Category Archives: Health

Keeping Up The Pace!

After I checked in the other day on Facebook, while at the KP Pacemaker Clinic for an update on my device’s performance, I noticed a lot of my friends aren’t exactly familiar with what all this means. Please allow me to explain what is happening and how my device works.

I have known for decades I had an electrical problem with my heart. My doctor told me a long time ago I had a right bundle branch block, which I could live with indefinitely or which could kill me in short order. I never let it bother me and figured I would live my life as best I could and not worry about dropping dead.

At the beginning of this year I started noticing I was having problems with heartbeat irregularities and I contacted my doctor. To make a long story short, it became apparent I was experiencing bradycardia (slow heartbeat). One of the diagnostic tools used was what is called a Holter Monitor (it’s a heart monitor, which I wore pasted to my chest for seven days). One night my pulse rate dropped to 26 BPM; not dead, but awfully slow.

After a telephone consultation with a cardiologist—now MY cardiologist—to go over the results of the Holter Monitor and blood tests, we decided a pacemaker might be indicated. That was February 27. Between then and March 3 I had trouble walking from the bedroom to the kitchen, or from the family room to my car, without requiring a moment or three to recover from a feeling of utter exhaustion. I couldn’t fathom living like that for long, so I called my cardiologist to discuss what was going on. I wasn’t scheduled for a consultation on my test results until late March, but that wasn’t acceptable to me. He indicated he had a surgical opening the following Wednesday, March 8, and I agreed to the procedure.

On the morning of March 8, I checked in to the Kaiser Permanente hospital in Woodland Hills, CA and the procedure was performed later that afternoon. I had a Boston Scientific Accolade MRI pacemaker implanted in my chest, just below my left collarbone. The device is about 25% bigger in diameter than a silver dollar, and three times as thick. It’s a nice size chunk of metal I’m still getting used to. It consists of a dual-core processor with 512KB of RAM, a large battery, and two leads – one to my right Atrium and one to my right Ventricle. It is programmed to send an electrical signal to “pace” my heart when it drops below 60 beats per minute. I also have a communication device that sits next to my bed that receives data from the pacemaker and transmits it through a dedicated cell connection to the pacemaker clinic at Kaiser. The pacemaker is also programmed to recognize when my heart rate rises above 130 bpm, at which point the device by my bed (it’s called a “latitude” and is also from Boston Scientific) will notify the clinic.

Two weeks after the surgery, I want for my first device checkup at the clinic. The Nurse Practitioner who manages the clinic advised me that my latitude was communicating properly and she had received data from it. She also told me that my right ventricle was being paced 100% of the time, but my right atrium was being paced far less. She reprogrammed the algorithm in my pacemaker right there (I didn’t feel a thing) and increased the timing between atrial contraction and ventricular contraction. Before I left she informed me my heart was beating on its own.

In The Waiting Room

She also told me the battery indicated it would last for 12 years, but since she had changed the algorithm that would likely change and we would know more the next time I came in. That was last Wednesday, May 24. At that visit I was informed my heart is being “paced” about 40% of the time and that the battery now appears it will last for 15 years.

As of now I will only need to go in to the clinic once a year. I’m feeling good, at least as good as one can expect after almost 76 years of heavy use. So if I use up the remaining battery life—assuming it lasts as long as it predicts—I should make it to 91. Of course, that’s assuming nothing else gets me first, and there are quite a few other things that I have to be careful about. Regardless, I’m thankful I’m reasonably energetic and my brain seems to function as well as it ever has, despite the wear and tear of my party animal past. Life is good, and every moment is precious to me – more now than ever.


Rick 2.0

In retrospect, I should have seen it coming. However, like the proverbial frog in the pot I didn’t realize the water was boiling until it required a drastic intervention. In the past nearly seven weeks, I’ve had the time to reflect on what was happening to me and realize the peak of the problem came up somewhat suddenly, but the signs and symptoms were there for quite some time. The farthest I can consciously go back as of now is to July of 2022.

I believe some of my symptoms were masked by the fact I’d been lifting weights for several years and I was working at a job that was physically demanding, which kept my heart rate up and lulled me into thinking what was happening was normal for someone my age. Every morning when I got ready for work I would pull on my zip-up boots. They were snug and it was a bit of a struggle to slip into them. I usually had to pause for a couple seconds to catch my breath before finishing my preparations for work. I also had to walk between two warehouses at times and was always a bit winded and tired when I got to my destination, which was only about 1,000 yards. Same with climbing one flight of stairs. Some of my problem I also attributed to the fact I was born with club feet, which required major surgery to correct and made walking more difficult than it ought to be.

