The Four Days of Birthday

To be sung to the tune of "The Twelve Days of Christmas"
(Never mind, just read the blog entry. I'll write you a haiku or something later.)

Three days before my birthday, I decided I wanted to treat myself to something fun. I haven't been to a hockey game yet in this season, so first I checked the Grizzlies schedule; they were out of town. Okay, maybe a trip to see the Sharks or the Avs? Nope, both of them would be playing away games in cities I had no desire to visit.

While I was checking hockey schedules, I had the Jazz game on the TV. They were in Los Angeles, playing the Lakers. (The Jazz had their worst fourth-quarter letdown ever. After the game, I realized the Jazz would be a great hockey team, because they'd only have to play three periods!) During the game there was an ad for tickets to the game against the Lakers on Saturday, my birthday. So I called and got a decent seat in the upper bowl.

Then I thought, I've never been to a 'Niners game. (Regretfully, I never got to see Steve Young play; I was planning a trip to do so during what turned out to be his final season, but he got his career-ending concussion two games before the one I was going to attend.) It soon dawned on me that because I was going to the Jazz game Saturday night, I probably wouldn't be able to get to San Francisco in time for a Sunday game. So, the only way I could go would be if they were playing the Monday night game, and there was almost no chance of that: in the previous five seasons, they'd only played three MNF games. But I checked the schedule anyway, and sure enough, guess who was playing on Monday night, and guess who started looking for a ticket!

I found a great game ticket online, but before I bought it, I checked to see if the cost of last-minute travel would be a deal-breaker. I got a terrific deal on a flight/hotel/car package, so I was all set.

On Saturday night, as a birthday present to me, the Jazz actually played the whole game and beat the Lakers! I happened to sit next to one of my mission companions and his wife at the game.

I got up early the next morning to head to the airport. When I left at 5:30 I discovered that we'd got a foot of new snow overnight, but it wasn't really snowing much in our valley. That changed as soon as I headed over the mountain. Soon I was in a total white-out, and scared out of my mind. I couldn't see the road at all, it hadn't been plowed in a long time; all I could see was a faint ridge of snow on the side of the road from the last time it had been plowed, and an occasional delineator post. I didn't dare stop, and I couldn't really turn around, so I just kept creeping along.

I eventually got over the mountain to Highway 40, followed a plow over Parley's, and finally got into Salt Lake. I was delayed enough that my flight was leaving right as I got to the airport; I could see the people on the plane pointing out the windows and laughing at me.

The airline got me onto another flight to San Fran, with a layover in Los Angeles. In L.A., I was hoping to have a few minutes to absorb some warm sunshine, and more importantly, gloat over the Jazz victory the night before. I didn't have time to do either; the plane was delayed getting off the ground in Salt Lake, and thus was late getting to L.A. Once there, I had to run to the next gate to avoid missing my flight for the second time in three hours.

I got there in time, but was at the end of the boarding line. I got to the back of the airplane and found my seat, but discovered that there was no room in the overhead bins to put my carry-on bag. A flight attendant grabbed my bag and said they would check it through to San Francisco.

Well, long story short (you wish), I got to Frisco but my bag didn't. Now, I know airlines lose luggage -- I know because they've lost mine before -- but I've never heard of them losing a carry-on!

I didn't blow up at the lady at the baggage counter, because that's really got to be one of the worst jobs in the world! While giving her the information for the missing bag report, I was calm and polite, which actually seemed to fluster her a bit. I was a little frustrated, but not angry; I guess surviving possibly the scariest driving situation of my life just a few hours earlier was helping me keep things in perspective. And I kept thinking, it's just stuff, nothing that would be devastating to lose. Also, at that point I'd been 40 years old for a whole day, and I was able to draw on the maturity and wisdom that comes along with that.

But I have to be honest with you: I'm pretty sure I would have reacted a lot differently if my game ticket had been in that carry-on. Luckily, I had put my game ticket in my laptop case, and thus didn't have to find out if the airport security guys carry tasers.

