This short essay started out to be named Mini-Seizures, TIA’s or Other Cardiac Related Disturbances. Later in the day after the overabundance of diuretics, prescribed and applied by myself, had tended to pass, this more civilized title now applies.
The burden of what I am trying to say in this essay, is that if patients take an extra diuretic drug such as Aldactazide and Furosemide in a 13 – 15 hour period, whether by prescription directions or by their own volition, some fairly sobering problems may be expected. This is probably true even if the extra drug was taken for an innocent and in an entirely praiseworthy purpose such as controlling weight.
This latest bout with diuretics took place on Sunday, November 30, Monday, Tuesday and early Wednesday morning, December 1, 2, and 3, this year.
For a long time, I have been concerned about my weight. On two occasions, Dr. Andrew Beamer of the Summit Medical Group, has voluntarily offered the opinion, after an examination, that my legs may contain as much as 10 pounds of fluid. That seems about right to me as I have regularly produced weights of 250 pounds over the past few years. My ordinary weight in years past was in the 240 range.
Don’t think that I drink a lot or eat a lot. Generally speaking, a half bottle of wine at Saturday dinner is all I consume in a week. That’s it. No beer, no booze. I was raised in an Irish family where the cooking was akin to abysmal, followed by more than three years in the United States Army. Sometimes, the cooking there made my family’s efforts look better.
In recent years, my portions have been controlled by Miss Chicka, my wife. She is 5 feet 2 inches and International boxing circles would classify her as a zephyr weight. Simply put, by tradition, training and experience, my food intake is pretty modest. On Wednesday evening, we had about 6.5 ounces, not pounds, of artic char for dinner for both of us. On feast days we buy 8 ounces. On NO days do we eat meat or fowl. Fish two or three times a week plus vegetables, beans, lentils, etc get us through.
Now in spite of this modest intake, my weight has consistently stood in recent months in the high 250’s. To deal with this problem over the years, I have stopped eating bread, using only nothing or Melba Toast. My most recent bread stoppage was on either November 5 or 6th, 2003.
To deal with the fluid in my legs, diuretics have been prescribed. Last May 1, 2003, I took K-DUR together with Furosemide and Aldactazide. The result is stated fairly clearly in the second paragraph of the letter to Miss Harhaj, wherein it is concluded that this combination of three drugs “…threatens to kill me.”
When June, 2003 rolled around, another separate seizure happened to me because my heart was hesitant to pump blood during the night. So Dr. Beamer installed a Pacemaker on June 9, 2003. I see no connection between the events of May which led to my letter to Miss Harhaj and to the later seizure. If there is such a connection, it would make my cardiac system glad to hear about it.
As far as can be told, the Pacemaker is working well. At least, when I submit to Teletrace tests, no complaints ever come back to me. Nonetheless, as always with Summer and warm weather, fluid tends to gravitate to my legs and additional weight is gained. This Fall has been exceptionally warm, so my problems continue.
A small aside here. Our front storm door ALWAYS swells up in warm, moist weather and refuses to close. It has done that for the 34 years that I know about it. So I planed it down and used a wood file on it. When the paint was removed, it appears the storm door is made of aluminum, so my wood plane and wood file are not of much use. My only conclusion with the door being metal is that moisture and heat cause the wood around the door to swell. We had a first class handyman here who did a little better than I did in getting the door to close. If it is the wood around the door swelling, as I believe it is, it is a matter of natural inevitability. My earth shaking medical discovery is that in warmer and moist weather, fluid will accumulate in my legs whether I like it or not, or whether the Summit Medical Group likes it or not, as a matter of natural inevitability.
This essay is about my getting into trouble by trying to meddle with the natural inevitability of fluid collecting in my legs.
During the winter months, I had taken Aldactazide in the morning and in the afternoon, either a Furosemide or another Aldactazide was consumed. That is two diuretics per day. I got along pretty well on this regimen. I still weighed more than 250 pounds and wasn’t threatening to regress to the size of ballerinas who must be lifted, with one arm, by other dancers.
During the Summer and warm Fall, 2003, inevitably my legs swelled and it was difficult to wear my slip-on shoes. My weight was approaching or passing 260 pounds. Thinking that this situation ought to be dealt with, on November 18, I started using two 20MG Furosemide and one Aldactazide 50/50 per day. Within a week, my weight fell back by six pounds. However, starting on November 26, or eight days later, certain symptoms occurred that I should have recognized as warning signs.
Here are some of them:
Excessive yawning. One followed by another.
On Sunday, November 30th, we took our usual four mile walk. It was a chore to make it back. There was a small dinner and I was in bed at 9:20PM. Balance was difficult.
On Monday, December 1st, I had less than a tuna sandwich, without the bread for lunch. I then sat in a living room chair with absolutely no inclination to move.
