Winter Solstice, 2008

As many of you know -- but others do not -- I have a bi-ventricular pacemaker / implanted cardio defibrillator (ICD for short). I've been suffering from congestive heart failure for several years and, a bit over three years ago, I woke up on the floor one evening -- functionally only minimally coherent after an episode of tachycardia -- and this resulting in my original pacemaker being replaced with the dual ICD.

Since then, on two occasions, the ICD choose to "zap" me -- kind of an emergency restart for the heart ... but also (literally) quite shocking. The feeling is very much like touching a livewire ... entirely too much like touching a livewire (feel free to try for yourself if you're really curious ... NOT). The first occasion was a few weeks after the ICD was implanted and it occurred while I was shopping for a winter coat ... and just as I was reaching for a coat.

That was enough to make me feel weak, disoriented and ... a little scared too. I had felt nothing before the shock, no dizziness, weakness, etc ... just the sudden zap.

I found a phone and called the clinic for instructions. Their response -- oddly reassuring -- was to just rest for a moment (or whatever) and then drive home (the clinic was much closer) and use my remote monitor to transmit a report (basically a massive data dump since the pacemaker/ICD is very sophisticated computer/recorder) to the central monitoring facility. I did so, I had a follow up phone call by my cardiologist and the conclusion was that, okay, I'd had a short run of tachycardia and the ICD had worked exactly as it was suppose to.

Now, fast forward a bit over three years (with no incidents in that period). One afternoon, earlier this month, I had walked up the driveway (fairly steep) carrying an empty trash can, came inside, sat down ... and found myself passing out. Then ... ZAP! Wakeup call ... with emphasis!

And, per instructions, I sent a data dump and followed up with a phone conversation with my cardiologist but, otherwise, it was really nothing of importance. (At this point, I'm living in Washington and I have a new cardiologist, Dr. Cynthia Dougherty or just Cindy, who, by all reports, is a very good doctor and superb cardiologist. I'm told to consider myself fortunate.)

So, earlier this week ... actually Sunday, a week ago ... while I was walking Reba along a snowy path (really no particular exertion or stress -- just a very pretty walk) I got another zap. Sudden, no warning, etc.

I came home, did a data dump, sent an email to Cindy, felt uncomfortable, finally called 911 (the roads weren't good and I try not to be stupid) and took a trip to the hospital for a blood workup (nothing unusual), medical check out, etc and then had a follow up from Cindy the next morning (I was back home). Conclusion: don't worry about it but, as a precaution, double my carvedilol from 12.5mg to 25mg. Okay, fine.

Tuesday ... roads have cleared, I have a couple of errands, went to pick up a friend ... and got zapped!

This time, aside from a heartfelt curse or two, I decided to ignore it until later. Went on with my errands, sent a data dump when I got home, emailed Cindy and advanced a theory that had occurred to me (static electricity as a trigger) and ignored it.

Next morning (Wednesday), another call, records showed some runs of tachycardia, change my amiodarone from 200mg to 600mg, with an extra 600mg right then. (Oh, yes, the static electricity theory isn't a totally ridiculous thought, I was told, but I could dismiss that one. And I have been staying away from high wattage transmitters, yes? Yes!)

So, it's snowing, the roads are getting bad, no, I'm not anxious to go anywhere ... wait for the weather to improve and we're arrange a physical follow up then.

Until later that day when I set out in the Jimmy (4WD, studded tires) to take a can of propane to a neighbor ... and, this time, I get zapped ... twice. Less than a minute between them.

Turn around, go home, data dump, email, rest ... and worry a bit as well. This is getting tiring.

Thursday, roads are definitely hazardous, Cindy emails while I'm still asleep, then wakes me up a bit after nine with a phone call. First, the weather has shut down Seattle, Cindy can't even get to the hospital, she's working remotely from home. Second, what are the conditions on my side of the Sound? (Lousy.) Third, is there any way that I can get to any hospital? (Yes, either PT or Harrison -- call 911 and they'll get me there.)

Harrison, Cindy advises, since they have a better cardiology setup. And then the VA will collect me there as soon as the roads are a bit more passable.

The ambulance shows up -- Mary called Larry R. first to alert him and Mo and then called 911 to make it official. (The paramedics and firefighters here are personal friends and neighbors -- makes a difference.)

They load me up for the run, attach monitors and we're off ... slowly. The roads are not good at all. And, while we're underway, Mo warns me that it was looking like I might get another zap ... which I don't want so I immediately try to steady my heartbeat (see my notes about tachycardia and stunt yoga) and, happily, avoided this one.

So, a couple of hours later, I'm in the ER at Silverdale's Harrison, connected to a remote monitor and being poked and prodded at regular intervals by a bevy of attractive young ladies (well, younger than me) ... but I'd still rather be home with Mary, Smoky and Reba.

