family i.e. pigs and boars. Intestinal means "of the intestines". Mucosa is simply that; mucus. Okay. So Lovenox is made from the mucus of pig guts. PIG GUTS! I was injecting myself with pig guts! This grossed me out on several levels. Firstly, being orthodox, being helped along with my recovery by Porky Pig was somewhat unsettling to say the least. Secondly, pigs are not known as very sanitary animals (although there are those who maintain that they only roll in their feces-laden mud to protect themselves from getting sunburned, yada yada, yada), nor are they very discriminating in what they ingest. And there I was, introducing their guts to mine. Thank G-d I was only on that horrid stuff briefly. I still shudder when I think about it. Now please excuse me; I'm late for my mudbath appointment. Oink!

Needles, Part One



After spending a significant amount of time in a hospital and then a nursing home, you become somewhat inured to having your body treated like pin cushion.  I was literally pricked daily, sometimes several times,  for about four months.  In Columbia Presbyterian they drew blood every day.  And then of course there's the IV.  An IV port is only good for a while; then it has to be replaced.  Now, I've always had veins that would make a vampire salivate.  They're big, fat voluptuous veins and all the nurses loved them.  That was until I went on Prednisone.  Among all the other lovely havoc it wreaks on your body, apparently it collapses your veins, too.  By the second or third week in Columbia, finding somewhere to stick me was increasingly becoming a challenge.  By the time I got to Silver Lake, finding a viable vein was dang near impossible.  So each time I was supposed to get stuck, I  usually wound up getting stuck three or four times.  And although most of my nurses were of the Florence Nightingale ilk, there was the occasional Nurse Ratched.  They positively enjoyed the poking and the prodding and the bleeding and the grimacing.  After a while it got so bad that Ron, a nurse in Silver Lake, had to start an IV port in a vein in my foot.  I kid you not!  So naturally I was waiting breathlessly (yes, I know: yet another poor choice of words) to be discharged so I would no longer have to worry about walking down the street and springing a leak.  Riiiiiiight.  Just before I left Silver Lake I was informed that when I got home I would have to test my blood sugar every day (by pricking my finger, of course) and if it was too high, I'd have to administer Insulin (by stabbing my belly, of course). They had been testing my sugar levels since Columbia.  I've never been diabetic, but as mentioned in an earlier post, Prednisone (there's that word again!) can make your blood sugar levels go all kablooie.  Kablooie is medical jargon for "messed up".  It was originally used by the great Jewish scholar and physician, Maimonides, after whom a rather mediocre medical center in Brooklyn was named.    He coined the term after watching his friend and sometime associate Louis slowly lose his marbles.  Louis, a gifted scholar in his own right and renowned short order cook and kabbalist, was affectionately known as "Kab-Louie" in their little shtetl*.  After years of playing the local lottery and never winning even one peso, Louie took to drinking.  Unfortunately he couldn't afford proper liquor and so became quite addicted to a home made concoction of his own, consisting primarily of  aged raisin wine and his Tante Rivka's toe jam. This elixir, as tasty and fragrant as it was, eventually caused poor Louie to go quite mad.  He could be observed all over town crowing like a rooster and singing obscure, old Russian folk songs (this behavior was particularly bizarre, since they lived in Spain).  One of his favorites was the beloved classic, "Don't tell Olga about Tatyana, or I'll smack you upside the head with my lizard." Okay, boys and girls, where was I?  Oh yes.  Prednisone induced diabetes.  Anyway, the day after I got to Chayie's house, a nurse showed up to show me how to use the glucose monitor and how to inject myself.  So for several months thereafter I checked my glucose a few times a day and stuck myself in the belly more often than not.  After I went on Coumadin, pretty much any time I injected myself a hematoma showed up.  After a while, my belly looked like an Appaloosa's hindquarters.  And I certainly didn't need that.  After all, it's long been established that I have perfectly wonderful hindquarters of my own.

*Shtetl = small European village.

There But For The Grace Of G-d...

