Foreword
Dear reader. This is a recounting of my battle with cardiovascular, cerebrovascular, and peripheral artery disease. I am not a Medical Doctor, I am just someone that was sick, and found a way back from the abyss.
From childhood, I have been a voracious reader, and the internet information highway, thanks to Al Gore, has allowed me to research my disease, and develop a lifestyle that lets me to live with my illness in ways I never thought possible.
It is a lifestyle free of Zocor, Plavix, Lopressor and all the other "medicines" associated with vascular disease, and the side effects that go with their use.
I present this information to you in the name of knowledge, good health and peace.
And to future generations of humans: "I hope they have a better understanding."
Disclaimer
The information contained herein is merely for informational and entertainment purposes. No cure or professed cure of any disease should be inferred from the reading of this material, or any portion of it. The writer is not a Medial Doctor, nor does the writer profess to offer any cures. In fact, much of what is written are the ravings of a lunatic fringe nutter, so enjoy, and take everything said with a grain of salt.
The following is simply a recounting of a portion of time in my life. A time when sickness ruled, and the days were long and bleak.
Chapter One
San Francisco
Everyone knows that I never mumbled prayers.
Everyone also knows I never tried to hide my faults.
I don't know whether a higher Judge and a higher Kindness exist - but still,
I am full of confidence as I have always been true to myself.
Omar Khayyam
It was 1993, and San Francisco State University was abuzz with students returning for the new semester. The smell of fall was in the air, a reminder that the monsoon rains would soon return, once again turning the hills a beautiful, emerald green colour. As I walked across the campus, my leg muscles suddenly tightened, making it extremely difficult to maintain my pace. It felt as if my legs were set in concrete. Unable to figure out what was happening, I didn't say anything to my companion. Thankfully we only had a short distance to go to complete our journey, whereupon I was able to sit. The cramps eased away shortly thereafter.
I was forty years old, and had just experienced what was to later become a life and death struggle with coronary and peripheral artery disease. I was six feet tall and weighed 165 pounds. I had always been athletic, and sailed a small sailboat 4-5 hours most Saturdays and Sundays, weather permitting. I was active. I snow skied, played singles tennis and water skied, however I was aware I was slowing down some. I was also a heavy, 2 pack+ a day smoker. And my eating habits were not the best. My life was changing and I wasn't aware of how serious the changes were. After the leg cramping incident, I did realize that I needed to stop smoking. So after 25 years of nasty cigarettes, I did just that. I stopped cold turkey. And enrolled in a health club, where I worked out 4-5 times a week.
This routine carried on for two years, until my girlfriend up and moved to Dubai. In a funk, I quit going to the gym, reverted to smoking, and cast my fate. There was no logic to my actions. The stresses of a drawn out divorce and work pressures would have been better handled by going to the gym. I chose cigarettes instead. It would be many years before I would be able to figure out a way to quit smoking for good. And in the process of quitting, I learned why it is so hard for smokers to quit. Armed with this information, it fortified my resolve to quit. Later on, I will tell you what makes the nicotine so bloody addictive, as well as how to wean yourself from it; for once and for all time.
Life progressed, and in 1999 I found myself in a position to pursue a business venture I had in mind. Carpe diem, eh! I did just that.
Chapter Two
Borneo
The island of Borneo conjures images of headhunters, isolation, mighty rivers, and wild jungle scenery. Situated in south-east Asia, it is the third largest island in the world, and is shared by Malaysia, Brunei (where I was headed), and Indonesia.
Brunei, or more formally, Negara Brunei Darussalam (Abode of Peace) sits a few degrees north of the equator, and roughly 700 miles east of Singapore. It is a small country, with a total population of 300,000 people. Out of that 300,000, probably 100,000 are guest workers, brought in to perform the jobs that Bruneians do not want. Most shop keepers and business owners are of Chinese ethnicity and a multi-tiered citizenship (caste) system exist, with different levels of citizenship and rights for non-Muslims born in Brunei, primarily Chinese. In the main, guest workers are from the Philippines, Indonesia (Kalimantan) and Thailand. It is similar, though on a much smaller scale, to what is happening in the USA today with the Hispanic migration, with the major difference being that all the guest workers in Brunei are there legally. In Brunei, guest workers do not have the rights illegal workers enjoy in the USA. In fact, in Brunei and most Middle Eastern countries, a guest worker may switch jobs, that is become employed by another employer, only by leaving the country for six months prior to beginning the new position. Needless to say, employment is full and stable.
