An Affair of the Heart

 As many of you know, I had a heart cath this morning.  Fortunately, it went  very well. This was my first experience with anything quite like this.  Before this summer, my experiences with hospitals and medical procedures consisted of being born at the old Baton Rouge General in 1962 and having to get stitches in my finger in 1986.  Maybe it is a symptom of getting old, but since June, I have had a colonoscopy, made a visit to urgent care to get a fish hook out of my finger and and ER visit after inhaling some chlorine gas while working on the swimming pool. And today it was the Big C; Coronary stuff, man.

I keep telling my doctors I am in pretty good shape for the shape I’m in, but for some reason they don’t want to believe me. About 10 years ago, my primary care guy suggested I have a treadmill stress test, not because I was having any problems, but because of my history and risk factors.  My Dad battled coronary artery disease for over 20 years. My maternal grandfather and paternal grandmother both had a history heart disease.  I have high cholesterol and high blood pressure, both of which are well controlled with medication. That time 10 years ago I gave in and had the test and it turned out perfectly.

Earlier this month, I went in for my usual ‘well care”‘ check up and my doctor suggested that it was time to try it again. Once again, I had no symptoms, but it was about my age and family history.   I did not really think I needed to do that again, but I decided to follow his advice.  So, last week I went to the cardiologist and took another treadmill test.  This time the results were not perfect.  In fact they were “abnormal” and indicated there was some possible blockage. My cardiologist suggested a heart cath to see what was going on, telling me it may be nothing, but if it was we needed to get it fixed.  It is kind of hard to argue with that kind of logic.

So my procedure was scheduled for this morning.  My preparations actually started last night.  My orders said nothing to eat or drink after 10:00 p.m., so naturally I decided to make the most of what I could eat and drink BEFORE 10 o’clock.  So Jo Ann and I took our future daughter-in-law, Anna, to Cheesecake Bistro for dinner.  Drinks, appetizers, dinner and dessert and a great time was had by all.

The first thing that struck me as strange today was having to get up at 4 a.m..  We had to be at the hospital for 5 and my procedure was scheduled for 6.  So we got up early to try to leave Watson for 4:30.  It struck me kind of like milking cows.  I know it has to be done twice a day, but I never understood why the first time had to be so doggone early.  We left out so early, even Starbucks wasn’t open when we passed by.

.  We got to the outpatient Cath Lab at OLOL on time and I was in the capable hands of the nursing staff there.  I have to say, regardless of anything else that happened, they were all great and took excellent care of me from start to finish.  We completed paperwork and I was assigned a room. And the indignities began almost immediately.

The first thing they did was give me a hospital gown to put on. You know, the kind that looks like, well, a hospital gown and leaves your derriere hanging out, even if you have it on right. As I am going into the bathroom to put it on, the nurse says, “Don’t tie your gown. Just put it on”  I went in the bathroom to change, thinking “surely she didn’t really mean that.”  Apparently she did, because right there on the wall was a 10×10 sign that said “Please DO NOT tie your gown!”  So I guess she did mean it. I soon found out why.

I am no medical expert, but after going through the procedure today, I really think it would be a lot easier to just tell cath patients to get under the sheets butt naked.  That way you wouldn’t have to keep moving that gown around and you would save  a lot on the laundry costs. But that is just me.  Then the nurses had to ‘prep’ me for the procedure.

If you know anything about a heart cath, they go in through your groin area, where they put the catheter in your femoral artery.  What you may not know is that your femoral artery and your Very Important Parts are very  close together.  In fact, they are so close together that, no matter how hard they try, they can’t get to your artery without exposing pretty much everything else.  Just what I was hoping for at 5:30 a.m.

The ‘prep’ consisted of shaving my right groin area and starting an IV in my left hand.   Like most people, I can tolerate having an IV started, but it is usually not a pleasant experience. But to give them credit, the Cath Lab staff has done this enough times that they have figured out an interesting protocol.  It turns out of they do both at the same time, you pay enough attention to the nurse with the electric device shaving your nether regions that you don’t really even notice the one on the other side trying to start your IV.   Teamwork and efficiency at its best.

Then they told me that Dr. Cefalu likes to start all his patients out with a dose of Valium.  Well, well .. let the party begin!  Not long after that they moved me down to the actual cath room for my procedure.  They gave me more sedation and we got started.

I wish I could regal you with cool stories about how the whole thing went and how interesting it was to see my own beating heart on the monitor and stuff like that. But I  can’t. Actually I slept through most of it.  I remember them giving me a local in the newly shaved area of my groin and making some adjustments to my gown, which made me think again  that I’d be better of naked, but not much after that.  The next thing I remember was the doctor leaning over me, shaking me awake and telling me everything was great. Awesome!

