MONDAY — A phone with a cord?

Did he think we were early-adopters at the cutting edge of technology?

As mentioned Sunday, the week turned out busy again, with me, Nancy, still run down, but at least I am keeping down food.  I spent many hours searching records of former grads that were on the alumni list at CWU marking people to email the invitation of the celebration to, that will occur on Oct 2, a Saturday afternoon, meet and greet and eat and drink.  Also went to a music event at the Rehab center where I spent 6 weeks.  They all call me by name when I walk by, or come stick their head in the door and wave.

There was no exercise class and although I didn’t probably have much energy, I stopped by only to find it was cancelled, Monday.  Wednesday and Friday I was not able to go because Wednesday I was still involved with getting the heart event monitor (supposedly for a week) installed.  John will tell about that, inserting it below, but meanwhile, I just read his treatise (and it is worth reading), and see he wants me to describe the second unit.

The first unit meant for a week is what he describes.  It only had two connections to the relatively light unit, but it was for a week, with a button I could push when I felt stress or to generate a recording.  There are only 9 tracks.  It was too sensitive and picking up (without the ability to filter out) something we already know I have, atrial fibrillation.

We changed to a unit that was only for 24 hours, but weighed a LOT more–really heavy hanging in my pocket and connected to me in six places.  The first top place was poorly placed by the installer on top of the worst, deepest part of scar tissue from my original scar down the middle of my chest (at the top).  This guy needs to be told, and I will.  Where it made the difference was taking it off 24 hours later – when I pulled the tape and the connector I had the worst pain I have had in many months.  I screamed and scared John, and probably everyone else on the Naneum Fan.  I got the dogs’ attention and probably the horses as well.  At least John was not out lifting one of their feet when I screamed.  After getting over that removal, the other five were not over scars, and did not hurt coming off.  But I was worn out from the experience.  My next visit to the cardiologist is 2 weeks away and we’ll get results and suggestions then.

Check below for a nice write-up by John explaining the first old technology I was supposed to live with for a week.

Meanwhile, I will insert the nice things that happened Saturday and Sunday, that also were very taxing on my system.  First thing we did was Saturday, drive to a restaurant on the Lake, at Moses Lake to meet our 40 year long friends (from Iowa) who helped us move to Idaho in 1974.  That trip we were quite a rig, with canoe atop and inside a station wagon, my driving and Ann as a passenger, two dogs, theirs and our Brittany, and two cats.  John and Fred drove a large Ryder van with all our belongings, pulling their VW bus with more belongings that wouldn’t fit in the van.  There are stories with that to remain in our memories.  Anyway, each year they come to Spokane to visit family and either drive to Ellensburg, or last year we tried this place, to which we returned.  The visit was wonderful and the food and the trip took about 5 hours total.  It took me a 4 hour nap to recover and then I slept all night as well.

Sunday was another busy afternoon with a potluck with our Trail Riding Club.  There were 43 people there.  I kept down all the food from both occasions, so that hurdle is over till I have to get a refill on the Reglan.

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John says:

It is not easy keeping track of what is happening to you as you go through the labyrinth of modern medical technology and practice.  Consider the simple suggestion of the cardiologist to wear a heart monitor for a week.  Sometimes the expressions used are historic relicts with no connection to modern understanding of the thing being talked about (for example, sinus rhythm – normal beating of a heart). Also, one finds old and new equipment intermixed because the technology of data recording, storage, and transmission has been advancing rapidly.

There is the problem of terminology.  Nancy was fitted with a “King of Hearts” unit. What’s that name mean? Nothing! It is the Instromedix company’s name for a device described as an event monitor.  It is a bit like telling someone you went to the “Golden Arches” for lunch.  Most everyone you know today would understand that you went to McDonald’s and got a cheeseburger or some other fancy fare.  If a person does not associate McDonald’s and Golden Arches that person could only guess, maybe thinking that you went to an expensive Thai restaurant.  Likewise a King of Hearts unit conveys no useful information.

So the idea of and event monitor is that leads attached to your skin pick up electrical signals and when your heart does something rare (key word) that it is not supposed to do, then signals just before, during, and after the event are stored in the unit for analysis at a later time.  The unit may also have a set of beeps to alert the wearer that an event is triggering the recording of the signals.  I should mention that the unit is about the size of a deck of cards but not as heavy.  They do not have a lot of storage, anticipating that the events to be recorded are rare.  With regard to such assumptions, Nancy rarely cooperates.

Nancy’s heart has very frequent episodes of atrial fibrillation, the most common abnormal heart rhythm or cardiac arrhythmia.  [This is partly the reason she feels tired much of the time.]  After being fitted with the unit we headed for the car and to a Costco warehouse store. The unit recorded 2 events before we were into the car and 7 more by the time we were in the check-out line at the store.

Here is why that is important.  First: The unit makes two beeps to let the wearer know it has been triggered but this one recorded silently. When recording is completed, if there is sufficient memory to record another event, the King of Hearts recorder emits a double beep and automatically restarts normal scanning mode on a loop-type scan.  So in the first 40 minutes we heard 18 beeps.  Second: The unit will only record 9 events and then one has to “upload” the data via a telephone.  One has to call a place in New Jersey (they thought), talk to a live person, send the info, talk to the person again, reset the unit, and start again from scratch.

Did you notice the use of the words telephone, person, and data all involved there?  If you are old enough and have had the experience of using an early connection to the internet you know where I am going with this.  That’s right, the unit uses an acoustic coupler of the sort found in the Novation CAT:

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

See the picture.  Notice the cord.  We are talking Apple II ® and 1980.

A device that modulates an analog carrier signal to encode digital information, and also demodulates such a carrier signal to decode the transmitted information – thus a modulator-demodulator — is called a modem.  The key idea here is modifying a sound into a digital signal so it can be sent over a copper line.  There is that telephone cord to think about.

Do you still have a phone in your house that is connected with a cord to a line that physically runs from your home to the rest of the world, including New Jersey?  If not, the King of Hearts isn’t for you.  Maybe a neighbor or friend does.  Check to see.

