How the Grinch stopped heart failure in its tracks.

I know you are wondering what the Grinch has to do with heart failure.  If you stick with me, I’ll make my case!  By way of background (a phrase lawyers love to use!), I have now been on Milrinone since July 23rd of this year.  What does Milrinone do for the heart?  The definition I found for Milrinone on many websites, to include the drugs.com website, is this: 
 

• Milrinone is a vasodilator that works by relaxing the muscles in your blood vessels to help them dilate (widen). This lowers blood pressure and allows blood to flow more easily through your veins and arteries.

 
My heart failure doctor and a heart transplant coordinator have told me that Milrinone acts as a whip to keep the heart pumping.  They have stressed many times that milrinone does not cure heart failure.  It just keeps the heart going while another method of treatment is pending.
 

In my case, the Milrinone seems to be functioning as a bridge to transplant.  I found some information on the sciencedirect.com website that seems to support this:
 

• The limited availability of donor organs creates a need for more effective management of heart disease when bridging a patient to cardiac transplant.  Inotropic therapy is becoming more commonly used long term to maintain baseline function.

 
Okay, I have just entered an area of medicine where I begin to look like a deer in the headlights.  Fortunately, I have a zany sense of humor and can quickly get us back on a brighter path.  As you can imagine, I have a humorous take on what is actually happening with my heart.  With apologies to Theodor Geisel, also known as Dr. Seuss, here is my take on the beloved cartoon version of How the Grinch Stole Christmas.
 
As you may recall, the Grinch was fed up with the incessant sounds of happiness and joy emanating from Whoville.  He decided to steal all the Christmas gifts and all worldly possessions, from each and every Who.  He gets a sleigh ready for his cunning masquerade as Santa.  He attaches a fake (and poorly fitting) reindeer antler to the head of Max the Dog. 
 
Max sees the sleigh.  He runs to it and leaps into the passenger seat, eager and overjoyed because he thinks he is going for a ride.  The Grinch quickly ends this joy.  He attaches reins to Max.  He throws him in front of the sleigh.  The Grinch hits Max with a whip, and a startled Max begins to realize that it is his job to pull the sleigh.  He begins to run, very slowly and ineffectively, with the Grinch continuing to hit him with the whip.
 
Yes, you have probably guessed where this is going.  The Milrinone is the Grinch, and my poor little heart is Max the Dog!  The more I think about it, the more I like the comparison between Max and my heart.  Why?  Well maybe the best explanation comes from a December 20, 2011 article by Jen Chaney on the Washington Post website entitled:  “Max from How the Grinch Stole Christmas:  Unsung Holiday Hero.” 
 
In the beginning of the article, Ms. Chaney observes that while the Grinch dominates the cartoon, “there is another character in “The Grinch” who already knows what it means to be loyal and kind, who willingly wears a tree branch on his head without one whimper of complaint and who already recognizes that Christmas day is in our grasp, as long as we have hands (or paws) to clasp.” 
 
The same things are true of my heart.  No matter what abuse I put it through in terms of exercise and stress, this heart always stayed loyal to me.  When it began to fail, it enlarged to keep up with the workload as I apparently missed the signals that my health was deteriorating.  My heart sent out some SOS signals, in terms of blackouts and fatigue, but it also continued to pump away as best as it could. 
 
The loyalty is so strong, it has not given up on me yet, even though I have attached it to the pump that is distributing Milrinone like a whip!  Even though my heart doesn’t have paws or hands (at least I don’t think those things have shown up on an echocardiogram), my heart does know that joy will soon be in my grasp as long as it can continue to pump.  So, my heart accepts the inconvenience and even unforgiving pace of Milrinone without even a small whimper, and with much grace and persistence.
 
Ms. Chaney also observes Max handles it all with good cheer because “Max is a dog — possibly a beagle, maybe just a mutt, we’re still not sure — with spunk and grace.”  I taxed this body with too much work and not enough balance for too many years.  Every time I reached the toll booth to go further in my career, meaning taking on more stress and duties, it was my heart that paid the fee.  My heart, like Max, has spunk and grace and continued to somehow manage the extra workload and the stress.   
 