Bandar Seri Begawan, or BSB, is the capitol and largest city of Brunei. Bandar was dubbed "The Venice of the East" in 1521, when Magellan's fleet visited, due to the large number of houses built in the river. The word for village in Malay is kampong, and for water it is ayer, hence kampong ayer, or water village. The homes are elevated on stilts, with interconnecting boardwalks. Accessibility is primarily by water taxi or private water craft. The kampong has its own schools, fire department, mosque, restaurants, shops and hospital. Roughly 30,000 Bruneians live in the kampong ayer. They have been doing so for over 1300 years. A ride out to the kampong is less than two minutes. Once there, you are free to walk around. You will notice the friendly nature of the residents. Do not be surprised if you are asked inside a home to visit, have some tea, and perhaps even stay for dinner. Bruneians are well known for their hospitality and friendliness. When the men shake your hand, they will do so with a light grasp and then take that hand and touch their heart. The Brunei women are some of the most fashionably dressed women in the Islamic world, and are not required to wear the tudong, or head scarf, though many do. When they do, you can bet it will be any colour but black!
Brunei is a cradle to grave society, or Shellfare state, as it is Shell Oil that removes the oil and gas deposits, giving Brunei one of the highest per capita incomes of any Asian nation. Predominately Muslim, it sends its young people off to uni for an education, generally to UK or Australia. When they return, university degree in hand, they find there are no jobs for them. It is a perplexing problem that Brunei has yet to fully address.
A monarchy, Brunei is ruled by Sultan Hassanal Bolkiah, who, until the ascent of Bill Gates and later, Slim Helu, was known as the richest man in the world. The Bolkiah family has been on the throne for over 600 years, making them the oldest seated, surviving, royal family in the world. A former British protectorate, Brunei loves things British .The Istana Nurul Iman, the Sultan's palace, contains 1788 rooms, plus 250 bathrooms. I have had the treat of seeing a portion of the Sultan's personal fourth floor residence, and it is opulent with a capital O.
A joke around Brunei among the ex-pats is that the Sultan will defend Brunei down to the last Ghurka, a reference to the 5,000 man contingent the Sultan employs as a personal mike force. The British also maintain a small garrison of troops in Seria, near the oil fields, conveniently conducting a jungle warfare training and tracker school. I remember that the only time in recent history that a guerrilla insurgency was successfully defeated occurred on the island of Borneo. The ChiComs or Chinese Communists were soundly defeated by British commandos, in the jungles of Malaya, with the conflict culminating in the political capitulation of Sukarno of Indonesia in1965.
Kuala Lumpur, Manila, Ho Chi Minh City, Hong Kong, Jakarta, Bali and Bangkok are all between 700 and 1000 air miles from Brunei, making it a great jump off point for traveling in the region. Brunei's flag carrier is Royal Brunei Airlines or RBA as the locals call it. If you have the opportunity to fly RBA, take it. I found the service to be as good as that of Singapore, whom many consider to have the best cabin service amongst the major global carriers. As with most air carriers of Islamic nations, RBA has video monitors throughout the cabins depicting the geographic location of Mecca and the real time position of your aircraft relative to Mecca, thus allowing the faithful to always know the direction in which their most holiest of cities lies. When inbound, the in cabin service announcements prior to arrival also includes one which states that the penalty for drug possession/use in Brunei is death, so if you are thinking of visiting, leave the spliffs at home. In reality, Brunei does not use the death penalty, as the last execution in Brunei was 1957, and was associated with the uprisings in the region.
So there I was. I had successfully negotiated a joint venture with a European company doing business in Brunei. I had a widening circle of friends and I had traveled to Thailand, Malaysia and the Philippines on business calls, with some side trips for sightseeing. I had also, with some luck, side-stepped a potentially sticky situation in Manila. The Philippine President at the time was Joseph "ERAP" Estrada, a former movie actor and film producer, known as the Ronald Reagan of the Philippines. In my experience, it is the rare Filipino that does not have a nick name. Erap is pare backwards, which means dude or buddy in Englog, which is English upon which Tagalog, a Filipino dialect, is infused. Anyways, I had presented a business proposal to President Estrada through his nephew, who ran a Philippines remittance bank. Before my deal could be consummated, ERAP found himself impeached and behind bars on corruption charges. He recently received a sentence of life imprisonment for plunder. No more Malacañang Palace or Forbes Park for him. Such is life in the Philippines, and such is karma.
