H-XM-2002

Merry Christmas 2002 Greetings to All

Our Nation 2002: We all know the world has changed since we were kids. We were reminded of just how much when I took Mary to the DMV in Fullerton CA to take her drivers test. I repeatedly remind myself this was a typical random sample of the US population today – the number of Caucasians were probably less than 30% -- the region has become a true “melting pot”.

Our Nation 1932: Daughn Avery gave me the above photos taken in front of the Oberlin Grade School, the year is unknown but they graduated from eight grade in 1938. These were happy kids, the year behind my class. To them Oberlin was the center of the Universe, they were oblivious to the nations slide into a severe depression and felt dressed up in freshly washed home made clothes. By high school all knew the Big Band sounds via radio and movies – and knew inflation when movies went from 10 cents to 25 cents and popcorn from 5 cents to 10 cents. Herbert Graves, top photos center far right, and I were in Basic Training together – Herbert a school teacher, has since died.

Our Nation 1957: The next two photos, Monica 1959 & Julia 1960, were taken in Garden Grove CA. Most classmates at that time were Caucasian. These TV era kids watched men land on the moon. Times were affluent, with rare exception they wore store bought cloths, Mary still sewed for the girls. Julia, Monica and David’s world included trips between CA and KS over newly built Interstate Highways.

Monica’s class 1959

Julia’s class 1960

An Eventful Year: The past year was eventful, if not exciting. In 2001 I learned I needed heart surgery, postponed till after the holidays. The family became overly protective, upset if I’d carry a TV of Monitor from place to place. I was feeling fine, in fact built a desk, but knew I needed repairs. I’d met with the Cardiologist and Heart Surgeon and had some understanding of what was ahead.

This could happen to you: The following descriptions of the process may be of help to others. I’m convinced many of my genetic relatives died from the condition I had – because procedures were not available. Last years Xmas letter told of my problem, suspected due to a heart murmur and verified by Echo Gram test. The main output valve was clogged by calcium, for which there is no Lime Away cure.

My Condition: I could observe my condition on the Echo Gram Monitor – it was obviously serious. Cardiologist Dr Lawrence Santora told me the main output valve was 7/8^th blocked. My response was, “I’m not sure I’m worth refurbishing.” He looked at me in surprise so I explained, “my kids are now grown and on their own, my wife will be well taken care of – I’m no longer needed by anyone”. He said nothing so I continued, “I’m very lucky having had a healthy life when so many of my relatives and friends have died – I’ve completed most things I set out to do -- I have no useful purpose to serve – I can go and not be missed.” Santora said, looking at his hands, most people are very pleased to have the option of an operation – otherwise you die. Previously Santora was observing my physical condition and made the comment: you look to be at least five years younger than your age. This statement was not made as flattery – he was judging my chances of handling the operation. He might not have recommended the operation if I’d seemed five years older than my age – I was 79.

Preparing Myself: The wait provided time to prepare for what was ahead. I resigned myself to accept the results, no matter how things turned out. I was concerned about my tendency to faint, at even the thought of blood – I didn’t want to be a problem. I had a talk with myself and resolved to be a model patient. If was asked to do something I was to do it promptly, as if to pass cadet training. This mind set served me well – a valuable attribute of human behavior.

The Game Plan: After the new year I called to set up time and place. The Dr’s were on vacation and facing full agendas, it would be some time before they could fit me in. I was feeling fine, kept busy and tried let the pending escape my thoughts. Dr Santora was to do an Angiogram of the heart, providing Dr Ott a map of what needed to be done. I was to stay overnight and have the heart surgery the next morning.

Pre Operation Tests: The process began with ProOp blood, urine and Xray tests. I was to learn the process well – I didn’t know then I’d repeat the process several times.

Early Morning Prep: On the designated day Mary and Julia took me to the Orange County St Josephs Hospital before dawn. I signed in and waited till conducted to the Pre-Operation Prep room. I was assigned to a stall and closed the curtain while I put on a Hospital Gown – the kind fully ventilated in back. A nice fellow brought a warmed blanket so I could recline in comfort. I was visited by a sequence of nice ladies who provided information and had me fill out forms. A nurse, who grew up in the Philippines, “installed” an IV on the back side of my left hand. The anesthesiologist came, indicating they were ready and I was given a pre-op-pill. I exchanged “see you later” hugs with Mary and Julia and was wheeled out. Julia looked after her mother.

