Category: Random issues

Many of you were not expecting anything to be written this past week till today, but we sneaked some in on you when things starting happening.  The end of the week was less eventful, thankfully, on the health, antibiotic infusion part.  The rest of the time after the mess on Monday, was pretty smooth sailing.   Today had a funny note, but the infusion went well.

The Out-Patient services put in a standing order for me for a milkshake with boost of Glucerna added to chocolate ice cream, two scoops.  Yesterday went without a glitch and the kitchen provided my shake.  Something got lost from yesterday to today, and first they brought a bottle of Glucerna with a cup, no shake.  The people in Med-Surg sent it back requesting a shake.  What came next was the Glucerna in a cup with ice as the base.  Finally, the third time was a charm, but it was only 10 minutes before I ended for the day.  I drank a bit and took the rest with me for the trip home.  We’ll see if tomorrow the kitchen gets it right the first time.

The other nice thing that happened today was a visit with friends, now in Rockville, MD who we have known a very long time – since starting at the Univ. of Idaho as an undergraduate student, going on through to a Masters, and being involved with me while a GIS manager on the west side, by employing several of my students as interns.  He and his family flew to Seattle, rented a car, and were driving over to Spokane, when they stopped off for lunch and a visit with us.  We met them at the Deli at Super One in town.  That was a good choice because the town is inundated with rodeo and fair goers and all major restaurants probably were packed.

The rest of our last couple of days was filled with moving hay (John), and playing with the puppy, who has taken a liking to the sofa in the den.  He actually made it halfway through the night in the washroom, went out to “pee” at about 2:30, and spent the rest of the night till morning, happily sleeping on the sofa with his mom.

We do not have any special plans for labor day so doubt there will be any blogs till next weekend, but that’s what we said last week.  So we will not speak ahead and just keep you informed if anything big happens.

Much of my time this past week was spent on email, contacting former students and workers who employed my students to invite them to my retirement party.  If you didn’t get an invite and are interested, let me know by email (nancyh@ellensburg.com) and I will send you the invite, knowing you cannot come but might just be interested in seeing the celebration the Geography Department has planned for me, Oct 2, Saturday afternoon.

Former students have responded by email with some good memories that make my day.  There are comments from them about their connection to me (and John) that I would never have known.  There will be a memories book at the reception, for people to write in, and they also can send to our secretary, for her to include in the memory book.  I hope she will just print the emails and save herself  the effort of writing in the book, and just slip them in the back.  Otherwise it might be an impossible task.

Other things have happened this week, on the minor side, but major in my book.  John had planted some tomatoes, but our temps have been low and the winds high, so we had broken plants and not a lot of ripe tomatoes.  Yet, this week he has harvest a few small ones and they are wonderful, tasting like tomatoes.  What a concept !  [from jfh, We have had many clear-sky nights and at 2,240 feet elevation the night temperature will and has dropped well below 50^o F.  Tomatoes hate that.]

I’m sure I left something out, but not to worry, there is another week.  Thank you for your phone calls and birthday and get well cards.

Have a nice week, and we will try to do the same.  I still have till September 28 to go daily to the hospital for the infusions, which have decreased this week from two to only one – 30 min., Rochephin.

See you on the blog hopefully only next weekend.   Nancy

Have to report on my birthday (67) yesterday, Sept 1.  It was a good uneventful day.  I didn’t want John to make me a Chocolate Cake with Chocolate Frosting, but I did want two presents.  One was a squeaky toy and a rawhide chew for the puppy, Rhu.   He now has a name, and a neat toy hamburger he loves.  He can jump up on the sofa along with it and settle down for a nap with his mom, John, or an aunt.

John put in more time digging for the bottom of the stand pipe where the leak is suspected.  He then went to the pasture to mow old grass, roses, and other nasty weeds, and ended up getting a stick caught under the drive-belt.  Apparently the belt and the stick both fought gallantly until they both died. The mower quit moving forward when the friction and heat stretched the belt.  So, yet something else to fix.

Birthday afternoon at the hospital out-patient clinic was delightful.  They were all attentive and everyone on the staff came by to wish me a happy birthday.  They had a little snuggle bear on my pillow for me to have and take home.  There was a milkshake ready with extra protein and supplements.  All went well, and they changed the dressing on my PICC (has to be done once a week).  It is nice to be able to report nice things.

Today is Thursday and was another great day.  We got my other present I requested when John got a haircut from the lady who has done my hair cuts since I arrived in town in 1988.  I normally do John’s hair, but was unable in the past few months and his hair was beginning to look like Einstein’s.

Then I went to play fiddle and sing at a nursing home and had another good hour.

Finally, left there in time to get to my infusion, which again went smoothly.

That’s all, but wanted to give you some good news for a change.

