The Mud Kingdom

A magical place, an independent spirit.

Hamburger Heart: Part 9

Ebb and Flow

My first appointment with my cardiologist couldn’t happen soon enough, but their case loads tend to be formidable. Heart disease is the number one killer of Americans after all. I was figuratively and literally dying to know what was next. Apparently, there are no real front line treatment regimes for conditions that people shouldn’t be having. My next stop would be cardiac rehab.

In a nutshell, the idea is that you take a guy with two untreated major blockages, a freshly stented open one, no prognosis, and stick him on a treadmill to see if he can run. At my home hospital, their facility had a wall of windows facing the entrance to the ER. So for the 30 minute treadmill sessions, I got to watch dozens of people being carried, carted, dragged, and stumble into the hospital.

I can’t say that it was entirely motivating, but it did make me think twice about slowing the belt or stopping early. You’re monitored through the session by EKG and the staff didn’t seem to mind that my rehab sessions frequently ran over the scheduled time into the next group. They really wanted me to get better. Not knowing what else to do, I pushed it. For a facility with an average patient age well over 60, the numbers I put up were unusual. Where they were used to hearing walking, when I was on the floor they heard running. But not unlike treadmill exercise, I was going nowhere fast.

The next years of my life was a cycle of clawing back some capacity to exist just to lose it all over again. I got to know the half dozen specialist doctors I went to by the kind of car I was making their payments for. The meager savings I gathered to protect me in the case of job loss wasn’t going to cover the expenses of living on the edge no matter how I stretched it or leaned on my friends and family. After months of excruciating existence I finally managed to stay awake for six hours at a time and partly focus on things for up to two.

I needed to go back to work. I asked my doctors to switch me to the cheap drugs that medicare would pay for so I wouldn’t get bounced on and off of the ‘good’ drugs every time I lost coverage or got booted off of my insurance due to mysterious autopay cancellations or random changes to my premium which required attention I wasn’t able to muster. Or hell, the six digit text verifications that I had to do one or two numbers at a time. I had even lost my sense of rhythm and struggled with my friend to relearn how to play my violin in maddeningly halting fashion. I was essentially broke and near declaring bankruptcy, looking for jobs I couldn’t even stay awake for.

I did find a job that would give me health insurance. It was full time so I was going to have to figure it out. When they were interested in hiring me, I let their HR department know that I had a heart condition and that I may need some accomodations to do the work. Their mood perceptibly changed when I told them so. “What do you need?” My normal response to that question (a million dollars) didn’t seem appropriate so I held my tongue. I told them that I may need to lie down for 20 minutes during the day. Their immediate response was that they didn’t have anywhere I could do that. Having worked for several years in labor law enforcement, I reflexively asked if they were willing to provide me that response in writing.

They were not willing and I started the next week. And there wasn’t any good place for me to lie down. There were lactation rooms, all-genders restrooms, unused storage closets, empty office areas, but nowhere for me. Ten minutes of shallow sleep on the metro, then ten more on the shuttle. Four hours at my desk. Twenty minutes on the last pine bench in the locker room or behind the unused ellipticals at the gym during lunch. The occasional five minute lean against the bathroom stalls. And I don’t think I ever worked harder in my life.

For the first time in eight months I was actually being productive. I led a team to setup a program and several supporting systems to operate a national operations coordination desk staffed by rotating volunteer teams and supporting professional staff. I broke new ground on a major operation to allow clients to self-schedule their appointments with our conselors with their phones having been given only a few weeks from an ask to live use in a major national disaster. I don’t think I had many fans above me. They placed a new supervisor to ‘manage’ me and she would do things like schedule me for the night shift, then the day shift, and then a night shift again all within the same week. I don’t think it was an accident, I was being pushed to leave.

Thus, I had to accelerate my work to make sure it was done before I left. At the same time I was working hard to claw back as much of my health as I could as well. Many nights after work you could find me on the treadmill in the basement at work walking and jogging as hard as I dared from what I knew I could tolerate in cardiac rehab. The constant pressure put on by my new bosses and the sad state of my health created so much turbulence in my life. One night on the treadmill, I fell. It was a little different from the other times I had collapsed while trying to exercise, on my commute, or at my desk in the office. I didn’t know it at the time but I had another heart attack.

When I picked myself back up, I felt weakness. Thanks to my blood thinners I saw big bruises all along the side I went down. I turned the damned treadmill back on and I could scarcely walk. So that’s what I did for the next twenty minutes. I struggled to get home, crawled to my dog, and fell asleep on her bed. I didn’t last much longer on the job. It took me a while to recover any sort of exercise capacity. While I could start jogging for more than a minute at a time after a month, after six months I found myself back in the cardiac catheterization lab with the cardiologist telling me that a once mostly open artery had completely closed.

In many ways I was worse off than I was after my first heart attack. I had saved up virtually no money after paying off many debts and bills. I was looking for work and subsequently new health insurance again. Without strong coverage I skimped on cardiac rehab. But even this situation is just a reflection of the cycles of my life. Cycles of pain. Cycles of exhaustion. Cycles of relationships with my friends, my family, my coworkers. Every two steps I took forward I fell two steps back. That night I passed out on Maggie’s bed – she stayed with me for a while until she knew I was asleep. Then she snuck into my room to go sleep on my bed.

So it was with everything. Running in place, knowing nothing , and watching the world getting dragged through the ER doors.