all at once
It seems like this week has been filled with bad news. S’s grandfather died. My neighbor was recently diagnosed with metastatic small cell lung cancer. JdG—one of my closest friends from college—just recently found out her mom has breast cancer, and both the sentinel node and the margins were positive.
And my dad got admitted to the hospital because of chest pain that seems to be increasing in frequency and severity.
My dad had his heart attack in late July 2006, which I completely failed to blog about because I have the very bad habit of not communicating with anyone whenever something bad happens. I can’t even begin to recall the turmoil I experienced during those fateful summer days. What quickly comes to mind are the interminable sleepless nights, the foggy, inchoate, murky days, the anxiety-ridden round-trip train rides from S.D. to L.A., and that look that came over my dad’s face that sent chills up my spine, having seen that look on so many other doomed patients. But fate smiled on him, and he made it out of the ICU despite showing up with a good-sized LAD (left anterior descending artery) lesion and new-onset CHF (congestive heart failure.)
He is, however, the prototypical patient-physician. They always say that doctors make the worst patients, and he’s no exception. Not that it isn’t a pain-in-the-ass to take half a dozen or so medications every day. Especially ones that make him bruise all over the place, and that make him bleed for an abnormally prolonged duration. He would sometimes hold his Plavix and aspirin whenever he had such symptoms. I actually doubt that this is the reason why he’s been having chest pain, though. Most likely, it’s because he decided to self-discontinue his long-acting nitrate, and when he did take it, he was splitting it in half—always a dubious decision when you’re talking about slow-release formulations.
But the frequency of his chest pain seemed to be increasing, so he made another appointment with his cardiologist.
The next thing I heard—via text messaging—was “Dad’s being admitted” from my brother at 1:36 p.m. on March 25th. This was, of course, while I was on-call. And perhaps it was a blessing that I was being bombarded with pages from all directions, too busy to actually worry about what had happened.
Turns out that it wasn’t because anything had changed all-of-the-sudden. My dad’s cardiologist apparently felt it would be prudent if they expedited his work-up in the hospital. An echocardiogram revealed a borderline ejection fraction of 50%, which, while not great, was probably pretty good considering he had had an anterior wall MI. The other thing that was of some concern was a 2 cm diameter thrombus in the apex, which, while having the potential for embolizing and causing a stroke, doesn’t really seem to explain why he’s having chest pain. He did have a 6-beat run of ventricular tachycardia while he was being monitored, but it resolved on its own, and it isn’t that unusual since he has had a heart attack, and his potassium was 3.4 milliequivalents per deciliter at the time. They did start him on an anti-arrhythmic medication—amiodarone—but I’m not sure why. His chest pain does get better with nitroglycerin, so there’s clearly something going on (although I suppose it could always be esophageal spasm.)
He also had an adenosine MIBI test, which is basically a fancy stress test that doesn’t make you run on a treadmill, and which obtains images of the heart after injecting a radioactive isotope, and I have no idea what the result was.
The admission did scare him straight into taking his medications as directed, though.
Still, the last few days have been a blur. Post-call, after working 30 hours in a row, I drove to the train station downtown and got a round-trip ticket to L.A. I pretty much slept the entire way, and my brother picked me around 6 pm. For some reason, police cars and helicopters were swarming around Union Station, but we never figured out why. We went straight to the hospital from there, and it turned out they were filming something directly in front of the hospital. (Only in L.A.!) I was relieved to see my dad sitting up in his bed, looking like his usual self except for the fact that he was wearing a hospital gown. He was disgruntled by the fact that the Laker game wasn’t available on the hospital’s T.V., and was pondering whether or not to sign-out against medical advice just so he could watch the game. My mom was there, too, badgering the nurses about letting my dad take a shower despite the fact that he was on monitors. We hung out until around 9:15 p.m., when my brother took me back to the train station to catch the last train back to S.D. Because of some delays, I didn’t get home until 2 a.m., and somehow I miraculously woke up at 6 a.m. on Thursday in time to get to work. The entire day is a definite blur. I can’t recall anything that happened. And when I got home around 6 p.m., I immediately fell asleep with my contacts in, and still half-dressed, with all my lights on. I keep thinking that it’s actually a day earlier than it really is.
I was intending to stay in S.D. today because, frankly, I’m exhausted, and I have to work tomorrow (yes, on Sunday.) But I actually didn’t even know if my dad had been discharged, so I came up to L.A. to make sure. I’m hoping to finally re-orient myself to time and place before the day is out.
