December 26, 2014

Little Manatee River State Park
Wimauma, FL

Both Monte and I slept great. 

When we dropped off the prescriptions at Walmart the total prior to submitting the coupons came to $64.  After the coupons were applied the total came down to $30.  That is manageable.

Summary of medications:

Baby aspirin (81 mg) daily –indefinitely.  Aspirin interferes with the blood’s clotting action.  When we bleed, our blood’s clotting cells (called platelets) build up at the site of the wound.  The platelets help form a plug that seals the opening in the blood vessels to stop bleeding.  But this clotting can also happen within the vessels that supply the heart with blood.  If the blood vessels are already narrowed from atherosclerosis (the buildup of fatty deposits in the arteries) a fatty deposit in the vessel lining can burst.  Then, a blood clot can quickly form and block the artery-which might result in a heart attack.

Atorvastatin (Lipitor) 20 mg- daily-until numbers improve.  Member of the drug class known as statins, which are used primarily for lowering blood cholesterol.  It works by inhibiting an enzyme found in liver tissue that plays a key role in production of cholesterol in the body.

Clopidogrel (Plavix) 75 mg- daily for up to a year.  This drug is used to inhibit blood clots and to prevent heart attacks.  It is also used, along with aspirin, for the prevention of thrombosis (the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system) after placement of a coronary stent.  It has been stressed over and over again by the nurses and the cardiologist that not even one dose of this medication can be missed.

If missed, it could result in a major heart attack.

Metoprolol Tartrate (Lopressor) 25 mg-twice daily-undetermined how long he will be one this medication.  This medicine is a beta-adrenergic blocking agent used to treat high blood pressure. 

 

 

Monte has officially become a member of the weekly pill maintenance container club. 

 

 

 

 

Back home we opened up gifts. 

 

 

 

 

 

As Monte revealed each package I threatened to return them all.  He has got to watch his sugar and salt intake.  He promised to eat the candy in moderation.  AH HA. 

 

 

I was happy to find a new pair of slippers. 

 I also got a particular type of spatula I wanted. 

One gift Monte bought me, a set of two new sauté pans is going back to the store. I really like my pots and pans and don’t have an issue with them.  A while back, Monte decided to make eggs (the first time in years) and the eggs stuck to the pan because he used margarine.  I usually use a little Pam spray.   So ever since then he decided I needed new pans.  Sorry Sweetie- it’s the thought that counts.  And besides-the best Christmas gift I received this year was more time with you.

Another routine Monte has to get used to is to check his blood pressure twice a day.  I downloaded and printed a blood pressure log.

As a result of Monte’s condition, a lot of things are going to change for us including our lifestyle, diet and outlook.  I am grateful that we have been given this opportunity for change and look forward to many more years of togetherness, loving and nurturing each other.

Monte had such great treatment from the staff at both South Bay Hospital in Sun City Center and Brandon Regional Hospital.  Every person we encountered from the nurses, to the orderlies, the technicians, the doctors, the ambulance team from Hillsborough Fire Rescue and the dietary staff delivering meal trays was friendly.  Their genuine concern and kindness made a frightfully stressful, scary ordeal just a little bit less stressful and scary. 

 

December 25, 2014

Christmas Day at Brandon Regional Hospital

Our little Annie misses her “Daddy”.  She is not eating and has begun to walk around making what I can only describe as a sad wailing sort of sound. 

By the time I made a few phone calls and uploaded a picture of Monte with an update on his status to Facebook it was 10AM before I left for the hospital. 

Monte said he slept well.  When lunchtime rolled around not only did Monte get a tray but I was given a tray as well because a patient had been discharged before lunch resulting in an extra meal being available. 

 It was very good and it was so nice to be able to share a Christmas meal together.

The doctor had not been in to visit yet so by dinnertime we were doubtful that Monte was going to be discharged. 

His nurse, Mark explained that usually a patient is not discharged for at least 24 hours following the cath procedure. 

At around 5:30, Dr. Nagamia arrived.  He had checked Monte’s vitals and said he was going to discharge him.  We were instructed to call to make a follow-up appointment for two weeks.  He also said Monte has to have a primary care doctor because he would be the one writing prescriptions in the future.

