Begin here (=Part Two)

Begin again, begin here, begin now.... dear few readers: it is a new
month, a new day, a new evening. Diego is standing by helping me type;
Gabrielle is in the bathroom towel drawer ( a good warm spot!), Steve
sits on the couch and writes by hand. Two tabbies sleep in the
kitchen. Luna, who is actually a tortie tab, is on top of the fridge,
and Sheyna Meydel is on a beloved desk chair. I think I saw Frida dive
into the pink room, which has many hiding places.

I am sitting up typing which is progress for me and less on Steve's
"to do" list. Steve has selected an attractive font for me, in size
18, which I like and recommend for the myopic and presbyotic amongst
us.

This first day of February started out lovely and mild; sky: blue; and
inside a geranium produces a peach blossom. I hauled in a window box
at autumn's end and we are likely to have petunias soon! Not bad, eh?

As for me: sleep was deep and long and upon waking my body wanted and
had REST, really good rest, with three cats taking turns joining me.
Gobs and Sheyna and Diego took turns having individual cuddle time. I
thought to get up and be ready to walk when Steve came home from the
library but a short amount of time vertical in the kitchen made it
clear to me that more horizontal was what my body wanted. My pulse
feels slightly more regular to my untrained hand but I am still not
sure what is going on with me. I will take up my theme of where did
January go but first: some big news of today, and then a preface here
in the second day of this typing re: how I got into this epistle....

Ethel (Steve's mama) called early this afternoon. Virgil died last
night. He was 89 and nearly two months and his ticker had been running
on only a cylinder or two so it wasn't a surprise but everyone agrees
it is still sad. Ethel is the youngest of 7 siblings. She had 3
sisters and 3 brothers. Now she has only one living sister, Lura, who
is two years older than is she.

All their lives, even into their 80's, Ethel and Lura were referred
to, by their older sibs, as "the little girls." So now only the little
girls remain.

Virgil was a twin and Viola, his "womb-mate" left this world last
autumn after a swift and ferocious attack by cancer.

They are both missed. Perhaps it is because they were twins, or
because they were the gender balanced center pivot of a large group of
sibs that they had such sweet and sunny personalities. ...

As for these words: as aforementioned, kind and good doctors E. and M.
called Friday. Dr. M. said
"e mail me and tell me how you are." He also said that he could get me
back into sinus rhythm with medication. Dr. E said Call Monday morning
and make an appointment with my secretary to Come Right Back Up Here
and have a cardioversion. Well. That is two different opinions, isn't
it, and how am I the patient and my dear spouse and kitty family, and
extended friends and family beyond this little cottage, to make sense
of it all? I was thinking I had to write Doctors E and M and I
couldn't quite think of where to begin or how to sort it out or what
to tell whom so I decided to do what I usually do: just tell the whole
megilla (that means scroll literally, but in this case and often it
means the whole story) to everybody and push SEND when done and see
what wisdom the universe gives me in return. Not knowing how to sort
it out: begin here, begin now, begin at the beginning.....

Actually "begin here" are the words Steve left on the screen for me
this morning, before he went off to work. Yup, he turned on the Mac
or as we say around here got it all Beamed Up for me his one step away
from Luddite wife. I *am* glad I learned to type on a manual
typewriter, even though I often pound these keys too hard; and I *am*
glad I took typing in summer school in high school even though it may
well have been the summer of love and all I can remember is a certain
dreariness. Anyway: Diego is now on top of the computer, which is
better than sitting on the mouse pad biting my hand moving the mouse,
and we were saying, WHERE DID JANUARY GO??? And what is going on
inside this body of mine, especially with mi corazon?

So: it was Elvis' birthday, and then it was the eve of the full moon.
We were ensconced at the Ray-Mar, subsisting nicely on microwaveable
food, and Luna was stretched out on the bed, totally luxuriating on
being the Queen of Room 23 and The Only Cat in the room. It was a mild
evening; synagog services were lovely. Despite some discomfort I could
feel new good energy coming from my heart. Yes, sinus rhythm! We
walked from the synagog to the infusion center and then tarried a
while outside the Gonda Building, loving the Chihuly. I was amazed:
gaze this way and see the full moon; gaze that way and see the 13 part
giant Chihuly! And the weather was mild with cloud cover and I felt
great walking back to the car.

