Wit and Wisdom
by Beth Broderick
“The AV Heart Block is still there.”
The new heart specialist was reading my EKG.
“Still first degree, I hope?”, I asked
“Yes. No change from the last report with us. The chart says you were here three years ago.”
“Sounds about right. The Rheumatology folks are always asking me to come back here, just to be certain that the medication I take is not causing any problems. I never had the AV block thing until I took Humira for a year. That stuff put the whuppin’ on me.”
She smiled. I liked her instantly. I had to switch because my former doctor at the Pacific Heart Institute is “concierge” now, which is annoying. (What about the American health care system is not?) It costs thousands of dollars per year just to be seen by her. We have to join a club now to get care. My Rheumatology office charges an annual fee before they will agree to treat you, and if you have a disease like Psoriatic Arthritis, believe me you are going to pay it. Thankfully this woman, Dr. Cazzulino, still sees patients the old-fashioned way … because they have an appointment.
“Any questions for me?” she asked.
“As a matter of fact, there is something I really do want to talk about.”
She nodded, somber and attentive.
“This hole-in-my-heart deal,” I said.
“The septal defect … CHD,” she said reflexively.
“It occurs mostly in women, correct?”
“Yes, that’s right.”
“Okay, so here is why that is interesting to me. I have been told repeatedly that no one treats this anymore for some reason and here’s the thing: I now know three different individuals with the same condition who have undergone surgery, just–you know–for the routine stuff. Knee replacement, etc., regular old-person stuff. And all three had a stroke afterward because of the hole or CHD or whatever. So, is non-treatment the medical equivalent of the raft? You know how, in tribal days, when a woman was considered past her use-by date, they would just put her on a raft and send her down the river? Have y’all just decided that if I stroke out at 70 because my hip hurt and it turns out I needed a new one … you’re good with that? We septal-defect broads will have worn out our welcome at that point, so who cares? Is that the deal?”
She tilted her head to one side. It was clear that no one had ever asked her that before, and the question gave her pause. She straightened her hair.
“Well, people your age …” She glanced at the chart.
“67,” I said.
“Yes. 67. We feel there are a lot of reasons you could have a stroke at that point.”
“Three.” I held up my three fingers on my hand for emphasis. “I know three women with the condition who have now had a stroke. That seems to point rather directly to the HOLE. Fried chicken and sodium and stress notwithstanding, the evidence indicates that there is reason to suspect the HOLE played a large part.”
“Well, I see your point, but there are risks to repairing the hole as well, so there is that to consider.”
She was a bit uncomfortable. It seemed like she was making a note to have a better answer next time.
“I am good with the crippling disease and the brain farts and the jowly bits and the shitty hair part of getting older, but I do not cotton to the notion of a stroke. That is no bueno.”
She laughed and rearranged the bangs on her forehead. “Have you ever had a CT scan?”
“I have no idea. People have poked around in there, that’s how we know about the MVP and the CHD and the AV thing.”
“Well, it’s probably time we take a look. I am going to send you to Tower Imaging and then we will run some more tests here and follow up. Sound good?”
“Yeah, okay.”
IT’S IN THE BLOOD.
I was not always proactive about my health. That sort of thing does not run in my family. Both my parents were in the medical profession. My mother was a nurse, Dad a hospital administrator. They were neither one keen on doctor visits.
My mom smoked two to three packs a day and had a very impressive drinking career. When her throat started bothering her, she soothed it by rotating a menthol cigarette in between the regular Benson and Hedges she adored. When she finally got it checked, she was shocked to hear about the cancer. Had not seen that coming.
We buried her with a bottle of scotch, a carton of cigarettes, three crossword puzzle books and a People magazine.
Dad was so certain that he would outlive his MUCH younger wife that he opted to have his pension end upon his death, so that they could draw more in the interim. He was 1) male, and 2) giant. Two accidents of fate which generally point to a shorter life span. It just never occurred to him that he might die, much less go first, which he of course did, but to be fair to his assessment he had a good long run. Made it to 93.
He refused to be buried and would not hear of a funeral. He had no intention of dying and no desire to broach the topic. He is in an urn on my brother’s mantel. His wife, who did in fact outlive him, and is still going strong, did not want his ashes, so Ben took them. No one knew what else to do with him.
I am still not great at doing the check-ups and the scans and colonoscopies and all of the preventive measures we are supposed to take to guard our health. I get to it, but these things are not top of mind. I only do it so that if, by chance, I die of one of the things we are all constantly scanning and x-raying and “oscopy-ing” for, people cannot whisper:
“Well, she NEVER did the testing and now she’s a goner.
Just goes to show you.”
I still let things go until I cannot take it anymore. I have, for the last 6 months, been stuffy and sneezy and congested and felt punk. I coped with this by eating my weight in chewable Children’s Zyrtec tablets. When I finally went to an ENT, the nice doctor did a scan, said I have a sinus infection, loaded me up with medicines and treatments and as a result I felt better in three days than I have in months. I would say “lesson learned,” but that is highly doubtful.
I am not the most health-mindful person in many ways, but the septal defect / stroke thing gives me pause. I just don’t like the sound of that, and I find it suspect that the (mostly) women who have it are not treated for it. I smell a raft.
I exercise and eat right, have low blood pressure and have good “good” cholesterol, which I don’t care who says good is bad now, my good is good and that is that. I am doing my best to live a long, healthy life, but we never know what is lurking inside these vessels we inhabit. Our bodies are built to break down; our lives meant to come to an end.
My parents’ approach was to simply deny the whole possibility of dying until it became imminent and then they made what I consider a graceful exit. Mom stopped eating and waited patiently for death, which she trusted would come quickly, and it did. The day before he left, Dad winked at his nurse–“You know, Meghan I think this thing has finally caught up with me” –then succumbed just hours later.
We humans are not great at planning ahead. Scientists believe that this is why we as a species cannot seem to address climate change. Whilst knowing that we are in the midst of a terrible drought, we will tell ourselves that the rain last Tuesday means we are ok. We lack the ability to grasp the future we face even when there is ample evidence as to the dire outcome it may entail. That is not great news, but when it comes to living and dying, there is a big upside to denial.
I am going to run these tests and then give up worrying about the whole hole thing. What if they fix the damned thing and I die from the anesthesia during a colonoscopy shortly thereafter? I’d hate to prove their point.
Maybe it is a good thing that De Nile “ain’t just a river in Egypt.” We all need a little of it sometimes and how lucky am I that it runs in the family?
Just gonna go ahead and get me that raft and float right on down.
On we go …
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