[posted Tuesday, after John said no more reports till Sunday]

A continuation of the drip, drip epistle:  We’re good at prematurely speaking about successful activities.  For my blood draw and infusion today, at 3:00 p.m., we found that the the PICC line would not flow, unlike the water line at home that won’t stop.  There was not a drip of blood to be had because there was a clot in the line acting as a stopper and wouldn’t allow anything by or from.  The first saline solution seemed fine, but subsequent attempts to draw blood resulted in dry air.  This normally is just over an hour in and out for the antibiotic infusion.  Not today.

The problem would have been either a fibrin tail or an intraluminal thrombus.

These and other PICC issues are reported here:

http://www.medscape.com/viewarticle/508939_6 Here are quotes:

#1  “Fibrin also may build up on a catheter without completely enclosing it. In this scenario, a small piece of fibrin hangs off the catheter tip. This is known as a fibrin tail, which also represents a persistent withdrawal occlusion. These can sometimes be resolved with an infusion of low-dose alteplase over 2 to 4 hours, but this is not always successful, and the fibrin tail may develop again.”

#2  “An intraluminal thrombus forms inside the catheter and can result in partial or complete occlusion. It often can be dissolved with a small dose of alteplase, a fibrinolytic agent that is instilled for 30-120 minutes and then withdrawn from the catheter.”

~ ~ ~

When the PICC is to be used the first thing done is to apply suction until blood is seen.  When none shows up it indicates a blockage.  Fibrin is explained here: http://en.wikipedia.org/wiki/Fibrin

When fibrin attaches to the inner-end of the line or tube (lumen in hospital speak) it floats in the blood stream until that backward flow from the external suction causes it to be pulled into the open end of the tube. If the lump or clump (thrombus) is formed inside the lumen then the condition is called an “intraluminal thrombus” as in quote #2, above.

If you have a broadband connection, try this video for an explanation of these things and the solution.  (This is an ad-like video for the chemical used in my PICC.)  http://www.cathflo.com/media/cathflo_moa.mp4

The production of this stuff involves recombinant DNA technology, fermentation, and Chinese hamster ovary cells.  Why Chinese hamsters?  Who knows?  We didn’t even realize hamsters had nationalities!

Which ever it was, we had to go to plan B.  That meant an extra hour plus while we awaited delivery from the pharmacy of  Cathflo Activase® and its forced entry into the PICC line with turbulent motions.  Push, push, to get the fibrin broken up and the line unclogged.  Meanwhile, John retrieved me a warm blanket to try to get me comfortable.  Those 45 minutes seemed to last forever.  I called a friend on the cell phone to tell her my plight.

Finally, the time came to search again for blood from the PICC turnip.  It came!

First item on the agenda was to draw blood for an INR test, from the PICC.  Before that, one has to clean out the Cathflo Activase® and about 10 cc of throw-away blood.   (No wonder I’m anemic; they put blood in one week and take it out the next).  So we continue.  She draws a full vile of blood for the INR test, more than enough to be on the safe side.

I had started the paperwork over a week ago from my family physician’s office to put the INR on tap for being done by a nurse in the Out-Patient Services where I am every day except the weekend.  This is a great service that prevents being “poked,” but Lab personal cannot take from a PICC line; only a trained nurse is allowed.   When I came in, before she started the antibiotics I mentioned the need to do the INR test and that the paperwork was in place.  Normally, I have a standing order at the Lab, but nothing at the Out-patient Services.   This nurse couldn’t find anything in the records, so off she went to call my family physician’s office to request it before she could draw.  There was plenty of time while we waited for the fibrinolytic agent to work its dissolving wonders.

Once done, as mentioned above, the nurse could change the head on the PICC line (cannot use one through which blood has been taken, and infuse the antibiotics into my PICC.  I think it was 4:16 when this part started that usually takes an hour.  We were about on schedule, only an hour + later than usual.  So begins the drip, drip – one from each bag of the two antibiotics, combining into one tube headed into my superior vena cava — a large diameter, yet short, vein that carries deoxygenated blood from the upper half of the body to the heart’s right atrium.

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

I slept through the first 35 minutes, but by now my back was hurting, the pillows weren’t right, and I was a basket case for reclining in an uncomfortable set up so long.  Oh, I had made a couple more cell phone calls to friends in the set up stages when we were just waiting.

So, I mentioned my discomfort to the nurse.  I was in a special bed with remote controls to determine height of back raised and the same with knees.  I played with the controls and finally found a good position.

At some point I was really wanting a chocolate milk shake.  The nurse overheard me and said they could order one for me.  They did.

I managed to rest through the last hour of the infusion.  We didn’t walk (wheel) out of there until 6:30.  That was 3.5 hours for an expected 1 hour stay.  I was not a happy camper.  Except I was thrilled to see the double saline solution flushing with a turbulent short pushes motion to force the solution to the line with the hopes of breaking up any clots.  I surely don’t want a repeat.

