FRIDAY — Better and waiting

It is 6:30 as I write.  Nancy has been resting well and improving.  The cardiologist felt she need not be on constant monitoring and so they moved her to the 4th Floor into a big room with windows and a potty.  Except for sky there isn’t much to see out the windows unless one stands up on the sill and looks over the SW wing of the hospital.  Still, the view – any view –is much better than in the ICU.  Likewise, having the ability to use a real bathroom is, compared to a bed pan or movable stool, a major improvement.  It also brings increased movement – we want no regression on the lack of muscle tone.

She is still on a liquid diet in anticipation of procedures to rule out (or in) possible sites for blood loss.  The INR test suggests this could be done on Sunday, but not Saturday.

While I was there this afternoon a blood-draw was done for the purpose of checking on the bacterial infection.  Her color and vital signs suggest a rapid improvement since she went to the ER on Tuesday.  I want to know more about the bacteria and what they measure.

I still haven’t met the infectious disease doctor this go-round.  Last December I sat at opposite ends of the same table with her when I was being briefed by Nancy’s nurse and the doctor was reviewing files.  Later the nurse told me about the doctor but Nancy’s issues at the time did not involve bacteria.  Anyway, Nancy may have to ask for a page or two of notes as the names and spellings of the critters is beyond us and so I have no key words with which to search.

That’s it for Friday.  John

THURSDAY — Progress, I think.

A correction to a previous assumption is in order.  Our thoughts on the ICD have focused on V-fib and that is what we assumed happened.  Upon reading the data stored by the unit we now know the thing fired-off because it sensed a too-rapid heart rate, namely, 188 beats per minute.  This is called tachycardia.  The term tachycardia comes from the Greek words tachys (rapid or accelerated) and kardia (of the heart). The gizmo on the dash of a car that gives RPMs is a tachometer and has the same Greek word origin. Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate – for folks over 15 years this would be any rate over about 100 bpm.

Nancy’s rate had been running a bit high (I thought) during the past few weeks, frequently 80+.  She has had frequent atrial fibrillation

from the Mayo Clinic:

http://www.mayoclinic.com/health/atrial-fibrillation/DS00291

“During atrial fibrillation, the heart’s two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart. Atrial fibrillation is an irregular and often rapid heart rate that commonly causes poor blood flow to the body and symptoms of heart palpitations, shortness of breath and weakness.  Atrial fibrillation can also cause fatigue …”

Monday’s report explained how the “King of Hearts” monitor was rendered useless by the frequent A-fib, and the need to switch to a Holter monitor.

[Small world story: Friends (Brittany related) write:

“Hi. Just read your latest comments and thought I’d share a bit of trivia with you guys. Dr. Holter was born and raised in Helena, MT. In fact, his home was 2 houses south of ours. . . he was a native son, the local history museum had a special display with his old stuff, photos, etc….”]

Now back to the main story:

When (on Tuesday) the ICD sensed the tachycardia it pulsed twice and converted the abnormal rhythm to a regular sinus rhythm.  Nancy was on the kitchen floor and shifted about until she was leaning against the oven.  She thought I was outside and sat there awhile thinking I would come back.  That plan didn’t work because I was down the hall sleeping.  From where she normally spends her time (a recliner overlooking the back forty**) she gets me awake or from the computer by activating the ringer on the house phone.  There on the kitchen floor she didn’t have that capability, so, after about 45 minutes of rest and frustration she yelled for me hoping I was near enough (outside) to hear her.  Had I been outside that likely would not have worked but being only a room away, it did.

**————skip, if you know “back 40”———————–

“back forty” is a reference to plots of land of 40 acres established by the USA’s Public Land Survey System (PLSS) –good explanation here:

http://www.nationalatlas.gov/articles/boundaries/a_plss.html

The settlers house would be located close to the public road that went by the ‘front’ of the property and frequently near the better farmland.  Some claim that if a salesman or other intruder visited the house and the spouse felt there was no need to bother her husband, she would tell the person that the entire crew was out on “the back forty” – far from the house and could not likely be found. (no cell phones then)

————————————————————————

Now it is Thursday afternoon — several phone calls later.  The INR is coming down but the colonoscopy won’t be done until Saturday.  At 1.7 INR the doctor can remove any suspicious polyps.  So we wait on that.  She has had antibiotics, blood infusions, and other liquids pumped into her.  Her fever is gone and her heart rate lower and steady in the high 60s.  She called after having the TEE (see Wed. posting) that did confirm something (filaments of bacteria or ‘vegetation’)

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

on the mitral valve (donated by a pig) .

