Circumnavigating the Covid and cardiac commotion.

When you have heart failure, sometimes it feels like you are just running in circles.  You find a new heart wrinkle and you adapt your diets and your exercise habits and your coping mechanisms.  You think all is working well.  Then another heart wrinkle develops and your back to feeling like a dog chasing her tail.  Well, once we descended into Covid chaos it seemed like this dog’s tail was winning.  I wondered if I would ever gain the lead again.

There was a glimmer of light when the State of Virginia began the process of reopening.  At that time, medical and dental offices and other businesses reopened but with lots of precautions in place.  I realized that as scary as it was to start going out into public again, I needed to start to catch up on all the necessary appointments and tasks that I had put on hold for four months.
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​One of the appointments I decided to reschedule was my 6-month dental check and clean.  But there was some uncertainty.  You see, for over 20 years, my dentist was located in Richmond, two hours down the road from my home.  You might wonder why I would pick a dental office that was not in my own locality.  The answer is that I visited Richmond numerous times each year to visit family.  It was always easy to tack on my twice a year dental visits to those family trips.

Up until six years ago, even if I had an emergency it was no big deal.  I could easily hop in the car and travel to Richmond in a relatively quick trip.  But then when my heart failure became more pronounced, that emergency trip did not seem like a hop, skip and a jump anymore.  It seemed like it was all the way across the United States, especially during the period where I was getting fatigued very easily.

After a visit to my Richmond dentist in September 2019, I decided the time had come to find a dentist in my own neck of the woods.  I talked to a number of friends to get recommendations, and then found a dentist less than a mile from where I lived.  In fact, this dentist was located in what is known as the Crystal City underground, a maze of shops, offices, and the Metro subway in the Crystal City area of Arlington, Virginia.  Life was good.  I scheduled my next appointment for April 3.  Then in mid-March Covid shut down the world as we knew it. 

By the last week in March, the virus was still spreading quickly in the area.  Additionally, Federal health authorities said that people with heart failure should be extremely careful because of their condition.  I figured it was a wise idea to postpone the dental appointment.  When I picked up the phone to contact the new dentist’s office, what I did not know at that time was that dentists had also been advised to only proceed with emergency appointments.  

I was in luck because my soon to be new dentist answered the phone.  I explained I was canceling my appointment because of the Federal health guidance regarding individuals with congestive heart failure.  He indicated that there was no problem, because based on current guidance, his receptionist would be calling all patients that day to postpone all but emergency appointments.  The trendsetter in me was just a little bit ahead of the curve.

I do remember that the dentist expressed surprise about my health condition, saying something like “You do not sound like you have heart failure.”  That may sound like an odd statement to anyone who doesn’t have a chronic condition.  But those of us who are branded with chronic illness are used to people expressing surprise that “you look normal” when they find out about your chronic illness.  Sounding normal pretty much fell in the same category.   

I watched the statistics carefully for the next few months, hoping that we would eventually start to “flatten the curve”.  I did everything I could to protect my health yet still get exercise and keep my body and heart (and my teeth!) in good shape.  After the reopening of life in the State occurred, I called to reschedule my appointment for the morning of June 19.

It should have been a piece of cake to get to my appointment that morning.  It was a sunny day, and so no weather issues were preventing me from having a nice walk over to the office.  It was a little warm and a bit humid that morning, but I did not have to travel a long way.  Thankfully I no longer had to make the two-hour drive to Richmond.  It should have been a breeze right?  Well things are not always as they appear.

Normally,  I would have taken the underground route to the dentist’s office.  As I said earlier, the Crystal City underground is an intricate maze of shops and restaurants and offices and it is extremely walkable.  However, the entrance closest to my condo building was in the area of offices and a fitness center.  I knew the fitness center was closed for at least another week or two, and I thought the offices might have only skeletal staffs.  Since that side of the building would have much less staff than normal, I wasn’t sure if the entrance closest to my condo building would be open to the public.  I decided to take the fresh air route over to the entrance that was nearest to the dentist office and the retain area.  I also figured that when it comes to Covid, I would probably be better off to avoid germs by being out in the open air as much as possible.