I'll call him Murray, although that's not his real name. He's about my age and he attends the same shul as my brother-in-law, Dave. He got sick about the same time as I did. The similarities were uncanny: he had pneumonia, I had pneumonia (different strains). He went to Cornell, I went to Columbia. He was on a vent, I was on a vent. We were discharged from our respective hospitals around the same time. He went to Rusk for physical therapy, I went to Silver Lake. Once again, we were discharged almost on the same day. We'd both been making slow progress since we got home. I don't know what other meds Murray was on, but I know that we were both taking Coumadin. I'm not sure why he was taking it. I was taking it because of my A-Fib episode. The way I understand it is that once you've had A-Fib, you have a higher propensity to develop a blood clot which in turn can then travel to your brain and then you're in big trouble. I was happy that Murray's recovery seemed to be going smoothly; I don't really know him very well but he seems like a nice enough fellow. Then suddenly about a month or two ago, Murray suffered a massive stroke. Bam! Just like that. Dave didn't even want to tell me. I can understand why; the news shook me to the core. When it happened, I was just beginning to believe that I might actually recover. It took me a long time to get there. I saw in Murray's progress positive signs for myself, as in "hey, if he's gonna be okay, maybe so will I". Then he goes and ruins it all by getting sick all over again. I happened to have an appointment with Dr. Katzenelenbogen that week, so I asked him if he knew Murray. Dr. K. is a special guy. He's not supposed to discuss other patients with anyone, HIPAA laws and all that. He knew, however, that this was important to me. Without commenting directly on their relationship, he assured me that he had heard about what had happened and was very upset about it. I asked, "isn't Coumadin supposed to prevent stuff like this?" His answer, I believe, was intended to help me face a sobering reality: "There's no such thing as 'prevent'" he said, "all you can do is cut down on risk and hope for the best." The answer was quite jarring, to be sure. Am I going to have to live in the shadow of a stroke for the rest of my life? I went to see Dr. Plawes today. As my cardiologist, he has the final word on how long I stay on the Coumadin. He told me that all things considered (I've only had one A-Fib episode, my cardiogram was normal and my lungs were clear), my risk of stroke was minimal. He and Dr. K. conferred by phone. Dr. Plawes wanted me on aspirin. Dr. K. vetoed that because of my history of gastrointestinal bleeding (boy, am I a mess!). So they compromised on Plavix. I haven't started taking it yet but it's waaaaay less toxic than Coumadin. No more mystery hematomas. No more worrying about cutting myself and bleeding to death. Plavix is one of the most prescribed medications in the world. Good riddance, rat poison!

PS As of this writing, Murray is in rehab and is making progress walking, but is still having trouble with his speech and cognition. Refuah Shelaimoh*, Murray; we're all pulling (and praying) for you!

*Refuah Shelaimoh = very freely translated: get well soon!

Minutiae V'simcha

A yak. No explanation necessary.



We had occasion to speak with one of you the other night. It shouldn't be hard to figure out whom, since there are only two of you. What precipitated the phone call was a comment left by the aforementioned blog-follower. He or she felt that a few of the latest entries (as brilliant as they were), when compared to our previous uniformly exemplary posts, had not quite measured up. Having already covered most of the major events of our journey, he or she felt that we were now getting caught up in the "minutiae" of our recovery which, at times, may have been (dare we say!) a bit pedestrian. Indeed, if one were to read between his or her well articulated, somewhat subtle lines, one might reasonably conclude that he or she felt that the posts in question were perhaps even a smidge on the gross side. Personally, we have no problem with discussing bodily functions in public but hey, that's just us. Admittedly, the bar has been set almost impossibly high.  Anyway, this little post (mini-post?) is to express our fervent hope that none among you has been truly offended by our ocassional flights of fancy. We are aware that said fanciful flights tend to be, on occasion, somewhat wet (for wont of a better term).

And we hope, too, that our fan base is still intact. We consider you all family.

Perhaps that's because you all are family.

