Wellness Wednesday: How I celebrated my second anniversary of being alive

As I sipped my first cup of coffee this morning, I checked for the Amsterdam time. It was about two in the afternoon, two years ago to the hour from when my heart stopped on May 5, 2019.

My second anniversary

We’d just crossed the Atlantic on a Holland America cruise ship and should have been at Keukenhof Gardens but my husband had bronchitis, so we had stayed in Amsterdam to pick up medicine when I fainted on the sidewalk.
The EMTs arrived quickly, but my vital signs were within normal range and I told them I felt perfectly fine. Of course I did not feel perfectly fine. I’d had several days of cramping in my abdomen but I had been ignoring it, focused as I was on the next leg of our journey and a reunion with family at the Oslo Opera. “Take us back to the ship,” I commanded.

The ship doctor would not let us back on board unless we signed waivers relieving Holland America of the responsibility for our actions. I was determined, R was sick, and getting back to our room seemed like the only thing to do. We signed the waivers and got to the room, but when R returned with lunch 15 minutes later I was sprawled on the bed, semi conscious. This time, the decision was made for us — the ship doctor and his staff, along with a new set of EMTs, evacuated us off the ship within minutes. Although I understand I must have been unconscious, I remember someone saying as I was rolled into the ER at OLVG Hospital, “We are starting CPR.”

Imagine my poor husband watching this drama unfold, sitting in the ER lounge with our luggage and still very, very sick himself.

Surviving

The ER team identified a ruptured arterial aneurysm in my abdomen as the reason for my condition, and they quickly performed a clamping procedure that stopped the leak. However, the amount of blood in my abdomen had already begun to wreak havoc with my organs, and I spent the next six weeks in the ICU as my body fought off failure.

Our daughter and my sister flew to be at my husband’s side through these very long and dark weeks, and they were supported by the remarkably compassionate OLVG doctors and nurses and the extended family of another ICU patient. These dear people became our friends forever — I just mailed them some gifts.

Recovering

When I was discharged to the hospital’s gastroenterology unit, I had lost 30% of my bodyweight and the ability to move. The doctors told me that I might not have made it at all had I not been strong, the result of teaching water exercise to fellow retirees in Florida. The lifetime exercise habit gave my body the muscle memory it needed as I slowly recovered my ability to move, then to stand, then to walk.

R and I flew to Florida at the end of July, where the University of Florida Shands Hospital took over my care and confirmed that I was strong enough to continue my recovery as an outpatient. I shuffled down my neighborhood sidewalk using a walker and then a cane, and regained my ability to walk unassisted through physical therapy. We even joined a gym, and then, just weeks before my first anniversary, the pandemic hit.

Living

Quarantine did not stop me. My walks got longer and faster. The hand weights came out from the closet. I worked out on Zoom with my sister’s Colorado fitness instructor. We bought a stationary bike. I swam in our community pool and jogged in the ocean.

I have regained, maybe even surpassed, my May 5, 2019 strength and resilience. My next Shands checkup is in July, and we’re expecting me to be discharged.

Gratitude

I really wasn’t sure how I was going to celebrate this day. But then, I got a surprise call from Marsha, who was the first person to entrust me with being her personal trainer in the water. Marsha had just finished a water exercise class with an instructor who was filled with joy and enthusiasm, the feeling that I hoped to impart with every class when I was teaching. The repetition of exercises we’d worked on together, the freedom of moving in water and connecting with others — well, she simply had to call me.

As we caught up with each others lives, I was filled with gratitude for Marsha and all my former students who helped me to be strong enough to survive in 2019. We have made it through this awful pandemic year and will see each other over breakfast or in a pool when conditions permit. We are in each other’s lives, and that is a wonderful thing.

Indeed, I am reminded, today and every day, that life is a wonderful thing.

How Our Superhero Daughter Saved Our Lives

Superheroes, the comic book characters, have become big box office draws. From Batman to Spider Man, from Wonder Woman to Elastigirl, these modern versions of mythological figures are endowed with special powers — strength, flexibility, the power of flight, extra-sensory perception — that vanquish the super villains. Superheroes make the world a better place.

