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Location: DownByTheRiver, Central Iowa, United States

Husband of the world's most wonderful wife, father of the world's four most brilliant children, grandfather to the world's eight most beautiful granddaughters and two handsomest grandsons

Wednesday, November 23, 2005

The Iowa 7th Cav Rides Again

The River Rat Ranger gets on occasion the opportunity to tap the intelligence of the some of the world’s most interesting people. Today there was a message on a scrap of paper by the phone to call an old friend, Dean, the curator of the museum at the Gettysburg Battlefield. Dean is back in the state doing some research for a book on an Iowa Civil War cavalry regiment. His voice on the phone took me back over 15 years.

I was working at the county hospital on the 3-11 shift taking care of adult psychiatric patients on a six bed maximum security unit. Dean was the evening unit clerk while he pursued his graduate degree, I think in museum science. He was responsible for all the clerical duties for my unit and the attached 40 bed acute care psych unit. He carried an unflappable dignity to a job that not only required dealing with the madness of 46 acutely ill patients but also a nursing staff which was often difficult to distinguish from the clients. Psychiatric care personnel tend to be VERY type B personalities with almost no organizational skills or interest. Dean had the organization and focus of a corporate accountant. I can picture myself now rushing into the nurses’ station demanding, “Dean, quick, where’s a pencil?” He would give a tired, long suffering sigh and say, “In the drawer…. labeled… ‘Pencils’”.

Nothings unsettled him. He was an island of calm in a sea of chaos.

I remember one night in particular. He had his work caught up and came back to the security unit to play solitaire at the table in the corner. It was visiting hour and I had my hands full with one patient whose husband had come to see her. They had met right there on the security unit a year or two before. Boy meets girl on the psych ward campus.

She was bipolar in the manic phase that night and was getting louder and louder and increasingly threatening and obnoxious. I made the mistake you NEVER make in that environment; I turned my back on someone, her husband, and ordered her to take a time out in her room. She cursed me in defiance. I put my hand on her elbow to guide her to her room. I felt a hand on my shoulder and was spun around by her husband, straight into a whistling round house punch to my face that set my on my rear and I slid into the wall.

My shouts for help carried out to the open unit over the ceiling microphones and a half dozen staff charged to my assistance, followed quickly by several security guards. The other patients jumped to the defense of the attacking husband and a general melee resulted. Though it all, Dean sat calmly playing solitaire as though he were at a table in the city park on a summer day. At last the visitor was arrested, handcuffed and removed to jail, the patients were locked in their rooms and I stumbled panting to the table and sat down across from Dean. I rested my forehead in my hands and watched my blood slowly drip from my split lip onto the table. He continued to place one card on another.

“My grandmother prays every day that I’ll get a job somewhere else.” I said when I got my breath back.

Dean looked calmly at a red 10 and placed it on a black jack.

“As do we all.” He replied.

It really, really happened. I’ve been delighted with him ever since. His visits are special occasions. We guzzle coffee and pour over maps of Iowa cemeteries where more of the vets of his “lost regiment” might be buried. We read over old obituaries and reminisce and I try to match wits with him. Good companionship and good times. It was a day to remember.

Monday, November 21, 2005

Strange Brew

The RRR has discovered the website, rock.com It has email service, but I'm ignoring that. What interests me most is the streaming music. Practically everything from classical to heavy metal is available. But what I find the most fun is the International Streaming Rock. I list them below.

Arabic Pop/Rock

Cantonese Pop/Rock

French Pop/Rock

German Pop/Rock

Greek Pop/Rock

Indian Pop/Rock

Israeli Pop/Rock

Japanese Pop/Rock

Latin Pop/Rock

Mandarin Pop/Rock

Philippine Pop/Rock

Thai Pop/Rock

I'm listening to Indian Rock as I write this.

Saturday, November 19, 2005

Cardiac Ward Ranger

The River Rat Ranger left his readers over a week ago with a story of health problems and a certain amount of discouragement. Suddenly everything changed… I started out with intentions of following Dr. Ganesh’s rules to the letter. I walked 5 miles each day for three days. I cut back severely on my food intake and lost several pounds. Things were looking up. I could DO this.

Saturday morning I woke up at 0415 with the feeling a rat was scurrying around in my chest. I felt my pulse. It was racing and irregular. Atrial fibrillation. I was certain of it. I went into the kitchen and listened to my heart with my stethoscope. My pulse rate was 158 with numerous irregularities. The long pauses are the danger in Atrial Fib. Blood pools in the heart and can clot. The clots travel to the brain and it’s a stroke. If they go to the lungs it’s a pulmonary embolism. Either can be fatal or even worse. So I swallowed four aspirins to thin my blood and took my morning blood pressure medicines. Then I called my family doctor. He told me to get to the Emergency Room. So Mrs. RRR and I drove the 50 miles to the Big City and the hospital where I work part time. It’s an odd feeling being in your own hospital, like standing in a mirror looking back at yourself.