Okay. So once the phone connection is made, one has to lay the telephone  on to the small holes  — see:

http://www.fcminc.com/KOHPatientManual.pdf

Scroll down to see the image of the phone handset on the unit drawing.  Here is an official company site:

http://www.instromedix.com/cardiac_event_recorders.htm

Then sounds are fed into the telephone from the unit’s speaker – such as beep, de-beep beep, beep, de-beep beep, and so on . . . for about 15 minutes per 9 recorded events.  What an extended racket.

[Funny story: one web site has a comment by a person that did the above and freaked out – thought all those high pitched sounds were caused by his heart exploding or some such.  He was too young to have heard an acoustic coupler modem.]

We did the arithmetic.  With 40 minutes wear time for 9 events and 15 minutes of telephone modem noise of upload time and 7 days of monitoring we came up with – who knows?  We called the heart center and went back for an alternative.

The alternative is called a Holter monitor.  I thought the person was tripping over the word holster and was expecting him to give Nancy a leather pouch to wear on a belt.  Not so.  The name comes from a fellow named Jeff Holter who (with others in about 1961) developed a back-pack size unit containing a heavy assortment of radio telemetry and tape recording equipment.  Dr. Holter invented telemetric cardiac monitoring in 1949.  So, the Holter monitor (as well known in the halls of the heart center as McDonald’s is in the halls of your kid’s middle school) was attached to Nancy’s body – she can tell you about that – but only for one day.  It does a continuous recording, makes no noise, and gets mailed back in a padded envelope.  Nice.

Just to pad the story some I’ll direct you to the following sites.  The first shows a horse (last image on the page) with a monitor:

http://www.petcardiology.com/placing-holter-monitor-leads

and the next:

http://www.morgananimalhospital.com/index.php?view=pageView&docid=6345

… has the story of Pico, a Miniature Schnauzer with a heart problem.

The story begins –

“ Pico began to have episodes of weakness and collapse that seemed to worsen over . . .”

and then …

“The monitor revealed that Pico had a heart rate that varied from 28 beats per minute to up to 229 beats per minute.  The normal heart rate for a dog is 70-120 beats per minute.  There were stoppages in the heart rhythm of up to 6.85 seconds long.”

You can read the rest with pictures.  John

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SUNDAY — TILT!

This week we have been as busy as the ball careening around in an old pin-ball game machine.  When one got a bit too animated with one of those it would stop working and the word “TILT” would flash on the screen.  That statement might dredge up a few old memories from your high school or college days.  Here’s more:

http://www.pinball-fixers.com/tilt.html

So, anyway, the point of this is that for this Sunday evening we have hit the TILT switch.  We’ve been too busy.  We prepared for and went to a potluck today and didn’t get home until 5 and then had some clean-up to do and horses and dogs to care for.  Nancy and I were working on different aspects of a post for this weekend and neither of us finished.  It was an interesting week and we’ll get it sorted out and posted by Monday evening.  But for now – here it comes: TILT!

John

SUNDAY — A roller coaster week

This was the week of the Washington Old Time Fiddlers Summer Workshop in Kittitas, WA, 10 miles from our home.  I was starting it in a very run down condition, having gone back to not being able to hold down food and therefore not having caloric intake and proteins for stamina and energy.   I had arranged for a doctor’s appointment Tuesday afternoon, meaning I would have to leave during the last break at Fiddler’s class.  Classes go from 9:00 a.m. to 3:00 p.m.

I had missed an atrial fibrillation medication, Metropolol, which apparently had elevated my heartbeat to 124 with severe atrial fibrillation.   That is way above my normal in the 80s.  So that was the concern of most of the visit.  The pacemaker attached to the defibrillator has nothing to do with regulating that heartbeat, and that is solely done through the one medication I missed.

The doctor did check my legs for fluid build-up (none), listen to my lungs, heart, and feel around the lower part of my body searching for pains.  The only thing I had was tummy grumblings from no food.  Everything else provided a good report.  The doctor requested more lab blood work there before I left, to see if that showed any problems.  I have been poked so much, it’s no wonder I’m anemic.

John and I left Cle Elum and went to Ellensburg to pick up the meds, and on home.  I took the missing med and proceeded to throw it up along with my yogurt from lunch.  This was at 5:00 p.m.    I didn’t feel like eating any dinner, but I took all my night meds at 9:00 p.m. with chocolate milk and Lucerna, a high protein supplement for diabetics to rebuild proteins in the system, hoping that would give me some sustenance.  (I had been on that while in intensive care in Yakima and then all the time during the time I was in the Rehabilitation nursing home from Jan 20 till Feb 26. because of the lousy food I couldn’t eat.)

My last entry to my stomach (all the meds included) did not last long.  They all came back up.  I had not retaken the Metropolol, and so decided to retake that medication only, at 10:30 heading to bed.  That stayed down, so the next morning my heartbeat was back to normal.  Still was having trouble with the stomach.

John, being the sharpest knife in our drawer of medical memories of all my health issues since last year (keeping this blog cemented things in his memory too), realized I was suffering the same symptoms I had in Intensive Care in March here in the Ellensburg hospital for 4 days, with fluid in my lungs.  Then after throwing up a lunch 3 hours after I ate it, the visiting hospitalist from the Tri Cities prescribed me onto Reglan.  The pharmacy did not have that in the records, so they requested a refill from my cardiologist in Yakima.  They realized it was not in their records, so they called my doctor’s office in Cle Elum, but they also did not have it.  Finally, late afternoon Wed. another doctor tracked down what John had already remembered (but the nurse calling for me earlier could not discuss with John because of privacy issues)—and so they ordered a refill.  John went to town late to get it.  I need to take a pill ½ hour before a meal.  I have now been doing that since Wed. night this past week, and I am keeping all food down and gaining more stamina and energy. [From John: earlier posts about this issue are in late March beginning on Wednesday 3/24]

It got me through the end of the class and the Friday afternoon recital, in which our class performed admirably on “For the Love of Tara” a song written by Denis Lanctot to honor the death of Tara his sister in law who died in an auto accident at 22.

http://www.youtube.com/watch?v=l33Mdji-4BA

takes you to a duet of the song played by Leahy and a fiddler friend; try to listen to it and I think you will understand our choice.  Our class of 26 played both parts, with our teacher backing us up on the piano.  Many people at the recital said it was the most beautiful “orchestral” piece they had ever heard, in an old time fiddling setting.  We have a reputation for that in that class, this being our 16th year.  I have been in the class all 16 years.

