Wednesday 04/25/2022

Went for a walk but cut the distance quite short. I am definitely feeling tired faster, although not short of breath. There should be a clear change by this time next week.

Did a number of small things that needed doing, putting my apartment in order and taking care of old paperwork. Then I mixed a bottle of raspberry-pink paint, using pink, black, red and gold to get a pretty fair match to the dusky rose spray can.

Solved a tech puzzle: neighbor Stew installed a lovely new 65″ Samsung TV in his 4th floor lounge, but then couldn’t put it on our in-house network because that needs its MAC address and neither he nor anybody else could find it in the TV’s menu structure. I had tried a few days ago and failed. Leon had tried. Stew had called Samsung and spent half an hour on the phone with their support, and still couldn’t find the MAC address. If you google it, you get clear directions that don’t produce it. Well I found it. Turns out the “About this TV” menu option opens a page that is longer than the screen, and unlike any other page in any menu, it needs to be scrolled to see it all. And if you scroll down, there’s the MAC address along with all the other details.

Set an alarm for 4:20. Neighbor Dr. Margaret is going to drive me down to the hospital. Next post will be from my hospital bed.

Tuesday 04/24/2022

Went for a short walk. Then I did some cleanup and prep for Thursday. I made a copy of my medical PofA and my Advanced Directive and put them in the bag I’ll take to the hospital. I thought carefully about what devices I would take and settled on only the phone. I’ve installed the WordPress app so I could if I wanted, post to this blog from the phone. And the phone has Kindle and the books I’m reading, and email and games. I have a battery pack I can charge the phone from, and tossed that in. That’s about it, for a 24-hour stay.

Then I cleaned off my coffee table, where I had been dropping things to “do something with” for a while. Some of those things were the Heritage Circle grant requests for the auditorium, and I realized that today is the actual deadline for turning them in. So I did that. Got other stuff off it and filed away or tossed.

I still had 45 minutes until the writer’s meeting so I quickly turned the account of when we had to drive from Feltham to Sudbury to use a computer, into a short essay and submitted it. So I had something to read at the meeting.

I ordered lunch to take out today, and for supper made a sandwich. Today’s Covid email said we have one more resident and one more staff infected. I am laying very low until Thursday.

As noted a while back, I used up all of the can of dusky rose color on the T-bird body. Later I realized that the dash and some of the upholstery should be body color. What to do? I didn’t want to order another spray can, and anyway I’d rather brush those parts than do the intricate masking to spray them. (Also, upholstery wouldn’t be pearlescent like the body.) So I need a matching dark-pink shade. None of the makers of model and hobby paints had the right color but two had pinks that were kinda close so I ordered a bottle of each, and they came today. So I spent some time trying to mix small quantities of pink to match the body color. Pink, plus a little red, plus a wee bit of black, plus a good dab of gold, does it. The gold because the spray was a “pearl” and the microscopic pearl flakes give it a yellowish cast.

Monday 05/23/2022

Went for an abbreviated walk. Still, over 2 miles for the day. Actually I felt pretty healthy all day. I climbed the stairs from the basement to the ground floor and was thinking, huh, that feels fine. Then, maybe 20 seconds after I got to the top, suddenly I was short of breath for half a minute.

Anyway, at 10am promptly a person from El Camino Hospital called and walked me through a long script of boring questions, mostly confirming my health record. He didn’t really know anything and couldn’t answer the questions that Dr. Margaret had suggested. So I emailed nurse Masket and she answered them a couple of hours later. Yes I will continue to need to take oral antibiotics before a dental procedure; no, I will not need to take an anticoagulant.

And the interesting one: what do they do if arrhythmia develops, do they install a pacemaker right then while I’m anesthetized? I’d have never thought to ask that. I’m not sure I totally understand the answer,

If you develop an arrhythmia that requires a pacemaker we usually leave the pacing wire in and observe you in the ICU to see if your rhythm returns to normal before placing the pacemaker. Many times the arrhythmia disappears.

Dr. Margaret was very impressed with this and said it was very clever of them. I am stuck with how do they get a wire into the left ventricle and “leave it in” when their only access is a catheter up my femoral artery. Long damn wire and it comes out down there next to my balls? Well, I’m just going to go with it. Arrhythmia is not common (remember, less than 1% complications and arrhythmia is only one of them).

After the phone interview I had to get in the car and scoot down to the hospital, and through their parking garage for a drive-up Covid swab. From there I went back up Middlefield to FOPAL and processed four boxes of books. Back to the barn by 3pm.

At 4pm there was to have been an open meeting with CEO Rhonda but that was canceled yesterday: Rhonda has Covid! She will be working from home until she is cleared.

There are a number of cases in the tower now: four residents and three staff currently. We went two years with no cases! And now that we are all double-boosted? Thing is, I absolutely don’t want to catch it before my procedure! So as of yesterday I am eating in my room, and since today’s stop at FOPAL, not going into public places. We can still order for take-out even since the dining room reopened a few months back, and a fair number of people do that often.

Sunday 05/22/2022

Never turned on the TV last night. Once I’d opened the old UK diary and found the very first entry answered Dennis’s question, I didn’t stop reading, but kept on to the end. It got pretty spotty after the first year, so it only took until 9pm to finish the whole thing.

And woke up this morning feeling… “depressed” is a word that casts a wide net, but what I felt is somewhere in it. We always said that the almost three years we spent in England were a peak experience, a great thing, and we were always glad we’d done it. And I would still say now. Indeed I believe, as an older person speaking to a younger one, the best life advice I can offer is to get out of the USA, live in another country for a spell, you will always be glad you did. (As recently as a decade ago, I’d have said, “go live abroad for a few years.” Today I’d say, “and don’t rush to come back.” You’re better off in any other first-world country, or in many a developing one, than you are here.)