I went out and picked up my rental car. It was about 50 degrees, and I noticed everybody else had coats on (I saw more than one parka, I'm not kidding.) But having just come from Utah, the 50 degrees was a little balmy for me; good thing, too, since my jacket was in my carry-on. Sigh.

Because my original flight would have gotten me to SF early enough on Sunday morning, I was planning on going to church at the local ward I served in as a missionary. To do that I would have needed to go from the airport straight to the church, so I had worn my church clothes to travel. Well, the flight change made me miss church, but there I was in my dress clothes, with all my other clothes in my lost carry-on. Sigh.

I checked into my hotel, then went and bought some toiletries to replace the ones in my carry-on. I realized my meds were in the carry-on, which meant I was going to miss taking them for the first time since I got out of the hospital.

By mid-day on Monday, they still hadn't located my bag. So, still in my dress clothes, I spent most of the afternoon shopping for clothes and a jacket to wear to the game. (Night games in December at Candlestick Park can get a bit chilly, even to me.) I wanted some 49er gear to wear to the game, but it was surprisingly hard to find.

I wanted to spend the day driving along the coast, but I didn't end up having enough time. However, I was able to go to Pacifica for a little while. That's one of my favorite towns in the whole world, on the ocean coast just ten minutes south of San Francisco.

I headed to the game, and got there early enough to park a couple miles away from the stadium, out beyond the parking lots. I figured I'd spend the $30 parking fee on souvenirs instead.

My seat was awesome, 20 rows up from mid-field, behind the 'Niners bench. I could actually see the players better on the field than on the big stadium screen!

I had the whole Candlestick experience: bought a souvenir shirt and hat, ate Gilroy Garlic Fries, peed in the restroom trough at halftime. I would have taken pictures of the whole thing (well, not the restroom; that's frowned on, even in San Francisco), but unfortunately, my camera was in that carry-on. Sigh.

Alex Smith played good but not great, the defense forced seven turnovers, and the 'Niners upset Arizona 24-9. I had a blast, it was a fun game in a fun atmosphere.

I got back to the hotel late, and my bag was waiting for me. I was glad to have it back, even though it was just a few hours before heading home again. It wouldn't do me any good this trip, but I was relieved I wouldn't have to find out how difficult it is to get the airline to reimburse me for my stuff.

But now I had a new dilemma: how to get the new stuff I'd bought in the carry-on to get it home! It briefly crossed my mind that this whole thing was a trick by United to get me to have to pay to check a bag on the flight home, adding insult to injury. Well, I wasn't going to do that, I was determined to make everything fit in my carry-on. It was like something out of a funny commercial, me jumping up and down on my carry-on bag; but I got everything in. (When I got home, I had to stand back a little when I opened the bag.)

The next morning, I got to the airport, and managed to fly home without a flight attendent abducting my carry-on bag. In Salt Lake, as part of the final day of my birthday observance, I treated myself to a nice lunch, then a haircut / shampoo / head-neck-and-shoulder massage. And finally, I finished the last of my Christmas shopping.

Okay, so that's the four days of birthday. Guess it's haiku time:

Jazz beat the Lakers,
Airline lost my carry-on,
Forty-Niners won.

A Test I Couldn't Cram For

I went into Salt Lake this morning for a stress test, to check how my heart's doing. The objective is similar to the angiogram, but much less invasive because it just involves an IV rather than running a catheter into my leg and up to my heart.

They injected me with a radioactive isotope, and took some images of my heart. Then they shaved little sections of my chest hair so they could hook up the monitor electrodes. (The hair had just barely grown back from the monitor patches I had in the hospital in July. Now I'm going to have to shave the rest of my chest in the morning, because right now it looks like some kind of bizarre jack-o-lantern.)

Then I got on the meanest treadmill in the world. They told me I needed to get my heart rate up to a certain target, then they'd inject me with more isotope, I'd run for a couple more minutes and be done. There are apparently seven possible stages for the treadmill. It starts out slow and flat. Every few minutes it starts a new stage by increasing the speed and the degree of incline. I couldn't get my heart up into the target zone (153 BPM) until stage five, which was 5.0 MPH at 18 degree incline. To give you some idea of how brutal that is, on my home treadmill I can run briefly at 7.0 MPH and 1.5 degree incline; my treadmill only goes to 10 degree incline, and I can only walk at about 4.0 MPH when I have it cranked up that steep.