Our teacher, Roberta Pearce, from Nampa, Idaho found that Leahy performed this piece on ‘youtube’ and she transcribed it into music for us to learn.  The whole class voted to play it as our one recital song from all the ones we learned all week, and there were sixteen total.

~~~~~~~~~~

The information that follows is by the writer of the song, Denis Lanctot – from Canada.  “For the Love of Tara” is my third recording and it is very special to me. I dedicate it to Tara Lynne Touesnard, my wife’s sister, who died in a car accident on April 25, 1994.

This tragedy drove me to immediately begin working on plans to recreate the fiddle that died with her – a fiddle that had once belonged to me and then to Tara.

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Thank you for going through my week and I’m happy to say I’m doing very well today, on Sunday.  Yesterday we drove part way up Blewett pass toward Wenatchee, to meet the new family of one more of our puppies, a nice female.  She is now in her new home with a huge backyard to romp in with her new buddy, a year old Beagle.  They renamed her Co-Co.

We were hopeful in the last post Aug 1 that this would be a better news week, and finally it turned out to be.

See you next week.  We are actually scheduled to be at a potluck for our trail riding club Sunday afternoon, so will try to get it out earlier in the day.

SUNDAY — the good news is

The week is over!  Wow.  This was one of my worst weeks in many.  Monday morning this past week started with a bang.  Well, there wasn’t much noise but blueberries cascaded about the kitchen like a 4th of July fire cracker.  I stepped into the kitchen to get some blueberries out of the fridge, to clean some and sugar them for our morning cereal.  John was outside explaining a subtle point of etiquette to a horse.  I had 2 pounds of blueberries in my right hand and was moving … when I tripped over my imagination or the rug, do not know, and slammed into the edge of the counter-top Formica around the sink.  It was full speed ahead.  The bag of blueberries got two holes in it and berries exited from both, but my left arm hit the sharp counter edge, halfway between my elbow and shoulder.  Immediately, I was in pain, and had a huge lump forming.  This is not good to have internal bleeding in a patient on the blood thinner Coumadin.  I first tried to pick the blueberries off the counter, still in the bag with — I thought — one hole, to put in another bag with no holes, but suddenly they started falling again out the back side hole.  So, I sat down for a few minutes to rest.  It was still swelling so I went and called to John to please come help.  [Someone had to save the blueberries! JFH]

He had enough sense to tell me to call my family physician’s nurse, who said get ice on it to reduce the swelling, do that every 20 minutes on and off, she would contact the doctor, and I was to report back in an hour.  Meanwhile, she called back to say to hold pressure on the ice.  So I did.  I started with a flaxseed bag that doesn’t get all that cold, but it worked.  She suggested a package of frozen green peas, which later when we had to go to town, John got for me to use for the afternoon ice sessions.

The swelling went down (probably started at the size of a golf ball) after a couple of applications of the ice pack, and so then they sent me to the hospital for a blood draw to check my INR for the blood clotting factor… before the doctor wanted to decide on the change to my Coumadin dosage for the night and succeeding days.

I missed my exercise class because of all the excitement and being at the hospital for a blood draw.  But, the swelling went down (although I still applied frozen green peas, once home from town).

Tuesday was spent totally on my back trying to rest and recover.  That’s not good for keeping the muscles working.  I did walk up the driveway and back that evening with a little bit of exertion and trouble.  It started my atrial fibrillation which really hasn’t been bothering me in weeks.

Next day, was exercise class again and I forced myself to go.  It was a most unpleasant experience.   I sat out a lot of class without energy or stamina to join in.  All my cohorts and my teacher are very concerned and responsive to me.  It’s nice being with such a great group of supportive people.

Thursday, was not much better.  I geared up to go to my music venue with the Fiddlers and Friends, at 2:00 to 3:00 at a local nursing home.  I played the fiddle but did not sing along because it was just too taxing.  I was not feeling well, and had no stamina.

During this week, however, I contacted both my doctors:  the cardiologist in Yakima and the family physician.  They are both concerned and we have upcoming appointments (this week and next).  The cardiologist will have me for a week on a heart event monitor which will show them what my heart is doing all the time.  I can also press a button to request a read-out report be stored on things when I feel stress.

I’m not looking forward totally to this coming week, the first in August, because it is my week in the Washington Old Time Fiddlers’ workshop classes.  I am concerned at my low level of stamina how I will make it through the classes M-F from 9:00 a.m. to 3:00 p.m.  There are afternoon and evening events as well – some educational, some just fun — which I know I will miss this year.

The nice thing, however, is that the people in charge know my condition, and plan to provide a room in the air-conditioned facility where we have classes, which will have a recliner and provide a place to escape to rest if (WHEN) I need.

Okay.  That’s a long negative report, but I will try to do better, eat better, and all the other things.

Part of this is my mental attitude and depression about being worse off 2 months after the defibrillator implant than I was going in for it on June 1st.  John thinks, perhaps, the many medications need tweaking.

Puppies – three still here – are still growing but remain cute, funny, and playful and we are looking for homes.

August is set to be a busy month.  We wish for all of you the best, and will report back next week with better news.

SUNDAY — Spoke too soon last week?

I think John got carried away with the header last Sunday.  I went downhill as I was unable (at 1:00 a.m. Mon.) to keep food down from a late supper.  It was sort of a long week, with a sick puppy too.

I’ve been trying to gear my mental state to be positive, but my healing process is still not as fast as I would like.  I spend too much time reclining in the recliner, but am thankful for it.  John says I just have to realize that the damage done is not easily recovered.

My meds have to continually be checked with blood work every two weeks to be sure my potassium level and INR (clotting range) is all right.  This week it was not, so the meds had to be readjusted.  Whether that played a part in my feeling down, is unknown.   My stamina just is not there as I figure it should be and was told it would be.

