Dieter's Blog
Rounding Up (medical update)
Welcome again, gentle readers, to the continuing saga of Dieter's recovery.Throughout much of this ordeal, the doctors and experts have been advising me that I could resume my normal activities after about 12 weeks. Today, I learned that I am not supposed to resume travelling until my next evaluation, which is scheduled for about 8 weeks from now.
No, they cannot just test me now.
There apparently needs to be time for the muscle to grow and heal before they can do the tests (meaningfully), despite me feeling (mostly) fantastic.
We'll be discussing at length if I might be able to resume travel with some physical restrictions. Maybe I'll promise not to change a blown tire by myself, but I'll be allowed to load my own luggage.
Rounding 12 weeks up to 19 weeks seems... abundantly precautionary.
Sitting around the house does not seem to suit me. I'm accustomed to doing most of my grocery shopping hundreds of miles from here. The walls are closing in, and wanderlust calls...
Chip sorting
I'm sure our CCotD enthusiasts can sympathize.
My chips, cards, and books got roughly thrown into a box about 9 years ago, and at that point the chips were sticky from a 3 year old spilling root beer on the table.
Three sets of housemates, two girlfriends (or was it three?), two house moves later, I can finally start cleaning, sorting, and get back to using this stuff.
Thank goodness I don't treat these like collectible artifacts, and clean them the same way casinos do - rattling them in a bucket of warm soapy water.
;)
Comments
search results,
CCOTD Meaning
What does CCOTD mean as an abbreviation? 1 popular meaning of CCOTD abbreviation:
CCOTD Meaning
1
CCOTD
Connecticut Coalition for Organ and Tissue Donation
[only thing that came up]
CCotD - Casino Chip of the Day is the thread where the chip collectors admire artifacts and exchange stories about going to get the chips...
of course!
are they real casino chips?
Are they real? Sort of.
One of the casinos I used to play rebranded and was selling old retired chips after issuing the new chips. (I'm sure they held the old chips for several years after the rebranding, so there was no obligation for redemption.)
$10 for 100 casino grade chips in the denominations I wanted (40 $1's, 60 $5's) seemed too good to pass up.
The poker room crowd had already bought off all the high-denomination sets, but practicing chip tricks or counting objects with the 3 year old works just as well with $1's as with $100's.
The CCotD crowd tends to pay face value for live chips from a casino they have played at; I bought retired chips at a fraction of face value from a casino that replaced the issuing casino. Nagging little details.
I also don't care much if I lose or damage one (or eighty), because there are a few hundred more on the shelf. Artifact collectors, on the other hand, sometimes get a bit persnickety if they scuff a chip while cleaning it for display.
The big stacks are 20x, the short stacks are 5x, and the 3 splashed reds are not stacked according to procedure. :P
Clearly I lost (about) half a box at some point. The 32 "different" reds (lower right) are Y2K souvenir chips. I'm sure the house was hoping people would keep them instead of redeeming for cash, and profit by seigniorage.
(That's 839 total by my count, but I know a few more are floating around... somewhere.)
The Coupon Circular
There is a curious phenomenon out here, that I missed while living in a city - the coupon circular.I am advised by the large print on the back cover that these are mailed directly to over 21,000 homes, 4 times a year. (This is probably intended as an inducement to potential advertisers.)
There are 5 pages in the middle of the issue, highlighting upcoming community events.
The rest is advertisements, many with coupons..
Selected highlights:
- $500 off wedding event invoice at the golf course (new bookings only)
- $20 off any $100 purchase at the tree nursery
- $25 off humidifier installation from an HVAC company
- $10 off chimney sweeping
- $25 off a quarter beef
- $15 off septic tank pumpouts
(and numerous others)
I have no idea what I'm in the market for, but some of these deals are just too good not to merit real consideration.
Comments
A friend on mine owned and operated a martial arts studio, and he used to advertise in the coupon circular. In the spring. he'd advertise to not let parents have their kids spend another summer on the couch. In the late fall ,early winter, he'd advertise to give their kid the gift of karate this Christmas. You get the idea. His school was always popular, had a lot of students and he and his students were accomplished Martial arts students and tournament competitors.
I actually used one for my daughter that came in recently: a coupon for 20% off any single item at the Spirit Halloween store!
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One month out
Some quick observations now that I've been out of hospital for a month:I finally felt flexible enough to crawl into a T-shirt today. More accurately, I felt flexible enough that I might be able to crawl out of a T-shirt later, rather than having to slice it off.
The doctors cleared me to drive a car again 3 days ago. It takes some readjustment. (I won't be travelling the country again just yet... I'll keep it to the tri-county area for home, therapy, and maybe some government offices for now.)