But I was able to do 2.5 minutes at stage five, and then called it quits (I called it some other things, too, but I won't repeat them here.) The technicians were impressed, I guess I might have broken some kind of patient record; but they said some of the technicians have got up to stage seven on it. I'm not sure I believe that, because it seems like stage seven would involve sprinting straight up the side of their six-story tower building.

Anyway, they gave me a chance to cool down, then put me back under the imaging machine for some fresh pics. I thought they might have to redo some of them because I had my eyes closed, but they said it didn't matter. I guess they can photoshop them if they need to.

After my cardiologist had a chance to look at the before-and-after images and the data from the treadmill, he came in and talked with me about the results. He indicated that everything looks really good. The heart performed well during the stress test. Only about 20% of the heart shows damage from the heart attack. I say "only" because he didn't seem at all concerned, based on how well I've been doing.

The coronary artery with the stent in it is putting through a good supply of blood to the heart. My primary reason for wanting to get the stress test done was to check on the two coronary arteries which didn't close off during the heart attack. He said the blockages in those two arteries was about 40%, which sounded alarmingly high to me. But he said at that percentage they don't even consider going in to open them up, it works better to just treat it with medication.

When they get the results from the lipid panel (cholesterol test) in a few days, he'll decide whether we need to adjust the cholesterol meds. Other than that, he told me I can just keep living my life. He said he doesn't need to see me again till next fall. Between now and then, I'm going to be in training: I want to beat those techs at stage seven.

Charity Telemarketers

I have a hard time keeping up on magazine reading, so when a company called selling magazine subscriptions, I wasn't interested, even though it was to benefit Special Olympics. After turning down the salesman several times, telling him I didn't have $80 to spend on magazines, he told me they did have a smaller Sports Illustrated package, 28 issues for $20. I gave in, thinking that although I probably wouldn't read them, it was for a good cause.

The next week, I received the invoice, along with a thank-you note from Special Olympics. In that letter, they mentioned they get 12.5% of the proceeds of the subscription price. I'll save you from having to do the math: they got a total of $2.50 of my $20. I was none too pleased about that.

My advice if you get calls such as this:

• If they're selling an item you were considering buying anyway, ask how much of the sale price the charity actually gets, then use that as basis for your decision whether to buy it from the calling company.
• Otherwise, if it's a charity you would like to support, tell the caller you'll just go to the charity's website and make a donation. Besides the charity getting the entire amount of your donation, that alternative would eliminate any questions you have as to whether the telemarketer actually represents the charity (which is a legitimate concern). Additionally, a direct donation allows you to help a good cause without adding unnecessary clutter to your life.
• Consider doing your online shopping through a charity shopping portal such as iGive.com .

Funny as a Heart Attack - Summary

For those of you without the patience and endurance to read the full blog posts, here are the highlights:

• Happened on Saturday, July 11th
• Cold sweats and shortness of breath at home after playing basketball for two hours
  
• Called 911
• In ambulance just before getting to hospital, went into full arrest
• EMTs used CPR and defibrillator to get heart started again
• ER got me stabilized, then put me on LifeFlight to IMC in Salt Lake
• Angiogram showed nearly full blockage in one coronary artery
• Angioplasty to open artery, then put in a stent
• Recovery has gone remarkably well, starting immediately after getting the stent; all vital signs good
  
• Quickly returning to full activity, from walking around the second day after the attack, to some good running sessions on the treadmill and getting back to the gym within three weeks of the attack
  
• Back to work full-time one week after attack, with no problems
  
• Caused mainly by hereditary factors, high cholesterol
• Will have to make a few changes to diet to help get cholesterol levels down
• Happened after three months of pretty healthy diet and exercise, adding to the surprise of having a heart attack at age 39

Funny as a Heart Attack - Part 2

'Cuz if you can't laugh at a little cardiac arrest, what can you laugh at?