Then I had to take the lasix, and the next day, the other lasix. They
exhausted me, but they did what they were supposed to do and took off
the fluid that was sitting on my lungs. Seven pounds gone! I had a
Headache with a capitol H and attributed it first to the lasix then to
the anesthetic then to the cardioversion....and days later Dean the
nurse-who-talks-like-a-doctor said that some people get a headache
from the catheter going into their atrium. Whatever the cause, I had
the H, and the weather radio was unequivocal about a Big Storm Coming.
We knew Sunday was our only chance to move south to Iowa, but it was a
Honey I Can't kind of a day. My head hurt WAY too much to move and I
was nauseous and dizzy. I looked at the sky (we had a door that opened
directly onto the natural world from our room number 23) and thought,
it looks clear, maybe the weather radio is wrong, but the next day:
there it was. Snow, and snow, and snow coming down, and school getting
out early or closed in Rochester Minnesota and Iowa City Iowa and
everywhere in between. DO NOT TRAVEL except in case of an emergency.
An emergency was what we didn't want to have so we exercised Wisdom
and stayed put even though Steve was about to miss the first day of
first year, second semester, Spanish, at 9 in the morning; and no two
ways about it, he was going to miss the second day too...

The snow was fine for a walk and walk we did. I felt strong and
healthy. We ate out: an omlette.

The next day (Tuesday the 13th) we left our motel home and got
ourselves on the road, after a stop at the wonderful Good Food Coop
and some soup and nut/veggie burgers in The Back Room Deli. (When in
Rochester, do go there! Also stop and gaze at the Chihuly even though
you are passing by when Gonda is locked. You can love the giant glass
art from the sidewalk, and even from your car....)
Per orders, we stopped and walked every hour, or, in some cases,
after only 45 minutes, so that I would not clot. (Sitting for the 4
hour car ride was absolutely forbidden!) There was no more snow coming
down, but there was wind, and it was COLD. In little towns in
Minnesota and Iowa we left the car running, Luna warm inside, and
walked two blocks down and two up again in Main Street USA. When we
entered Iowa at Chester and stopped for gas the nice lady in the
convenience store said O HONEY! It is so cold out. You can just walk
around my store. She was a sweetie and told us her story of good care
at Mayo; cancer survivor; many pounds lost.

By the time we got to Waterloo it was colder and light was waning so
we opted to hike all the aisles at the Hy-Vee supermarket just north
of Allen Memorial Hospital where our dear friend Barbara sometimes
works. We thought of her and said hello to the building. Oh, back at
Hy-Vee we bought two pears.

Between Waterloo and Cedar Rapids we took it slow and stayed in the
right lane as snow was coming down again......


BEGINNING AGAIN, BEGINNING HERE, BEGINNING NOW: 7:57 p.m. 2-2-09

The sky is overcast. Small snowflakes fall. I don't know what the
groundhog saw today. Despite intentions to walk with Steve, I didn't
get out. Through the window I saw a good looking sunny day. Bits and
pieces of the mundane got done. And, I got myself in and out of the
tub and put on fresh clean loungewear, thus in some way preparing
myself to join the normal beings.

But I am not normal now. Something is wrong.

For sure I am in a-fib. How I got here and what to do about it are the
questions.

I will resume the chronology of January, but first some comments
symptoms and questions from NOW.

And of course, thanks, especially today to Kirsten who, when I
returned her call, gave me her e mail and promised to pass this
epistle on to Dr. E. I don't think she expected it to be so long, and
it will be a surprise to him too, as well as to Dr. M, but at least it
should arrive legibly typed. As aforementioned I don't /didn't know
where to begin so I tell all and let the reader skim skip or delete.
One never knows what is important. Once I interviewed an old Rabbi and
he told me about teaching an Israeli guest how to eat potato chips.
The non-American was about to take utensils to that side dish on the
plate next to the Famous Nebraska Steak and the Sensitive and Clear
Thinking and Tactful Rabbi simply said " May I have one of those?" and
reached over and fingered a potato chip, thus teaching by example.
This anecdote was DELETED from the transcript of my interview with the
rabbi when the interview was published in the journal of the Nebraska
Jewish Historical Society. Extraneous? Perhaps to some. But I thought
it was a gem.

Speaking of gems: when I told Maria they gave me more joules this year
than they did in '05, during cardioversion, she said, Oh they gave you
jewels? Rubies and emeralds....... Well we need something to laugh
about in the worst of times (which this isn't but something is
wrong...it's a fib......).

