King of Hearts

June 20, 2006 at 12:50 pm (Uncategorized)

I’ve crossed my fingers and my toes. I’m not stepping on any cracks in the sidewalk, walking under any ladders, or breaking any mirrors. And I’m certainly not removing the good luck bracelet the Buddhist monk tied around my wrist in Thailand even though it has turned a sad grey color and is getting smelly. Today, and for the next thirty days, I need all the luck I can get.

Today I began my prednisone taper. I have dropped from 20 mg. a day to alternating days of 17.5 mg. and 20 mg. Because the last time I decreased my prednisone dose, I developed all sorts of odd heart rhythms, the cardiologist at Penn insisted that I wear a so-called 30-day event monitor for this initial phase of the taper. So, I’m hooked up to this little EKG recording device, and if I feel like my heart is misbehaving, I record the episode and then phone in the recording every evening via telemetry. Please don’t ask me what telemetry is; I only know that it sounds like a higher pitched version of the old dial-up modems.

I would be nervous about this taper, except that I continue to feel incredibly sick from the pneumonia. I went to see Dr. Doogie the internist this morning and he said I still have pus pockets (yum!) in my lungs, gave me another antibiotic prescription, and told me it was probably viral pneumonia but to take the third antibiotic anyway. Then I went to the cardiologist’s office to get hooked up to my event monitor.

I suppose I’m translating some of my anxiety about the prednisone decrease and what will happen if I cannot lower the dose without screwing up my heart, by finding everything about my situation highly ironic. For example, I kept chortling to the nurse who placed the monitor on me that it was such a hoot they called these things “event monitors.” I mean, really, what do you think of when I say “event?” Your probably conjure up images of a party, a wedding, some sort of significant festivity, right? Would you ever, in a million years, think of cardiac events – abnormal heart rhythms, heart attacks, sudden death, that type of thing? It’s all so innocuous and nice-sounding. “Oh, I’m just monitoring my events.” It makes you feel more like a wedding planner than a heart patient.

Then, there’s the fact that they call the monitor the “King of Hearts.” I found this really amusing, though Margaret, the nurse with a lovely British accent who kept scraping my skin with sandpaper to affix the electrodes, didn’t seem to agree. But, honestly, is it a good marketing strategy to associate a heart monitoring device with a card game? I guess health is ultimately a game of chance, but who wants to be thinking about odds when we’re talking cardiac issues? Even funnier is the way I associate it with the 1967 movie of the same name, in which a soldier has to take up residence in an insane asylum. Do the makers of cardiac event monitors even have marketing departments? Can’t you just see a bunch of doctors huddled together trying to figure out a brand name? “I know, let’s make the patients think of games of chance and crazy people!!!”

It should have taken Margaret and the rest of the staff at the cardiologist’s office about twenty minutes – tops – to place this thing on me. Instead, it took an hour and a half, which was really no big deal since I brought a book and it was quiet in the reception area. Unfortunately, they had all these magazines nicely fanned out on the table: Oprah, Good Housekeeping, Self, In Style. I’m a complete sucker for trashy magazines. I never buy them, but I love reading them at appointments. It’s part of the whole office visit gestalt for me, and I’ll gladly toss aside my “serious” book for lurid articles about sex, weight loss, more sex, and more weight loss. Anyway, in one of these decidedly middle-brow publications, I ran across an article about the power of positive thinking in dealing with illness. As I believe I’ve mentioned, nothing makes me pissier than the positive thinking brigade.  Not that I believe we should sit around and focus on everything crappy in our lives. But I do despise the notion that we can just will our illnesses away with happy thoughts. The article made a special point about “loving and nurturing” the parts of our bodies afflicted with illness.

As I waited, and waited, and waited some more, I wondered how I think about the organs of my body that are affected by the sarcoidosis. Loving and nurturing were not the adjectives I came up with, particularly when it comes to my heart. I don’t speak with gentle acceptance to my heart. I don’t know that I ever have. Even when my ticker was on its A-Game, I never paid it much attention at all. Now that I have begun an ongoing dialogue, I have taken a decidedly sterner tone with my heart. I talk to my heart with an abrasive inner New Jersey-accented Mom – let’s call her Fran. I picture Fran and her pudgy daughter, my heart, as my heart gets ready for a big date, say prom. Fran is zipping up the shy heart’s satin dress, all the while keeping up a steady stream of reproach. “Oh my Gawd. Look at your right side. It’s awl enlawrged. I can barely zip up this gowgeous dress. What? You don’t like me to point out that you’re looking thick on that right side? Should I, your own mother, nawt bring up your poor function? Do you think you can just keep blaming it awl on those granulomas? Well, maybe you should think about how you got those granulomas. All that running around on the weekend…”

Perhaps mock berating my heart isn’t the nicest thing to do, but it sure is a lot more fun than nurturing and loving it. And maybe it’s inappropriate to snicker in the doctor’s office about the name of a monitoring device. But it keeps me laughing – even when I have pneumonia and am hooked up to electrodes and am worried about what the next day will bring. So, I’ll keep my fingers crossed that this taper goes smoothly. But just in case that doesn’t work, I’ll have Fran prepped and ready for back-up.

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