Rehab is a terribly boring workout. One hour, 3 days a week. Low impact, and I'm not allowed to use my arms (much) (yet). Unexpected upside: someone brings in apples, and we patients are encouraged to take them.
Making the bed is a surprising challenge. Sheets are no problem, but wrestling some of the thicker blankets around slightly exceeds the official weight (force) limit.
Low Salt diet is no joke. I figure I'm allowed maybe 4 potato chips a day. Enjoying the more typical 'few handfuls' seems to cause some weight gain (they notice at rehab weigh-in, and tell me about it), muscles start aching, and blood pressure is up 25 points.
Most of the holes are sealing up nicely, the hairs are growing back, and every day is a bit stronger. I feel darn cranky from the lack of nicotine, but the family says they'll put up with my sour attitude as long as they can. (I am declining gums and patches, because I'm cruel.)
I am increasingly ready to get back to old tricks. Still waiting for my arms to be usable at full-weight
I much prefer ignoring promotional emails because I don't want to go collect an offer, rather than because I'm just not up for the few hundred mile round trip.
Comments
Hi,
I knew you'd been ill, but didn't take in quite how ill.
I hope you continue to get better and return to full and long term health.
The little apples they're giving out. Pretty nice!
Keep at it! You'll make better days become a reality!
Dollar Tree sells a really good salt-free seasoning that I use as a salt substitute. It's very tasty and I usually buy a whole case of it when I'm there. I also use fresh lemons a lot instead of salt and flavored vinegar. You'll be amazed how quickly you get used to not putting salt on everything. And how quickly you discover what real food tastes like.
My grandfather used a salt-free seasoning. I tried some once, and asked if he enjoyed it.
He told me that - like it or not - this particular blend was the only thing he found he could still taste. He sprinkled it liberally on everything and pretended to remember what food tasted like.
My experience with a number of seasoning blends has been similar.
The tiniest sprinkle of salt is much more satisfying.
What with being ordered to convalesce, I get the happy privilege to walk the little one to and from kindergarten every day. She will likely never believe that when I was her age, I did 2 miles each way, by myself, uphill both ways... her reality is walking across the street, 700 feet door to door. There are (minor) hills inclines each way, and we'll see about the snow drifts when the season comes.
What happened???
Dear reader, I shall now attempt to provide an accounting of the events, with minimal only modest omission and embellishment. Some of this stuff is gross.On the evening of July the 12th (Wednesday), I was preparing myself to depart on a cross-country road trip in the morning. This is all usual; Dieter-Business takes me all over the place. After carrying some luggage outside, and having an "enthusiastic discussion" with some other members of the household, I found myself in a coughing fit. Lots of nasty stuff was coming up from my lungs, but I didn't think much of it - heat, exertion, 2 packs a day for decades, the soot heavy in the air from Canadian wildfires, pollen having plagued me this way years before, all could have contributed.
After a few minutes of coughing, I finally stopped - and had great trouble catching my breath. This was unusual. Highly unusual. I contacted the nurse question hotline (your health insurer likely has one) to determine if this was a check it in the morning situation, a get a ride to urgent care situation, or a call for a helicopter ambulance situation. She heard me wheezing (lung noise when breathing) through the phone and decided I needed to get to an emergency room.
I'd had a minute or three to further settle my breathing, so I felt pretty OK. I packed an overnight bag, because... I've learned. (New Lesson: your overnight bag needs a button-up shirt.)
I got dropped off at the ER, and walked myself in. They got me into a room almost immediately. Two learnings: blood glucose over 500 (normal is somewhere around 80-130, I think), and SPO2 was around 84% (they worry if it's under 92% - this is blood oxygen level). They listened to me breathe, said "pneumonia" and got on with what they do.
I don't remember what scans happened next, but an hour after the scans, a doctor burst in, told me that I'd failed to notice that I'd basically been walking around having a heart attack for about the past 6 weeks (maybe more), they were sending me to a different hospital, and they would quite appreciate it if I could manage to keep alive until I got there. The emergency room called me an ambulance. This is not generally a good plot twist for a memoir.
There was much discussion about what sort of breathing assistance I would get during transport. They took me off the nice hospital grade BIPAP pump and attached me to a discount ambulance service grade BIPAP pump. The transport BIPAP did not have the same rhythm - I often found myself fighting against it as I tried to inhale and it tried to make me exhale. (New lesson: cannula (nose-hose) for oxygen during transport.)
After about an hour in transit, we arrived at the bigger, fancier hospital. They applied new labels to my wrists, installed new hoses to connect to my internal plumbing, and started settling me in for the night. (This is impossible. All hospitals are miraculous places, but to achieve the miracles, they insist on poking you every 90 minutes, so you can't really sleep.) I finally got a signal on a non-firewalled connection, so I could start to get messages out that I would be incapacitated for a time. (Sorry.) (New lesson: you want to set up a firewall bypassing VPN for your messaging before you need it.)
