Didn’t do much today other that to take a moderate walk over to Gamble Gardens, and to work on polishing the T-bird body. I have decided to cruise gently toward the TAVR, not pushing anything physically.
Had dinner with neighbor Dr. Margaret who is concerned that I properly understand my condition. I do, but I enjoy talking about myself and my medical issues, and she did too so that was nice. She explained why “shortness of breath” is the first symptom of cardiac insufficiency: it’s just that if the heart isn’t pushing enough volume, it isn’t moving enough blood through the lung tissue to pick up oxygen. It isn’t “breath” you are short of, it’s blood flow through the lungs.
She turned me on to the POLST form which I hadn’t known about. I have an Advanced Health Care Directive but not a POLST. Although I downloaded and printed it, I don’t know how I’d get it signed by my doctor before next Thursday anyway.
Decided to go for a short walk mainly to get rid of old phones. After I got a new phone last week I had two old ones: the iPhone 5 that Jean was using and didn’t want, and the SE 2 that was replaced by the SE 3. Then I remembered I had kept the previous SE when I got the SE 2. Pulled it out of the drawer it had been in for 2-3 years. Now I had 3 old iPhones.
So took them to the Apple store and a sales person walked each through the process of turning them in. First you power them up (the oldest SE had to be on a charger for a few minutes but it did come up) and connect to the store wifi. Then you use the phone to take a picture of a QR code that starts a special diagnostic running, at the end of which it tells you how much trade-in the phone is worth. That was $45, $35 and $0, from youngest to oldest. Then you reset the phone to factory (it’s right there in the Settings/General). It took twenty minutes to do all three and now I have two small gift cards for when I want to buy something at Apple.
I noticed walking the 8 blocks or so and back, that I was getting tired. I think the valve is getting worse. It had been three days since I talked to the surgeons with no call from a scheduler, so I emailed the nurse, who soon replied apologizing, saying PAMF was having a Covid outbreak and were short-handed. OK, Channing House too, so I know how that goes. (Actually, per today’s email update, we are several days without a new case and our outbreak is over.)
Soon after that, a scheduler called and we set the time: 7:30 AM next Thursday, the 26th. Since I will have to be there at 5:30am, I figure to take a Lyft. If it was in normal work hours the CH car would take me, but I don’t think they would do this; and I don’t want to impose on any neighbors. On next Monday I have to drive down to El Camino hospital and get a drive-through Covid test.
At 2:30 I met with new treasurer Joanne and we walked over to Wells Fargo and closed the Resident Association account. Now she is free to set up a new account with her choice of the six banks she has talked to, which is Comerica bank.
First thing today was to drive sister in law Jean to a dentist appointment with her cousin, Pierre Lacrampe, who has a dental office in San Ramon. A 40-minute run on freeways each way. I was home by 12, in time for lunch and then the monthly FOPAL volunteer zoom. After which it was time to start the laundry, and then walk across the bridge to the salon in the Lee Center for a haircut with Leah. After finishing the laundry I had an hour off before it was time to go help with the tech for the Choir performance. They gave two performances today; Ian had handled the morning one. Not much to do, really, except mute a couple of mics when they weren’t being used.
I had intended to make a video recording of the performance, and I did record most of it. However I hadn’t practiced the process and messed up the sound recording of the first two numbers.
TAVR addendum: I forgot to mention in my TAVReport yesterday, that another possible complication is arrhythmia: some of the electrical timing nodes of the heart are in the area where the top of the TAVR metal basketwork expands. Some people — they didn’t mention what percent, but their total (claimed) complication rate for all problems is under 1% — end up needing a pacemaker.
Anyway, today first thing I went out in the car to stock up on coffee, because I realized I didn’t have enough left to get through to next Monday, the day I usually hit Peet’s, it being next door to FOPAL. Then it was time for the writers group. The cue this week was “someone who influenced you”. I didn’t write. At first I couldn’t think of anyone that I considered an influence, except for my half-sister Joyce. Then later I realized that the most profound influence on my life had been Marian. I could not imagine writing about either one in a short essay, or indeed at all.
At 2pm I went to the Auditorium to set up for the CH Choir’s tech rehearsal. They give two concerts tomorrow, at 11am and 7pm. I can’t attend the first, but fortunately Ian can. So he and I fiddled with the mics during this rehearsal, and he will be on his own tomorrow morning.
Simultaneously I had promised to set up a zoom meeting for Jan, who organizes the Hearing Support Group. So I’m trying to talk him through joining the meeting I’ve started, while all around me the Choir is assembling and doing voice exercises. Well, it all got done.
