November 3, 2016
Just when things seem to be on a solid footing, life throws you a California earthquake. We've had some difficult challenges the last 18 months. Those challenges have kept me from going to court and covering cases the last four months.
As I'm hitting "publish" on this post, Mr. Sprocket has been on the operating table undergoing open heart surgery for six hours. He still still has the next 12 hours of post-op to get through, and a long recovery.
2014 Heart Attack History & The Lives of Kitties
Back on May 30, 2014, Mr. Sprocket had a big heart attack. We were very fortunate that he survived the event and bounced back rather quickly. You can read the posts about Mr. Sprocket's heart attack and eventual recovery HERE.
Within a couple weeks of coming home from the hospital, he was back to work. He had a ton of energy. He was doing well. To celebrate his new lease on life, we adopted a new black and white tuxedo kitten, Rudy Rocket from the Baldwin Park Shelter.
There was no way to know then, that Rudy Rocket would only be with us for such a short time, and what would happen later.
Rudy Rocket quickly won over our hearts and became Mr. Sprocket's favorite. He would follow Mr. Sprocket around the house and made sure to visit him each morning in the bathroom. He liked to get inside Mr. Sprocket's shorts.
Rudy Rocket, 1/15/2015
Rudy Rocket would watch the washing machine and bird videos on my computer. He was very smart. He learned to fetch toy mice and bring them back. Sometimes he would leap high into the air and catch the mice mid jump. He could play that game for well over an hour, taking breaks by lying down and panting off his built up energy.
However, our older kitties Scout and Jumpy were not too happy with this little energy dynamo.
The Older Kids
Jumpy was our kitty we adopted along with his litter mate Katie in June 2003. They did everything together. Katie was more outgoing and engaging. Jumpy, almost twice a big, followed her lead and was afraid of his own shadow. If you dropped a pen on the floor he would freak out and go hide. Katie suddenly died in 2007 at 4 years old. Jumpy never seemed to be the same after the loss of his sister. He became even more shy and reclusive. He eventually bonded some with Scout. They would sometimes sleep side by side, fighting over the best spot. Jumpy would let Scout groom him, but he never groomed Scout back.
A rare photo of Jumpy (l) and Scout (r) on wicker chair, 11/24/2015.
Scout adopted us on a cold February in 2006. Scout found the sanctuary of our back patio. During that cold winter, he was looking for a warm place to curl up and sleep. He found it in a large box of commercial filters that Mr. Sprocket had stored under the covered patio. After he arrived, we left food out for him on the patio table. We provided a warm, insulated cat bed inside an elevated, padded box. Scout had found a forever home in our bed and breakfast. We were lucky he stayed. Affectionate nick names were "Noodle" because when you held him he would often become a limp noodle, not wanting to leave your arms and "Butterhead" because if he smelled butter on the table, he wanted some. We never new how old he was. He was already fixed and had the classic ear notch of a TNR [trap, neuter, release] kitty when he arrived.
When Rudy Rocket joined us, Jumpy didn't want to have anything to do with him at all and retreated to our bedroom. Scout barely tolerated Rudy Rocket's desire to play rough house. When it got too much he would find some out of the way place to nap quietly.
Here is a rare photo of all three kitties together on Christmas day, 2014.
Christmas Day, 2014.2015
In February 2015, we got the devastating news that Rudy Rocket had FIP, a disease that is fatal in cats. We tried alternative therapies, even an expensive experimental medicine out of Tennessee but Rudy Rocket continued to decline. He crossed over the rainbow bridge April 25, 2015. It was a difficult time. I was in the middle of covering the third Cameron Brown murder trial.
A month later, Mr. Sprocket closed his business and started looking for a job with a company in his field. That journey took many months. A few weeks later, we got the news that Scout had intestinal lymphoma. He had cancer. We started Scout and Jumpy on a raw diet, added turmeric paste and a low dose steroid. Scout came around and appeared to get better. We hoped for the best.
2016, A Challenging Year
Mr. Sprocket landed a new job. Scout was doing well on his turmeric. It was a busy hot summer with Mr. Sprocket working lots of hours.
In July, Scout started to eat less and less. Blood tests didn't detect anything unusual. He started to decline more and several visits to the vet did not give us any answers.. In mid August, I noticed that his jaw appeared uneven, like there was something wrong. There was. Inside Scout's jaw under his tongue was a tumor. The lymphoma cancer was spreading. It was a very sad goodbye. Scout crossed over the rainbow bridge to join Rudy Rocket on August 25, 2016.