Prior to Monte going in the hospital he had made an appointment with a doctor for next week just to get a check-up and see if he should get a PSA test.  He hasn’t had a test in almost 4 years.    Dr. Nagamia told us to make sure we take a list of the medications Monte is on to the new doctor.

Luckily, Monte had been given all his meds for the day so we could wait until the next day to fill the prescriptions.  This would give us a chance to go online when we got home to research which store had the cheaper prices between Walmart and Walgreens.  Because we travel we need to be able to get the refills from a national chain so going to a local pharmacy or supermarket was out of the question. 

By the time the discharge paperwork was done it was already after 7:30.  We walked (Monte was wheeled) out of the hospital with a handful of prescriptions, aftercare instructions and a wallet sized implant card detailing the type and size of the stent.

Back home, Monte went online to GoodRX that allows you type in the name of the medication and get a list of prices from all the local pharmacies.  It also provides coupons for a certain medications.  It came as no surprise to us that Walmart had the cheapest prices.

It was so good to have Monte home.

December 24, 2014

South Bay Hospital, Sun City Center, FL

& Brandon Regional Hospital, Brandon, FL

When I called Monte he said he had a miserable night because his roommate, who has COPD, was hacking all night and one of the nurses wore chemically strong cologne that caused Monte to have an allergic reaction that had him wheezing all night.  

The cardiologist, Dr. Nagamia, had been in to see Monte to list the tests he has ordered beginning with an echocardiogram.  During this test, sound waves directed at the heart from a wand like device (transducer) hold on the chest bounce off the heart and are processed electronically to provide video images of the heart.  An echocardiogram can help identify whether an area of the heart has been damaged by a heart attack and isn’t pumping normally or a peak capacity.

When I arrived at the hospital at 11AM, Monte wasn’t in his room.  His roommate told me he had been taken downstairs for a stress test.  Monte had to walk very fast on a treadmill while attached to an ECG machine.  Stress tests measure how the heart and blood vessels respond to exertion.  

 

Following the stress test, Monte was taken to the CT (cardiac computerized tomography) lab.  This test is used to diagnose heart problems, including the extent of damage from heart attacks.  He had to lie perfectly still on a table inside a doughnut-shaped machine.  An X-ray tube inside the machine rotates around the body and collects images of the heart and chest.

Within an hour of Monte returning to his room, Dr. Nagamia ordered a second CT because he wasn’t satisfied with the results of the first test.

We were treated carolers. 

What a sweet thing to do!

 

When Dr. Nagamia came into Monte’s room a short time later, he told us the results of the all the tests were conclusive.  They showed Monte had suffered at least one heart attack in the past causing permanent damage.   We were presented with three options.

Option one was to do nothing.  Not really an option.

Option two was to treat the condition with medication and hope for the best.  Not a very good option.

Finally, option three (the option the doctor recommended) was to do a cardiac catheterization to find out if there is any blockage that contributed to the attacks.  If there is blockage a stent might have to be placed in the artery.  Option three would present two options.  South Bay Hospital has a brand new Cath Lab.  Monte would be only the third patient to have the diagnostic procedure done in the lab.  Because 300 procedures have to be completed before certification is granted for placing stents, the lab can only be used for diagnosis. 

If the catheterization reveals blockage, Monte would have to be transferred to another hospital to undergo another catheterization for the placement of the stent. 

Option one was to wait until Friday to be transferred to Brandon Regional Hospital where the catheterization can be done and if necessary a stent inserted.

The reason we would have to wait until Friday is the doctor didn’t think he could get together a team on Christmas Eve.

Option two was to have the diagnostic catheterization performed at South Bay immediately so Monte wouldn’t be sitting in the hospital stressing about the unknown for two days.  And if necessary, he could be transported to Brandon on Friday for the stent procedure.  BUT at least he would know now.

After discussing it, Monte opted to have the diagnostic catheterization.  I walked down to the lab with him, kissed him goodbye and made a quick trip to Taco Bell because I hadn’t eaten in hours.  The doctor had told me the test would take at least a couple of hours because of the amount of prep required.

I was back in Monte’s hospital room within an hour.  A nurse rushed in the room instructing me to gather up Monte’s belongings because he was being transported to Brandon immediately. 