Took an abbreviated walk, about 2 miles. Then attended the Events Committee meeting at 10:30, nothing exciting there. Then to FOPAL to tidy up my section after the sale weekend, and do a post-sale count: 58 books sold.
Finally it was time to head to PAMF South, at El Camino and highway 85, to meet with Dr. Rammohan, whose title is Interventional Cardiologist, and Dr. Pei Tsau, a Thoracic Surgeon, to discuss installing a TAVR for me. Here’s an actual TAVR:
The metal basketwork gets squished to a pencil shape, and they run it up your femoral artery, around the aortic arch, and push it between the leaflets of the aortic valve. Then they let it go and it springs out as seen above, pushing the leaflets of the old valve aside and taking over its function.
Dr. Rammohan is middle-aged, very tall, lean, brown and confident. Dr. Tsau is also of middle years. She knows, and often works with, Dr. Vincent Gaudiani who installed my first valve, back in 2000! Dr. Rammohan knows “Vince” well, also. We had a good time talking about what a character he is. The two doctors, Rammohan and Tsau, work together as a team doing TAVR procedures. They seemed to have a very comfortable, chatty working relationship, which was reassuring. It was further reassuring that they knew all about the previous procedure, knew in detail what Dr. Gaudiani had done, what kind of valve he had used, and so on. One of the things I had planned to ask was, “are you aware just how thoroughly my valve has been messed-about with?” And they definitely were aware, better than I am. They’d studied all my CTs and MRIs right back to 2000.
Dr. Rammohan said something Dr. Dibiase had not been explicit about: that just one of the three leaflets in my porcine valve is failing, but that allows nearly half of the blood the heart pushes out, to flow back on each stroke. The heart tries to compensate by enlarging, which mine has done, so as to push more per stroke. Hence the need to replace the valve.
We talked about possible problems. One is that some cardiac arteries spring off the aorta just above the valve, and in some cases the TAVR can partially block these. But in my case, Dr. Gaudiani had relocated those arteries higher when he reconstructed my aorta, so that will not be an issue for me. Another possible side-effect is stroke: less than 1% (but not zero percent) of TAVR procedures result in stroke. However, that is probably more common in cases where the procedure is done because of stenosis, where the valve being replaced is failing due to calcification. That is not the case with me; my valve is not calcified.
Then the two surgeons left, and I got an orientation session with Kathleen Masket, RN. I’m not sure of her job title, but she does the administration and patient orientation for this cardiac group. She pointed out a page in the booklet she gave me, showing the safety numbers for their group compared to national averages. They had helped to pioneer the TAVR technology and consistently have fewer complications (less than 1%) than the national average.
The procedure is often done under partial anesthesia, similar to a colonoscopy. In my case, they want to use a Trans-esophageal echo during the procedure so they can visualize the valve. That’s where an echo transmitter wand is pushed down the throat, and Dr. Rammohan said, “you wouldn’t want to be awake for 25 minutes while that’s in there.” So I will get full anesthesia.
Following the procedure one is moved to a normal ward (not the ICU) and has to lie flat for six hours to ensure full closure of the entry to the femoral artery. (Hey, I can do that.) Then you can sit up, get up and walk around, but you remain in the hospital overnight. Next morning there are a few tests and an echocardiogram and, assuming all is good, normally you can go home by lunchtime.
The actual date for this adventure is TBD, but probably in a week or so.
Today was a lovely open day with no commitments other than a ticket to a play at the Bus Barn tonight at 8. I did some paperwork first, then went out and did the thing that had been pending for a month or more: changed my T-Mobile contract to eliminate the second line, and got a new phone as well.
Back around the turn of the millenium we got our first mobile phone, a flip-phone with AT&T. That was 387-3645, secondary to our home land-line of 321-1986. Sometime around 2010, unhappy with AT&T service, I changed to the first iPhone 5 and T-Mobile.
Around 2014, pissed at the constant robocalls on the land-line, I changed the land-line to a second line on the T-Mobile service, and got an iPhone SE. Marian carried the older iPhone and I kept 321-1986 in my pocket. But the contract was for 387-3645 plus a second line.
After Marian passed I gave the old iPhone 5 to Jean, thinking she could maybe get used to using Lyft instead of driving. That didn’t happen and it basically sat there. But on the rare occasion that T-Mobile wanted to do 2FA they would offer to send me a text to 387-3645. No, no, that’s sitting Jean’s drawer in Mountain View, send me an email.
