MY BROKEN HEART BLOG

BIG NEWS!!

noreply@blogger.com (allison graff, creator) — Fri, 07 Aug 2009 03:40:00 +0000

after six years, i am leaving jacksonville, fl.

no idea what is next, but i am moving back to syracuse, ny to take some time and figure it out.

The following responses to my announcement summarize my thoughts:

doreen (cousin)
“be proud of your accomplishments in jacksonville. you came as a young lady and are leaving as a wise woman. you have earned your advanced degree in life.”

billie (friend)
“best wishes. i will miss you. i am glad you are doing what you know is best for you at this time in your life. take good care.”

jeanette (colleague)
“i just want you to know that you a) made very important, concrete positive impact in this community and b) I will miss you. you are an amazing person and I know that the future holds many wonderful opportunities for you both professionally and personally!”

i plan to leave jacksonville sometime in october.

cardiomyopathy CURED?

noreply@blogger.com (allison graff, creator) — Wed, 15 Jul 2009 01:31:00 +0000

best news in months

noreply@blogger.com (allison graff, creator) — Wed, 08 Jul 2009 22:29:00 +0000

On June 11, I found out the results of
my most recent eccocardiogram and twave tests.

And no, I did not see Dr. Bling.

Got the best news in months -
Not only do I feel better,
but I am g e t t i n g b e t t e r.

my ejection fraction is up to 35%
no defibrillator for now!

my junior prom pictured above

please note the
converse allstars high tops
with black faux-satin gloves

I don't quite feel like I did in high school,
but I feel better than I have in years.

next cardio appointment is in August. more then.

back to work report

noreply@blogger.com (allison graff, creator) — Sun, 10 May 2009 19:54:00 +0000

On Monday, May 4, 2009, I returned to work as the public art manager at the Cultural Council of Greater Jacksonville! It have been on leave for six months. I have been with the Cultural Council for a bit over two years.

THANK YOUs

My coworkers at the Cultural Council are amazing. Since beginning leave, they have done everything they can to make my return to work possible, pleasant, and smooth. They have worked so hard to cover my responsibilities and to keep me headed in a positive direction. Bob, Amy, Betty, Sandy, Martha, Susan, Amy P, and Gerri - you are the best!!

(Pictured left to right: Susan, Amy, Bob, Martha)

I also wanted to mention a special "coworker" who made my world a better place - Sandy 2 (I have never actually worked with her, she covered my responsibilities when I was gone. Sandy 2 has been a fabulous "seat warmer", program manager, and friend over the past few months.) "Seat warmer" was her term, not mine.

Pictured: Sandy 2

The other half of Sandy 2 is Sandy 1 - our master chief. Sandy covered my immediate responsibilities when I first applied for medical leave. In various ways, Sandy has been with the public art program since the beginning and is the half of my brain that I have forgotten. Thank you Master Chief! Sir! Mam'!

Pictured: Sandy 1

A huge THANK YOU to my colleagues at the City of Jacksonville. Although I was on unpaid leave, I was eligible for the "Critical Leave" program that converts COJ employee's leave donations into a paycheck for me. To the many COJ employees that donated to my leave bank, "Thank you for your generosity. I am so very thankful for your kindness and support. Thank you a million times."

SO HOW DID IT GO??

It was Grrrrrrrrr...GREAT! I could not imagine changing anything about last week. I don't move at the same pace, but I did what I could - turns out that meant 9am-5pm each day!! Not a bad start at all. By eating well, going to bed early, and by learning to manage my pace, I did quite well.

Pictured: Marilyn and I at Knitwitz.

Last, but certainly not least, I wanted to thank my parents. My return to work would not have been possible without my parents. They are the best-est nurses I could have ever had. It has been a long road, but my mother and father have always been there for me. Happy Mother's Day, Mom! I love you!

Pictured: My parents at Jax Beach, FL.

Going back to work soon…May 4 approaches

noreply@blogger.com (allison graff, creator) — Tue, 21 Apr 2009 16:19:00 +0000

Although my heart is still very weak, I am feeling better enough to return to work and a normal routine. My dog Brutus (below) has been my constant and faithful companion, but I yearn for human interaction and to return to the world of art.

Brutus and his favorite toy

I have been able to attend several art events in Jacksonville over the past few weeks. As I see friends and colleagues, many respond with, “you look great.” My common response is, “I have been on a diet that I don’t recommend.”

My new outfit for the Fowler Memorial Dedication.

I am slowly building up my stamina - right now I can go out for two-three hours before starting to "poop out". I have been able to go to an opening at the Cummer Museum of Art & Gardens, the Tillie Fowler Memorial Dedication (below), and the Cultural Council’s Arts Award Luncheon. I am learning that social skills are lost if you do not use them - even a brief conversation can be difficult to maintain when you are out of practice.

Tillie Fowler Memorial, Showing the Way

During the last couple weeks, I have felt more tired and slower. As the dose of heart and blood pressure medications increase, I feel weak and sometimes nauseous. Getting up from sitting is often followed by dizziness, which Dr Constantin says is normal. It doesn’t feel normal when I almost passed out shopping for shoes the other day. As I become used to the level of medications, the symptoms will subside.

Dizziness is a term used to describe everything from

feeling faint or lightheaded to feeling weak or unsteady.

Dizziness that creates the sense that you or your

surroundings are spinning or moving is called vertigo.

Although it may be disabling and incapacitating,

dizziness rarely signals a serious, life-threatening condition.

Treatment of dizziness depends on the cause and your

symptoms, but is usually effective.

Characteristics of dizziness may include:

* A sense that you or your surroundings

are spinning or moving (vertigo)

* A loss of balance

* Nausea

* Unsteadiness

* Wooziness

* Lightheadedness

* Faintness

* Weakness

* Fatigue

* Difficulty concentrating

* Blurred vision during quick head movements

Under normal circumstances, your sense of balance

is controlled by a number of signals that your

brain receives from several locations:

* Eyes. No matter what your position,

visual signals help you determine

where your body is in space and how it's moving.

Sensory nerves. These are in your skin, muscles and joints.

Sensory nerves send messages to your brain

about body movements and positions.

Inner ear. The organ of balance in your inner ear

is the vestibular labyrinth. It includes loop-shaped

structures (semicircular canals) that contain fluid

and fine, hair-like sensors that monitor

the rotation of your head. Near the semicircular

canals are the utricle and saccule, which contain

tiny particles called otoconia (o-toe-KOE-nee-uh).

These particles are attached to sensors that help

detect gravity and back-and-forth motion.

