Health

I.C.E.


I am big on being prepared. Even if the preparation consists of nothing more than periodic dress rehearsals in my daydreams.

It’s weird to daydream about disaster and tragedy, but I was the little girl whose Barbies’ were all widowed women. And I was the teen who stared out the window of Sister Jean Freund’s South American history class and fantasized Red Dawn scenario’s. The readiness is all, as Hamlet would say once he quit whining.

During last summer’s mini-health alert, Rob put a file together for me containing all the “just in case” information. It was overkill. But it helped knowing that neither of us would be forced to wade through boxes in search of policy numbers and phone contacts. Sometimes having the details worked through in advance makes it easier to face the unthinkable.

But when he had his heart-attack, I realized that I had no idea where the file had gotten to. In our perpetual state of renovation, the minutia of life shifts from room to room, depending on where the hot reno action is taking place.

Rob took the office apart right after Christmas and the contents of the room were scattered in totes, boxes and file cabinets between the living and dining rooms. The file vanished into the triangle.

We’ve been putting the office back together these last few days, and Rob decided we needed an I.C.E. binder.

In case of emergency – crack open.

There are two of them and they have a prominent place in the organizing cabinet. Everything pertinent to life after one of our death’s is there.

“You’ll need it, ” he said, “as it’s clear now that you will outlive me.”

I scoffed and reminded him that I could be wiped out in an instant on the road from town or at the intersection. And for all we actually know, my heart could be riddled with disease just waiting to surprise us.

But I am always cognizant of the promise I made before we married, that I would let him go first. Even though it’s not my call, I did offer and the universe has a way of taking one at one’s word in these matters.

At any rate, Rob was quite sober yesterday as we discussed the I.C.E. book. He’s chafed a bit this last week. He is still on driving restriction, forbidden to engage in work even via email and bored out of his mind.

He doesn’t look sick at all. I had another husband who didn’t look sick to the naked  eye either once.

On his walk yesterday though, he overdid it. Went too far and then had to get himself back because he forgot to take his cell phone.

Six miles.

At about an hour and a half, I began to toy with the idea of hopping in the truck to go look for him. He was surprised to see I hadn’t when he finally got home – which is telling.

“I thought about Shelley, ” he said. “She used to walk that same loop with edema and a compression bandage on her leg and cancer spreading everywhere. If she could finish it, so could I.”

He is stubborn like that, but this morning he is still in bed at 10 AM.

In case of emergency, you break glass or open a binder. I am not there and I may never be. But I could be. So we organize, just in case.

After Your Husband Has a Heart Attack


The aftershocks come in waves and they are not proportional to the severity of the event.

Rob’s heart attack barely rocked the cardiologist’s Richter scale, but it lifted us up off our foundations and set us down again hard. I am left feeling slightly askew and wondering about the direction of the path I thought was straight forward and relatively paved.

In the last six months, I’d prepared for a new career path that focused more on the real world rather than the innerscape my writer self shelters herself in. I’d become more or less content with writing for the Internet and questioned the purpose and practicality of finishing the memoir – or even going back to a fictionalized account of how I ended up in such a different life from the one I’d imagined a bit more than a decade ago.

“It’s funny how we end up where we are,” Rob mused as we sat sipping tea on the back deck after his first long stroll yesterday afternoon. “I didn’t ever really picture myself a heart attack survivor or even having one at all.”

I can’t say I haven’t pictured myself a youngish widow again. I am wired for “what if” and have buried everyone I know and love dozens of times as my mind grapples with far-flung scenarios they way other people plan their weeks. But I will admit that I have grown comfortably complacent enough to suppose that Rob and I will celebrate many a double-digit anniversary together.

“You really freaked out on me,” he pointed out later in the day.

I can’t tell if he is disappointed or surprised by this. As I told the older girls while I paced the waiting area during the hour of time we had no idea where he was or if he’d sustained any unplanned damage during his angiogram,

“Grace under pressure is not me, so I hope you weren’t looking for it.”

Indeed, it took me well over two months to adjust to my late husband’s death sentence and the dementia that came with it. Which is not to say that I lost my presence of mind or that I was unable to tend to the details, I function – sometimes at quite a shockingly high altitude, but I am sharper than recently honed blade and my Sagittarian bent for action is idling constantly when not actually propelling me.

