Thursday, May 24, 2012

Surgical Consultation...and I Cheered!

For those who have been following this little journey of mine, from the testing of my arteries, to the discovery of blockages, to this post... I'll cut to the finish line before I tell you the story.
   I found out yesterday that I do not need surgery to clear the blockages in my carotid artery, and I do not need angioplasty. With any luck at all (and some help from God), I won't ever need those things. If I do, I'll cross that when the time comes.

   I was nervous about my visit to the surgeon. Some have asked if I was scared, and I'll admit I was a little scared. I've been more scared of other things. Nervous and anxious are better words to describe how I felt.

   My appointment was at 1:50 PM, and I arrived fifteen minutes early as instructed. They always hand me blank forms to fill out, but I never have to fill them out while I'm there. I fill them out before I walk in, and I'm surprised that they're surprised the paperwork is done.
   I had a paperback book with me, but I only skimmed the first couple of pages. I watched people coming in to see other doctors or have tests done. I looked around the room. It's a big lobby with several television monitors on, and comfortable modern chairs. There's a huge fish of some kind in a tank. He looks like he could eat my shoes and ask for more. The sun shined through skylights, and the view out the sliding glass doors to the river was bright and sunny.
   I sat there and wondered if I was about to meet a man who would tell me in no uncertain terms that someone would cut my throat in the near future.
   It's hard to keep your happy thought when you wonder if they're going to cut your throat. Just a little FYI there.
  A blond woman in a black top with bright speckles on it, and hot pink scrub pants came and claimed me. She took me through a door, past a receptionists desk, and then to (dah-da-DUM!) Door Number Two. The exam room.
   One thing that made me happy before I got there was the thought that I would finally walk into the place and be able to keep my pants over my ass the entire time. It's a consultation, I thought. You get to keep your pants on when they talk to you. The thought of keeping my trousers over my ass the entire time I was in the place (for the first time, I might add), made me happy. Giddy, almost, in light of the fact that I was pretty sure Dracula was warming up in the next room. Don't let the sun fool you. Dracula gets himself in a tizzy in a dark interior room... I could feel him.
   The blond lady stuck a device on my index finger to measure my oxygen level and pulse. My oxygen level as 99, and my pulse was 88. I had an explanation for the high pulse--scared. She understood, or said she did. She pointed to a couple of brochures on the table. She said I could keep them after the consultation, and that the surgeon would show me the pictures inside to describe what needed to be done.
   I was afraid to even glance at the brochures. I could wait until the surgeon made me look. Let's say I learned my lesson about over-anticipating when I opened the drawers in the cabinets in a urologist's office a few years back. Never, EVER do that! They have hooks, and prods, and stuff that looks like it's designed to hook a lost prod and give a tonsillectomy at the same time. It's always a bad idea to look in a urologist's drawers...
   I digress.
   She took my blood pressure and chatted merrily away about something. Then she told me to take my pants off and put on a gown.
   "Why?" I asked, staring at the gown she handed me. "This is a consultation."
   "He'll want to listen to your chest, and neck, and take a look at your legs."
   "He's got tests that show every inch of stuff under the skin," I said. It was a useless protest, but I had to make it.
   She shrugged. She smiled. She got out of the room.
   I put on the gown. The doctor came in. He's a nice guy, an older guy. They told me he doesn't do surgery anymore. He consults and makes recommendations. I watched his eyes as he talked to me. He wore glasses that made his eyes look huge, and he had that wide-eyed stare some older men get that make them look surprised even when they aren't. I looked at his name before I came in. He's from Italy originally, and I didn't--until that moment--realize that Lu is short for Luigi. That's the kind of random thought that shoots through my brain like a rocket with da red glare when I get scared. It explains why I laugh sometimes when I ought to scream.
   Hey, Luigi! Are ya gonna slash this little guy's throat, er what?
   This whole thing, this testing of my carotid artery, and discovery of blockages and hardening started during a routine exam in 2007, when my family doctor listened to my neck and heard a bruit. A bruit is a sound. In my case it was a whooshing sound. The sound of blood running through my carotid, and my doctor said he shouldn't have been able to hear it. He ordered an ultrasound. The ultrasound in 2007 showed some hardening, but not much. On April 11, 2012, we ran the test again. Blockages and hardening showed up. Unfortunately, the report didn't give numbers. It just said "significant" blockages. That meant I didn't know what Lu was about to recommend.
   He stuck his stethoscope all over my chest, back, and belly. He looked at my legs. Why? I don't know, and I didn't want to know. He listened to my neck. I said, "My doctor heard a bruit."
  He said, "I hear it too. It's loud."
  Thanks. Just what I needed. (sounds of the Star Spangled banner) And the rockets red glare!
   He sat down, crossed his legs and said, "You're skinny. Your blood moves fast through a small carotid. I always hear whooshing in the necks of skinny men. Always."
   That explains it! I thought. My doctor's office is in a small, rural town. It's a farming community, mostly. For whatever reason, there aren't a lot of skinny males in that town. I would wager--and I normally don't do that--I'm one of the few scrawny pencil necks my doctor has heard in the recent past. Not that I mind having everything checked out. Frankly, I've been through enough medical stuff that I don't want to take any chances when it comes to things cardio and vascular.