The Heart Angiogram: Some dozen years before I had a body angiogram, prior to clearing my right carotid artery, and intended to have Santora explain what he was doing – as had the prior Dr. I asked if they still used the “Franklin Units”, which was a stepping photo mechanisms under the table that recorded the sequence of images while opaque die pumped through my anatomy. Santora said no, it’s all electronic imaging now -- and that’s all I remember though Santora reported I kept asking questions. I’d been conscious during my prior test and could feel the die spread when injected – for this test I was out of it when die was injected in my heart for these images.

Observation Room: I became aware again when nurses came to check the condition of my groin. They exclaimed – you certainly have a big bruised spot! They were careful to not give me cause for alarm – but they knew the procedure had encountered problems. Initially I was oblivious to their concerns. When asked to stand up and take a walk I immediately responded – pausing half out of bed due to a severe cramp in my leg! I commented, guess I need to take more salt, I have a severe cramp in my leg – only it never hurt in that place before? They said nothing, but observed as I encouraged my leg to function so I could stand up. With a nurse on each side I walked down the hall and back. When back in bed they asked me about my “cramp”. I said it’s still sore but seems better. Later I realized they had missed the artery in my groin and had caused a clot to form which was working it’s way down my leg. Santora’s office called a couple times after I was home asking if I was experiencing any problem. I told them the back and blue area was less intense and had moved down my leg – it seemed to be clearing up and I felt fine.

The Portable Sonogram: When I first met with Dr Santora he commented, because of your prior problem in all likelihood your left carotid artery is now clogged. Thus I was not surprised when a technician arrived with a portable sonogram and checked both carotid arteries. I could tell the technician had observed obstruction. Mary had gone home, taking my things, and Julia stayed. Dr Ott arrived shortly after I’d finished dinner and said the Sonogram tests show you are 90% blocked on my left side and 70% blocked on the right. He advised it would be best to have the left artery cleared before he proceeded with the heart surgery. I said OK. Ott said you will not need to stay, you can go home now and arrange a time with Dr Flannigan to clear the artery. I said fine, but I have a problem -- I don’t have any pants! Julia spoke up, saying Mom took his clothes -- don’t you have some hospital “sweats” he could wear? Dr Ott grinned and said sure, I’ll have the nurse bring you some “scrubs” to wear home.

Dr Flannigan: Dr Flannigan had a busy agenda, when he looked at the sonogram results he said, Oh yes I’ve been expecting you. After a brief discussion I said I have one request – that you use a “butt joint”, a woodworking terminology, when you sew me up. The last time they used a “gunny sack” stitch that folded over some of the skin. It took two years for some of the whiskers to find their way out. He smiled and said, yeah we do butt joints.

Pre-Op tests set #2. This time, at my suggestion, they used the same X-Ray’s.

Early morning prep #2: Mary accompanied me in the wee hours – standing by while I put on the hospital gown and they installed the IV.

Body Angiogram: I’d never seen this Dr before but he and his team seemed very proficient. I told him they had just done one of my heart via my right groin – wondering if I should be rotated to use the other side? He said no problem, the equipment is set up to work from your right side, I can enter from either groin – I’ll use your left side this time. The nurse gave me some knock out pills and I soon found myself in a recovery room. He did an excellent job, there were no black and blue secondary effects.

Pre-Op test set #3, Early morning Prep #3 and Left Carotid Operation by Flannigan: I again went through the sequence of pre-op test and early morning preparation. I’d been given pills and was oblivious of my trip to operating room. Monica was there to give Mary support. I came too in the recovery room then a short time later was moved to a regular hospital room for an overnight stay. I stayed over one night and was home by noon the next day! The prior time I was in intensive care for one day and in the hospital for two more days. That time my neck was swollen and it took time to heal. This time I was surprised at how well things went. My incision looked as if it had been closed using a zipper – the staples were neatly spaced. There was a small plastic container taped to my chest – connected by a tube draining water from the incision. The incision healed rapidly with no side effects – it was not swollen and did not hurt. I was soon back in Fannigans office so he could remove my “zipper”. He quickly removed the staples and I congratulated him on his excellent “butt joint”. Before parting he said, we also do legs. I said I’m glad to know that and will probably be back, after I have the heart valve replacement.

Pre-Op test set #4, Early morning prep #4 and Heart Operation: By now I knew the routine well and recognized most of the people – they were familiar faces. I was just another of their never ending patient parade. A nurse came in and said, I’ll be your nurse during the operation. I smiled and said I’m glad to know that. She said, the first thing you will be aware is my telling you we are removing the breathing tube from your throat – when that happens don’t fight it – just keep relaxed and let us remove it. Continuing she said I hope you don’t feel apprehensive. I said, I’m OK -- after all you will be there. Julia and Mary smiled and said, he’ll be fine -- he has a good attitude. The anesthesia Dr came in indicating they were ready. We exchanged “see you later hugs” and I was soon oblivious, on my trip to the operating room -- those knock out pills worked fast.

