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Janie Albright (Blank)

Mike, we are all rats having been born in the year 1948. Maybe not the special street rat variety like Jack...

Michael McLeod

Janie:

It's an inside joke and I should have explained it.

Jack was one of a small group of guys from our class who got caught, one night, stealing sweatshirts out of a tent at the Ohio State Fair. The sweatshirts had a picture of a crazy guy driving a souped-up car. Underneath the cartoon image was a caption that read: "street rat."

The highway patrol caught us and kicked us out - we were quite lucky they didn't charge us.

And we wound up with a story to tell and an inside joke about being "street rats."

Which, looking back, was a pretty good descriptor of us.

Janie Albright (Blank)

Dave, hopefully Fred will remember the name of the restaurant! 

Jim, you were mainly addressing afib. I was diagnosed in 1981 at age 33 with multi focal ventricular arrhythmia. I ve had an ICD (defibrillator/pacemaker for those fortunate enough not having a need to know this) since 2000. I'm on my fourth and hopefully it (and I) will last a couple of more years and then I will get the newer 3 lead device. I am paced almost 100% of the time so of course HF is in my future. But right now I am hanging in there with an EF of about 48% and swim an hour at a time a minimum of 3 x a week, walk 10k steps a day and close all the rings on my Apple Watch most days.  For those of you who know I don't drive much this is why. For quite a long time I didn't drive at all but I am better regulated these days so drive short distance but never fast or on the highway. 

Larry, with heart month coming up I thought it would be nice to use on our home page the lovely art work you posted if that's ok with you. No offense Jim, but I think it is probably better than the anamtomy heart you used in your excellent lesson. Lol.
Hey girlfriends, this is not an exclusive gentleman's club. Feel free to join me with an occasional post. 

James Hamilton, M. D.

Thanks to all who are sharing your cardiac stories as they have helped illustrate some of the things that I wrote in my posts.

Janie,  unlike atrial dysrhythmias ventricular ones are the kind that often need ICD therapy. Combined with a pacer function this seems to have served you well. The 3-lead pacer you mentioned is one of the latest in a series of advances for HF patients. Also known as Cardiac Resynchronization Therapy (CRT) these devices are designed to pace the atria and then pace both ventricles simultaneously thus increasing the EF. I suspect that will push your EF into the normal range. Advances in this technology just keep coming and who knows what the future holds!

And, yes, Larry's art beats my anatomic cartoons anytime! 

Jim 

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David Mitchell

First of all, we need to come clean and realize that Jim's so called text book illustrations of the heart are really just "fake news". Larry's artistic rendering of the heart is a far more accurate rendtion. Agreed?

Okay, then let's move on. I would like to ask Herr Proffesor Hamilton if the next class session will be about respiratory issues? If so I can add my contribution about Sarcoidosis. Uhh, the human kind, not the street rat version.

Or, should we try "Sleep Disorders" for $300, Alex?  

p.s. Yes Janie, last time I checked, I thought we allowed females on this Forum.

Mary Ann Nolan (Thomas)

Jim, I too am a heart patient with CHF. I developed heart failure as a result of the high doses of chemotherapy and radiation  I received for breast cancer. One of my heart muscles was compromised and my EF is now only 30%. 
This showed up 20 years after my cancer diagnosis which I understand is not uncommon. At the same time I developed lymphedema in my arm. There were 29 out of 30 lymph nodes removed. I also had a Biotronix ICD implanted in 2013 which at the time was state of the art. I am remotely monitored and have not had an event to date. Unfortunately I will never be able to have an MRI because the metal in my heart would heat up and my heart would burn up. Fortunately do to medical advancements they are now making ICDs out of non metal leads going into the heart. With all this being I went on a mission to take care of the heart  muscle I have left. I exercise five days a week plus yoga and meditation almost everyday. I am particularly aware  of what I eat and my weight. I have low cholesterol and low blood pressure.My heart surgeon now calls me his poster patient and shakes his head in disbelief evertime I see him. He told me that most patients he sees with the same EF as mine can't get off the couch! I am also on a a new drug called Entresto for EF  that has been life changing. I truly believe that we must participate in taking  care of our health, medicine can't do it a all.❤️❤️❤️❤️❤️❤️😍

David Mitchell

Mary Ann,

You left out the part about your rowing, and the annual rowing event you raise funds with every year. I think they would enjoy that information.

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John,

Please understand that Mary Ann and I both live in Beaufort County in the state of South Cackalatchie. In fact, Mary Ann actually lives in the town of Beaufort (film location of "The Big Chill", "The Great Santini", "Full Metal Jacket", "Prince of Tides" - actualy about Bluffton - and othrs). We here, are not permitted to use words like "scatological". 