“I didn’t know what was going on or where you were,” I said, again.

“Well, were you expecting them to hand me back to you in an urn?” he asked with a smile.

“Yes,” I said. “I had no idea what had happened and no one seemed interested in clueing me in. All I needed was a ‘we were able to fix him during the angiogram but he needs to stay overnight and he’s being admitted, go get something to eat and check with admittance for his room number in an hour.’ Honestly, I would have been a totally different person had someone been bright enough to do that.”

Waiting though did give me time to reassess, and sometimes this is not reactionary as much as it is necessary redirection.

One of the things that was painfully clear as I paced was that I was in no way prepared for a disaster.

Last summer when Rob went into the ER for an abscess, he prepared a file for me with all the pertinent information I would need “just in case” – and no, it’s nice to have him leap to morbid conclusions the same as I do. It makes me feel less of a dark, twisted freak.

But in the interim, the file vanished beneath piles of paper which in turn were scattered thither and yon as we moved our lives from one room to another to stay ahead of reno work.

I was also painfully aware of legalities that still haven’t been completed like Dee’s adoption, my being on the house title and some banking details that would give me access without having to wait on lawyers and courts.

And we’re still fairly non-committal on the whole “last wishes and remains disposal” thing despite numerous conversations.

And yes, this is what races about in my brain in a medical emergency. While all of you superior humans focus on the positive and can readily put hands on rose-coloured specs, I start compiling lists for my worst case scenario action item agenda.

I find myself checking Rob’s colouring and watching his breathing. I ask him constantly how he is feeling and match up my exterior check with his answer. I am always trying to get him to rest.

“You almost died,” I told him last night as I curled up on his lap while he waited for the data recovery program to finish snatching Edie’s life off her barely breathing hard drive.

“I did not,” he countered, a bit annoyed.

“Well,” I said, not ready to let it go, “it could have been much worse. You did ignore your symptoms all week.”

“There’s nothing like waking up with sharp chest pains,” he said.

“And if you hadn’t, you  would have gone to work,” I said, “and anything could have happened. What if we’d been at the family reunion? Miles from medical help.”

“But we weren’t,” he said, “and it was hard to know what was really wrong before.”

“I told you even before Thursday that your symptoms could be heart attack related,” I said.

“When?”

“Repeatedly, ” I insisted. ” And I was right.”

“It’s important for you to be right?”

“Yes.”

And it is. I have been down this road of scoffing, pooh-poohing husband with scary and persistent physical maladies.

“If I had experienced chest pains while we were camping,” I pointed out, “there is no way we wouldn’t have packed up and headed to the ER.”

He couldn’t refute me. Rob is hawkish about my health but very much like the typical man when it comes to his own.

I am uncertain about how I feel. The medical professions thus far appear blase with the discharging cardiologist telling Rob he can go back to work in a couple of weeks (a “couple” means “two” where I come from). He handed Rob a recipe of prescriptions – some of which make zero sense. They want him to take medication for lowering cholesterol even though his levels are fine and in spite of the very serious side effects of statins and the recent studies that show there is no link between high cholesterol (which Rob doesn’t have, or did I mention that) and heart disease. Apparently in the Alberta medical world, heart attack treatment is one size fits all.

And even Rob is agitating to work from home at least via his computer and the phone because he is in charge of some major projects with multi-million dollar scope and long-range implications for his career.

“When did I become a corp whore,” he asked bemusedly just the night before his heart attack.

But I find myself grappling with need to hurry up and finish things – the reno, writing projects and such. Time being suddenly of the essence again in a way it hasn’t for a few years. That’s probably aftershocks. I have a feeling they may continue in unexpectedly ways and waves for a while.

The Patient’s Wife


There are studies showing the effect of care-giving on spouses, and they aren’tpretty. But they miss the heart of why it sucks to be the spouse of someone who’s dealing with a severe illness, no one is interested one whit in how they feel or how they are doing.

While healthcare professionals of questionable intellect, and dubious interest, carted Rob thither and yon today as though he were just another carcass, I rated nowhere near as important as meat on a rolling slab.

Never did I even see a doctor. The only nurses I encountered either ignored me or made it clear that I was wasting their time, though I can honestly say I didn’t see a single nurse above LPN status doing anything other than visiting with other staff members.

