Saturday, June 20, 2015

Cliff Notes Version

Hi, I'm your new prescription, and in four pages I'm going to explain all the ways I could kill you even if used correctly. In fact, the only way you should even be using this is to prevent another different life-threatening problem. And by the way, this may not prevent that either.

Friday, June 19, 2015

911. Twice.

I try not to call them for myself. I was raised not to bother people. I'll call them for Steve when he indicates a breathing issue, and I called them for Daddy back when. I did call them for myself after the school bus rear-ended my car, though that was much more to report an accident than to freak out over a neck injury: I could still move, after all. But I'd rather drive myself to the ER if at all possible. I took my cardiologist's advice to heart when he said I could just sit quietly and wait out an A-fib attack, unless I passed out. I have done that now, several times. The waiting, not the passing out part. I've even gone to bed for the night during an A-fib episode, fairly confident that I would 1: wake up the next morning 2: with the A-fib having run its course.

Wednesday night was different. It did start in the usual way around 6 PM, a little something bringing my attention to what was going on in my chest before the maddened sparrow started trying to beat its way out. I even was dealing with a phone conversation through the early stages. But then it changed.

When I was a young teenager, I fainted twice. There is a distinct feeling ahead of the blackout where all the blood seems to be draining out of your head. If you recognize it, it's your 1.5 second warning to get your head down between your knees or find something soft to land on. That, or you wake up with the consequences. Wednesday I ended the conversation early after getting that feeling about three times.

It continued happening, enough that I actually mentioned to Steve that I was having A-fib. I usually try not to, at least not at the time, to keep him from worrying. After all, if I could just sit through it, why fuss? I hadn't said anything just Tuesday night when the last "regular" A-fib event occurred. But this was new, and just a tad scary. Just a tad, that is, until it kept happening. Rich got home, and by then I'd mentioned that I kept feeling like I was going to pass out. In fact, I added, I was about 4 minutes from calling 911. And maybe they could kinda keep an eye on me in case I actually did pass out.

Steve wasn't about to wait my 4 minutes after hearing that. Before those 4 minutes were up, the first of what seemed at least a dozen first responders, paramedics, and deputies were filling the living room and half the driveway.

We have excellent response time here.

I was hooked up to their EKG, allowed an escorted trip to the bathroom (A-fib always does a bang-up job of stimulating my kidneys, mandating that trip about every 15 minutes!), strapped onto the gurney, wheeled down the driveway and loaded into the waiting ambulance. I'm not sure who answered all their questions. I fielded some, but there were too many simultaneous conversations going on at once to follow. Nobody even asked about insurance! But off we went.

Allison, the paramedic in the back of the ambulance with me, noted that I leaned my head back every time I got that blood-draining feeling. After establishing that connection verbally, and noting what was happening on the EKG at those times, she asked me to let her know as it happened so she could hit the button to make printouts to document them. As they were now happening about every 30 seconds, and the EKG showed they were long pauses in the ventricular beats, she told the driver to hit the lights so we could avoid any traffic build-up in downtown Taylors Falls, or the rest of the way to the hospital in St. Croix Falls across the river.

She also commented to me that my feeling like the blood was draining from my head was likely exactly what was happening. During those pauses, nothing was pushing it back up.

OK, now I was scared. I had kinda been wondering how much of an over-reaction this whole ambulance thing was, up to this point. Now I was thinking it was a damn good thing we were closing in on the end of my ride. Oh yeah, and it had been about another 15 minutes since that bathroom break, and I was even more worried that my bladder wasn't going to hold out that long! Allison and I spent those last few minutes discussing adult diapers - yes, they had them - and bedpans - they had one - as options, but neither was feasible with all the straps pinning me in place. She finally decided to quit trying to solve that problem, reassuring me that if it happened, oh well.

Yeah, tell my Mom that! Even from the grave, she'd be mortified! Me too, of course.

I was quickly wheeled into a private room in the ER, not just a curtained cubicle, and a commode brought in before transferring me to the ER's bed. WHEW!

