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How I spent my summer vacation

Image of Right Coronary Artery nearly blocked

Okay, it’s been awhile. Many of you know that I have had some health issues recently, but some of you will be in the dark. So let me explain.

Things at work were/are hectic for me. This redefining the way the world measures stuff takes its toll. We’ve been at the Planck measurement for over eight years. Hell, I’ve been trying to reinvent mass measurement since 2000, when I launched my first major project at NIST. Anyway, it’s been a lot of years burning the candle at both ends, and I guess it shouldn’t surprise me that something would give. It ain’t the years, it’s the miles.

I wasn’t feeling quite right starting back in February, when I noticed that my normal hike at the little monadnock down the road was causing a tightness between my shoulder blades and a shortness of breath that I’d never experienced before. I chalked it up to being out of shape, and I made a note to watch my diet and try to hike around work a little more.

March took me to Uruguay on business, and I noticed that I was struggling to hike around the city as I went in search of a music store. I always try to find a music store within a 2 mile radius of the hotel I am staying at when I am on business travel. This is a reaction to Naomi’s reaction to me when I first started traveling as a NIST employee. She was dumbfounded that I would have the opportunity to visit places like London and Paris and never venture beyond the conference hotel. It is embarrassing, but I must admit that I am a very timid traveler. To overcome this timidity, I cooked up this idea that wherever I go, I need to play a guitar. And that’s been a thing with me now for the last ten years. Every town I go to, I go out for a hike, find a guitar shop, and play some guitars. I’ve played guitars all over the world. And seen a little of some very famous, and not so famous cities. And Montevideo was not to be an exception. I was determined to play a guitar in Motevideo, and Google maps had a store for me within my walking distance (I haven’t quite worked up the courage to take a taxi, or lyft, or uber).

While I succeeded at playing a guitar in Montevideo, I was again puzzled at how simply walking a couple miles around a city at sea level was leaving me winded. Again, I thought I was just out of shape. Too much time working, not enough time exercising. March was so busy with work. I didn’t have time to record a video. And I was thinking that I should probably post things every other month. And maybe quit worrying about writing a blog. Who reads it anyway?

April came, and Naomi and I managed to work up a song to play together on a video. If you haven’t seen it, you should check it out. It is a little Bossa Nova I wrote that we used to perform as a family band for Red Wiggler fundraisers. It’s a nice bit of schmaltz that I thought would be a nice change from my usual schmaltz, and kind of fitting since I was just down in the part of the world where Bossa originated. We barely finished the recording when I was off on another business trip, this time to Colorado. To my shock and consternation, okay, mounting dread, I struggled to even walk around the streets of Boulder without feeling short of breath and tight of chest. Altitude has been bothering me more with each passing year, but this didn’t really feel like that, so I vowed to finally check in with a cardiologist.

Things came to a head at the end of May, when I discovered that my right coronary artery was 95% blocked (image at top of post). I guess that explained why my energy was a little low through the winter and spring! Interestingly(?), the diagnosis of this blockage was not immediate or obvious. I passed a stress test at the start of May just fine. The cardiologist who administered this echocardio stress exam found no evidence of any problems with my heart. He even cleared me to go give the next talk that was on my schedule, May 20 in Bogota Colombia. And I was supposed to address all of NIST when I got back, for the premiere of the trailer for the documentary film about our work. I was freaking out a little, and I asked the cardiologist

Are you really sure that my heart is fine? Yes, there is nothing wrong with your heart. You do know that my dad passed a stress test just before they cracked his chest open and performed bypass surgery on his 90% blocked left coronary artery? That artery they call the widow maker? Is there some way we can check to make sure I’m not dealing with something like that? Before I go off to Colombia? Yes, we can schedule an angiogram, that will tell us for sure.

I requested the angiogram ASAP, canceled my trip to Bogota, and on May 24, showed up for outpatient surgery. I was scheduled for a catheterization and x-ray image of my coronary arteries. I was pleased to hear that odds were in my favor that they would be able to do the procedure through my arm, rather than up through my groin.

All the nurses said something like...

Oh, you’re kind of young to be here, and you look very healthy, but it’s a good idea, with your family history and all, that you elected to have this procedure, that way you will know if you have a little blockage, and be able to watch it.

And the cardiologist who would do the procedure came in to my little curtained off section of hospital, stood by my bed and said something like...

Based on your exams and the way you look I don’t expect to find anything here, but it will give you peace of mind, and will give us a good baseline for the future, given your family history. This is really just a formality, but please sign this release. Sure, what is it? It gives me permission to place a stent in your heart, in case I find severe blockage. I don’t think I will, but it’s a standard form, and it’s good to cover all the bases, just in case.