Right around the time that we were having our last week with Scout, Jumpy's appetite declined dramatically. He hardly ate at all. We took Jumpy to the holistic vet in Calabasas, Dr. Tyneway. She is amazing. Jumpy's blood work indicated he had kidney disease. He was put on subcutaneous fluids, a vitamin regimen and a low phosphorus diet. Jumpy would take a bite or two and wouldn't eat any more. After a few more vet visits, Dr. Tyneway was able to detect a faint irregularity in Jumpy's heart. And, his heart rate was too fast. That was new. The problem with having kidney and heart disease at the same time, is the treatment for one is not good for the other. Dr. Tyneway told us to stop the subcutaneous fluids, because that was creating extra stress on his heart. Soon after that diagnosis, Jumpy stopped eating altogether. He crossed the rainbow bridge on September 16, 2016.
It's been a very difficult time for us, losing three fur babies and Mr. Sprocket's business in the span of 17 months. This is the first time in 22 years that I've been without a kitty to come home to. We buried Rudy Rocket, Scout and Jumpy in the back yard next to Katie and Sprocket Cat, each in their own special box, blanket and their favorite toys. We still miss them very much.
Early Wednesday morning October 12, Mr. Sprocket went to do his regular workout routine at the gym. He goes about twice a week. He usually warms up by jogging the one-third mile there. He then starts on the stair climber, climbing as much as 50 flights of stairs. After the cardio, he works out with the weight equipment. This time, he worked out with the weights first. He didn't do as well with the weights as he usually did. He did his stretches then started on the stair climber. He set it for his first set of ten flights. After climbing five flights of stairs, he could barely do any more. He paused the machine. He started to panic. He couldn't get the energy to work out. He was hyperventilating. He couldn't catch his breath. He thought he might be having a panic attack. He was dizzy and he slowly walked home. He rested for a while on the sofa then went to work for a few hours in the afternoon.
That night, trying to sleep, he could not catch his breath lying down. He then took his vitamin / heart protection concoction of D-Ribose, L-Carnitine, Hawthorn Berry, Taurine and Magnesium, all blended together in water. Some time after he took his drink, he was able to go to sleep. The next few days he took it easy but he slowly started to feel better.
Mr. Sprocket's conclusion as to what happened was, he had a bad reaction to a new CoQ10 supplement he took that morning before his workout. This new supplement had an ingredient called Polysorbate 80. [There are all kinds of concerns about this ingredient.]
The following week, Mr. Sprocket started to feel better and did a few couple mile runs. On Thursday October 20, and Friday, October 21, Mr. Sprocket had two very long work days in a row. He was a little tired, but he felt okay. Sunday night the inability to breathe lying down came back. Whenever he tried to lie flat, he could not catch his breath, he had to sit up. When I woke up Monday morning October 24, he was still on the sofa. He told me that he didn't sleep all night. The breathing problems came back. He didn't know if he was experiencing a panic attack or if it was a problem with his heart. He didn't know what to do. So I made the decision for him. I told him we were going to the hospital to find out. We needed to know.
Olive View Hospital - Monday
We waited for several hours in the emergency room lobby. They did a preliminary evaluation and drew blood. When we got into a room, an ER doctor stopped by almost immediately. He told us that they found a globular enzyme in his blood called Troponin. Troponin is a heart enzyme involved with muscle contraction. When it is found in the blood it indicates the heart muscle has been damaged in some way, usually from a heart attack. Additionally, he had fluid in his lungs and around his heart. This is why he couldn't catch his breath lying down. The stark realization was hitting both of us like a ton of bricks. It wasn't panic attacks. Mr. Sprocket probably had a mild heart attack while working out in the gym. They were admitting Mr. Sprocket to the hospital right away to monitor his heart and perform tests.
Although it's not been proven, Mr. Sprocket believes the polysorbate 80 in the CoQ10 was the culprit. I think it was the progression of the heart disease in combination with the heavy workout.
In the emergency room, they wanted to give Mr. Sprocket Plavix but he refused. He had such a bad reaction to Plavix back in 2014, he didn't want to take the drug again. They gave him Lasix, to get the fluid out of his lungs and from around his heart. He peed out more than a liter and he started to feel better. He got to his room about 9:30 pm and settled in.
Olive View Hospital - Tuesday
Mr. Sprocket was put on an IV drip of Heparin. Tuesday morning Mr. Sprocket had an echo cardiogram. It revealed that he had a clot in the bottom of his left ventricle. This was from stagnant blood not being moved through the heart. That's because the heart wasn't doing it's job. There was a risk of this clot traveling to other parts of his body. They put him on an ACE drug and a statin.
That afternoon, they took him into the cath lab, to see the condition of his arteries. We thought that he might get another stent or two. When he came out of the cath lab, the doctors were all standing around his gurney with me. They did not install any stents. That's when Mr. Sprocket said to me, "They're telling me I need open heart surgery." The doctors said that Mr. Sprocket needed at least a triple bypass. And that's when I started to cry.