[John says: Health issues are not translatable from person to person.  For example, an otherwise healthy person that has by-pass surgery may feel much better within weeks – if that surgery was preceded by a heart attack, recovery to a former medically-free healthful state will not occur and the actual recovery may be slow.  Nancy, following a heart attack, had a complete system-wide collapse involving multiple organs.  Issues from congestive heart deterioration remain even though a malfunctioning heart valve has been replaced.  Comparisons with others don’t make much sense.  We have to acknowledge the individuality of this existence and with medicines, exercise, activities, and diet encourage the best possible outcome.]

I’m continuing to try to get better.  Sleeping throughout the night with uninterrupted sleep is impossible with food issues (see above) and puppies, and particularly sick ones.  That obviously is playing a part in the process.

Nothing else on my health this week so I’ll switch to the puppies and other events that keep us going and busy.

John tries to work every day with the horses, and some days are better than others, with associated wind or heat.   He does most of his work in the morning cooler hours.   He also takes out time to help our neighbors  (ages 87 & 84) with things around their farm.

Tuesday we drove to Ritzville (a little over 100 miles away) to meet a family from Lewiston, ID who got a nice female puppy for their family.  They have named her Lucy.  She made the trip well, with John holding and my driving, until Moses Lake when she got antsy.  She had to “pee” so we found an empty field and John took her for relief.  She settled down for the next 40 miles and we met the folks at their aunt’s place a little after 1:00 p.m.  The area near Ritzville includes dry-land farming and there were thousands of acres of fields with multiple whirlwinds lifting columns of fine soil into the air.  These “dust devils” were numerous and varied greatly in height, width, color, and lifespan.  Very interesting but we failed to take a picture.  Otherwise, it was an okay trip, and the temperatures were not that hot here in Ellensburg, where we left her 3 siblings, and our adult dogs.  We got home about 4:15, checked, and everyone seemed fine.

It wasn’t till later that we realized the one puppy was not acting right and she was very uncomfortable sleeping and miserable all night just as if she had a bad stomach.   She was crying in her sleep and shivering in pain (we guessed).

Wednesday morning was filled with more sick puppy and finally taking her to the vet.  She was treated for a seizure and there are only guesses to the cause (bump on the head, heatstroke, ate something wrong, was bitten by an insect, who knows).  She spent the night in the vets and came home the next morning back to being a puppy again.  She has been fine since, so I doubt we will ever know what happened.

We heard good news from puppy owners with new ones in their homes.  Those stories are always welcomed.

John picked blueberries (24 pounds) at a location just west of Yakima on Saturday and got them in the ‘fridge’ before we left late in the afternoon for a music gig for a local church.  (Sunday now and he is freezing and bagging them.)

Finally, besides exercise class for me, I played music at a nursing home on Thursday afternoon.  Then Saturday evening we played again at a church picnic and had a great dinner as well.  The temperature was not nice, sitting at 96, but they provided shade for us, and it cooled off to 90 by the time we left.  The church is of one of the members of our music group, and we have done this for about the past five years.  The interest of the young kids in music and our instruments was most fascinating.  We found ourselves playing songs we don’t normally do in nursing homes, because the kids requested them:  Old McDonald Had a Farm; Mary Had a Little Lamb; Pop! Goes the Weasel, and one about popcorn on a apricot tree I’d never heard.  It was actually fun to see them keeping time to the music and participating.  There were a few old timers as well who came over and joined us.

I’d better stop and when John comes back in from watering the raspberries and giving the puppies a big dish to use as a pool, and after lunch, he will put this out on this blog.  We will also bring in the puppies to share the a/c in the house so they don’t overheat. Our afternoon temps are topping out at just under 100 degrees F., but Monday may get that high.  By Wednesday we will only be in the high 80s and low 90s.  We are without clouds so at night the temps drop to near 50 degrees (our elevation is 2,240 feet).

Thanks for staying tuned.  Nancy

SUNDAY — Is no news good news?

We made a trip to Cle Elum to our family physician, Monday, our anniversary.  I got a clean bill of health and he changed a few meds.  Went over my labs and had positive feedback from my doctor about my concern that I wasn’t gaining stamina as much as I desired.  He was nice and said I’m still in the healing process and I just have to be patient.  Get my rest and do what I can.  I told him about my cardiologist wanting to put a heart monitor on me for an entire week to keep an eye on how my heart and body is responding to my normal week’s activity.  That’s in the future for August.  He encouraged me to participate in the experiment.

Oh, we also started me back on another medication to see if it would control the “acid reflux” — that seems to be occurring occasionally.  The last 3 nights I have eaten away from home, so I have restarted taking that medication before dinner.  So far; so good.  (John was with me Thursday and Friday but I was by myself Saturday night.)

That’s all I have to report (thankfully) on my health, so will end with a few stories of the other things in our life right now:  puppies, jam sessions & potlucks, etc., and music events, and John’s horse training.

Happily, we went for a healthy “Sammie”  sandwich as Quiznos after the doctor’s appointment.  The appointment started around 1:30, so it was time for lunch when I was through.  Funny thing is how much doctors depend on computers in treatments now.  When we got there the computers were down, which affected getting some of my lab work out in a timely fashion.  Oh, well.

Puppies.    (turned 7 weeks old on Monday this week)

We sent two puppies to their new homes on Wed. and on Thursday.  The little “runt”, Trouper, went to a home with two boys, 4 and 2, and the older one was totally smitten by the puppy.  He is doing fine, and I am very impressed how good the little boys are with the puppy.  This morning, we received 5 great pictures of his new life with them and their 12 year old dog.  The next day, a liver/white female went to her new home here in the valley with a family who had a dog from us for 14 years and loved her lots.  She just died this spring.

We have one more puppy to transfer this coming Tuesday, and then we have 3 who need new homes and for which we do not know yet for sure who will be their new owners.  If anyone is reading this within a decent driving distance of Ellensburg, who might be interested in adding a wonderful Brittany puppy to your family, please let us know.  They are so smart.  We keep introducing to them to new things to keep them learning and adapting to human handling and interaction.

