So Long, My Toxic Friend

458980Yes, I know I’m a respiratory therapist. I had a reply for people who would point that out to me: “Haven’t you ever heard the phrase, ‘Do as I say, not as I do?'” Or I would tell them that, unlike my patients, my lungs were healthy and I was not in a hospital bed.

I’m not stupid. Perhaps one of my coworkers summed it up the best: “Andrea, you aren’t stupid. Far, far from it. You’re a very smart girl. You just aren’t being very wise by continuing to smoke.” So the part of me with a brain knew that I was being a hypocrite, knew that I could use the defense that I wasn’t laying in a hospital bed.

Not yet.

You’re probably judging me right now. And that is fine. I have been a smoker since I was 21 years old. I put down the cigarettes when it was required to grow healthy babies. I banished the habit to outside when juvenile lungs took up residence in my home. As a healthcare professional, I can tell you that I never bought the idea that the odor of smoke on clothes was as bad as breathing second-hand smoke any more than the mere odor of marijuana makes you high. If you are allergic to smoke, I can imagine that the residue can be an irritant, but for the average person? I just could not believe it.I was content to just go outside. If I was outside when the kids were outside playing, I would move far, far away. Both my kids and those of others. I never smoked in restaurants because I don’t like to taste smoke with my food. If I was outside smoking somewhere and someone came up to sit next to me, I would ask them if it bothered them and then I would move away if they said it did. I was a conscientious smoker. I made great strides to ensure that the only person I was hurting was myself.

The problem with this is that I lost my mother to smoking-related lung disease. She probably only thought she was hurting herself, too. Now there are two little boys who will never meet their mom’s mom.

I have tried to quit more times than I can count. I can feel the changes in my body. I am a respiratory therapist, for shit’s sake. I know. I know that I am most likely to the point of irreversible disease. I knew all along that, while I could not change that, I could halt the damage in its tracks. And so I tried. Patches. Gum. Lozenges, Tapes. Wellbutrin. I even tried those Nicotrol inhalers, thinking that would be the miracle since it also replaced the physical act of smoking. I’ve tried support groups and keeping journals, all the while feeling stupid that I was having this much trouble with giving up cigarettes. Not crack. Not crystal meth. Cigarettes. A few years ago, I did have some luck with quitting. I was one month into treatment with Chantix, and in the middle of pre-med. I thought it was the medicine that was making me so queasy, so I would skip it, waiting until I had a solid meal to take it. Problem was tat I never got solid meals. My meals consisted of grabbing a granola bar between classes and grilled cheese sandwiches from the hospital cafeteria in the middle of the night on my lunch break. I stopped the medicine and picked smoking back up. And then discovered I was pregnant with Zachary.

With the exception of pregnancy-related quitting, I would always have the same reaction to lack of nicotine. I wouldn’t just get irritable. I would literally go crazy. I could be sitting with you, having a benign conversation about the weather and just burst into tears. My tolerance for anything would be so low that I would become completely dysfunctional. Once time, I got so upset that I had found a speck of missed food on a supposedly clean plate that I threw said plate at John’s head, leaving a massive knot. His response, instead of having me arrested, was to recognize what the true problem was and go and buy me a pack of cigarettes. He returned to the house with the pack and a new lighter and ordered me to smoke. For this reason, quitting scares me. I have a successful education going. I am good at my job. I have two children I love more than anything. I cannot allow myself to fall apart.

On the other hand, John’s heart cannot take exposure to any second-hand smoke at all. I need to be around for him. For the kids. I have to give it another go.

They tell you that in order to be successful, you have to want to quit for yourself. Maybe I am sick in the head, but I am more likely to quit for John and the boys than I am to quit for myself. I love them so much that I will do anything to give them what they need in life.

So nine days ago, I started Chantix again. I smoked my last cigarette almost 72 hours ago.  I have not killed anyone. I am not suicidal. I have only cried a few times, and it was soft, subdued tears instead of violent, crazy-bitch sobbing that would have taken place during other quit attempts. For the first time ever, I really feel like I can do this.

