Angina - This is Getting Old

October 31, 2019
Not again! A few days ago we were walking the Fort to Fort trail in Fort Langley. Soon into it, I felt some minor tightening in my chest. I recognized the feeling but there was no real pain and it did not get worse, even after continuing the walk. In fact, by the time we sat down for a coffee, the feeling was gone. It returned a little on the way back but was not serious. I knew I had to keep an eye on this.

That night was Lauren’s birthday and I did not want to cause alarm or put a damper on things, so I took it easy. I did tell Joanie later that night, and since the next day was Halloween, I suggested perhaps going to the hospital on November 1. However, I think I already knew what was happening, but also that it was in the early stages, so it was difficult not to think about it and stress a little, or a lot. After all, we had a big trip to Australia  planned for late January and I couldn’t let health issues get in the way. My fellow travelers would be upset if I keeled over before the trip I had planned for over a year. After the last trick or treaters left, and we had reached our usual limit of five, I decided to confide in Joanie that perhaps we should go to Emergency NOW.

Surprisingly, we arrived at the Royal Columbian hospital ER to an empty waiting room. I beat the little kid who had fireworks shot at his face. I was soon admitted and moved to a room to wait for medical staff. While I would be loath to complain, it still took a total of an hour and a half to get moved to a bed. I did wonder when the admitting nurse asked me why I was there, and when I said I had chest pains, she said “Of course, you look like a typical heart patient.”  What does that mean?  Was my Australia trip in more danger than I imagined?

My temporary bed was placed right in the heart, pardon the pun, of ER, with the central nursing station nearby to one side and staff hooked on steroids coming in from the other side. I was immediately hooked up to monitors with wires. This involved suction cups plastered down on my chest hairs, making for a nice reminder that I was still alive and could feel pain every time I tried to move in bed. One lead went across my chest, threatening to choke me if I ever tried to lie on my side.

Any illusion of rest was soon taken care of. Nurses talked to each other in full volume the entire night. A crotchety fellow was in a bed a few feet away, separated only by a curtain. He was a pleasant enough fellow when his mouth was closed, but I think his goal in life was to create conflict. First he complained that my daughter was visiting beside my bed. He was told visiting hours in ER are 24/7. He also refused to cooperate with nursing staff asking him to do certain things. Things boiled over at about 2:30AM when he called over the nurse in charge. He bitterly complained about the staff talking loudly in the middle of the night and not doing any work, making it impossible to sleep. Her answer was somewhat surprising. She said the staff were on night shift, so for them the middle of the night was the middle of their day. Huh? He said they were not doing any work, but just sat around talking about Christmas presents. She was feisty and would have none of it, so he called her a half wit. In the morning a doctor came to see him and he claimed he had not slept a wink, even though I swear I heard snoring besides his farting. He also got into a fight with the doctor. He was on record as a recovering alcoholic but he objected to that as well as the bad treatment and wanted to go home right away. One nurse threatened to call security if he did not cooperate.

That was only one of the distractions. A lady behind the curtain next to me soiled her bed several times, each time needing clean sheets and diapers. She was nice about it, apologizing for the mess. At 3AM she threw up, loudly, very loudly. This was followed by moaning and apparently messing her newly cleaned bed again.

Across the narrow walkway from my bed was a machine in the wall. It was used to send blood sample, etc. to different lab locations using a vacuum tube. It sounded like the old pop machines dropping your selected pop can down onto a metal tray. This was used throughout the night. Then there was the intercom, spewing out messages frequently and the nearby printer which did not have a silent mode.

I think all of the noise was designed to see how much your heart can take. Just to be sure though, they attach a cord to your finger, the one on the opposite side of the monitor so it too can drape over you and prevent shifting to a comfortable position. The monitor sends out regular beeps. I soon learned one beep that happens when one or more of the monitor cords becomes disconnected. This did not seem to matter to anyone. I guess they needed the bed because before the end of that first night, there was a huge waiting line down the hallway in admissions and people were left in beds in the hall. I learned to find and reattach the cords myself. How else would I find out if the old kook next to me would get hauled off.

I spent much of the next day in ER. I missed breakfast in case they could squeeze me in for an angioplasty but finally got lunch at 1PM, just when the woman beside me started vomiting very loudly again. By dinner they finally found me a bed in the cardiac area. Dinner was already waiting for me. If food comes, you know you are not going to get your angioplasty any time soon, and after about 5PM, forget it, you are in for another night.