Feeling of faintness

"Presyncope" is the medical term for feeling faint and

lightheaded without losing consciousness. Sometimes nausea,

pale skin and a sense of dizziness accompany

a feeling of faintness. Causes of presyncope include:

1. Drop in blood pressure (orthostatic hypotension).

A dramatic drop in your systolic blood pressure — the higher

number in your blood pressure reading — may result in

lightheadedness or a feeling of faintness. It can occur after

sitting up or standing too quickly.

2. Inadequate output of blood from the heart.**

Conditions such as partially blocked arteries (atherosclerosis),

disease of the heart muscle (cardiomyopathy), abnormal heart

rhythm (arrhythmia) or a decrease in blood volume may

cause inadequate blood flow from your heart.

**That’s me.

As I prepare to return to work, I am planning how I will do things differently, more efficiently, less stressful. I am normally a “let-me-do-it-all-myself” worker. This illness has reminded me that I can’t do everything myself. I hope to start slowly and be able to build up my stamina and strength. I am certain my supportive colleagues will help me along the way.

One step in front of the other…

Here are a few additional images I have taken over the past month.

Kingsley Plantation

My parents at the beach

Flamingos at Jacksonville Zoo

Loop Train at Jacksonville Zoo

broken heart update

noreply@blogger.com (allison graff, creator) — Wed, 01 Apr 2009 17:03:00 +0000

Welcome to My Broken Heart Blog.

This entry is another stop on a long journey.
I am definitely learning patience as a result of this adversity.

Patience (pā-shəns) is the ability to endure adversity without irritation.
Also steadfast, diligent, steady perseverance.

Today, my parents and I went to see Dr Magnano at
Diagnostic Cardiology Associates (also Dr Constantin's group)
about the results of the t-wave test I had on Monday.

Dr Anthony Magnano ("The Electrician")

The t-wave alternans test was negative (the results we wanted) so I do not have an increased risk of sudden heart failure from cardiac arrythmia. Those who are found to be at high risk would therefore benefit from the placement of a defibrillator device which can stop an arrhythmia and save the patient's life. The test examines the t-wave of the EKG or the measurements of the heart's electrical conduction. See diagram below.

The test was very simple and non-invasive stress test. Twelve leads were attached to my chest and midsection (after the nurse roughed up my skin with sandpaper at each lead site - OUCH!). Then I walked at a slow pace on a treadmill for approximately seven minutes. The leads fed data to a monitor that recorded the electrical wave patterns of my heart. The computer analyzed the data and issued its finding - My results were negative.

T-wave alternans testing acts as a risk stratifier between patients who need implantable cardiac defibrillators (ICDs) and those who do not. Patients who test negative for t-wave alternans are LESS likely to require a defibrillator than those who test positive.

Dr Magnano, nicknamed "The Electrician" by Dr Constantin, explained that my "electronics" are stable and my heartbeat is regular. If my t-wave alternans test was positve, a defibrillator would have been ordered immediately. Because of my age, both doctors are cautious of implanting this "machine" too soon, but they are very concerned about my low ejection fraction - still below 20%. Basically, my blood flow is good, my electronics are good, but my "ticker" is weak and can't push the blood at a healthy rate. Both doctors believe I will continue to improve as they slowly increase my medications.

I am gradually getting stronger and my stamina is increasing. The picture about was taken during a trip to Jacksonville Beach for dinner at Tacolu with my friend Toni. Lately, I move easier, with less effort, and my heart is not as stressed as before. For example, after helping my father give my dog Brutus a bath this week, I was tired, but not out of breath or palpitating.
I have had outings to First Friday in Five Points (below right)
and the Jacksonville Zoo and Gardens
(new Bamboo Gardens are a must see, below left).

I am still monitoring my sodium intake - learning about food along the way.
I am trying to move into the new Whole Foods - I hate leaving that place.

Get the Salt Out: 501 Simple Ways to Cut the Salt Out of Any Diet
by Ann Louise Gittleman

In this day and age, when fat is blamed for all our health problems, it's often easy to forget that salt can also be a dietary culprit. While salt is necessary for both bodily and cellular function, and is certainly crucial to the satisfying taste of some of our favorite foods, recent research shows that its excess consumption can also lead to hypertension, strokes, and a variety of cardiovascular problems.

In Get the Salt Out, nationally recognized nutritionist Ann Louise Gittleman reveals 501 ways to avoid excess salt intake by serving a variety of delicious low-sodium foods, taking advantage of tasty salt substitutes and steering clear of many surprising hidden sources of salt. She provides more than fifty delicious recipes for low-sodium foods, which will add healthful new staples to the diet of anyone who wants to "get the salt out."

Other features include:

¸ Advice on how to use herbs effectively to reduce sodium intake
¸ Tips for reading labels to expose salt where it is hidden as well as supermarket salt savvy
¸ Ways to reduce the salt level in your water
¸ Advice for avoiding salt when you eat out
¸ Tips for dealing with stress and other impediments you may face
¸ A week-long menu plan
¸ A resource section

Get the Salt Out has all the tips, menu plans and recipes to help you enjoy real foods again and create meals that both your taste buds and your body can truly savor!

ISBN:9780517886540

Author: Gittleman, Ann Louise
Publisher: Three Rivers Press (CA)
Subject: Salt-free diet
Publication Date:December 1996
Binding: Paperback
Pages: 240

Found this tattoo online - thought it was very appropriate.

NEXT UPDATE: June 30, 2009
Appointment with doctors regarding progress.

To my loved ones, friends, and colleagues.
Thank you for your love and support.
I could not have made it this far without you.

the state of the heart

noreply@blogger.com (allison graff, creator) — Tue, 24 Mar 2009 17:33:00 +0000

I just returned from my cardiologist, lovingly nicknamed “Dr. Bling Bling.”

Last week, I had an echo-cardiogram to determine if my heart has improved since I was in the hospital four months ago. The test showed that my heart has strengthened and is returning to its normal shape. My ejection fraction has improved, but not enough to take me out of the danger zone. My ef is up from 10%, but still well below 35%, so I will be seeing a doctor that specializes in defibrillators next week. On Monday, I am scheduled to have a T Wave test.

What’s that?

The T wave alternans (TWA) test uses an electrocardiogram (ECG) measurement of the heart's electrical conduction.

The microvolt T-wave alternans (MTWA) is a non-invasive heart test that can identify patients who are at increased risk of sudden cardiac death. It is most often used in patients who have had myocardial infarctions (heart attacks) or other heart damage to see if they are at high risk of developing a potentially lethal cardiac arrhythmia.

Those who are found to be at high risk would therefore benefit from the placement of a defibrillator device which can stop an arrhythmia and save the patient's life.

For more information on the T-wave test,

visit: http://en.wikipedia.org/wiki/T_wave_alternans

Bottom Line

The results of my echocardiogram alone were not enough to determine whether or not a defibrillator is necessary. The T-wave test will provide additional information to determine this.