Finally, the other events – in our life:  music keeps me busy, as Saturday night, when our “group”, the Kittitas Valley Fiddlers and Friends, went to the upper county to play for an antique car rally at the Cle Elum Senior Center.  They treated us to a catered dinner that was very nice, including chicken and rice, green beans, tomatoes, salad and a great (rich) dessert.  It was yummy, and we played during the “cocktail hour” before dinner, and they had a program afterwards so we didn’t play our normal hour of music.  They seemed happy with what we did.

John is making progress with the new horses.  They are slow in trusting him, but they are learning well.  They had never worked with but one person, so gaining their confidence has been a chore.  John is patient with them, and it is paying off.  Our weather could have cooperated a little better – earlier cold and rain, and now hot sunny and windy days.  [John – Horses are difficult when it is windy.  Things move in the wind and make noise.  As a prey animal, their attention goes to the things “out there” that might be sneaking up on them.]  These guys never had treats (carrots & apples), but now they will walk up to us in the pasture (to John for sure), to get treats.  The youngest will take a carrot from me, but the older ones do not really know me yet.

That should be enough for this week.   We wish you all well and we are happy I’m getting better, even though my stamina has not yet returned to allow me to do more than a couple hours.  And then I have to take naps through the day (probably to make up for no sleep from the puppies), to get through the day.

Love and thanks for all the good wishes you keep sending by email or phone, or cards.

SUNDAY — Dog Days of Summer

Please note that Monday is the 12th of July.  In 1969, the 12th was on a Saturday and we married on that date – 41 years ago.  So,  Happy Anniversary to us!

[from John :    Wikipedia < http://en.wikipedia.org/wiki/Dog_Days > has an interesting write-up of the Dog Days of Summer which references Sirius, the Dog Star, and “a time period or event that is very hot or stagnant, or marked by dull lack of progress.”  As a side note, years ago Nancy named one of our Britts ‘Sirius Sashay’ and the puppies we now have are her great grand children.]

from Nancy:    John reminded me I am supposed to write an update on my health for the blog, as promised last weekend.   I must say sadly I don’t have a lot of good things to write, except that I’m alive and still kicking but I’m not ready for the Rockettes, just yet.  My energy level has not returned, and I find myself only good to gear up for a couple of hours for an event, and then I have to rest.  It could be that sleep during the night being interrupted with puppy care is part of the problem.  They usually have us up at midnight and then 3:00 and finally when it is light, we can put them out in the backyard as early as 5:30 (this morning).  They turn 7 weeks tomorrow.  We transferred a sweet puppy today to her new owners (more on that later).

Back to my health and lack of energy.  At first we wondered if the change in meds might have prompted some of the problems – that may still turn out to be the case, and tomorrow is a doctor’s visit to my family physician in Cle Elum.    I was scheduled last week at the hospital here in town for blood draws for various lab tests.  I had them all done right after playing fiddle with my group for a little over an hour.  I did not drink during the playing time.  I guess I should have and should have been hydrating my system all along (I thought I was doing this).  I drink an awful lot of lemonade that John makes for me from powder.  However, a call from my family physician’s nurse indicated my lab tests showed I was dehydrated and needed to intake more liquids.  That said, I did.  That probably explains why I had a headache and was feeling so lousy.  I missed my Friday afternoon exercise class because I didn’t feel up to getting there and doing it. It’s from 1:30 to 2:30 MWF and in an a/c room with a bunch of supportive ladies (and one man).

The other tests were apparently okay, although one was still being processed.  I do not know if the results will be back before my appointment right after lunch tomorrow.

The new medication affects my potassium balance and that was one of the tests.  I called my pharmacist Saturday morning (who also is my fiddling buddy), and she ran all my medications through the system to alert them/us to any possible drug interactions.  None were found except for the concern with this new medication and the potassium imbalance, and the need to keep an eye on the potassium.  That was my cardiologist’s concern for this doctor’s visit and the labs drawn, 3 weeks after my last visit with him.  He wanted to stay on top of that.

I’m still on a diuretic (Bumex) and that pulls fluids from my system, contributing to dehydration.  It’s to keep the fluids from piling up in my lungs or my legs.  The potassium was cut back because of the interaction with the new drug that actually helps shed sodium (the Na of salt) and retain potassium.  This means I have to be aware of something called hyperkalemia, or “ higher than normal levels of potassium in the blood.”

“The hormone aldosterone regulates kidney removal of sodium and potassium. Lack of aldosterone can result in hyperkalemia with an increase in total body potassium.  Hyperkalemia may be caused by medications, including medications that affect kidney function (potassium sparing diuretics, such as spironolactone, amiloride, or triamterene) and potassium supplements (especially intravenous potassium).” (Taken from a Mayo clinic site)

Spironolactone is the new med I am on.

My pharmacist continued to counsel me from her records and outlined the symptoms.  My cardiologist had also mentioned some of these and said if I had any such signs of severity that I should check myself into ER immediately.  These are the symptoms in her literature:  muscle weakness, cardiac Arrhythmia (which I have anyway), and hypotension (low blood pressure).

The symptoms mentioned in the Mayo Clinic report are as follows, “Hyperkalemia often has no symptoms. Occasionally, people may have the following symptoms:

  • Irregular heartbeat
  • Nausea
  • Slow, weak, or absent pulse

Well, the first I always have; the second I have occasionally too, as today when my body decided over the noon hour that it no longer wanted to keep the strawberries from morning late breakfast, in my system.  I have had a lower heart beat (in the 60s), but not worth worrying about, and certainly no absent pulse.  In recent checks on my trusty measuring device, my blood pressure has been fine and the heartbeat as well, although it will occasionally show the atrial fibrillation we already know I have.

Well, the few sentences John is expecting me to write have gone on into much more, and I will stop now on the health part.  It’s good for me to review this before I visit my doctor tomorrow.  Food for thought and he will be interested in my research and reporting.

