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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

Sunday, November 12, 2006

A Ranger Ablation

"Where has the RRR been?" some Ranger Readers have asked. To answer... right here, often wallowing in self pity over his health problems. At least one I've finally been able to take some action on... that is the cardiac arrhythmia or atrial fibrillation as it's called. The episodes continued. At the last one I waited in the cardiologist's office with Mrs. RRR for a bed to open up on the telemetry unit at the hospital. The Dr. came in to announce I could now go to the hospital and be prepped for a "jump start", defibrillation. But moments before she entered, I "converted" back to normal sinus rhythm. That was enough. We scheduled a procedure called a Cardiac Ablation. In this treatment, an endoscope is introduce through a large vein in the groin and another tube in the opposite side and the Dr. "crawls" it up into the heart. There he or she maps the areas where the incorrect electrical impulses are sourcing and running and then burns the improper areas out with a cautery or laser. It involves at least one perforation of the central cardiac wall and is scary to think about, much less undergo.
The Thursday before the Monday procedure, I stopped taking my blood thinner... coumadin. Something else scary. As my blood got more and more able to clot quickly, the danger of stroke or pulmonary embolism increased. Then Sunday night I stopped eating and drinking at 2200 (10 P.M. to non-rangers). Saturday Papa Gringo, my father, and my Step Mom drove Mrs. RRR and I to the hospital. The ablation was to start at 0800. At 0810 a nurse came out to the waiting area and said they were doing an emergency pacemaker placement on another patient and that I'd have to wait about 3 hours. She was exactly correct. By 1100 I was tremendously thirsty and sitting with my family in a tiny changing room wearing only a hospital gown and slippers. They rolled a cart into the room. I kissed Mrs. RRR goodbye, hugged the folks and got on the cart.

They rolled me into the cardiac cath lab, which should be named, as is my cheap pup tent, The Ice Palace. In order to naturally slow down the patient's heart beat and metabolism, the room is kept agonizingly cold. And I had on only a thin cotton gown. The nursing staff had me get onto the stainless steel table. I had only THOUGHT I was cold up to that point. My bare body rested on the icy steel from head to heels. Then two staff lifted my torso and slapped a cold gel pack to my back for a grounding device for the electronics. I began to shiver. They lay me back down and stuck more gel pads to my torso and legs for the EKG monitors and the cautery. By this time my gown was folded down to my waist. Two staff strapped my wrists down to "help you remember not to move." Then my legs were spread and ankles restrained. I felt the deep stick of an IV being started in my right hand. The gown was pushed further down and a restraint fastened around my belly. Now I lay totally helpless.
The nurse lifted the bottom of the gown and flopped it back over my belly. Barely bothering to drop on a small towel for a little and I mean LITTLE modesty she began shaving my groin. "If you find my lost dignity down there," I complained, "will you please leave it in my suitcase in the changing room"?

"I'm starting the sedation now." The other nurse said as she fussed with my IV. And I was out. Five hours later I came to in my room on the cardiac floor, more chilled than I've ever been in my life and ravenously hungry. They piled on the blankets and brought a dinner. Mrs. RRR fed it to me a bite at a time and I rewarded her by vomiting back up spectacularly. The ward nurse rushed to give me a shot of compazine and once more I descended into the fog. I awakened at midnight, entangled in dozens of blankets and not certain where I was. By noon the next day I was discharged and Papa Gringo and Step Mom drove me back to the cabin. In the days since the monstrous bruises that covered me from knees to chest have finally began to fade. I had to take shots in my belly to re-thin my blood. That's done too now. And thankfully... the newly resculpted heart keeps beating regularly. If it keeps on doing it for a year, I can start tapering off the blood thinner and if I've lost enough weight, the blood pressure meds.

Meantime... the RRR plods on. One step. Then another step. Each one the first on the journey of the rest of my life.


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