My husband and I have a special superhero who’s saved our lives in a dramatic way at three critical junctures, not with super powers but by just showing up. Our hero is our daughter.

Our superhero made us parents in Albany

We have one child. She appeared as a little cross on a white stick one January day in 1992, when I was 37 and we’d given up hope of my getting pregnant.

Her birth made us a family. Her childhood brought us joy.

Her persistence, patience, intelligence, and heart helped her emerge into adulthood as the first doctor in our extended family.

Our superhero held our hands in Amsterdam

Our daughter’s birth was my only hospitalization — until May, 5, 2019, when I was struck down by an undiagnosed arterial aneurysm while on vacation in Amsterdam.

Our daughter flew in the next day, along with my sister. They held up my husband while his world was crashing, and our daughter was at my bedside in the ICU for the six frightening weeks.

When I was strong enough to travel back to Florida, it was our daughter who made it possible to transfer to Shands Hospital, whose excellent care has deemed me well-recovered.

Our superhero signed us up for the vaccine in Palm Beach County

This morning, our daughter did it again, by signing my husband and me up to get the coronavirus vaccine.

It’s a Hunger Games scenario in Florida, with millions of people over 65 trying to get a limited supply of vaccine with minimal public health infrastructure and conflicting messaging. I sent the recommended email to the Palm Beach Health Department more than a month ago, finally receiving an acknowledgement a couple of weeks ago, then silence. Now, Governor DeSantis has pulled the rug out from under the county by assigning all vaccines to a grocery store chain which began assigning appointments a week ago in a 6AM web game with a limited door. All appointment were taken while I waited for two hours to get in. It’s been an exhausting week.

This morning, our daughter also logged as she ate her breakfast. And, just minutes before her long day of work, she got access to the site and signed my husband and me up. We receive the first vaccine tomorrow morning and the second one in a month. She’s done it again.

There are superheroes all around us

There are superheroes all around us, in truth. People going out of their way to help their neighbors. First responders. The kid featured in Inauguration Day’s Celebrating America who made $53,000 from her virtual lemonade stand to feed the hungry. Maybe you.

I thank you all.

It’s Always Time to Celebrate the New Year

Last year at this time, I had finally returned home after a three-month hospitalization in Amsterdam’s OLVG Hospital following a ruptured aneurysm. My diagnosis was Segmental Arterial Mediolysis (SAM), a disease that weakens the walls of the abdominal arteries. My belly had been a mess of aneurysms when I was in the Amsterdam ICU. There was a significant likelihood of additional ruptures, but the medical literature could not yet say how this relatively recent disease would progress.

The University of Florida’s Shands Hospital gave me some good news when I flew there at the end of July. The aneurysms were gone. We drove home. I began outpatient PT and walking with a walker and a cane.

My foot rises. Before it falls there is a tiny moment when neither of my feet are really carrying weight — a suspension, a moment of physical trust. Something in me knows that the ground will still be there. Let me return to this innate knowledge — this ancient confidence.

Gunilla Norris, “Walking,” Being Home, A Book of Meditations

My November checkup at Shands continued the good news. No aneurysms. I graduated from PT and walked up the three flights of stairs to our daughter’s apartment.

Help me to not be so afraid of the heights and depths! Help me to concentrate on the connection between the two: those humble steps, those one-after-the-other steps, which are the only ones I can really take. Help me to love a slow progression, to have no prejudice that up is better than down or vice versa. Help me to enjoy the in between.

Gunilla Norris, “Climbing Stairs,” Being Home, A Book of Meditations

I kept progressing. I added weight workouts to my routine. I walked longer. I jogged a little. I felt like I could run, but I wanted medical clearance first.

My six-month checkup was to be at Shands in May, but the pandemic threw off those plans. I stayed home and kept my eye on Florida’s Coronavirus infection rate as the virus burned viciously through the state. I felt great but I had felt great before my illness, too.

Finally, the COVID curve peaked and bent downward, and Shands, which is a five-hour drive away, accommodated my request to have the CT scan done locally and forwarded to my doctor at Shands for her review. I suited up and had the test on August 19.