I will end on a nice, fun note.  We transferred a white and orange female, Milly, to her forever home today.  We gave her a bath before the meeting, and she slept afterwards while drying.  I also clipped her little toenails (with a human’s toe clipper) while her toes were moistened.  We did that first drying and changed to a different towel.  She laid in John’s lap awhile and then we changed towels and I had her again in my lap.  She went through the bath just fine; John is good with bathing young puppies, and she handled it well, not fighting it at all.  Her new owners already have a Brittany from us and she was along to meet the new entry to the family.  This will be a wonderful home and we are grateful.

Not much else new in our world.  There is the daily horse routine, plus John has been volunteering time to help our elderly neighbor with his haying, and getting the bales to the barn.  Yesterday and today it was more a re-stacking thing from a harobed.   I know most people not in the rural west do not know what a harobed is.  That truly is what it is called, and it was named after the inventor’s daughter, Deborah (spell that backwards).  It is a piece of machinery that goes through a field of baled hay and lifts them up into a carrier that can be stacked as high as 9 bales, 3 across.  Once filled, the load, having been lifted row by row, is ready for the barn.  The harobed comes back to the barn and a lift stands up the stack and pulls away from it (under good smooth and clean conditions, the stack stays standing).  Under a full load, one of these can carry 3.5 tons.  Yesterday was not working well, and the stacks kept collapsing  — the old shed has an uneven floor and the bales are not as uniform as the ought to be.  Today was a better hay day.

What a technical advancement from loading bales of hay by hand onto a truck or wagon and stacking in the barn!  (And before that loose hay was muscled onto a wagon and off again in a barn.)

Thanks for staying tuned in and I hope for a nice week this week with more energy.  Yesterday, a few of our musical group went to Briarwood Commons (a retirement community in Ellensburg, for people over 55).  We go play for them the second Saturday of every month at 2:00 pm. till 3:00 and they serve us a late lunch for our efforts.  They love us and always sing along and sometimes get up and dance.  It is a worthwhile event that pleases us as much as them.

And on another worthwhile event: Wednesday night last week we had a great experience.  We joined a group of square dancers and host families and friends, at the Swauk-Teanaway Grange.  There are six young people (most are in their Junior year in high school) here from July 5 to Aug 10 in a program called the Children of Chernobyl.

See  http://www.cofcusa.org/factsheet.htm .

Most are from the region around current day Minsk, Belarus.  One of our musicians in our group that play at nursing homes, and his wife, are again a host family this year, for 3 of the gals.  The other 3 are guys and are in different households.  We met them and had a great potluck.  Afterwards the Blue Agate Square Dance caller got most of the people on the floor to do some dancing (I sat it out and watched and enjoyed seeing how well the kids did).  We stayed also through one of the gals playing a piece on the piano.  She is quite a musician.  Turns out she also plays the guitar, and she joined us at our Rehab facility play date the next day, Thursday.  Amazing.  She was playing songs she had never heard and sitting where she could watch Charlie’s fingering for chords.. and keeping up with us all.  One we had printed words for and she sang along and one she knew the words.  What talented people exist in our wide world !

Hope you have a nice week as well.

Independence Day Update

We wanted to wish you a happy July 4th, and hope you are having a less windy day than we are.  We have had gusts to 48 mph, and average winds over 35 mph all day, at the airport, 5 miles south of us.  We are protected somewhat by the trees to our west, but it has been really crazy for the past couple of days.  I’m glad we are not out for a picnic today.

The last posting told you about my recent visit to my cardiologist, and nothing much has changed along those lines.  I’m still recovering, slowly.  My energy level is not back where I would like it, and I still cannot yet raise my left arm over my shoulder.  But, I’m alive and well, and getting better each day – and very thankful for it.

As time goes by, we hear more and more about people who have had challenging medical emergencies and made it through as well.  There have also been some who haven’t, so that is always food for thought and prayer.

We just learned of a serious accident with friends; a swather (machine for cutting hay) fire in Oregon (in their field) that caused severe 2nd and 3rd degree burns to our friend.  He and his family are in our prayers, as he gets through the burn unit in Portland, OR.

Speaking of swathers, our neighbor ran over a rock and jammed his swather.  John volunteered to chisel the rock out, and it worked.  Amazing.

We are still caring for our puppies, who turn 6 weeks old tomorrow.  We have a lot of care taking them in and out of the house, and now we are in charge of feeding them instead of their mommy.  She has weaned them with our help.  They are eating hard puppy chow just fine now, and are romping and playing in the backyard.  They have a big dog house they can escape to, to get shelter from the wind when they need rest from playing.  It’s nice because they do all their peeing and pooping outside, and not in our washroom, where John has to clean up the papers and carry to our compost pile.

We have homes for all but 3 now, as one we were counting on, fell through, because of the facial markings.  That is NOT the way to choose a hunting dog and family member, in my estimation.  I’m just as happy he’s not getting her.  We are thrilled the little guy, who is doing very well, has a forever home, here in Ellensburg, where we might keep track of him.   I’m sure he will eventually catch up, but he is still half the size of his siblings.  He is going to a fishing family as is his sister to another, so they will be introduced to fishing soon.

We won’t want to ship any of these puppies, so if you are reading this and know of someone interested in a fine hunting dog, but who is within the Pacific Northwest, then let us know, please.

Speaking of dogs:  since we last wrote, our Brittany (the brother to the mom of these puppies) finished his show championship — in Pennsylvania.  Yes, you heard that right.  Our trainer (field) was out West, but inherited his family farm in Aleppo, PA, and moved there a couple of years ago, taking our pup with him.  He and his wife have been campaigning him in field trials, and also in shows when the availability presented itself.  Just this last weekend, he was entered in 4 shows, and won two of them and was runner-up in the other two.  The significance is that it finished his show championship, and he is now titled, Ch. Cedaridge Vintage Cork.  We hope they finish his field championship this fall, and then he will be a Dual Ch.