The Heart Operation: I was informed the following took place. For about an hour my blood was cooled as the way to lower my body temperature and I was put on an automatic heart and lung machines connected to auto sensors for blood and oxygen readings. During this my chest was opened and rib cage spread to make room to work. Three incisions, 3.5 to 4.5 inch each, were made and veins removed for use as heart by-pass plumbing, then the incisions closed. Once cooled to the desired level they used chemicals to stop my heart. Dr Ott then connect the removed veins as by passes at locations determined from Dr Santora’s heart map. This took about one hour of two hours allocated for the cold state. The next hour was spent installing a prefabricated “tissue valve”. A three flapper valve device made of cow tissue attached to a ring. The tissue comes from the bag that houses a cows heart, and is treated to inhibit rejection by removing all protein. Ott explained he could install one with a ring in one hour vs two hours without a ring. This gave him time to finish the heart surgery in two hours. Once the valve was installed the closing procedure followed during the hour used to warm blood and body to normal. The procedure performed by Ott’s team had taken four hours. My first awareness was a voice saying, we are going to remove the tube – I remained motionless and felt the long tube exit my throat. I had no recollection of being carted to the Intensive Care Unit -- I was one of perhaps 15 heart patients that day.

The Intensive Care Unit: Eventually I became sufficiently aware to perform a self evaluation. I wiggled my left foot, then my right – then tested my left arm then my right – then my sense of humor? All seemed to be working just fine – I felt relieved and smiled inside – things had gone far better than anticipated. I was in no pain just tired and groggy -- I paused and gave thanks for my good fortune. I could hear Mary and Julia taking with the nurses. Each patient had a nurse assigned to them. I remember speaking to my day nurse and was aware of the change to a second shift.

Get up and walk: Two nurses from the second shift came in and said I would need to get out of bed and stand up. In keeping with my pre game resolution I immediately responded and started getting out of bed. The nurses called out not so fast! You have tubes attached – we need to help you. With one nurse taking my arm, the other gathered the tubes and I made my way to the doorway. I was told “that’s far enough, just relax here for a while.” My vision was lousy but my thought processes seemed clear, to me at least. I found myself talking with the two nurses who were asking “what’s the secrete to your lasting marriage? I said, well it takes a lot of understanding by both. Then added, it also helps to have kids, looking after kids keeps you together. Then added, it also helps if you come from the same back ground where you know each others family and friends. I felt rational and talkative and sense of humor handy. Abruptly I had a coughing convulsion that produced chest pains. One of the nurses observed my pain and that I’d coughed up a glob of gunk. She said that’s good – it’s important to clear that stuff out of your throat. I realized the gunk was due to it the tube down my throat. I was soon back in bed with the tubes dangled over the right side to something under the bed. They would periodically record instrument readings of my status and ask how I felt – commenting to the family, he’s doing very well

You can’t let him die: Mary later told of seeing me for the first time in ICU – I was pale as a sheet and she was sure I was going to die! She cried out to the nurses, but you can’t let him die, we’ve been married for 53 years! This, unknown to me, was why the nurses asked me the secrete of a long marriage.

Cause of being Overweight: I drifted in and out of sleep during the night. I was connected to a urinary drain tube, thankful I didn’t have to manually manipulate a urine container as during prior over night stays. All night I heard the sound under the bed, like the sound of our water softener being recharged at home. The next morning they weighed me in bed – ICU beds are so equipped. I asked how much do I weigh? They said about 215 lbs. I said that can’t be, I only weighed about 185 when I came into the hospital! They told me the tubes extending from my belly were connected to containers under the bed – the containers collected water and air trapped inside when they sealed my incision. My excess weight made sense – I envisioned them squirting water to rinse off blood so the Dr could see what he was doing – then closing up the cavity full of water and air.

Hallucinations: I don’t recall my first meal, only that I ate all of it. I saw crazy images of geometric patterns on the wall during the night. I told Julia of these hallucinations! Julia had been going outside, observing what was happening with other patients – saying some out there must really be having hallucinations, some are trying to pull the tubes and IV’s out -- the nurses are having a time with some. I didn’t want to alarm Mary or Julia by telling them I was totally blind in my right eye at times! I’d relax, blink a few times and vision would return -- as if lifting a window shade? My thoughts searched for an explanation of these various phenomenon. How could my eyes, or mind, create such geometric images or cause an effect as if lifting a blind? How did the anatomy perform such “tricks”. What I was “seeing” seemed absolutely real – reason said it was false.

