Aronson, Louise. Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life. New York: Bloomsbury, 2019.

If this book wasn’t a best-seller in 2019, it should have been. Easy to read and digest, the book explores the entire scale of one’s life: birth, childhood, adulthood, middle-age, young-old, and old-old. Aronson boldly shares her experiences as a doctor who loves working for and with the elderly. She reveals that when people hear the word “old,” they think: wrinkled, bent over, slow moving, bald, and white hair. When people hear the word elder, however, they think respect, leader, experience, power, money, and knowledge.
 
The book isn’t entirely anecdotal; Aronson weaves in lots of data, lots of science, much of it contradicting the current (and for the last fifty years) “wisdom” on how to treat the elderly (mostly by isolation and medicating them as if their bodies were still younger). With the population of elders in this world only growing by the day, she calls for a new way of thinking about the old. New ways would treat the elderly as individuals, as if their lives still mattered, not just their bodies. Physicians don’t mind keeping the old bodies alive; in fact, they almost insist on it. Yet they don’t necessarily want to handle the rest of the old body: the brain, the emotions such as loneliness, fear, and anxiety.
 
I read this while a loved one of mine (an elderly) was in the hospital and now rehab. The author’s words helped tide me over, so that I might make better decisions for him. Again, well worth the time. Aronson is a fine writer, an excellent physician, but most of all, a caring human being. I wish she were my doctor.

Up Next:
TUES: A Writer's Wit | Ida Tarbell
WEDS: A Writer's Wit | Maria Shriver
THURS: A Writer's Wit | Guy Gavriel Kay
FRI: My Book World | Julia Alvarez, ​The Cemetery of Untold Stories: A Novel

On June 21, 2018, I rose at six-thirty a.m. but felt rested. Had a pleasant conversation with Nurse Jennie who is from Vietnam. She gave me a Lasix infusion to help me urinate. Dr. Gallinghouse came in at seven-thirty. He said everything went great. Inside of the heart looked as he had thought it would but felt that the work  he’d done would provide the hardened tissue needed for blocking the errant electric signals. (I guess; the procedure is still somewhat of a mystery to me.) He will have me continue my current medications until further notice. For a couple of weeks I’ll be on Carafate, a high-powered antacid, which will help any irritation that may have taken place near the esophagus, where he worked. Ken arrived at eight-thirty, missing the doctor’s visit. A young man with dreadlocks said he was going to help me shower and remove the surgical tape covering my groin wounds. 
 
Word came down that I might be dismissed before noon. Frankly, I believed they would need the space ASAP. When things were expedited, the shower was eighty-sixed. I might have needed some help because the surgical tape was so powerful it could have been used to patch broken plumping. It was so strong that it tore skin from my body when I carefully removed it myself.
 
Out at eleven a.m. 
 
I posted on FB that everything had gone well. In fact, I’d posted twice before the procedure, once while I was in the first holding room, and then again after I was in my room and I took a picture of the marker board stating: “Monitor groin areas overnight.” Two of my friends gave me some real grief over that, all in good fun, of course.
 
In closing, Doctor Gallinghouse is a very personable, passionate, and intelligent gentleman with a great haircut, using some of the most sophisticated knowledge and equipment at his fingertips at Saint David’s. More important, his heart is in the right place, caring more about ridding people of the annoying, debilitating, and potentially harmful condition known as A Fib than riches or fame. The organization of which he is a part--Texas Cardiac Arrhythmia Institute—is by many accounts one of the best, if not the best, medical centers of its kind in the country, if not the world. I’m NOT engaging in hyperbole! People from other countries journey to Austin every week to have this superior level of ablation performed. I can’t speak highly enough of the Saint David’s and TCA staff members. Each and every individual I came in contact with was exceedingly competent, helpful, and caring. And caring. I can’t say that enough: caring!
 
In the days since the ablation (thirty-seven and counting), I have NOT experienced one twinge of A Fib. I feel that the repair has increased blood flow to all parts of the body. I am now able to bend over or stoop down without triggering an episode or becoming dizzy when I stand. I can now do my complete Pilates workout without having to worry. I returned to achieving my 10,000+ steps per day within a week! I feel great, and I hope I never take that feeling for granted ever again.
 
If you are experiencing atrial fibrillation or believe you have its symptoms, I encourage you to contact TCA in Austin, Texas and make an appointment. Their surgeons meet with people from all over the state, so be sure and check with the Austin office for a cardiologist near you. And finally, if you’re worried about costs, consider that Medicare and insurance companies are willing to pay for this procedure because in the long run it reduces their costs. (Warfarin tests, drug expenses, appointments, cardioversions, and other charges add up over the years.) In fact, I have by now received the bill for my share of the expenses at St. David's, and my insurances covered all but 5%—an amount I can live with.