ALEPPO — meaning: as John found on the web, is a pine tree.  It’s also known as the Jerusalem pine.  It is unlikely it would grow there in Aleppo, PA, but could be. It is found mostly in eastern Spain, the south of France, and on to Jordan and Morocco.  Supposedly, it is grown in the southwest U.S. (It is also an ancient town in Syria.)

Finally, about the 4th of July celebration for us.  For John and me supper will be a good inside picnic with BBQ pork and beans tonight, but the real celebration was on Friday, July 2, when the music group I play with … Kittitas Valley Fiddlers & Friends, entertained at the local Dry Creek Retirement Center who together with the Adult Activity Center put on their annual July 4th BBQ for the community.  We have provided music for 5 years.  This year we did our regular old-time music, but interspersed patriotic songs:  Battle Hymn of the Republic, There’s a Star Spangled Banner Waving Somewhere, America, America the Beautiful, This Land is Your Land, and our specialty, the national anthem, sung acapella.   We did it at the beginning and near the end.  We stood up and so did almost all of the elderly people, many in walkers, and they sang at the top of their lungs, with their right hand over their heart.  It was a most moving and awesome experience.   It is not something we will soon forget.   We played music from 11:30 to 1:30 with a short break to eat of the catered picnic buffet.

Hope this finds you all well.  Thanks for continuing to check this blog.  We will try to update it every weekend.

WEDNESDAY — Routine stuff

John tells me I need to update this from the June 21st visit to my cardiologist.

I’m still tired from yesterday and not feeling up to much updating, but I will try.

Good news today is that the puppies got moved tonight to their new digs, and they are happy, but Mama Annie is not yet sure she wants to go in the different place.  She got sort of attached to that back computer room pen.  I did manage to do their toenails (cut them) today before the move.

Best news of the day is that our house roof is finished.  It is beautiful.

Okay– back to yesterday.  I drove myself to Yakima Heart Center for a 10:55 (I originally was planning for 10:15) so I was up way too early and with a lousy night’s sleep Sunday night.  I got there 20 minutes early and then had a 25 minute wait to get in to see the nurse, and then the doctor.  However, once there, he spent a full hour with me, so I felt good about that.  First words out of his mouth; “Where’s your hubby?”  John had always been with me since our first visit last July 2009.  I explained that John was working on the roof, and that I could drive now, so I had driven myself down.  I didn’t tell him I used John’s car and I think the seat is not set for my back, so the driving an hour down and back was actually painful.

The cardiologist had briefly seen me when I was in the hospital June 1 for the defibrillator implant and he just happened to see my name on the ICU floor.  He dropped in to say hi.  That was very cool.  Previously, he hadn’t seen me since April 14th and we both agreed that seemed like ages ago.

We debriefed and he looked at all my recent lab blood draws.  He determined that I need to be back on a statin type drug, which I had gone off of over a month ago, because of joint pain when I exercised.  He wanted me to go on Lipitor, but I told him I doubted my insurance would pay for it, and they wouldn’t (well they wanted me to pay a co-pay of $60/month.  Yikes.  I had asked him if that happened, could I go back on Simvastatin, which I was on last fall.  He said yes.  So, I requested a refill on that, and thankfully, it is only 9.99/month.  A lot better for the pocketbook, eh?

He also looked at some test which made him decide to change me to a medication to help my kidneys balance the sodium/potassium components.  The new pill (Spironolact) is meant to help remove sodium and some water while keeping some of the potassium. Thus I can cut back on the intake of potassium.  I should be able to start that tonight.  I was taken off the huge dose / week of Vitamin D, and just have to have 1000 mg (or mE) each day.

Then he asked a bunch of questions about what I was doing, and what, if any symptoms I was having.  He examined me with a stethoscope and pronounced me in pretty good shape.  He also mentioned again that I was fortunate to be alive and what a challenge I was to the medical community.  Not news – that.

He wanted to know what would tire me and cause my heart rate to increase.  I said, “Well, if I ran up the driveway, which I have not tried to do.”  He says that later this summer he will fit me with a heart monitor for a week to see how my heart is responding to the various things I’m doing.

He also went over the meds and the lab tests he wants me to have before I go to my family physician and to do that in about 3 weeks.  Then come back and see him.  I wish it were not so far to visit Yakima but it does have a Costco store and we do buy things there.  I will have to go every 3 months for checking up on my ICD.  My family physician is only 30 miles away, but the driving time can be similar in the winter (bad roads).  Now it is fine and a pretty drive up the Yakima River Canyon to Cle Elum.

His report will be transcribed and I will get that transcription within a couple of weeks.

Then about 1:00 I was out of the office, and needing to eat lunch.  There was not time to make it up for my exercise class that starts at 1:30, and I also wanted to visit Costco for dog food and such.

I picked up a nice grilled chicken salad and ate it before going to shop.  Yum, and I was hungry.  Off to Costco, where I got a motorized cart and asked for help lifting the heavy dog food.  They were happy to help.  I then motored around to get the rest of my needed things, and then got help to put them into my car.  I filled John’s car with gas (his takes Regular, where mine doesn’t recommend it), and got it there at Costco for 2.85.  Sweet.  Then home.  I didn’t make it back home until 3:30 and I was VERY tired.  I might have slept for 1.5 hours– don’t really remember.

But, that’s the best I can do on updating you to my latest.  Nancy

SATURDAY Nancy’s 2+ week . . .

. . . report since the ICD implant happened

