The medical condition of “heart failure” is a term for the progressive weakening rather than the actual failure of the heart to function, which means death. A common cause, which I happen to have, is aortic valve “regurgitation,” also referred to as “insufficiency.” The early stage of this was diagnosed six years ago, however the strength of the heart as a pump, referred to as ejection fraction was high enough that replacement of the valve was not indicated, until about six months ago.
The trade-off is a risk of cognitive loss that is especially meaningful for those such as myself who are experiencing somewhat more than the normal decline in function. While there are copious formal studies of this side effect such as this one, this article in the New York Times “Saving the Heart Can Sometimes Mean Losing the Memory” although now two decades old, describes the profound choice that someone in my situation must make. The personal narratives of this article are aggregated in numerous research papers that obfuscate the emotional meaning of rapid change in cognition, which is not only loss of memory but the essential element of one’s being.
I happened to have been diagnosed by an acclaimed cardiologist, whom those from around the world often seek out when they have conditions such as this. He manages to go beyond excellence in the practice of his profession, having founded an alternate organization for periodic recertification of cardiologists. Yet given his group’s expertise, when I was attempting to get more details on the post operative cognitive side effects, his fellowship associate refused to even acknowledge that peer reviewed comprehensive studies conveyed an actual problem. There was clear condescension in her telling me that she was not aware of this, and my concerns were my personal problem.
I had thought that I had more time to enjoy my life before I had to make the choice between surgery or allowing my heart to irreversibly weaken, but over the last week it’s come on rather suddenly. It’s not only after sprinting during doubles tennis, but yesterday after intense discussion with friends I was mildly nauseous with chest discomfort. The decision is no longer something I can ignore and imagine how valiantly I will deal with it in the future. It’s now knocking at my door and won’t go away.
Just last week I had a letter printed in the L.A. Times where I was critical of this website, which I posted here, acknowledging the community side of this partisan site, where the most personal problems can be shared. Dailykos not being a venue for objective analysis of political issues would not be such a problem if such a venue existed at all, which it seemingly no longer does.
For me, my diaries here fall into three categories: Most are affirming my belonging to a progressive liberal site, even though I am not on the cutting edge of fully embracing this movement. The second is my critiquing what I see are its excesses, often resulting in a rather universal opposition — sprinkled with a few expressions of appreciation. The third is the rare unique insights that I have, where the community rewards me with a status that my essay remains up for days — or conversely, on occasion, such as when I warned that HRC was in danger of losing the election, I faced a deluge of contempt for, which to everyone’s regret, actually occurred.
So, this morning, as sleep is elusive, I face a personal crisis, and I reach out to the stranger-friends who may read this and have an idea of who I am from this odd way of knowing someone. If I do have this operation, I could have some extra years, old age years which are not what younger ones are worth; and there is that small risk of my becoming a different person, with a brain transformed in ways that can’t be predicted.
It’s one hell of a crap shoot.
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5/9/18 Early Morning
This article being put on the Community Spotlight list has brought many valuable, incisive and compassionate responses. Based on this abundance of information and personal experiences, I have decided to proceed with the surgery.
I still welcome comments, especially those that add to the understanding of the cognitive sequelae, but this decision is made. When it is over, hopefully, hopefully, hopefully, I will post a diary with the results. (I’ll even throw in a “knock on wood” or “kenahora” — magical words that indicate one’s fate is not in our hands )