About six hours after that, another ambulance takes me from Silverdale to Harrison at Bremerton, sees me installed in the Progressive Care ward and, with about 45 minutes to spare, I'm allowed to order dinner. Yeah, I'm really hungry at this point -- juice is nice but some solid food is nicer.

So, that's two ambulances for Thursday, my second hospital and I'm finally fed and allowed to get some sleep ... off and on, anyway.

Friday, meet another cardiologist, give him another data dump, talk about my history, eat lunch, sleep a bit ... eat an early dinner ... word is that the VA's sending an ambulance, should be there around 7'ish ... if I'd like some supper, go ahead and order before the kitchen closes at 7:00 -- second dinner ... ambulance ride (long way around, through Tacoma, instead of the ferry -- matter of timing and a bit faster this way ... and they don't seem to think the remaining snow is a big factor).

So late Friday evening, I'm looking down on the lights of Seattle (actually quite pretty, especially with the snow). Another cardiologist drops in and spends some time ... but I'll meet his boss in the morning. In the mean time, rest (actually, that was attractive despite having been in bed all day already).

Biggest concern (cardio aside): there's 6-24 inches of snow predicted for Saturday evening and the biggest snowfall is predicted for ... yeah, want to guess? ... the Hood Canal and Dabob/Quilcene. That means us. I'm not really anxious for a long stay at Seattle but I may not have a choice.

Saturday morning, bright and early (and it is bright outside), two cardiologists are standing outside my door -- the doctor from the night before and his boss -- with the senior physician getting a detailed update on my history/status while a couple of nurses are getting my vitals, a phlebotomist is tapping me for blood ... and breakfast is being served.

I've had no more serious episodes since Wednesday so, a couple of hours later, the conclusion is that they'll let me go home if 1) they can get a rep from Medtronics (mfrs for my implant) to do a little reprogramming and 2) I can get there safely. Otherwise, it could be next week -- maybe -- before I could get home.

Well, the snow isn't expected until evening so it's all a matter of timing and, happily, the Medtronics rep shows up pretty quickly (the small world of cardiology; turns out that he knows my original surgeon down at the SF VA, ask him to pass along a hello, then get down to business). The basic thing here is that when the ICD senses a V-tach episode, it begins by trying to resync (a soft reset). If that doesn't work, then it does a hard reset (and zaps me).

The change in programming is for the ICD to try a soft reset three times before zapping me.

Now, I have to wait for someone from Pharmacy to go over the prescription changes with me (never mind that I've already researched them ... on the web, of course ... I'm not objecting to receiving careful and complete information), then pick up my new prescriptions, have a taxi ordered up, get to the ferry dock ... and Larry R will meet me at the other end. His decision; the roads are too bad for Mary to be out (even with 4WD and studded tires) and he'd hauled me in so he'd haul me back again (good neighbors are a treasure beyond price.)

And, a bit after 7 (and it's snowing, of course), Larry R delivers me home to hot, homemade soup (my choice of Tom Ka Gai or Bitter Melon/Mustard Green -- a tough choice) and then some real dinner ... and it's snowing outside ... and Mary's been keeping the hot tub warm ... until we find out that the snowload has collapsed the canopy (a permanent roof is next summer's project, I hope ... strength and health permitting) so we'll try to uncover it tomorrow (or, more likely, Mary will.) We have a replacement canopy (they're very inexpensive) in storage so ... maybe we'll put it up, maybe we'll wait.

There's a hot tub under here ... somewhere. The remote thermometer says that it's warm ... but it's also out of reach ... at least for the moment.

Later, here's Reba helping Mary clear the hot tub canopy. To her, it's all simply a wonderful game ... and, being half-lab, she'll be like that for years to come. I mentioned this shot to Mary and, according to her, Reba actually was providing assistance -- intentionally or otherwise.

Here's the accumulation on the roof of the Jimmy -- six inches of moderately wet powder. (See the magnified inset at right.) By Christmas Eve ... the snow load was double this ... but should begin thawing in the next few days.

Smokey manages the weather pretty well. (He's outside because he wants to be -- he comes and goes as he wishes.) His roof (above) is showing more like eight inches accumulated ... and still coming down so no telling what the final will be.

And, out front, the accumulation on my sign.

Looking up the drive. (That's Reba at the lower left.)

Reba seems to be enjoying this more than I am -- she's certainly bouncing through it readily enough. The snow's not too deep right here but it's belly-deep for her elsewhere ... and I'm sure she's glad I have her new (all weather) dog door installed.
One comment about the color in these photos. What I'm seeing without the camera is simply white on white (see Smokey's photo above), no blue tints at all. The blue is an artifact of the digital camera. Last, just to show you how lovely it is here ...

Finally, if I haven't already -- or if I have -- I want to wish all of my friends and visitors a very Happy Solstice, Merry Christmas, Happy Hanukah, Merry Qanza or other holiday of your choice as appropriate to the season.