Here’s an assumption:  When bacteria in the blood inflames the heart it is called endocarditis.  Nancy’s medical problems flared last spring when this happened and she went to the ER in Ellensburg. If you look at the list of symptoms on this site

http://www.mayoclinic.com/health/endocarditis/DS00409/DSECTION=symptoms

there are several that she has been experiencing (again), namely, fatigue, fever, weakness, and weight loss, blood in urine (microscopic).  To me, this appears to be a slow-motion version of sepsis and septic shock.

http://www.mayoclinic.com/health/sepsis/DS01004

http://hopkins.portfolio.crushlovely.com/reference/article/septic-shock

The cocktail of antibiotics has been upped to four (to cover all possibilities I assume).  She is feeling much better except for a bit of raw throat from the TEE.  That and a liquid diet in anticipation of the colonoscopy.  She isn’t happy with the lumpy Jell-O just served and she questioned me on how one screws up making Jell-O.  I don’t know.  Too little stirring or the water is not hot enough, I guess.

It is almost 6 P.M. here so I have to send this to the cloud.

Bye.

John

WEDNESDAY — Take a number.

There should be a sign above Nancy’s door.

While in the Ellensburg ER a test revealed an anemic condition so a unit of blood was started before they transported her to Yakima Regional.  She also had a high white cell count.

The latter is likely caused by a bladder infection – now being treated.  The cause of the low red-cell count is thought to be internal bleeding.  Why is not known.  An upper gastrointestinal (GI) exam is planned, as is a colonoscopy.  With all that is going on with her body the INR (blood clotting test) reading is high so that has to be brought down before any invasive procedure. That is being worked on.  When that reading is where they want it, then those tests can be done.

An  echocardiogram or ‘echo’ revealed something on her heart valve, possibly a bacterial growth (she had this last year).  A blood culture revealed two strains of bacteria in her blood so they started a 3-drug cocktail that may be adjusted when the exact strains of the little devils are known.  However, to get a better look at the valve and its hitchhikers they scheduled a transesophageal echocardiogram or TEE, where the echo transducer (sound producer) is placed in the esophagus or food pipe that connects the mouth to the stomach.  This gives a much clearer “picture” of the inner heart as the waves do not have to travel into the body from the surface. See:

http://www.heartsite.com/html/tee.html

So with all that has been done and all that will be done on Thursday there is a steady stream of nurses, doctors and more doctors, blood takers, blood infusionist, menu bringers, cleaners, and others lining up at the door to get in and question, prod, poke, stick, listen, and so on.  They get in each other’s way.  She needs that sign.

Take a number.

TUESDAY — Yikes!

We’re back in the ICU at Yakima Regional.  Nancy has something going on and not being sure what, the consensus of the medical profession was that Yak-Reg ICU is the best place for her for a few days.

I’ll make this short (for now):  We woke early this morning, I think about 5:30.  I let the puppies out, asked Nancy if she was okay.  She was, then she wanted something to spit into.  I got that for her and went down the hall and went to bed.  At some time later she got up and went into the kitchen and was dumping here tiny waste bucket into the sink.  At that point she apparently had a ventricular fibrillation episode and sank to the floor.  Her ICD responded with a double whammy and converted the beat back to normal.

Her legs and arms are weak (and maybe more so from the incident) and she rested a time on the floor but did not get up.  She thought I had gone outside and expected my return.  After about an hour she yelled for me and, being just down the hall, I appeared after the first yelp.

We then went to the Ellensburg ER where they soon determined the main thing wrong, as far as they could tell, was from a blood sample.  She was quite anemic and the doctor thought that might have triggered the V-fib and set off the ICD.  Test of the kidney function did not suit them either. They cannot download the data from the ICD here and so, with a unit of blood hanging beside her – off to Yakima she went.

I talked with her a few minutes before 5 P.M. and she sounded fine but had little real news.  I’m posting this at about 5:25 and will head on down.

More Wednesday.

John

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.

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

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

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

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.

~~~~~~~~~~

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.