I lived with these issues for about six months before I experienced what felt like a sudden, drastic change. I was sitting in the lounge of our local Planet Fitness, waiting for my youngest daughter to finish working out. I hadn’t worked out myself and was just biding my time while she was getting in her exercise. When she finished, she came in to let me know and I stood up to leave. I was hit with an overwhelming wave of exhaustion and my knees nearly gave out on me. I didn’t realize it at the time, but I was likely experiencing syncope (fainting). I was able to make it to the car, but it wasn’t a walk in the park.

We made it home (I have lots of experience driving under, shall we say, impaired conditions, during my well-spent youth) and, checking my heart rate with my Fitbit Charge 5, I noticed it was wildly erratic. The next day I contacted my doctor at Kaiser here in Simi and, although he was not available, I was able to get an appointment with another physician. As a result of that exam, I began a series of tests, including wearing a Holter monitor for seven days. I was also scheduled for a cardio stress test a couple of weeks later.

When I finally (it took longer than I thought it should, but that’s another story) got the results from the monitor I’d worn, they were published for me to read on the Kaiser website and their mobile app, which I have on my phone. Reading the results was sobering and alarming. My heart rate had, at one point, dropped down to 27 beats per minute and I had experienced numerous instances of tachycardia. I also had experienced numerous incidents of AV (atrial ventricular) Block. There was enough jargon in the results that I was able to look up and get enough of an understanding to be quite concerned about my heart. This was exacerbated by the overwhelming exhaustion I was beginning to experience when walking from the bedroom to the kitchen or from the house to my vehicle.

The results were published on February 8, but I wasn’t scheduled to consult with a cardiologist until the end of the third week of March. As I read more about my results and experienced longer and more difficult periods of exhaustion, I became increasingly concerned that I might not make it to the consult. I started agitating for things to speed up. After an phone conversation with a cardiologist, I decided to purchase a KardiaMobile personal EKG device. It turned out to be difficult to get good readings because I have essential tremors in my hands and the shaking is accompanied by electrical activity in the muscles of my forearm, which confused the EKG device. When I could get a good reading, it wavered from normal sinus rhythm to bradycardia to possible atrial fibrillation. This somewhat paralleled my experience, as there were times when I felt quite normal and did not tire easily from a short walk.

I sent some of the results to who was now my cardiologist and, after several phone conversations, we determined there was a good chance I needed a pacemaker. My condition continued to deteriorate and we finally decided an implant procedure was indicated. On Friday, March 3 my cardiologist informed me he had a time slot open the following Wednesday, March 8 in which to perform the procedure. I agreed immediately.

On the 8th my wife drove me to the Kaiser hospital in Woodland Hills, CA and I was admitted for surgery that afternoon. All went well, I stayed overnight for observation, and was discharged in the afternoon of the 9th. My wife and youngest daughter picked me up and we stopped for some Chinese food on the way home. I felt great and continue to heal and recover. I was told not to raise my left arm above shoulder height for six weeks and did not do so. My next goal comes on June 8, when I will be able to swing a golf club again. A week and a half after the surgery I attended an air show at Pt. Mugu NAS and walked over two miles without experiencing any shortness of breath. A week later, I want to Arizona to attend to spring training games and walked over two miles on each of the two days I was there, again with no discomfort or deleterious effects.

It’s difficult to say how long I’ll live with this device and, of course, my aging heart. I’ve already outlived my father—who I was told I was “exactly like”—by 16 years. I have numerous comorbidities as well. The battery in my pacemaker, according to the Nurse Practitioner who runs the pacemaker clinic at Kaiser, has over 12 years of life remaining and it can be replaced if necessary. A review of the available information on the remaining lifespan for men like me range from 5 to 15 years or more, depending on numerous factors, including lifestyle. I have to balance my desire to enjoy the life I have left in a fashion that suits me, or live longer by changing my habits and desires. I’m working on that now. My outlook and philosophy are undergoing a transition and I’m not quite sure where I’ll end up, but I’m still here for now and I intend on living each day to the fullest.


