2017 – Affairs of the Heart (NOT a love story!)
Very early in the year, I noticed some odd breathing problems that usually showed up when I carried heavy grocery bags up stairs. I surmised that it might be due to a gastroenterological problem I have: silent reflux.
You’ve all had heartburn on occasion, right? I used to, but I can’t feel it anymore. I have no indicator that damage is being done. Supposedly, the acid has burned the nerve endings. A few years ago – by luck – it was discovered that some serious damage was being done to my esophagus by stomach acid, but the problem was caught in time and reversed by medication.
But that didn’t address the overall problem: acid was getting up my esophagus and I was none the wiser…………….until my voice started getting a little higher-pitched: it had reached my larynx. More medication.
Overall, the voice is pretty much back to normal, but not always. Then, another problem popped up: I couldn’t clear my throat. Oh great – post nasal drip?
The ENT (Ears, Nose, Throat) doctor said no – all clear in the nasal cavity. The gastroenterologist, however, had an answer: the acid was reaching my throat. And if it got THAT far, it was only a short roll over to my windpipe – and if it was getting in THERE, then shortness of breath was a distinct possibility.
Fortunately, I am not one of those men who refuses to go to the doctor when problems arise, so I went right to my regular MD, Dr. Robert (every Beatles fan needs one of those).
Needing to rule out all other possibilities, he handed me prescriptions to see a cardiologist and a pulmonologist. I passed all of their tests, including separate stress tests, but the cardio noticed a heart rate reading that was a little bit low when I was active. Not alarmingly-low, but enough to tell him that there might be a blockage somewhere.
He gave me a choice: have a CT scan that was not sophisticated enough to see EVERYTHING or undergo an invasive cardiac catheterization that would be pretty definitive. This would involve threading a catheter with a tiny camera from my wrist to my heart.
I wasn’t thrilled by the sound of that, but I told him I wanted answers, so let’s go with Door #2.
Here’s the microscopic c-cath wrist incision (taken 10 days later) and what they put around it to protect from direct infection into the vein (taken the next day):
I went into this procedure on October 6 for only one reason: to rule it out and solidify my belief that the problem was reflux-related. I came out of this procedure by being told that three blockages were discovered and that one of them would be too problematic for a stent, so triple bypass surgery was in my immediate future.
While in recovery, a heart surgeon visited me and told me that there was no time to waste and that he wanted to schedule the surgery for October 18. I knew that I had too much to do beforehand, so I told him I would call his office when I had figured out a date.
Being one of those immortal types, I had never gotten around to preparing the minor things that most mortals had taken care of at a certain stage in their lives, like making a will, a living will, etc.
I had also planned on doing a shoot on the George Washington Bridge that could only be done on November 11 – Veterans Day – when the world’s largest hanging US flag would fly from the New Jersey tower of the bridge.
I’ve photographed the GWB flag a couple of times before, but only from the south walkway – the one that most people are familiar with because the view from there is of Manhattan down to the New York Harbor. The north walkway – which is much more difficult to access – is usually closed.
But because of a recent spate of suicides into the Hudson River, the south walkway was closed in September (to reopen by the end of the year?), so that higher fencing could be installed. The north walkway was opened in its place.
This meant that my only opportunity to do this shoot from a different perspective would be on the one day during this period when the flag would fly – Veterans Day.
I called the surgeon’s office and scheduled the procedure for November 16. Fortunately, I didn’t keel over during that one-month delay and here are some of my November 11 images (I’m glad I waited).
As far as I’m concerned, this was the shot of the day (if you look closely, you can see the moon):
And if you don’t look closely, you can see the moon better here:
Looking toward Fort Lee, New Jersey, you can see two new residential towers – The Modern 1 & 2. When I took this, 2 (far left) wasn’t finished yet and 1 was occupied:
This is one of the sets of stairs you must navigate to access the GWB’s rarely-opened north walkway:
From the GWB, this shows Ross Dock, the Palisades and the Hudson River, north of the bridge:
Looking straight down, I saw a long shadow attached to a tiny man, who was about to walk under the bridge:
(left to right): The Modern 2, The Modern 1, a GWB access ramp from the southbound Palisade Interstate Parkway (silver tollbooths are behind the ramp), a sign for the northbound PIP (you thought it said, “PIMP RAMP”, right? “Where are the tricked-out Escalades?”):
The view from under the southbound PIP ramp:
Selfie in the convex mirror built into the Palisades (“for all the bicyclists that use the walkway”, said the guard in the booth behind me):
NOW do you see why I postponed the surgery? I couldn’t do this any other day.