Granted, I was not ill. Rob was ill and seriously so with blockage that required a stent to correct. But I count. Regardless of my healthy status, I am deeply affected by anything that threatens my husband’s life and having had one die on me already, I have no illusions about it being impossible a second time.

Dr. Fortune Cookie had come and gone by the time Dee and I reached The Fort Hospital, a place I hope to never have to utilize again because there are one, maybe two tops, nurses on staff who seem to have any idea whatsoever of what is going on.

Exaggerate? Not I.

The nurse who helped load Rob up for his trip to the Royal Alexandria Hospital in Edmonton didn’t know that Dr. Fortune Cookie hadn’t shared any of Rob’s test results with Rob or me and that I had never even spoken to the doctor. She was slightly (emphasis on slight) surprised to find that neither Rob nor I had any idea of what test he was going to have once he got there or that we would even want to know that.

Earlier I’d asked Rob if it was typical of Alberta doctors to not bother to discuss things like what’s wrong with you or treatment options with patients and their families.

“It’s the nanny state in action,” he said. “We simply surrender to the void.”

Void is a good word for it.

Dee was a weepy mess by the time the EMT’s had loaded Rob onto the ambulance. As she and I stood there at the back of the ambulance bay waving goodbye, one of them jumped out and gave her a teddy bear – she was that distraught and I could tell it was making the EMT’s uncomfortable.

To their further credit, the EMT in charge attempted to explain Rob’s labs to me and update me on the angiogram he would be having.

EMT’s are apparently not required to take the same “patient’s and their families are incidental to the great health care process” course that RN’s and Doctors receive in the Great White Socialized Medicine North.

And I am not knocking the idea of universal heath care in general. Rob and I will never see a bill regarding his heart attack, treatment or follow-up care, but the system only sorta works. And the people who make it run on a nuts and bolts level are as big a part of the problem as the politicians who continually under-fund and slash health care budgets.

Half way to the hospital, my cell rang – and yes, I answered it because my husband who just had a heart attack was having an angiogram and god only knew what else because I sure hadn’t been briefed.

It was the nurse at the cardio-cath lab. Rob had asked her to call and give me an update. She told me that he was just going in and that the procedure would take 45 minutes to an hour and that we could see him after at the Digital Imaging Recovery Unit. She even gave me directions.

She would turn out to be the ONLY one who told me anything.

Dee and I found Edie and Mick in the waiting area. We dutifully waited for close to an hour before I questioned the receptionist – who unsurprisingly didn’t know squat. Couldn’t even find Rob’s name on the list of scheduled procedures and just waved me toward the recovery unit with instructions to “ask someone there”.

Just a note about the reception desk at  the Royal Alec imaging wing – it says “someone will be with you shortly”. Dee, Edie, Mick and I came in and sat for nearly an hour – were they only ones there – and the dimwitted receptionist never once asked if she could help us or who we were waiting on. Perhaps it is not her job, but it is the only waiting area for non-patients in that area.

Not only that, the doctors who treated Rob didn’t come out after the angio to let us know that it was over and that all was well.

I was told by the two nurses behind the desk in recovery that Rob was on his way to admittance.

“He’s being admitted?” I asked. I’d been told he would go back to the Fort Saskatchewan hospital – even if they ended up treating him. “Why?”

No reason was given and they dismissed me with instructions to meet up with my husband in admitting.

Needless to say, he wasn’t there. But a kindly young registrar made a couple of phone calls and at least tracked down his unit and room number for us.

Of course when we got to Unit 24 – the cardiac wing – he wasn’t there either.

And the nurses chattering happily away to each other behind the desk were in no mood to make a quick phone call to see where he was or if he’d come through the angio okay or if he was being admitted because something further was amiss or had gone wrong or he was going to need surgery.

Do I sound frantic? Ready to drop-kick lazy nurse ass all over Unit 24? Because I was.

“Go down and wait by the elevator,” the nurse waved me off like Queen Elizabeth shooing the help away. “He has to come that way sooner or later.”

And so I paced and was furious – mostly because I was worried.

I still didn’t know what had caused Rob’s heart attack, the extent of the damage, what the treatment would be, how long he’d be in hospital. Nothing.