In future, kindly show some respect to those of us who are still fighting the Civil War - NOT! 

Now ifin ya'll wanna talk about "Shreeimp", "Crayabs", or "Ohystas", then we can go there. 

Mary Margaret Clark (Schultheis)

Jack, Bill, Janie and Mary Ann......Thank you for sharing your heart health battles with all of us.....your stories are truly inspiring.  Thank you Mike for the question about the heart which prompted this sharing and discussion, and thank you Jim for providing the valuable medical information.  Medical miracles are happening every day.  My younger brother had an oncology follow-up in June having passed his five year cancer survival marker for stage 3 colon cancer.  After his routine CT scan, he was informed that a suspicious nodule was found in the soft tissue of his pelvic region, so close to an artery that they feared attempting a biopsy would nick the artery and he could bleed to death.  They suggested that he wait 3 months to do another scan to see if it had grown.  Tough news to just sit on, but what else could be done?  When he went back in September, another scan showed that it had in fact grown slightly and blood work showed his CEA levels (tumor markers) were elevated.  His colon surgeon, in consultation with his oncologist and radiologist, determined that surgery presented too many life-changing scenarios as the tumor, in addition to be positioned near an artery, was also  extremely close to the colon and the bladder.  Therefore, he underwent an intense 2 week radiation therapy targeting the tumor, and just this past week had another CT scan and blood work.  His CEA levels have gone back to normal and the CT scan was clear!  Of course, he must now go back to every 3 month onocology visits, but as he said to the radiologist, that is a small price to pay for another victory over cancer. 

I might also add that a my son-in-law's mother, who is a very devout woman, gave my brother some St, Padre Pio oil and told him to place the oil directly on the site where the radiation was to be targeted each time he went in for his treatment.  Prayers and modern medicine.......a dynamic duo!!   

James Hamilton, M. D.

Mary Ann,

I am totally in agreement that medicine can't do it all and you are an excellent example of that. Living a healthy lifestyle is very important in helping not only to prevent problems, but also to treat them when they occur.

Entresto is one of the newest drugs for HFrEF (heart failure with reduced ejection fraction) and has made a great leap in it's medical management. It is actually a combination of two medicines: valsartin, an angiotensin receptor blocker (ARB) which has been on the market for a long time for hypertension (I take it for that) and HF, and sacubitril, a neprolysin inhibitor which blocks an enzyme that is involved in generating vasoactive substances that would increase the pressure against which the heart must pump.

Some implantable electrical devices (hey, I think I just discovered a new use for the abbreviation "IED") as I mentioned above can also increase the EF as well as control the rate and rhythm. Many of these, indeed, are a contraindication for MRI but that is beginning to change as you said.

In the early 1900's William Osler, the "Father of Internal Medicine" once quipped that it is impossible to improve on the assymptomatic patient. Dr. Osler was obviously not an invasive cardiologist! That being said, it appears you are doing quite well with your EF of 30% on your current regimen. In the future, resynchronization therapy may also be a useful tool. That will be a matter between you and your providers.

And, MM, I do believe in the power of prayer and faith. There was actually a scientific study done about 30 years ago on patient outcomes who, in addition to medical therapy, prayed compared with those who didn't. The ones who used prayer did better.

Keep active and best wishes,

Jim

Michael McLeod

Dave I am glad you brought up an issue about Jim's pictures of the heart that might have gone unnoticed and I just want to add that the left ventricle of the heart in the picture is so much more intelligent looking than the right ventricle. Which is usually the case.

John Jackson

Mike,  I enjoyed the article on Riley, but how could it not mention “When the Frost Is on the Punkin”?  And the omission of that masterpiece of folksiness “Does Your Chewing Gum Lose Its Flavor On the Bedpost Overnight” is truly hard to fathom.

Getting back to affairs of the heart, I’ve decided to tell my (pretty tame) story.  About six years ago, I started to have occasional bouts of arrhythmia/atrial fibrillation lasting anywhere from 10 minutes to 6-8 hours.  I’d have a few incidents each week for 5-6 weeks and then I’d go 4-5 months before I’d have another cluster. This condition is called “paroxysmal atrial fibrillation”.  I  made a point to increase my physical activity (when I wasn’t fibrillating) and I’ve been fine for the last few years. But I have to say how unwell I felt during these incidents – it’s very disconcerting when you can feel your heart beating irregularly and I was really "low energy" (don’t report that to Trump!) – out of breath and lightheaded after going up a flight of stairs with, as Jim tells us, my heart beating at only 80% efficiency.

But I have to say I was overwhelmed with a profound sense of wussiness after reading about Janie and Mary Ann getting on with their lives at less than 50% efficiency, pretty much all the time.  Even leaving childbirth out of this discussion, do we need any more evidence about which is the stronger sex?