Neil Young Can Kiss My Shriveled Ass

So there I was, minding my own business, living my best life when all of a sudden this old guy snuck up behind me and took over my body. I don’t think I can kick him out, either. Maybe some day, but it will probably be fatal. Tis a bother.

You may find I will be harping a bit on this subject. You see, I’ve never been this old before and I’m learning how to be a senior, or an old fart. I’m not used to it. I find it interesting that I look far older in pictures than I do in the mirror. Why is that? (Don’t answer; it’s rhetorical.)

You may now move about the cabin.


Not For The Faint of Heart

I’ve heard it said many times that growing old is not for the faint of heart. This past Sunday I had an experience that brought that saying home. It was hardly the first time I’ve experienced something that threatened my health or slapped me upside the head with my mortality, but it was sufficiently different that it definitely got my attention.

My wife had decided to make homemade shrimp/pork wontons. She had spent some time getting all the ingredients for the filling and our daughters and I had filled and formed a little over 50 wrappers. We decided to cook them outside on the side burner of our Weber Silver-C gas grill, using a cast iron dutch over and peanut oil. I wasn’t quite sure it would get hot enough, but it definitely did. In fact, no sooner did I start deep frying then I had to turn the flame down a bit.

I was only able to fry four or five at a time, so it took a while and I was standing still for the entire time, using metal tongs to flip the wontons over so they would cook the meat, veggies, and seasonings thoroughly without burning the wrapper. During that time I barely moved a thing other than my arms and hands.

The tops of my feet had been feeling a little strange for the past couple of days, but I hadn’t paid really close attention to them. I finished and went inside, sat down, and enjoyed our meal with the family. Shortly after I finished eating, I happened to look at my feet, as they really were feeling weird. To my horror, not only were my feet swollen, but my ankles were as well. Where I could normally see tendons and veins, there was nothing but stretched out skin.

I recalled this was a symptom of possible congestive heart failure and I know I have a history of moderately high blood pressure and two years ago was also diagnosed with atherosclerosis of the aorta. I was concerned. My first response was to ensure I drastically limited my salt intake and I decided to see how I did after a night’s sleep.

When I woke up the next morning, my feet were a little less swollen. I sent a message to my doctor and am awaiting a response. I really hate the term, mostly because it’s used so frequently by anti-vaxxers and science deniers, but yesterday I decided to do some of my own research. As a result, in addition to limiting my salt intake (something I wasn’t being careful enough about) I wore a pair of knee-high socks to bed and placed a couple of pillows at my feet to elevate them over my heart.

When I awoke this morning, the first thing I did was remove the socks to look at my feet. To my relief, they had pretty much returned to normal. I could see all the tendons and veins that normally stood out rather conspicuously. I’m still waiting for my doctor and will consult with him, but I think I have a fairly good idea of what I need to do to ensure this doesn’t happen again. This is definitely not something to ignore or sweep under the rug. The body does not heal or remain healthy by ignoring what it’s telling you and this was a cry to do something different. That I will!

PS – The condition I experienced is called edema. As a result of looking into it and posting something about it on Facebook, I learned the adjective form of the word, which is edematous.


First Week On My Own

This was my first week running the business I’ve been working at for nearly eight months. The owner had to return to England with his family to renew their visas and for him to take care of some family business.

One of our three warehouses

It wasn’t a surprise. He had asked me early on if I was prepared to do it and I told him I would be happy to. Today was fairly slow, but the guy who’s been helping me out—and who I’m training to replace me when I get a job more suitable to my skills—decided not to come in.

I had to do a bit more than I expected to and by the end of the day I was whipped. I don’t generally have any problems doing the physical work I have to accomplish each day, but I ain’t no spring chicken and some days I really do feel my age. Today was one of them.

Going to bed early so I have the best chance of getting a refreshing night’s sleep. It will be another two and a half weeks before the boss returns. Fortunately, there are cell phones, texting, and email.


Top Gun Fitbit

My buddy, Steve, treated me to a screening of Top Gun Maverick on Saturday for my birthday. Ironically, a day or two earlier, in response to a question posed on Twitter asking what fictional death affected me, I commented with a pic of Anthony Edwards as “Goose.” There have been quite a few, but his death in Top Gun really tore me up.