Somewhere in the process of my getting in the bed and the new set of leads being attached, I converted. No, not religiously. I converted to normal sinus rhythm. Blessed normal heartbeat. No more nearly passing out, no more mad sparrow. While that was in process, the doctor was informing Allison that if she saw the same thing on an EKG again, "a little electricity is never a bad thing."

Oh. I couldda gotten the paddles. Good to know. For next time. I'll be sure to mention it.

Meanwhile they noted the conversion, but decided justifiably I needed observation for a while. And just because, and neverminding my allergic reaction to the medical adhesive holding them in place, they taped the huge patches on me that they use when they do have to shock the heart, one in front, one in back. They wheeled in the machine to do the job too, just in case. Saving time, you know. (Yes, the marks are still there and still itch, in case you wondered.)

After a couple more hours and some discussion, I was OK'd to go home. The last thing to wait for was removal of the IV in the back of my hand. About half an hour earlier they'd had me up and walking, to be sure I was able to do so safely: bad PR if the patient passes out just before discharge. The bag was disconnected from my IV pole for the walk and the line was clamped to prevent bleeding.

Nobody unclamped it.

A half hour later I was thinking it might be a pretty bad idea now to do so. Some blood had backed up into the line, enough that it looked black for about 4 inches, gradually changing to red, then pale red. Even on Warfarin, surely a half hour was enough time to form a blood clot? Seemed to me I was dealing with enough issues that a blood clot wasn't on the list of what to add to the mix. So when the nurse finally arrived to take out the line, I had pinched it off tightly with my thumbnail in order to slow her down enough to ask a question. Meanwhile she was squeezing the IV bag to try to empty the remainder into me. It wasn't getting past that thumbnail, by gum. She insisted that there couldn't possibly be a clot formed even after half an hour, and I wasn't buying it or anything except that she was not going to listen to me. Especially so after her "because I'm the nurse, that's why!" She finally quit trying after letting me know that nothing was flowing through the line anyway, never admitting the possibility of something having clotted as the reason, and never noticing my stubborn thumbnail.

Close to midnight Paul picked me up, Steve being reluctant to drive after dark, especially over lesser-known streets. I arrived wired, not ready for sleep, so Steve and I watched a little TV to unwind. Around 2 AM we finally hit the sack, still talking about the events of the evening.

Oh oh. Just after laying down, the A-fib returned. That too is something it's never done so shortly after converting back to normal sinus. Of course it already had occurred two days in a row, by far another first. We were both still so unnerved from the previous experience that I promptly mentioned it to Steve, and he grabbed his phone for another 911 call. I wasn't feeling the ventricular pauses this time, but neither of us had the fortitude to wait for them.

The deputy was the first one in the door this time, and he came carrying the defibrillator unit, with the disclaimer that he would only use it if I became unconscious. Which I wasn't. There were other new faces this shift, and a few familiar ones. One of the repeats was apparently a neighbor across the street.

Ain't it reassuring to know your neighbor has seen you without your shirt or bra on? Twice?

This time by the time the initial questions were asked and the leads attached, I converted again. (If only I'd known!) I can hereby attest to the fact that it is possible to feel both silly and scared simultaneously! I refused their offer of another ride, since now having converted without the threat of falling unconscious I wanted more than anything to spend the night in my own bed with an actual possibility of getting some sleep. I was rather sternly informed that should I call them again, I would not be given that choice, and would in fact be taken all the way to St. Paul Regions Hospital for a real cardiac workup and treatment.

I had orders to contact my regular doctor for an appointment the next day. Having lived here for over 20 years before moving to Arizona, I had medical contacts with history with me. My former primary was full for the day, but they found me an appointment with a PA, luckily one down the hall from my former cardiologist if a consult was needed. Of course, I couldn't have gotten in to the cardiologist on shorter notice than a month but the PA could consult for whatever was needed on the spot. She wound up also calling my Arizona cardiologist, having actually gotten acquainted with him a few years before! Small world.

