Livin’ on Nitro

It’s just a little-bitty thing. I carry it everywhere I go because it keeps me alive. Inside is an even tinier, smoky colored bottle with teensy weensy little Nitroglycerins pills. Since I was a kid I’ve always had this image of Nitro as an explosive. Maybe because of Maxwell Smart or James Bond, I don’t know. But there have been no explosions in my pants and I would think that I would notice…

It’s been a long time since I’ve written in this space. I reached a sort of homeostasis about 6 months after the open-heart surgery to remodel my heart. We thought it failed, at first. Then my heart function improved and the blood clot within the left ventricle seemed to have dissolved. My exercise limits have expanded. I’ve ridden a bike and walked for a couple miles. It feels like Dr. Herschberger’s goal to “buy me two to five years” before needing a heart transplant might come true!

There is not a day, however, that I do not awake surprised and grateful to be alive. We saw Enchanted a few nights ago and I was very moved by Giselle, the main character in the movie, who seems to find something good in every moment and every person. I’m nowhere near that zen-like level, but I feel that way about life.

Part of the reason for that is the reminding function of my heart. Reminding me, that is, every week or so with humongous chest pressure and sometimes staggering pain.

It’s hard to describe. Everyone seems to experience it differently. I have used farm animals to describe it, which can be very confusing in an emergency room. “How bad is it?” “Well,” I’ll tell the attending, “it’s like a small goat right now, but it was Clydesdale a few minutes ago.” Goats. Horses. Since the heart surgery I’ve moved into the larger farm and zoo animals.

Judy and I were at DMV a month or so ago, she in line and me sitting in the waiting area reading the Oregon Driver’s Handbook. At about the moment she finally reached a window, I felt the familiar tightening across my chest. It’s not huge at first and sometimes I let it ride for a few seconds to see if it’s a foamy little wave or full-blown Tsunami. Or, to stay in Dr. Doolittle land, is it a bunny rabbit or a rhino? It takes about 15 seconds to know. Fifteen seconds is a darn long time when you’re wondering if “this is it.” And I suppose I should just whip out the nitro and get one in just in case. But we all have our lines and this is mine.

At the DMV it was a rhino. Definitely a rhino. I pop one of the tiny little pills under my tongue (you don’t swallow nitro. You let it dissolve under your tongue so it goes directly into the blood stream…) and wait for the familiar metallic/minty taste to fill my mouth. It’s almost a little spicy hot, which, if they lose the heat, is how I know if the pills are no longer any good. I’m supposed to wait 5 minutes before taking another one. 5 minutes. That’s a damn long time when you’re not sure if your heart is on its way out and these last few minutes sitting in a DMV waiting area will be your last experience. So sometimes I’ll wait the full 5 minutes. I can usually feel it when it kicks in. The pressure begins to release, the pain dials down. I can wait the full 300 seconds in that case.

But sometimes, the last few times, the rhino starts gaining even more weight and decides to stand on its head with the horn nearly piercing the long chest scar and the pressure starting to make it more difficult to breathe. So I pop another. I don’t really care how long it’s been. I’m mostly interested in staying alive. When I hit three nitros, I have a decision to make. 4 nitros is a 911 call. It generally means it’s not going to get better and could actually be IT. So at the second nitro I get Judy’s attention and sign language that “I’m having chest pains and taking nitro.” Two fingers indicates it’s still going on. Of course, she has to decide whether to leave the window and come to my side. Is this it?

What a weird life, huh? But she stays there as I wave her off with nonchalance. But inside I am wondering the same thing. The third nitro is scary not because of what it does (which is make me awfully dizzy), but for what it fails to do. I become an internal monitoring device measuring pain and pressure in the tiniest increments, trying to pickup a drop that means it’s finally letting go. I’ll wait the full 5 minutes after a third nitro. Maybe 6 or 7. Dumb, huh? But it’s a 911 call, an ambulance, a hospitaliztion. Phone calls and worry and sticky EKG patches all over my body. Beeping monitors and relentless fluorescent light. Small talk and black humor (especially if Pat is there, which he almost always is with Jenny after an emergency ride in the darkness on the metro up the hill to the hospital) and bad TV. Fear. A strange feeling of failure that I couldn’t make it any further than this without going back to the hospital.

So I wait an extra minute or so. And, at the DMV, it begins to let go. I’m dizzy as hell and flushed, but the rhino morphs into a goat, and then a bunny, and then…well, only the body-memory of it is still there. And then we leave the DMV and get in our car and go on with our lives.