The room I was in was filled with three recovering open-heart surgery patients. Most of them had had operations and pacemakers 4 to 5 days ago but most looked in rough shape. I on the other hand, was limited to walking to the bathroom but for the rest, felt great. This was generally a much quieted place, except for the guy across from me, who looked like he could be a retired proper British professor who was often vomiting, gagging or calling for help getting out of bed and onto his bedpan.  He had a pacemaker that was old and not working properly any more. One day the nurse convinced him to wear mesh underpants, and he reluctantly agreed. For the umpteenth time he called the nurse to complain that the underwear took too long to get off. As she went off to get something, this proper gentleman suddenly muttered, “Aw, fuck, I just shit my pants.” It was a real challenge for Joanie and I not to burst out laughing out loud. There was a man down the hall in another room who sometimes moaned very loudly.

And then the was the guy who had the bed space I had my eye on. My bed was right near the door and with the curtains drawn all the time, for six days sunshine was just a distant memory. (Yes, it was apparently quite sunny during my stay.) I hoped one of my roommates might get discharged and I could move up the ranks. This one guy had his bed right by the window and could look out over New Westminster and see people who were not in open-ended gowns or nurse outfits. He only had one visitor during the time I was there, but I learned a lot about him. He spoke loudly on the phone with buddies every day. He was totally into fixing up old cars and selling them, and made several purchases while in the hospital. He lived alone but was going to stay with his brother. He doubted his brother would take real care of him, so he actually preferred to stay in the hospital as long as possible. If we had exchanged bed locations, perhaps he might have had more incentive to leave. He had some odd views on spirituality even though his brother was a Christian pastor.

After five days, I was still waiting for my angioplasty. I guess that was good because it meant that I was in better shape than all the other patients getting in ahead of me. Angioplasties were done all day long, one after the other. The man in the bed beside me was a nice Chinese man whose family always greeted me when they traipsed in. I heard him say on the first day that he was probably going home the next day, but then he complained about headaches and other things, and his discharge was delayed. This seemed to happen every day. On night five I enjoyed the rhythm of his snoring, starting already before 9:30PM, but the next morning he complained that he had barely slept. He was still there when I left, but word was that he could go home the next day. Sure!

The cardiac ward had a rest period every afternoon from 1 to 3. Being the time of day when the sun is shining nicely on otherwise dreary winter days, this is also when all the curtains were drawn and lights went out. Visitors were not allowed to stay. Except the guy with the window view who had his brother visit one day for the entire rest time. Neither thought to speak softly, so I could follow their conversation word for word. Of course, wanting patients to perhaps nap did not stop staff either from talking loudly down the halls, popping in to poke and prod and ask questions over and over. The British fellow across from me was asked one day what day it was, and he responded, "Who cares."

What is sad is how people take advantage of invalids. As I lay in my bed, my family decided to go for a walk, and visited the Dutch Store down the street. Here they found the largest chocolate letters I have ever seen. Since I was not there to protest, my family got the biggest chocolate letters ever for Christmas.

One of the things that I learned to entertain me was tracking the emergency codes announced over the intercom. We learned the different codes. “Code White in the Psych Ward” was popular. Another violent patient. Code Yellow, missing person, was also a regular. Code Blue seemed popular. It was sad to hear a Code Pink in the pediatric ward. One night at around 1AM there was a Code White down the hall. I could hear all the commotion. A patient was flipping out and needed to be restrained. Staff came running down the hall. Very exciting!

I did find that no one trusted anyone else in the hospital. I had the pleasure of being woken up at 6AM so some student could take blood samples, blood pressure, etc. Then, just before I could fall asleep again, the nurse would come to do the same thing because she was ending her shift. Chances were the nurse starting her shift would also take a crack at me. No one seemed to trust that the readings taken 30 minutes earlier could be right I guess.

On day 6 I was woken at the usual pre-dawn time. (Why would anyone want to wake up early if the only thing to do that day was to lie around.) I was told they got a call from the operation room that I might get in first thing this morning and staff would come to prep me. I barely got in a text message to Joanie who wanted to be there when I went in, and a two operation staff came to get me ready to move. Within 15 minutes I was wheeled to the operating room, and 15 minutes later I was on the table, ready to go. The cardiologist talked for a few minutes, and said he would be entering through my right wrist.  He gave me a needle that I did not even feel, and soon I was able to watch the screen as he explored my arteries and pumped me with a dye that made my entire body hot. I could feel it travel up from my feet and take over my whole body. He found a collapsed artery that had already been stunted twice. He inserted another stent, an object that looks like the spring in a ballpoint pen and holds the artery open. He said it was a triple layer. Hopefully this stent was superior to the previous stents which were inserted years ago and did not keep the artery open any more. I did not feel a thing. I was back in my room within 45 minutes. Strangely enough though, this operation threw me for a loop. It was my fourth one, the last one being 9 years earlier. Each time I felt great afterwards and assumed that the problem was fixed and over. However this time I asked if it was unusual to have to have more stents. He said no, I had 9 years between and hopefully I will not be back for another 9 years. Also, at some point you cannot keep putting in stents, but need to do open-heart surgery to do a by-pass. I did not need to hear that! This was probably not the last time? Unlike other times, it took me weeks afterwards to feel confident again and not be obsessed with feeling possible chest pains.