A few fitful hours had passed. The day shift began to arrive. I was moved down to some other laboratory, poked, prodded, evaluated, and returned. A team of doctors showed up to tell me that my treatment options were limited to ... open heart surgery. Stents were not a good option. They would need me to sit tight, enjoying the fine low-sodium, low-sugar, heart-friendly hospital cuisine for a few days while I got strong enough to survive and they could work me into the schedule. Hospital gowns are neither particularly comfortable nor the heighth of fashion, but when in Rome, as they say. (New lesson: the overnight bag needs more boxer shorts.)
July 17th - Monday. They got me on the schedule for the 20th. Just sit tight. Begin the preparatory ablution protocols for disinfection. Hot steamed vegetables are markedly improved with a sprinkle of italian salad dressing as compared to the fine quality imitation butterette cups or that heart-healthy pepper seasoning blend packet they insist on sending up from the bowels of the dietary department. Keep getting "labs" drawn every few hours. The blood vessels in the back of my hand are not up to this constant abuse, and the phlebotomists vampires refuse to draw off a port (something isn't suitable).
July 19th - Wednesday, afternoon. Everything gets scrubbed. Everything. Do they let me sleep? No. Hospital services continue. Early morning chest X-Rays, bloodsuckers for the mysterious "lab", routine nurses checking that I'm still breathing (eliciting an annoyed response is apparently the best way to do this).
July 20th - Thursday, pre-dawn. A pair of nubile attendants arrive and try to awaken me. (They fail, since the nurses were in an hour prior, and how can you get back to sleep that quick after a few minor stabbings?) I am to perform the bathing ritual while they supervise. I am to place myself on the prepared white shroud. They will shave off all body hair. They will transfer me to the other altar (also white-shrouded) for the impending ritual. I will be transported to the ritual chamber. As I wait in the ritual antechamber, another round of questions, from another group of nubile attendants. The ritual chamber is prepared, I am transfered onto another altar, and the sacrifice commences. (I can't remember a darn thing.)
I awake someplace else, choking on the intubation pipe. This is disconcerting. All I can do to communicate is slap my hands on things to make noise, and gesture that I want it out - my wrists are bound. (They warned me about this.) The attendants are reluctant to pull the thing out, but I am as emphatic as I can manage and they finally relent.
July 21st - Friday, morning. I begin to assess the aftermath. I have drainage hoses and wires disappearing into a new hole in my chest. I am stronger than I was a day or two prior, but weaker than I remember being a few months ago. The sadists in the physical therapy group want me to walk around the halls. I am not strong enough for much of this. The doctors congratulate me for such a dramatic improvement. The nurses tell me it's normal to feel like I've been run over by a truck. The kitchen crew has not learned how to cook any better in the last 2 days.
(Dates uncertain) - After one of the drainage hoses is removed, I am suddenly much stronger. They are useful for getting the nasty Dieter-juices out, but they get in the way of things like breathing and moving. IV hoses are removed. New IV hoses are installed. The doctors want me to get my shadow off their floor as soon as I'm ready, please.
July 24th - Monday morning. More people show up to poke and prod me. When they want to yank out the final drainage hose, they are kind enough to give me something to bite down on. (The removal is mostly smooth, but there is an initial "tug" which is rather startling.) Once the hoses and gizmos are out, I feel fantastic. I am able to wander all over, pass the physical therapy evaluations for traversing stairs and general mobility. It turns out they're not actually sadists. The surgeons show up and begin the paperwork to get me out.
July 28th - Friday, afternoon. I'm at the house, typing this up through a haze of muscle relaxants and narcotic painkillers. Breathing exercises, walking exercises, special protocols for standing, sitting, coughing. Everything is on hold for another 7 weeks, until they decide I might not die if I drive. 10 pound weight restriction for pushing, pulling, lifting, carrying. No driving. Everything is in slow motion. Plans for the day: get out of bed, sit in the chair for a while. Go for a walk to the corner. Use the breathing-practice gizmo as often as I remember.
Still alive. The 5 year old seems pleased by this.
Comments
Hang in there Dieter. As one who has had 26 operations I know the hospital routine well. BTW, the tube that hurts the most on removal is the urinary catheter in your penis.
They did not give me something to bite down on for that tube. I just found it ticklish. Couldn't stop laughing for moment.
yikes! somehow wasn't expecting all that. Get well
Thank you for the report. May every smoker on the forum read it. I too wish you a speedy recovery.
It hurt DRich so much to have the catheter removed because he has an unusually small penis. Nothing to be ashamed of, or so I've heard. I wouldn't know from personal experience.