Lucky Me, Part Two

I actually still remember my original point.  Amazing.  Short term memory is not my forte' these days.  And did I mention that It's hard for me to remember things from just a few moments ago?  Well, while I was in Manhattan last week, I got a prolonged glimpse of the big world out there.  That's very unusual for me; I tend to be a stay-home, curmudgeon-ly type and when I do venture out, it's usually within the confines of my insular, cloistered community.  I used to travel to the Big Apple every day by subway, but now I see that trip and the city itself not through the jaundiced eyes of a tired commuter but rather through the fresh eyes of a pilgrim.  It's a remarkable place, En Wye Cee!  But I didn't start this ridiculously long, two-part post to sing the praises of Gotham.  No, indeed.  Yea, were I to choose a place to immortalize in this humble blog it might be Paris or Rome or perhaps even London.  Or Bayonne.  I like Bayonne.  There's a dairy Queen on Route 440 that has these incredible milk shakes.  But it is cholov stam, so caveat emptor ("the cows are dying").  Those are all wonderful places, to be sure, but they are not where I went.  I was in Manhattan.  And while there I had time to people-watch.  My epiphany was not one of those sledgehammer-upside-the-head moments; it was much more subtle.  First I noticed a woman who was no older than her mid-fifties.  She was in a wheelchair.  Then there was a guy who couldn't have been more than sixty or sixty one who was using a walker.  Then I saw a young fellow, maybe twenty-eight or thirty, in one of those computerized wheelchairs.  I started thinking back to my days at Silver Lake, when wheelchairs and walkers were my only means of getting around.  Not to mention the oxygen tank or concentrator that I was tethered to 24/7.  That kind of cuts down on your mobility as well.  So my epiphany came sneaking up on me like one of those salty sea breezes that somehow occasionally finds its way up Ocean Parkway or Coney Island Avenue from Emmons Avenue or the Brighton Beach Boardwalk.  After noticing those first few unfortunate souls quite by accident, I started counting.  By the end of the day I had seen thirty-two people either around my age or younger, who were dependent on either a wheelchair, a walker, a cane, or an oxygen tank.  Thirty-two!  Suddenly my little bouts of dyspnea* didn't seem very significant.  Suddenly my slight drop foot seemed inconsequential.  I had almost forgotten those interminably endless days and nights in the ICU, wondering if I was every going home, let alone do any people-watching in New York.  Want to go get some Good Humor in Central Park?  No problem.   Want to take in a movie?  Sure, what tickles your fancy?  Have you been to the Guggenheim?  No, let's go explore it!  Nothing is beyond reach, nothing is undoable.  Amazing.  I stare at the picture I carry in my wallet at all times, the picture Kalman took while I was sedated.  Eyes tightly closed, but somehow the expression is angry nonetheless. Tubes everywhere.  A picture of someone hanging on by a thread.  Then a horn blows and shakes me from my reverie.  Lucky?  Me?  Nah.  The luckiest man on Earth.  Thank you, G-d.  Thank you very much.

*Dyspnea=shortness of breath

Lucky Me, Part One

Wasn't so lucky for the rabbit.  Or the horse.

People who know what I've been through this year are always coming up to me and telling me how lucky I am. Well, they don't phrase it exactly like that. Most people I know are of a religious bent, so it's usually more like wow, G-d has really been good to you because you're still walking around and still breathing and still functioning reasonably well. Please forgive me, but I sometimes have trouble with that concept. After all, wouldn't G-d have been better to me if He hadn't made me so deathly ill in the first place? So I'm going to file that away in the box in my brain marked "Things I Don't Understand". You didn't know brains had boxes? Well they do. Actually only men's brains do. Women's brains are completely different. I'm attaching a link at the bottom of the post to a very funny video of Mark Gungor who'll explain it all to you. Anyway, please don't get me wrong: I'm incredibly grateful for this second chance that G-d has granted me. I wake up each morning and sincerely thank Him, and then I try to really appreciate the day, no matter how lousy it turns out to be. I think of my dad, lying out there in Farmingdale, and I figure if he had the opportunity to come back for just one day and there happened to be a blizzard on that particular day, he wouldn't complain. So I'm very happy to still be here. Grateful, too. But lucky? Anyway, last Thursday I was in Manhattan pretty much all day. I had to see a man about a horse. Now, that's not really true. I don't need a horse. What would I do with a horse for crying out loud, I live in a small apartment in Flatbush. I don't even particularly like horses.  They smell.  Give me a bird every time.  Seeing a man about a horse is just an expression. After I used it just now, I decided to check what it meant. So I googled it. Here's what I found:

To see a man, to see a man about a dog, or to see a man about a horse is an English language colloquialism, usually used to apologize for one's imminent departure or absence – generally to euphemistically conceal one's true purpose, such as to go to the bathroom or going to buy a drink.The original non-facetious meaning was probably to place or settle a bet on a race, thus dogs or horses.