My heart is working better than it was four months ago, but still below the minimum acceptable levels.

I will continue to take medication – Coreg was doubled to continue the progress of strengthening the heart.

My heart is still alarmingly weak and I am still at high risk of heart failure.

To defibrillate or not to defibrillate?

After the test on Monday and the consultation with the "electrician" (cardiologist specializing in the electronics of the heart) on Wednesday, I will know more about the defibrillator.

Surgery to Implant a Defibrillator (According to hearthelp.com)

Implanting a heart device involves making a small incision, approximately 2 inches, in the upper chest, and guiding leads (thin insulated wires) through a vein and into your heart. It is not an open heart procedure. Patients are generally awake throughout the procedure, and a local anesthesia is typically used.

Your doctor will then connect the lead wires to the implanted heart device and program the device settings. Finally, the heart device will be inserted beneath the skin and the incision in your chest will be closed. Most people stay in the hospital overnight and go home the next day.

Before the procedure you will be given medication to make you sleepy and comfortable. After the implant you may see a slight bulge under your skin where the device is located. The leads are very thin and will not be visible.

You will usually stay in the hospital overnight and receive instructions for home care. You may be asked to restrict movement of the arm near the device for a short period after the implant.

For more information, visit http://www.hearthelp.com/sca/defibrillator-surgery.html

noreply@blogger.com (allison graff, creator) — Thu, 19 Mar 2009 14:44:00 +0000

Azaleas are in bloom all over.
This is from my front yard.

A quick update.

On Tuesday, I had my echo-cardiogram.

The technician who administered the test was not able to read it, but she did suggest that the medication was "helping."

In the meantime, I am spending time with my parents, going on stamina-building excursions,
organizing my entire picture collection, and exploring the Internet. I won't be running any races anytime soon, but I feel stable and centered, which must be a silver-lining.

I will be posting following my results next Tuesday. Wish me luck!

Echocardiogram on Tuesday

noreply@blogger.com (allison graff, creator) — Sun, 15 Mar 2009 13:08:00 +0000

Over the last few weeks, I have started to feel much better.

My spirits are up.

(picture taken circa 1980)

I managed to stay out of trouble since my dad has been gone.

(picture taken circa 1996? please note: eyebrow ring)

I have been cooking!!

I am reorganizing my photo collection.

(I am on the left, sitting next to my sister, Anne Marie.)

I have been taking a lot of photos of whatever is around me.

(Dumpster I parked next to on Valentine's Day.)

I try to get out each day on an "outing" of some sort - groceries, dinner, movie, etc.

(Bob White, Betty Francis, me, Susan Demato)

My weight, blood pressure, and heart rate have been stable.

I will be having the first echo-cardiogram since my hospital stay in November on Tuesday, March 17 (St Patricks Day). This test will determine whether the medications I have been taking have improved my heart. I will find out the results of the test on March 24. I am not sure what will happen next...pacemaker? more meds? Will know more soon.

From youtube

normal echo dilated cardiomyopathy

From Wikipedia

An echocardiogram, often referred to in the medical community as a cardiac ECHO or simply an ECHO, is a sonogram of the heart. Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart. The latest ultrasound systems now employ 3D real-time imaging. (click here to see an echocardiogram)

In addition to creating two-dimensional pictures of the cardiovascular system, an echocardiogram can also produce accurate assessment of the velocity of blood and cardiac tissue at any arbitrary point using pulsed or continuous wave Doppler ultrasound. This allows assessment of cardiac valve areas and function, any abnormal communications between the left and right side of the heart, any leaking of blood through the valves (valvular regurgitation), and calculation of the cardiac output as well as the ejection fraction.

I plan to post after my March 24th appointment.

How are you feeling?

noreply@blogger.com (allison graff, creator) — Tue, 24 Feb 2009 00:53:00 +0000

convalesce (verb) to recover health and strength after an illness

Thank you friends for reading my blog and for all of your
thoughts, prayers, love, and support.

This time has been difficult – I am uncertain, impatient, frustrated, isolated, depressed, doubtful, and hopeless – and that’s all before breakfast!
but I am taking one day at a time and I know that this will make me stronger!

In the beginning, I did not reach out to many people -
It is hard for me to tell my story, but I am using all of my means
to keep in touch with everyone. Please excuse me if I do not respond to messages right away … don’t worry, I will be in touch.

I wrote this to help develop my "laidbackness"

noreply@blogger.com (allison graff, creator) — Tue, 24 Feb 2009 00:29:00 +0000

Wait & See
by Allison Gale Graff

There once were two brothers from Relax-city,

One was named Wait and the other one, See.

The whole family always seemed to go with the flow,

Their mother’s name was Patience and their father's name was Joe.

They never worried or scurried or pondered so much,

They never planned breakfast or dinner or lunch.

They took what was given and did the best that they could,

They never said I should of or I could of or I would.

So the next time that you begin to stress, just think of Wait and See,

Take in a breath and hug yourself, be all that you can be.

to be continued...

Waiting...

noreply@blogger.com (allison graff, creator) — Fri, 20 Feb 2009 14:04:00 +0000

Right now, I don't agree with Andy Warhol, waiting is not making this experience more exciting. It has been awhile since I posted last.

Not much has happened, but let me catch you up.

I was on FMLA leave from November 17 – February 8, 2009, after being hospitalized for ten days and diagnosed with cardiomyopathy, a serious heart condition. After five weeks in New York, my father and I returned to Florida. On January 20, I met with my cardiologist who recommended returning to work part-time. Unfortunately, the City of Jacksonville does not offer benefits for part-time employees. After reviewing my options on January 27 with my supervisor, I applied for Leave without Pay for three months (February 9 – May 1, 2009).

My cardiologist supported this action.

Currently, the medication I am taking has stabilized my blood pressure and heart rate, but I am not able to exert myself without having increased heart rate, weakness, and extreme fatigue. I also have decreased stamina and low endurance for any activity. The medications are also (supposed to be) strengthening my heart, but their effect will not be measured until March (three months from start of treatment).

In order to maximize my recovery, to ensure my return to my full-time position, and most of all, to guarantee my long-term health, I decided to request this additional leave.

I am scheduled for an echo-cardiogram on March 17 and a follow up with my cardiologist on March 24. This test and appointment will determine, for the first time since my hospitalization, if my heart function has improved. The echo-cardiogram is typically administered three months after starting pharmaceutical treatment. It will measure my “ejection fraction” - the amount of blood exiting my heart to the rest of my body. During my hospital stay in November, my ejection fraction was dangerously low at 10%. If my ejection rate does not improve by March 17, I will be referred to a doctor specializing in pacemaker/defibrillators. This, of course, may required heart surgery. Following this additional leave, I hope to return to work full-time.