Two days before the procedure, I had to spend half a day at the hospital for pre-surgery testing. This involved CT scans, X-rays, blood tests and vascular testing (ultrasounds).
The ultrasounds were the most interesting because they produced something I had never seen before: a line drawn on my right leg from my crotch to my ankle with purple skin marker.
As you may know – in most cases – a long vein is removed from the leg and is used for the three bypasses. The ultrasounds identify the vein and the sonographer makes a dot on the leg every few inches as she goes down the leg and then connects the dots. This tells the surgeon exactly where the vein is and where to cut.
This was taken on November 14:
It used to be that one cut was made along the entire length of the vein to remove it. This made for a much more painful recovery. Now, they use three small cuts and wind up pulling the entire vein out through one of the cuts – actually, more like a small hole – by the crotch.
These two pictures were taken on November 23 – a full week after the surgery. You can still see a bit of the purple marker line and that it looks like they beat the hell out of my leg trying to get the vein out (it’s still sore a month-and-a-half later). The closeup of the extrication hole shows that it’s still oozing (you didn’t just eat, did you?):
I was told to be at the hospital by 5:30am on the 16th for the 7:00am surgery. My sister Lorraine – my designated angel – got me there in plenty of time.
I remembered being wheeled into the room and expecting to be fussed over for an hour like I was for the catheterization, but my next memory was waking up in the ICU, where a VERY cute nurse greeted me with a huge smile and a question:
“Remember me? I was there when the surgery finished and you practically jumped off the table!”
I have no such memory nor any idea how one could “jump off the table” immediately after having major surgery………….and then sleep in the ICU for a long time.
A sign in the ICU (I think that last line in the plan of care has to do with the cessation of sedation):
The ICU stay was actually fairly pleasant. The nurses were all very nice and one of them – from my hometown of Teaneck – told me that when she went home, she looked me up on bobleafe.com and was looking at a picture I had taken of my mother. Her father happened to walk by, saw the picture, said “That’s Eunice Leafe!” and told the nurse that my cousin – who was in the Fire Department – once saved his life!
Needless to say, I got even better treatment after that.
One ICU incident went particularly well. You’re told in advance that they expect you to be on your feet and walking on the second day. I had my doubts about that, but they got me up and walking………….and I was walking faster than the nurse!
It felt completely normal (I’ve always walked fast). I freaked one of the nurses out on my next walk. You know those little yellow signs that are put on floors after they’ve been mopped that say “Caution – wet floors”? As I approached one, I decided to lift my leg up over it so it appeared that I was stepping over it (but I was really sort of waving it in the vicinity). It’s possible that the fact that I was wearing a hospital gown made it look more dangerous than it was, but I think that if such a thing existed, I would have gotten the “Best Walker” medal in the ICU.
The only time I didn’t feel normal was toward the end of my stay in the ICU when they told me that a room was opening up for me in the hospital and they put me in a hall somewhere that had me looking through a window back into what I think was the ICU. It began to look like a building and I was sure I saw a UFO hovering over it. This is a closeup shot of what I saw, so you’ll have to imagine it as a small part of a larger picture:
I don’t know how they medicated me that day, but I guess it was to keep me from running around the ICU. And I wound up waiting for nothing – the hospital room didn’t open up until the next day.
So now I’m out of the ICU and in the hospital proper in a private room and after my first night there, I wanted to go back to the ICU.
Daytime wasn’t too bad, but trying to sleep at night was horrible. My bed was right by the door and you were not allowed to close that door. The daytime hustle and bustle of a hospital was to be expected and it DID slack off in the evening, but that first night was miserable.