The three of them worked together and wound up with a plan that will hopefully keep me healthy long enough to spend the rest of the summer up here with only the intervention of a change in medication. I already made a set of September appointments before heading north with the cardiologist, and best case scenario is we can wait until then for any more drastic interventions, including possible surgery, either to remove the cells which are sending the wrong timing signals to my heart, or possibly, now with ventricular arhythmia, get a pacemaker, or both. None of which come with guarantees.

Neither does the new medicine. Just the warnings that come with it are enough to make me think that surgery may well be the preferred option. You can explore that further in my next post. Meanwhile, I'm just hoping for time enough to be able to make my choices down there, where my insurance gives much better coverage.

Wednesday, June 17, 2015

Everything But the Payments

Steve bought an old ('95) van a while back. He's vague about the mileage, but it was pushing 200k. While it made a few interesting (!) noises while running, it got better gas mileage than his previous vehicle and sported lots less rust. I could actually get into this one, rather than the old one where there was so much rust that nothing was holding the step in place so the floor was my only way in and that was above my knees.

Wasn't gonna happen. Nuh uh.

When the old one died, I wasn't exactly crying about it.

When Steve got the newer one, I was a little leery, but it was something he could afford, and afford to keep running. Well, keep insured and gassed up, anyway. It was his fishing vehicle, big enough to hold his gear so he didn't have to pack, unpack, and repack every time he wanted to head out. It was his independence, especially while I was still working and there was no other car available. It got him to his favorite fishing holes, whether the local Franconia Landing or the one he calls the Dairy Queen dock because that's the first corner he turns to get there, or whether the fishing hole de jour was down Stillwater way with his buddy Les or up near Cambridge with his son Lance.

It was also his chance to give back, loaning it to Rich when his regular transportation option dried up and he needed a way to keep his job. That was a strong point of pride with Steve. When one lives on a fixed income, as we both do now post-retirement, it becomes difficult to find ways to do that.

But good turns often come with consequences for the giver. In this case, the van started accumulating mileage at a steady pace. The inevitable happened, on an early Sunday morning on Rich's way home. He nearly made it, with the van coming to rest on the shoulder of the exit ramp from 35E to Hwy. 8 in Forest Lake.

He thought it was the battery, meaning it may have been the alternator. The cell call woke us, including the location of his set of jumper cables and the request to help after nearly 24 hours of his being on the job. We connected the batteries and he tried cranking the van. From the noise and how it acted, we both believe the engine froze up. Rich had added oil the day before but the dipstick now showed bone dry.

As bad as Rich feels about the van dying under his hands, I think of it as a blessing in disguise. It was bound to happen, sooner rather than later. At least it didn't happen with Steve driving, unable to walk any distance for help, and well within cell range rather than out in the boonies or down in the river valley in a coverage hole and unable to get help.

After giving up on the van and cleaning it out, being Sunday there was nothing to do until the next morning. Other than feeling bad, in Rich's and Steve's case, or feeling some relief at a narrow escape in my case, we all took advantage of the opportunity to grab some much-needed sleep. Rich made arrangements regarding work and alternative transportation. Steve made plans for towing and disposing of the van with a little help from me for Monday.

That help turned into a 250 mile drive since we had to go to Litchfield to get the lien waiver card from the seller in order for the junkyard to "buy" it for scrapping, a price that nearly covered the cost of the tow. Luckily, I had some cash I was sitting on, since there were still a few hundred owed on it. My Master Card can get that payment later, since I'm paid past minimum owed for this month. Steve will just make his final payments to me rather than the seller. The timing just happened to be perfect to enable the deal.

Eventually, all the Ts were dotted and the Is crossed. The van is just a memory now. Everything but the payments.

Saturday, June 13, 2015

Fishing Stories

Steve goes fishing a lot, now that it's the season. I don't, so I get treated to a lot of his fish tales.

A whole lot.

It's not that I don't believe them. Steve's not the kind to tell tales. If he says a fish was a foot long, I believe it was fully twelve inches long.


I think old age has damaged his elbows, possibly the tendons. Maybe something else in there, but I don't have the medical expertise to make that kind of diagnosis. But when he says a foot, he spreads his hands to show how big he means, and he can never seem to bring his hands quite that close together. From my vantage point, they tend to waver between 16 and 18 inches apart. If he can manage to bring them to 12 inches apart, it's because he was trying to show me what the 7 inch fish looked like.