Just the same, going through that diary made me sad in ways that are hard to define. One was a sense of “we could have done so much more.” Except that’s really not true; we did a lot, saw a lot, all while working fairly demanding full-time jobs.

Just the same, we were in a suburb of London, a half-hour train ride from Picadilly Circus, and, so far as I can remember or the diary mentions, we never went to a single art gallery, not the National, not the Tate, none of them. We went to the ballet exactly once. We went to no plays in one of the great theatrical centres of the world. We went to no concerts of any kind of music, at a time when British music was at its peak. We visited the V&A, the Science Museum, and the British Museum just one time each; and after each of those museum visits we actually noted how we saw only a fraction of what was to see, and should go back — but we never did. Truly, I saw more of London’s cultural life in my ten-day visit in 2020, than I saw in two years back then.

And, also, the diary gave me an extended look back at how we related as a couple… We were good together, but in hindsight it could have been so much better. I could have been so much better a partner, which would have benefited both of us. But that’s how I, and we, were, and there’s nothing to be done about it now. But it makes me sad.

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Well. Here’s another thing that seems truly remarkable in hindsight. We both worked in a relatively small IBM group, the Data Center Systems Support Center (DCSSC) in Feltham, UK: 25 or 30 people who provided software support for IBM’s commercial data centers in Europe and Africa. (IBM had been forced to give up its data center business in the USA by an anti-monopoly consent decree, but these centers were still an important revenue source outside the USA.) So this group, a dozen programmers, a few tech writers, managers, and secretaries were in a single building and we all used — drum roll, please — ONE computer. It was a 360/50 running VM/CMS, a time-sharing system tied to maybe three dozen, type 3270 CRT terminals.

Think about that. A whole department including programmers, writers and editors, managers and support staff, working from one computer. It didn’t seem unusual at the time. That’s how everybody worked. When THE computer went down, everything stopped.

And the computer did go down, for a month. I don’t know any details now. It was a planned outage, some kind of major upgrade or move, but for a month our entire group had no computer. What did we do? Well, there was a larger IBM location half an hour away in Sudbury Hill. We could use their (one and only) 360/50, but only after 5pm. So for a month, everyone who needed computer time was on a split shift, working from 2pm to 5pm at their desks in Feltham, then driving half an hour to the IBM Ed. Center in Sudbury Hill. We would have supper in the cafeteria there, then use their 3270 terminals to do programming, writing, or whatever until 11pm or so, and go home.

Just think about a world in which it was a half-hour drive to get to the nearest other computer. (OK,the nearest one we could use. There were probably IBM and other makes of computers in businesses scattered along that route.) Nowadays, when are you more than six feet from the nearest other computer? Probably it is on your wrist.

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So I decided to do the NYT puzzle out, at a coffee shop. (My diet is over; my weight has been at 163 for 3 days straight, and I can haz carbz again). Drove to the old place in Midtown. After, looked up and realized it was a lovely day, far to nice to go back in my room. So I took a long drive, up and over the Coast Range to Highway 1, up to Half Moon Bay, and back by Hwy 92. Got out of the car a couple of times at scenic spots.

Saturday 04/21/2022

Puttered, basically. At 3pm I was to project a movie in the auditorium. At 2pm I took the old macbook down and made sure I could drive the projector with it. I wanted to show something prior to the main feature. Poking around on YT I found a 1976 performance of Rhapsody in Blue with Leonard Bernstein at the piano. Seventeen minutes long, perfect, I started that at 2:42 and lowered the lights and started the real movie at 3 on the dot. Felt very pro. Just like being in high school in the 50s and being the nerdy kid who ran the 16mm projector.

The movie was Belfast by Kenneth Branagh, about growing up amid the Protestant/Catholic riots of the 1960s, with lots of songs by Van Morrison.

Dennis has been going through albums of stuff, organizing to write about his past, and he came upon a picture of me and Marian, Emil, Cecil, and Joyce, with a “Bon Voyage” banner, dated in Cecil’s hand, May 1976. This confused me because I was sure we had started our two-plus years in England in 1975. But! During that time we kept a diary. It would have been a blog, except blogs didn’t exist then. Thirty years later, in 2006, we scanned it to digital and edited it, and I knew it existed, so today I found it and here is the very first entry. Tell me the tone and style of this sounds familiar:

Friday 28 May 1976
Up at 6 am in Flamingo Motel on El Camino . Rang up Joyce in the Folks’ room as promised; said “This is an obscene phone call… when you have your pencil & paper ready we’ll begin…” Had coffee in motel restaurant and set out. Dropped Emil at bus depot. Goodbyes. Left Joyce & Cecil at airport. More Goodbyes — ech. All checked in in fine style, with 1-1/2 hours free; had more coffee. TWA 760 lightly loaded to LA; there, had 90 min. layover, very dull. Immense crowd of people then boarded. Not so badly jammed as prior BOAC flight.

My writing, no doubt at all. Except for the date, that could have come out of this blog.

Anyway, what that establishes is that we left to begin our England assignment in 1976, not 1975. And it exactly fits with the picture Dennis found, which would have been taken the night before. (The reason we were all staying in the old Flamingo Hotel on El Camino is, we had rented our Tasso street house and had already moved out.)

Friday 05/20/2022

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.

Thursday 04/19/2022

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.

Wednesday 04/18/2022

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.

Tuesday 04/17/2022

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.

Monday 04/16/2022

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.