I followed her to the cath lab where Dr. Nagamia explained that he found an artery that was 95% blocked so placing the stent was a matter of urgency. 

  When a coronary artery (an artery feeding the heart muscle) is narrowed by a buildup of fatty deposits called plaque, it can reduce blood flow. 

 If blood flow is reduced to the heart muscle, chest pain can result. 

 If a clot forms and completely or almost completely blocks the blood flow to the part of the heart a heart attack results.

I followed the ambulance to Brandon.  By the time I parked, went through security and found Monte’s private room, he was already being prepped for the procedure. 

A stent is a tiny mesh tube that props open an artery and is left there permanently.  Stents help keep coronary arteries open and reduce the chance of a heart attack.

Monte was wheeled out of the room at 5:20.  I sat in the room with the TV on but not really watching.  What I did watch was the slowly moving clock.  At one point a code blue was announced that had me imaging the worst.  Finally, at 7:30PM Monte was wheeled back into the room. 

 The doctor said everything went well and told us that Monte may be able to go home the next day if he has a good night.

December 23, 2014

South Bay Hospital

Sun City Center, Florida

Monte went off to work at 8AM and was back within an hour complaining of chest pains and difficulty breathing.   I asked him if he wanted me to call an ambulance he said no but did want me to drive him to the ER at the closest hospital only a few miles away in Sun City Center.

I was a little leery about going to South Bay Hospital because it was small but my fears were quickly allayed when we entered the ER waiting room.  They had a self-check kiosk that had Monte registered with just a swipe of his driver’s license.

Within two minutes a nurse was ushering us through the ER doors and within 5 minutes of us entering the hospital Monte was being hooked up to an EKG machine.   The EKG or ECG records the electrical activity of the heart via electrodes attached to the skin.  Impulses are recorded and printed.  Because injured heart muscle doesn’t conduct electrical impulses normally, the ECG may show that a heart attack has occurred or is in progress.

A flurry of nurses and nurse practitioners swept into the room performing different tasks, taking vitals and asking medical history questions. 

 He had an IV inserted with a heparin drip.  Heparin is an anticoagulant used to decrease the clotting ability of the blood and help prevent harmful clots from forming in blood vessels. 

Blood was drawn within a half hour of our arrival to check for enzyme levels because certain heart enzymes slowly leak out of the blood if a heart has been damaged by a heart attack.  

When I was asked to step out of the room so an X-ray could be taken I took advantage of the time to go seek out a bathroom.  The chest X-ray image allows a doctor to check the size of the heart and its blood vessels and to look for fluid in the lungs.

All of the above happened in less than an hour.

We were told that the EKG looked fine and the blood test to check for enzyme levels came back acceptable but the protocol was to take another blood test an hour after the first and then again six hours after the first one.

In the meantime a nurse placed a nitro patch on Monte’s chest. At this point we weren’t sure if Monte was going to be admitted but we knew he was going to be moved to another area of the hospital because the ER was full and they needed his bed space.  I was amazed that one of the very last people to enter the room was a clerk from registration.  My experience in the past, when going to the ER, has been to show proof of insurance before being seen by a doctor.   

I followed behind as Monte was wheeled from the ER to the Endoscopy Center.  Because the hospital was full and there were no procedures scheduled the center was being used as a staging area while patients awaited tests results to determine if they would be admitted or discharged.

After the final blood test results showed elevated enzyme levels, Monte was admitted because further testing would be required to see what was causing his shortness of breath, chest pains and numbness in his left arm.

When I left at 6PM, Monte hadn’t been moved to a regular hospital room yet.  I was reluctant to leave Monte but I was hungry and tired and knew no more tests would be performed until the morning. 

I also think that at this point I thought this was going to be a false alarm and he was going to be fine.

December 22, 2014

Little Manatee River State Park

Monte worked in the morning.  After lunch we took a ride to Walmart to pick up a few items I needed to make for our contribution to the pot luck Christmas Eve dinner at the park. 

I also wanted to buy something for Monte for Christmas.  We had agreed not to buy anything expensive for each other but I did want him to have something to open Christmas morning.  So I walked around aimlessly, picking up and then putting down items.  Perhaps a flashlight-no he already has at least 10.  Ah, but this one is waterproof.  Okay, what is he going to do with a waterproof flashlight?

