Sunday, Nov 1
For Oct 31 CPAP. Reported figures. 6 hrs 34 min with AHI=0.91 Events: 6 H, 1 CSR, 8 RERA. No major mask leaks (max=16 L/min); no oximeter.
Day spent by me working toward getting the news out to people in our email address book of our changed domain for the blog and for our web pages, including the annual end of year greetings. At the end of the week, I still have not completed the send. I also have only barely started our 2015 Greetings. It is on the list of things to do, along with 100 others. Maybe after this blog is posted on 11/8/15, I will get an announcement of the change out, and continue to add or correct bounced accounts. If you have changed your email address since 2013, please notify me of your new one.
Monday, Nov 2
For Nov 1 CPAP. Reported figures. 8 hrs 27 min with AHI=1.66 Events: 13 H, 4 CSR, 1 CA, 11 RERA. No major mask leaks (max=20 L/min); no oximeter. Activity around 4:00 a.m. I must have moved over my air tube and shifted the mask.
John wore his new Knudson’s sweatshirt I won at Friday’s Halloween Party to the hardware/lumber store to get two items he needs for installing the patio door. He visited with the lady in charge of, among other things, making donations to community events. Seemed like a right thing to do. I spent time finishing working on the pictures from the party and shipped them off to the AmeriCorps volunteer at the Adult Activity Center for their photo collection.
Tuesday, Nov 3
For Nov 2 CPAP. Reported figures. 8 hrs 26 min with AHI=0.47 Events: 4 H, 3 CSR, 13 RERA. No major mask leaks (max=20 L/min); no oximeter.
I went for my fasting blood draw (for next week’s visit with my cardiologist) and back home to get John for the trip to visit the surgeon. This required follow-up visit happens after my implanted device’s warning that its battery needed replaced. Yesterday, I had 81 days left for the procedure. The surgeon’s name is Dr. Dao Pham, who is certified in Nuclear Cardiology, with a fellowship completed in VA in electrophysiology, and had his residency at the Mayo Clinic in Rochester, MN. He performs surgery on implanted devices including defibrillators (as mine, with a built-in pacemaker), and plain pacemakers, as well. He performs surgery mornings or afternoons daily, and sees patients in the office daily too. Mine today was scheduled for 1:10, so I assume today he was in surgery in the morning.
Today, the three of us, in consultation with my cardiologist, Dr. Anatole Kim, agreed on the procedure. The two doctors conversed via internal email on questions of dosage on my Metoprolol medication. I have been on a very low dose, lower than any of the doses studied in clinical trials. Dr. Kim would like to go higher but that might degrade some other heart function parameter that the extra wire would compensate for. But apparently medical protocols are established on “current” conditions and not “anticipated” conditions. Seems this is an issue that makes you go, Hmmm. The plan may change next week, when my cardiologist has reviewed my entire case that will include interpretation of this morning’s fasting labs, of the 24-hr Holter heart monitor a few weeks ago, and of an echocardiogram over a week ago. John and I both got the impression today that only two wires would possibly be considered (maybe one more added to the same right side of my heart that already has one).
Currently, the plan from today, is for scheduled surgery December 18, Friday, to be there (Yakima Memorial Hospital, for check-in at 8:00 a.m.), no food after midnight, water and medications all right (except blood thinner that will have been stopped). The surgery is planned for 9:30 a.m. within a 1.5 hr period. If it is only a battery and unit replacement, and no new wire added, I can leave the hospital afterwards. Currently, that is what is scheduled. I accepted and signed to authorize the scheduler to have the required paperwork for their records. The surgeon feels I do not meet the criteria to put in more wire leads through my veins. He arranged, however, for a switch from the Biotronik unit I now have to a new Boston Scientific unit, which is smaller and has a longer-lived battery (9-10 years). Sounds good to me.
However, IF my cardiologist decides to add the second wire to the unit, THEN, it becomes major surgery, and I will have to stay overnight in the hospital for observation. Regardless, we will stay with the same date and time.
This is all I know right now.
I do have this report plan from the surgeon, primarily written for my cardiologist, summarizing our visit today. {Note: Acronyms in text are defined below.}
The patient has been stable. Her ICD battery reaches ERI and will be replaced. She does not meet the criteria for CRT upgrade due to her narrow QRS and having only 9% RV pacing. She remains in sinus rhythm and regarding the question of possible upgrade to dual chamber ICD, if she needs to increase HR to prevent the low output syndrome and to be optimized on her Metoprolol dosage, then she will need upgrade from a single chamber to dual chamber ICD. However, she has been asymptomatic with activities, it is felt she can continue her current regimen and needs only the ICD battery change.