The ER staff kicked into high gear and did all the necessary actions; EKG’s, drew blood for laboratory tests, started an IV, and put me on a monitor. The job in Atrial Fib is to “convert”—that is, to get the heart to convert back to a normal heart beat called “normal sinus rhythm”. But my heart didn’t seem to WANT to convert. They ran in Cardizem, the powerful anti-arythmatic and blood pressure medicine I usually take orally as an IV solution. Nothing. The rapid, irregular rate continued. They kept increasing the amount of Cardizem. Still the Atrial Fib would not convert. But my blood pressure went lower and lower till at last it seemed there was no choice. I was going to have to be cardio-verted. This is done just like in CPR, by giving a jolt of electricity through the heart that makes it beat normally again. The cardioversion was scheduled for early Sunday morning and I was admitted to the cardiac floor.

I was now wearing a transmitter that continuously sent my heart information to a screen in the nurse’s station. All of this is mechanical and terminological. But it doesn’t address the feelings involved. We count on our hearts. They beat away quietly and efficiently from a few weeks after conception for up to a century. I seldom give it any thought. But when it doesn’t work and you can FEEL it not working, suddenly your mortality becomes very real. I thought about this as we drove in to the ER. I held Mrs. RRR’s hand and thought about the third of a century we have together, of the good times and bad and knew every one of those irregular scurryings in my chest could be the last. In the ER the quick efficiency of the staff and all the technology was reassuring. “Everything’s going to be OK. They are going to fix me.” But I wasn’t fixing. By noon I was lying in bed realizing that the technology wasn’t my salvation. The nurse came in with a new medication: Betapace.

“The Dr. wants you to try this…” I took the tablet.

In a short time I became drowsy. Then drowsier. I remember thinking, “If I have to die, this is sure an easy way to go.” There are certain things a man wants right in his soul before he meets the Maker. My mind went to them… then drifted and I seemed to sink down into the bed as I slept without dreams. An hour later I awakened alone in the room. For a second it seemed… no, I wasn’t through the veil, I was firmly on the mattress in the hospital bed. I found myself disappointed a little. To wake up in heaven would have seemed natural and proper. But there was a change in my body. The bubbling, scurrying feeling was gone from my chest. Mrs. RRR came into the room smiling from ear to ear.

“You’ve just converted to a regular heartbeat; the nurse could see it out at the desk!”

The Betapace had done the trick.

Four more days in the hospital making sure the Betapace wouldn’t turn on me and have a paradoxical effect and I came home. I’m still here readers. You won’t escape me that easily.

Thursday, November 10, 2005

God is Good

In my last post, Youngest Daughter had fears about her pregnancy. But lab tests and a sonogram show mom and pre-born infant are both just fine. Good, very good news.

Wednesday, November 09, 2005

Rendezvous With Ganesh

The River Rat Ranger has many strange experiences. Here is another. Monday I visited the Veteran's Hospital in the Big City for the latest word on treatment of my Hepatitis C. It had at long last become time to meet the new liver specialist. I've been waiting since April. I got off work at 0730 and drove along the river taking all my favorite short cuts and arrived at the VA at 0745 to have my blood drawn. Then with typical Federal efficiency I had to wait until 1300 to see the Dr.

As I'd been fasting for 12 hours for the blood test, I had breakfast at the nearby cafeteria and went out to nap in the Green Hornet till appointment time. It was unseasonably warm so I didn't need to cover up. I just lay the seat back and went into one of those occasional naps I have where my body seems to solidify into an immovable object, become heavy like metal, and my mind drifts into sleep with complete awareness of noises, people walking past, etc. My dreams rolled back to the week before.

I had made myself face the duty awaiting me up at Grandpa Ranger's house on The Farm where I'd grown up. Dad wanted me to come up and go pheasant hunting with him. I have nothing in particular against pheasants except that I am almost totally unable to hit moving objects with a shotgun. So they are safe from me. If I MUST hunt, I would prefer it be things that can hunt me back... bear, wolf, big cat, feral dogs or coyotes should they pack up. But this wasn't about hunting really. Dad, now almost 80 and I took our shotguns and walked down through the fields I'd grown up in. Many things have changed, including farming methods, so it wasn't exactly the same, but close. We walked along the railroad tracks that had fed my wanderlust by tempting me with one slow moving empty box car after another, begging me to hop in and ride West forever. We tramped through the deep grass along the old pasture creek where younger brothers and I had camped and reminisced about that.

Younger brother and I spent more nights outside than in the house during summers in those days. Sometimes youngest brother with us. Good times.