If you have any questions, please message me using the contact box on my Home page (I no longer have a Facebook account), and I’ll try to answer or put you in touch with someone who can. You or those whom you love no longer have to suffer! Also, if I’ve misstated anything, please inform me, so I can correct it. Thanks.

NEXT TIME: My Journey of States-16 Connecticut

On June 20, at Saint David's Medical Center @stdavidsmedctr, in Austin, Texas—in association with Texas Cardiac Arrhythmia  Institute @tcainstitute—Doctor Joe Gallinghouse @GallinghouseMD performed an ablation on my heart. Doctor Gallinghouse is one of the preeminent doctors in this field, worldwide, and I felt very fortunate to be in his care. Ablation is a process just short of a miracle. Sending a scope up arteries on either side of the groin, Doctor Gallinghouse used energy (re: heat) to ablate five key places inside the heart, correcting the errant electric impulses that had been causing the heart to misfire. The procedure hardens areas of the heart which then block those wild electronic impulses—causing the heart to beat in a normal sinus rhythm. I’ve not had any symptoms since before June 20. More than thirty days and counting!

The day began at 7:00 a.m., as usual, except that I had no breakfast, of course. While I scoured my body in the shower, Ken had something to eat in the hotel restaurant. We used Uber to get to St. David’s. Again the driver had some difficulty (or else it was his app) finding our hotel. I finally had to enter the address again! It was amusing watching the phone screen as that little black car kept turning around!

We knew exactly where the hospital's main entrance was because we had scouted it out the day before. I got checked in after more filling out of a form on a tablet. There was a man who served as sort of concierge, making it the most efficient hospital check-in I’ve ever seen. Then more answers to more questions ad infinitum—perhaps a truth-check to make sure facts are consistent? I was then placed in a “holding” room for over two hours, dressed in an odd-patterned gown of oranges and browns. During that time, lying on my back on one of those comfortable gurneys, I met my anesthesiologist, then an assistant/intern, and consented to become involved in two different tests or studies: 1) To check if half-saline solution would work as efficiently as the usual saline solution. Preliminary studies show yes. 2) I can’t recall the second study . . . 
 
Then off to the next holding room, which was colder, three walls with a fourth facing the hallway and only a flimsy curtain. And . . . oh, yes . . . yet another nurse named Clayton who would roll me into the OR soon enough; he was a Labrador retriever in nature, friendly, nurturing, smart and alert. As I lay there alone, I used my usual meditation mantras to try and relax. There was noise coming from every direction as I waited. I believed it was the OR doors opening (and I would be right), and the roar of tech would emerge as well as heavy metal rock music. Please don’t play raucous music during my procedure, I pleaded. Maybe some Mozart, Debussy?

I sent my silent message down the hall, imagining it taking wing as it fled through banging doors, noisy alarms, and raised voices. Not complaining. It’s just the way of a well-functioning contemporary hospital! In another thirty minutes Clayton rolled me across the hall to the OR, which he stated was kept at fifty-eight degrees. I asked why so cold, and he said it was to keep the technical equipment cool, but also the staff (I later learned it also cuts down on bacteria growth). Clayton was kind enough to place some heated blankets over me.

At that point, three chatty female nurses began to prep me for the procedure, having me slide from the gurney to the table, sliding a hose pumping warm air under my blanket. Thank Christ. They hooked up the IV into my left forearm. Then I realized they were engaging me.
            "You are NOT seventy," one of them proclaimed.
            "I can show you my birth certificate," I said.
            "We just want to know what your secret is."
            "Good, clean living," I quipped.
           "I missed out on that a long time ago," one of them said.
          "I think it’s probably just good dee enn aaye," as my voice slowed, and I went under. Probably their ploy all along. We always flatter patients. That helps them relax and get out of themselves so the anesthesia can do its job.
       
I didn’t recall anything after that until I woke up in the recovery room with the words that everything had gone well. Rather than literal heart burn, I was experiencing more pain in my groin areas where the scopes had traveled up through arteries to my heart. I was put into a private room about six. Ken helped me negotiate my way until about seven-thirty when he took off for the hotel. He had had a rougher day than me, speaking on his phone periodically to Clayton to see where I was in the process—sitting, sitting, sitting.

I ate some chicken noodle soup and an entire baked potato. My sugar levels were a bit above average, and the nurse offered to give me a shot of insulin. Since I’m not a diagnosed diabetic and because it was offered as an option, I passed. I took my usual night pills at nine p.m. I ate some ice cream at ten-thirtyish and finished watching Rachel Maddow. Finally to bed after midnight. The nurse gave me five mg. of Ambien—enough to help me drowse between her visits. I did like it that she informed me when she would be back at three thirty and then again at fiveish—like most nights when I have get up to pee. Return next week as I conclude my story.
 