36 plus hours after he landed in the emergency room at Fort Saskatchewan Hospital and going on four hours into his disappearance into the bowels of the Royal Alec in Edmonton and I knew exactly nothing. Had spoken with not a single doctor and been treated like a nuisance by all but one nurse – and she was the first one back in the Fort ER on Thursday morning, an exceedingly kind woman who answered questions and treated us like people.

The girls offered to go on the hunt for their father. It beat waiting and watching me pace in a futile attempt to quell the rising tide of fury and fret.

They’d been gone about ten minutes when Rob arrived.

He looked better than he’s looked in weeks – all summer really – and I was in such a tizzy all I could do was hiss at the women pushing his bed.

Where had Rob been? What happened? And didn’t anyone think I needed to know any of this?!

I wanted information. I cannot deal with being marginalized and treated as though what ails Rob has zero effect on me. The bed-pushers patted my head – which did nothing to improve my mood – and move on into the now off-limits ward.

Rob had no idea I hadn’t seen a doctor after his procedure by the way. He planned to call my cell if I wasn’t on the unit, forgetting, of course, that I had taken his phone before they hauled him into the city. He was actually expecting to see us there and was confused by the fact that I was upset.

The unit had closed for its two-hour “silent time” when I noticed that every patient who was ambulatory or allowed a wheelchair fled to havens unknown.

The girls arrived and as they were planning to head to the family reunion if the news was positive, they needed to see Rob pronto. It’s a long drive north and they were already under the gun to arrive before the sun set.

I sent them in despite the “closed” sign.

“Just look menacing,” I said. “No one will shoo you off then.”

I was past menacing, in case you missed that. I radiated displeasure and staff that went in and out, ducked their heads and scuttled around my pacing dervish self.

At that point, I wouldn’t have spoken to anyone had someone bothered to approach me with information. In fact, when Dee and I finally saw Rob – almost two hours after our brief reunion in the hall – I ignored the nursing staff entirely. I’d taken the information that Rob had given me and called my BFF in the states. She is a home health care nurse, and she filled the details in for me.

Dee and I visited only a little while with Rob. He was tired. Hungry too because Dr. Fortune Cookie had needlessly starved him with a clear liquids diet back in the Fort – it wasn’t necessary for his procedures. And Dee and I were worn to a nub with waiting.

They put Rob in one of those horrid little quad wards that I noticed on a previous visit to the Royal Alec. I think it’s an English thing. They remind me of the psych ward Will ended up on before the doctors finally admitted that I was right and they were wrong and stopped treating my late husband’s illness as mental.

Which brings up the bigger point. Although my Canadian experience was worse, in some respects it runs par with what I encountered in the early days of Will’s illness back in the states. I was ignored and made to feel as though my stake in what was going on was negligible. My spouse’s illness was none of my business because it didn’t affect me.

And to that I say  – “like hell”.

“If I ever get sick,” I told Rob, “do not ever bring me to this place.”

“Stop, ” he admonished. “That’s not being very yoga.”

“No,” I said, “it’s not at all and I don’t care.”

“All that ground lost,” and I could see he was trying to get me to smile – and after a while I did – but I still will never willingly be a patient at the Royal Alec.

The least scungy looking areas in the Royal Alec are the main atrium and the food court.  Everywhere else: the wards with their double and quadruple occupancy rooms, the nurses stations, the Digital Imaging Recovery Room  – every washroom I was forced to use – ooze age in a weary day labourer pushing past middle age kind of way.

A person could be coerced to look beyond appearance if  the personnel exuded dedication and love of what they do, but generally, they came off as utterly uninterested in patients beyond what they needed to do in order to get paid, and they reacted to families like they were bad smells.

Ask a question?  At best you’ll draw a blank stare and at worst a suggestion that perhaps you go bother someone else. Somewhere you will have to hunt for and walk such a distance away from the first person you queried that you won’t  have the energy to double back to the unhelpful sot who knowingly sent you on a snipe hunt.

And back to the doctors. I am still not convinced they do anything other than phone in and it’s even possible they are urban myths.

The most important thing in the end is that Rob is going to be okay, and that he won’t be trapped in that disappointing, underwhelming medical experience for too long.