Recovery

Once they got the artery propped open again with the stent, I started doing really well. The only pain I had was swelling, tenderness and bruising in my leg where they went into the artery, and around the myriad of IV lines in my arms. The irregular heart rhythm I'd had all morning evened out, so they didn't have to put in a little defibrillator like they had been considering doing. (When the doc told me my rhythm had improved, I asked him if that meant I'd be a better dancer now.) My blood pressure and heart rate were both good.

My oxygen levels were a bit low, so they had me on oxygen for a couple of days. "And here I've been using my own lungs like a sucker." (That's Homer; just like with Steven Wright, there's a Simpsons quote for any situation. In fact, that Tuesday in the hospital I turned on the TV and it was on. It happened to be the episode where Dr. Nick performs heart surgery on Homer, so right there was half an hour of relevant lines I could use.)

My recovery has been quite remarkable. After two days in ICU, they were ready to move me downstairs to the regular cardiac ward, but there was no room, so they kept me there another day. Then they were going to let me come home on Thursday, but the docs added one more medication, so they kept me another day to see how I reacted to it. There were no problems, so they discharged me on Friday, five and a half days after my attack.

I've recovered so quickly, in fact, that I think some people suspect I faked the whole thing just to meet some nurses. If that was my plan, it was genius. It was certainly nice to be paid attention to by so many smart, beautiful women. I did feel a little cheated that about a fourth of the nurses were male; but they were pretty cool guys, and all of the nurses, both male and female, were excellent at their jobs.

As far as exercise goes, they let me get up and walk around the second day after the attack; the only reason they wouldn't let me get up before that was to protect the artery entry points in my leg. After they moved me out of ICU, I did a few pretty long sessions walking on the treadmill. I did more treadmill work the week I got home, then the week after that I got back to the gym. This week I've done some running on the treadmill.

The only restriction they gave me when I left the hospital was to not do any heavy lifting for a couple of days, again to allow the holes in my leg to heal. They told me I could return to full activity as I felt up to it, and I've felt up to everything I've done so far.

Causes

The main cause appears to be hereditary. There's more family history of heart disease than I was aware of, and the genetics have a much greater influence than I realized they could have. But then, I can't blame it all on heredity. I've been too heavy for quite a while now. (In fact, Jer's two-year-old son Gage has this thing where he comes up to me and pushes my belly in because he thinks it sticks out too far.) I've also known for a while that I have high cholesterol, and have been on medication for it. But although I've put a lot of effort into losing the weight, I have been expecting the medication to do most of the work in getting my cholesterol levels down. Apparently there's some flaws in that strategy.

The timing of the attack surprises me. I'm not talking about having a heart attack at 39, although yes, that was rather unexpected. I'm referring to the fact that I would have been less surprised if this had happened at the start of the year. In the three months preceding the attack, I'd lost 20 pounds; hadn't eaten fast food or drank carbonated drinks (soda); had been exercising pretty regularly; and had reduced what limited stress I had at work. And yet after all that, I had a heart attack! Well, lesson learned - I'm going back to the stuff I was doing before!

Changes

For many years I've claimed to be a meat-atarian (long before the Wendy's commercial). It just seemed to come naturally as a result of my being a vegetable rights activist. (Have you seen the conditions on those farms? Those poor things are raised in the dirt!) I told one of my doctors I'd try to limit myself to one bacon double cheeseburger a day, but I couldn't guarantee anything. He didn't find that nearly as funny as I did. Come on, Doc, lighten up a little.

All joking aside, I do need to get my cholesterol under control. The doctors have changed the meds I'm on to help do that, because the stuff I was on wasn't really working. But now instead of watching caloric intake like I was doing to lose weight, I need to pay attention to the fat and cholesterol numbers. I suspect as I focus on a more low-fat, low-cholesterol diet, the weight thing will take care of itself.

Luckily, the transition to a healthier diet is going to be a lot easier than it would have been without the regimen I've been on this spring. Still, it makes me sad to think I have to give up having a whole shelf in my fridge dedicated to cheese. Sigh.