The doctor's told him, "Look. You can go home, you can see how you do, but it's likely you would be back here in three to six months with another heart attack and in worse shape." Then they tell us, "We don't do that surgery here. You would need to be transferred to another hospital, either Harbor UCLA in Torrance or LAC USC in East LA. The doctor's would need to know his decision soon, if he wanted the surgery or not because they would need to find a bed for him.
Mr. Sprocket and I talked it over. This is scary stuff for us. His chest would be opened, his heart stopped. He would be placed on a bypass machine for several hours, then his heart started again. If he didn't get the surgery, I would be worrying that, at any moment he could have a heart attack all by himself on the top of a 10 story building, and no one would know he's up there, dying. After talking about our fears, he decided to get the surgery. I searched for one of the doctors to tell him to start looking for a bed so he could be transferred.
I left the hospital around 10 pm that night. Then I get a call from Mr. Sprocket at 3:30 am. They found a bed for him at Harbor UCLA and the transport would be picking him up at 6:30 am. I needed to get back there, to help him pack up and follow the ambulance down there.
Wednesday Morning - Traveling Man
When I got to the hospital around 5:00 am, I had forgotten to bring his special dental floss. Here he is going to another hospital to get open heart bypass surgery, and Mr. Sprocket is obsessed with getting his dental floss. The paramedic and driver are about to arrive and he wants me to stop at a CVS on the way down to pick up some dental floss for him. I tell him I'm not going to do that. I'm going to follow his ambulance the 49 miles to the new hospital. Now he starts getting a little crazy. He's telling me he wants his wallet. I'm a terrible wife. I won't give him his wallet.
He doesn't need his wallet, but he thinks that, on the long ride down there, maybe the paramedics will make a stop so they can pick up some dental floss for him. I tried to explain to him how off the wall that sounded, and did he really think these professionals would stop on their trip so he could get some dental floss. He wanted dental floss so bad he though he would ask. You can just imagine the looks the paramedics gave me when he asked them.
Leaving Olive View Hospital 6:30 am, 10/26/16
Following the ambulance 10/26/16
Right before the ambulance pulled into the special entrance for them, they pulled over and the driver got out. He walked to my car and gave me the floor and room number where Mr. Sprocket will land.
Harbor UCLA - Cardiac Unit, 4West
Every room on this floor is a mini "ward" with four beds to a room. There is a nursing assistant who is in the room at all times, ready to help you if you need anything. He had a wireless monitor on his vitals so the nurses can keep track of how he's doing at the main nurses station.
Later that day, we meet the Cardiology Team as well as members of the Surgical Team. Usually, the surgical team doesn't monitor the patient until they are ready for surgery. However, at this time the Cardiology Team was handling quite a few cases so the surgical team would be monitoring his case.
One of the first things we wondered was, how soon could Mr. Sprocket get his surgery. Unfortunately, this week was already full, so they were estimating early next week. We were quite disappointed. Part of the problem was, in the cath lab, they gave him 75 mg of Plavix. That's actually a very small dose of Plavix. It's a blood thinner, but it works differently than the Heparin. In the operating room, they cannot reverse the effects of Plavix like they can Heparin. They will have to wait until they are certain the Plavix is completely out of his system before they can operate.
The Long Wait
Mr. Sprocket settles in to hospital life and tries his best to convince his doctors to let him take all the supplements and things in the hospital, that he takes at home. Every day, he demands that I bring in more items from home so he can ask the nurses and the doctors if he can take it while he is here. Many of the items are passed onto the pharmacy department and the response back is, "No, not until you get back home." They do let him take CoQ10 and Vitamin C, because the pharmacy has those items in stock. The surgeon's readily agree to letting him take those. Mr. Sprocket found research studies that showed taking CoQ10 while on a statin helped to alleviate the many side effects of the statin. He notices a difference as soon as he starts taking the CoQ10. The statin side effects are hardly noticeable.
Saturday, October 29
Members of Mr. Sprocket's surgical team stopped by to give him some details on his surgery and the risks involved. There is a 10 percent chance of a complication, anywhere from a minor complication to a major one, including death. Mr. Sprocket is a pretty good candidate. His kidney function is good. His liver function is good. He's never smoked and he doesn't drink alcohol. Except for the artery disease, he was in otherwise good health. He exercises and has a physically demanding job. His prospects are pretty good. And, he's still very ambulatory. He gets up and takes many laps around the ward several times a day, so he doesn't get bored, pulling his IV pole behind him.