Meanwhile...

My father stayed with me in Florida until March 18.

Now he is enjoying the snow in New York (haha).

My mother and father will return in March.

My father and I visited Silver Springs, Florida and rode in a glass-bottom boat.

I visited Catsby at 11E - his new mom is taking great care of him.

My father and I enjoyed the Super Bowl with Sandy and her family.

I have been taking a lot of photos of things around me.

My father and I discovered the joy of flea/farmers markets!

The Cultural Council invited me to a Valentines Day Tea Party at Cozy Tea in Five Points.

Most recently, Pops and I explored Timucuan Ecological and History Preserve.

Look for a post following my March 24th appointment.

BACK HOME

noreply@blogger.com (allison graff, creator) — Fri, 16 Jan 2009 20:46:00 +0000

My father and I returned home this week on Tuesday, January 13.
We set out for Roanoke, VA on Monday and arrived in Jacksonville
at 5:30pm. Still 1100 miles, no matter what route you take.

A night shot of 81 South in Virginia.

I will visit my cardiologist next Tuesday - Inauguration Day.
I am unsure what I will find out, but I hope to find out that I am improving.
I may not know my ejection fraction (EF) until February - that will be three full months of treatment. It is important to me to find out that my ejection fraction (previously 10%, should be 50-70%) has improved before returning to work. My chances of heart failure remain high while my ejection fraction is low. If the EJ does not increase, my cardiologist has suggested a defibrillator or pacemaker.

Everyone keeps telling me...One step at a time.

WHAT IS A DEFIBRILLATOR?

Defibrillation is the definitive treatment for the life-threatening cardiac irregularities. Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator. This depolarizes a critical mass of the heart muscle, terminates the arrhythmia, and allows normal rhythm to be reestablished by the body's natural pacemaker, in the sinoatrial node of the heart.

Defibrillators can be external, transvenous, or implanted, depending on the type of device used. Some external units, known as automated external defibrillators (AEDs), automate the diagnosis of treatable rhythms.

An implantable cardioverter defibrillator (ICD) is a small device that's placed in your chest or abdomen. This device uses electrical pulses or shocks to help control life-threatening, irregular heartbeats, especially those that could lead the heart to suddenly stop beating (sudden cardiac arrest). If the heart stops beating, blood stops flowing to the brain and other vital organs. This usually causes death if it's not treated in minutes.

A problem with any part of the electrical system process can cause irregular heartbeats called arrhythmias (ah-RITH-me-ahs). During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. Faulty electrical signaling in the heart causes arrhythmias.

ICDs use electrical pulses or shocks to treat life-threatening arrhythmias that occur in the ventricles (lower chambers of the heart).

When these ventricular arrhythmias occur, the heart can't effectively pump blood, and a person will pass out within seconds and die within minutes if not treated. To prevent death, the condition must be treated right away with an electric shock to the heart. This treatment is called defibrillation.

An ICD has wires with electrodes on the ends that connect to the chambers of your heart. The ICD will continually monitor your heart rhythm. When the device detects that you're having an irregular rhythm in your ventricles, the ICD will use low-energy electrical pulses to restore a normal rhythm. If this doesn't restore your normal heart rhythm, or if your ventricles start to quiver rather than contract strongly, the ICD will switch to high-energy electrical pulses for defibrillation.

Doctors also treat irregular heartbeats with another device called a pacemaker. An ICD is similar to a pacemaker, but there are some differences. Pacemakers can only give off low-energy electrical pulses. They are often used to treat less dangerous heart rhythms, such as those that occur in the upper chambers of your heart. Most new ICDs can act as both pacemakers and ICDs.

Comparison of a Defibrillator and a Pacemaker

The illustration compares an implantable cardioverter defibrillator and a pacemaker.
Figure A shows the location and general size of an implantable cardiac defibrillator in the upper chest. The wires with electrodes on the ends are inserted into the heart through a vein in the upper chest. Figure B shows the location and general size of a double-electrode pacemaker in the upper chest. The wires with electrodes on the ends are inserted into the heart through a vein in the upper chest.

A photo showing an implanted pacemaker.

WHAT IS A PACEMAKER?

A pacemaker is a small device that's placed under the skin of your chest or abdomen to help control abnormal heart rhythms. This device uses electrical pulses to prompt the heart to beat at a normal rate.

Pacemakers are used to treat heart rhythms that are too slow, fast, or irregular. These abnormal heart rhythms are called arrhythmias (ah-RITH-me-ahs). Pacemakers can relieve some symptoms related to arrhythmias, such as fatigue (tiredness) and fainting. A pacemaker can help a person who has an abnormal heart rhythm resume a more active lifestyle.

Information from the National Heart Lung and Blood Institute

www.nhlbi.nih.gov

Seven Week Status Report

noreply@blogger.com (allison graff, creator) — Sat, 03 Jan 2009 15:32:00 +0000

A lot of family and friends have been asking me, "How do you feel?" That question is hard for me to answer,
but I have several statistics to share.

I have been out of the hospital for seven weeks.

My cyst is completely healed - that means that the open incision that was originally 4.5cm long by 2.4 cm deep has completely closed. The wound is left open, instead of sutured closed, to allow the area to drain and to prevent the cyst from reforming. See more information below.

A Pilonidal excision wound is also called a "Cavity Wound",
meaning that a large chunk of tissue has been removed, leaving a cavity.
Small cavity wounds can be closed with stitches, but larger cavities
are in much greater danger of infection and will likely be smoother and less prone to splitting if the cavity is allowed to fill in with new tissue.

An "open" healing happens by letting the wound "fill in" from the bottom.
The wound will fill itself in by building new tissue starting at the bottom of the wound. The most important part of open healing is to keep the sides of the wound from touching - if the sides touch, then they can form bridges and heal together, trapping drainage in the wound. Sterile gauze is used to fill the wound to absorb drainage and keep the wound walls separated.

I routinely measure my weight, temperature, blood pressure, and heart beat.

My four week averages are:

WEIGHT: 140 lbs
TEMPERATURE: 97.7 degrees
BLOOD PRESSURE: 103/69
HEART BEAT: 86 beats/min

WHAT IS YOUR WEIGHT?

Before being hospitalized, I weighed around 160lbs.
One week after returning home, I had lost 20lbs.
I blame it on hospital food and diuretics.

Average Weight Chart - Women

Age	lb
20	130
30	140
40	148
50	152
60	155
70	147

My weight varies depending on the amount of sodium I ingest.
A build up of water in the body contributes to increased water levels
in the body causing the blood pressure (and thus strain on the heart) to increase.

WHAT IS YOUR TEMPERATURE?

Most people think of a "normal" body temperature as an oral temperature of 98.6F.