He has stated emphatically and repeatedly that he doesn't want any more surgeries, especially including any more knee replacements. Thus I doubt there will be a forthcoming cure for this elbow condition. On the plus side, it doesn't seem to be painful for him, or bothersome in any other ways.

I only mention all this as an introduction to his aim to collect his long history of fishing stories on a new blog.  His first tale is posted, and you can view it, and future tales, here:


Wednesday, June 10, 2015

Finding Crex

"Follow the goose to Crex Meadows." That's what the signs say when you hit the stoplight in Grantsburg, WI. They came up with a clever idea to help make it work, using a large flying goose stencil and yellow highway paint to leave symbols on the roadway to follow. Mostly it works, except when it doesn't.

There are a couple small problems. Nobody apparently has repainted the geese for a few years, judging by how faded most of them are. And when you come to a corner where you need to turn, it would have been easy to angle the goose in the direction of your upcoming turn, rather than leaving them straight and you wondering just how you missed your trail when you fail to turn and there's no new goose.

So if you haven't been there yet, here's a little help. You start with the Grantsburg stoplight at the intersection of Hwy. 70 as it heads east-west between Miinnnesota (you can pick it up off I-35 south of Pine City) and, say, Siren, WI, and the northern point of Hwy. 87 as it heads up from St. Croix Falls. If you are shooting at it from somewhere up north in Wisconsin you're on your own: get a map or try to trust your GPS. Once at the stoplight, I like to hit the Subway for the only fast food chain in town. You'll be a while in Crex. There's also gas and restrooms there, if it's been that kind of drive.

Then head north down the hill a few blocks to the stop sign. Go left a block, right for several blocks past the city park and campground (great place to tent or RV) to the "T", right a block, then left/north again. In other words, you'd just be going straight north if the streets went that way, but you gotta detour a block for the bridge over the creek and back again. When you get to Co. D, turn right. Crex is northeast of you starting at that corner, a sign there announcing that fact. Looking past it reveals the information center.

You can watch videos there, peruse their museum of stuffed animals and birds, shop the store, interview the staff. Your choice. But by all means, use the facilities since there's only one more rustic building on the north end of the refuge. And get yourself a map: you will need it. Crex covers 30,000 acres and has a variety of roads running through it, turning often enough that even after going through it regularly for several years one can wind up with no sense of direction. There are both east and west Refuge Roads, different Dike roads, and plenty others to take you around and confuse you without that map.

But it is worth the effort.There is a central wildlife refuge where you are absolutely not allowed to set foot for any reason. You can, however, drive all around it, park in several overlooks, and photograph anything you can see from the edge of the road. The surrounding area has roads, paths, even a rest area where overnight stays are allowed after registering at the info center. Fall brings duck hunters, who are a major contributor to sponsoring the area for the rest of us, in conjunction with the WI DNR.

So why go there? It has a wolf pack, coyotes, deer, otters, and many other varieties of mammals just to start. Add 270 species of birds, particularly during migrations. Throw in 86 butterfly species, 720 plant species, and a plethora of reptiles, amphibians, and insects.

You will of course never see more than a merest fraction of them in any given visit. But you will see plenty, given a little patience, a little more time, and keeping your eyes open. I have never failed to visit without seeing trumpeter swans, and it's primary claim to fame, sandhill cranes. (OK, I only visit during the warmer months.) Today, for example, I saw at least 46 trumpeter swan adults and over a dozen cygnets recently hatched, though the babies are harder to count, being carefully shepherded by their parents and often far enough from the roads that they only register as something extra with the adults.

I also managed to spy 4 sandhills, though none close nor still enough for a picture. Most of that is my own fault, as they are most visible early and late in the day, and I picked the middle to show up. This area is a major fall (Oct./Nov.) staging ground for the cranes before their southward migration, often holding between 10 and 20,000 birds during a period of a month or so. So many collect that a couple of years they were joined for a few weeks by young whooping cranes, presumably seeking company.