Well, it’s really 19 days since, but who’s counting.  We have been very busy with various chores, besides dealing with the healing process and follow-up doctor visits and lab work.  Will get to that in a minute, but for now I may tell you about something I left out of the device check write-up June 8th.   I did say that I will be part of a research study, but I didn’t mention the fancy name.   It is called GALAXY, and the acronym, (don’t we love those?) comes from this.  I’ll try to highlight BOLD and CAPS the letters in the following phrase about the GALAXY Registry (LonG-term EvALuAtion of the LinoX FamilY ICD Leads Registry).   How long do you suppose it took for someone to figure that out?  It’s really not any different from just going in every 3 months for a device check-up, but I had to agree and to sign paperwork to give them permission to put “my data” in a research study.  The purpose is to work toward improving the device technology for the future.  I guess it is pretty good now, but I figured I would participate.  Why not?  Doesn’t cost me anything and I have to go in for all the checks anyway.  I’m interested in participating in good things for the future of others needing the same help as I did.  I have been grateful for all the comments from so many of you about success stories on friends and family who have had defibrillators.  It’s amazing how many are out there and have reportedly been operative for some time.

I am going to visit my cardiologist this Monday, and will be driving myself down to Yakima.  John is staying behind to care for the mom and the puppies, and to help taking off the last of the shingles (old) on the roof of our house – the front part.   While there I will take a trip to Costco to pick up a few items.

So, there is not much new to report on my progress, except I seem to be a little stronger each day.  I have been doing a lot of music venues, and turns out my fiddle would normally be held and rested on the place where the defibrillator is implanted.  That wound is still there and still has on all its little Band-Aids (it has a fancier strip name, but I don’t know what it is).  They haven’t rolled off yet.  So, I moved over the fiddle to under my chin and lower down so I didn’t have to raise my left arm too high.  I still need to use it to finger and to hold the fiddle, so the past 3 days of fiddling have been tiring.  My right arm is getting more use too, so it aches some.  I’m doing all right with Acetaminophen, just more than twice a day.  People enjoy our music so much, and we enjoy providing it, that it all has a happy ending.

The puppies will be 4 weeks old this Monday, June 21st.  That means they are ready for mushy puppy chow and their own water.  This also means they are outgrowing their pen, so we will be moving them (probably Sunday) to new digs where they have more room.  While I was gone to town to play for a 94th birthday party gig at one of the nursing homes, where they also gave us lunch, John took them out to play in the grass.  One ventured away from the rest and into the raspberries.  Then another went and almost got lost under the Nanking Cherry trees.  Funny, but not so for John.  He gathered them up and put them in a box and brought them back in ASAP.

I have not gone back to Physical Therapy because I’m waiting to hear if my insurance will pick up the rest along with Group Health.  If it is costing me $25 for 45-minutes on a machine, and I’m already paying a couple hundred to have medical insurance each month, plus the cost of Medicare each month, it makes no sense.  I am going to the SAIL class (earlier mentioned in this blog), at the Adult Activity Center 3 times/week for an hour, for only $3 for 3 months.  That’s a fine deal.  We get lots of stretching, strengthening and balance exercises each session.  I cannot do anything with my left arm that causes it to be raised above my shoulder, but I still can do a lot of the exercises.

I have done a little bit of walking around our place.  A couple days ago I walked into the lower pasture with John to retrieve the 3 “new” horses.  They now return to their pen on command from John, off the high grass.  It’s amazing to me to see how responsive they have become to his wishes and commands.  They also had not been fed treats before in their life and it is great to see them coming over to him for a carrot.  The day I went, the youngest (4 years old), Breeze, came up to me for a carrot.  (He has not seen a lot of me, so that was a rewarding experience.)

One of our recent times this past week was having the farrier in to do trimming on some of the horses.  While John rounded up the new ones, I held Myst for her trimming.  That was nice to be back in the thick of things around the “ranch”.

Our roofing project is going well too.  The barn was done in time to load it with hay last Sunday.  Lucky for John our provider came with two large trailer loads and a person to help unload and pack into the barn, and a powered bale elevator/conveyor.  Had John had to do this alone as we have in the past, it would have required at least 10 trips in the truck and trailer, across the valley, and back, and also he would have to do all the lifting and packing into the barn.  This was great.  He had only to supervise, open gates (which he had just built) for access for the big tractor trailer truck, and open windows and doors on the barn, plus build fences and tarps to protect the hay in the runway from having the horses nibble and break into the bales.

Other chores around the yard have kept John busy as well as horse training.  This is a year when we have had more rain than usual and the grass is high everywhere.   He has shifted the horses in and out of the pasture (and our backyard) twice a day.  It also has been very windy.  The temperatures have been down, however, which has made the yard work and roof work bearable.  I have been able to join the two guys each day for lunch outside.

Another thing we’ve been able to do is go to lectures at school and in the community.  There was an interesting 6 lectures given in downtown Ellensburg by one of our former colleagues in the Geology Department.  We missed two unfortunately, when I had this recent procedure, but we made the last one, and that was special.  The topics have all been on Washington State geology.  It is totally fascinating.

I guess you must be tired of hearing all this unrelated to the heart procedures, but to know I’m back to doing some of this stuff is very positive.  I’m happy to be alive to enjoy my retirement.

I’m still attending yard sales when I can and picking up bargains.  I had to get a whole new wardrobe because of my weight loss, and while doing that I also have found a few items for John.  There are pretty nice shirts out there that are almost new and of a quality we probably wouldn’t have bought new.

Thanks for staying tuned, and thanks again for all your prayers and thoughts that got me this far.

Nancy

[from John: I’ll add something medical but unrelated to Nancy’s heart.  In December, while Nancy was in the ICU, I developed a “floater” in my right eye.  This turned out to be something of a false floater called a Weiss Ring and of little consequence, especially for me as I am left-eyed.  My right eye is of little use (sort of a spare) that would wander off until a couple of muscle-relocations brought it into alignment.  However, my brain ignores the image that eye sends and so the “floaters” in it are not noticed. Yesterday the left eye developed its own Weiss Ring and this one is going to take a bit more getting used to.  I’ll have it inspected this coming week because occasionally a small retinal tear occurs during detachment and that could be serious.]