I want to document the process. I am hoping this will add some accountability, but I don’t want to turn the blog into a smoking cessation website, either. I rather like talking about whatever the hell I want on here without a real theme. Instead, I’m going to create a new tab. If you want to follow along, feel free. Maybe someone will be helped. Who knows?

But wish me luck, because I am taking this on at the same time I am taking on major lifestyle changes for John’s heart. Wish me luck.

His Heart

I have been wanting to write this one, but yet find myself procrastinating. It’s sort of a difficult story to tell, one that has changed our lives.

John’s heart.

John’s heart holds within it memories of his grandparents, now all gone. Memories of his younger years, of Marine Corps boot camp and Camp Lejeune. The day we met, the day we said “I do”.The day Evan was born, his first steps, first words and everything since. Zachary. Me. Our hearts, our lives, are completely intertwined. I live in that heart as much as he lives within mine. Of course, we’re speaking of the metaphysical heart, not the one made of muscle and sinew. And after all of my years working in all things cardiopulmonary, one would think I could separate the two. I’ve had years of cardiopulmonary anatomy and physiology, pathophysiology, pharmacology. I hold certifications that say I know what to do if your heart were to stop beating. My coworkers and I function in this capacity daily.

But on June 7th, all of that experience, all of that education halfway went away while at the same time breaking my heart.

It started a couple of weeks before that. I noticed John breathing a certain way after carrying a small load of clean laundry into the living room to be folded. I asked him what was wrong, and at first he told me nothing was, completely forgetting that I am a respiratory therapist who makes a living recognizing and treating disordered breathing. He finally told me he was just out of shape. This exchange happened a couple more times throughout the course of the next couple of days. Then I caught him rubbing is chest along with the breathing. Again, I asked what was wrong. “Oh, nothing, Andrea. I’m just out of shape. My chest hurts just a little after climbing those stairs.”

Chest pain and dyspnea on exertion. Classic. I tried to get him to go to the ER. He wouldn’t citing the recent medical bills we had for Evan’s testing, which was astronomically expensive. But nothing I would say to him would convince him to go. I had to concede and just settle for an appointment with our family doctor. We went the next day. A stress test was scheduled for 2 days later, as well as some labs. The day after the test, the Saturday before Memorial Day, the third-year resident called me back to tell me his labs looked much improved. His A1C was done, is triglycerides were down. The stress test showed some minor changes that could just be anginal, so John was placed on nitrates. All seemed to be okay.

Four hours later, evening by this point, the same resident called back. She told me that something was just nagging her about the situation, that John has a personal history of diabetes and hypertension, and a strong family history of cardiac disease, that she would just feel better if a cardiologist saw John, just to be extra safe. It was a holiday weekend, so I had to wait until Tuesday to make the appointment, but when I called, the caller right before me had cancelled an appointment on the following day. John got in to see the cardiologist the next day, Wednesday. The cardiologist, for the same reasons, decided to do an angiogram, and asked permission right then to do stents if he found anything while he was in there. We were told it would be scheduled and they would call us that it would be the following week, since it was non-emergent.

They called later that day to ask if we could have John there on Friday morning, just 2 days from the appointment. Someone had rescheduled, leaving a hole in the schedule for John to take.

He had his heart catheterization on June 7th. His mom and sister had come into town to help me with Zach because John was going to be given some sedation and, if they found anything else while in there, they would need me to give consent as his next-of-kin.

