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Today's Featured Biography
James Schrock
Hello,
Jack wanted me to tell you about some of the health issues he has dealt with over the past few years. Unfortunately, some of these issues are hanging on and still cause him problems in life.
To start with I will tell you the obvious things: Four or five years back Jack began to notice a marked increase in his loss of both mental and physical abilities. At the time he was unaware that there was a genetic problem with his heart which later would prove to be one of the major causes in his decreasing health. It was a struggle for Jack to get up in the morning and off to work; work itself was a battle for him on multiple levels. When he returned home at the end of his day he would head straight for bed to get an hour or two nap and then would get up to eat something only to return directly back to bed.
Work at the time was both a physical and mental challenge for him. He was losing his physical strengths and endurance; he also, was losing his ability to think as clearly and precisely as he had been able to only a few years before. Jack was beginning to have problems with his mental acuity and abilities to mentally trouble-shoot situations around him, both mechanical and human situations. Those he worked for and with were either unable or unwilling to sound a warning to him or me that things were not like they had been that things were changing.
Not that I had not already noticed the changes. They came very gradually, Jack had always been one to want a nap in the afternoon when he got home from work, he had been that way when he was a kid at home…get home nap for a half an hour or so and then he was good to go until bedtime. The naps began to need to be longer and there was less energy restored, finally getting to the point where he would nap, eat supper, and then to bed for the night. He was sluggish in responses to things we would talk about, often misunderstanding what was being said and taking a negative stance to what was said. And then it would be necessary for me to ride the storm out to be able to breakdown what was said and explain to him what was meant, not what he thought he heard.
At one point, not fully aware of his cardiac problems I thought that Jack might be in the early stages of Alzheimer’s. He had less sparkle, less initiative and drive, trouble remembering words, had trouble with his abilities to finish routine tasks (he would ask me to open a pop top can, saying his hands didn’t work well with something that small), he became very self-absorbed and insensitive to others, wanted to stay home in the familiar not wanting to do the unfamiliar (same restaurants, not wanting to try a new one), had less control of his temper, had trouble handling frustrating situations, anxiety, increase in periods of depression, paranoia.
Then one night Jack began to experience severe pain in his back, between his shoulders. There was a tight feeling in his jaw and soon he began to feel a cramping feeling along his left arm…he actually asked if I thought he should go to the hospital. When I said yes he argued with me that he wasn’t going to the hospital, he said, “Call the hospital and see what they think is going on and what you should do.” Of course, you know what the hospital said…he needed to come in and be checked out, after a little more arguing he did concede to go to the ER with me. I pulled out of the drive way and was informed that my driving was less than acceptable and to move over he was driving. We changed spots and he drove into Frankfort to the hospital. As we were turning onto St. Rd 39 Jack looks at me and says that the pain had let up and he didn’t think he needed to go to the hospital after all, luckily for me, he took my advice to go onto the hospital to have them check him out since we were so close. He parked at the ER entrance and almost collapsed on me on the way in to the hospital. The nurse that I had talked to on the phone was nearby waiting on us to show up. She helped him into the ER to the restroom…she needed a sample and Jack said he had to “pee like a racehorse.” Before I could finish registering him, one of the other nurses on duty came out and said that I was needed in the restroom to help with Jack. He had become agitated and was being argumentative with the nurse. I was asked to get their sample and help him. When we were done the nurse came into the restroom to help me get him into a gurney to wait on the doctor and have some other tests done. The nurse was on Jack’s right side and I was on his left to give him support, before either of us was aware that something was happening the nurse was lifted and shoved into the handle of the door and I was flung across the wash basin. A male technician and EMT that were present moved in to try to calm Jack down, it appeared that they might be having a bit of a problem so the doctor sent the other nurse in with a rather large dose of IM Ativan that seemed to do a decent job at calming him. Once on the bed he was hooked up to a monitor that was reading even after the Ativan 200-220 heartbeats per minute. Jack was not acting normal that night because of the a-fib. To shorten the story, he was stabilized at Frankfort, and then sent to St. V. Indy where he was started on the discovery of what was one of the contributing factors to his decreasing health.
Although Jack ended up having surgery to replace the faulty aortic valve and the ascending aorta which had been damaged as a result of the genetic problems of the aortic valve he still did not recover his physical strength or his mental acuity. The A-fib that was a symptom of the genetic problem had affected him (in what seems to be a permanent way); his heart was unable to pump blood adequately through his body because of the a-fib. Jack was not getting an adequate supply of blood to his brain, causing a condition to exist similar to a stroke…and what contributes to a condition called vascular dementia. His brain was starved for blood and oxygen at those times when the a-fib appears.
End part 1
Of course, his heart surgery was an adventure of its own…After the ER experience in January we went through a lot of MD visits and tests including a heart cath. The MD that did the cath told Jack that he had the cleanest arteries he had seen. The MD told Jack he wished he had arteries as clear. But, he was also the one that told Jack about the malformed aortic valve. The area around the aortic valve had begun to stenos and had invaded the area of the heart that sends the signal for the beat. Jack also learned that the ascending aorta had been damaged; it was stretched to 4.5 cm, with 5.0 cm considered an aneurism. The MD urged Jack to have surgery to replace both the valve and the aorta.