I was discharged later that day and was home for dinner, with my daughters treating me to my favourite meal, Dutch “boerenkoel”. I slept well beyond 6AM and no one poked and prodded me all day!

The Art of Travel

This morning I was again reminded about my love for travel, as is reflected in this blog account. It was a message about the wonders of nature and an encouragement to get out and enjoy it this summer, but not let the wonders overshadow the fact that they are there to point to the God who created them.

Travel is perhaps my greatest pastime. It begins long beforehand. First, deciding where we should go for a trip. Then, the fun of researching the possibilities, narrowing down what is realistic, what are the things we definitely want to see, where we would stay, and all the logistics to make it happen. Unlike many people who throw a trip together a few months or weeks beforehand, I like to start very early, not wanting to have to compromise my plans because we are too late to do what we want because the tour, flight, accommodation, etc. is full. Many, many hours are spent long before the trip takes place.

The first consideration is always, what kind of trip do we want to do? For me there are three alternatives, with naturally, some overlap. There are those trips that I would consider more historical or cultural. These would include visiting places like Europe, where I find myself immersed in exploring history as we visit historical sites, see ancient ruins, cathedrals, observe a different culture or make a connection to my own Dutch roots. I find these trips very enlightening. Traversing England and Scotland opened my eyes to the historical development of these countries and afterwards I read several books on the history and the past kings and queens of the British Isles. Visiting Rome piqued my interest in the Roman Empire, the influence and corruption of the Papal church in history, the power and influence of the Medicis and others, works and influences of the great Renaissance artists and everyday life in old Europe. I am always fascinated and disgusted at the evil nature of people who think nothing of torturing and killing others, including family, for their own power or influence, whether in government or in the church of the time. How did these people sleep at night? How could they believe that the evils they were doing were "good"? This kind of travel definitely leads to greater awareness of history and I think a more rounded appreciation of life and how we got to where we are. I think those that never leave the comfort of their neighbourhood are limited in their knowledge or appreciation of human and world affairs.

The second kind of trip I classify as recreational. These trips for us generally include beaches, places to relax and simply enjoying warm weather, particularly when it is winter at home. As I get older, my criteria keeps going up. Besides cruises, we prefer oceans and the water temperature needs to be warm. The beaches need to be sandy, not pebbly. Most places in the Caribbean meet this criteria. So does Maui, Hawaii. The Mediterranean does not. Costa Rica is very high on this list, with the only drawback being surf which sometimes makes for concerns of undertows. While I have always resisted all-inclusives, a recent trip to Mexico, meant to be a winter escape between more elabourate trips, changed that a little. While spending my time sitting at poolside was not a reference, especially since the pool did not meet my water temperature criteria, there was a nice sandy beach nearby with snorkeling and a few excursions made it a pleasant experience.

The third kind of trip is my favourite, and involves enjoying exotic wildlife. I have a passion for wildlife photography. While some people say you should put the camera down and just enjoy a scene of elephants, or lions, etc. I disagree. My excitement is getting a good photo of the wildlife, and then capturing the soul or actions of the animal. This I can enjoy over and over again, unlike a memory that fades over time. There is always time to enjoy the scene outside the lens of the camera once the essential photos have been captured. I am sometimes called a birder, but I resist this label. I have always enjoyed animals, spending my vacations in places like Banff and Jasper, looking for bears, elks, mountain goats and sheep, etc. To me, there is no such thing as an ugly animal. Each is fascinating in its own way. As I began to expand my travels and photography, I have concentrated more and more on birds, but for the simple reason that there are more varieties to find and capture on film. I stand in awe of the amazing colouration of toucans, bee-eaters, African rollers, hummingbirds... I see all these beautiful creations and I imagine God having a great time designing them, putting a splash of blue here, a strip of red there, some feathers that shine in violets, greens, blues and other variations in the changing light of the sun. Man alone could never create the infinite variety of colours, shapes and sizes of birds. Or designing animals that walk along the tiniest mountain ledges or have an array of different patterns in their fur. I sat for a long time in Africa viewing a large herd of zebras, observing how each had distinctly different stripes and patterns where the stripes come together on the back or face. Some people say wildebeests, also known as gnus, are ugly. I have close-up photos of them where the manes look so soft and shiny, and their backs look velvety. Beautiful!