It appeared that a room down the hall was being converted at around midnight to some other use that involved machinery. I can’t be sure what it was, but it was quite noisy and involved a bunch of young hospital workers who sounded like they were unaware that there were patients nearby who were trying to sleep. It was almost a party atmosphere.
I mentioned this to someone who I thought might have some say in the matter and here’s the reply: “Hey, it IS a hospital, you know”…………….not exactly helpful.
On the next night, there was a serious problem with a screaming patient. It woke me up and I felt like I was in some sort of altered state…………..and I may have been, but I was never told about taking any medication that would do that.
And – of course – they couldn’t tell me what was going on with the patient, but it was uncomfortable being there at night. And you KNOW something isn’t right when you wish you were back in the ICU because the situation was more comfortable there.
During the day, I could take a couple of pictures out the window, but that was pretty limited, although the third shot was a challenge. Fortunately, I also had my iPad with me and kept myself semi-amused.
Amongst the many buildings that comprise the Hackensack University Medical Center, ONE of them has a helipad – the building that I was temporarily residing in. I could hear the choppers when they landed and took off, but could never actually see them. One of the buildings that faced my window had a lot of greenish-blue glass, so I looked for a reflection……..and saw one that lasted about 2 seconds. I captured it, though I have no idea why the helicopter looks like it’s enmeshed in netting – maybe my camera was under sedation:
The nurses started walking me around and said pretty much the same thing they said in the ICU: “SLOW DOWN!”
They seemed surprised that I could go up and down stairs and decided that it was time to send me to a cardiac rehab facility (CRF).
The way the CRF thing plays out could use some repair. I was aware early on that the next step after the ICU/hospital stay was at least a couple of weeks at a CRF. The cardio told me well in advance that I should visit CRFs to see which one I liked.
“That’s a good idea, but I’m not familiar with any of them. Got a list?”
“No. Call the surgeon’s office for that.”
The surgeon’s office didn’t have one either and told me that a hospital social worker will visit me with a list ON THE DAY BEFORE THE HOSPITAL RELEASES ME AND I HAVE TO PICK A CRF QUICKLY WITHOUT VISITING ANY OF THEM!
Sure enough, on that day before discharge, I was given a list of about 20 facilities to choose from…………..and there’s no information given about any of them! Once again, I’m very fortunate that I had my iPad with me and could check out the reviews on all of them online.
About ¾ of the CRFs were all from one company and almost all of them had terrible reviews…………..except for one, which had reviews that were fairly glowing(!). My choice was made for me – there was no other.
Then it became “but do they have a bed available”? They did.
When I finally got there (after 9pm on November 21), I was brought to a room. While still in the hallway, I could see that the room was occupied.
“This is the wrong room. Somebody’s in there.”
“This is the right room. That’s your roommate.”
I hadn’t counted on that. Richard turned out to be a slightly gruff, 85 year-old man from Brooklyn and we talked for the next hour or two while he straightened me out on what’s what at this CRF.
He forgot to mention that patients got woken up at 3 or 4 in the morning and when it happened that first night, I nearly freaked – not only at the timing, but also at some of the reasons:
“Wake up, Mr Leafe – it’s time to take a pill.” (“Come back later.”)
“Wake up, Mr Leafe – I need to weigh you.” (“I will weigh the same at 9am. Come back then.”)
“Wake up, Mr Leafe – time to take your blood pressure.” (“You mean the blood pressure that you just caused to go up? Come back later after it goes down.”)
Sleeping here wasn’t much better than at the hospital, but at least you could get 3 hours here and two more there. My bed was closest to the door to the hallway. You could not close the door if you wanted to – there was no latch. The 6am shift gathered in the hallway and talked (and laughed) loudly. It was as if they had no clue that all their patients were just a couple of feet away TRYING to sleep.
You kinda wanted to just open the door and say, “EXCUSE ME – WE’RE TRYING TO SLEEP HERE”, but you knew you’d pay for it later when it was time for one of them to come in and give you an injection.
Breakfast was brought to the rooms at around 8am. So was a small plastic cup with MANY pills that you were expected to take all at once (is that a medically-sound practice?):
After that, you were expected to show up at the gym down the hall for morning (AND afternoon) physical therapy. If you didn’t, the therapists would come looking for you.
