Sunday Decaf; You Gotta Have Heart and a Cool and Hot Doc

I asked my doctor how many more years I have left and he said, 'You're too ornery to die.'

Jimmy Piersall (Baseball player)

Can I call these Sunday offerings, Sunday Coffee anymore?  Is decaf. really coffee?  The cardiologist that I recently hired told me to ease off caffeine.  That I have to forego real coffee is the proverbial downer.  That I required the services of a cardiologist when I’m on the cusp of 58 is a big downer.

It started a couple of weeks ago when I felt my heart skip a beat.  Whoa.  Nah, I imagined that.  Again.  Catch my breath.  I remember an elementary school teacher of mine described heartbeats as, lub-dub, lub-dub, lub-dub.  Well mine was suddenly, lub-dub, lub-dub, lub……dub.  To be certain that my hypochondriac mind wasn’t playing tricks on me I put my fingers to my wrist; lub-dub, lub-dub, lub……dub.  Dammit!  In some respect heartbeats are kind of like the wife you take for granted.  You never really knew she was around doing all those great things for you until the old woman got fed up and left.  You mean I have to get my own dinner now?  It’s pretty much the same with heartbeats.  They don’t cross your mind at all until a few of them turn up missing.  We never really notice the heart except for that brief time lying in bed when its reassuring rhythm lulls us to sleep.  Well there are those other times like before you’re going to ask that special, she is so gorgeous girl out.  That’s when you feel your heart pounding like a pile driver and you almost think she must be hearing it as well.  At times like this it’s usually accompanied by that impending fart that forms about the time you begin talking to her.  It grows exponentially in your gut until you’ve reached the safety and solitude of your car where you can unleash the roaring monster.    

I gutted out the skipped beats for a few days before deciding that it was time to give my doctor a call.  I'd waited because the episodes were intermittent and of pretty short duration and I was hoping it would all go away.  There was that and the fear we all carry with us to such appointments that the doc is going to dispense a dose of really bad news.  Actually my doctor called me.  I’ve been on blood thinner lately to help dissolve the blood clot in my lung that developed after I broke my ankle the day before Mother’s Day.  Yeah, I know, I’ve kind of had this black cloud over my head for the last few months.  I often mull over what I did to kick start this bad karma.  The doctor wanted to discuss getting off the blood thinner.  “When can you come in?”

“As soon as possible please.”

“This afternoon?”

“Book it.”

Here’s what I like about doctors.  They walk into the exam room and the first thing that they say is, “How are you?”  What the hell.  Isn’t the purpose of this visit for you to tell me how I am?  Even when I’ve gone to emergency for a broken bone; “How are you?”  Well aside from the fact that my ankle is a deep purple and rivaling my thigh in terms of size I’m just great; moron.  I don’t actually say those things.  One philosophy that I subscribe to is, don’t piss off the doctor or dentist; at least until the procedure is done and they're safely beyond arm's distance.

My doctor walked into the exam room, “How are you?” Grrrr.  We discussed the blood thinner and then she asked if I had any questions.  “Well there is this little matter of skipped heartbeats.”  We discussed that for a while and she took a listen.  Nothing; no I don’t mean no heartbeat at all, just no skipped beats.  Of course; one truth about doctor’s visits is that the symptom goes away as soon as the doctor looks for it.  “Well I think you’re a head case.”  Doctor P. isn’t like that.  She suggested that I have PVC and would need to wear a “halter monitor” to determine just what was going on in there.  That’s another thing I like about doctors.  They talk doc speak.  They’re like Jaworski and Gruden on Monday Night Football who talk football speak.  I think they all do it to show us lay folk how ignorant we are.  Okay, PVC, polyvinyl chloride; something that they make sprinkler pipes out of.  Halter monitor suggested to me that I was going to wear something resembling equestrian gear.  When she was done speaking in tongues she translated the medical mumbo jumbo to English and cut to the chase.  I needed to see a cardiologist. 