I was so terrified. Heart caths are very routine. They do them all of the time. As an RT, I have been in on them many times. But the problem is that the ones I am called to are because the patient has coded. The worst case scenarios are literally all I have witnessed. So for my 38-year-old husband to be the patient, for me to know exactly what they are going to be doing to him and how they were going to be doing it…I was scared. Not of what they would find, but of the procedure itself. And then there was the whole weirdness factor. On the trackboard they have in the waiting area for family, it lists part of the last name and the age of the patient so you can tell where your loved one is in the process. John, 38. Everyone else? 68, 80, 72, 67. And back to John: 38. People in the waiting room were asking Zach if he was there to see his grandpa. A parent young enough to have a 3-year-old should not be going through that. Coworkers, seeing me in denim capris and fleece, were asking me what the hell I was doing there.

My husband. My heart.

John was back there, asleep on that table for over two and a half hours. At some point, his nurse came out to tell me that he was getting a stent, but she didn’t know where or how many.

I was at his side as soon as he came out. The cardiologist came out to explain to me. I wasn’t trying to be dramatic, but my knees almost buckled when I heard.

John’s right coronary artery was 95% blocked. His left anterior descending artery was blocked over 80%. There were 3 more blockages of smaller arteries on the posterior side of his heart that they estimated had been there for some time and they could do nothing about. The cardiologist said he had consulted another physician while Jon was on the table. Immediately upon him saying the name of the doctor, I started to cry. John, his mom, and his sister didn’t understand, but I did. The name belonged to one of our top cardiothoracic surgeons. He and the cardiologist were in agreement that open-heart surgery would be in John’s best interest, but they has started blood thinners 2 days prior to the cath as a prophylactic measure. Open-heart surgery would mean too much blood loss, disordered clotting. Normally, in these situations, they would put the patient in the hospital to be monitored while they stop the thinner and wait a few days for it to be out of the system before doing surgery. I just had a patient go through this this past weekend. The problem was, with the location and severity of two of the 5 blockages in John’s heart, taking him off of blood thinners and sitting on him until the following Monday could have resulted in his death. He would have coded while in the hospital. They had no choice: John got 2 stents while the two doctors hoped for the best and I nervously sat in a waiting room, wondering what was taking so long and completely oblivious.

I heard the doctor talking, and all I could hear was the What-If’s.

What if that third-year resident hadn’t acted on her hunch? If the cardiologist hadn’t had a cancellation? If the cath lab made him wait until the following week to schedule? Those 2 major vessels could have completely blocked at any moment, depriving his myocardium of oxygenated blood. And the location of the blockages would have basically cut off almost all of his heart. He would have died. I could have done CPR. But I don’t think I could have kept him from death. I doubt that, had he coded in the hospital with the entire team present with our equipment, he could have been kept alive. It was that bad.

John's right coronary artery was blocked 95% and his left anterior descending artery (a branch of the left coronary artery) was blocked over 80%.

John’s right coronary artery was blocked 95% and his left anterior descending artery (a branch of the left coronary artery) was blocked over 80%.

What if I wasn’t with him? If he were out driving the kids somewhere?

What if I lost my husband?

We are in our thirties. We are too young. And I realized a lot. First of all, I can do none of this without him. And I wouldn’t want to, even if I could. After all of these years, he is where I belong. The degrees, the plans I have made, the life I have tried to build–without John, there is no point. And the boys. What would become of these two little boys without their daddy?

All of this, everything I have just said, is what went through my mind in the blink it took the cardiologist to explain. And with that, it was all over. He was being admitted. I could not allow myself to leave his side. The next day, we were sent home. We weren’t really told how to live with this information. We weren’t told how to process the concept that the only thing keeping my husband alive is two very tiny (albeit expensive and high-tech) pieces of metal mesh.

stents

 

We weren’t told how to live life, how to get the most out of life. Yeah, plenty of couples go through this, but not at this age. They don’t have this much left of their lives together to live.  So we are doing all we can. Low-fat diets, with no saturated fat, no trans-fat, and very little unsaturated fat. Whole grains, fresh veggies and fruits, low sodium. Exercise. John is going through cardiac rehabilitation 3 days per week. To minimize the risk of re-stenosis of those vessels, John will likely be on blood thinners for a long, long time. Plus a beta-blocker, a statin, and a full-size aspirin daily. I remember the cardiologist telling us that John will eventually need open-heart surgery, but I can’t remember any more. His follow-up is tomorrow, so I will get more information then.