But that didn’t happen much because the therapists were pretty nice people and you really didn’t want to disappoint them. Besides, it was required and good for you and meant that you might go home sooner if you took it seriously.
Because I was the King of All Walkers at this place too, I got to go for outdoor walks with a VERY nice physical therapist, who was friendly, funny, smart, but also took her profession VERY seriously, so slacking off was not an option.
At the walk’s midpoint, we’d take a break and sit down and talk – sometimes seriously, sometimes hilariously. And sometimes, those conversations would continue as we walked up a small hill, where I’d begin to run out of breath. We’d stop and I’d quickly recover. Toward the end of my stay there, I wasn’t running out of breath after walking up the hill, so it became obvious that this P.T. was a tremendous help.
Lunch showed up at about 12:20pm and the afternoon was spent pretty much as you pleased (after physical therapy, of course, and outside doctor appointments). It was a good time (for me, anyway) to have visitors. I think my two most memorable lunches occurred on consecutive days – November 23 and 24.
The 23rd was Thanksgiving and they served up a really nice plate of REAL turkey. I was quite surprised to see turkey on my lunch plate on the 24th (leftovers from Thursday?) and was even MORE surprised that they actually served FAKE turkey on the day after serving excellent REAL turkey on Thanksgiving. WHAT were they thinking?
FAKE turkey (and crappy photography):
Occasionally, the desserts surprised:
I guess this counts as a surprise:
Dinner came somewhere around 5:30pm and the rest of the evening was set aside for the battle of the TVs.
Richard and I each had one mounted on the same wall (his is on the right). Sometimes we’d agree (top) and sometimes we didn’t (bottom):
And sometimes I’d watch Jan rocking out Christmas tunes on her slide trombone for Toyota:
Occasionally, Richard fell asleep early with his TV on, but it really wasn’t my place to go turn his off. Besides, he’d probably wake up suddenly and take a swing at me.
I’d rather face Jan’s trombone.
On a somewhat humorous side note, I had a pretty good time with the therapists. One day, I showed up with a certain t-shirt under a regular shirt and announced that my t-shirt had something on it that would illustrate a generation gap………..unless, of course, they could identify what it was.
Here’s what the shirt showed:
Guesses ranged from a stylized swastika to “something to do with penises”. It took a while for some of them to understand about record players, spindles and the CENTRAL differences between LPs and 45s, but no one felt bad about not knowing that it was a 45 adapter because that meant they weren’t OLD!
Something REALLY odd happened 3 days before I was discharged. A man with white hair – who I had seen in the hallway the day before – walked into my room and asked me if I recalled a certain name. It was the name of a girl I knew over FIFTY years ago!
“Yeah – I remember her.”
“She’s in the next room.”
Slightly astounded, I went next door to say hello and spoke to the two of them for about an hour. The man was her husband. I asked him how he knew that I knew her. He said that she showed him an article about me in a magazine 5 years ago. He remembered the name, saw something similar by my room’s door and asked her how my last name was spelled (“We have a match!”).
On my next-to-last morning at the CRF, I was awoken by a nurse and a burly doctor who shined a flashlight in my face – always a fun way to wake up – and told me to open my shirt. He inspected my chest with his beam and said something to the nurse that sounded like either “It’s resolved” or “he’s resolved” and then left without another word.
I later found out that he was the “wound doctor” and I’m guessing that my surgical scar had healed enough to allow me to be discharged.
The facility sent me home after 17 days – a fairly short stay – because both the physical and occupational therapists “had nothing left to throw at me” (their words). I passed all the tests, including two very important ones that seemed incredibly easy: stepping in and out of an empty bathtub AND sitting down and standing up from a toilet without holding on to anything.
So am I cured? Is everything back to normal? There’s no way to know right now. The cardiologist recently put me through a 4-hour nuclear stress test that will help him determine the level of outpatient physical therapy that I will probably still need and it will take months before all systems return to normal function and strength.
It may be that the odd breathing problems will come right back and we’ll have to move on to another possibility, but I can at least be reasonably sure that I will not be interrupted by heart problems while we explore that possibility, thanks to the cardio noticing one ever-so-slightly-off result.