John Maxwell

Michael McLeod

Interestingly enough, that's exactly what Jack said when he broke down like a wuss as the big mean highway patrol guys interrogated him.

Me - I was gansta then and gansta now. Or as James Whitcolm Riley would put it, I was "rough as a cob."

Utmost respect any sympathy to those of you who are wrestling with heart issues. I'm nearing the age when my father died of heart failure after open heart surgery. Have been lucky so far, genetically and otherwise - "otherwise" being advances in preventative medications that would likely have given him a few more years, had they been available back then.

Mary Margaret Clark (Schultheis)

Eternal rest grant unto him, O Lord, and may the perpetual light shine upon him.  May his soul and the soul of all of the faithful departed, rest in peace. Amen.  

https://churchpop.com/2015/12/26/how-kobe-bryants-catholic-faith-pulled-him-through-his-darkest-hour/?fbclid=IwAR1VLIzkavcMEbD6ytkoK9OyrnEuV_uiRsSQkiYMHfeSLJUQouE9yc3ITRg

David Mitchell

In a world gone crazy with blame, division, and disrespect... 

I just came home a little over an hour ago and saw the shocking news about Kobe.

Ironically, I had been in attendance for a "Celebration of Life" after the funeral of one of Bluffton's most interesting characters. He owned Morris Garage, a car repair shop with a real flare for the unusual. He was a very large man of about 60 and his shop was the craziest, filty mess you ever walked into. Most notable was a glass cage near the counter with a huge Boa Constricter, which he would occasonally take out and play with around his neck. Jeffrey was a devout Jew with three children, one of which - get this - was the youth ministry director at a nearby Christian mega-church. I had started going to his garage only a few years ago but quickly realized, not only did they do good work at a lower price, but that this man was engaging, funny, friendly and loved by many. He did more favors for more people on hard luck than you can shake a stick at. And somehow, he and I had become sort of buddies. You couldn't stop in there an not get into a friendly conversation. I confess, I have even stopped in a few times just to say hello to Jeffrey, and his cast of supporting characters. 

Today's event was the single biggest crowd down at the Oyster Dock Park in my 18 years here. Everyone knew him and loved him. Black, White, HIspanic - men, women and children - Lawyers, Politicians - shrimpers and "shuckers" - garbage men and ditch diggers. And truth be known, he had probably done a special favor for every one of the hundreds (maybe more like 1,000) in attendance today. I saw people I hadn't seen in years. And I heard several wonderful stories of what had done for customers in need.

But, to our shock and dismay, he is gone from us. What an odd person to have such a positive influence over this diverse, quircky little town. 

And then an hour or so later, so too is Kobe gone. 

Over the last hour or so, I have been listening to a few very recent interviews with Kobe about his plans for making more films (both real life, and animated) out of good books - many for children. I don't think anybody ever expected to see a basketball great, become so involved and so accomplished (an Oscar winner) at this new, and completely different carreer blending art (film) and education - all with the goal of helping people improve their circumstances in this cruel but beautiful world. So sad! 

Could Kobe and Jeffrey have been products of some higher calling? A Jewish guy with a filthy car garage in a small Southern town, and another one of those "spoiled overpaid athletes"? Finding unique wasy to help others?

What a concept?

All of us who have experienced health issues, or any type of life changing circumstances can remind ourselves tonight what it means to survive - to be able to breath deeply in the miracle of our own existence. I myself happen to be one of the luckiest stiffs on the planet. Not so so much for health reasons, but otherwise.  (I'm very lucky at drawing straws)

Nothing is guaranteed. But life sure is good when we try.

Somewhere at the end of John 16, Jesus said to his 12 buddies, "I tell you that you will have trouble in the world, but take heart, I have overcome the world."

I'm betting Jeffrey and Kobe have overcome the world.

David Mitchell

Frustrated - I just have to say this.

In a lifetime of following stories of aviation accidents like this one, I will never be able to fathom why some pilots, flying smaller aircraft at lower altitudes (and near mountains) think they can chance it in poor visibility conditions. It just boggles my mind. Why?

Honestly we never cancelled a mission because we thought there might be too many VC or NVA waiting for us "out there". But when visibilty was bad, we were grounded - period! 

I do recall a couple of times hearing of a "Dustoffs" (Medivac rescue), flying pickups in poor visibilty. But they stayed close to the nap of the earth (almost entirely flat in the Delta), and just above the trees, all at slower speed. They managed to get in and back out - a couple of times. But it was slow going and tedious flyng - and only for a desperate emergency. And this meant they refused to have Gunship cover escorts, for fear of mid-air collision in the fog.