We are doing the best we can with what we have. Instead of gradual lifestyle changes, we’ve had to make massive ones because John’s life literally depends on it.

We have to protect his heart. Within his heart is all that I hold dear in this life.

What I Said I Would Never Do and Then Did Anyway

Kid-With-Cell-PhoneKids and cellphones. It drives me crazy. I work with someone who literally bought their two-year-old an iPhone. No, I’m not kidding. I am being completely serious. I didn’t have a cell until a couple of years ago. It just wasn’t a need of mine. When it became a need, I went and got one. But a little kid? Call me crazy, but when you are too young to be left alone for a second, when you are chauffeured around to every destination, go no places on your own, you have no need to be reachable at all hours and in any locale. And besides,  the only person who should need that type of contact with you at that age had better be a parent, and aren’t you with one of them?

Read: “No, Evan, you CANNOT have a cell phone!”

I did, however, let him have a Facebook account and email, with the password known to me and the username set as the email address, so every stinkin’ time he gets a like, a comment, a message, a friend request, I know about it. It’s a pain for me, as my phone vibrates non-stop almost, but it is necessary to keep him safe from himself and from others who prey on kids. And as a result of these other internet uses, he inherited an old smartphone of ours that no longer has service. He could still use the wi-fi functionality at home to email his new friends. (A long story that will have to be told at another time.)

So this has been going on for some time now. Fast forward to now. Well, to a couple of days ago. He is currently at his grandfather’s house for his annual summer visit, when he gets to fly planes and boat and jet-ski to his heart’s content. See evidence here:evan fliesSo this past Saturday, he calls. John answers the phone. I can hear the worry in John’s voice. He’s asking what is wrong. Then I see John roll his eyes, say, “Oh my God, talk to your mother!” as he thrusts the phone at me. Evan is completely hysterical. I can barely understand him. I get him calmed down and then it starts to become clearer: the phone he was using–my old one–finally bit the dust. He is 4 hours away. He cannot email his friends or anything, and he is going to be down there for awhile due to some health issues John is having. (Oh my GOD, that makes it sound like John has the plague–he doesn’t. You’ll understand later.) I assure him we will find a solution, hang up the phone and go to work on this little issue.

I could do any of the following:

A. An iPod Touch. It has wi-fi and messaging capabilities. Maybe Grandpa could take Evan to get one and I could reimburse him. Nope, they’re too expensive, so I can’t ask someone to do that for us.

B. Send Grandpa to get Evan a cheap pre-paid cell and reimburse him for that. Ehhh. Wouldn’t that give Evan a long-distance phone number?

C. Call our cell carrier and see if they can sell me a cheap smartphone to have shipped down there to Evan. Hmmmm. And that is when it happened.

They tell me that I have a family plan, and that if I add a line, they are giving away free iPhone 4S’s.

Shit.

And that, since we have unlimited talk and text, Evan could call and text however much he liked and it wouldn’t run up our bill.

Double Shit.

And that they have this service called Smart Limits that allows us, as his parents, to limit what he is allowed to do on his line. For example, he would only be able to make purchases with a credit card and not simply by billing to the cell bill. We could limit who he calls, who calls him, how much data he can use (the other sure-fire way for me to one day get a $800 cell bill in the mail!).

Triple Shit. Evan got a cell phone. 

An iPhone at that. Which may have been free to me, but is still a $500 phone. And I don’t think it was a bad decision. He’s starting middle school in the fall. He’s still a little awkward, but he’s blossoming socially. He’s making friends. Just before he left, he was outside playing with some friends and lost track of time because nobody wears a watch anymore and none of the kids had phones. He’s getting to the age where he will be old enough to drop off at the mall to hang with friends or be permitted to have a house key and let himself  in after school. Not quite yet, but soon. It was time.

