Walking the Walklet

Walkin' the Walk

One week ago today I had open-heart surgery — a double bypass. Today is my third day home. I’m still amazed at how quickly the recovery begins. Years ago people were kept in hospital, then in bed, for weeks. Now they have you up and moving the day after surgery.

I’ve been assigned several tasks: deep breathing, foot wiggling, and what I call ‘walklets’ — little five-minute walks during the day. The deep breathing part is to help re-inflate the lungs, which partially collapse during the surgery. The foot wiggling helps pump blood back towards the heart. For the first time in my life I have swollen ankles, but I understand it’s de rigeur for bypass patients.

The walklets are my favourite. I was provided with a chart to follow that starts out by working my way up to six walklets a day, totalling 30 mins. Today I’ve already taken four walklets and it’s only dinner time. That was my personal minimal goal for the day. I should be able to do at least one more walklet today.

Eventually the walklets get longer in duration and the number of them gets smaller until the walklets have smoothed out into a single 30-min walk per day. At that point I will be ready to begin rehab.

It’s interesting to be in a situation where I have to learn patience, howevermuch it goes against my nature.

Detour

I’ve been away

Originally uploaded by StarbuckGuy

I’m writing this blog entry on my Linux laptop while sitting up in my hospital bed. I’d been getting a little bored during my stay, but once we heard that the hospital had a wireless Internet service, Marion brought me my laptop and I gave it a try. Bingo. Connected. A modest fee paid for a few days of service and here I am.

It all started a week ago, Friday, 11-April-2008, when an increased amount of angina pain that had gone on for a few days looked like a change from the milder pains to which I was accustomed. Marion and I agreed that a call to 911 was in order. Right after I had a chance to shower and enjoy a fine home-food meal. So, we casually called 911 and the big fire engine arrived shortly followed by the paramedics with an ambulance. They’re trained to take chest pains very seriously so I was bound onto a gurney and scooted up to Trillium hospital, a short five minutes or so away.

There I was stacked in the hallway with all the other patients waiting admission into an emergency room. The place was full up, as usual. But after about seven sprays of nitro with no subsiding of the pain and a steadily low BP reading, I was given a room. Blood work was done and an x-ray was taken. Both indicated that I hadn’t had a heart attack. I was relieved of course, and due to crowded hospital conditions, I expected to be sent home with a Popsicle or ice cream cone. Instead, I was admitted for further testing and observation.

Fridays aren’t good days to pick for having an emergency. Make a note to yourself about that. It was decided, based on my past history of a heart attack, and two stent procedures, that I should have an angiogram. I quite agreed this would be a capital idea, but the cardio cath labs are shut down on the weekend. On Monday my case was put forward to see if I could be fit in. Feeling a bit like a stand-by passenger on a holiday weekend I had three different appointments set for Tuesday, and each one was cancelled. I didn’t really mind, knowing there were people in more urgent need. I’d been stabilized and was resting comfortably — or as comfortably as one can in a ward with four patients, one bathroom, and an Italian guy whose snores could probably be heard two floors down at Tim Hortons.

They then gave me a “for sure” Wednesday morning appointment for 7:30am. I was awakened at 6, fed my heart pills, and reminded that I could have no breakfast. At around 10:30 I was told that my appointment would take place sometime in the afternoon. The nurse reminded me that I had to fast so I couldn’t have lunch. Uh huh. I think I got in around 2:00pm. My poor surgeon, Dr. Singh, had performed both of my previous angioplasty/stent ops and looked discouraged. “How was it this time?” I asked. “Blocked again!” He looked personally insulted. “How blocked?” I asked. “95%” he said. “Well,” said I, “at least it wasn’t my imagination that I was experiencing this.” “No,” he laughed, patting me on my shoulder, “you weren’t imagining.”

I can’t say I was greatly surprised. Despite the excellent work Dr. Singh performed, I’d already re-blocked once and if your body is prone to this kind of thing, I’d read it’s not unusual for it to happen again. For most people stents are excellent — the least obtrusive heart fixes going.

The hospital cardiologists reviewed my films and decided that it was time for an open-heart, bypass operation. Again no surprise. Of course the weekend is upon us again so I’ll be marking time for a few days more. I’m tentatively scheduled for noon, Tuesday, 22-April-2008, but I’ve already learned that schedules can evaporate quickly. And once again, if a new patient turns up who urgently needs the surgery in order to survive, that patient should obviously be treated first.

In the meantime I’ll trade emails with my friends, check out my favourite photo forums, listen to podcasts, and read the hospital menu carefully to identify what I’ve just eaten.

