Nyel – This Morning at Legacy Emanuel Hospital

Five or six decades ago when I was teaching in California, my closest friend was a colleague who had been born and raised in Caspar, Wyoming.  At odd times, she would break into the Wyoming State Song (or that’s what she said it was) and often talked about the feed lot that she would go to with her father when he was making his morning rounds (whatever they were.).  He was pig farmer, as I recall.  Although Nancy – his daughter and my friend – adored her father, she hated the smell of pigs and could not wait to leave Caspar.  Forever.

However, as long as her parents lived she would dutifully go home at Christmas to celebrate the holidays with them and, while she was at it, to pay a visit to Dr. God.  He was a dentist and had nurtured Nancy’s teeth since babyhood.  If a crisis-of-the-tooth-variety occurred in California, Nancy would take sick leave and fly to Caspar.  No other dentist would do.  Only Dr. God.

Yesterday Nyel and I returned to Portland for an early morning visit with Nyel’s Dr. God.  He is not a dentist – far from it.  He is a cardiologist of the ‘General Contractor’ variety and, in my mind is a counselor, a poet, and a walking medical dictionary, as well.  He has a way of explaining, prescribing and putting one’s mind at ease with gentle seriousness and a tad of humor, too.

At Legacy Emanuel, Portland

He had been in foreign parts on vacation during Nyel’s recent crisis and, although his esteemed colleagues dealt with Nyel with professional expertise and in a timely manner, it wasn’t until today when we saw Dr. God, himself, that we felt we understood what had happened.  And, more importantly, what will happen next.

After studying all the events leading up to Nyel’s Christmas Eve hospital admission, Dr. God determined that Nyel had experienced Acute Decompensated Heart Failure.  In layman’s terms, it is a sudden worsening of the signs and symptoms of heart failure, and typically includes difficulty breathing (dyspnea), leg or feet swelling, and fatigue.  The cause could have been a combination of things – a sudden change in his atrial arrhythmia and the pacemaker’s attempt to adjust to the 130 beats per minute, plus a worsening of a ‘minor’ leakage of the mitral valve – which is now a major leak.  Plus something could be going on with the four stents which were put in place in October.

In Nyel’s case, all the symptoms have seemed grossly exaggerated.  Add torso, neck and face to the swollen legs and feet.  Chalk up six or seven consecutive nights of no sleep due to breathing difficulties.  Consider fatigue to the point of non-responsiveness at times.  Dr. God put it all in perspective.  Everything can be fixed.  And soon.  Then Nyel can go back to ‘enjoying’ regular old heart failure for many, many years of quality life.  OMG!  Music to our ears.

Morning Decaf at the Heart Beat Cafe, Legacy Emanuel

New meds start tonight.  Dr. God will call tomorrow with tweaks if this morning’s lab work so indicates.  If necessary, Nyel will be back in the hospital next week for meds to be delivered intravenously.  And, in three weeks Dr. God and colleagues will see Nyel again to determine what needs to be done about the valve leakage.  (Apparently, it could partially fix itself if other things fall into place.)

I’m pretty sure it’s not Dr. God who is hearing our prayers for Nyel.  But someone is.  Keep praying, please.  So far, so good!