I’m hardly a movie critic, but I’ll offer this. My Fitbit HR5 measures my heart rate (among other things) and “awards” me points for a couple different levels of exertion. Although I was sitting still the entire movie, except for the occasional gulping of beer or munching of buttered popcorn, my tracker recorded about 50 minutes of an elevated heart rate. Make what you will of that.

I recommend the movie, but don’t listen to me. I’m a sucker for fast planes and dogfights — and vicarious emotional scarring.

GOOSE

Booster #2 Was a Killer!

Last Thursday (April 28, 2022) I left work a little early to get my second Moderna Booster shot. The nurse who administered the dose told me the 15-minute waiting period that had been observed for all three previous inoculations was no longer mandatory and I chose to go straight home. I only live a couple of minutes away from the Kaiser location here in my home town of Simi Valley, CA., and I have never had a sudden, bad reaction from any vaccine in my nearly 75 years.

Image of syringe and vial saying "Common Sense."
Anti-vaxxers are Idiots

I enjoyed the rest of the day, slept well (my Fitbit tracker and app noted I slept well, giving me a score of 82, which is good, not excellent) and got up at 6:00 am to head off to work. I was fine until about noon, when my body started to ache a little I attributed it to the rather heavy packages I had assembled and loaded into a container to be picked up that afternoon by the USPS. I didn’t think too much of it, though I worried I may have injured myself in a way that would preclude my being able to do my job.

I began feeling uncharacteristically lethargic and my legs felt a little rubbery. Finally, after completing some tasks that needed doing, regardless of how I was feeling, I chose to come home early. When I arrived I was beginning to feel pretty bad, but I still didn’t connect it to the booster I had received the previous day. Friday evenings are normally reserved for a short trip to the gym, then an evening of dinner and craft beer with a couple of friends.

I decided to do something I hardly ever do; take a nap in the afternoon. By 6:30, a half hour before I normally go to the gym, I knew I wasn’t going to be able to make it and texted my friend and former colleague to let him know I wouldn’t be making it that night. I went back to sleep and, according to my Fitbit, slept for close to twelve hours.

Yesterday was absolutely miserable. I experienced both the chills and cold sweats. I was at times dizzy, nauseous, and had no appetite at all. At one point I experienced a strong sense of dizziness, despite my being nearly asleep and horizontal. When I opened my eyes, the room was shifting back and forth as though I was looking quickly from side-to-side, yet I don’t think my eyes were moving. It was one of the strangest feelings I’ve ever had and I couldn’t help thinking it was a precursor to something I did not want to experience.

My wife, bless her heart, kept trying to get me to eat, but I wasn’t having it. I think I really pissed her off by asking her to leave me alone, that I would eat when my appetite returned. I can understand her worry, as I had slept nearly twelve hours Friday night and hadn’t eaten dinner. I ended up eating nothing all day yesterday and, after sleeping over nine hours last night, I finally had a half cup of coffee, a mini baguette, and a bowl of salad a few minutes ago. I’m still a bit nauseous and still experience dizziness, but it’s subsiding with each passing hour.

I finally got up this morning and am sitting at my laptop in my home office. I was able to do my daily bookkeeping, something I wasn’t the least bit interested in yesterday. I’m also taking the time to record my experience here. My youngest daughter, after asking me how I felt today, asked if I regretted getting the second booster, as I had no reaction from the first one. I told her I regretted that it knocked me down, but not that I received it.

I was diagnosed with Covid-19 on December 29, 2020 and spent the first week of 2021 quarantined in bed, miserable as can be – but I didn’t require hospitalization despite my age and numerous comorbidities. I received my first and second doses of the Moderna vaccine on 3/22/21 and 4/19/21, which was as soon as they were available. I experienced some discomfort and flu-like symptoms both times, but they only lasted a day. When I received the first booster on 11/24/21 I experienced nothing I would consider a side-effect.

I think what happened has to do with how hard I worked on Friday. With all three previous vaccines I was not working and was able to either stay home or stay in bed and was in no way exerting myself for a day or two. This time, however, I was at work climbing, lifting, and walking far more than I was doing before. I’m thinking all that extra effort sped up the internal distribution of the vaccine in my body, and it reacted in a way that I had not truly experienced before.

I plan on getting up tomorrow at 6:00 am and heading off to work. Monday is generally our busiest day and I’ll have lots of lifting and climbing to do. I think I’ll be up to it. That weird-ass feeling I had with my vision happened a couple more times yesterday, but it seems to have subsided. I look forward to discussing it with my doctor when the opportunity arises.