Yesterday, I got the results. No aneurysms. No restrictions. I did the happy dance and went for a run.

Photo: Lannis Waters, The Palm Beach Post

Next checkup is in twelve months. It’s the first appointment on my 2021 calendar. Happy New Year!

Signs of Recovery

May 29 was my scheduled six-month CT scan at the University of Florida’s Shands Hospital, under whose care I have been since flying home from Amsterdam last year. The five-hour drive seemed less daunting as my strength and confidence returned, and the appointment appeared poised to be the maiden voyage for the new car we bought at noon on Friday, March 13.

Friday the 13th. While we were at the Earl Stewart car dealership, the public schools closed. By the end of the weekend, Florida and the rest of the United States were in the Coronavirus pandemic lockdown. Suddenly, getting in a car to go anywhere — much less five hours away — was fraught with danger. We waited at home for things to get better.

Things are not better. Five months later, America’s shameful government leadership has failed to stop the Coronavirus. The number of cases in Florida alone is far greater than other countries’. We still are home most of the time, but, when we do go out, we wear masks, wash our hands, and keep our distance from people.

Recovery is a long, slow, and uncertain process in the best of times. A wise doctor in Amsterdam counseled me to keep my expectations low, treasure the small accomplishments, and stay in it for the long game. It did take me a full year to feel like myself again.

Those who survive COVID have it much, much worse, as the medical community is discovering in the survivors they’ve described as the long-haulers. But one thing that I have in common with these brave souls is hair-loss. Alyssa Milano’s recent Tweet documenting her own hair loss went viral.

In her recent article in USA Today, reporter Adrianna Rodriguez has written about hair loss as another consequence of the coronavirus. The Harvard Medical School says that “telogen effluvium,” the medical term for this condition, can be triggered by major physical trauma, a shock to the system.

There’s a growing phase, a resting phase and a shedding phase. When you see a lot of shedding, that’s when people perceive hair loss.

Jennifer Ashton, MD

Cleveland Clinic’s Dr. Shilpi Khetarpal says that hair loss comes after the illness.

This is why we’re seeing these patients now, several weeks after COVID-19 symptoms resolve. Telogen effluvium isn’t a symptom of COVID-19 as much as it is a consequence of the infection.”

Dr. Shilpi Khetarpal, Cleveland Clinic.

So, losing my hair was part of getting better. It became very thin about three months after my illness. Though it sure didn’t feel like a positive thing at the time, it was the beginning of recovery. Although it’s not very stylish (stay-at-home-mullett!) and gray/brown/blond (stay-at-home-color!), it feels thicker and curlier than it was before. Silver lining category.

The long game seems endless, and then you put a pan away without thinking and realize you’re getting better.

This morning, I took another step in the right direction by finally getting my six-month (now an eight-month) CT scan. My diagnosis in Amsterdam was Segmental Arterial Mediolysis, a disease in which the walls of the abdominal arteries are weak. It’s a relatively rare diagnosis about which not enough is known, including whether it can resolve itself. In addition to keeping blood pressure in control, you want to keep an eye out for aneurysms. Now that I am able to move as I want, it was time to be sure my body and my head are in synch.

With a nod to the pandemic, Shands sent the order down to an imaging facility a mile from my house. I suited up — mask, gloves — and followed the distancing protocol to guard staff and patients alike. I was in and out quickly. Fingers crossed.

Meantime, I’m taking Kumba’s lead and not worrying about what I can’t control. Wishing you and yours continued health and courage!

National Doctors’ Day

This Letter to the Editor appeared in The Palm Beach Post on March 29, 2020:

When a healthcare crisis upends our lives, the care of a trusted physician is valuable beyond measure. Now, with COVID-19, physicians are putting themselves at risk without hesitation to save lives, provide testing and reassure patients.

On Monday, National Doctors’ Day, there’s no better time for us all to say thank you.

Tim Stapleton, Florida Medical Association

The doctors and nurses at OLVG Hospital in Amsterdam who saved my life and got me back on my feet over three months last year are now arming for the coronavirus onslaught. Here is what one of them wrote me recently:

It’s a strange and especially unreal situation. Amsterdam is deserted and you know how crowded it can be! I work a lot now, and the pressure is high. All hospital staff are to be available at all times. There is a great sense of togetherness among the nurses and doctors in the OLVG. We will fight this successfully!!!!

