PORTLAND PICKLE VOL 1 ISSUE 3

We are definitely in recovery mode and I should probably be sharing a bit more about what this whole grand adventure has been about.  Open heart surgery, even just the phrase is fraught with the sense of impending doom.  I am here to report that the medical profession treats it as just another “day at the office”.  And from what we have been told and based on my understanding of what Mick has experienced, it’s pretty accurate for a significant minority (as in 40%) of those who undergo the procedure.  Yes it is incredibly invasive, and yes the anaesthesia and narcotics really do a number on your sense of well-being.  But for those lucky ones the pain is minimal, a couple of Tylenol a day will take care of that.  It is a feeling of total exhaustion that seems to permeate your whole being that’s the most difficult thing with which you have to deal.

While still in hospital he was treated as a bit of a pincushion.  If they weren’t pumping drugs into his system, they were extracting or draining various fluids out of it by way of assorted tubes from innumerable and diverse portions of his body.  If that is not indignity enough they still expected him to stand up and take a stroll around the ward trailing bags and wheeled poles, all the while dresses in a stunning hospital gown.    To add insult to injury, for the first three days, there was an hourly finger prick to check insulin levels.  What the relationship between heart surgery and blood glucose might be I have no idea, but consider what a minimum of 36 pin pricks in the end of your fingers must look and feel like.  As I said, a human pin cushion. 

Learned that one of the ways they use to determine how well you are recovering from the drugs is to ask personal questions.  Such as, how old are you, or when were you born?  I always thought that the DOB thing was about being sure they have the right person but it is more about how lucid you are.  They actually scan your arm band and link it to your medical records on the computer.  Next thing you know we all have a bar-code tattooed to our wrist or a chip implanted in our neck.  Too much like big brother is watching for my taste but in an environment like a hospital it does have value.

I knew things were improving when he demanded that someone give him a shower, or at least a wash down in the bed.  In British parlance also known as a blanket bath.  Next request was a razor, nixed by Ben on the grounds that he could hardly stand up, never mind wash his face and then drag a blade across his chin, all while connected to all their monitoring equipment.     

Between a white board in his room and a glass door panel with grease pen markers they catalogued who was on duty, which therapists (respiratory, physical or occupational) were expected to visit, how many walks he had taken, how many times he had sat up in his chair (a comfy looking recliner), the does and don’ts of “sternal care”, and other bodily functions and measures, oh my!

Sternal care, now there’s a euphemism for you.  What it really means is they cracked open your chest, mucked around inside, wired it back together, quickly basted (a sewing term) the opening back together and then said “be careful” you don’t want things falling out in your lap.  In the end our rules for living (aka guess what Gayle gets to do) over the next six to eight weeks are:

• ·         No lifting anything weighing more than a gallon of milk (10 pounds)
• ·         No pushing or pulling anything heavy, like doors and windows or garbage cans or even unscrewing tight jar lids (hmmm)
• ·         No putting your arms over your head, i.e. No high cupboard, careful putting on shirts, jackets and t-shirts.
• ·         No reaching out to the side, turn your body instead.  The horror story to go along with this one was the gentleman who reached from the front seat to the back seat of the car to hand his grandchildren something and had to have the all their seamstress like handiwork redone.
• ·         No driving. 
• ·         Use a pillow against your chest to hug yourself when coughing or sneezing.  It also works well when getting up and down as a reminder not to use your arms.  
  
• ·         Avoid using your hands to push yourself up from a sitting position, or when getting out of bed. 

Early on I would help him get out of bed (remember, now he is restricted to sleeping FLAT on his back) by putting a hand behind his shoulders while he swung his legs over the edge of the bed in hopes that the momentum would propel him in to a sitting position.   Now, with no assistance from me, he goes through an acrobatic manoeuvre akin to something a break-dancer might do to get from his back to his feet, all the while holding his arms across his chest. 

So, not many pretty pictures this time but our next instalment should be entitled the walking fools.  And if I can get my head in to it, a series of images of walks in and around the Pearl.  In closing know that we/he is making great progress, all systems are normal and the prescribed therapy is walking, and walking and more walking.  With of course many intermittent naps in between.  

PORTLAND PICKLE VOL 1 ISSUE 2

UPDATE:  All is good and we’re back in the condo trying to establish a new sense of what is normal.  But more of that later, I did promise something of a mini travelogue in conjunction with medical bulletins.

