The Golden Hour – the State of My Health

For us photographer types, the “Golden Hour” is that time just before sunset when the sun is low and orange, the shadows are long, and the contrasts are dynamic.  For me, there is also another “Golden Hour”, though not quite as spectacular still very impactful to me…the hour before sunrise.  It really has always been my time for the clearest thinking without being too nostalgic, sarcastic, or cynical.  That hour is right now.

Yesterday, we spent the entire day at Kaiser in Santa Clara.  When traffic is light, it’s an hour and forty five drive from Modesto ending just south of San Jose – a major part of silicon valley, near the southern end of San Francisco Bay.  Lots of people, lots of traffic, and beautiful weather.  We left home at 8am and got back at 8pm – long day.

The reason for this visit was to meet with the team of doctors, nurses, and social workers in the Heart Transplant Program.  I was also scheduled for a VO2 test (a bicycle test to measure my O2 and CO2), and part of the scheme of things with the program.  They were all very nice people, each and every one upbeat and respectful.  Notice I didn’t say “comforting”.  Although I didn’t really learn anything new about the condition of my health, I did learn a lot about what to expect in the coming years, heart transplant or no heart transplant.

So why are we talking heart transplant at this point in my life?  Briefly, the docs have found there is nothing more they can do with my cardiac arteries to improve my condition, partly because of the depleted state of my heart muscle itself.  Any surgical improvement to the circulation of blood to my heart muscle would not be tolerated.  My heart wouldn’t be able to handle it and worse problems would ensue.

Calling this program the Heart Transplant Program is a bit of a misnomer.  More accurately it should be called the Cardio Repair Program.  Their first and foremost goals are to make a patient feel better, live longer, and keep what they got if at all possible.  An actual transplant is really the last resort.  So, with that being known, here is what they have planned for me:  a slew of new meds and constant testing for results.

Am I on the so-called “transplant list”, ie, waiting for the right donor to ride his motorcycle into the back of a bus?  Not yet.  In the coming weeks and months, more information will be gathered about me. The criteria for getting in that line for a new heart is very strict.  I won’t go into it all, but suffice to say, you gotta have your ducks in a row…especially your attitude and your ability to adhere to a rigorous protocol after the transplant.  You have to convince a plethora of doctors and boards that you are the right person, one who deserves something so delicate and precious as a heart from someone less fortunate.  It will be a while before my case is “presented” to this “Star Chamber” of doctors, nurses, and social workers for consideration, unless, of course, my condition worsens suddenly.  And speaking of that, my “condition” is not good compared to the average Joe on the street, but I am at the top of the class compared to most other patients in that program.  A good thing?  Sure. But it puts me farther down on the list for potential transplantation.

For anyone who doesn’t know me well, I have a long history of heart problems beginning with a heart attack at age 36 (I’m 63 now), several angioplastys, and bipass surgery.  It has all progressed to this…a state of congestive heart failure caused by coronary artery disease.  Though the final chapter is far from being written, the cardiologist handling my case feels confident I could live comfortably into my 80’s with the right treatment.

This month marks the second anniversary of my diagnosis with colon cancer.  Two years ago next month I had surgery to remove the tumor and a portion of my colon, then six months of chemotherapy.  I am in what is referred to as “surgical remission”.  I feel good about it.  The caveat here:  chemo takes it’s toll on your heart, especially if it is already in a depleted state.  Of course it was a no-brainer choosing to have the chemo…kind of a die sooner or die later decision.  I chose later.

No sarcasm or cynicism here!  I am committed to this program.  And if they even smell a falling from grace, I’m out!  For better or for worse, with all due respect, they are the Soup Nazis of the medical field…and rightly so.  Though unlike the Seinfeld character, these are truly warm, congenial people and they do it all with great attitudes and genuine smiles.  Despite the nasty drive from Modesto to Santa Clara, I am actually looking forward to my future visits, of which there are several scheduled.

I am planning on this “Golden Hour” of life being more like a “Golden Twenty Years”.  With my compliance in doing what the docs say along with a lot of grace from the powers above…that may be an accurate assessment.