for Debbi at dubiquilts

I'll warn you right now, this is going to be one of my stream-of-consciousness rambles so bail now if you want. I just want Debbi to know that she really helped me with something.

I was raised by midwesterners who lived through the Depression. This means, I've been told (and have lived the evidence), that medical care is for emergencies only. I remember going to the doctor when I was 8 to get a boil lanced, 14 for a German measles shot (and if they hadn't been taking my little sister for her kindergarten physical, I'm not sure that would have happened) and not again until I took myself in at 20 to the gynecologist for a check-up and contraception before my wedding. I married a hypochondriac. Every little ache or twinge is cause for panic. I remember one year his heart skipped a beat. He worried and worried and - sure enough - it did it again. Off he went to a cardiologist and eventually had cardiac catheterization (angiogram), in which he learned that he has NO plaque anywhere. Diagnosis - stress. One missed beat and he worried himself into an invasive, potentially dangerous procedure. At his ten-year check the cardiologist told him to expect to live to at LEAST ninety.

Because of my upbringing and - frankly - disdain for DH's overreactions, I tend to want to blow off medical things. I did go on blood pressure medication several years ago, but my doctor moved out of the area and I let my prescription run out and didn't do anything for my health for about five years. Finally, about two years ago, I heard a little voice say to me, "You know, you're just committing slow suicide neglecting yourself this way." And it is true. One of the things I wrestle with all the time is the feeling that I've done what I was sent here to do. I won't take time here to dissect all the reflection I've done over this, but will just say that two years ago I again went on the hunt for a physician I could bond with. It took a while until I found just the right woman. She advises and I choose.

I've done a lot of things (by my standards) for myself in the last two years. Saw a dermatologist to have a couple of pre-cancerous growths taken off my face. Had every filling in my mouth replaced and a resorbing tooth extracted (and have kept up my cleanings.) I'm up-to-date on mammograms. My blood work comes back every year in the normal range - no diabetes and my cholesterol ratios are good. The biggest challenge so far has been getting my blood pressure down where she wants it and we've been trying different combos of stuff to get it down.

Because I had tolerated enalapril in the past, we started with 5 mg. My bp came down, but not far enough, so we increased it to 10 mg. I had an appointment in August 2007 and while my BP was down more, it still wasn't down enough. And my internist was not pleased at that visit that my heartrate was up. She first asked if I was feeling any tightness in the chest or shortness of breath. "Yeah," I said, "but it's kind of a 'bad air day" feeling, like from time to time I need a big sigh." (Note: this was during the big Ojai wildfires and the air was full of smoke for days and days.) Off the doctor went to get a device to put on my finger to measure my O2 levels - 96%. Finally she said, "You just look too comfortable," and added, "Stress can cause these symptoms. Are you under any stress?" At which point I burst out crying. She passed the tissues and said, "Guess so."

"Well," she mused, "I just think you're way too comfortable to be really concerned. If I were really concerned, I would send you off to the emergency room right now, but instead I'm just going to suggest that we call a cardiologist and get you in next week to make sure everything is OK."

No way. I was leaving the next day on my long-awaited vacation. In Utah. Two weeks in the Rockies. At 5200 feet. When she learned where I would be, she ordered an EKG. "If there's something wrong with your heart," she warned, "you will REALLY feel it up there." The EKG was fine. She gave me a copy of the read-out, a copy of my last bloodwork and orders to hightail it to the hospital at the first twinge of chest pain. She also suggested adding a different medication to the regime to bring my BP down some more. I explained that I was a little nervous about trying something new while 800 miles from home, so we opted to increase the enalapril to 15 mg for the two weeks I would be gone and see what happened. The next day Dh and I were in the car and headed up the 15.

I had no problems in Utah. In fact, by the end of the two weeks I could haul my fat butt up and down the stairs without getting winded. I even ended up walking uphill at 12,000 feet when we had to park in the overflow area to see some friends finish the Xterra triathlon at Snowbasin. I was panting a little, but recovered in about a minute. And, while resting for two weeks it finally dawned on me! When I had been on enalapril before, we had to reduce the dosage because it made my heart race! I was pretty sure that was the problem.

I saw the internist again when I returned. I shared with her what I had remembered about enalapril, and we immediately reduced the dosage and added one called diltiazem. She was changing practices at the end of that week - after a vacation - and could not tell me where she would be. It took me almost three months to find her again. At that visit we were thrilled that my BP was down to 114/74 and my pulse down to 64. As we rebuilt my file, she asked, "Are there any loose ends we need to tie up?" I was SORELY tempted to just drop the cardiologist thing. After all, she had SAID that if there was anything wrong with my heart, I would feel it in the high altitudes but I didn't. And once the air cleared after the fire I had no tightness or shortness of breath. And my pulse was down to 64! Seems to me our previous concerns were all for naught, right?

But then I thought, "After all of this work to build a trusting rapport with this doctor, shouldn't I honor our relationship by at least being honest? So I reminded her about her advice to see a cardiologist. DAMN, she wanted me to follow through with that. "If it's nothing, you haven't lost any more than a few hours. But if there is a problem, isn't it better to learn it now while it's less serious?" Yeah, yeah, yeah.

So, just after the MLK weekend I had a consultation (and took an immediate dislike to this guy). I explained what had happened (the short version, believe it or not) to get me to his office. I also said "morbidly obese 56-year-olds drop dead every day. The only way I'm going to lose weight is to build an exercise program, and this visit is also to find a safe way to do that." First thing he said was that my pulse (about 100 in his office) wasn't THAT high and my BP was under control. ("Great," I thought to myself, "I might get off easy.") No such luck. He didn't like my cholesterol numbers. "It's not really that high, and your ratio is good, but cholesterol and high blood pressure work synergistically to increase your risk of heart disease." Swell. So, now I'm on lipitor. And a baby aspirin "for circulation."

And I have an appointment tomorrow for an echocardiogram and myocardial perfusion scan. Which brings me to my message for Debbi.

I SO DO NOT WANT TO DO THIS tomorrow. I've been trying and trying to find a way to talk myself out of it. Oh, I know I'll do it. But it was really bugging me to be in such conflict over it, to be so resentful of having to take the time off (seems like a waste of TWO sick days to me, 'cause I have to go back the second day for some part of the procedure.)

And then I visited Debbi's blog, dubiquilts. dubiquilts was one of the first blog links to go into my sidebar, mostly because my cousin's little girl used to call me "dubi." I always enjoyed reading Debbi's posts, although she's into some things (like fabric postcards) that don't really interest me that much. Consequently, hers is one of the blogs I don't read every day. In fact, due in part to switching to my new computer, I hadn't checked Debbi's blog in about three weeks.

I was absolutely shocked to read that Debbi had nearly died in the time that I'd been away. FIVE heart attacks, angioplasty and TWO stents later she seems to be on the mend, thank goodness. I hope any of my friends still reading this will go check out Debbi's story. We all need to take the lesson that she offers.

And Debbi, if you came over, I want to THANK YOU for taking the time to share your story. I'm still not looking forward to tomorrow's adventure, but thanks to you I AM looking forward to whatever I will learn. If it's good news, great - I'll get started on a walking program (but it may take me a while to build up to the 1.5+ miles you are doing.) And if I need to do some repair, so be it. I have your example to inspire me.

I have a rather strange spiritual belief system. It's personal and I feel no compulsion to explain it to anyone. All I'll say is that, after weeks of not checking in on dubiquilts, to pop in today and learn what I did, the day before I go for heart testing procedures, it just too weird to ignore. I have to believe that I was sent to you, Debbi, and I again say, "Thank you," for the help!