Another close brush with death

Contrast view of coronary arteries before and after stents
At left: my Left Anterior Descending coronary artery, before stents. Vessel is shown by contrast material; multiple occlusions as high as 90 percent are visible. At right: same artery with 3 stents, (indicated by marker lines alongside artery) restoring blood flow

To be honest, my doctor wasn’t that helpful. I had a bad experience with a statin drug; he couldn’t suggest any alternative. But for one checkup he was not available so I got his assistant. She listened carefully, outlined different kinds of statins and got me on one that doesn’t seem to have awful side effects. Based on my symptoms, she also suggested a calcium scan for my heart.

The heart is a muscle; it isn’t supposed to have deposits of calcium in it. But arterial plaque has calcium in it, making for a simple and cheap test using an ordinary CAT scanner. It was only a hundred bucks, not covered by insurance. I went in.

A calcium score above 400 indicates “extensive plaque burden”. My score of 1,325 for the Left Anterior Descending artery was… concerning. I met with the PA again. She called for a coronary perfusion scan coupled with a stress test. The results of that test confirmed the calcium scan.

Bridge Out SignCould it wait until the end of the semester to address? Well, no. Actually, the choice was between meeting the cardiologist this week for a procedure next week, and just doing the procedure this week. The cardiologist’s nurse advised just going ahead with the procedure. There was no “snooze” button.

The procedure itself was fascinating, and carefully-chosen drugs allowed me to recall every detail, only with a sense of detachment, as if it had happened to someone else whom I’d read about in a magazine article. I could see the flow stopped by occlusions. I could see it improve in real time, as the stents were inserted.

Some takeaways: My exercise habit is probably responsible for the fact that I saw a cardiologist and not a coroner. Even though the intensity of exercise had declined sharply, I had kept doing it every day. This kept blood flowing.

I have tendinitis in my left elbow. Often, the entire arm hurt, quite severely.  Coupled with lack of energy, shortness of breath, and sudden dizzyness, was the signal that prompted me to ask the sympathetic PA for a deeper investigation. Now, only my elbow hurts. Not my whole arm.

Because I’m on Plavix now, I can’t take ibuprofen, which is the only medication that really helped with my chronic pain. That’s a trade-off. After 25 years however, I have many strategies for dealing with pain. This is familiar territory, don’t worry.

I’m gonna have to find a new doctor. Unless I can just keep seeing his assistant. She’s a better ‘doctor’ than he’ll ever be.

I do not yet have a dramatic improvement in energy, but it’s only been two days. In earlier times, this would have been a bypass operation with six months of recovery.  I’m going back to work on Monday. Once the semester is over, I’m gonna take an actual two weeks off. Spend some time at the senior activity center.

What did I mean by “Another” brush with death? Well this post is already getting long, but it’s been an eventful couple of decades, and I’ve got to go for a walk.


Pain dreams

Second in a series on Chronic Pain

The dog had my upper right arm in his jaws, biting down hard. I could feel nerves, muscles, blood vessels, tearing. I could feel pressure on the bone. I pushed away; I hit him on the head. But each blow only seemed to tighten his bite…

What the hell?

I learned about pain dreams 20-some years ago. Pain will keep you from sleeping, but only until fatigue overcomes it. But your brain remains active even when you sleep, and sleep has no analgesic properties. Pain is still coming in.

Ever hear a sound in your dreams, only to wake up and find that the sound is actually present in your bedroom? Or dream about going to the bathroom, only to wake up and find that you really need to go to the bathroom? You can see where this is going…

The collapsed building

One of my pain dreams has recurred hundreds of times over the years. I’m in an old, inner-city office building with brick walls and radiators and tall windows. Usually it seems like the offices of a newspaper, or some kind of bureau, and I’m talking to someone at an old-style, gray Steelcase desk with a linoleum top and rubber borders, and a manual typewriter and dial telephone on it. Then something happens and the building collapses. There’s dust and noise and rescuers are moving around. I’m laying in the street and a huge pile of bricks is crushing my legs. And then I wake up. In my bed. My legs hurting like hell in the darkness and quiet of my bedroom.

Shards of glass

In another dream, I am walking down the street, again in an older part of a downtown area with plate-glass windows. It is evening and the street lights are coming on. There is a flash of light in a store and I throw up my hands to protect my face. Then I am sitting on a park bench looking at my hands and forearms. They are full of shards and splinters of glass. As people move around me, I begin to pull out the pieces of glass, one by one. Some of them are small, but others are three inches ling. After pulling out a few glass pieces, I wake up, with my hands and arms hurting. Usually it’s a generalized ache punctuated by flashes of sharp pain, even though my hands are actually uninjured. Just pain for no damn reason. This dream has recurred probably 50 times.

Klein bottle pain dream

I’m lying in bed, seemingly bathed in pain. My feet hurt, my legs hurt. My arms and hands hurt. My face hurts. I let out an involuntary moan… and wake up. I’m lying in bed, just like in my dream, and my whole body hurts. Should I get up? Move around the house a little, have a glass of milk? Take some ibuprofen? Or something stronger? I lift up the sheet and my shoulder protests… and I wake up. I’m lying in bed. I dreamed that I woke up and found myself in pain. And I am in pain. Awake. And usually I get up and plod down the hall for a glass of milk. This dream has recurred 20 times or so.