What about a tool?  I headed to the hardware section.  No, I’m pretty sure he has all the tools he needs.  How about a pair of slippers?  No, he likes wearing socks when his feet are cold.  And so it went on for an hour.  I finally settled on something I KNOW he would like. 

 

 Oh yeah! 

December 15-21, 2014

Little Manatee River State Park

Wimauma, FL

Monday-I guiltily stayed in bed when Monte left for work at 8AM.  I had all good intentions for getting chores done during the day but other than getting caught up on my blog entries I didn’t do much of anything.

Tuesday-

 

Removed mower disc from brushbull cutter.

Next I had to remove the cutter blades.

After sharpening I reinstalled the blades back onto the mower disc.

The blades are about worn out, good for one more cutting cycle.

============================================================

In the late afternoon we took a ride to Sam’s Club and Walmart to pick up a few grocery items.  I also picked up a couple of lottery tickets--

 Wednesday-Monte put in a full day of work (8AM to 4PM) with a short lunch break-

Thursday-

The tractor needed a good service and had to repair a

few problems from heavy use. 

I removed all the covers from both sides of the engine and cleaned

and replaced the diesel fuel filter, adjusted the transmission clutch  

and repaired the gas throttle cable.

The emergency flashers also had to be repaired.

Everything is now working and I finished up the service on the tractor.

 

I took a long walk in the park starting down the road leading to the maintenance area and our volunteer village. 

 

This area had a controlled burn just a few months ago.  I was amazed at the extent of new growth. 

 

 

 

 

 

 

Walking towards the campground I detoured to the trailhead parking area. 

 

This barrier fence blocking entry to the old canoe launch steps is new since we left back at the beginning of August.

 

 

 

 

This trail connects the trailhead parking lot the picnic area.

 

Deer tracks.

The Oxbow Nature Trail is a short loop.

 

 

 

The trail exits by pavilion 3.

 

There are a few options when exiting the trail.  I chose to walk past the restroom towards the picnic area.

 

 

 

 

When I returned Monte was just finishing up work on the tractor.

In the early evening we attended a Holiday Concert at our grandson Timmy’s school.  We were treated to a medley of holiday songs-the kids were great.

Tim, Melissa & Timmy 

 

Friday-Monte has been complaining about his vision for quite some time now.  He also was concerned because he has had a stye for a couple of weeks that is still sore and he is also experiencing frequent headaches.  So I have been nagging him to make an appointment with an ophthalmologist.  I guess he was tired of me nagging him because he finally called a nearby eye doctor and was actually given an appointment immediately.

The doctor said the stye is healing nicely.  Monte made an appointment for next week to get a complete eye exam.

After the appointment we took a walk through a nearby Kmart.  Monte bought a couple of things but I didn’t see anything I couldn’t live without.

 

But I was surprised to see a 5 lb box of chocolates for $19.99.  I wonder if it will go on sale for 50% off the day after Christmas.

 

 

 

Saturday-We had a little over an hour drive down to the North Port area for an 11:00AM brunch at the home of good friends of my parents’, Wolfi and Helen.  The house was beautifully decorated for the holidays.

 

 

Wolfi poured mimosas and then invited everyone to dig in. 

 

 

 

They put out a big spread including eggs, bacon, pancakes, assorted cheeses, salmon, fruit, breads, rolls, cookies and cake.  Oh my!

 

 

 

 

 

Mom & Dad 

Thanks Wolfi & Helen

After brunch we went to my parents’ house to visit for a little while.  My dad had bought my mom tulips, her favorite flowers, for their anniversary. 

These beautiful stockings were a handmade gift from my sister-in-law Margaret last Christmas. 

Sunday-

 

Our neighbor was complaining of a stinky sewer smell. 

Chris the Ranger drove the tractor over and hooked up a chain to the septic

tank cover and removed it. 

He proceded to run a bead of silicone caulk around the rim of the tank

to provide a seal for the cover. 

He then reinstalled the cover on top of the septic tank. 

We all gave him proper instructions on lifting the concrete blocks

and putting them on top of the cover so the wind would not blow the cover off.

No more stink. (Maybe)





The rest of the day seemed to fly by even though we didn't do much of anything.