ERI—Elective Replacement Indicator
ICD—Implantable Cardiac Defibrillator
CRT—Cardiac Resynchronization Therapy
QRS—Ventricular Conductance Time
RV—Right Ventricular
Sinus Rhythm: normal cardiac rhythm proceeding from the sinoatrial node; in healthy adults its rate is 60-90 beats/min.
HR—Heart Rate
At the moment, John and I are translating that to mean I will only have the unit changed and my battery replaced with no other wire(s) connected. The wire currently there will be attached to the new unit, but no other adjustment is required.
After our session with the surgeon, we went to the scheduler to fill out the paperwork to request the date.
From there we went to return the unused stovepipe section, a roof-top flashing, and an outside air intake kit connector for our new wood stove to Fosseen’s Home & Hearth to trade against the remaining balance. They ended up owing us $7, which will be credited to our charge card used to buy the original unit.
While on that side of town, I managed to locate a BNE person to whom I was giving an extra music stand. It was easier to drive by her work than to try to meet her at her home or in Ellensburg. Our schedules were always conflicting, and our houses are 1/2 hour apart. This worked, and it has a new home with her daughter, a 6th grader, learning to play the clarinet. She will be playing Jingle Bells in an upcoming concert.
From there, a fast trip to Costco for gasoline for my car and a few small items for our neighbor and us. By the time we pulled into the driveway it was nearly dark.
Wednesday, Nov 4
For Nov 3 CPAP. Reported figures. 7 hrs 35 min with AHI=1.85 Events: 14 H, 5 CSR, 15 RERA, 1 PP. No major mask leaks (max=20 L/min); no oximeter.
Resident does with buck out back, eating old apple throw-a-ways. These were store-bought and still in the fridge, not our handpicked Honeycrisp.
I left for town at 11:00 and took apples, BBQ sauce, and a Veteran’s Calendar by her house to Gloria and her sister, Shirley (visiting from CA) on my way to the Food Bank for music there. We had a bunch of singers today along with four instruments. The neatest part of the performance was the audience participation. They were really into it—singing, dancing, and applauding. That makes us all very happy. After playing, they feed us. Today it was pasta with mushrooms and sausage (too salty and garlic ridden for me), bread, salad, and the best part of the meal was a wonderful PEAR upside-down cake.
I left there (picking up some bran muffins and angel food cake loaf for my neighbors), and went near the hospital to pick up bag of socks from a BNE site give. Then on to SAIL class where we had 18 people participating. On the way home, I stopped off at Grocery Outlet for a good deal on real mayonnaise.
I came home to a closed gate, nothing decent in our mail, and a surprise of an almost-installed patio door. John has it in place, but the job is not by any means complete. But, it is there!!!, held in by 3 nails at the moment, and with paper filling the spaces that could leak cold outside air. A couple of other projects now have priority, so the door is on hold, awaiting fine tuning of the door-unit in the opening and then sealing with minimal-expansion foam sealer. The outside will get winterized but next spring it will get a re-do. Inside, who knows what it will look like when “finished.”
I called the Briarwood Retirement facility resident potluck coordinator about changing our Dec 19 date to 12/12 instead (because of my impending operation). Unfortunately, that won’t work because they have a new Gospel sing-along event that has moved from a Friday evening to the second Saturday of the month. If that doesn’t work (and I won’t know until next week), then we also have the option of canceling, but have to notify them by Nov 17. Currently, not knowing if I have to stay overnight, makes the planning difficult. People are busy during December, so a cancellation might work well for everyone. They will have already heard our December music fare we start the 3rd week in November (coming up soon).
Thursday, Nov 5
For Nov 4 CPAP. Reported figures. 6 hrs 40 min with AHI=1.65 Events: 11 H, 6 CSR, 20 RERA. No major mask leaks (max=14 L/min); no oximeter.
In the cool morning temperatures, John went to town for 4 stops, brought home lots of stuff, not the least of which was a new digital wrist blood pressure monitor for me. It is so much easier to use than the one that seems to be too big for me with the cuff on my arm and the need to take off my long-sleeve shirts in the morning and the evening. I have to take my BP daily and record it for a week prior to my visit with my cardiologist. John bought all sorts of stuff on sale today, at the Bake Sale at Super 1, cat food at Bi-Mart, and house-brand colas for only 78¢ /2 liters at Safeway.