It took me an hour to get from out-of-the-tub to sitting at this
computer. During my few days in normal sinus rhythm *that* symptom was
gone. What symptom? Well, for many years I had what I called my p.b.h.
(Post Bath Headache)(Not to be confused with GBH, Great Blue Heron);
or, at the very least, a tremendous need to remain horizontal in my
post-bawth dry cycle. In my young teens I sat on the shower floor mid
washing, to guard against falling from lightheadedness. I never told
my parents about it at the time, and I had black coffee and aspirin
for breakfast most high school mornings. When I was under the care of
the Wonderful Doctor Kelly Cobb who graced us with her wise and
intuitive healing for about 7 or 8 years before moving to Louisiana
from whence she came and we were trying to figure out my headaches she
said I Think Something Vascular Is Going On. This was well before my
a-fib diagnosis. I think Something Vascular has been going on for a
long time, and at the very least I experienced episodes of a fib on
occasion before they became persistent and then diagnosed.
Particularly memorable: a huffy puffy incident in the late 20th
century while attempting to hike with my sister up a mountain along
the Hudson River in New York.....

So, it is with Effort that I sit here. I yearn for the horizontal. Any
minute now I am going to take a break into it. I really need a lap
top. I can't fathom laying back pen in hand and scrawling all these
words only to ask Steve to type them on my behalf when he comes home
from The History Of Jazz. The words are coming out of my fingers just
now and they are awakening more words. Last night I couldn't sleep
because I was thinking about the stories I want to write, stories
significantly removed from this topic. Stories R Us. It's my calling.
But my stamina is low. A break is needed now.... There, I've got my
legs up on the low table and the keyboard is resting on a pillow which
is resting on my thighs. This will have to do for now if I want to
get this work of words done tonight, which I do. Of course, I can't
see the keyboard so I will have to trust that summer school, high
school typing class to see me through. (How I love the old Royals!)
And, a lot of proof reading by me later, and by Dear Steve.

Another symptom is this breaking out in sweats.

So, what to do about it, docs and lay people?

I want to call forth a team of advisors and have you come to some
agreement. PLEASE???

A-fib feels so incredibly like anxiety, but I know what I feel is a-fib.

Post bath while horizontal I was looking at the Dec. 08 Yoga Journal.
It has poses for anxiety relief. Would that help a-fib?

In one place in the article I skimmed the Journal says pressure on on
the bones under the eyes slows the heartbeat. Many of the asanas or
poses are inversions, and my instinct tells me not to do them. Am I
right? It wasn't even a month ago that a catheter snaked from my leg
to my heart....

Mayo's exit instructions were a little vague.
No lifting for a week, not more than 5 or 10 pounds (which is it, 5
or ten?); after a week, return to work. Do not remain sedentary. Walk
every day. I phoned the nurse who seems like a doc who is actually a
physician extender, a funny term that fills my funny mind with an
image of a gizmo with which to reach boxes of tea off high shelves. So
I asked the PE what should I do, it's cold out; should I lie on the
floor and do some crunches? And he said NO! We were in there with
catheters. Don't do any ab isometrics and NO! Don't go out and walk
in this cold. Don't even breathe that cold air! We were down your
esophagus..

It's true, they were, and it often feels like a bunch of wrestlers or
some circus acrobats are in there jumping around. But that feeling is
subsiding. It's not quite a month. Healing is slow. But then again, a
month is a third of the three months that follow the ablation, the
critical three months in which I've got to remain in sinus rhythm, and
I'm already out....So, what to do, team??? Please, Help me now...

Ok, I'm sitting up....There are just too many typos. I had to look. I
don't know how long I can sit up. I will have to take breaks.

It hurt to sit up. That's another symptom but I don't know what it is.
In the area of my lower right abdomen, about 4 inches right of the
belly button and an inch down there is a pain. It's sharp and it has
been there since yesterday. Persistent. And hurts more with position
shifts. Is it a) a muscle pull from yesterday's typing session (for I
sit here on a futon with legs akimbo and rear on futon and computer on
low table) b)something to do with the journey of the catheter up that
right side or c&d) something to do with my digestive or reproductive
systems? That has nothing to do with the ablation or this typing?
Because truth be told I've felt that pain before, intermittently for
at least a year but never this constant. Do I need an ab ultra sound
or what? Didn't I have a whole body CT scan two months ago (almost)?
Would that rule out....whatever????

But what to do next, what to do....