So this was a heart issue and not a diabetic issue?
Great write up.
Remind me to never have a heart attack :)
Apparently having the heart attack - or whatever - spiked the blood sugar way out of normal range.
Diabetes is known to exacerbate heart conditions.
Yeah, don't have heart attacks. They're not healthy.
You are in need of a total life makeover. Look at your 5 year old when you read this! If you ever smoke another cigarette again ……. You also need to tackle the diabetes with fervor. Get a CGM. Have a nutritionist show you how to eat properly. Without those two life changes…….
12 days in the hospital, not supposed to light up on oxygen, and they wouldn't let me duck out for a smoke... this pretty well got everything out of my system. (Those in the know that I spoke with said 10 days is good for purging nicotine.)
Next round of consultations and rehab to start on the 17th. I'm sure a CGM will be discussed.
So glad this had a happy ending , so to speak. Great write-up! Very funny, although it didn't seem so humorous at the time, as I remember it. Do the nubile attendants really shave all the hair on your body? Even the pubes?
They started at the neck and stopped at the ankles where the grippy socks took over. Arms, armpits, chest, navel, pubes, legs... the works. I tried to get them to do the rest (chin & up), but they wouldn't accept a tip bribe, and there were time constraints.
If that sounds odd, when I woke up, there were several extra holes in strange places. I had apparently been carrying some spare parts in my right calf (now extracted & woven in), and they needed to stab my neck, groin, arms, and a few other choice spots to either get surgical juices in or Dieter juices out.
Ingrown hairs are a minor hassle as things grow back. Uncomfortable, but trivial.
The scars seem to be healing nicely. For scale, if I stretch my hand fully, my thumb touches the top edge of the main incision, and the tip of my pinky just touches the lower edge.
Comments
Insist to Take the treadmill test. If you pass that, then you're muscles are fine now. No need to wait 8more weeks.
- Dr 100xOdds :)
Is this what they're calling a "stress test" on the treadmill?
I overhear people talking about them...
(Their main concern seems to be weight restrictions on the arms. Their secondary concern is that I will be way out of timely reach of emergency services, should something go horribly wrong.)
yes stress test. your heart rate goes to like 180bps, kinda like your wife walking in on your with another woman. :)
Why limit arm lifting weight?
They're worried that my arms will overload the spot where they cracked open the chest to do the heart surgery.
I feel fine, but I'd hate to be in a position where I have to choose between overloading myself to the point of injury or being stuck for 3 days - a real possibility travelling the mountains during tire chain season.
Update (again):
Another several phone calls clarified that their concern is ejection fraction - how much juice is getting squeezed out on each squeeze of the juice squeezer.
Apparently, it's low.
If you've ever thought I seemed heartless, there may be a medical explanation...
I had 4x bypass a few years back… 1992, when I was 35. Just hang in there. Nothing about recovery is going to be fun. Everyone’s path afterward is different, so I can’t give any advice, but I will say that maximizing your recovery potential is directly correlated to your lust for life. All the best.
I rarely take the doctors advice. When I had my back surgery they said to plan on taking six weeks away from work. My surgery was on a Wednesday and I was back at work on Monday morning. Granted, it was a desk job so there wasn't a lot of movement involved. The hardest part was walking up the stairs to the second floor where my office was.
Sadly, disregarding the medicos isn't a ready option.
Since I (used to) travel for work, and work is insisting on a clean (enough) bill of health before I resume travel... I'm somewhat stuck using as directed instead of going off-label.
I guess it's an opportunity to make time serve me. I've got a hefty stack of books I've been meaning to read, and now, fortunately, not much better to do.
Current audiobook: The Last Shadow by Orson Scott Card. Audiobooks are very convenient for the prescribed rehab exercises, like long walks through the park.
Wait.. your heart isn't pumping out as much blood?
Why is that? And how do they fix that?
So you feel tired and dizzy often?
I feel great. I begin to get light headed if I keep a too-vigorous pace for more than about 10 minutes. (This happens on the treadmill, sometimes. Walking through the neighborhood, a few seconds pause here and there to take in a view or sniff the autumn leaves is amply restorative.)
When they last measured the ejection fraction, a few days after the surgery, they found that the number was a bit on the low side. I don't find that surprising, since I had just had my chest cracked open, I believe I was still full of surgical drains, and I had spent the past several decades trying to live fast and die young.
They're just declining to re-evaluate the number (yet), since for most patients, the improvement before the next scheduled test is insufficient to warrant a change in status.
So I wait, and go for walks, and spend time reading. Blackjack Blueprint (Rick Blaine) currently. I'm not learning a whole bunch, but I agree with many other reviewers that it's well organized, well written, and a very good starting point for a modern beginning counter.