We never saw a single pheasant, not even tracks or droppings. The birds had moved into the neighbor's standing corn. But that wasn't important. A warm fall day and Dad and I together again. We went back to the house, had a great meal made by Step Mom and I went up to the attic to sort through the past.

In the Northwest corner was a pile of my stuff, covered with a sheet of plastic. I didn't want to go there, but it had to be done. First the books. Hundreds of books. Novels, history, reference. Old dusty books. Some old friends, some I'd forgotten. The terrible sorting process. I hate getting rid of books. Most I repacked for the brothers to look through. I made myself be ruthless and determined to only take what would fit in the Green Hornet for one trip. And each layer moved me back further into childhood.

There were the old .45 rpm records I'd collected, mostly children's and novelty songs. Letters from old friends. The correspondence course I never finished. Odd trinkets. A box of clothes. Old army uniforms. Bell bottom jeans from the 60's. And my army records. 3 years of my life compressed into a stack 6 inches tall. Pay slips, travel orders and a few pictures. An 8x10 glossy of an impossibly young RRR standing in front of the battalion commander as he pinned on a medal. And the memories of how that happened. The crying sob of metal as the helicopter hit the ground 50 feet from me, crumpling, breaking apart, sliding. The whistling whipping noise of the tail rotor zipping past me. The hot flash as the little chopper burst into flame. My friend's screams. His melting face looking right into mine as his seatbelt burned through and I tugged him out the door on top of me. My hands on fire as the flaming jet fuel spread to me. Me screaming on the radio for a dust off. (helicopter ambulance) The smell of burnt meat that wouldn't leave my nostrils for days. Kneeling by the ice chest with my burnt hands in the frosty water as the other soldiers dropped pieces of the other passenger in a pile close to me.

Under the records folders, the medal in a box. Small compensation for a tall, laughing red haired Iowa boy who had befriended me. And a certificate printed in Vietnamese. Only my name typed in English, all else incomprehensible. A medal granted by a nation swallowed up. And more memories. The NVA running at us along rice paddy dikes. Our allies dropping a wounded soldier at the bottom of the hill that dark night. The black medic, Candy screaming obscenities and running down the hill to him. Me suddenly finding myself passing him. Tracers sizzling past on the way up and down, ours red, theirs green. Cradling the young South Vietnamese irregular in my arms as he coughed and retched pieces of his lungs onto me. His comrades taking his boots, knowing he wouldn't need them anymore.

A big machine went by in front of the Hornet, sucking up autumn leaves. The paralysis slowly left me. I'd slept two hours. I walked back into the VA. We vets look at each other. Look away. Was he there? Did I know him? Brothers in arms.

Back upstairs I wait to meet the new Doctor. They call my name. And I walk in to the most American office you'll find and stepped instead into India. The man who stood to greet me was so handsome as to make my teeth hurt. I could have been shaking hands with the young Omar Sharif in Lawrence of Arabia. Dazzling smile. Much touchier than most Americans. Shaking my hand with both of his, little pats on the shoulder and on the knee as we talked. About 8" less personal space than Americans tend to like. On his identification badge his first name... Ganesh. The Hindu anthropomorphic elephant deity. Son of Lord Shiva and goddess Parvathi, if I remember correctly.

I absorbed his new information. The lowered virus count was meaningless. My biopsy showed I have progressed almost to cirrhosis. The Great Pumpkin disease looms. Liver cancer risk is increasing steadily. I need to go on another year of chemo-therapy. At an even higher dose. Another year. Imagine having the flu 24/7, with neuropathy, depression, irritability, loss of hair and libido... for a year. No listen carefully, a MINIMUM of a year. I feel as paralyzed as I had been in the car refighting that long lost war.

But good news! (smile, pat on leg) I have type 2 genotype, the easiest to cure. "Dr., my type 2 genotype and I have been on a year of interferon and ribobviran FIVE times in the last decade! It didn't work." Dazzling smile repeated. "But Mr. Ranger, hasn't anyone told you? You are obese. It only works on people who are thin and fit." I know I stared with my mouth open. New information, right? No, right there on the internet when I looked later. Rage at the "professionals" who forgot to mention it. Sick despair at the thought of wasted time and money and physical deteriation.

I need to lose 80lbs. Fast. Walk a minimum of five miles a day the elephant god tells me with a smile. Starve yourself. Here's a referral to the V.A. weight loss program. Call the nurse when you're ready to start.

I drove home on autopilot. Phone call from Youngest Daughter. She fears she may lose her 2 month pregnancy. Sometimes the well seems too deep to climb out of. But... one foot ahead of the other the old soldier marches on. Today was better. Youngest Daughter may be doing OK after all. The blood tests look good. The first 5 miles didn't go TOO badly. Mrs. RRR walked part of them with me. Ganesh smiles.