I’ve now been home for 3 weeks and have been quite busy. I just finished almost 3 weeks of scanning (on spec!) for the 2018 Rock and Roll Hall of Fame Induction Ceremony and program (fingers crossed). UPDATE: I sold ONE picture (The Cars) to the Hall for the Induction Ceremony program.
I decided 2 days ago that it was important to create and get this post up (I wished I had seen something like this before surgery – it would have answered a lot of questions…………maybe it will help someone else in a similar situation) and I wanted to get it done before New Year’s (I DID – 12-30-17!), so I’ve been hauling ass on that and just realized that I “finished” it without posting the big money shot (taken exactly one week after surgery) – the representation of what this whole thing is all about (and my least-favorite selfie). NOTE: exactly 4 months later, I took another picture, combined it with the original and posted it on 3-23-18:
I guess it could have been worse:
So I’m now keeping everything together – literally – by hugging a pillow when I sneeze and hoping that no car taps mine and explodes the driver-side airbag at my knitting sternum…………things I couldn’t possibly imagine worrying about 3 months ago.
Life sure is interesting……………and precious.
Late addition (1-16-18):
Regarding the above-mentioned 4-hour nuclear stress test, I still don’t have the results yet (end of the month), but I DO have a 4-picture photo stitch that I took from the treadmill room after the test.
As with all photo stitches on this blog, click on the image to enlarge. After it enlarges, put cursor over image. If it shows a + sign, click the image again to make it full size (you will have to scroll from side to side). When finished, click the image once and then hit your back button to shrink it back to this post.
All information is on the stitch:
SO……….after the surgery/hospital stay and and the cardiac rehab facility stay, there’s a third component that’s voluntary, but STRONGLY encouraged:
OUTPATIENT PHYSICAL THERAPY
It took WAY too long to get started on this. It makes no sense to me to have a 3-month gap between the end of physical therapy at the CRF (Dec ’17) and the beginning of the outpatient version (Mar ’18). And if I didn’t complain about the lag to the cardiologist’s office, it probably would have taken even longer.
Eventually, I got started in this 3-times-a-week, 12-week program of one-hour sessions (ALL covered by Medicare) at Hackensack University Medical Center. I was offered a choice between treadmill and walking and took the latter and just whipped around the indoor track, faster than almost anybody (one-hour sessions were scheduled throughout the day and Usain Bolt might have been in one of the other ones, so I have no way of knowing where I ranked).
Who cares? Speed wasn’t the objective. I was moving again.
Various numbers of laps were alternated with sit-down exercise machines that worked my arms and legs. My blood pressure was taken before, after and sometimes during exercises. I wore a monitor that was attached to me EKG-style and transmitted information to the central desk, where attentive nurses and physical therapists kept a watchful eye on everyone.
And all those staff professionals were very nice, knowledgeable and extremely helpful, so I’d like to salute each and every one off them with this gorgeous group portrait I took of them:
In my defense, I kept asking when their pictures were going up on the wall and was assured that it would be “very soon”. Two months later, my time ran out. I even went back to shoot the below video a month after that and the wall was STILL blank.
Hey – I tried.
Regarding the video, I wanted to shoot it on my last day there, but privacy laws don’t permit that, which was fully understandable, so I made arrangements to go back on a day when the gym wasn’t in use.
However, I DID manage to take a couple of shots of things that caught my eye during my tenure there.
The first thing I wanted to get was the Privacy Curtain, which I refer to in the video as the “fancy locker room”. BTW, there IS a locker room there, but I never used it – or even saw it – so as far as I was concerned, the privacy curtain must be it:
Shapes and colors brought me over to an area of the gym I never got familiar with:
When I returned to shoot the video, I took a couple of stills in the half-dark gym, including two from opposite corners of the room and one of the monitoring desk with my favorite nurse at the helm. You might not recognize her from behind, but she’s definitely in those staff shots on the wall:
On to the video, which I had to do quickly. I mumbled here and there (I had to be quiet – people were working nearby) and have had some on-and-off voice problems that make it sound a bit higher than normal. And of course, it had to happen on a day when I needed to narrate.
Maybe I should have asked about vocal rehab while I was there.