Eventually she gave it back. Meanwhile I have 321-1986 in every business or web service I use. It’s crucial to me. And I was afraid of messing with the T-Mobile contract for fear that somehow I’d lose that number. But today I marched into the T-Mobile store and got the help of a lovely person named Ana who was able to make all the relevant changes. Kill 387-3645 service, make my contract a single line at 321-1986, and sell me a new iPhone SE third generation and set it up. Now all I have to do is carry three — somehow I have three old iPhones — to the Apple store to trade in.
At 7:15 I drove down to the Bus Barn in Los Altos. The show was Ruthless, a musical about a cute kid who is determined to star in her school play and who will do (and does) anything to get the role. It’s a comedy with a murder played for laughs. I was only mildly amused and the whole thing was a bit cringe-y and tedious to me, so I left at intermission.
Had a date with new treasurer Joanne, to visit WFB to get info on our existing account. She has done the legwork (talking to six banks) to decide where best to move the RA account. But all of them want a tax ID number as part of the application. As far as we know, the resident association doesn’t have a tax ID. The Gift Shop might; Channing House as a whole surely does; but not the RA. So the question is, what ID did our predecessor use when they initially opened the account? And when was that? Joanne had talked to Diane our historian, but she couldn’t turn up anything on the actual founding of the RA. So we have to go and make nice with WFB to find out what they know about us.
Since I had a 12pm docent tour, and wanted to start for the Museum at 11, I brought the car up from the basement. Joanne and I met in the lobby at 10 and drove over to WFB. Talked to a very nice and helpful banker. Anyway, he was able to print off the original application, with, yes, a tax ID on it. We didn’t tell him why we needed it, of course. (Joanne said later, if we’d talked to him before maybe we wouldn’t want to change. I reminded her of the bank’s sending a new debit card with the name of the prior treasurer to me, two years after I took over.) The original application was in 2006, so not as far back as I expected, and none of the people named on it were familiar to me. Presumably departed this sphere before I moved in.
So off to the museum to give a tour to just three nice people. That’s a very different experience to talking to a dozen or more.
Tidied my house for the cleaning lady, especially since, owing to Covid keeping staff at home, we only get cleaned every other week for the next month or so.
Then off to Yosemite. Sherman and I were tasked with moving more boxes of artifacts from lower shelves to higher ones (playing Museum Tetris). After lunch, I catalogued a group of artifacts (a Sun “Sun Ray” Terminal from 2000 and its various parts), and then went through the artifact database changing all object names that contained “mouse pad” to read “mousepad”, the new standard terminology.
Back home I was queried by two different event sponsors about AV support. One’s events were in my spreadsheet and had committee members assigned. The other’s events were not in my spreadsheet. I’m not going to snarl at her because it is just possible I dropped the ball. But I strongly suspect that no Event Planning Forms were filed for those events, grrrrrr. Anyway I worked out coverage for her.
While I was at Yosemite I checked my email, and I had received the updated quote on the auditorium work. So I turned that around in an email to the people who are interested asking for comments. By the time I got home, I had some cogent questions to answer which I did, and somehow the time flew by and it was 6:40 and I hadn’t eaten. So I ate in my room.
Went for a walk in the morning. At 10:30 I had a date with Grace to talk about phones. She considers me her personal expert on phone stuff. She’s thinking about changing carriers to T-Mobile because of all the dropped calls she has with AT&T. She had one interesting bit of info: she called AT&T customer service and the service person looked up her location and told her, there was an AT&T antenna on Homer st. (next to our building) and one on University ave (4 blocks away), but the one on Homer had been inoperative for a year. Aha! It’s been about a year that she (and others here) have had problems with reception. I seconded her plan to switch, agreeing with her that she had nothing to lose, she wouldn’t be any worse off certainly.
My neighbor Caroline had asked to borrow my X-acto knife to cut a matte for a picture. This turned into a major project, she and I took the large matte and the picture up to the artist workroom on 11 and spent an hour hacking away with two box-cutters to neatly enlarge the opening in the matte.
At 4:45 it was time for the monthly floor meeting and dinner. No real news except that Jerry is handing over floor rep. duties to — Caroline. No issues with that, but he claimed he announced that at the last meeting and I was there and don’t remember it. Whatever. In casual chat with Doctor Margaret I learned that beta-blockers such as Metropolol can have mood-altering side-effects. Hmmm. I haven’t communicated it much here, but I’ve been feeling kind of stressed and low in spirit for some time. Hmmmm.