Your temperature may actually be 1°F or more above or below 98.6F.

Also, your normal body temperature changes by as much as 1°F (0.6°C) throughout the day, depending on how active you are and the time of day.

Body temperature is very sensitive to hormone levels and may be higher or lower when a woman is ovulating or having her menstrual period.

What can cause a fever?

Infection. This is the most common cause of a fever. Infections may affect the whole body or a specific body part (localized infection).

Some medicines, such as antibiotics, raise the body temperature directly; others interfere with the body's ability to readjust its temperature when other factors cause the temperature to rise.

Severe trauma or injury, such as a heart attack, stroke, heat exhaustion, or burns.

Medical conditions, such as arthritis, hyperthyroidism, and even some cancers.

WHAT IS YOUR BLOOD PRESSURE?

WHAT IS YOUR HEART BEAT?

The average adult heart beats about 60 to 80 times a minute at rest.

The resting heart rate usually rises with age, and it's generally lower in physically fit people. Resting heart rate is used to determine one's training target heart rate. Athletes sometimes measure their resting heart rate as one way to find out if they're over trained. The heart rate adapts to changes in the body's need for oxygen, such as during exercise or sleep.

I am on a low to no sodium diet

noreply@blogger.com (allison graff, creator) — Tue, 23 Dec 2008 18:15:00 +0000

Sodium

It's present in nearly all foods.
It's essential to life.
It enhances the flavor and texture of many foods.
It can be difficult to sort out all the facts about it.

You might be surprised to learn that most of the sodium in your diet doesn't come from the saltshaker.

About 75 percent of sodium comes from salt added to foods during manufacturing. Salt has many purposes in food including enhancing natural flavors, preserving freshness and improving texture.

Some common sources of sodium are canned soups, vegetables, and tomato juice; processed meats such as ham, bacon, hot dogs and lunch meats; frozen entrees and pizzas, packaged seasoned rice dishes, and pickles.

About 5 to 10 percent of sodium intake comes from salt added during cooking or at the table, and another 10 percent comes from sodium found naturally in foods.

Questions & Answers about
Salt vs. Sodium 

Q = How do salt and sodium differ?A = Table salt is 40% sodium. The other 60% is chloride. Salt (sodium chloride) is the major contributor of sodium in our diets.

Q = Should I try to eliminate foods with sodium from my diet?
A = No. Sodium is an essential nutrient. The body needs a small amount of sodium. Health experts suggest choosing a diet moderate in salt and sodium.

What is Sodium?

Sodium is an essential mineral or micronutrient          which along with potassium helps to regulate the body's fluid balance.          Unlike other minerals, sodium (or sodium chloride, alias salt) has a recognizable          and popular taste, and is widely added to snack foods and other processed          foods.

Sodium deficiency is not common, and according          to some experts the average Western diet provides more than 5 times the          recommended daily allowance of sodium. Excess sodium intake is linked          with high blood pressure and heart disease.

Dietary sodium is measured in milligrams          (mg). The most common form of sodium used is table salt, which is 40 percent          sodium. One teaspoon of table salt contains 2,300 milligrams of sodium.

Salt for human consumption is produced in different forms: unrefined salt (such as sea salt), refined salt (table salt), and iodized salt. It is a crystalline solid, white, pale pink or light gray in color, normally obtained from sea water or rock deposits. Edible rock salts may be slightly grayish in color because of this mineral content.

Chloride and sodium ions, the two major components of salt, are necessary for the survival of all known living creatures, including humans. Salt is involved in regulating the water content (fluid balance) of the body. Salt cravings may be caused by trace mineral deficiencies as well as by a deficiency of sodium chloride itself. Conversely, overconsumption of salt increases the risk of health problems, including high blood pressure.

PROCESSING TABLE SALT

Since the 1950s it has been common to add a trace of sodium ferrocyanide to the brine in the United Kingdom; this acts as an anticaking agent by promoting irregular crystals.  Sodium ferrocyanide has been banned in the United States and a similar ban has been discussed in the United Kingdom, but was determined to be unnecessary. These agents are hygroscopic chemicals which absorb humidity, keeping the salt crystals from sticking together.

Some anti-caking agents used are tricalcium phosphate, calcium or magnesium carbonates, fatty acid salts (acid salts), magnesium oxide, silicon dioxide, calcium silicate, sodium aluminosilicate, and calcium aluminosilicate. Concerns have been raised regarding the possible toxic effects of aluminium in the latter two compounds; however, both the European Union and the United States Food and Drug Administration (FDA) permit their use. The refined salt is then ready for packing and distribution.

What is a Diet Moderate in Sodium?

Food labels state that the "daily value" for sodium is
less than 2,400 milligrams per day.

Health experts realize that many people consume more than 2,400 milligrams of sodium per day. Less than the 2,400 milligram sodium goal may be unnecessarily low for many healthy people.

Other individuals on medically prescribed diets might need to consume less than 2,400 milligrams of sodium per day.

Here's what food product labels tell you about sodium:

Sodium Free	Less than 5 milligrams sodium per serving
Low Sodium	140 milligrams or less sodium per serving
Reduced/Lower Sodium	At least 25% less sodium per serving when compared to a similar food
No Salt Added	No salt is added during processing (when this product is normally processed with salt). The product may not be a sodium free food, so check the nutrition facts

THE HISTORY OF SALT

In the Iron Age, the British evaporated salt by boiling seawater or brine from salt springs in small clay pots over open fires. Roman salt-making entailed boiling the seawater in large lead-lined pans. Salt was used as currency in ancient Rome, and the roots of the words "soldier" and "salary" can be traced to Latin words related to giving or receiving salt.

During the Middle Ages, salt was transported along roads built especially for that purpose. One of the most famous of these roads is the Old Salt Route in Northern Germany, which ran from the salt mines to shipping ports.

In colonial India, only the British government could produce and profit from the salt production conducted by Indians living on the coast. Gandhi chose to protest this monopoly in March 1930 and marched for 23 days with his followers. When he arrived on the coast, Gandhi violated the law by boiling a chunk of salty mud. This march became known as the Salt March to Dandi (see below). People across India began making their own salt in protest, and the march became an important milestone in the struggle for Indian independence.

Salt production also played a significant role in early America. The Massachusetts Bay Colony held the first patent to produce salt in the colonies and continued to produce it for the next 200 years. The Erie Canal was opened primarily to make salt transportation easier, and during the Civil War, the Union captured significant Confederate saltworks and created a temporary salt shortage in the Confederate states. It continues to be important to the economies of many states, including Ohio, Louisiana and Texas.

