The BAC Birthday Bash will be held on July 4th at Saint John the Baptist Airport in Reserve, LA. This is a small airport just west of the New Orleans Class B. We plan to fly down on the 3rd and back on the 5th.
Sandra's birthday is June 30th, and on June 19th, I asked where she would like to go to dinner. Of any place we had been to dinner. We decided on King's Tavern in Natchez, MS. Then after thinking about it, decide to put off the Birthday dinner until Sunday night and hop the 100nm from there to Reserve on Monday. Good plan.
Thursday, the 29th, I started trying to make arrangements. One dead end after another. The FBO at Natchez offered no help this time, but I did get a room for Sunday and possibly Monday. By Friday afternoon, I still had no car in Natchez, but a fellow pilot offered us transportation. I could possibly arrange a car in Louisiana on Monday.
But I had been ignoring the worsening weather forecasts. Saturday night, the isolated rain and partly cloudy had deteriorated to a high percentage of rain across southern LA and MS, moving north. We watched Sunday morning as a line of rain formed from Lake Charles to Hattiesburg and moved NW. It was through Natchez by noon, but now stood between us and any route to Natchez. No trip east today, and the outlook for Monday was no better.
The weather made the fly-in to Reserve a drive in. Even a pilot from Baton Rouge couldn't make it. The worst part was that the skies here were clear and hot.
Big time trouble.
The weather just kept getting hotter, but we have a big summer planned. Having missed the Birthday Fly-in, I need to get some hours in July. Sandra has scheduled her annual school teacher get together for the weekend of July 15. I offer to fly her to Tyler so she can ride to the get-together with the other girls, but that seems senseless as they will be staying in Richardson, less than 5 miles from the house. I try to arrange a passenger for Saturday morning with no success. The plan is to go to the airport early Saturday and fly by myself if I have to.
Sandra leaves at 5:00PM and I settle back to watch Special Report. Then the world went to hell in a handbasket:
- 7/14 1800hr: severe angina attack stopped after heaving my guts out.
Into the bathroom where I could lean further over the porcelain throne. I managed several less than dry heaves and the chest pain stopped immediately. Oh, well... My diet for today closely matched the diet on a day several weeks ago that had ended with severe abdominal cramps. Maybe I had better not eat like that again. I passed the rest of the evening quietly except that I didn't eat any dinner and went to bed around 11:30.
- 7/15 0400hr: severe angina attack terminating in a 911 ride to the hospital.
I called 911 and put on some clothes. The operator stayed with me until the EMTs arrived. Nitro spray, baby aspirin and all the wires for EKG, along with an IV and we are off to the hospital. The EKG isn't quite normal, but shows no indication of a heart attack and I am doing quite well by the time we get to the ER. I had called Sandra on her cell, but went to voice mail. She called back as we were loading up and I told her the current situation.
In the ER, a better EKG was hooked up and the resident vampire drew 5 vials of blood for tests. Sandra arrived and we were all having some fun except for the location not being conducive to partying. They determined that there was no indication of a heart attack of any type, but need to run some more tests.
We get up to a room about 8:00 and I order breakfast. Their French toast is quite good. About 10:00, the doctor comes in. The good news is that I definitely did not have a heart attack. He is concerned about my high cholesterol and tri-glyceride numbers and the fact that I smoke. He will schedule a cardiac catheterization on Monday and place stents in all the blocked arteries.
Wait a minute here! I am 64. My weight has been within +/- 3 pounds of 165 for 30 years. My normal blood pressure is 120-125/80 (again over 30 years). There is no, repeat, no history of heart disease in my family. In spite of what the record he is looking at says, I do not smoke a pack and a half of cigarettes per day. I smoke a pipe and a 14oz can of tobacco lasts 5 to 6 weeks. The cholesterol numbers he is looking at say 139/33=172 and the tri-glyceride number is 204. Aren't we jumping to conclusions here?
I tell him that I am a pilot and I must protect my medical status. Even if we run tests first and find nothing wrong, if he does not word his reports cautiously, I could spend lots of time and money trying to retain or regain my medical certificate. He agrees to some tests first, but keeps saying, "let's get you well first, then worry about flying.". So, I will stay in the hospital over the weekend and have a stress test on Monday. If it is negative, I can go home, else the catheterization will be Tuesday.
- 7/15 1400hr: echocardiogram showed nothing untoward.
Get accustomed to the nurses coming by regularly to take blood pressure, heart rate and pulse-ox readings. I have some fluid in my lungs and my potassium is low and they are giving me pills for that. But the worst is the blood thinner shots. These are given in the "love handles" and they burn going in and keep burning for 30 minutes or more afterwards. By Sunday evening, I already have an ugly bruise on the left side and the beginning of one on the right side.
Roger comes by Sunday afternoon with a couple of magazines and sits for a while and talks aviation. That is about the high point of the day. The low point comes in the late afternoon. The day nurse checks the IV needle and it is leaking around the needle entry as well as no longer functioning. So we need a new one. Remove it from the back of my right hand and try another one in the back of my left hand. Can't make it work there, and the vampire comes in to draw some blood. The nurse finally gets a good insertion in my left arm just as the oncoming night nurse comes in to take my vitals. No big surprise that my blood pressure is 160/90!