At around 2PM – 2:30PM on Monday, a chill followed by some shaking.
That was followed by tenseness in the body. It was pointless to read the paper because I could not focus on it. There was some difficulty in speaking. Putting one thought after another proved very difficult.
I knew that it behooved me to stay wedded to that living room chair because to walk might mean falling.
Dinner on December 1st was one scrambled egg and fruit for dessert. I broke my bread fast, eating a multi-grain heel from Wegman’s bread. No butter.
Looking back to the Wednesday, pre-Thanksgiving dinner, the fresh lobster and the Argentinean wine did not go down well at all. I blamed the lobsters and it was my thought that an Italian Barolo would have been preferable. It wasn’t the food and the wine that were off; it was my system.
Hoping to make Thanksgiving dinner stay down, the meal was a simple lasagna.
All the meals during this period did not sit well on my digestive system.
I had the impression that the problem was in my head or brain. On December 1st, the attacks happened at least three more times. On this day I eliminated the second Furosemide tablet, taking only one Aldactazide and one Furosemide per day.
On Tuesday, December 2nd, it seemed that the attacks were a little less severe. During the day, there may have been four such attacks. They were not as strong as the previous attacks.
Concentration was largely impossible during such attacks as well as before the event occurred. As evidence, I offer my first draft of a letter to my 13 year old Texas grandson. It is attached. It took me at least an hour to write this draft which suited me not at all. As you will note, the second word is clearly unintelligible. Ordinarily, I knock out a draft like this in perhaps four or five minutes, but this one caused great doubt. It was impossible for me to concentrate.
For your information, the finished letter is also attached, which while it doesn’t qualify as a masterpiece of the English language, it will do to send old Kevin a valve Tappet feeler gauge. It is hard to believe that anyone at SMG will know about such a sophisticated instrument.
On Tuesday night, December 2nd, a final attack came at around midnight. It was far from pleasant, but it was handle-able.
The attacks have not occurred since that time and I have no reason to expect them again as I write this at 9:30PM on December 3rd.
Here are some general observations:
From Saturday, November 29th, some 12 days into the three diuretics regimen, I had the impression that I was walking on my heels. Balance was difficult.
During the attacks, occasionally there was some pain in the left arm, particularly during night time events. It was dismissed as minor.
For the last week or so, it was sometimes difficult to articulate clearly what I had to say. Words with two consonants like “black” came to me with some difficulty and were often mispronounced.
Since going back to two diuretics on December 1st, yawning has stopped.
During the diuretic attack bouts, it was my impression that my jaw had been hit by a hard right hand. Not that my jaw hurt, but my ability to concentrate and to articulate were largely lost. And there was trouble in remembering important events.
I returned on Monday, December 1st, to one Aldactazide and one Furosemide. It is my unsubstantiated belief that Aldactazide and Furosemide can probably also be tolerated as long as they are taken several hours apart. The addition of the third diuretic will probably not be tolerated.
With my confidence restored, Judy and I went to Bills, that high class shop on Morris Turnpike, and spent $78 for a new 3XL sweatshirt and some more tee shirts and shorts. I wouldn’t have done that if the diuretic attacks had continued, as I would begin to prepare to see Ippolito, Summit’s leading undertaker. The fact that Ippolito’s place of business is located one downhill block from Overlook is a matter of significance to me.
I feel better and stronger and, as you can see, this old essayist can still put one word after another. That couldn’t be done a few days ago.
At this point, I can return to worrying about Linda Harhaj, the only Ukrainian nurse I know. That’s only the half of it. The fact is that the Ukrainian community is completely unknown to me. When the Ukraine was under Soviet domination, I had a meal with Boris Chirkov, a big shot Russian Communist telecommunications official in Kiev, the capital of the Ukraine. It was not memorable. I don’t see Boris very often these days, but it would pain both of us to know that Miss Harhaj is thinking about relinquishing her Ukranian surname. I would point out that my wife, Miss Chicka, has retained her Serbian surname. My oldest daughter, married for a long time, still happily uses Carr as her surname. The other daughter also did that until her son’s teachers were hopelessly and utterly confused by boys of one surname with a mother of another surname. But that happened in Texas, so what can you say.
Well, that is for diuretic attacks and unauthorized changing surnames. It is my hope that the medical and surname knowledge of the Summit Medical Group is increased by Himalayan leaps and bounds. If that doesn’t occur, even Herr Professor Doctor Beamer will say that Patient 3477569 gave it his best try.
E. E. CARR
DECEMBER 4, 2003
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Poor Pop — seems like it was just one thing after another like this for years and years.
I’d be very curious to see those two letters if Judy still has ’em! Otherwise they’ll have to wait until my next Austin visit.