Newsletter 052 – December 8, 2023
“Old age isn’t for sissies,” as the saying goes. In the last newsletter I mentioned a major incident that may affect my working conditions for several months. Let me preface this by saying I’m okay, but temporarily limited in my ability to ambulate. This will be a two-parter (some background first, then the incident in the next newsletter). Here’s what happened.
The Background: As far back as twenty years ago, I began to notice that my joints weren’t operating as smoothly as they did when I was younger. Lots of little aches and pains everywhere. Arthritis runs in our family, so I assumed that was the culprit. As my mother aged it got especially bad for her. On visits to see her in Massachusetts I noticed that her hands were misshapen, and saw that she was taking a great deal of ibuprofen for the pain. Eventually she had several surgeries, but they didn’t help much.
About fifteen years ago I noticed a grinding noise in my left knee. Within a few months I could barely walk. In 2008 I had a full knee replacement for my left knee, and it was miraculous. About ten years later my right knee was nearly as bad as the left had been. I had a partial replacement done on it, and things were fine, for a while. But then my wrists and most of my other joints started having problems. I mostly ignored them and put up with the pain, sometimes taking an ibuprofen at bedtime to help me sleep.
I was still able to exercise three days a week, using stretch bands. I also wore fingerless boxing training gloves to bind my wrists whenever I lifted any free weights (because of the extra stress the weights would put on my joints). I also discovered a couple of years ago, thanks to some x-rays my doctor had taken after I complained about pain I was having in my back, that the L1 through L4 vertebrae in my spine had no padding left between them. My arthritis was eating away at the cartilage in my joints. Partly because the pain in my joints and back had gotten worse, I asked my doctor if I could take a treadmill stress test to make sure it would be okay for me to continue with anything resembling rigorous exercise.
If you’ve never taken a treadmill test, it’s an interesting procedure. First, they attach about ten electrodes to your chest, then attach wires from each of those to an ECG monitor. Then you step on a treadmill and they start it going. The technician will likely have a conversation with you while you walk on the treadmill. They will also gradually speed the treadmill up and raise the front of the treadmill so you’re walking slightly uphill. I suspect they try to keep you talking so they can also measure how quickly you get out of breath.
On the scheduled day (in May 2021), I didn’t even start the treadmill test. The tech had all of the electrodes attached and I was just sitting there waiting to start. She excused herself, saying she would be right back, and came back with my doctor who said, “Your pulse rate is 160. You need to get to the emergency room right now.” Most adult humans have a resting heart rate of between 60 and 100 beats per minute (bpm). The lower the bpm, the more efficiently your heart is working. I couldn’t feel anything different, no pounding in my chest or anything like that. I asked if they were sure, and they said yes, go now, and they pointed me to the closest hospital in our network.
I didn’t quite believe them. I didn’t feel any different than normal. I called Minay while I was on the road and told her what was going on and where I was headed. She said she would meet me there. My doctor called ahead, and they rushed me into a room and hooked monitors up to me. Sure enough, my pulse rate was a little over 160. Over the next hour it dropped slowly back into the 80 bpm range, and they sent me home. Minay followed me in her car to make sure I would be okay.
My primary care doctor, and the cardiologist (who was added to my roster of doctors at that point), determined, after a successful treadmill test a few weeks later, that I had something called A-Fib (atrial fibrillation). It’s fairly common in older adults, and isn’t life-threatening if treated well. What happens is that the heart doesn’t pump in the perfect rhythm you might have had as a youngster. Occasionally it hesitates for a fraction of a second before pumping blood out of the atria into the ventricles. Over time, some of that blood can get temporarily shunted into a side pocket in the atria. If it’s there too long without getting pumped out again it can clot and cause a stroke. I take Eliquis now, an anti-coagulant, so even if some of that blood remains too long in my atria it won’t clot. No clot, no stroke. This also necessitated one more change, though, Eliquis doesn’t play well with NSAIDs, pain relievers like ibuprofen. Taking both anti-coagulants and NSAIDs in any sizable quantity at the same time can lead to internal bleeding, so I had to give up ibuprofen. Truthfully, it wasn’t that bad. I found the constant ache from the arthritis was bearable most of the time.
They all agreed that I should continue to exercise, which I did, but it became increasingly more difficult because the arthritis kept eating away at my joints, especially in my wrists. I was also experiencing some occasional pain in my left arm, so I asked my cardiologist a few weeks ago if I should be worried about that (left arm pain is supposed to be one of the heart attack signs in men). He scheduled a Coronary CT-Scan for November 14th to look for calcium buildup in my heart and arteries.
The CT-Scan didn’t happen that day thanks to my Adidas sneakers and a polished stone floor. Don’t worry, the floor is just fine. 😊 The next newsletter will about what happened just before the test, and why that may (or may not) slow me down for the next few months.
See you then,
[“An old and gray-headed error,”
Sir Thomas Browne, Vulgar Errors, 1645.]
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