Aside from economics, salt also has cultural and religious significance. It has long been used in Shintoism to purify things, and Buddhists use salt to repel evil. In Judeo-Christian traditions, salt was used to purify people and objects, as an offering, and to seal covenants. There are numerous references to salt in the Old and New Testaments of the Bible. One of the most famous is Lot's wife, who was turned into a pillar of salt in Genesis after disobeying God's command. A rock-salt pillar that stands today on Mount Sodom is known as "Lot's Wife" (see below).

There are lots of sayings related to the use of salt. It was often traded for slaves, which is the origin of the expression "not worth his salt." Someone who is the "salt of the earth" is a dependable, unpretentious person. "Salting the earth," on the other hand, refers to an ancient military practice of plowing fields with salt so that no crops could be grown.

FMLA: Family Medical Leave Act (originally posted Dec 17)

noreply@blogger.com (allison graff, creator) — Tue, 23 Dec 2008 00:53:00 +0000

When my12 weeks of FMLA leave was recently approved,

I found out I would only be paid if City of Jacksonville employees donated their own leave time to me.

That's right, FMLA is unpaid leave.

I will go three months without pay unless City employees donate.

I wanted to share the facts about FMLA with everyone.

This is a federal program that many people know nothing about.

For more information, visit http://www.dol.gov/elaws/esa/fmla

Frequently Asked Questions and Answers

Q: How much leave am I entitled to under FMLA? If you are an "eligible" employee, you are entitled to 12 weeks of leave for certain family and medical reasons during a 12-month period.

Q: Does the law guarantee paid time off? No. The FMLA only requires unpaid leave. However, the law permits an employee to elect, or the employer to require the employee, to use accrued paid vacation leave or, subject to certain restrictions, sick or family leave, for some or all of the FMLA leave period. When paid leave is substituted for unpaid FMLA leave, it may be counted against the 12-week FMLA leave entitlement.

Q: May I take FMLA leave for visits to a physical therapist, if my doctor prescribes the therapy? Yes. FMLA permits you to take leave to receive "continuing treatment by a health care provider," which can include recurring absences for therapy treatments such as those ordered by a doctor for physical therapy after a hospital stay or for treatment of severe arthritis.

Q: Which employees are eligible to take FMLA leave? Employees are eligible to take FMLA leave if they have worked for their employer for at least 12 months, and have worked for at least 1,250 hours over the previous 12 months, and work at a location where at least 50 employees are employed by the employer within 75 miles.

Q: Do the 12 months of service with the employer have to be continuous or consecutive? No. The 12 months do not have to be continuous or consecutive; all time worked for the employer is counted.

Q: Do the 1,250 hours include paid leave time or other absences from work? No. The 1,250 hours include only those hours actually worked for the employer. Paid leave and unpaid leave, including FMLA leave, are not included.

Q: Do I have to give my employer my medical records for leave due to a serious health condition? No. You do not have to provide medical records. The employer may, however, request that, for any leave taken due to a serious health condition, you provide a medical certification confirming that a serious health condition exists.

Q: Can my employer require me to return to work before I exhaust my leave? Subject to certain limitations, your employer may deny the continuation of FMLA leave due to a serious health condition if you fail to fulfill any obligations to provide supporting medical certification. The employer may not, however, require you to return to work early by offering you a light duty assignment.

Q: Are there any restrictions on how I spend my time while on leave? Employers with established policies regarding outside employment while on paid or unpaid leave may uniformly apply those policies to employees on FMLA leave. Otherwise, the employer may not restrict your activities. The protections of FMLA will not, however, cover situations where the reason for leave no longer exists, where the employee has not provided required notices or certifications, or where the employee has misrepresented the reason for leave.

Q: Can my employer make inquiries about my leave during my absence? Yes, but only to you. Your employer may ask you questions to confirm whether the leave needed or being taken qualifies for FMLA purposes, and may require periodic reports on your status and intent to return to work after leave. Also, if the employer wishes to obtain another opinion, you may be required to obtain additional medical certification at the employer’s expense, or rectification during a period of FMLA leave. The employer may have a health care provider representing the employer contact your health care provider, with your permission, to clarify information in the medical certification or to confirm that it was provided by the health care provider. The inquiry may not seek additional information regarding your health condition or that of a family member.

Q: Can my employer refuse to grant me FMLA leave? If you are an "eligible" employee who has met FMLA’s notice and certification requirements (and you have not exhausted your FMLA leave entitlement for the year), you may not be denied FMLA leave.

Q: Will I lose my job if I take FMLA leave? Generally, no. It is unlawful for any employer to interfere with or restrain or deny the exercise of any right provided under this law. Employers cannot use the taking of FMLA leave as a negative factor in employment actions, such as hiring, promotions or disciplinary actions; nor can FMLA leave be counted under "no fault" attendance policies. Under limited circumstances, an employer may deny reinstatement to work - but not the use of FMLA leave - to certain highly-paid, salaried ("key") employees.

Q: Are there other circumstances in which my employer can deny me FMLA leave or reinstatement to my job? In addition to denying reinstatement in certain circumstances to "key" employees, employers are not required to continue FMLA benefits or reinstate employees who would have been laid off or otherwise had their employment terminated had they continued to work during the FMLA leave period as, for example, due to a general layoff. Employees who give unequivocal notice that they do not intend to return to work lose their entitlement to FMLA leave.

Employees who are unable to return to work and have exhausted their 12 weeks of FMLA leave in the designated "12 month period" no longer have FMLA protections of leave or job restoration. Under certain circumstances, employers who advise employees experiencing a serious health condition that they will require a medical certificate of fitness for duty to return to work may deny reinstatement to an employee who fails to provide the certification, or may delay reinstatement until the certification is submitted.

My Road Trip from FL to NY (originally posted Dec 12)

noreply@blogger.com (allison graff, creator) — Tue, 23 Dec 2008 00:38:00 +0000

Images from along the way...

From left to right, top to bottom:
Bridge; Brutus with Mom in the back seat;
South of the Border in North Carolina; Mona - our GPS guide;
the Moon visible during the day; my father while driving.

My parents, myself, and my dog Brutus left Jacksonville, FL for West Monroe, New York at 10am on Monday, December 8. We drove about 400 miles each day. The first day we drove through Georgia and South Carolina to North Carolina. We decided to sedate Brutus since he had never traveled in the car more than 15 minutes before. He was one calm pup and slept most of the trip (even without medication on the second and third days).

My mother and I joined Brutus cat-napping continually throughout the day while my father drove hour after hour. We stopped to eat our lunch at a rest stop in SC. We enjoyed our meal outside, enjoying the last of the nice weather. That evening, my father and I enjoyed a steak dinner while my mom stayed with Brutus and she dined on McDonald’s as a special treat.