   The surgeon was looking at me as if waiting for something. I think he was waiting to see if I was about to start singing the Star Spangled Banner. Maybe not. Probably not.
   "No surgery," he said. "No angioplasty, either."
   I raised my hands in the air and shouted, SHOUTED, "YESSSSSS!"
   That seemed to startle him. If I hadn't been so tired, I would've hopped up on the table, gown and all, and danced.
   He did what most folks do when they're surprised by joy on the part of another: He tried to bring me back to earth. I have no idea why people do that, but it seems to be human nature.
   "You do have blockages," he said. "There is stenosis."
   I lowered my arms, but didn't wipe the smile off my face. How could I? Dracula was going to have to feast on someone else, at least for now.
   "You need to keep taking your statin (cholesterol reducer), and I want you to start taking one aspirin a day."
   "Regular aspirin?" I asked. Some folks take baby aspirin, and I wanted to be clear.
   "Yes. Regular aspirin. It really is the miracle drug. It does good things. One regular aspirin a day. If it upsets your stomach, let us know, and we can switch to baby aspirin. We'll test your artery again in a year."
   I started to get up, but he wasn't finished.
   "You will need to watch for signs of a stroke. If you lose your vision, like a black curtain being drawn, for ten or fifteen minutes, call us and we'll schedule you for surgery right away."
   I believe cartoon punctuation appeared over my head in a bubble. It contained several exclamation marks and question marks. I agreed, but what I was really thinking was, Like hell. If I go blind, I'm calling 9-1-1.
   Seriously. Maybe I'm being overly cautious, but since that appointment yesterday, I taught myself how to find 911 by feel on a keypad. Finding a phone when blind might not be easy, but if I do, I'll know how to push the buttons while I wait for my sight to come back or the good Lord to say hello.
   I left his office feeling good. Darn good. Happy-they're-not-going-to-cut-my-throat good.

    In an earlier post, I said I prefer to hear bad news first and that good news can wait. I meant that for myself, but I don't think my wife shares my philosophy. I make it a rule never to go into her classroom while she's teaching, but I broke that rule yesterday. I know she's been concerned. Concerned to the point she was having trouble sleeping. I went to her classroom during the last hour of the day, walked in as if I owned the room and said, "The doctor said to take an aspirin a day and get checked again in a year."
   I could see in her eyes that telling her then was the right thing to do. It was fun letting a few of her students see me, too. They thought I was a myth, but that's a different post for another day.

   For now, aspirin and Zocor are my hope for good blood flow to the brain. We'll keep checking my cholesterol--every 90 days--and I'll keep having my arteries tested. I plan to keep kicking around on this beautiful world for some time to come before I go on to the next one.

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