Of course, he could completely make a fool out of me. I wired money down to him with orders that, as soon as the phone arrives, he is to take it the local AT&T store and buy an OtterBox for the damned thing. This will minimize the chance that it will be destroyed on accident. Given how badly he has begged me for this for a couple of years, it isn’t likely that he will destroy it on purpose. And the smart peeps at the phone company have limited his ability to drive me to financial ruin with the thing. So I have moved forward with calculated risk.

And besides, he is growing. How is he going to prove he can be responsible without the opportunity to prove it?

The Smallest One

393096_10201215393853547_1875360026_nZachary is three whole years old. This happened last month. Remember how he wouldn’t talk? Well, now he doesn’t stop. And it amazes me to hear what he has to say. All of that time he was silent, he was absorbing so much so that now that he is completely verbal, he can show us that he was learning all along. He was listening.

Yesterday, while going to eat at a local restaurant, we were occupying him with some coloring while we waited on our food to come to the table. He asked for a crayon I was holding. I reached out to hand him the one in my hand. “Not that one, Mommy. The blue one!” He was pointing to the blue crayon laying on the table, but John and I had the same reaction: to stare, mouths agape, at this kid. As if to say, “When did he learn his colors???” Well, of course he learned colors because, from the time he was about 3 or 4 months old, I have included the color of everything in my sentences. “Here’s your cup, Zachy. The cup is red!”, or “Look at that tree’s green  leaves!”

And he learned empathy and how to be concerned for others. You could try this one for yourself. All you have to do is act like you have hurt yourself–stub a toe, get a papercut–and he drops what he is doing, stops in his tracks, to come to you and look at you with with those big green eyes and ask if you are okay. It is so cute that, I must admit, I have said “Ouch!” on more than one occasion just to see him in action.

I’m trying to convey how much he has grown and I am struggling here. He is just his own little person. I could spend all day just watching him. He has his own tastes and preferences, sense of humor, ways of doing things. The wobble of toddlerhood has been replaced with confident running, jumping, climbing, playing. For his third birthday, his little green tricycle was replaced with a green bicycle.

The shadows of dimples that were once there on his little cheeks have been replaced with real dimples. We knew they were there. 253495_10201210419249185_1369711929_nWhere Evan was always temperamental and a little introverted, Zach is the opposite. He is rambunctious. A true boys’s boy. He says “Hi” and “Bye” to everyone he sees, which can make leaving a grocery store or any other outing quite the experience. (Oh, there’s a bag boy 5 checkout lanes to whom we didn’t say goodbye! Let’s take care of that now!) When he hear’s a song on the radio he likes, he has complete confidence to just belt it out. Our current favorite is this:

*Note that the radio plays the edited version and since Zach associates all bridges with crossing the Ohio River, his version involves crashing a car into the river, not a bridge. But it is still hilarious to hear him sing it.

And yes, he’s starting preschool in August. And it breaks my heart because it has gone so quickly.

My Return to Blogging: Testing, Testing…

Hi.

I think it’s been so long that I forgot how to do this. I’ve had tunnel vision, trying to keep my family alive and well while the throes of grad school give me some good lashes across the backside and work is, well, work.

Zach turned 3. And will be starting preschool in the fall.

Evan will be 12 in a couple of months. And will be starting middle in school in the fall. I’ve done what I said I would never do, but more on that at another time.

I am down to the last 6 months of my MBA program and got some pretty heavy props from the school-stay tuned for that one, too. Oh, and I finally met my academic match. God, I sound like a conceited snob when I say that, but it’s true. I found the subject that is my kryptonite.

And then there was the day I almost lost John. I think I may be able to finally write about that now, too.

I know there’s probably not a single one of my readers left. That makes me sad. But I’m writing for me now, which is how I started blogging in the beginning. Let me know if you’re out there.