After spending about 15 minutes in recovery, mainly to make the second largest artery in my body did not suddenly spring a spontaneous leak, they moved me back to my room. I groggily remember saying Hi to my sister Cindy, my brother-in-law John and my friend Chris, who had come to sit with Jo Ann. They stayed around to see if I was okay and then left me to sleep.

This stage was the worst part of the whole experience. You have to spend the next four hours flat on your back, head on the bed and not moving your right leg.  Believe me, it is harder that it sounds. I slept through about 2 hours of it, until the sedation wore off.  Then I was on my own. Staring at the ceiling, listening to the clock tick.  Of course, they came in regularly to check my ‘wound site’. And of course, pretty soon I had to go to the bathroom.

That was an interesting experience to say the least. How do you go to the bathroom when you are on your back and not supposed to move around?  You guessed it, a urinal.  My nurse was very helpful.  She got me the urinal  and told me she would step out while I used it. I figured that meant she was going to leave the details up to me. But being the helpful type, before I knew what was happening she was putting it in place.  She even demonstrated the “insert Tab A into Slot B” part.  Okaaaaay.

Well, eventually I got sprung after about 4 hours or so of recovery.  It was a different experience for me.  But, the good news is, it turns out what I had been telling the doctors all along turned out to be true. I am fine!  All of my arteries were in great shape, with one having only a minimal 10% blockage.  I don;’t know about everybody else, but I think that is pretty darned good for a 52 year old fat guy who smokes, drinks and thinks pork is a separate food group!  And the best part is, if I stay on the same track, I will be 104 before I get to 20% and have to do this all over again!

How to Vote on Those &%#$ Amendments?

Once again, the November 4 elections will ask Louisiana voters to vote on the approval of 14 proposed Amendment to the Louisiana Constitution of 1974. It seems that every other year, in even numbered years when the Legislature holds a general session, there is another pile of constitutional amendments for us to say “yea’ or ‘nay’ to. The amendments come so regularly and are so technical, even informed voters seem to scratch their heads over what to do. I am regularly asked my opinion on how to vote on “those doggone amendments”. So, since I am now somebody, with my own blog, I an going to give my humble opinion about the 14 amendments on the November 4 ballot.

But, before I do, a little background and history. As a rule, a constitution is different from a regular statute. First, a constitution is generally recognized as a ‘blueprint’ for government in general. Its purpose is to set forth the structure of government, identify the various departments, define the role and limits of each, protect basic rights of citizens and protect certain ideals and principles, such as Civil Service, that are important enough to warrant, well, constitutional protection. Unlike an ordinary statute, a constitution cannot be changed by a simple majority vote of the legislature. For instance, the Louisiana Constitution requires that a proposed amendment be approved by a two-thirds vote of both the House and Senate AND a majority of voters statewide.

Historically, one of the reasons we now have the Louisiana Constitution of 1974 is the absolute mess that had become the Louisiana Constitution of 1921. The 1921 version was wordy to start with and over the years, as legislators, and the string pullers they worked for, began adding amendment after amendment, it constituted over a quarter million words and had been amended over 1,000 times. It had become so burdensome, archaic and unworkable that Edwin Edwards, in his 1971 campaing for Governor, made calling a convention for the establishment of a new constitution a central theme of his campaign. Shortly after taking office, Edwards was successful in doing so, which was the Constitutional Convention of 1973, which lead to the Louisiana Constitution of 1974. The 1974 Constitution was a good one. It was well written, to the point, streamlined the State government and, everyone agreed, was a nice piece of work.

Unfortunately, in the next 40 years, it seems we have fallen into the same trap be had before. Voters are asked again and again to approve amendments, many of which are “pet projects” of one group or another. We are continually adding amendment after amendment, most of which Louisiana voters don’t really understand or know why we need.

So, I said all that to say this. As you read my take on these things, remember that my philosophy on amendments is (1) many things may be a good idea, but that doesn’t mean they need to be in the Constitution: (2) some things may be a good idea but STILL don’t belong in the Constitution; (3) if I am not really convinced that an amendment is necessary, I am going to vote “NO”; and (4) if I do not know or understand what an amendment is supposed to do or what problem is it supposed to solve, my default position is to vote “NO” .