The Zonules of Zinn

I’ve taken the title of this posting from a new book that arrived from Amazon.ca today: Beyond the Zonules of Zinn: a Fantastic Journey through Your Brain, by David Bainbridge.1 I learned about this book from the extensive coverage given to it by one of my favourite podcasts: The Brain Science Podcast, hosted by Dr. Ginger Campbell. Brain science? Yes, for Marion and me brain science and research has become our latest study — in a lay person’s sense of the word.

Our interest in brain study has been increasing gradually over the past few years. Of course we, like most people, have been fascinated by the brain as long as we can remember. But after her Mom’s stroke and eventual death due to heart problems, we became interested in knowing how much of her former self could be recovered, as well as wondering what, exactly, happens during a stroke.

Later, after my heart attack, I felt I was losing my ability to think clearly and systematically about anything and that my memory was slipping. I was fumbling on everyday words too often for my liking. Part of this was compounded by clinical depression and the meds I was taking to ameliorate the condition. Around this time we both began to hear about new studies and findings about neuroplasticity — the ability of the brain to recover some lost functions and to continue functioning well into late old age.

As I rehabbed from an angioplasty/stent procedure, then a second procedure when I developed more arterial blockage, I became very interested in the keys to a healthy recovery and to overall health and wellness. Not surprisingly, all the things I learned about that contribute to heart health also contribute to brain health: a good diet with a lower-overall glycemic index, regular cardiovascular exercise, and good mental habits for dealing with stress and keeping the mind active.

As I began feeling better, I began reading more and with joy, in the way I did in my younger life when I was interested in nearly everything. A career in computing curtailed that enthusiasm for years because so much energy was required in learning and keeping up with technologies and methodologies. Marion had evolved along a similar path and we both once again began to study art, literature, philosophy and science. Being retired is a great boon to self study.

A healthy brain, so I kept reading, needed to be worked and challenged constantly — whether by learning a new language, taking a course, or even solving challenging puzzles such as non-trivial sudoku and crossword puzzles. I took to both, having never been a puzzle person before (as opposed to being puzzling, at which I excel). As a result of this continuous challenge to my brain, I could feel my mental functions improving. I was remembering things better, word loss was becoming no worse than what would be expected for someone in his early 60’s, and my appetite for learning had returned.

We watched Norman Doidge speak about brain plasticity in a couple of television interviews so we tracked down a library copy of his popular work The Brain That Changes Itself. It was so remarkable we’ve since bought our own copy.

About that time I was browsing the courses that were on sale from The Teaching Company. Marion and I like their courses very much and have purchased courses on history, art, linguistics, and philosophy. I wanted to buy a science course, but nothing quite as abstruse as particle physics or an overview of mathematics. I spied Understanding the Brain, taught by Dr. Jeannette Norden. It was either that or their course on Genetics and DNA. I bought the brain course and now, 36 half-hour lectures later, we’re awed by what we’ve learned from the course and we now have enough foundation knowledge to move on to further study. In our opinion, this course is excellent for people like us who are relatively new to neuroscience. Dr. Norden is a fine lecturer and the course material progressed in a logical and orderly manner.

Our studies have led us to V.S. Ramachandran’s Phantoms in the Brain, Daniel Amen’s Change Your Brain, Change Your Life, Jeff Hawkins’s On Intelligence, and now the Zonules of Zinn.

We both feel recharged. Brain study, for us, has been one of the most powerful areas we’ve ever explored. It gives us a scientific perspective on where we’ve come from, in an evolutionary sense, and how we are what we are. So much has been learned about the brain in the past twenty years and so much more discovery lies in the future. Like all fields of science, some of what we think we know will likely be discarded as our knowledge increases, and there will be whole new areas of investigation not yet guessed at.

Brain study has been the most powerful intellectual stimulant we’ve encountered in years. We think that brain research and Genetic/DNA research are at the forefront of our current understanding of what we are as evolved life forms on this incredibly diverse and improbable planet. As lay persons looking at science from the outside, we’re delighted so many wonderful, thoughtful scientists and researchers have taken the trouble to write for, and speak to, the non science-trained community.

When things slow down a bit, which could be some time down the road, you can guess what our next course purchase will be. Genetics/DNA, of course.

1 The Zonules of Zinn, for those interested, is one of the areas of brain study with an exotic name. It refers to a ring of fibrous strands that attach from the muscles that ring the lens of the eye. They function in pulling the lens flatter so we can see distant objects more clearly, and relaxing so we can see nearby objects. The eye is a direct outgrowth of the brain. As neuroscientists tell us, it’s the only part of our brain that is visible from the outside.