Wednesday, February 12, 2014

A little background

It's a longish story and I'm going to go into some detailed descriptions at times.
    Expectant mothers should not ride.
    Service animals are not allowed on this ride.
    Riders should be in good health, free from high blood pressure, heart, neck or back problems. This ride may aggravate motion sickness.
    Guest must transfer from wheelchair or other motorized vehicle to enjoy this ride.
    Guest with small children may take turns riding this ride. Ask a cast member about doing a baby swap.
    Fastpasses sometimes run out prior to the end of the day.

About five years after I got out of the Military because of various medical issues - one being cardiac - I had my first pacemaker inserted (by the VA) in the upper left chest area.  It was a single chamber, fixed rate type that only paced the right ventricle at a set lower limit, and eventually failed.

The second was a Dual Chamber Dual Lead variable rate type pacemaker (it added a second lead into my Right Atrium and paced both chambers as needed).  This involved tunneling the original lead to the right ventricle across my chest to the right side, since they could not feed the second lead into the original insertion site into my left Axillary/Subclavian Vein.  The bruises were spectacular.  This pacemaker was great!

Eventually, the battery of the second wore out, and this led to the insertion of my third pacemaker.  A 'new and improved' pacemaker version was installed, but there were a few 'issues' involved.  The leads from my pacemaker to the inside of each chamber of my heart had an inner and an outer conductor - one of the conductors on my Right Ventricular lead had failed over time.  They wanted to replace it then, but the surgical suite was not available (yes it IS a fairly major thing as you will find out later on this ride) ... so they let it ride.  This meant that the pacemaker was forced to perform in less than optimal mode.  Additionally, I had a "minor" infection show up in the surgical site a week or so after surgery.  The surgeon waved the 14 days of antibiotics wand and said all was ok.

I never felt "right" with this pacemaker; I was a pain in the ass of the cardiology department at the VA Hospital in Gainesville, FL; etc., etc. ... Then came March of 2006!  I was at Gainesville for my annual pacemaker check, and I pointed out that I had some 'puffyness' over the pacemaker site, and it felt a little warm.  The Pacemaker Tech had the on duty Cardiologist over asap.  Antibiotics and return in 10 days.  On return I saw an intern from Shands (this is the routine).  By then, I had some open drainage from the old suture line.  He wasn't sure about more antibiotics, so he called in the resident that was the Cardiologist supervising that day.  He said it was a pimple that was draining.  After 13 years of being a Firefighter/Paramedic, I knew he was full of shit, but I headed home - a four hour drive.  Half way home it REALLY started draining!  I was at the VA OPC (Out Patient Clinic) in Tallahassee when they opened the doors the next morning.  Triage sent me straight back to their 'micro ER'.  My Primary Care (a real gem), took one look and called in the local surgeon.  He took one look and said MRSA.  Cultures were taken; big gun antibiotics were handed out; - all the trimmings.  Later that day, I was called my my Primary Care - he said, get on the road to Gainesville RIGHT NOW!  You are being admitted and they are waiting for you!"

A little over 4 hours later (this is longer than that 14 day Safari, isn't it), I was back at Gainesville, FL.  They WERE waiting on me; gallons of blood for lab work; every hole probed at least once; culture this; culture that; your electrolytes are a mess; IV here; IV there; off to your bed - at about 2am.  It had been a LONG day.  The next morning bright and early, in comes a Doctor who introduces himself and states he's the Chief of Thoracic Surgery and I'm scheduled for Monday morning first thing.  They are going to remove the pacemaker; open and debride both pacemaker pockets; debride the tunnel across my chest ... and remove the leads in my heart.  :o  This is MAJOR surgery!  The leads get imbedded in the heart walls - you don't just snatch them out.  It takes some serious equipment!  Next up - Anesthesiology.  Boy was he in for a shock.  I told him I was VERY resistant to being put under and he better bring his big guns.  Finally, the Chief of Cardiology slunk in.  He defended his Resident's call (that it was just a pimple) yada yada.  This has resulted in a Hate-Hate relationship between me and Gainesville Cardiology ever since.  I told him to get out of my room and neither he nor any of his staff was welcome nor would they be allowed to treat me.  That remains in effect to this very day  :rofl2:

