Sunday, August 22, 2021

Garage sale day


So, today's the day.  The day we hold our first garage sale.  Diane has been talking about having a decluttering garage/yard sale for years but procrastination and inexperience have sidelined this activity.

The past year,2020, created a perfect storm, so to speak; I retired and closed up my apartment in Dansville, 4 hours away, and the landlord of the cottage we've rented on the river finally sold the place causing us to have to move 16 years of accumulated "stuff" back home.  The upshot was, two households returning to the main manse and us leaving in a couple of weeks for our yearly retreat to Florida for 6-8 months.

Alas, what to do with all this "stuff!"

The only reasonable and practical choice was to put all the extra furnishings in our two stall garage.  Now I've prided my self that since this structure (garage) was erected some 25 years ago that there was always room to park both of our cars inside.  But now my side of the space was crammed full to the seams and off we flew to our winter home.  Just to say, we drove my car 4 hours south to our daughter's home in Albany, NY and left my car there, so both cars did actually winter inside the protection  of a garage.

But, fortuitously, or not, we returned north and were presented with a garage full of materials we no longer were in the need of.

Family to the rescue! 

August 5th our daughter and her beau came from Albany with truck and trailer and my sister and her husband came from Rochester with their recent knowledge of garage sales to help us get organized and set up for a garage sale to divest ourselves of excess furnishings.

Stan's truck and trailer to remove stuff to be used in his construction business or be hauled to a landfill.

After getting everything laid out across both garage bays the "team" takes a break: L. to R. Michelle, Julie, Dennis, and Stan.

On Saturday august 21st, Diane checking to make sure everything that needs a price tag has one. Sale to start in one hour.

Our son, Jacob and Kristy, and his family arrived from Niagara Falls to help us on sale day.  Our entrepreneurial grandchildren, Ethan and Sophia, decided to set up a lemonade stand, which turned out to be successful on this hot, humid August day.

Grandpa in the far right distance manning the cash box as seen from the lemonade stand.

While we didn't sell everything, I'd say we fared pretty well overall.

Tuesday, August 17, 2021

PCP follow-up phone conversation


Yesterday afternoon, following the morning's dobutamine stress test and echocardiogram, I received a call from my PCP  to discuss the results.

He said he had discussed the results with the cardiologist, Dr. Geetanjli Sangwan, and that she had suggested a follow-up cardiac catheterization.  I like Dr. Jaitly and respect his abilities as a top notch physician.  One of the things I like most is his manor of discussing what our options are and asking how I wish to proceed.  He never pushes one option over another other than to point out the  customary path for many.

I shared with him my, always overriding, concern in doing interventions without symptoms to warrant procedures just based on previous "tests.;  this is not a new exchange between us, i.e. statins to control cholesterol.

Since the echo was normal throughout with an ejection fraction of 60%, and all V/S were stable even at a sustained heartrate of 133, (110% of predetermined test rate) and that the ST wave depression on the EKG recovered quickly with a reduction in my  heartrate while I objectively experienced no ill effects; no pain or discomfort anywhere and no unusual changes physically, I suggested holding off on any further tests or intervention such as coronary artery catheterization.

He agreed. He thinks it is a safe  way to proceed and if any symptoms reflecting cardiac compromise occur down the line we'll reevaluate our options and proceed from there.

Dobutamine stress test


My PCP (primary care physician) has been urging me, for the past 3 years, to get a stress test based on the results of a yearly low density lung CT scan.  He orders the CT scan due to my history of smoking, which I stopped on August 26th, 1996 at 3 PM.

I have had 2 previous stress tests which I did on a treadmill, one being a nuclear stress test.  All of these, including yesterday’s are predicated on; my smoking history, my dad, a smoker, dying of a heart attack at age 58, and my chest CT scan showing “significant” calcification in my coronary arteries.  This last finding always prompts our radiologist, Dr. Ali Gharagozaloo, to encourage Dr. Jaitly, PCP, to urge me to get a stress test.

Two things that have motivated me to put off taking the test are: 1. Lack of symptoms of circulatory impairment to my heart. I was a runner for twenty years as well as a lifelong weight lifter, down grading to walking since age 70. I’m aware of the Jim Fixx illustration that running does not prevent heart disease.  On that note however; I do believe that years of regular aerobic exercise can ward off circulatory disease. Also for the past 3 years I’ve been an ardent Pickleball participant, playing 3 to 6 days a week for the 6 - 8 months we are in Florida.  All of this without symptoms of coronary insufficiency.  2. Physicians are obligated to find something wrong with you; that’s their job.

I had agreed to the stress test last year but on the scheduled day for the procedure the cardiologist failed to show up for work and since we were leaving for Florida in 2 days a reschedule was out of the question.

Yesterday’s appointment for a stress test was like an old homecoming reunion with two co-workers from my years at Claxton-Hepburn Hospital; Kathy Beauchamp and Renee Palmer.  Renee did the echocardiography and Kathy was the infusion nurse starting my I/V and administering the dobutamine and keeping track of my v/s; B/P, Pulse, respiration’s and EKG. For the moment I’ve forgotten the cardiologist’s name (amended from report on 8/20/2021; DR. Geetanjli Sangwan) but she was adept and explained what she was observing while watching my EKG and echo.

The target heart rate to be obtained, as explained by Kathy, was 128 bpm.  I’m assuming that that is determined by some age/weight formula i.e. “Your  target heart rate during a stress test depends on your age.  For adults, the  maximum predicted heart rate is 220 minus your age.”  However infusion rates can be imprecise at best and subsequently a rate of 133 was achieved, 110% of predicted.  During that time, at a rate of 133 for 3 - 4 minutes, the cardiologist noted a 1 mm (millimeter) depression in my ST segment of my EKG.  She  explained that this was indicative of some degree of coronary insufficiency but that during that same time period (well, in fact through the entire test) my echocardiogram showed no abnormality and just as significantly I displayed no objective symptoms of insufficiency, i.e. pain. They asked me repeatedly during the test if I was experiencing and discomfort or any abnormal feelings. To which my reply was always no with the exception of hearing/feeling the drumming of my pulse in my right ear.

The cardiologist, Geetanjli Sangwan, called Dr. Jaitly while we were still in the procedure room and explained her findings to him and to me as well along with the suggestion that a follow-up cardiac catheterization might well be indicated to pinpoint any area of narrowing while noting the fact of no objective symptoms.