Doc P. is cool.  She’s worked the labyrinth that is the Kaiser system to get me quick referrals without the usual wait, got me an MRI for my Achilles tendon when I was previously denied and she believes in non-traditional medicine.  She encouraged acupuncture for a shoulder injury contradicting an orthopedist with an itchy finger who wanted to pull the cortisone trigger. The acupuncture took care of the shoulder within a month thank you.  Doc P. answers emails evenings and weekends.  She puts tests that I need in the system and leaves them there for a year, nagging me every couple of months to go in and get them done.  She even called me once on a Friday evening after I was in the ER for a short stint to see how I was doing.  All of that and she is, to use my dad’s vernacular, hotter than a two dollar pistol.  No really, she is.  I had no idea when I hired her.  She walked into the exam room the first time and I thought she was a hot nurse fresh out of nursing school; do your mom and dad know you’re here pretending to be a doctor, I thought.  She wears the shortest of skirts that would never pass the appropriate test in most work places forcing me to look her straight in the eye during the visit.  Elevator eyes might piss her off and you know that rule about pissing off the doc.

The day after my visit with Doctor P. the symptoms were scaring the hell out of me so I carted myself to emergency.  Mention the words "chest," "pain" or "heart" to the ER receptionist and you get into the express lane to be seen.  I wonder what the penalty would be for telling the ER receptionist that I'm having chest pains when all I have is a sore throat.  You know, just to skip to the front of the line.  I imagine that would really piss off the doctor and I've mentioned a rule about pissing off doctors.  I'm on a bed wearing that ridiculous open in the back gown, an IV connection already in my arm and wired up to a monitor when the ER doctor walked in, a fellow named Moses.  Sizing me up a bit, Doctor Moses said, “How are you doing?”  A snappy answer rose up my craw but I choked it back down; “Don’t piss off…”  It was an encouraging sign that my doctor was Moses.  I suppose you can get higher up the Biblical hierarchy than Moses; you know Holy Ghost, Mary and Joseph but Moses must be there in upper management.  The plan was to keep me on the monitor to see what story it told and to run some blood tests; Vampira had already taken some vials and I suppose Igor was in the lab running the tests.  Three hours later I was discharged after the blood tests turned up negative and the monitor had no story to tell; head case.  An hour after I got home I had an email from Doctor P who had found out I was in the ER while I was still  in the ER and she was already busy lining up a cardiologist for me.  The next business day I was at the cardiologist.  I told you my doctor is cool.  And did I mention she’s hot too?  Yeah, yeah I’m a pig but point out a single person who doesn’t make note of beauty.

When Doctor D. walked into the exam room I noted that he is not hot.  But he is young, professional, courteous and seems to know his trade (this last is very important).  "How are you?”  Once again I admonished myself, “Don’t piss off the….”  He listened to my heart and noted the skipped beats removing that head case yoke I was starting to put on myself.  Well not entirely.  He noted that I’m a “type A.”  I reasoned from that conclusion that he’s been talking to my wife.  One of his first suggestions was to prescribe what he called “anti-anxiety” medications; doc. speak for tranks.  I had flashbacks to Brett Farve who developed a dependency to pain killers and my mom who had a similar dependency to “anti-anxiety” medications and so I demurred.  The doctor noted that an echocardiogram taken a few months back and all other indications were indicative of a strong, healthy heart.  He noted that the skipped beats were probably not a serious condition but a better idea of what was going on could be revealed by a “halter” monitor.  Once again I imagined equestrian gear.  Doc. D. dispatched me down the hall for a monitor.

The EKG lab wasn’t expecting me but a quick call to the cardiology department got me into the exam room where I was fitted for the monitor; five leads pasted to my chest connected to a little device similar to a pager and worn on the belt.  I was handed an instruction sheet for the Holter (Hole-Ter) monitor; okay, it’s a name not a description.  Twenty four hours later I turned in the monitor and the next day I received an email from Doctor D.  It said that my heart was skipping beats; no shit.  I knew that a week and a half ago and I didn’t need to be strapped to an infernal machine to find that out.

Doctor D. and I had a phone consultation the next day.  As things turned out the episodes of skipped beats were lessening as days passed, a story that the Holter monitor had verified.  The doc. noted that overnight there were 100 beats and the next morning about 50 beats.  I asked my allotted stupid question; “Is that skipped beats?”  As the words came from my mouth my mind was telling me, stupid question and I imagined the snappy comeback forming in the doctor’s mind. “No, you had one hundred beats all night long.”  He didn’t say that of course.  As it turns out he isn’t sure what is causing the skipped beats, is not concerned about it both short term and long and prescribed a beta blocker to take if I want when I’m symptomatic.  At this writing it's been a more than a couple of days since I've skipped a beat.  I think I'll stick to decaf and if I keep naming my Sunday posts "Sunday Coffee" you can call me a fraud.