The next day, we all got up early and enjoyed breakfast in our room. We were on the road by 8am. We traversed North Carolina and bits of West Virginia and Maryland. Virginia seemed like a long drive because we avoided Richmond and Washington, D.C. Virginia was covered with horse and cow farms and the mile-long fences directed us from one magnificent homestead to another. Once in Pennsylvania, the weather and the landscape changed dramatically. The rolling hills and well-manicured farms were replaced with rocky and wooded hillsides.

When we reached the New York border, the temperature was 46 degrees. Within approximately 20 minutes, the temperature dropped to 32 degrees and driving became difficult for the first time during our journey. Before we knew it, we had passed through Binghamton where I had visited my friend Karen many times, Cortland where I had lived and worked before moving to Florida, and finally Syracuse where I went to graduate school. The entire trip was about 1120 miles, 21 hours of driving, and took almost 4 tanks of gas. It snowed as soon as we got home.

CHECK UPS (originally posted Dec 6)

noreply@blogger.com (allison graff, creator) — Tue, 23 Dec 2008 00:20:00 +0000

I went to see my doctors this week
for my post-hospital checkups.

My pilonidal cyst is healing very well. The incision has shrunk from 4.5 cm long and 2.5 cm deep to 3.0 cm long and .5 cm deep in just three weeks. The home aid nurse said that I have healed faster than anyone she has seen before. The infection that the home visit nurse detected was found to be harmless and I can now change the packing every two days instead of each day.
That makes my mom happy since she is my in-home nurse.

The last two weeks I have slowly built my stamina up by going on "outings." I went to the Light Parade Downtown (see photo above) and watched a movie at a friends house. I am now able to be up and about for much longer and I don't get as out of breath as easy. I am napping frequently, but not for as long. Most importantly, I am learning my limits. That makes my father happy - he keeps me on a pretty short leash.

I also saw my cardiologist this morning. My blood pressure and heart beat is good. He is adding COREG to my current medications that include Lasix, Lisinopril, and Digoxin.

Coreg (carvedilol) is prescribed for the treatment of mild-to-severe chronic heart failure of cardiomyopathic origin, usually in addition to diuretics. Coreg is indicated to reduce cardiovascular mortality in clinically stable patients.

Lasix (Furosemide) is a diuretic.

Lisinopril is in a group of drugs called ACE inhibitors.
ACE stands for angiotensin converting enzyme.
Lisinopril is used to treat high blood pressure (hypertension),
congestive heart failure, and to improve survival after a heart attack.

Digoxin treats heart failure and slowing the heart rate in patients with chronic atrial fibrillation, a type of abnormal heart rhythm. It may also be used for other conditions as determined by your doctor. Digoxin is a digitalis glycoside. It works by increasing the force of contraction of the heart and slowing heart rate.

THANK YOU for the LOVE and SUPPORT (originally posted Dec 5)

noreply@blogger.com (allison graff, creator) — Tue, 23 Dec 2008 00:07:00 +0000

Over the last month, I have received so much love and support
from friends, family, and colleagues.
Thank you Thank you Thank you!

Beautiful flowers, humorous gifts, and inspirational cards
have not only raised my spirits,
but have given me the reassurance that I needed.

When I was in the hospital,
all of the nurses and phlebotemists would comment on my flowers.
They said that they were the MOST beautiful flowers.

I always said that my friends and family have great taste.
In response, the would add that
I definitely have a lot of people who love me.

I felt very loved and I never felt alone
when I was in the hospital.
Thank you for the company.

When I got home, I received just as many flower deliveries.
The dogs went crazy every time the doorbell rang
which made everyone jump and made my heart skip a beat (in a good way).

I received so many cards that warmed my heart.
It is wonderful to know how important you are to people...
too bad it takes an unfortunate event to find out.

I teared up several times reading emails,
listening to messages, and receiving Facebook and Myspace notes.
Those tears helped make me strong
and encouraged me not to give up because people believed in me.

Thank you for all of your love and support in all of the many forms.

Dilated Cardiomyopathy (originally posted Nov 22)

noreply@blogger.com (allison graff, creator) — Mon, 22 Dec 2008 23:40:00 +0000

Basic Facts

This is an abbreviated version of the complete article.^*

Cardiomyopathy is a term for chronic disorders of the heart that reduce its ability to pump blood.

The weakened heart compensates for reduced output of bloodby dilating, or enlarging, to hold more blood.

Dilated cardiomyopathy is a common cause of congestive heart failure.

Click here to see an animation of cardiomyopathy.

Cardiomyopathy is a chronic disorder that occurs when the heart weakens and can no longer pump sufficient amounts of blood. Although there are several types of cardiomyopathy, the most common form is dilated cardiomyopathy, in which the heart enlarges to compensate for its inability to pump blood effectively.

By dilating, or enlarging, the heart holds and pumps a higher volume of blood. In addition, the enlarged heart might temporarily increase the force of each heartbeat or elevate the heart rate (number of heartbeats per minute) to continue pumping an increased amount of blood.

WHAT ARE THE SYMPTOMS?

Because the body compensates for dilated cardiomyopathy, the disease may have no symptoms initially. As the condition worsens, the heart may perform normally when a person is resting, but may cause symptoms during periods of exercise or psychological stress.

Dilated cardiomyopathy is a common cause of congestive heart failure, the symptoms of which are often the first indication that a person has cardiomyopathy. Symptoms of congestive heart failure include:

Shortness of breath
Shortness of breath while lying down
Swelling of feet, ankles, legs, or abdomen
Awareness of one's own heartbeat
Lung congestion
Fatigue

CAUSES AND RISK FACTORS

Although most cases of dilated cardiomyopathy result from unknown causes, known causes include:

Myocarditis (inflammation of the heart's walls)
Ischemia (lack of oxygen in the heart)
A previous heart attack
Severe coronary artery disease
Heart valve disease
Chronic alcohol abuse
Chemotherapy drugs
High blood pressure
Arrhythmias (disturbances of the heart's rhythm or rate)
Autoimmune illnesses (such as lupus or rheumatoid arthritis)

DIAGNOSIS

A physician diagnoses dilated cardiomyopathy after a physical examination. He or she may check for shortness of breath during exercise and weakness. The physician may also hear rales, or wet crackles, through a stethoscope, indicating fluid in the lungs.

To confirm the diagnosis, the physician may order tests, including:

Blood tests
Chest x ray
Echocardiogram
Electrocardiography (ECG)
Cardiac catheterization and angiography

TREATMENT APPROACH

A physician may recommend that the patient first make lifestyle changes, including:

Rest adequately
Control weight
Stop smoking
Consume alcohol moderately
Exercise moderately
Limit sodium in the diet

The physician may also prescribe medications to control the symptoms of heart failure that can accompany dilated cardiomyopathy, including:

Angiotensin converting enzyme (ACE) inhibitors
Anticoagulants
Beta-blockers
Calcium channel blockers
Digitalis
Diuretics
Nitrates
Vasodilators

Patients with severe congestive heart failure that is associated with
dilated cardiomyopathy may require a heart transplant.