Monday came quickly.  The anesthesiologist did his thing; I counted down from 100 - twice; he rethought things and reached back into his bag of tricks.  He started to grab one vial - but he remembered what I had said, and grabbed something else.  After I hit 100 for the second time around this time, he whispered into my ear, This had better work - it's the most & strongest I can give you with the other one".  I was holding on and HAD to get to 100 that time just to check his pucker factor ...  :rofl2:  I let go in the 70's and ...

7+ hours later, I'm in Recovery; I'm FLAT ON MY BACK - OMG.  I told them NOT to have me flat!  I sat up, hung my head over the side and  :barf: .  The Recovery Room Nurse was totally shocked that I was awake so soon; stunned that I had sat up; and luckily, VERY fast with an emesis (barf) basin.  I then said I needed to make a phone call - out to the Waiting Room.  PureTCrazy (my sister, Rita) and the OldeKoot (The Momma) were waiting for information.  Having ME call might have been a little bit of a shock to them, but I told them I would soon be in Cardiac Intensive Care and when they had me settled in, they could come and see me.

CICU - I had a GREAT nurse.  For the first time in many years I had no pacemaker; some of my meds were very clear that they are NOT to be given in certain medical conditions without a pacemaker in place - guess what.  Let's just say that the On Duty Cardiologist spent 'some time' with me one on one.  I spent three weeks in the hospital at Gainesville with a central line running Vancomycin and other nasty stuff into my body.  Why a Central Line and not a PIC or whatever.  My veins were plugged up to some extent even then (more about this later), and they could not physically insert a PIC Line.  I had a Vacuum Healing System in place - and stayed on it for months!  It was NOT fun changing the sponge packs, etc VERY frequently.  Morphine IV was my friend.  It took the edge off.

Finally, I was cleared by Thoracic Surgery.  They did NOT want to put another pacemaker in because of my risk of re-infection.  I spent years on prophylactic (go ahead - laugh damn you!) dose levels of antibiotics.  I never did recover from the lack of a pacemaker.  I became a couch potato; I gained weight; I ... felt like hammered whale shit on the bottom of the ocean!

Make sure you hold on to your children, the ride gets 'dark' shortly ...

The end of April 2010 finds me at the Tallahassee OPC with a nasty cough, etc.  My WBC (White Count) is over 21000 - which is 'Not Good'.  I get transported to the nearest hospital by ambulance!  I get admitted!  I get stuck with IVs and more nasty stuff is poured into me for almost a week.  While I'm there, I have various tests run and I am scheduled with various follow-ups.  One of these is with Pulmonary in Gainesville ...

Pulmonary in Gainesville has various tests run - one of which is an Enhanced High Resolution CAT Scan of my chest.  The Chief of Pulmonary Service calls me at home and tells me I will be called by Thoracic Surgery to set up an appointment ...!  My medical background (both knowledge and my personal background) leads me down the garden path, and when I go in to see the Thoracic Surgeon on July 12th, I have my bags packed.  The Surgeon used to be the Chief of Thoracic Surgery at the Gainesville VA - until he got to tied up doing Heart & Lung Transplants at Shands  :o  He was called over because of ME!  :rofl2: We really clicked - I knew the key words and tricky phrases ... and had already 'self-diagnosed myself WITHOUT the CAT Scan to go by.  He didn't pull any punches since he saw I knew the score.  The years of having pacemaker leads in my veins - and the nasty MRSA infection - had resulted in the major veins to my heart on BOTH sides (Axillary; Subclavian, Brachiocephalic and Superior Vena Cava) becoming occluded (plugged up and no rotor rooter was going to help that).  This is 'Not A Good Thing".  For one, the Brachiocephalic Vein is what the Jugular Vein drains into.  Blood goes into the gourd, but it has a hell of a time draining out - this leads to MASSIVE headaches 24/7 ... which I had been complaining of for over a year.  For those interested, this is known as Superior Vena Cava Syndrome ...