It was, in some ways, reminiscent of a brief venture a business partner and I had in Russia shortly after the planned fall of Gorbachev and Communism. It was a 10 year multi-million dollar deal. Payment initially was made with Irrevocable Letters of Credit, but switched quickly to wire transfers in U.S. Dollars to an off-shore "sweep account" and. from there on to another corporate bank account.
Our initial contact was a New York based "Russian diplomat," read KGB, who parlayed the deal for a consulting fee of $5,000 US per month. Well, within the first year the whole thing went south on us. The company we were dealing with was taken over, literally, by Chechen mafia types that sped around Moscow in a convoy of black Mercedes 600's.
Most were fond of carrying big iron, and one would occasionally catch a glimpse of a pistol butt under a $2,000 Armani sports coat. It was the Wild West in the East, Russian style. All that was missing were Crockett and Tubbs. I had set up the contract agreement in anticipation of problems, but being in a business dispute with gun toting Black Russians wasn't part of the deal. Our agreement stipulated that any contract dispute be adjudicated in Sweden, under Swedish law. It had become necessary to try and enforce our position, as the Chechens had abrogated our contract. Well, by the time we were about 50 lawyer hours deep into this, the Russian legislative body, the Duma, or House, passed a law allowing complete reorganization of all businesses of the Rodina. There was absolutely no redress for us once this happened. Das vidanya, tovarish
Not too much later, some eighty odd top Mafioso types were killed on the very same day across the 12 time zones of former Mother Russia; presumably compliments of the new and improved "wet affairs department" of the "former" KGB. Since that time there has been a melding of ex-KGB operatives and gangsters. It makes for a particularly violent criminal type, with criminal activities now largely controlled behind the scenes by the state as a result of the contrived "birth of capitalism" there.
Back in Borneo, I am still smoking cigarettes and not doing any exercise. I feel okay, but not great.
One day a friend called and invited me to a Hash. For the uninitiated, a Hash is a staged athletic event in which middle aged men with too much testosterone crash through the jungle, hell bent for leather and crying "On," On" as they follow a trail of cloth strips laid out the preceding day. At the end of the run, all gather round and drink copious amounts of beer, accompanied by ceremony and ritual that seem bizarre to the first time initiate.
Hash House Harriers, aka H3, came about when A.S. Gispert, a British accountant of Catalonian descent, more informally known as "G", along with other British ex-pats in Malaya conceived the idea in a Kuala Lumpur (KL) hash house; harriers are a British dog used to run game; think of a beagle on steroids and you have a good idea of the size and look of the breed..
Billed as a drinking club with a running problem, the Goals of the Hash from the 1938 charter are:
-To promote physical fitness among our members.
-To get rid of weekend hangovers.
-To acquire a good thirst and satisfy it in beer.
-To persuade the older members that they are not as old as they feel.
Well, that all sounded fine to me, so at the appointed time, my friend rang round, and off we went to run in the jungles of Borneo. After a short ride, we arrived at the edge of a jungle clearing in Kota Batu district. Cars were parked on both shoulders of the road, and a gang of roughly 100 men milled about, exchanging jokes and small talk. This was to be a male only run, as the kennel I was with, BH3 (Brunei Hash House Harriers), is male only. There are mixed and female only kennels in Brunei as well. BH3 is the 4th oldest hash around, and was formed in 1963, following Singapore as number two and a one-off kennel in Italy as third.
As the group started walking out across the clearing, the cry On, On rang out, and the chase began, as the trail was struck. I managed to go 100 meters before my legs began to cramp in a most severe fashion. I recognized the déjà vuness of the moment instantly.
Well, needless to say, I was not able to do the Hash. I did start a walking regimen the next day with my friend, who kindly offered to buddy up to make the walking a little less boring. We started walking in a park called Tasek Lama, (old lake) sited below the BSB water reservoir. It was a good place to begin, as there was a flat portion leading to a water fall. We did this for several days, and then began the climb up to the reservoir.