I must have been in sinus rhythm for just a few days. Or a week and a
half? When I had my inr checked 6 days ago and a nurse came and
listened to my heart and felt my pulse I said what's it like and she
said FIB. But I already knew that then. What was a surprise was: she
said *it felt like fib when you were here on the 16th too* and I said
IT DID??? If so that would give me not even a normal week at home.
Then she said that was you wasn't it and if she doesn't know, well how
do I? Since we exited the hospital together and she had a bike helmet
on and we had a conversation now we probably have more of a sense of
who one another is. Are. Whatever.

Anyway...back to the chronology: I felt pretty good but my activity
was limited, partly by Our Climate, or The Weather. Then on the 22nd
of January I went out to see Dave the Great PT who had gotten me into
great shape between a fall on a bone on bone knee in '02 and the
slowing down after the diagnosis of a fib in 04. I didn't want
*ANYONE* to touch my torso but Dave worked on my left arm creaky with
the old elbow break that never was correctly set after injury, and he
did some gentle Headache Be Gone work on my occiput. Then I went to
be Gentle in the Gym. I rode the stationary recumbent bike 5 miles. It
felt easy but I did notice my rate was erratic on the wrist readout;
then again my speed wasn't consistent either. I felt fine. I took the
elevator upstairs and was determined to walk .
.......................................
........... It is 8:51 and I am back in the bed. My wrist won't like
this and I don't have the strength to get up and get my wrist support.
No one is in this room but me and Luna and she woke from her nap and
looked at me and said NOW. She did. Say NOW. Write this now.

Even in fib, the recumbent, with its back on which to lean, wasn't too bad.

Then with ridiculous determination I took the elevator upstairs and
walked 4 rounds clockwise and 4 rounds counter-clockwise, or vise
versa, making a mile. I had That Huffy Puffy Feeling and the voice in
my head chanted am I in fib or am I just deconditioned, am I in fib or
am I just deconditioned . . . I gave myself permission to tarry at the
windows, well placed at frequent intervals, to really tarry and catch
my breath and watch the play of soon-to-be-sunset light on the
landscape. Then I drove home. And hours later commenced the "Judaism
is aerobic" pre-Sabbath (1-22) housecleaning prep, and I *really* felt
huffy and puffy, and I slept good and sound, and woke for meds with
breakfast and slept again, a deep nap, tired in my mind and my muscles
including my heart. . .The good nap caused Lateness to the cardiology
appointment. The EKG was not a surprise. A-FIB. (1-23-09)

Oh -- of course three days before we were part of the miracle of the
powershift. The kitties, Steve, and I huddled 'round the radio just
like grandma and grandpa did and listened to the inauguration. Someone
will give us a disk; we'll see the colors in motion, even though we
saw them in the newsprint, and NPR's power of verbal description met
the day. The kits clearly paid attention. They liked best the speech
by our new president, and the classical music.

President Barak Obama can you help me now?

Sec'y of Health Daschle, who was on the board of Mayo, and was Senator
of one of my previous homes (South Dakota), can you help me now?

I was exhausted, and felt Lost in the Universe, though happy to have a
new President and to be in the season of Aquarius. . .

And the Chinese New Year came, a Cow Year, and I felt no shift and my
INR was a bit low. And I went to a New Doctor here on the east side,
so as not to have all my docs in one University basket. She's two
years older than am I, and smart, and personable. We had great
rapport. She said: we are old cars.

Then Mary gave me gentle healing touch and said I was cold all over
but there was lots of heat coming off my heart, like energy leaking.
She told me to visualize my heart beating normally and to think that
where and how I was was just the way things were supposed to be. The
music she had--possibly Native American flute--was conducive. . .

And then I didn't go out to hear Mary's brother sing. I couldn't.

And then the 2 Good Doctors called, and it was Sabbath again. In the
Global Jewish Book Club we read about getting out of Egypt.

Had I been in de Nile?

No, I *was* better for a little bit of time! Steve saw it: my energy
shift up, then come crashing down again. He said it was dramatic. (The
sinus week; the fib again week.) He said I thought I understood
before, but now I really understand.

Then January ended, and it was February, and it was now, and now---What?

There is a Fellow in Cardiology here at the U of I (UIHC), a very nice
fellow. He was in the Twin Cities, and he could have gone to Mayo, but
he chose UIHC. Amazing! And he is from Nigeria. His first name means
"on-the-right-path." So, I get it, that Doctor On The Right Path
wanted to come here and work with Kind and Good Dr. M. And that it's
smaller here. He has more opportunities. But: he thinks there are so
many doctors at Mayo each one doesn't necessarily have as much
experience as the good docs here. But: my first cardiology experience
at UIHC was a traumatic one with Dr. Bad + Mean. And, though they both
allege to be tertiary health care clinics, most of the time I, and
many, many other people I know, feel themselves, as patients, to be at
the bottom of the isosceles triangle at UIHC.