(But then, "Dustoff" pilots were even dummer than we were.)

Frank Ganley

First, let us rejoice if you are lucky enough to be born in a year of the Rat. The Chinese selected the Rat to be the first in their calendar because they considered it to be the hardest worker, great family providers and parents. Second, the tragic crash of a helicopter with 9 aboard and 1 pilot. Everyone is sad because we lost another ultra rich athlete. Sad for the daughter but her father was not a very good husband or father. Though at the time of his death he was trying to be better. Our sorrow should be directed towards all the unknowns who died Sunday. Car crashes, murder and abortions and old age. They too left loved ones etc but did not have the means to be famous. Third to Dr jim, i was recently diagnosed with a fib, my heart was beating at over 160 bpm. I also have a left branch blickagesomething. I had a heart attack and have two stents. I had a visit to the hospital for a little procedure which required me to be put under so they could say "clear" to get it back in a corrected beat. So my wife insisted i get an Apple Watch 5 which Santa brought me because it has an ekg app. My question, sometimes I'm in sinus and sometimes I'm in afib but i don't feel different from one or the other. Serious?

James Hamilton, M. D.

Frank,

Here is my take on what you have going on with your heart based on what you have mentioned:

That left branch block you mentioned is probably a Left Bundle Branch Block (LBBB) - see that green electrical system of the heart picture I posted in Post # 6743. This as an electrical conduction blockage/delay as the signal passes through that left bundle branch. It is possible that your heart attack (Myocardial Infarction, MI) caused damage to that tissue. The stents you had placed are designed to restore good blood flow to the muscle and other tissues of the heart that were at risk of being damaged in the future and help prevent another heart attack. In an MI some of the muscle fibers of the heart are permanently damaged and heal with a form of scar tissue. Your Left Bundle may have had a similar injury.

When you were in the hospital and given anesthesia, then they said "clear", that was most likely a cardioversion (again, refer to Post #6743) to convert your A-fib back to a normal sinus heart rhythm (NSR). Whenever we cardiovert or defibrillate a patient, the person operating the paddles will say "CLEAR" so that no one else is touching the patient and could get shocked inadvertently.

Your Apple 5 device that monitors your heart apparently indicates that your heart occasionally goes into paroxysms of A-fib (PAF) which then spontaneously revert back to NSR. You did not mention any meds you may be on but I would guess you are on something to attempt to keep you from going into A-fib too often and perhaps a blood thinner or something in addition to help prevent blood clots. It sounds like you are getting good care from a cardiologist.

As to the seriousness of your condition, only your doctors can evaluate that. I will say that the treatments you have mentioned sound very appropriate to me and are giving your heart excellent care. There is an old saying that "Minor surgery is that which is performed on others; anything performed on you is major." That can apply to medical procedures as well as surgical ones. Thirty years ago the conditions you have would have been more serious than they are today because the treatments were not as good. So, follow what your doctors advise and I suspect you will do very well.

Jim

Michael McLeod

It's been said before, Jim, but once again won't hurt: you are aces for taking the time to talk people through these difficult issues.

Still shaking my head over how your karma was foreshadowed 60 years ago or so when the teacher chose you to walk home a groggy classmate who'd slipped on the ice and cracked his head on the frozen IC playground blacktop during recess one wintry day.

I'm just surprised you didn't diagnose my concussion-contusion along the way.

David Mitchell

Mike,

Have you paid him yet?

David Mitchell

OMG!   It took me a few mintes - but it just now dawned on me. 

That's it! You fell and hit your head.

So that explains why you lost your bearings in life and became...wait for it,

an English Major!

John Maxwell

Michael McLeod

Not sure how old the phrase "never speak ill of the dead" is.

But you can rest assured it ain't going out of style.

There is, indeed, a possibility that my head injury had a long term effect on my behavior.

I'd love to think so, because then I could use it as an excuse for all the dumb ass things I have done since then.

James Hamilton, M. D.

Mike,

Your TBI so many decades ago would have been treated totally different today. You would have been banned from having to do homework for about six weeks, among other things, to rest your injured brain. That would have probably put you back a year and therefore, not been a member of our BWHS Class of '66. That means we would have been deprived of all these posts you have placed on this Forum! It would have also most likely changed your direction in life and you may have gone into a research scientific field instead of English and writing. You might have discovered a cure for heart failure and atrial fibrillation. That would put some doctors out of business.

Wow, we all should be happy that no help was available for that brain of yours back in our grade school years!

Jim

Donna Kelley (Velazquez)

Sorry to interrupt with what may be a silly laywoman's question, Jim but in Mike's case would a lobotomy have been an option back then?