I've been taking the long drive to the hospital every day, bringing Mr. Sprocket every little thing he thinks he can't live without. His bedside is looking like he's been living there several months instead of a few days.
The HCD Risk to Open Heart Surgery Patients
Saturday afternoon, a friend forwarded me an alarming October 16, 2016, Consumer Reports story about a frightening new risk for open heart/ lung surgery patients. It has to do with these "Heating Cooling Devices" [HCD's] that are used in conjunction with the heart/lung bypass machine. These machines regulate the patient's body temperature, as the blood moves through the heart/lung machine and the body. Patients have become infected. Since their immune systems are already compromised, they have difficulty fighting off the infection. Mortality is 50% of those infected.
Mr. Sprocket spent all day Sunday reading all he could find on the web about these HCD machines and the NTM bacteria that can grow in these machines and infect the patient. Mr. Sprocket reads everything he can find on these machines and the bacteria that was found to grow in them. Through DNA, the outbreak was traced back to one manufacturer in Germany, where it was determined [or suspected] the machines were infected at the factory, in production.
On Monday morning, Mr. Sprocket's surgical team [the surgical fellow, not the attending surgeon] stopped by and he talked to them about his concerns about these devices. He wanted to know what model of HCD the hospital used. He was concerned that it was the same model that was found to be infected.
The surgical fellow side-stepped his question and asked Mr. Sprocket, "Do you want the surgery or not?" Upset, Mr. Sprocket replied, "ARE YOU CRAZY? OF COURSE I WANT THE SURGERY!!!"
I believe Mr. Sprocket asked again if he knew the type of HCD machine was the Stockert T3. The surgical fellow said, "We don't use that one." He mentioned a name that Mr. Sprocket didn't recognize. And then he left, saying he would stop back in later, which he never did.
Not long after that, I woke up and Mr. Sprocket told me the story. I couldn't believe the doctor was so disrespectful, ignored my husband's concerns and tried to intimidate him into silence. Mr. Sprocket spoke to one of the supervising nurses about what the surgical fellow said and his concerns. She arranged for the Infection Control Dept. to speak to him. A whole team came up. The department head, the clerk and two RN's. They confirmed that the hospital uses the Stockert T3 HCD machine.
Mr. Sprocket was devastated. This model is the one that was reported to have been pre-infected in the manufacturing process in Germany. The prevention team told Mr. Sprocket that they were following the latest cleaning guidelines [bleach] from the manufacturer.
Mr. Sprocket had spent all day Sunday researching the design of these machines not just the Stockert T3. Mr. Sprocket has spent over 30 years in the HVAC field. Although he's never worked on one of these devices, he tells me that it's basically like having a portable ice machine in the operating room. It has a water supply, a heater, a fan and an exhaust that vents into the operating room.
In talking with the Infection Control Dept., he explained to them [his opinion] that because of the flaws [no hermetically sealed water supply] you can never disinfect all areas of the machine that can develop a bio-film. As Mr. Sprocket tried to explain it to me, Would you think your entire toilet was clean, if all you did was fill it with bleach, let it sit and then flush it? There are areas that can still get bacteria, that are not touched by the bleach.
Later on Monday, Mr. Sprocket spoke to the surgeon who would performing his operation. He listened patiently to all his concerns and was sympathetic. Mr. Sprocket really liked this surgeon. He didn't know what to do.
So Mr. Sprocket went through Sunday and then Monday not certain if he wanted to take the risk and go ahead with the surgery. I urged him to put his faith in God, that he was brought to this hospital and this surgeon for a reason. He told me he needed to sleep on it. That night, Mr. Sprocket located online, the new cleaning manual procedures for the T3 and read through it completely. That must have turned the tide and he decided to go ahead with the surgery. His surgery was first scheduled for Thursday morning, but we learned late Wednesday it was moved to the afternoon.
Mr. Sprocket, in pre-op, getting prepared for surgery.
A Request for T&T Readers
First, if you believe in a higher power, please keep Mr. Sprocket in your prayers.
Second, we don't know what the future holds for us. The surgeons have told us that it may take Mr. Sprocket up to four months to heal his cracked chest and return full time to his physically demanding job. It isn't possible to do his job on "light duty." He needs to be able to haul heavy equipment up on a roof. That extended time away from earning a living will be exceptionally challenging for us.
If you have enjoyed reading T&T's in-depth trial coverage over the past nine years, and you are able, please consider making a donation. On the right side of the blog is a DONATE link, that connects to my sewing Paypal account. Mr. Sprocket and I would be forever grateful for your generosity.
CDC Health Advisory on HCD's
Heater Cooler As A Source of Infection
WaPo: What you Need to Know
Consumer Reports Article
University of Zurich Testing