How to Die Well, According to a Palliative Care Doctor

Came across this wonderful, reasonably short article about death and dying, a subject I have long been interested in; especially as I’m winding down my 75th year here.

Preparing for death by making peace with it.

Excerpt:

Read more (much more) by clicking on the link below:

Source: How to Die Well, According to a Palliative Care Doctor


Back In The Saddle

I posted the following to LinkedIn two days ago. It was the first time I’ve posted there in approximately two years. I was very apprehensive about sharing some of these personal details on the site, as I’ve always used it strictly for business, but I felt it necessary to explain to my over 1300 connections where I’ve been for the last two years. I’m gratified to be able to say it was more than well received and I am now jumping back into the fray as carefully (and delicately) as possible.


Hey everybody. Well, at least the people who know me and, perhaps, have wondered where I’ve been. Two years ago, my youngest daughter announced she wanted to drop out of school. She was a sophomore in high school at the time.

Needless to say, I dropped everything I was doing and concentrated on helping her deal with the issues that were causing her to feel like giving up was the best course of action. As an older, internationally adopted toddler, she was saddled with some difficult learning issues and has struggled to get through her classes. Fortunately, she has an IEP (Individualized Education Program) which allows her teachers and the school to take those issues into consideration.

She is now a senior and is attending a school that is an independent learning academy. During the pandemic lock-down of our local schools, she thrived working at home. She has a problem with other children and having to work with dozens surrounding her has always been a challenge.

Her new school, coupled with a new medication for depression she started taking (and which seems to be working) has tamped down her anxiety, which means I’m not living moment-to-moment awaiting her next trauma and having to deal with it.

So – I’m just coming up for air after two years of trauma, exacerbated by the pandemic and my having been infected with Covid at the beginning of this year. I am still experiencing some long-haul symptoms, but am doing remarkable well for someone my age, with my comorbidities.

I may not be fully functional until next June, when she graduates (God willing and the creek don’t rise,) but I’m working on it and will be spending more time on LinkedIn as I seek a few clients/gigs. I’m deeply thankful I was in a position to spend as much time as I have with her, but I’m really looking forward to having more time to spend on myself and my continuing desire to be useful to others.


Who’s Counting?

From Worldometer.com

I’ve been following the inexorable path of this pandemic since the very beginning, primarily through Worldometer’s website located here. In early 2020, I was paying really close attention as the casualties mounted. I was recording the figures into a spreadsheet and plotting a graph of how deaths and infections were growing.

Sometime toward the end of the Summer I gave up; I had other things to do and the pandemic seemed to be waning. That was just before the Fall and Winter spike really ran up the numbers. Even then I didn’t return to recording and plotting. I decided to leave that to others as I was merely replicating what several organizations were already doing, and my desire to be able to pore over the data wasn’t enough to justify the time it would have taken.

On December 29, 2020 I tested positive for Covid-19 and spent the next ten days both quarantined in my bedroom and miserable with the virus. I came close to going to the hospital but, thankfully, it didn’t happen and I recovered. I am now fully vaccinated (Team Moderna) and have fully recovered, with the exception of a couple of “long-haul” symptoms: occasional fatigue; loss of smell (it returns intermittently); some brain fog … which is maddening but seems to be subsiding with time.

Through this time, I’ve continued to monitor the ebb and flow of this virus and its movement through the country. One thing that’s always struck me as odd is how the numbers really go down on the weekends. I’m pretty sure this is more an artifact of reporting, e.g. how many admin staff are home for the weekend, etc., but if you look at the graph (above) you can see a consistent drop in reported cases and deaths each and every weekend.

It’s almost as if the Grim Reaper doesn’t exactly take the day off, but certainly puts the brakes on every Saturday and Sunday. Maybe people are so accustomed to relaxing on the weekend that even the gravely ill manage to hang on through those days just out of habit. I know that being calm and taking care of business played a significant role in my recover. I was “lucky” in that I have dealt with lung issues most of my life, so I was closely attuned to what was happening to me and was able to relax and allow my body’s natural defenses to take over.

As the above graph clearly shows, we’re on the way down again, but I’m somewhat apprehensive that we’re going to see another spike as the weather cools down and people start spending more time indoors. I hope I’m wrong, but history seems to want to tell a different story than we’d all prefer was the case.


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