My broken heart (originally posted Nov 22)

noreply@blogger.com (allison graff, creator) — Mon, 22 Dec 2008 19:34:00 +0000

THIS IS HOW IT HAPPENED

On Sunday, November 2, I started to feel more tired than usual. After work Monday and Tuesday, I came home and went straight to bed. Wednesday at work I could not walk to The Landing without sitting down several times (it is only about 50 feet between buildings). After vomiting that day, my coworkers kicked me out of the building and sent me to the doctors.

My doctor treated me for asthma and sent me for blood tests and a chest xray, which I had done the next day. Meanwhile, I slept all day Thursday and Friday, barely able to walk to the bathroom without becoming extremely fatigued. By Friday night, I was frustrated and not convinced that the asthma diagnosis was correct. My friends Beth and Lee brought me to the Emergency Room at St. Vincent's Hospital.

I was admitted to the hospital when the doctor ran an EKG and found some irregularities in my heartbeat. I was immediately hooked up to a heart monitor which I wore for the remainder of my stay.

On Saturday morning, I met my cardiologist, Dr. Jonathan Constantin. I nicknamed him Dr. Bling Bling because he is quite handsome and a snappy dresser. I later learned that others called him Dr. Gigalo. Regardless, he proved to be a very compassionate and informed doctor.

The first test I was given was an echocardiogram.

What is an Echocardiogram?

An echocardiogram is a test in which ultrasound is used to examine the heart. The equipment is far superior to that used by fishermen. In addition to providing single-dimension images, known as M-mode echo that allows accurate measurement of the heart chambers, the echocardiogram also offers far more sophisticated and advanced imaging. This is known as two- dimensional (2-D) Echo and is capable of displaying a cross-sectional "slice" of the beating heart, including the chambers, valves and the major blood vessels that exit from the left and right ventricle. Above is an example.

The test showed that I had an enlarged left ventricle which was only ejecting oxygen-rich blood to my body at 10%. Average ejection fraction is 50%. Ejection fraction (Ef) is the fraction of blood pumped out of a ventricle with each heart beat.

Finding out that my heart was pumping out very little blood was very scary. I was relieved to finally know what was wrong with me. It just didn't seem like it should be happening to me. Maybe they read the wrong test. I mean, I am 33 years old. Even my doctor said I was "special". These are problems that older people deal with. Heart failure was not something I thought I had to worry about.

Dr. Constantin explained that cardiomyopathy can be caused by a virus that settles in the heart. Searching for the virus would be a waste of time because it would not alter the treatment at all. Dilated cardiomyopathy can be inherited. It also can be caused by certain diseases, conditions, and substances, including:

· Coronary artery disease and heart attacks
· Infections, especially viral infections that effect the heart muscle
· Alcohol, especially when a person has a poor diet
· Complications during pregnancy
· Certain toxins, such as cobalt
· Drugs, such as cocaine, amphetamines, and some cancer medicines
· Diseases such as diabetes and thyroid disease

The next test I had was a heart catheterization to make sure I did not have any blockages.

What is cardiac catheterization?

This is a procedure to examine blood flow to the heart and test how well the heart is pumping. A doctor inserts a thin plastic tube (catheter) (KATH'eh-ter) into an artery or vein in the arm or leg. From there it can be advanced into the chambers of the heart or into the coronary arteries. This test can measure blood pressure within the heart and how much oxygen is in the blood. It's also used to get information about the pumping ability of the heart muscle.

I was given a sedative and a local anesthetic during the procedure. Although I could have watched everything, I fell asleep. I awoke to a nurse holding pressure on my thigh . That was strange. I had to lay flat without moving for four hours following the procedure. After it was all done, I only had two small pinholes on my upper right thigh. I am pleased to report that no blockages were found.

With these tests finished, Dr. Constantin was able to determine the best course of treatment. When he mentioned changes in lifestyle, diet, habits, and the possible need for a defibrillator and perhaps a heart transplant, I have to admit that I was shocked, angry, and sad. My parents shared my range of emotions.

While in the hospital, my sister Anne Marie was a constant consultant as a former respiratory therapist. She helped us figure out which questions to ask, what to expect, and helped put everything in perspective.

After all of this, on day seven of my hospital stay, I was subjected to the worst test ever - an MRI. I developed a pilonidal cyst at the base of my spine after about 5 days in the hospital. When I complained of the soreness, everyone thought it was a bed sore. I had no bump, no redness, and no pain when I entered the hospital. I was given an egg crate to sit on and some cream. Finally, after a large, pinkie shaped/sized sore developed, the general medicine doctor, Dr. Doan, or as I prefer to call him, Dr. Duh, ordered an MRI. "An MRI for my butt?" I asked.

What is a pilonidal cyst?

A pilonidal cyst is a unique kind of abscess that occurs in or above the crease of the buttocks. Pilonidal cysts often begin as tiny areas of infection in the base of the area of skin from which hair grows (the hair follicle). With irritation from direct pressure, over time the inflamed area enlarges to become a firm, painful, tender nodule making it difficult to sit without discomfort. These frequently form after long trips that involve prolonged sitting.

MRIs SUCK!!!

They tape you down, stick you in a tube (mine was smaller than the one in this picture), put ear plugs in your ears, turn on a wicked loud roaring noise, and leave you there FOREVER. Then, they pull you out, stick "contrast" in your arm, and put you back in again.

It was AWFUL! I had to lie on my back, where the sore was located - that hurt a lot! And I had to go to the bathroom. By the time it was over, I was squeezing the emergency bell and excited to return to my room.

The MRI revealed that the bump was a pilonidal cyst. That meant surgery to drain and remove it. That meant a few more days in the hospital. My care shifted from my heart condition to a bump on my butt. I went into surgery at 9:30am, was in the operating room by 11:15am, and out of recovery by 12:30pm.

I was not able to be anesthetized because my ejection fraction is so low, so I was given a local anesthetic and a sedative. Luckily, I fell asleep again. All I remember is moving onto the operating table, being covered with warm blankets, thinking that there were a lot of people needed to remove a bump, and noticing how cold my exposed tukus felt. When I was roused from my slumber, I thought I was in an episode of Doctor Who. I swore I was in a hospital bed in the Tardis. It seemed very real.

Every day since the surgery, the wound has been cleaned and dressed. A home care nurse comes every few days to take my vitals and to take a look at the incision. Earlier this week, a bit of infection was detected. I went to Solantic for a culture and we are waiting to find out the results. Yeah!