What I did not take into account was the fact that there is a lot of building renovation and construction going on in some of the buildings.  I did remember that the dentist’s receptionist had said a lot of work had been done to the building they were located in, and that I might not recognize the area.  But I did not realize there was still on-going construction – and how much it impacted access to that building.

As I walked closer to where the entrance was, I saw that the building entrance area was under construction.  All I could see were a few men in hard hats and a blocked building entrance.  In other words, I couldn’t get there from here.  I soon realized it might take me a while to figure out where the nearest entrance would be, and I would likely be late to my appointment.  You have probably realized that I am very obsessive about being on time – especially since the office had sent me a reminder text asking me to “be on time”!

I took out my cell phone and called the office.  I told the receptionist that I was in front of the Crystal City Waterpark but could not enter the building because it was blocked by construction.  I told her I needed an alternate route to their office.  (The good news is that I was later told by the dentist that I was actually quite articulate in letting them know where I was.  He said sometimes lost first time patients just say things like – well, I’m on a street.)

The receptionist said that she was going to have me walk over to 18th street and up a hill to the Metro entrance.  Oh great – a hill when I need to apply some speed to make up lost time is not a good thing when you have heart failure.  I told her it was not easy for me to go up hills fast because of my heart condition and that it might take a little longer for me to get to the office.  She assured me this was no problem.  But as I was chatting with her and walking uphill, I began to realize – Hey, I’m walking at a pretty good speed and talking on the phone the entire time – in relatively hot weather with a mask on.  Maybe I am underestimating my weak heart! 

I saw the metro entrance and told her I was about to hop on the escalator down into the underground.  It’s funny how Covid makes you really conscious about things that used to be second nature.  Normally, I would get on the escalator and put my hand on the handrail for balance.  But not knowing how well those surfaces are cleaned, I avoided it like the plague – or like it might have the plague.  I walked into the underground, over to the dentist office, and made it through the doors just a minute or two late.

So the practice actually has two dentists – a father and his son.  The son’s wife is the receptionist.  Each of them is very friendly, knowledgeable and personable.  The son greeted me when I entered and gave me the usual paperwork you complete at a dental or medical office.  Then I went back to the exam room with the father, who is my dentist for now.  But it was nice to know that when he decides to retire, his son will be available to become my dentist.  I think I picked the right practice.  As is the case with my heart care, it is good to like and respect and feel comfortable with your health care providers.

Of course, my dental forms included all the issues with my heart – cardiomyopathy, heart failure, the pacemaker/defibrillator implantation and all the drugs that I take.  The dentist wanted to know how someone who not only sounds so healthy but looks so healthy could have such a heart health downward trajectory.  I gave him the Readers Digest condensed version of how my heart tanked on me.
 
Fortunately, I was very relieved to learn that my teeth and gums were in good shape, and so it was a matter of cleaning them and sending me on my way for another six months.  This means that I am slowly but surely starting to cross appointments off the list that are necessary to monitor my heart health but to also make sure no trouble is brewing with other areas of my health. 

Since the dramatic shutdown of life in mid-March, businesses have now opened up to safeguard and maintain many areas of our lives.  This covers more than just medical and dental offices, but businesses that perform car inspections, or HVAC inspections, and other necessities of modern life.  Yes, I am a little apprehensive to interact with more people.  But if they take precautions and I take precautions, it does not seem to make sense to put them off any longer.  The backlog since March is already a bit daunting.

​Yes, appointments have become more cumbersome in the age of Covid, and you are continually being reminded that there is a risk that you could contract Covid in a medical or other business settings.  But there is also a risk that if I don’t have the appointment, I could get a condition that is also life-threatening.  Or if I don’t keep  my car maintained, it could break down or worse when I’m driving it.  Like everything else in life, it is a matter of balance and doing the risk benefit analysis. 

​One thing that helps is a sense of humor and family members and good friends who can help you maintain some sanity and walk you off the ledge when you start to worry about the what-if scenarios.  I seem to be steering through the icebergs of Covid and cardiac complications without damaging the ship of Melanie yet.  With their help, and the help of God, I think I can keep this ship afloat.