I was happy to begin my BP recordings a day late. My trip to town was not scheduled until afternoon, to play music at the Rehab where I spent time recuperating in 2010. We had 8 people there today and a nice time and large audience. Our 93 yr old dancer, Helen, with her walker danced at least 1/2 our 22 songs. As she dances she smiles and sings the words to the songs. She points at her eyes during “Blue Eyes Crying in the Rain,” and says, mine are brown!
On my way home, I stopped and delivered my flax seed filled (hot/cold) bag by to friend, Kathryn, on loan. I took a few apples to my guitar friend and made 2 others stops.
The biggest surprise of the day was arriving home and finding John had installed our new Patio door.
Let me explain the above collage. The left is the door (on wooden rollers) with its packing still intact. The middle is the back of our house with reddish siding cut away to get to the nailed flange. The old door (dark brown metal) is on left, and the newly unpacked door to its right. The red rope and blue twine are there as a precaution because the door-unit is not attached to anything. There is just a very slight lean, in towards the house. The right shot is what I came home to today, taken from inside looking out of the installed door – still with protective sheet coating on. It still has a lot of framing (paneling above and below, and other adjustments (such as the blinds) inside the glass. It is a workable door and now that the plastic has been removed from the glass (still there in the collage), it is possible to get a clear view outside. Today was a beautiful view from my recliner–looking out to a great view of blue skies with yellow-leafed trees and green Ponderosa pines.
Friday, Nov 6
For Nov 5 CPAP. Reported figures. 8 hrs 35 min with AHI=0.82 Events: 7 H, 1 CSR, 15 RERA. No major mask leaks (max=11 L/min); no oximeter.
I succeeded in getting the new Pella® Patio Door’s registration confirmed.
I received a funny phone call this morning. I had a number that I did not recognize on our caller ID on our home phone, so I called and asked what it was about. A fellow had loaned me his cell phone because I forgot mine and I called home from the grocery store on that number. I did not realize that was the timing, and I left a message asking who had called me. He returned a call to tell me, “An elderly lady had borrowed his phone to call her husband.” I laughed and thanked him for lending her the phone, and said, “That was me, but I don’t think I am elderly.”
This was a long, tiring, but fun day. Our purpose was to drive to Seattle, for the annual Washington Trails Association (WTA)’s Volunteer Appreciation Recognition program, we try to visit each year, the first Friday of November. This year John did not attain any milestone awards. We think the next on his list is 250 days on the trail working, and it is a Full Bench achievement, with the gift of a soft-shell jacket. His last award was a knit hat for 100 days of trail work but he had about 150 then. This year was going to be a record year for him (and maybe is), but he did fewer days than intended because of being sick with Giardia the entire month of August and unable to participate in anything until mid-September.
His total for the year is 25 days, including 4 days at Mt. Rainier National Park on a section of the Wonderland Trail called Summerland. Two days at Crew Leader College did not involve trail work, but he did get a Red Cross basic first aid badge, and some good information in other activities there. The white ’09 Subaru got a workout – getting to Dorothy Lake involved 12 miles of dust and the color changed completely.
During meet-and-greet on Friday there was a slide show (maybe 100 photos in a loop) and one of them was of the North Bend Crew Leader College, where John is seen in the lower right.
John is on the front row, 3rd from right, holding his orange assistant crew leader hat. I took photos of some of the other photos showing some neat places where WTA folks go. These are not places John went to, though.
A raging drainage near White River, Mt. Rainier & teams of crosscut sawyers.
We left the end of the driveway a little before 3:00 p.m. thinking we would stop at Thorp or Cle Elum for $10 worth of gas in my car. I determined (I thought) from gasbuddy.com, that the cheapest gas cash price was at Thorp ($2.19); however, when we got there, the price was higher than either Ellensburg or Cle Elum, so we continued to Cle Elum, where we expected to pay $2.25, but had to pay $2.35/ gallon. Oh, well, we did not need a lot, but wanted to be on the safe side. I was driving because John needed to be the navigator for finding the right exit from I-90, and getting the right streets in Seattle, to our destination. Once we made it to the 405 intersection, the speed limit lowered, but the traffic was 4 lanes wide and very slow moving. We never stopped, but for a long while, over Lake Washington and Mercer Island, we were traveling at 10 mph. Our exit was 3A to the Pacific Tower on Beacon Hill.
We did not find our way to the parking garage on the west side of the tower, where the parking would have been $3.00, but instead, we were able to find a free parking spot on the street.