AB, Nurse, OLVG7A

The doctors and nurses at the University of Florida Shands Hospital who cleared me to return to our house are girding up for the same battle. Our daughter, a health psychology intern at Shands, is providing support to both patients and staff via telemedicine.

Thank you, Medicare, Medicaid, and private health insurance, for leaping forward this past week to pay for Zoom-facilitated medical appointments. Thank you, Zoom, for being the glue that is helping families and neighborhoods and whole populations to stay connected. Click here to sign up to this free app. Thank you, the world’s medical community, for being in the front lines every day.

Here’s what today’s CBS Sunday Morning Lee Cowan had to say today about doctors, our front line defenders.

We give a nod of gratitude to those bound by an ancient document, with a very modern purpose:  the Hippocratic Oath. It’s a contract more than 2,000 years old, and while it’s evolved over the millennia, it’s perhaps more sacred than ever, especially now that we’re mired in a health crisis that Hippocrates himself could only have feared. One modern version of the oath reads in part: “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”

Today there is no “chemist’s drug” to fight the coronavirus (not yet, anyway), and on top of that, masks, gowns and gloves – those paper-thin barriers between sickness and health – are in impossibly high demand, which makes the oath’s “warmth, care and understanding” promise dangerous to keep.

Our exhausted doctors and nurses are often forced to re-use masks; some are simply going without. That may soon leave many of our healthcare workers unprotected, charging up this viral hill every day, knowing they may die on it.

It’s becoming increasingly possible that the physician you have today could be another physician’s patient tomorrow. There is no greater calling than tending to the sick and suffering. But it doesn’t require an oath; what it requires is courage, selflessness and compassion, all traits seemingly in ample supply in our medical community, thank goodness.

Because these are the souls who are our best hope.

Lee Cowan, CBS Sunday Morning, March 29, 2020
Andy Marlette, Pensacola News Journal

Water Wisdom

A pool just worked its magic again, connecting me with people who I didn’t know I needed to know.

As you may remember from a recent post, I met a water exercise teacher on Christmas Eve who teaches from the same playbook as I did. She encouraged me to write an article about how much water fitness impacted my survival and recovery from a serious illness last year, and I’ve just submitted it to the Aquatic Exercise Association, which certified both of us. I now look forward to Marcy’s class every week, thrilled to be a healthy student!

Marcy and me after one of her classes

The other reason that connecting with Marcy was a remarkable coincidence is that her husband is a vascular surgeon familiar with arterial aneurysms. He has the expertise that dcotors used to save my life in Amsterdam and to monitor my recovery in Florida (thank you Shands Hospital in Gainesville, about 5 hours north), only he is just 20 minutes down the road from my home in South Florida. Jack Zelzter is at JFK Medical Center. Marcy urged me to contact her husband.

Dr. Zelzter and I exchanged emails — “Be glad to help if I can,” he said — and I put off doing anything else for a while. Then, my husband reminded me that taking care of my health should be my number one concern (as compared with editing my Foreign Service memoir like a fiend for the past month) and so I called Dr. Zeltzer’s office last week to make an appointment. One last hurdle — they need my pertinent medical records faxed first. I pulled my copies and prepared to send them over today, after a swim at gym on my way.

The pool at my gym

There were a couple of people doing laps when I got to the pool. Getting a lane isn’t usually a problem — the concern I have is that I’ll pick an hour when no one is swimming. One reason I swim at the gym instead of in the community pool in my neighborhood is that I am finally smart enough, and old enough, to heed the advice to never swim alone. Oh, and I’ve promised my husband, too, that if there’s no one in the pool I’ll keep upright and do a water workout. But it’s not the same as the Zen of a lovely long swim.

The pool aboard the Holland America Nieuw Statendam in April 2019

So I took the empty lane and pushed off. Eventually, my strokes became smooth, my breath took over, and the water slipped by like silk. About a half hour later, I pulled off my googles.