If you are an early morning person, during staging season you can park near one of their gathering sites and watch sunrise mass liftoffs. Otherwise, load the family in the car, head in with or just after supper, find your parking spot, and watch them land in twos or fives or twenties. Ditch those I-pods, turn off the radio, and just listen to their primordial cries as they arrive and dispute each slice of nighttime territory: shivers! I just recommend you have some familiarity with the place before all that. It could take you a couple hours to find your way out in the dark otherwise.

Today's drive through also netted several turtles, one doe, one loon, both yellow-headed and red-winged blackbirds, tree swallows, one hawk tentatively identified as a harrier but the glimpse was brief, canada geese, unidentified ducks plus one definite drake mallard, though I missed the white ibis the center's staff pointed me to on the map. There were numerous flowers including lupines, iris, paintbrush, nymphaea and white water lilies, an abundance of  unidentified blooms in pink, yellow, white, purple, orange. Plenty of scenery caught my eye and my lens, varying from prairie to forest to marsh to lake or pond. If you are like me, you also enjoy the remnants of dead tree trunks left peppering the landscape.

Add the variety of seasons, daily or hourly changes in clouds and lighting, and it's a feast for eye or camera. Just follow the goose. Or whatever.

Monday, June 1, 2015

A Son's Letters Home From Antarctica

First, context: my brother was lucky/smart enough to do, as part of his graduate studies, research on birds in Antarctica. Normally not terribly communicative, he did manage to write two letters back to our parents - that's two over 7 years. At least these two were ones Mom kept: I can't vouch for more. In going over papers kept by my mother to see what is still important and what is recyclable 8 years after her death, I ran across these tucked away and nicely preserved. Each is written in tiny script on both sides of a single small, thin sheet of paper, very slightly yellowed. For clarity, I am inserting paragraph breaks for reading ease where space needs didn't allow. Otherwise all is exactly as he wrote them. The Dr. Parmalee mentioned is his faculty instructor with the U of M in charge of the trips.

The first comes with colorful Argentinian stamps, air mail, at a cost of $1.20. Return address is Steve's name, c/o R/V Hero, Ushuaia, Argentina, S.A. Our parents at the time were living in Roseville, MN. The letter is dated 9 Nov. 73.

"Dear Folks,

I am now in Ushuaia, Argentina which is located on the southern tip of the continent on the Island of Tierra Del Fuego. We've been here three days now and may be here a few more because the ship has been slightly delayed again and is still on the way from Buenos Aires. Actually, that is not so bad. This is a terrific place. Birds are everywhere and I've seen 30 new species so far.

There are snow-covered mountains here as spectacular as those between Banff and Jasper. Yesterday we took a taxi about 20 miles up in the mountains and walked about halfway back. Today everybody has sore feet.

The day before we went to a National Park about 15 miles from here. Dr. Parmalee had run into an old friend of his down here from San Diego so he was with us and gave us a guided tour of the park. We were mainly looking for Andean Condors there, but we saw just about everything but those. Oh well, we may see one of them yet.

It is early spring down here which is a little hard getting used to. The leaves are just coming out on the trees, flowers are blooming and birds are nesting. There are several species of geese here which are very common. There are so many of them  that a bounty is paid on them because they supposedly compete with the cattle and sheep for grass. These geese are much more colorful than the N. American geese so I've been taking lots of pictures of them as well of all the other birds.

Another interesting bird is the Magellanic woodpecker. It is similar to the pileated woodpecker but the entire head is bright red. It is apparently somewhat rare. While in the park we saw a pair of them and took several pictures.

Today we talked with a Mr. Goodall who owns a 50,000 acre ranch about 40 miles down the coast from here. From what he said there apparently is an article in the Jan., 1971, Nat. Geographic about the area which you might want to look at.

In general, the people here have been very friendly and helpful although language has been somewhat of a problem. One of our group speaks a little Spanish so we were able to get by so far.

I guess that's about it for now. The return address on the envelope should (theoretically at least) get a letter down here to the port & it would be delivered to me when the ship returns from Antarctica.