So what does a family of four (Leigh, Ben, Dino and me) do when they have had enough of hospitals and hospital rooms.  Eat and shop, of course.  Ben and Dino have just bought a condo in the Mission District of San Francisco, so as you may well imagine, shopping for furniture and fittings is pretty high on their agenda.  And it certainly doesn’t hurt that there is no sales tax in Oregon.  An outlet mall on the east side turned out to have a selection of shops for all comers.  I’m just glad they didn’t choose the one in Woodburn, about 30 miles south of town.  It’s so big I think we would still be

shopping, in an attempt to see every possible business.  Had a productive visit to the Pendleton Outlet.  They actually had some seconds at real savings and most of their stock didn’t feel as though it was purpose manufactured for the “outlet market”.

As we all know, shopping makes you hungry, so we turned to our restaurant guru, Mr. Constantine Konstantakis (aka Dino) for a recommendation.    He is totally amazing at deciphering the YELP and coming up with unique dining establishments.  I want to let him loose in the hinterlands of the UK and see what we find.  His latest score, Shirley’s Tippy Canoe in

Troutdale, Oregon.  It’s what might be termed a “road house” at the side of the “highway” along the Sandy River.  We were well outside the liberal sprawl of Portland and easing our way in to the more red-neck part of the state.  A two land road, banks of trees, trailer parks and old dilapidated cottages as well as modern McMansions dot the landscape and possibly, most disturbing, what the boys identified as a white supremacist flag in someone’s front yard.  Welcome to Oregon, the western headquarters of the Ku Klux Klan.  We pulled up in their tarmac and gravel parking lot with few other vehicles around.  It is a curious building and my impression was of a conglomeration of multiple building and add-ons, kinda like Topsy, it grow’d.  Passing through the doors and we were greeted with a number of locals belly up to the bar.  Rumor has it this was once a biker bar, so, they seem to be carrying on the tradition.

We had hoped to sit outdoors, but Mother Nature was not cooperating so we chose a table with a view of the outdoor garden and the river.  I don’t remember what the others ordered but I do recall that everyone was thrilled with their meal.  I went for their special, cubes of toasted sourdough, topped with small shrimp, smothered in clam chowder, sprinkled with cheese and green onions and baked.  Their claim to fame is apparently a homemade Sloppy Joe.  Strictly comfort food but my guess it really is made from scratch, in house. 

After filling our bellies we made the pilgrimage up the Gorge to Multnomah Falls.  It is still a delightful location, but after last year’s fire access is severely restricted.  Most of the old road is closed and the only access by car is from the highway.  Once there hiking is virtually non-existent.  You can’t even climb up to the bridge.  The extent of the burn is not particularly evident, perhaps some burnt trees on the ridgeline.  Guess they worked real hard to preserve the location and associated buildings. 

Having started the food thing, let me tell you about After Dark Cookies, a gift from Ernie (a Rhodesian Ridgeback) via his people Hubert and Stacy Ban.  A knock on our door (a surprise in and of itself) produced a young man with a delivery of four each, of six different types of cookies, hot from the oven.  And did I mention the two pints of ice cream.  Welcome to Portland, the land of food.  Small wonder people

say newcomers to the city gain 15 pounds.  You should have a look at their FAQs AFTER DARK COOKIES if you need a giggle.  Apparently you can only get deliveries Thursday thru Sunday after 8 p.m.  I can definitely recommend their Snickerdoodle, a personal favorite of mine.    This is definitely a business I did not need to know about.  Who can resist freshly baked cookies, on demand!

We did actually visit with Mick in between shopping and eating.  He was moved from the intensive care cardiac unit to the telemetry unit about 36 hours after surgery.  The drugs kept him pretty groggy so conversation or prolonged visits were not particularly satisfactory.  We made the pilgrimage twice a day and fortunately it was an easy drive from our place.

Hospital food is not exactly what one would call wonderful, but Providence takes it to new heights of inadequate.  Fortunately he wasn’t particularly interested but was well enough to remark that it wasn’t what one would call a peak experience.  We did sneak in some elicit Safeway Chinese which met with his approval.  And then there was the peanut butter and graham crackers, which under normal circumstances would be totally unacceptable.  Amazing what feels wonderful and exotic when you are flying high on narcotics.  The one plus from his point of view, no one tied to serve him Jello or pudding.

Long story short, he came home on Saturday afternoon.  The doctor had said that about 40% of people go home using nothing more than acetaminophen for pain relief and this is true for Mick.  The biggest challenge is the exhaustion and lack of energy, which was also to be expected.  It’s just that you can’t really know what that is unless you experience it.  We’re back in the condo, the family has left and we are experiencing what our friend Cynthia Care calls “Deep Local”.  We have become very familiar with the two blocks around our building.  The view from the window with children in the playground and dogs in the park is better than tv.  The weather has been pleasant, he’s on the mend, what more can you ask of life. 