The woman swimming in the next lane was finishing up, as well. She was a good enough swimmer to have mastered the flip, something I never did, and I liked the variety of her workout. So, I told her so, and we started to chat while we stretched in the water. One thing led to another, and another amazing coincidence emerged.

Maureen is a nurse at JFK Medical Center who has worked with and admired Dr. Zeltzer for years. “You’d be in excellent hands,” she said, when I told her my story. So, another testimonial, and another Locker Room Lady friend with whom I’ve exchanged phone numbers. I faxed over my records and will call tomorrow to make an appointment.

I can’t go wrong. There’s too much going right.

Getting Back to Living

Six months out from my May 5 burst arterial aneurysm, I recently headed up to Shands Hospital in Gainesville for a check-up. After all, my Amsterdam doctors had attributed the near-fatal bleed to Segmental Arterial Mediolysis (SAM), a disease so rare that no one can yet say how it all turns out. I might have another unexpected burst anytime. It might go away on its own. Maybe there were surgeries ahead. I felt good, but I had also been feeling fine before fainting and nearly dying in Amsterdam.

I had other concerns I wanted Shands to address, the most pressing of these being getting myself off the blood thinner Warfarin, an old-fashioned standard when addressing pulmonary embolisms as appeared in my body. The daily required bloodwork of Amsterdam has trickled to a weekly lab jab, manageable but not my preference, but staying away from leafy green vegetables (loaded with Vitamin K, a leaf of spinach can throw off the efficiency of Warfarin) has really cramped my salad style and dulled my dinner plate. A recent bone density test revealed, for the first time, some bone loss: lying on your backside for three months can do that, but losing Vitamin K at the same time has probably increased the damage.

My primary doctor had armed me with blood work on various clotting factors from which Shands could draw a conclusion.

Floridasturnpike.com

So, up the Florida Turnpike we drove on Thursday afternoon, our frequent pit stops (age and illness have us pretty needy) extending the four-hour drive to five.

The two-lane Turnpike was intended to be the Less Stressway alternative to multiple-lane Interstate 95, but its promotion has attracted so much traffic, including the big rigs, that two lanes are insufficient. Within the first 30 minutes, we narrowly avoided being slammed into by a truck and a car jockeying for the same lane. The eye-popping drive had us both exhausted by the time we arrived in Gainesville.

Florida’s Turnpike strives to maintain a strong level of communication with its customers in order to make their experience with us more useful and efficient.

floridasturnpike.com

Here’s a strong level of communication: Hey! A third lane might keep us alive long enough to get to the hospital.

My appointments at Shands were scheduled for the following morning, so we headed directly to the hotel, a beautiful new La Quinta, a brand we were familiar with from our days plying I-95 between New York and Florida with dogs in the car. We’d agreed to bring home Victoria’s black lab, Pancho, in advance of her Thanksgiving travel plans north.

The hotel was bright and spanking new, an oasis of light in the dimming evening. It was also NOT our hotel, the very pleasant and apologetic clerk told me. The original La Quinta, now a Day’s Inn, was where the online broker had booked us, but luckily it was literally right behind the new highrise.

We repacked ourselves into the car, drove around the corner, and … there was a Chinese restaurant but where was the hotel? Finally, an old La Quinta sign confirmed that our reservation was in a dingy three-floor walkup, barely lit, its entrance blocked by construction equipment. Hell, no. I got us out of the commitment with some excellent Spanish (Gracias, Luis!) and we drove back around the corner to the Good Place. Allelulia. And we had the best Chinese dinner since New York City’s Chinatown at the oddly empty Mr. Han’s Restaurant and Night Club which lived up to its Yelpings: “You’ll think you stepped onto a movie set!” And what a fortune in my after-dinner cookie!

So, on to Shands the next morning. I had an imaging appointment, followed by an appointment with the vascular doctors. Victoria, who is completing her doctorate in Clinical Psychology at the hospital, met us just before I went in for the imaging work. She’s making a difference in the lives of patients and their families every day. What some of us would find depressing she finds inspiring. God bless this wonderful young woman!