The second envelope has only one stamp on it, but bears a variety of postmarks. The postage is a USA stamp for 15 cents showing USA Olympics and part of a rowing team  in the water. The official postmark, made on both sides, says Miami, 7 Feb, 1980. One inked stamping across the front postmark says PALMER STATION, ANTARCTICA, 64 (degrees circle symbol which I can't duplicate) 46' LAT.  64 (degrees) 05' W. LONG. An oval inked stamp on the front also says NATIONAL SCIENCE FOUNDATION, R/V HERO  PALMER STATION, U S A R P, GENERAL OCEANOGRAPHIC, INC, HOLMES & NARVER, INC. Inside this oval is a line drawing of a small ship and rocks in the water, a spit of land with a fence along the shore, recessed buildings in the background in front of a mountain range.

Mom also noted on the front that it was received 2/11/80. It was addressed to them at that time in St. Paul. Steve's return address in tiny printing is simply his name, Palmer Station, Antarctica.

The back of the envelope again has the circular Miami postmark accompanied by a rectangle announcing SAVE YOUR VISION WEEK. Two large circles are inked on the back, the first bearing a solid black map of Antarctica with white lettering USARP with longitude and latitude lines filling the rest of the inside of the circle. The outside ring says UNITED STATES ANTARCTIC RESEARCH PROGRAM around the top and NATIONAL SCIENCE PROGRAM across the bottom, a single star on each side dividing the two. The second circle shows not-so-solidly inked patterns of mountains, a glacier vertical wall, and a gull landing in the ocean in front. The ring around this has UNIVERSITY OF MINNESOTA across the top and ORNITHOLOGICAL ANTARCTIC RESEARCH across the bottom, this time with only empty space dividing the two.

The letter is dated 29 Jan 80. Again, is is in tiny script on both sides of a small, thin sheet of paper, only slightly yellowed.  The "George" referred to is wife, George Ann, also working on her advanced degree.

"Dear Folks,

I'm having one of the fellows carry this back to the ship again so this should arrive in a reasonable length of time. It's getting to be that time of the season when people are starting to go home. The Hero arrived last night for the first time since it brought us down here (it was in dry dock in Argentina) and brought in some more scientists who were supposed to have been here in mid-December. Also last night Polar Sea (a Coast Guard Icebreaker) arrived & will be taking our cargo to be returned to the states.

As of this moment (subject to change) we're scheduled to depart Palmer on 13 March. We plan to do a little travelling in S. America on the way back so probably won't arrive home until at least the last week in March. Will contact you again when dates are more firm. We got 2 letters from you (5 & 25 Dec.) and several from George's folks when The Hero arrived - nice to have some news from home - sounds like you are having a very mild winter. Glad to hear the fish are growing.

We are having a mild summer with early snow melt & now all the pack ice is gone so we can boat out to the islands any time. Had lots of pack ice earlier & it prevented us being together on Christmas as I was stuck on the shag Island for 11 days and couldn't return to the station. Shags, gulls and penguins are nearing the fledging stage while skuas and giant petrels still have fairly small chicks.

I've been taking lots of slides again & should have good shots of many things I wasn't able to get before. Yesterday I got close-up pictures of a skua eating a penguin chick. I've also taken 24 rolls of movies and should have some interesting footage if it turns out.

Both of our studies have been going about as well as can be expected given unpredictable weather & pack ice conditions. We should have lots of good data by the time we're done (we have lots already). The gull work will be finished within a couple weeks but shags will keep us busy through Feb. Dr. Parmalee is due to arrive about mid-Feb. & will probably spend most of his time banding skua and giant petrel chicks.

We've just gone through a 10 day stretch of beautiful sunny weather which is very unusual down here. Last year the longest stretch was 5 days. Hope it keeps up but it's not likely.

Saw a leopard seal eating a penguin near the shag island one day and took some movies but it was a little far away to show up well. Also see whales from time to time. George & I have both seen killer whales poking their heads out of the water near ice flows looking for seals. Have seen several of the smaller baleen whales (20 - 30 ft) in the area as well.

All for now - must get back to work. Hope all goes well on the home front.