The above explanation is from Wikipedia.  If that is indeed where the expression comes from, then my using it makes even less sense than I originally thought, because I didn't go to the city to go to the bathroom or buy a drink.  I'll have you know that I have indoor plumbing in my apartment, thank you very much, and I could buy a drink in Brooklyn, for crying out loud.  And I'm certainly not apologizing for my imminent departure or absence.   So let's start over: last Thursday I was in Manhattan pretty much all day.  I had a bunch of errands to take care of.  There.  Now, wasn't that a bit more forthcoming?  Hey, that reminds me of the horse again (or is it "hay"?)!  You know, during a race at Belmont for example, there are the three horses that pay: the Win horse, the Place horse, and the Show horse.  After that there is the horse that is fourth coming. I think I'll have to start this post over if I'm ever going to get to my original point, which actually eludes me at the moment.  With each brilliant new sentence, it seems fodder away.  And sometimes when you wander too far away from what you wanted to say, it's darn near impossible to get back there without incurring what I like to call "writer's whiplash".  So I guess I'll go shower and take care of all my morning ablutions and come back and write some more; perhaps then I won't be so full of horse#$%*.

http://www.youtube.com/watch?v=0BxckAMaTDc

To Pee or Not To Pee

  

Turning over in his grave.



Frederic Foley

 A few years ago I had some minor surgery done. It was on an outpatient basis and I was discharged directly from the recovery room soon after the anaesthesia wore off. I went home relatively happy. Then when I got home and realized wife #2 wasn't home, I was downright ecstatic. I just kind of lolled around the apartment, watching TV and having a grand old time. Oh, and learning Mesilas Yeshorim*, too. And I have a bridge to sell you. After a while I had a slight urge to relieve myself, um, urologically. I waited a while (till the commercial) and went to do my thing. Nothing. Pushed a little harder. Still nothing. By now the slight urge was no longer slight. I will not bore you with the gory details. Suffice it to say I was back in Maimonides that night, having a large, black amazon of a nurse introduce me to my first experience with a Foley catheter. Invented in 1935 by Dr. Frederic Foley, a urologist, it is basically a tube with a balloon on the end that is inserted into one's whatchamacallit to drain his bladder. Anyway, back to the nurse. Her hands should fall off! I've gone through painful procedures before. I would have preferred root canal (perhaps without anaesthesia) to the way she manhandled me. Poor choice of words, but you get the idea. Again, I won't share the details, but I made up my mind that if anyone every wants to do that to me again while I'm conscious, they're going to lose an extremity or two. Now let's fast forward to me waking up from my induced slumber at Columbia Presbyterian. I had a bag of urine hanging at the side of my bed. That meant that I had a Foley. Taking it out hadn't been nearly as bad as putting it in, so I wasn't too upset. So a few weeks later the time came to yank it out. Afterward, I was supposed to be able to pee. Uh-uh. Not so fast, Kimosabe. Couldn't do it. They gave me Flomax. Nope. They gave me Hytrin. Nada. They gave me Proscar. Nein. I was as dry as the Sahara at noon. Not the Mojave, because I've already used that in a previous post, and no, let's not have another contest because I don't remember which post and I'm too lazy to try and find it now. So they decided to put the Foley back in. I told the nurse that if she hurts me I will find her and her family and force them all to listen to Celine Dion for twenty-four hours. Then she did a remarkable thing: she put it back in and didn't really hurt me much at all. Obviously it's never going to be my favorite way to spend time with a young lady, but it wasn't nearly as terrible as I remembered. Columbia was discharging me soon so they decided to leave it in and let Silver Lake deal with my urological issues. At Silver Lake they tried something new to stimulate urination. It's called a straight cath. What they do is insert the damn thing and then pull it right out again. Why this is supposed to work, I have no idea. Well, it didn't. Back to the proverbial drawing board. Stuck the Foley back in for a few days and bombarded me with everything they had: Flomax. Hytrin. Proscar. Stuck my finger in a cup of warm water (I made that one up). When they finally took it out again, I went to the bathroom and tried to relax, to clear my mind and consequently my bladder. YES! Success! There'a a scene in the movie "The Green Mile" where prison guard Tom Hanks is urinating for the first time since a prisoner with magical healing powers cured his urological tract infection. When the stream starts and there's no pain, a look of absolute ecstasy washes over his face; the man is in heaven. That's pretty much how I felt. Proud, too. After all, I had peed all by myself! I texted Chayie and the kids: "Stop the presses! I peed!!" What a guy!

PS Check out that picture of the bard. Would someone tell me when he had time to write? Can you imagine how long it took him to get dressed in the morning??

*Mesilas Yeshorim=a scholarly Jewish tome.