The Mayo team feeling is palpable. Everyone's nice. But: in this year
I felt myself to be more in the hands of paraprofessionals half my age
than Real Doctors. Then again, in '05 I had the good fortune to be
under the care of kind and wonderful Dr. E who just happened to be on
Joseph floor 4 when I was.

Minnesota and Iowa have crazy rivalry.

Each state makes jokes about its neighbors.

Minnesota has lakes. Iowa has rivers. Minnesota is a union state. Iowa
is a right to work (yourself to death) state.

Rochester, Minnesota, and Iowa City, Iowa, are both company towns.

In downtown Rochester there's the Mayo campus, and its surrounding
eateries and hotels.

In I.C., there's the U, and it's surrounding bars, and hordes of
adolescent males so full of beer and testosterone they may at any
moment puke on their shoes. Or yours.

In I.C. the civil religion is football, not our favorite thing. Guys
bashing into each other? War games? Sheer brawn? And with the
requisite beer and brawl afterwards?

But Iowa produced a former governor who is now Sec'y of Agriculture!
And Minnesota doesn't even know who their senator is.

Minnesota is Scandinavian. One person who drew my blood had a tattoo
peeking out of his shirt sleeve. Is that a Celtic design, said I? No,
it's Viking, said he. Me: Are you a Viking? Him: Viking's not an
ethnic group; it's a job description.

Oh, wow. . .

Iowa has more people of German origin than any other state. Also more
Methodists.

So what does this have to do with anything? Not much, except that I'd
like to visit a Minnesota state park. . .

And the Mayo Clinic has a wonderful palpable team sensibility. And
UIHC is renowned for a competitive feeling, a pecking order like the
worst dysfunctional family.

But, I never received a thorough report from Mayo after this visit,
like I did in '05.(NOTE: IT ARRIVED LATER THE SAME DAY!!!!!) Is that a
particular delinquency, a change in protocol, or an accidental
omission; or, in the case of the thorough report in '05, the work of
the Great Dr. E???

I have a friend living and dying in Saint Paul, from ALS. I have to go
thataway anyway.

But now, but now.....

Near the Mayo campus, in downtown Rochester, there is a mosque, and
next to the mosque is a store. In December I bought thick
Levantine/African yogurt there. All the men had beards, and the ends
of all their beards were dyed orange. I didn't know why, or who to
ask.

In January a woman from Somalia came to my hospital room to draw my
blood. Her hair was covered, her fingers were long; her hands
especially beautiful. Her father ran a gas station, and spoke seven
languages, and taught his children to Respect Other Cultures. She
explained to me about the Eid it was in December, and how henna-ing
the beard is a way to dress up for the holiday.

Everyone I met in Rochester--the many people from there who chose to
stay, and the people from Cambodia, Somalia, Trinidad, and England,
seemed to like it there.

Well, I'm a New York born 2nd generation American. I belong in the
shtetl, on the border of Russia and Poland. I belong in a world that
flourished between two World Wars and was destroyed.

As far as I know, none of my ancestors, before my parents, lived into
their 80's. Oh maybe one or two. On both sides of the family we are
full of heart disease. And words. We are the people of the book. We
are full of what we read, and stories we tell.

And I need help figuring out the next chapter of this story of me. Of
mi corazon.

Dear Team of Who is Out There
Dear Kind and Good Doctors E and M
can you help me now?
Can we have a cabinet meeting and come up with a plan? A team of
opposites working together, here in the wonderful world of a new
president, whose life, like mine, has been shaped not by competition
but by organization and cooperation?

For the first time in my life I am older than the president!

I know it's greedy, but I want to see a little more of this world, to
act in it, to walk in it, to breathe in it, and to write about it. I
want to be strong and fit again, like I was under Dave's care, before
the a-fib diagnosis of '04 (which nearly coincided with the
re-election of the Bad President, and heartbreak for the whole wide
world).

I can't do much now. The lasix took that 7 pounds away. I got rid of
another 5, by carefully limiting my intake when (once again) confined
to couch potato land. I take the flecanide almost precisely. Steve
helps me so much: oatmeal and flecanide early, then more
sleep.....Okay, today there was Wheatina and it got into my nightgown
and on the sheets but...I'm trying! What should I do now besides
STOP WRITING ALREADY??