Chapter Three
June 2003
Blue Ridge Mountains
It's been some time now since we spoke. When last I left you, I was in Borneo, and things were going okay for me. Time and circumstance are of a new day, and my health and economic situation have, hand in hand, steadily deteriorated. To say I am depressed would be a huge understatement. I live a sedentary lifestyle, brought on by my worsening health. I know that I am on the edge, and chew aspirins whenever I have chest pains or faintness. And I am still addicted to those nasty cigarettes. God how I hate them and my addiction. I managed to roto-till a 20x20 foot patch of dirt this spring, and though it was physically very demanding, today I am blessed with a bumper crop of vegetables. I have just returned from the garden with some of them when I get that familiar sensation in my chest, so I make a beeline for my bed. Five minutes and two aspirin later I am feeling no better. In fact I am feeling like I am going to slip away very quietly. I am at peace with myself. I fully understand what is happening and a call to 911 is made
Like Eric Burden says, "There I was." The time had finally come to pay the piper his dues. And pay I would. I remember very little of the next four or five hours. I awake in a hospital bed, where I am told I have suffered a massive heart attack, and am alive because of two 325mg aspirin I chewed at the onset, and a $10,000 miracle drug that I was given-a super clot buster. I also learn that my heart suffered very little damage thanks to the aspirin I chewed. Stabilized, the following day I am transported to a regional medical center, where I meet with a cardiologist. Actually, he is now MY cardiologist-a sobering thought. There seems to be an endless stream of people into and out of my room for the first few hours, and then everything settles down. This is my first experience with hospitals since I had my tonsils out at age 8. So far it hasn't been too much fun. I'm hooked up to a heart monitor, IV lines, oxygen tube and monitor etc. I am slated for a trip to the cardiac catheterization lab the following morning, where my cardiologist will make a small incision in my groin, and insert a sheath into the artery. He will then carefully thread the catheter through the sheath to the blockage, where he will inflate a small balloon at the tip of the catheter, thus mashing or pressing the buildup of plaque flat into the vessel wall. Often a mesh metal stent is then inserted to ensure the vessel remains open. It all sounds good to me and I sleep as well as one can when a guest in a sick factory. As I slip off to sleep, I reflect on my situation, and recall a line from Persian poet Omar Khayyam; "If you truly want to live in peace, smile at your Fate." I fall asleep with a smile on my face. I am ready for whatever tomorrow will bring. Kismet is my bedfellow.
The catheterization lab is a busy place. Your last food and drink is the night before the procedure, and you are prepped around 5:00 that morning and told you could be called any time. I finally made it to the cath lab at 2:30 p.m. Like I said, it is a busy place. By then, I am starving for something to eat. The cath lab is a cold place and air conditioning reigns supreme as it cools all the high-tech gadgets and toys used to re-plumb you. I am wrapped in several very warm blankets and given Benadryl. It burns briefly as it enters my bloodstream. I watch with interest on the monitor above me, as the catheter is inserted; I see the dye marker and the blockage. I find it all fascinating and I try and hang on, but wind up closing my eyes and resting, until an incredible tightness grips my chest. I am certain I am having a heart attack, and tell the cardiologist of my discomfort. The procedure is halted and I do not remember too much else of what transpired, other than awaking in my hospital bed. After a stent implant procedure, you must lie flat on the bed for 5-6 hours. You may not lift your head for the first 2-3 hours, and then a pillow may be used. A plastic suction device is strapped over the incision and remains on until the incision has healed, usually around 6 hours. If you are not good at going inside your head, this might be a difficult time for you. A friend or relative is always a welcome sight.
I am able to find out that I did have a heart attack, or infarction, in the cath lab. The discomfort I felt was from the brief closure of one of my vessels during the procedure.
My cardiologist had already successfully implanted two stents, and was attempting a third when I experienced the pain in my chest. I now have one Johnson & Johnson Cordis Stent Implant Cards, and one from Boston Scientific. Stent cards should be carried with you at all times my nurse seriously intones. The manufacturers' card provides the basic information, such as the name of the implant physician, date of procedure, location of implant, etc. You get the idea.
Well, I was laying there in my hospital bed thinking that I had come through okay, and that maybe now I could get my life back in order, when the cardiologist came in. He explained that I had heavy plaque buildup in my arteries, and that cardiovascular bypass surgery would be required if I wanted to continue to live. What was that about smiling at your fate?
Next I meet with the guy that is going to crack my chest. He seems competent, and I certainly don't have any options at this late date. The rest of the afternoon is spent subjected to blood samples, x-rays and other diagnostic tests. Everything is a go for surgery tomorrow morning. I am fifty years old.
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