And with that, they wheeled me into the operating room for the procedure. It was an operating theater and experience that reminded me of a high-tech version of the sitcom Scrubs, complete with wise cracking technicians and staff prepping me to a soundtrack of rock music piped in through speakers I saw mounted in the ceiling. Oh, and by the way... Once they have you strapped in and splayed out like Christ on a reclining crucifix, jovially injecting opiates in your left arm, while obsessively cleaning and sterilizing your right, you learn that you will be awake through the whole damn thing. I mean they told me before I got in there. But they've told me I'll be awake through colonoscopies, and I'm always out like a light. This is different. No anesthesia. Just mellow drugs. You wind up having a chat with the surgeon during the whole thing…while on fentanyl…so this is loosely how it went down…

I’m putting in the catheter now. Do you feel anything? No. Good. I’m going to insert the contrast agent now, you may feel something. Yes. I’m going to put some drugs in you to dilate your blood vessels for the image, this may make you feel some of the symptoms that brought you here. Yes, I feel a little tightness in my chest. Oh, yes you have some significant blockage. Your RCA is 95% blocked. I’m inserting a stent now (yep, it was that quick). There. Now I’ll image with the stent. Much better. Alright, we’re done. So my heart was fine? Yes. But my plumbing sucked. Yes. You have some other blockage in your left coronary arteries. It looks like your (medico techno babble) is 40% to 70% blocked and your (medico techno babble) is about 50% blocked. Nothing you should feel or notice, so I’m not going to stent those at this time. I’ll talk with you more in post op, when we go over your meds. You should be able to go home tonight.

And that, as they say, was that. I did go home that night. My daughter picked me up. Naomi, as it happened, was out of town helping her parents. But that’s another story.

There’s been more twists and turns since, the slow adjustment to being on blood thinners, the night when I was still recovering at home during the brutal heat wave and our airconditioning went out, the continuing tightness in my chest that got me examined as part of an NIH MRI imaging study (nothing sinister was found, but some evidence of limited microvascular damage that they can’t treat anyway), and having to go it alone sometimes so that Naomi can spend extended time back in the Midwest helping her parents. There’s no shortage of things I could bore you with. But I think you get the idea, and it is important to stress that things continue to improve, and I expect I’ll feel fairly normal by the end of this first year. But it’s a new world, and I continue to plod along the road to understanding what my body and heart are willing to do. In the meantime, I’ve tried to keep up the recordings, because I still like playing songs! So here are some brief comments on the songs I’ve posted, post cardiac intervention procedure.

The Smallest Things

Okay, strictly speaking I recorded this before the stent. The song is a Bossa Nova and is built around a chord progression that allows the bass note to wind its way down chromatically from E to B flat. It’s played on my Craviola, my odd shaped guitar from Brazil that is perhaps the only guitar I own that literally has Bossa in its DNA. Lyrically, the song simply observes that life is funny in the way that chance encounters, random events, whatever, seem to loom large over our destinies. If our eyes don’t meet across a crowded room, do we spend our lives alone? To which this song answers: No. This song takes the position that we are fated to be together, that our hearts know that we two should be as one, and that come what may, our hearts will somehow arrange for us to enjoy a life together, geography be damned. I am not a fatalist myself, so this song doesn’t square with my worldview. But the idea is romantic and makes a good song. It’s also a song that Naomi and I had played together before, when the kids were young, so it seemed like the easiest way to suck Naomi into the monthly music making.

Write me a letter

For my first recording after the stent, I chose something that would be easy. Write me a letter is one of the early Pate songs, part of the canon that I refer to as She songs, which grew out of my moping around during my early college years after breaking up with my highschool sweetheart. I was trying to create something like the songs I loved by Squeeze, and for the original Poignance through Volume version I sang with a British accent, because I literally had Brit pop so deeply ingrained in my head that I couldn’t sing these kind of pop songs any other way. I wanted to be Paul Carrack. This time out, I bring it back to its blues underpinnings, and achieve a more American music version of the song. The guitar is my small body, Vega archtop from 1938, which plays and records well, now that we’ve figured it out. During this phase of my recovery from the stent, I was surprised to discover that playing electric guitar would cause my heart to have fits. The vibrations were too intense. I’m past that now. But it was weird there for a month or so. And I wasn’t sure it would ever change.

Fast when you ought to move slow

This is an All the Fixin’s song that would have appeared on Fact or Fixin, if we’d finished that recording project. Alas, it was not to be, but I’ve always liked this simple GCD strummer, and, as is so often the case with the songs from that period, it’s nice to take the opportunity all these years later to actually finish the lyrics and play the song as a singer/songwriter composition. Although a fully blown string band arrangement of this one, complete with harmonies and fiddle, would be cool. Lyrically, the song owes a debt to Richard Thompson, particularly verse two, where I give a weak tea version of 52 Vincent to propel my narrative along. The guitar is my Vega FT-85, a nice small body flat top acoustic.

A Moon Spell

Which brings us to my latest, another of my attempts to write in the mode of the American songbook. This time the progression is very simple, but it has just enough harmonic complexity to leave room for a nice melody that is fun to sing. And I had great fun working out the guitar solo at the beginning. I’ve watched Bill Frisell and John Pizzarelli play together on the Fretboard Journal. Their performance is in my head when I sit down to compose and play songs like this. I’m not in their league. Not by a long shot. But that’s what I aspire to. Frisell’s inventive, playful single note phrasing that is unhurried. The way he stresses melodic and harmonic invention over flash. And Pizzarelli’s encyclopedic knowledge of the classic jazz canon and his superb ability to comp and accompany a vocal. And he can play the hell out of a lead line. But it’s the juxtaposition of Frisell’s arty soloing and Pizzarelli’s classic comping I enjoy most. Lyrically, this song picks up where Rope around the moon left off, bookending the common emotions and musings of love in a long-term relationship. The guitar is my large body Vega C-66 archtop from 1938. This time I’ve electrified it again. I made the rose wood pick guard and the pickup mounted on it. I love the way this thing sounds and will do a rig rundown video sometime soon to review how I create my jazz sound.

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