I couldn’t help but take a picture of the child-sized blood pressure cuff, as this was what the Amsterdam nurses had to use on my skinny arms during my long recovery there. No more. My arms were now lifting weights, pushing through water resistance, and I had walked a mile on the hotel treadmill that morning.

My ultrasound was confined to the area in which Shands had treated a “pseudo” aneurysm in my hip area at the end of August. I was pretty confident that the problem — in the area the Amsterdam ER doctors had inserted the probe to seal the original rupture — had been resolved.

The vascular surgeon, who had last seen me in early August, didn’t lead with those results when he came into the room. Instead, he complimented me.

“You look great. You’ve really improved. You’re making your way back.”

“Yes,” I said. “I have done my part.” And now you are supposed to do your part.

“The pseudo aneurysm is gone.” He handed me the two-page report without looking at it.

“Okay. Good. And what do you think about the clotting issue. Can I get off Warfarin?”

He shrugged. “We don’t have the expertise to advise you on that. You should get a hemotologist on that.”

“Right,” I said. “Just wanted to be sure you guys weren’t needing to be part of that conversation.” Glad to have cleared that up, we’ll handle it at home.

“Hey, we’re really just plumbers. But, as to the health of the rest of your arteries,we should get a CT scan. Maybe we can get that done next week.”

Victoria broke in. “You know, they live five hours away and came here specifically for this. Can’t you get it done today?”

Did I tell you that she took charge in Amsterdam? And that her excellent relationship with the doctors there continued long after she flew home?

The answer was yes. They got me in that afternoon, though it was nearly dark by the time we got back to the hotel. The doctor assured me they’d call me with the results the following week. I warmed up my leftover mu shu for dinner.

We spent Saturday with Victoria and her boyfriend Christian. Birthday Breakfast — an Amerson family tradition born of my parents’ frequent evening Embassy responsibilities — kicked off my 65th birthday week, along with a pair of gorgeous earrings found in Cancún when V and C escaped ahead of Dorian.

A visit to the Florida Museum of Natural History included the truly awesome Crocodilia exhibit and the magical Butterfly exhibit.

Florida Museum of Natural History, Butterfly Exhibit
Florida Museum of Natural History, Butterfly Exhibit
Florida Museum of Natural History, Butterfly Exhibit
Florida Museum of Natural History, Butterfly Exhibit

I sailed up the steps to Victoria’s third-floor walk-up Sunday morning, nailing yet another goal. We drove home with Pancho. The Turnpike wasn’t as scary as during our drive up, but the travel still knocked us out. I waited to hear from Shands.

But, first, Ray and I had a birthday lunch date on Tuesday at the Dune Deck Cafe with my sister, Susan, and my brother-in-law, Michael, during a short FL visit. We’d last seen each other in the Amsterdam ICU, so it was a warm and loving reunion, complete with a beautiful necklace (and the package ribbon ready to tie up in my hair)! I’m looking forward to visiting Susan and Michael in their new Colorado home next summer.

Wednesday. Got the hematologist working on the Warfarin issue but still no news from Shands. I left a voice mail, feeling a little sorry for myself. My days as the starring patient seemed long past.

My actual 65th birthday arrived on Thursday with a perfectly festive crepe-paper decorated breakfast of Boston Creme donuts and a fancy new crown. And we capped off the week’s celebration with dinner at Bimini Twist in the company of new neighbors Carol and Pierre, toasting Carol’s coming birthday as well.

My phone rang at 8:51 Friday morning, showing an Atlanta number. I normally don’t answer calls that are likely robo-marketing, but I thought there was a chance a Shands doc was using a personal cell phone. I picked up.

“It looks perfect,” the doctor said. No aneurysms. No need for further tests, interventions, hospitalizations. Another look in 6 months, or maybe even one year.

SAM was silent.

“You can get back to living,” the doctor said.

And that’s when I realized that I’ve been “getting back to living” since I woke up in the ICU. Relearning how to use my body. Refueling. Restabilizing. Regrowing. Restrengthening. Moving forward.

It was great to get the good news, but I hadn’t been waiting for anyone’s pronouncement to get on with living.

I think I’ll just keep going.