We got there pretty close to the 5:30 p.m. start time, picked up our name-tags, and found a nice seat on the front row, where I could take photographs if I wanted. They had a slide show running the whole time before the program (mentioned above). We were encouraged to get our food. The “heavy” appetizers were catered by FareStart, including a variety of different kinds of things, from smoked salmon, meatballs (the best thing on the table for John’s and my tastes), carrots, onions, colorful grilled squash, different colored grilled peppers, red grapes, cheese (brie and blue cheese), crackers, and things I don’t even know what they were. The plates were very small saucer size, and we only went through the line once.
Thankfully, at the end of the program they served quite large cookies (raisin, chocolate chip, chocolate with white chocolate and nuts, and a great lemon one). That was the best part of the “meal.” Beer was available, but we had Coca-Cola. John drove home, and I enjoyed stretching out and relaxing.
We visited around the room, and one of the tables was a company related to mapping and hiking, Green Trail Maps, a supporter of WTA. The President and his daughter were there giving volunteers a nice baseball hat. Here is my collage of it. I am sorry I did not take a picture of them and their table of donated goodies.
Here I am modeling my hat and showing my howling wolf silver necklace, a retirement gift from a former student who was graduated in 1997, our good friend (with this wife and family). I received several compliments during the evening. I always do when I wear it, and even more when I wear it with a black shirt. I took the right photo above when I got home of the back of the hat.
I made good use of Green Trails Maps in my Map Reading, Interpretation, and Cartography class I taught at Central WA University from 1988 until 2009. Check their website:
John and I own another 15 or so personal ones we have bought over the years. John refused a hat – suggesting they give it to someone that would wear it. He does not wear baseball hats — they don’t cover ears. I love them, and don’t get in the sun for long periods of time.
Alan Coburn—Green Trails Map was a very early donor to WTA.
Here is his explanation; my video
Another video below the picture is the presentation of the Crosscut Saw Club Award to three folks for reaching 500 work parties on WTA crews. John has worked with all of these, and the presenter, too. He is Alan Carter Mortimer.
This is Marta Sheridan, sitting behind us at the recognition ceremony, and in the following video, check out the award to all three recipients this year.
Next is a view from where our car was parked, about 1 mile from the tall buildings.
The Smith Tower is the building with a pointed top, just right of center, left-most of the tall buildings. It is a 100-year old building my grandfather worked on (carpentry) for a few years. My mother was the third child and was born in Seattle. The family lived in West Seattle and moved back to GA when my mom was 8 months old (she was born in 1914). Here is my final video of the evening:
Seattle from Dr. José Rizal Park on Beacon Hill
If not dark, Elliot Bay would be visible.
Saturday, Nov 7
For Nov 6 CPAP. Reported figures. 4 hrs 19 min with AHI=0.23 Events: 1 H, 14 RERA. No major mask leaks (max=15 L/min); no oximeter.
Much work on the computer today, some emails, mostly working on the blog and on getting stuff processed from my camera, taken at last night’s party. John worked on a gate-post, put the racks on the newer truck so as to carry a cord of firewood, and cleaned and sharpened the chainsaw.
I had a call from my friend, Gerald, who has been gone for a week of elk hunting. He and his sons and grandson got a “spike” – they were not allowed to shoot any with fancy racks. Tomorrow is the family’s day for cleaning, cutting, grinding, and packaging steaks and roasts.
Sunday, Nov 8
For Nov 7 CPAP. Reported figures. 7 hrs 23 min with AHI=2.03 Events: 15 H, 3 CSR, 15 RERA. No major mask leaks (max=17 L/min); no oximeter. I wore the new Dreamwear mask with overhead tubing connection. It made a high-pitched but soft sound–irritating trying to go to sleep. My ears are sensitive. Seemed very comfortable except for having trouble adjusting the weight over the back of my pillow to hold it up and not pull down on my head. Might have to support it from above somehow.
This video will get your day off to a good start. It is a baby bear playing on a putting green in British Columbia. Worth the two-minutes.
John and neighbor Ken went looking for a 4 to 6 foot iron pipe that would fit over the threaded end of a gate hinge. John needed to straighten out a bend in it. They succeeded.
I stayed inside working on the blog and dishes, and John has worked more on the gate and then on cutting and splitting wood. Our needy neighbor decided she would need an extra cord. Maybe someone told here this winter would be cold. We’ve gotten a sprinkle of rain happening. John came in after covering the split wood and feeding the horses. We fed the outside cats. Mama-Sue came prancing down the driveway after the other two were finished so John stayed with her – the male, Lemon, will push her away if he does not have a plate at the same time.
Hope your week was fine.
Nancy and John
Still on the Naneum Fan