What I've Learned

The main thing I've learned from all of this is that daytime TV is awful. Another equally important thing I've learned is that it's really important to know your family health history.

Other than that, I really don't know that I've learned anything. I know that sounds like I'm either being flip or arrogant. But I already knew the things you'd think someone would learn from such an experience; the experience was just a jolting reminder to stop and think about those things.

I already knew that a healthy body is a miraculous blessing. I don't think I've ever taken my good health for granted; I thank God for it every day. I'd already made good progress at not letting things get me annoyed or frustrated. I'd already started making time in my life for more things that are truly meaningful, and cutting out some of the frivolous things on which I've wasted so much of my life.

I already knew that I have so much to be grateful for. A few people have expressed to me that they're sorry I'm in such a terrible situation. While I appreciate the sentiment of what they're trying to express, I honestly don't think I've been dealt a bad hand, not in the slightest. I have a good job that I enjoy. I don't live in poverty. I get to pursue my interests and hobbies. Sure, I missed out on playing lacrosse this summer, but I'll get back to it soon enough. Sure, I have to cut out some foods I enjoy, but I'm in no danger of going hungry. Sure, I had a heart attack, but I haven't even briefly experienced the kind of pain that so many people deal with on a daily basis. I have great relationships with my family and friends. The list goes on and on, I could easily fill another lengthy blog entry with it.

Sometimes I think people expect me to be more zen-like since my brush with death. In actuality I'd already been pondering what's really important in life; maybe that's due to my rapidly-approaching 40th birthday. The insights I've gained are highly personal - not meaning they're necessarily private, but that many of them are realizations each person has to come to on their own.

As a closing note, just let me thank all of you who have offered positive thoughts and prayers on my behalf, as well as any assistance I might need. That's certainly something that belongs on the list of things I'm grateful for. And let me assure you that I'm doing well, feeling good, and hoping you are also.

One last thing...

You didn't remind me to tell you the second thing that kinda freaked me out. In the ER, I was concerned because for the longest time it seemed like the only one who would talk to me was Haley Joel Osment. No, I'm just kidding, here's the real second thing...

A couple of days after I got back to my house, I looked on my DVR for something to watch. I discovered that I had recorded the series finale of Eli Stone on Saturday the 11th, from 9 to 10 pm. The episode was about a couple of heart patients, but that's not what freaked me out about it. In the last commercial break, there was a commercial for LifeFlight and IMC, right at the very time I was having my heart attack. Weird, right?

Funny as a Heart Attack - Part 1

'Cuz if you can't laugh at a little cardiac arrest, what can you laugh at?

The Attack

Saturday, July 11th, 9:20 pm: I'd just finished playing basketball for a couple of hours at the stake center. No problems, other than the fact I couldn't hit a three-pointer to save my life (good thing that turned out not to be a requirement.) I stuck around for a few minutes, shooting and talking to a couple of the guys while I cooled off.

About halfway home, I started feeling a bit of pressure in my chest that was making it hard to breathe, and I started sweating again. I pulled over, and after half a minute the feeling passed. Whoa, that was weird, what the heck was that? As I pulled into my garage five minutes later the pressure and shortness of breath returned, and by the time I got in the house the cold sweats had started again. There's definitely something going on here that's not normal. At this point everything was starting to feel a bit surreal. There was no panic, just a growing sense of, I don't know, weirdness. (Right now somebody's saying, "I thought you said you didn't feel like you normally do." Very funny. Quit interrupting.) I thought, in a very detached, conversational way, I wonder if this is a heart attack; then, as I closed my front door, Leave it unlocked in case the EMTs need to get in.

I really considered waiting to see if it would pass, as the episode in the car had. But if this turns out to be a heart problem, that's not a risk that's worth taking. So I picked up my cordless phone and dialed 911. As I chatted with the emergency dispatcher, I laid down on the floor, put the handset on speaker, and set it next to my head. I tried to relax my chest so I could take deeper breaths. The dispatcher got the ambulance on its way, then asked if there was somebody she could call to come lend some assistance. I had her call Jeremy, who is my cousin-in-law, closest friend and co-worker. She called him, then came back on the line with me and kept me talking.