 Other pain dreams

There are a few other, less-repeated brain inventions to explain pain while sleeping. I’m being interrogated. I got an electrical shock and have that weak, trembly pain all over. I’m walking down the street and someone punches me in the kidney. I fall, and my ribs hurt terribly. I’m in a movie theatre, and my legs hurt so much I can barely pay attention to the movie. Or I’m talking to someone in an office, and my legs hurt so that I can barely pay attention to them. Or a large dog has my arm in a vise-like grip and won’t let go.

Morning finally comes

These dreams usually occur between 2 and 4 am, and they often signal the end of that night’s sleep. Occasionally I can get back to sleep. On a few occasions there will be a second pain dream the same night. It’s fair to say pain dreams do not improve my efficiency or demeanor at the office. They usually portend a painful day as well.

Why these dreams are interesting, though…

With the possible exception of the kidney-punch* dream, these experiences are not correlated with any actual organic damage or disease. It’s simply a malfunction of the nervous system. The part of my brain that handles imaging, interpretation, context, and story is still active even when sleeping, and still receiving stimuli from the rest of the body.

This is actually normal dream functioning. If there is a cricket in your bedroom, you may hear the cricket in your dream. Different parts of your brain are doing what they do, even though you are asleep. I might speculate that there is an evolutionary reason for this; some animals barely sleep, or only some parts of their brains sleep while others keep watch. It appears this is true to some extent of humans. You smell smoke? Feel a large insect crawling on you? Hear footsteps in the hall where there should be no footsteps? Wake up! Pump adrenalin!

The human brain is a small universe that fits inside our heads. It reflects, prioritizes, images, and in small ways manipulates the universe around us.

About This Series

In this series I’m trying to write about pain as a subject. I have a strong intuition that understanding pain and its effects will do more good than our reflex to offer sympathy. In this series I will be posting links on social media for discussion purposes.

Chronic pain is very common, but little discussed. It can be caused by arthritis, fibromyalgia, or at the other extremes of intensity, cancer or nerve damage from accidents or surgery.  It affects personality, relationships, employment, goals, and sleep to name a few.


  • The kidney-punch dream may be related to passing a small kidney stone. I have passed a number of them in waking hours over the years; big, spiky nasty ones. And possibly a bunch of smaller ones.
  • I don’t write about my dreams – positive or negative – very often. Mainly this is because I don’t think most dreams mean very much. But in this case I think they reveal something about how the brain and body work.

Pain, part 1

This series started out as one humongous postDaudet-200

I’ve been trying to write this post about chronic pain for more than 2 years, but finally decided to break it down into parts. After all, books have chapters, don’t they? This post is the first of several.

I’m not attempting anything profound here, just writing down my thoughts about an interesting aspect of my life. Writing stuff down is sort of what I do, so here goes.

When this started and maybe what started it

Starting around 22 years ago I had a series of operations, in which it seems that something went wrong with the anesthesia. At least, that’s my guess because doctors have not been able to explain why, since then, ordinary sensations are downright painful. Even washing my hands and drying them with a towel, or sitting in a chair for more than an hour. Even lying in bed only starts out comfortable. Sleep is a challenge, since staying in motion is the only thing that helps.

One doctor said that I have “fibromyalgia”, which is an ill-defined cluster of symptoms related to pain and fatigue. Because of pain’s effect on sleep I suspect the fatigue is a by-product. It’s been said you know that you have fibromyalgia when you wake up every morning feeling like you have a hangover and got into a bar fight the night before. When that goes on for years, it begins to wear on you.

Pain and personality

Chronic pain is very common. Something like 2 people out of 5 experience it, ranging from my miswired nerves to the relentless agony of a cancer or accident victim. Think of all the people you know, and several of them are probably in pain at least half of their waking hours. And (as I’ll discuss in a future installment) their sleeping hours as well.

Funny thing about pain; if it is persistent it warps your personality. Over the years, other people have noticed. Some years I become impatient with others, and struggle to filter what I say. This is, I assure you, a bad combination.

People with chronic pain actually get tired of sympathy

There’s a reason people generally don’t talk about their pain, and it is sympathy. That’s right; ordinary, well-intentioned compassion and kindness begins to wear thin. When a friend or co-worker says “Well I hope you feel better soon!”… and you know you won’t, you just don’t know how to respond. You also start to become cynical about their sympathy. And while cynicism is corrosive enough when it’s about strangers; it feels awful when you think it of your friends.

And why this series

I get through hospital stays by geeking out over the technology. It’s just so interesting, that I try to forget that I am the character in the story. And that’s what I’m doing here. I’m writing an inside perspective on something that’s a bit of a mystery: why do some people’s bodies experience pain when there’s no injury? What’s up with that? How to live with it? That’s my focus.

I plan to write about pain and doctors, drugs, depression, sleep, relationships, and anything else that comes to mind. And I’m writing it on my blog with links in social media because social media just seems too ephemeral to me. Social media is made for discussion but isn’t much good for archiving.