So, with all that in mind, here is my take:

Amendments 1 and 2: NO. No. 1 would establish a Trust Fund for the payment of Medicaid reimbursement. No. 2 would establish the Hospital Stabilization Fund. Both amendments would constitutionally dedicate funds the state is already collecting to a single purpose. While such a thing sounds good, the same thing could be accomplished by the Legislature having the intestinal fortitude not to raid these funds, which are already being assessed, to pay other bills. When you and I do this, it is called “theft” or “embezzlement”. More importantly, we already have way too many constitutionally dedicated funds in the state budget as it is. The result is that, for years, when things run short, the only thing that can legally be cut is health care and higher education. If these amendment pass, higer ed will be the Lone Ranger when it comes to budget cuts.

Amendment 3: NO. Amendment 3 would allow the sheriff or other tax collectors to employ private debt collectors to “assist” in collecting delinquent tax debts. First, if the sheriff can’t collect a debt, what makes anyone think that a private collector could do more? Of course the only reason to think so is to believe that the ‘collector’ can take actions the sheriff is legally prohibited from taking, or won’t take for other reasons. Which is exactly what makes this amendment a bad idea.

Amendment 4: NO. Amendment 4 is a perfect example of what is wrong with this whole process. It would allow the state to invest public money in something called the Louisiana Transportation Infrastructure Bank. You have likely never heard of the Louisiana Transportation Infrastructure Bank, because it does not exist. The enabling legislation, which would have set up the Louisiana Transportation Infrastructure Bank failed to pass. However, the constitutional amendment to make the enabling legislation legal did, so the amendment is on the ballot, although the legislation it was supposed to bless is dead. For God’s sake, please vote NO!

Amendment No. 5: YES This amendment would remove the 70 year old mandatory retirement age for judges. For some inexplicable reason, Judges are the only elected officials in the State who have such a mandatory retirement. I can think of no office where experience and tenure are more important than the judiciary. I personally know many competent, experienced and capable judges who have been forced to retire when they could still have done a good job.

Amendment 6: NO . This is a special bill that applies only to Orleans Parish. For the life of me, I cannot understand why they can’t play by the same rules as the rest of us.

Amendment 7: YES. This amendment would raise the Homestead Exemption for ad valorem taxes for veterans with a 100% service related disability rating, and their surviving spouses, to $150,000.

Amendment 8: NO . This amendment would give constitutional protection for monies already being collected by the state in connection with establishment of artificial reefs from old offshore oil platforms. First, this would be another dedicated fund. See my argument for Amendments 1 and 2 above. Second, I am all about coastal restoration, environmental clean up and all that. I am even in favor of fishing. But frankly, this Artificial Reef Development Fund will actually only create good fishing spots for a very small handful of offshore fishermen and charter operators.

Amendment No. 9: YES. Louisiana voters have already approved special assessment levels for property owners who are permanently and totally disabled. This amendment would merely remove the requirement that they have to submit income information annually to keep the special assessment.

Amendment No. 10: NO. In the interest of full disclosure, I am a strong proponent of private property rights. I believe we should make it more difficult the government to deprive owners of their property rather than easier, which this amendment would do. It would shorten the redemption period for tax sales from 3 years to 18 months for property which is blighted or abandoned. While it sounds like a long time, 18 months is too short. And, who decides whose property is “blighted” or “abandoned”?

Amendment No 11: NO. One of the reasons we got a new constitution in 1974 was to streamline and consolidate state government. One of the ways this was done was to limit the number of state departments to 20. This amendment would increase that to 21, to create the Office of Elderly Affairs. First, this department would handle services which are currently being performed by other departments. Second, the legislature, in its wisdom, has not allocated funds to expand services to the elderly.

Amendment No. 12: NO. I could do a lot of explaining, but this one would change the membership of the Louisiana Wildlife and Fisheries Commission and won’t make a rat’s *ss bit of difference to anyone who lives south of Bunkie.

Amendment 13: NO. This amendment would allow the City of New Orleans to sell government owned property (i.e., property seized for non-payment of taxes) in the Lower Ninth Ward for a nominal fee to certain buyers. If you have lived in Louisiana longer than 6 months, you would be very uncomfortable about the ‘nominal fee’ and who are the ‘certain buyers’. And, this is a proposed amendment to the State constitution that only affects one ward in one parish. Really?? And, once again, I am not sure why Orleans Parish can’t play by the same rules everybody else does.

Amendment No . 14: YES. This amendment would close a loophole that the Legislature loves to jump through. Under the current Constitution, revenue measures may not be introduced in even numbered years, which are supposed to be general sessions. “Fiscal” sessions are supposed to be in odd numbered years. However, some legislators love to give away tax rebates, incentives and abatement all the time. The amendment would confirm that these things are fiscal matters which may only be considered in odd numbered years.

Okay, I know that was long, but it is what it is. In closing let me say this:

Laissez le bon ton roullier! It’s election time y’all!