Now, Jack being Jack, he didn’t want to do the surgery until after I had graduated from nursing school. He waited until my graduation in May to schedule the surgery and then managed to be running a temp the day we went in to do the pre-testing the surgeon wanted. He had decided that he was not going to have the surgery before I passed my Boards…my Boards were scheduled 3 days after the first planned day for surgery. I’m still not sure if he planned the temp or not but, it sure was convenient for him, hum…
As we were walking in to the Heart Hospital in Carmel, Jack was determined to walk in on his own power. He did, thankfully the Concierge saw us coming and met us at the front of his desk with a wheelchair, and Jack could not have gone any further at that time. They wheeled him back to prep and got him ready…he was shaved in areas he had never been shaved before…and they “slipped him a mickey”. He doesn’t remember me coming back to say goodbye and that I would see him later. I also took the opportunity to tell the nurse that Jack has an unusual way to wake up from anesthetic; in the past he has come up either fighting or flirting. I advised her to have restraints handy just in case. To me the nurse pooh-poohed the need but, I told her if they didn’t need them fine but, if they did just to bring me the paper afterwards and I’d sign it. Just shy of 6 hours later the surgeon comes down to talk to me with the chaplain in tow….Jack had almost waited too long for the surgery to be successful. The surgeon told me that the valve had stenosed to less than one millimeter and the ascending aorta had stretched to 5.1 cm.
Jack has a mechanical valve and synthetic ascending aorta up to just below the carotid artery. He tells me the first thing he remembers as he came out of the anesthetic was this loud clock that was ticking away. I was allowed up to his room for a few minutes after they placed him in the room, then was told that I had to leave and could return in half an hour to visit again. The room was cool during the first visit. I went up for my second visit and promised his nurse that I would stay out of the way if I could stay up there with him. She felt sorry for me I guess, she let me stay. And lo and behold setting on the counter was a set of restraints (unopened). I guess the OR nurse decided to err on safety.
On my first trip up to Jack’s room I left in his hand a Hello Kitty pez. This was so that he could have me, his kitty, at all times. About 6 pm I finally asked why the room had to be so cold…there was an internal coupler left in his chest that was reading at that time 107, that was when the nurse started to ice him down. It was also the time when Jack raised the Hello Kitty asking for me. The rest of the night I sat beside his bed under 3 blankets holding his hand. Temp broke and he became more aware of things around him. Especially the vent that was still in to help him breath….
With the amount of anesthetic that is used to do the type of surgery that Jack had done it often takes a number of days before the body returns to a state that it can function with out aid. Two and a half days is not normally enough time for the lungs and stomach and other organs to wake up and function. Jack started the second night wanting the nurse to remove the breathing tube. Finally after a day of hand signals and sending me out to the nurse’s station his nurse explained that only Respiratory could discontinue the tube. That would have to wait until morning when they returned. The tech showed up to check the vent and was told that he wanted the tube out. She tried to explain to Jack that it had not been enough time, Jack wanted the tube OUT! She called the head of her department who came up and tried to explain to Jack that it was too soon. He tried to explain that Jack was not demonstrating the “signs” that they look for to pull the tube. While the guy was trying to reason with Jack I asked the MD that had walked up if the tube was pulled could someone replace it, the MD agreed that it could be done. The respiratory guy comes to me to try to reason with Jack. I tell him that Jack wants that tube out. If he can’t breathe you can put it back in, right? He looks at the MD and gets the nod. He calls for a fresh tube kit because he knows he will have to re-seat it. I explain to Jack that we are going to remove the tube but, if he can’t breathe on his own it would be replaced. Jack agreed.
Tube was removed, and he breathed on his own, they didn’t have to replace the tube. One of the things that they look for before removing a breathing tube is resistance. It is human nature to control the machine not the other way around. Jack will look for the most efficient way to do something. He was breathing with the machine; to him it was counter-productive to fight the machine.
Jack managed to get me in trouble a couple of times. He was only given ice chips to quench his thirst. He bullied me into letting him get a few actual “drinks” of water. I got caught twice; I was told that if it happened again I would be barred from his room. Again, the theory was that the organs took time to wake up. The stomach wasn’t supposed to be “awake” yet. They just didn’t know Jack the way I know Jack!
Several days out the staff started to get Jack up to the recliner next to his bed. One day he had finished lunch and was settled into the recliner. He placed his transistor next to his ear to listen to Rush Limbaugh and kicked back. I told him I was going down to grab lunch and I’d be back in 30-40 minutes. I returned. As I walked through the door the man in the recliner was gray, the same grayish color that comes with death. I had seen the look several times while working as a CNA. I had not crossed the threshold of the door and turned to holler for the nurse. Before a sound could be uttered I hear “Get out of the way!” It seems that telemetry had also registered an extreme drop in his blood pressure, to unregisterable. Two of the male nurses very ungraciously picked Jack up out of the recliner and back onto the bed; another nurse had a rather large syringe that went into Jack’s IV almost before he landed in bed. He came back. The doctor had not altered any of Jack’s pre-surgery meds, some of which were no longer needed evidently. It seemed like hours but, in reality only a few minutes passed. That old saying about time moving in slow motion!
Finally 2 weeks later, I get to take him home. Now through out Jack’s stay at the hospital I had been unable to hear this Timex that was clicking away in his chest. We were just north of Zionsville and I’m rolling down the car window trying to figure out where the noise is coming from. We were at the last stop light north of Indy and Jack starts laughing at me…over the traffic, the radio, and all the other noises I finally could hear his mechanical heart.
End part 2
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