My heart and Max are alike in several ways.  If you have seen the cartoon version of How the Grinch Stole Christmas, you are probably familiar with the scenes where Max continually sways and totters as he tries to walk with the burden of an oversized antler.  This is how I felt when I first was saddled with the bag that contained the pump and the pouch.  I complained that my back hurt and that the shoulder bag disrupted my balance.
 
I also feel that both Max and I are attached to reins.  The rein on me is a restraining influence.  It is the long piece of tubing that keeps the Milrinone flowing through my vein and into my heart.  When I am inattentive, which can be more often than I would like to admit, it gets caught on everything in sight, and pulls me back.  (It has dawned on me that perhaps the purpose of the rein on me is to pull me in, slow me down, make me breathe, and give me the signal to be patient).  The Milrinone reins on Max are the whipping force that keeps it pumping.
 
The main reason I like the comparison of Max to my heart is because I believe Max suffered from heart failure.  Look at the circles of fatigue under his eyes, see how short of breath he is and how he seems to be retaining quite a bit of water.  Think about it.  Being the pet of the Grinch is a pretty hard and stressful job.  I am sure the accommodations and meals leave a lot to be desired.  Nutrition, comfort and good health were not present in Max’s life. 
 
I also bet Max is often pulled into the hare-brained schemes of the Grinch to disrupt and destroy the lives of the residents of Whoville.  These schemes likely cross the lines of legality and morality.  Poor Max is probably stressed to the max (pun intended!).  Perhaps he participates in these schemes hoping that he and the Grinch will be arrested, and his accommodations and meal plan will improve?
 
With all that stress and lousy diet, his heart probably is enlarged, and it certainly isn’t helping this poor pup to be pulling a sleigh down Mt. Crumpit and all over Whoville.  His whip is administered not by a Milrinone pump which at least has some therapeutic value.  No, the holder of the reins is an evil curmudgeon. 
I think that in the last few minutes of the cartoon, the Grinch has a mind altering insight that leads to his redemption and Max’s cure.  Spoiler alert for all medical personnel!  If you can’t suspend disbelief and feel the spirit of miracles, stop reading now!
 
According to the cartoon, the Grinch and Max get to the top of the mountain with a full sleigh.  The Grinch is about to dump the Whos’ gifts and belongings down the side of the mountain, but he stops when he hears the Whos singing.  He realizes that the holiday is not based on gifts and material objects but in deep, enriching love for others.  We learn that the Grinch’s heart that was two sizes small grew three sizes. 
 
All that is true, but I think there is more truth that doesn’t fit into the 30 minutes of a cartoon.  I think the ice that has encased the Grinch’s soul and heart for years breaks and melts.  While that is happening, Max is in his line of vision.  He sees the truly poor physical condition of Max.  He realizes how poor Max has been struggling to keep on going for his master, the Grinch, despite his bum heart.  The Grinch realizes Max is hanging not just by a rein over Mt. Crumpit.  Indeed, his whole life is hanging by a thread if he doesn’t get a better and smaller heart. 
 
In the scene where we see the Grinch’s heart magically grow in size, I think there is additional magic the viewer does not see.  I think the greatest of all exchanges happens.  I think the Grinch’s tiny heart is swapped into Max, who can no longer function with a honking big heart.  I mean think about it.  The Grinch never seemed to suffer from stress, he just seemed to relish inflicting stress on others.  So, it’s the perfect, non-stressed, and likely unused, heart for the loyal, faithful Max. 
 
In the other side of the swap, the Grinch gets Max’s heart.  Think about it – as a much bigger being, the Grinch can accommodate a much bigger heart.  Even with some care and compassion now flowing through the Grinch’s veins, I suspect he has enough of the drill sergeant in him to tame that wayward heart.    
 
I find it appropriate to be inspired and touched by this unsung hero from a Christmas cartoon – because lately my life seems to imitate a cartoon more than real life;  however, the inspiration is really in the fact that this cartoon is a reminder that Christmas is on the way.  Christmas is a beacon of hope that tells me I will receive a gift of life, energy, compassion and renewal when the new heart comes.  That is a blessing I need to await with patience, joy and gratitude.