The challenge for me in planning a trip is to try to find a balance. My wife enjoys seeing wildlife but no where near my passion. Therefore, finding places that have wildlife and nice beaches as well is important. Costa Rica fits the bill. We found a place near Dominical that had it all. It was tucked into a mountain above the main highway. It overlooked a beautiful beach and had a great infinity pool. The rain forest flowed down the mountain and around the property. Each day two different variety of monkeys would descend and frolic beside us. We had a baby sloth which spent each day sleeping in the tree within a few feet of our sundeck. We named him Sid and we saw him almost every day. Some days his mother came from one of the nearby trees to check on him. We were visited daily by toucans, fiery-billed aricari, a variety of trogans, very colourful birds, different tanagers, warblers, hummingbirds and other small exotic birds, iguanas, and woodpeckers. We were visited after dark by a mouse opossum, who seemed to live in the reed roof of our palapa, and would poke his head down from the roof before beginning his nightly foray into the forest. We also had visits from a regular opossum, some peccaries, agoutis, and a kinkajou which all came through our property during the day. We had a colourful dart frog living by our foot path. It was like a zoo. The best of both worlds. Only Africa could compare for wildlife, but Africa lacked the warm pool and ocean. 

Whenever we travel with other people, I am often the one who does most of the research and organizing of the trip. The problem with that is that I feel responsible. If accommodations are not quite up to snuff, or things do not go smoothly, I feel I let people down, and yet, I wouldn't have it any other way I guess.

The effects of a great trip are fleeting. Within a few days of being home, the trip becomes just a memory. The feel of the soft sand in your bare feet, the refreshing breeze on a warm tropical night, or the sensation of warm ocean water are soon gone. But, the trips lives on for quite some time for me. Now comes the hours and hours of organizing the thousands of photographs, sorting in chronological order photos from a variety of cameras, all with slightly different time settings. In addition to sorting out the general trip photos, I copy all wildlife photos to a separate folder on my computer so I can spend the next few months going over them, identifying each bird, animal, reptile, insect and fish. The best of each species is selected, cropped and filed in another folder where I am accumulating the best of all the animals, bird and sea life I have ever photographed to be used in a future photo album. A digital photo album is created, although my wife insists on doing the albums of our major trips because she is more creative than I am. This is much to my chagrin, since this album may not be ready for anywhere from 3 months to several years. I have to grit my teeth, because by then I am already completing plans for the next trip. At this very moment, I am completing the final touches on a trip we are taking to Australia in January, 2020. I just need to book hotels in Melbourne and Sydney. At the same time, I have been playing around with a future trip to Europe, selecting potential bus tours as well as mapping out a route and pricing out the cost of train fares and estimated hotel costs to see if that may be a better option. I am also accumulating information on potential places to book for a safari trip to Zambia and the Chobe River in Botswana. 

I think travel opens one mind. It is also very cool to watch the news, or a movie or other media, and think, "Hey, I know where that is! I've been there. I what they are talking about." Historical references have more meaning when you have actually been to the places or seen the monuments. Unfortunately, most people say the best thing about holidays is the people you meet. I have a brother-in-law who's greatest pleasure is hanging out and joking around with the locals. I feel bad for saying this, but I do NOT go for the people. My highlights are birds and animals we have seen, or amazing warm beaches we have spent time at. I have met some very nice people, but I have also been disillusioned. So many talk about going to Africa to meet the indigenous people who are so friendly and accommodating. I found that too often, people such as the Maasai of Kenya and Tanzania see us as nothing more that wealthy people they like to hit up for donations or sale of cheap trinkets I no interest in.

I would encourage anyone to get out and see the world, and marvel in the things that interest you, whether that be getting to know and understand people of other cultures, enjoying nature in all of its amazing forms, of just finding a new place to just hang out. Sure, sit and read to your heart's content if reading is your way of vacationing, but also take time to look up from your book and just absorb the surroundings.

The hardest part of enjoying traveling is to live long and healthy enough to visit all the places you want to see, and still have time to return to those places that have given you pleasure in the past. Happy travels!