Back ache: I was puzzled by why my back hurt, at first I thought it was how I was laying in bed – I’d shift to relieve bed stress. Later I realize the ache was caused by the rib spreader used to open my chest. The rib connection to the back bone does not include a hinge, the attachment had undergone much stress. I was not in pain but hurt in places for a few days. Dr Ott came by the end of my second day in ICU. He said, I could move you but this is Fri and there will be no more patients for these rooms, you will get better care here. Thus I slept in the ICU bed three nights.

Standard Recovery Room: The first morning in the standard recovery room, Dr Ott came saying we can remove these tubes. He pealed off some instrumentation taped to the upper right of my chest – in doing so some hide came off with the tape. He commented, they sure use strong tape for this. I said, yeah I’m sure glad they didn’t have that kind when I played football! He then took hold of the three tubes extending from my belly – without a word gave a heavy yank – out they popped! Startled I looked down, thinking there should have been stitches to remove. There was no bleeding, just three quarter inch red dots where the tubes had been! I thought, how remarkably cleaver. This was the bacon region, the holes had sealed as if a self sealing tire! Later nurses came, saying it was time to take a walk. I was quickly up and going – the nurses calling out, not so fast we have to take readings while your walking. I was wired to a transmitter to the nurses station and the nurses with me were also monitoring my condition. We took the long route and were soon back. I felt good, sprinkling good humor on the nurses, which they enjoyed.

Three blade razor: Mary brought my shaving gear and I decided it was time I shaved my beard. I got my razor out and showed it to the nurse saying, this kind has three blades on a floating head. These are great for shaving over difficult places. I can shave over the recent incision on my neck and not snag or cut myself.

I’m Ready to go Home: When Dr Ott came by the fifth day I told him, I’m ready to go home. He said you can’t go until you’ve had your walk. I said I’ve already had my walk. He paused then said, yes but you can’t go until you’ve had a BM. I said consider it done. He made no commitment but grinned when he said you seem to be doing just fine. The chest incision area hurt when I strained and I could well understand a patient could put it off. I learned he had signed me out before he left, but it required two signatures, his and Santora to release me. Later Dr Santora looked at my records, listened with his stethoscope saying cough, which I did. I asked, how did that patient do, a patient of yours they brought in yesterday as an emergency case – he was diabetic. He passed out and fell near the bed next to me – moments later the nurse came in. She sent out an emergency call and, people rushed in. They moved me out while they cleaned up the room (he’d messed his pants). They moved him to Intensive Care. Santora paused and said -- he’s all right now – and left before I could tell him I was ready to go home. After lunch the nurse came in and said I’d been released to go home. My room mate a Dentist Dr Smith, was told he would have to stay another day. Smith & I had visited late into the night – he’d been an enlisted man in the navy during WW II and we exchanged war stories.

Photo taken when we first got home

Home again: Julia and Monica took turns looking after me and brought me home, it was good to get back. One of the first things they did was take a photo of my condition. They insisted I use the plastic contraption provided to improve breathing and measuring progress. It hurt to breath deep, as it applied pressure to the chest seam which was still held connected with staples. It hurt to cough but otherwise I felt OK, just low on zip. The family made sure I took my pills. They took measurements of temperature, pulse rate and blood pressure, writing these down as requested for reporting to the Dr. For a few days I continued to take pain medicine. In time I realized this is what was causing the hallucinations! I’d see some real weird stuff. Like bright red freckles all over Julia’s face. Of flowers and blades of green grass growing right up out of the rug. Of a strip of rug lifting up, forming a sine wave with the surface material active while the main rug remained unchanged! When I’d urinate the water would be alive with black pepper like objects moving about within – it was a fascinating phenomenon. When I stopped taking the pain medicine, the hallucinations ended.

Taking a shower: The family, on expert advice, obtained a chair for me to use when taking a shower. To me this was awkward and I didn’t use it. I managed to give myself a shower using our main bathroom which has shower head for use while standing in the tub. This was an exhausting effort. For the first several times it was necessary for me to immediately lay down on the bed to recover my strength. I believe this fatigue was cause by body tension I was using to keep from slipping and falling – there were no hand grips.