~  ~  ~  ~

In the “for what it’s worth” department:  At home, the day started with nary a drip.  In order to prevent loss of water from the well John flipped the circuit breaker to the pump; turning it on only as needed to have running water in the house.

A Culligan man was due at 10:00 a.m. but was delayed ½ hour.  He got to the house and John explained the problems.  They determined the Culligan-Softener (21 yrs old was shot) and the Iron removal equipment was doing fine still. (Ours is ferrous iron that oxidizes in the lines and tanks.)  The Culligan-man and John discussed the pressure problem in the tank and decided there was a leak in the house or between the house and the barn somewhere.  Turns out it is between the house and the barn but John hasn’t yet located it.  He has to dig 4 feet down through alluvial fan material that has been refilled in a ditch for the buried water pipe.  He’s hopeful that the leak is in a frost free stand up faucet for the horse tank at the barn. While the exact location of the leak is sought, replacement equipment has been ordered to provide sparkling water inside the house.

Blood and water go drip – drip.  Money goes in clumps.  Ouch!

Life continues . . .

I think Nancy feels better today than she has in a couple of months.  A lingering question about the blood loss remains.  If not caused by the bacterial infection, then what?  The heart issues will be treated continually, so, while she is examined, tested, and treated appropriately for her finicky heart over the next few weeks, the anemic aspect will be watched.  Multiple exams ruled out many things, so with respect to this, we are in a period of watchful waiting.

She went to the local hospital for antibiotic infusion via the PICC line today.  The pharmacy folks indicated they were okay with both of the compounds going in at the same time.  That cut the procedure down to about an hour.  They fixed up a nice comfy bed for the duration and when I returned she was ready to go.

I hadn’t stayed.  That’s the “double dang” part.  One of my jobs yesterday was to clear out the hospital room.  Things such as un-opened fruit juice and the plastic pans for holding tape or other incidental items – these things all get sent home with the patient or tossed out. I cleaned up all these things into a couple of small boxes and a plastic bag.  A nurse brought a wheelchair, I went ahead and brought the car to the front door, and minutes later we were on I-82 heading toward home.

Big mistake.  Someone (me?) forgot to unplug two power supplies – one for her cell phone and one for the laptop.  Bummer.  Ensconced in a fluffy bed, Nancy recharged while I boomeranged from Ebrg-to-Yak and back.  Wind gusts today were nearly 50 mph and the passenger side of the car sometimes makes an odd woodwind sound when air begins passing over us at about 100 mph.  I got that a lot today along with the turbulence.  I did see a large column of dust coming from the lower valley south of Yakama and streaming into the area above the clouds over my route. That was very interesting.  On the ground these dust steams make for nasty driving, accidents and closed roads.

Now that Nancy has her computer back I will expect her to write on Saturday.

There is a potluck by and for the Kittitas Valley Fiddlers and Friends tomorrow evening, so, Friday will be an off-day for our communications.

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.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

John tells me I need to update this from the June 21^st 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 14^th 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

. . . 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 8^th.   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 21^st.  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 94^th 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.]

Garage/yard sales are the order of the day.  It is 6:30, the sun is barely up, it is cold out, and the wind is still blowing.  About that wind – for about 3 weeks the sustained velocity has been above 25 mph, often in the low 30s, and gusts up to 50.  Yesterday was the first day in three weeks I didn’t do something outside – I fed and watered the horses.  I’m sure they were thrilled with their day of rest.  Sunday morning the forecast claims the blowing will be down to 10 mph.

I tagged along with Nancy Friday afternoon to a meeting of the Trustees of Central Washington University.  First order of business was to have someone say nice things about recent retirees from across the employment categories.  They don’t give out gold watches.  Maybe the deep thinkers finally realized that someone that is retiring really doesn’t have the need for a watch, gold or otherwise, that might have been useful while they had a job.

The Trustees are empowered to vote on bestowing titles on faculty and in the current situation have voted to name Nancy as an Emeritus Professor of Geography.  She got to say a few words of thanks to and appreciation of CWU and of her joy of working with students.  I took a couple of pictures that are not too bad considering the nasty lighting, and then we (all the various honorees and tag-alongs) hightailed it out of there before the trustees and CWU administrators got back to figuring out how to run the University in a period of declining State revenue.

In addition to the new title, Nancy will be given a continuing parking decal which, truthfully, will be more useful than the gold watch they didn’t give her. In her remarks, Nancy was dignified as is appropriate for one with such a high-falutin ’ phrase in front of one’s name.  She did manage to insert a comment about her under- appreciation of “departmental politics” and that created a moment of hilarity.