NEXT TIME: My Journey of States-15 New York

For a long time I was wary of having the ablation procedure done (They go inside your heart? I thought), as one is when one doesn’t have all the facts. When I ran into a friend who had had this procedure performed by Doctor Joe Gallinghouse, she had not experienced an episode in over a year after her ablation (it has now been over two years). I was intrigued, and kept Dr. Gallinghouse in mind (he travels twice a month to Lubbock from Austin to conduct follow-up visits, as well as consultations with potential patients). I continued to see my friend from time to time, and she would ask me how I was doing, and she would once again extol the doctor’s virtues.

One day when I had a routine appointment with my PCP’s Nurse Practitioner, I was experiencing A Fib, and my heart rate was 142. She had an EKG taken and emphatically said, when she showed me the results, “This is not pretty!” She, knowing the NP of my cardiologist, Doctor Brogan, called that office and set up an appointment with him the very next afternoon. I was still in A Fib at the time, and I informed him I was ready to consult with Doctor Gallinghouse. Brogan’s office scheduled an appointment for late April. At that time, I went in with a long list of questions, and he addressed them all and a few that Ken had for him. In all, he met with us for thirty-five to forty minutes—valuable as gold.
 
Monday, June 18, 2018 
Ken and I used Uber as a trial run to get to St. David’s Hospital, where I shall meet with Dr. Gallinghouse’s PA tomorrow. The ride went without a hitch, and the driver was flexible enough to drop us at the Garage #2 where Dr. Gallinghouse’s office is located on the seventh floor. We took the elevator up, and the receptionist told Ken where he would find the cafeteria on Wednesday.

Later we walked from the hospital to the LBJ Presidential Library—fifteen minutes. The heat got to Ken so we won’t be doing that again soon. I didn’t like it either; I hate getting sweaty with good clothes on. While we wandered among the exhibits, I kept thinking ahead to Wednesday! Not good. Took Uber back to Holiday Inn Midtown.
 
There, I had a meal of fish tacos and potato crisps, both of which were spicy, but I enjoyed them. Buttered, steamed broccoli—al dente, just right. Return next week for Defeating A Fib at Last-3, when I head into the OR!
​
NEXT TIME: My Journey of States-14 Delaware

I’ve battled A Fib @Afib_Disease #AFib since 2003, living through (if you want to call it that) episodes in which my heart speeded up to 130-140 beats per minute. For hours. Sometimes days, intermittently, until additional drugs and rest could coax the heart rate back to a normal one. When the heart is in A Fib, the upper two chambers of the heart beat fast while the lower two, unable to keep up, sort of quiver, inviting blood to pool, coagulate, clot, and possibly cause a stroke (thankfully, meds like Warfarin and Xarelto “thin” the blood to reduce the chances). In addition, I take a cocktail of four other medications to maintain this thin margin of being in A Fib or not in A Fib. The biggest trigger for me (although there does not need to be a trigger) was stress, inner stress I often wasn’t even aware of until it was too late, and there I was under attack inside my own body.
 
June 17, 2018 Austin, Texas
 
I can’t believe the hour has arrived . . . almost. Here in Austin for my ablation on Wednesday. We've flown down direct from Lubbock—only a slight delay and the flight takes but an hour and five minutes! In some cities that’s a driver’s daily commute. No wonder Doctor Gallinghouse makes the trip twice a month from Austin to Lubbock—easy peasy.
 
As we approach the cab queue, the first driver in line waves to us and smiles. His skin is the color of wintered pecans, and his teeth almost iridescently white. 
 
Midtown Holiday Inn, we say once we are inside the cab, and the driver hands us his phone—white but smeared with constant use—and asks us to type in the address. Lucky for us I have memorized it so that when I enter about half to it into his phone, the address pops up and I tap it. Then as we take off from the airport into Austin, I wonder if I have selected the correct address. “We might wind up at Big Lots,” I say to Ken.
   “Check your phone,” he says, and I do, opening my map app. Yes, I believe once he hits IH-35 that we are on our way. The fare winds up being $34.70 and Ken gives the man a fifty and tells him he's earned it. We had gotten stuck in slowing downtown traffic and for a neophyte, seemingly, he did well, weaving in and out, using the frontage roads here and there. I haven't been listening to the music he is playing until I hear the word Jesus and then I imagine he might be a seminary student. He has a Mother Mary decal glued to his glove box.
 
I read a more detailed account of what the ablation will be like—eight to nine hours flat on my back after the procedure is over. Possible palpitations. Pain because of the “heart burn.” But . . . I’m ready to go through with it because I’m tired of living half a life. I want to swim again. I want to do a National Geographic trip with long hikes. I want to do writing and photographic field trips. I want to get out of town longer than a couple of weeks. I want to live and live forever! Come back in a week when I continue this saga of conquering A Fib!

NEXT TIME: My Journey of States-13 New Jersey