The talking thing was getting more and more difficult. I never did feel the proverbial elephant standing on my chest, but the pressure I did feel was making it harder and harder to breathe. I felt like the dispatcher was asking me a lot of essay questions when I only had enough air to give yes/no answers.

Jer actually beat the ambulance there. He came in the door, and I had him go out to flag down the ambulance. This is the point where my memory starts to fade. (That's good news for you, because this story's already getting pretty long, and the less I remember, the less you have to read.)

The paramedics... wait, I can't call them that, there were more than two of them... the EMTs asked me more questions while they got me prepped and loaded onto a gurney. I don't remember the questions or my answers, but I think I got most of them right (I test well.) Then, into the ambulance for a quick ride to Heber City. Ironically, that's where I got my last speeding ticket; the ambulance lights and siren sure would have come in handy that day.

Apparently I went into full arrest just as we were turning down the lane to the hospital, so they had to start CPR, and then cranked up their power tools. While they were doing that, I was having a really bizarre out-of-body experience. Rather than seeing them working on my body, I saw the electro-shock therapy scene from Strange Brew:

"Take it up to thirty this time!"
"No way, eh, it's my turn!"
"Okay. Hey, let's try the head this time. (In a mock reprimanding tone) See, if you'd stick to your 12-point maintenance program, eh, we wouldn't have to jumpstart you like this."

I wanted to watch more of the movie, but they got my heart going again, and I got sucked back into my body (that's okay, I have the movie on DVD.) The doctors later told me that the EMTs did a perfect job with both the CPR and the defibrillator, for which I'm very appreciative.

The ER and Cardiac ICU

I don't remember much about the ER, but from what Jer has told me, I repeatedly wished him a happy birthday (it was on Sunday), and repeatedly told a few Steven Wright jokes which applied to the situation (there's at least one which applies to any situation.)

There are two things about this whole experience that have kinda freaked me out. The first one happened in the ER and prompted one of the Steven Wright quotes (remind me to tell you the second one a little later.) Jer said he hoped I wasn't too attached to the shirt I'd been wearing, because they had to cut it off of me. Why does that freak me out? Because earlier this year I had a dream, and in that dream something serious was going on; but the only part of the dream I could specifically remember when I woke up was that Jer had said that exact thing to me. I'm dead serious about this (okay, briefly-dead serious).

So I was having really strong deja vu, and apparently kept forgetting that I'd already mentioned it. That led to the first Steven Wright joke: "Right now I'm having amnesia and deja vu at the same time." (Told you there was one for any situation!)

They decided to LifeFlight me over the mountain to IMC in Salt Lake. Jer said he'd meet me down there, to which I reportedly replied, "Wouldn't it be cheaper for all of us to ride down together?" I only remember a few seconds of the helicopter ride, looking out the window and not being able to see anything.

All I remember of the rest of that night and Sunday morning is being poked and prodded, and being asked the same questions I'd already been asked several times (and yet I was the one who supposedly had the short-term memory loss.) That's just fine, though, because one of the questions they asked gave me the perfect setup to apply another Steven Wright quote:

I filled out an application that said, "In Case Of Emergency Notify..." I wrote "Doctor"; what's my mother going to do?

Sunday morning the cardiac team ran a catheter in through my leg up to my heart. I was expecting them to use some complex medical imaging to guide the catheter, so I was surprised when I looked over at the surgeon's monitor and saw that he was using Google Maps!

They did an angiogram to get a look at the coronary arteries. That involved injecting a dye through the catheter that made me glow in the dark, and hopefully gave me some kind of cool superhero abilities. Then they did an angioplasty, where they inflate a little balloon at the point of the blockage to open it up. Finally, they placed a stent in the artery at that same point. The stent is a bare-metal framework to support and hold open the artery wall.


More to come in Part 2. If you want to make this long story short, you can just read the Summary; I won't hold it against you. Well, maybe a little. But I'd probably never know. Unless the next time I talk with you, I ask you a question that only somebody who'd read Part 2 would be able to answer.