It’s weird. For me those moments have become surrenderings. Not in a bad way. In a real way. I am prepared. I have done my best, I have loved as well as I can and given everything that I can. I am lucky, so very lucky, to love so much and to be loved so well. I have not failed as a father or, too often, as a friend. If my life is to be measured by the people in my life, I could not possibly ask for more.

A curious addition to anxiety has been the recall of my defibrillator. Really! Evidently the lead that is planted in my left ventricle can degrade prematurely and cause inappropriate defibilizations and worse. The unit in my chest has been reprogrammed to beep if the lead goes to far out of set parameters (pardon me while I beep?). And I have a home unit that I use once-a-week to “interrogate” the ICD and which sends data to my cardiology team for review. When they re-programmed the thing, a large mouse-like device hanging over my chest and leads running from my body to a laptop computer, they tested the lead by “pacing” my heart. From the computer they touched a few settings and caused the defibrillator to send a pacing current into my heart. Suddenly I was weirdly flushed and, um, not exactly dizzy but sort of hyperventilated… It lasted just a few seconds and, with a couple taps on the screen, Cindy stopped the pacing and I returned to normal.

As I watch Enchanted I felt as if I have lived some sort of fairy tale life. Though sometimes it gets me and my whistling and foolishness take leave, for most of these lovely waking moments I am so fully alive and so completely involved with living that I cannot seem to keep from talking with the strangers around me or marveling at some tiny little miracle of this world. It’s a delightful way to live and the farm animals are a small price to pay.

Two Sundays ago I was sitting in my regular place, a pew about three-quarter’s back and right on the center aisle. I’m always early so that I can sing as the choir warms up and learn the music. Friends began piling into the spaces around me. Paul and Sheri and their daughter, Riley Ann, whose tiny little 2-year old hand I love to hold during the Our Father; Bob, my good friend who pulled me aside months ago to ask me what I was waiting for to propose to Judy, who slides into the pew in front of me; Josh to my left, a young adult with the youth ministry fever who I am blessed to mentor; and Rich to my right who wears saddle shoes and believes in sustainability…

Half way through the mass, when all of us Catholics are standing, then sitting, then kneeling and then standing again, someone cinched a belt around my chest and stuck an ice pick deep into my chest. It was as bad and quick as it has ever been and I sat down a little too quickly with a thud. I had my nitro out and one under my tongue when the people around me began looking concerned. I gave them the nonchalant wave off. Lot of good that does when you’re sitting and everyone else is standing.

On my third nitro I was in so much pain and so scared that I was contemplating laying down on the carpet in the aisle. My thought was that if I could just relax enough I would be okay. The irony of possibly dying at church wasn’t lost on me, either. So I hung there in the pew with number 3 dissolving under my tongue while people started getting up to go to communion. By the time the pew before me filed out into the aisle for communion I was desperately monitoring my body for signs of change. I felt it shift and stood up. Either this is or is not it. If going to communion is the last thing I do it wouldn’t be the worst thing.

I sang quietly as we shuffled toward the altar. I have sung the song often as a choir director and, with my body seemingly on such an edge, it seemed like the right thing to do. The host sucked what little moisture was left in my mouth and I was grateful for the sip of wine that came next. By the time I was back to my seat the ice pick was nearly gone and my chest felt loose and comfortable.

That is just the way life is right now. Every day I feel a bit like George Bailey when, in It’s A Wonderful Life, he reaches into his pocket and finds ZuZu’s flower petals and realizes he has another chance to live his life. So I cried a bit at Enchanted. And tears well up easily when, in Charlie Brown’s Christmas on TV, Linus tells the gospel story, and all the history with family and children swamp my memory.  Imagine what will happen when I watch It’s A Wonderful Life again this Christmas season?!

I view this Christmas as a bit of miracle for me. I am alive. Judy will marry me on December 29 and many of the most wonderful people in our lives will be there with us. In my tuxedo pocket, as I say my vows, will be a little vial of Nitroglycerin. Don’t think for one moment that the wonder and glory of just a few more minutes will escape me, nor that my hope in that ceremony or in this Christmas season will dim one iota.

It has been so long since I have written. Thank you for your many notes and calls and visits. Have a glorious Christmas!

Now go put on some carols, grab a mug of hot chocolate and sit by the fire.