July 14th, 2010 I'm back in surgery.  This time they are cracking my chest to get access to my heart; they are "harvesting" (a nice word for ripping out a chunk of vein from each of my thighs) the large part of the saphenous veins from my thighs; they will use those veins to jumper from my Jugular Veins right into the top of the Right Atrium of my Heart  :o ...  This time the Anesthesiologist was ready - I only made it back to 100 and down into the 50's this time  :rofl2:

Many Hours later -  I'm awake; I'm in Cardiac Intensive Care and the head of the bed is cranked up - woohoo!  I wiggle a little and ummm - I'm sore. 

The nurse is there and asks if I'm ready for my pain meds.  I tell her I'm fine.  (I have an EXTREMELY high pain tolerance to go with the tolerance to pain meds & anesthesia).  PureTCrazy & the OldeKoot are allowed in.  Their eyes are VERY expressive, but they don't say much.  I only spend a week or so this time.  They were VERY surprised at my activity levels and let me go early  :argh:

For the first time in YEARS I was feeling better.  I was tired of being a couch potato.  On a telling note, 3 weeks BEFORE the surgery, I had started on Weight Watchers.  I was feeling 'froggy', and after much arm twisting, the Thoracic Surgeon cleared me to start walking.  That was September 17, 2010 at 1:33pm.  I also convinced him that it was necessary for my mental health to ride roller coasters at Disney World.  A little background here.  I had a Cardiology appointment on Friday the 17th at Gainesville; I had a Neurology Appointment in Gainesville on Monday the 20th; it was 2 hours to Disney World - or 4 hours back home; I had vouchers for FL Resident Seasonal Passes for OldeKoot & Myself; I had already made reservations for Friday - Monday at Disney World for the two of us and the car was packed!  With some more arm twisting (and maybe some other threats, I was cleared to "ride any coaster I wanted".  I did.  Expedition Everest; Space Mountain; Big Thunder Mountain Railroad; Rock-N-Roller Coaster ... YEE-HAW, how I missed those for YEARS!

I got home, and followed through on my clearance to walk - I started the Couch To 5K plan.  October 30th, I did my first 5K - EVER .
November 25th, I did another - a 5K Turkey Trot in Tallahassee.  December saw me doing a 5K Jingle Bell Run in Panama City. 

Which leads me to the Marathon Weekend in January of 2011.  I did the Woody & Friends 5K at Disney World! 
February saw me at it again.  This time the 6K 'Flash' in St. Marks, FL.
I registered for the Expedition Everest Challenge on May 7th and did what is essentially a 10K walk.

I was accepted onto the AllEars Running Team for the Disney Marathon Weekend in January 2012!  That has me committed to doing fund raising for Deb Wills (the person behind ).  The money goes to

I then proceeded to do numerous walks - including 1/2 Marathons. Never fast, but always completed.

That brings us to February of 2013 - and the first of my falls while walking. I wasn't sure at the time what caused to fall, but I would find out why at a later date. That fall resulted in a rotator cuff tear and a deltoid insertion injury. Because of my history, I am NOT a surgical candidate, so I was sent to PT to do what they could. 3 falls later, we realized that I had foot drop. My toes would drop and drag causing the falls. Why was that happening? I have a Spinal Cord Injury that has progressed with time.

The VA doctors said no more run/walks. Being stubborn, I told them I was going to continue. They mentioned a new program primarily for Iraq and Afghanistan Vets to keep them involved in sports (and healthier and cheaper medically in the long run). As a Vietnam Vet that was active in sports, I qualified! The VA is (slowly) in the process of getting a handcycle approved for me.

It's been a LONG and convoluted ride to get to this point - I hope you enjoyed it!