- 7/17 1345hr: stress test indicated possible blockage on bottom of right ventricle
Finally, just after four, we go into the stress test room. Exam table, treadmill and humongous computer setup. A fully equipped medical torture chamber. I never claimed any athletic ability. I have proudly enjoyed a sedentary lifestyle for greater than 35 years, and now I get to get on a treadmill? The plan is to get my heart rate up to the desired level and then continue for 10 minutes. This rate is calculated as some arbitrary number minus my age which worked out to 133.
The attendant hooks me up to the machines and gives me another shot of juice. After another wait, the doctor comes in and we begin. Just a stroll, right? Level 1 and I start walking. The heart rate just barely breaks 100, but I start having cramps in my calves. Level 2 and the heart rate slowly rises to 127 and then steadies then drops back to 125. On to level 3. My rate climbs to 146 and my legs and hips are giving me anguished cries for help. They terminate the torture after 8 minutes.
No chest pains, no arrhythmia and my heart rate is back under 100 in less than 2 minutes. Into the waiting area for another echo. The lovely nurse brings me some food. A sandwich and a bowl of soup and a pudding cup. Get the echo and back to the waiting area. Sandra and an orderly come looking for me and then back to the room where the nurse has ordered me some food also. A salad plate and a fruit plate. I made serious inroads in them also.
- 7/17 1730hr: discharged to seek second opinion and line up cardiologist more in tune with pilot medical issues.
I again bring up the medical certificate issue and he dismisses it. I ask if I can go home tonight and get a second opinion after checking with the AME. He agrees reluctantly and signs the discharge. The nurse gets copies of the admission report and all other test reports except the stress test as they aren't available yet.
- 7/19 1100hr: angina attack returning home from picking up records for new cardiologist.
The discomfort worsens all the way home, and I rush in to get the nitro that I had forgotten just as the nausea strikes again. The spasms end the chest pain again. I call Sandra and tell her that she should come get me for the appointment.
- 7/19 1330hr: appointment with cardiologist. Cardiac cath scheduled for 7/21.
- 7/19 1800hr: severe angina attack terminating in another 911 ride.
Another ambulance ride to the Plano hospital. The ER doc is the same one that was on duty Saturday morning and he quickly takes charge of the situation. He gets in touch with Dr Akbar and the procedure Friday in McKinney is cancelled and I am scheduled for the procedure in Plano at 8AM tomorrow.
By the time the ER is done, it is too late to order supper. I have no illusions about scheduling after starving until the stress test on Monday, so the Redhead makes a fast food run while they are transferring me to a room at the other end of the cardiac care ward. Tummy sated, I settle in for another night of hospital routine.
- 7/20 0800hr: cardiac cath with 2 stents installed.
The bad news is that I will have to lay flat on my back, not moving my right leg or raising my head until some time after mid-afternoon. This is the real torture! By one, I hurt everywhere and I am starving. You can't eat anything solid laying on your back without the risk of choking. Finally, Sandra goes down and returns with a strawberry smoothie.
Around 3:30, a crew of terrorists come in to remove the catheter. The boss of the crew is a large fellow named Abdul. It seems like he has one knee on my hip and one hand on my thigh holding me down as he pulls it out. Sandra said it was huge, but I couldn't care less. Now, I can sit up and go to the bathroom. But that is all I can do.
- 7/21 0930hr: discharged home.
Why am I telling you all this?
For those who read this journal because our paths have crossed somewhere, I write to keep you informed of my current activities. For those who follow the journal for its aviation content, I intend to continue the detailed story so that you might hopefully gain some knowledge of the symptoms and activities surrounding a cardiac event and it's consequences to pilots.
We in the aviation community have some unique medical concerns and perspectives. First, our love of flying leads us to minimize medical symptoms which can affect our ability to continue flying legally. Second, a large part of the medical community has little consideration for the medical hoops that we must jump through. The "get you well first, then worry about the flying" mentality is well and good, but can cause unneeded problems and expense later. These two factors cause us the most problems when we must visit an emergency room and trust ourselves and later our medical certificates to the assigned doctor.
As it currently (Aug 06) stands, I fall in the category of "self-grounded". This means that I have determined that I no longer meet the medical qualifications to be pilot in command. No official action has been taken to revoke my current class 3 medical which expires 11/07. No action will be taken unless my status comes to the attention of the FAA as having violated the rules. My pilot's license is still valid and my biennial flight review is current until 5/07. But, I cannot exercise the privileges of "pilot in command" until my medical status is reviewed and approved by a Medical Examiner. I cannot fly solo under any circumstances. I cannot fly with non-rated passengers. I can fly with another qualified pilot in the right seat.
If I can pass a stress test in January, I can fly again. The six month delay is because if a stent is going to collapse or clog back up, it will normally be detectable within 6 months. So, we will sit and wait. Hopefully, I will be able to find some willing pilots to fly with me in order to keep my skills sharp. More important, Sandra has suddenly gotten real interested in learning to fly enough to take over if I have an incident in the air. Now to find an instructor as Dave has about given up hope of ever getting his medical back.
The follow-up visit.
August 9 is the first follow-up visit to the cardiologist. To date, I have had no symptoms of discomfort. My weight is still 168 and BP is 122/77. Dr Akbar is pleased with all of the data and says that he expects no further problems. He would like to see my LDL cholesterol level drop below 100 and will check it in November. In the meantime, I can do anything I feel like doing except fly as PIC.