PORTLAND PICKLE Vol. 1 Issue 1

Hello from Portland, Oregon.  The Ashland Avatar is going on hiatus for the next month or two.  In fact it will be reinvented for the short term as The Portland Pickle.  Next disclaimer  . . .  many of you know that Mick was diagnosed with a mitral valve (heart) problem and has just gone through open heart surgery.  That said many more of you were totally unaware of this event and really only follow the Avatar as a means to do a little armchair travel.  So, after this installment, if the title is the Portland Pickle you can anticipate a blog about our experience with surgery and recovery in Stumptown.  When it reverts to the Ashland Avatar you can expect further adventures in travel.

This whole episode came as a total surprise to both of us but then who plans or expects to have heart problems or require open heart surgery.  That phrase “open heart surgery” is really quite terrifying, but the medical profession seems to treat it as just another surgery.  Love the response from his primary care physician . . . He initially schedule an appointment for something mundane like an ingrown toenail or some such and in the course of conversation mentioned that he was unable to run as far as he once had and was enjoying a midafternoon nap more than occasionally.  This prompted her to do an EKG while he was there in the office just to see if it showed anything of interest.  After reviewing the results she walked in to the exam room and commented “well, aren’t you a surprise!”  

Long story, short, from there it was a referral to a cardiologist, a bunch of tests and exams and ultimately a diagnosis of a leaky mitral valve and an

additional hole in the valve itself which was producing a jet of blood back in to the heart chamber.  The specialists all found this quite entertaining and unique and were anxious for a good look/see. 

If you are going to do something as dramatic as have you rib cage split open, or as the surgeon so eloquently put if “crack you open like a lobster” you may as well do it somewhere where the recovery will be a little more entertaining than sitting in a lovely, though ultimately not particularly stimulating environment, like a single family residential neighborhood like Ashland, Oregon.   

We opted for Portland, where the surgeons have more experience, walking during rehab does not require an uphill slog regardless of what direction you go, there are services that will deliver food and do you shopping for you and the view out the window is endlessly entertaining. 

So Portland it is.  We did our research, thank you Benjamin for your assistance, made our plans, informed our kids (sorry you may be adults but you will always be kids to us), reviewed and updated our Advance Directives and transplanted ourselves to Portland for the foreseeable future.  Leigh, Ben and Dino have joined us for the week and surprisingly two of the hoteling suites in the Cosmo were available.  So it’s happy family time, which, we all recognize is absolutely wonderful and totally chaotic all at the same time. 

Portland, and the Pearl in particular, is totally walkable, 10,000 paces a day, no problem.  The first day we were all together, Sunday, we explored the Saturday Market (a bit of an oxymoron I understand) walked the waterfront and had a quick explore of the gallery district.  Capped it off dinner at Grasso (I think that’s the name) which is a new restaurant by the owner of Lardo that specializes in pasta.  Totally casual, you order at the desk on your way in and they deliver to your table (communal).  The pasta was really outstanding and their eggplant parmesan bites a delight. 

Monday, our first face to face visit with the surgeon, left the rest of the family on their own to entertain themselves.  Leigh remarked that at the end of the day her Fitbit registered in excess of 20,000 paces and 11 miles.  Dino did the research on places to eat and Ben made friends with every dog in sight.  Need to hire him to stay a while and introduce me to all the dogs and owners who frequent Fields Park which is the view out our window. 

So where are things now . . . Surgery was this morning, had to get up at 4 a.m. and be at the hospital for no later than 5:15.  The things you do for love!  Providence Hospital has it down in terms of making things flow, providing guidance and assistance where and when needed.  Really impressed.  If you want to know more specifics about that or the surgery specifics just email me and I will share.  Otherwise, I will leave off for now with the fact that the surgery is over, the doctor was pleased with the procedure and didn’t need to do a valve replacement, just a repair.  As I said in a previous text to some of you no need to save up your pig jokes, some portion of his heart might have gotten zapped or toasted but there is no smell of frying bacon.  We’re going back to see him this evening when might actually be conscious and not be hooked up to so many machines.  Going forward I hope to share the recovery and rehab process while expounding on the newfound delights of living in Portland.  Hoping this won’t turn in to a medical treatise or morose descriptions of problems and process.  There’s gotta be some fun in it somewhere.  Like, the joys of being asked to take 3 iron tablets a day or the whether sleeping in a recliner (hopefully not one of those where you push the button and it propels you on to your feet) is really necessary.