Dr Ott Removes stitches: Julia and Monica went with me to see Dr Ott to have stitches removed. The stitches were removed in short order and while he did so I gave him a report on what I’d experienced. I told him of the hallucinations and wondered if this was typical? His bottom line response was that “your body has gone through tremendous stress”, implying it was quite natural to not feel normal right away. He said, you’re doing very well and we parted with smiles and hand shakes. I was supposed to go back but never did, there seemed to be no need. I was to walk for 20 minutes each day.

Dr Santora: Dr Santora was busy as usual. He listened with stethoscope and cut my beta blocker pills from one-half twice a day to one half once a day. He had his nurse set up an appointment for me to attend exercise therapy sessions and later for a stress test. I decided not to drive to the heart center for physical therapy. I could walk OK and had been doing so, didn’t need therapy to relearn how to walk. My problem was that I could not walk far, as both legs would cramp – I needed to see Flanigan who said, we also do legs – to clean them out.

Nurses make house calls: First a female and then a male nurse came to the house to take readings and call them in to the hospital. They offered to come more frequently but I declined their offer as un necessary.

Stress Test: The stress test had been postponed until our return from a our trip to Minnesota for a Family Reunion. I was told not to take any beta blocker pills before the test. Before during and after exercising on a tread mill I was given an echo gram test to measure how my heart was doing. When done Dr Santora said there seems to be no leakage and your hearts beating as it should. I said, then how about discontinuing the beta blocker altogether – I don’t want to be more lethargic than I am. He said OK, you can always start taking them if need be.

Summary of Refurbish status: At first my attention was drawn mostly to my chest and heart. I could lay on my right side for longer periods than on my left side when sleeping. Eventually I could sleep either way. I’d find myself rubbing the seam in my chest at night – the lower “bacon” region required more time to heal. My leg became my greatest concern. The lower incision initially leaked water, a good thing, but did not hurt. The upper incisions developed bulges as if there was a small “hard boiled egg” under the skin. These gradually diminished with only one small one remaining. My lower leg and foot were always puffed with water – it was important to take my diuretic pill. Gradually, very gradually, the swelling has been going down. Santora has said, for some it takes a year to get better, and a few never fully recover. I’m now confident my left leg will be back to normal in nine months. This is the least developed part of the procedure, it’s left to mother nature to develop a new return paths for the lower leg. Make sure your Dr has you take an echo gram test – I could have gone on for years – perhaps too long, in the belief I was just getting old. I was to squeeze the heart pillow when chest hurt, but it seemed a bit juvenile so I didn’t.

Computer upgrades: While recovering I assembled two Pentium 4 machines. The standard size on left includes a Flash Card reader in lower floppy slot. Electronic camera memory cards can be read directly. The small unit on right is 7”8”x11” saves room on Mary’s desk. Above is wireless interconnect.

Standard size left, Half the size right for cramped conditions.

Cousins Reunion in Minnesota: We met at Warren Kump home in Minneapolis MN this year for our Cousins Reunion. We had a great time, taking a tour bus about the city. Warren gave Mary, Marjorie and I a tour of the North Memorial Hospital Warren Kump Radiology Extension – named after him in recognition of his roll in designing the facility. Unfortunately I don’t have a photo to show the Kump home, in a lovely setting and beautifully done inside.

October Winter in Oberlin: The day after we arrived at our home in Oberlin it rained, froze and snowed.

Life Begins at 80 Project: To make room for two cars in the Oberlin garage I dumped some and rearranged other content. At the last moment I decided to build a work bench, a home without a shop seems not a home. The end photo shows where the effort ended just before we returned to CA.

New Used Car: The kids have been after me to get a “new” car, the 86 T-Bird bought in Oberlin from Jack Kump has accumulated some 150,000 Freeway Miles and sat outside all it’s years. By making room we could place it in the garage as a second KS car. Arrangements were made to do a car swap, high school classmate Joyce Sumner and son Larry will drive 95 continental to CA and Larry drive 86 T-Bird back to KS. With this plan I’d have room for a new used car in CA. I decided on the LS-2 Lincoln shown in following photo, after getting “bosses” approval, and drove it back to CA. Mary prefers “her” more comfortable car – saying the LS “takes off too fast”. I became sold on the LS when I found I could haul 6 foot lumber inside and close the trunk lid, besides driving it makes me feel young again – rather than the old man I am.

86 T-Bird destined to return “home”

Mary’s Birth Day:

Monica & Brian brought cake and flower, Mary brought smile – “refurbished” old man enjoyed

Mary’s email station: small computer left, small printer right, thin flat screen monitor in middle.

Duck at right -- in our pool -- seeking and found mate.