January 21, 2021

Well, dear blog I am writing to you today with updates to the present both newsworthy and personal. A new president inaugurated with high security due to a chaotic mob insurrection January 6, 2021 and a continued severe pandemic contained still by social distancing and wearing masks. We now have a 78 year old president, a senator, vice president, widower and grieving father who won a contentious primary whose vice president is ethnically mixed, an Alpha Kappa Alpha fraternity member, mother in a blended family, senator, and former attorney general of California. We have a house of representative with a Democrat majority and a Senate evenly split but with VP Harris barely a majority. Mitch McConnell has acknowledged the big lie about the election being stolen from Trump and involvement of Trump in the insurrection mob invasion of the capital where legislative members were in jeopardy of being attacked. The Proud Boys are berating Trump. The Qanon conspiracy believers are somewhat in disarray since their predictions have not come to pass (remember my blog about the Millerites?). At the inauguration Amanda Gorman a 22 year old poetess did give a poem which with her youth and enthusiasm was high theatre. She wants to run for president in 20 years. Today we had a White House press secretary Jean Psaki gave a briefing much different than before. Even Colbert is happier but continues to blast Trumpers. 

So last Saturday in my hike from Waimanalo to Maunawili I was more winded, slower, and taking my ECG from my new Apple Iwatch revealed evidence of atrial fibrillation. Tuesday I went with Richard and David up to the Kamilo Iki ridge via a new route. Once on the ridge again I was very winded and ECG again showed again atrial fibrillation. This time I felt dizzy when standing after sitting for five minutes so I ended the hike by going down the very steep volcanic rock face back to my car. After two hours in both instances my heart was back to sinus rhythm. Yesterday I did not go on the hike into Hoomaluhia but used my bands and other workout routines at home. Again when my heart rate increased there was signs of atrial fibrillation which went away with rest. The technology of ECG, pulse monitoring, and oxygen saturation of the watch is amazing. The reports transferred onto my Iphone allow me to send all the date to my cardiologist who called back to let me know that he'll have a video appointment with me to discuss the next steps! Well, the side story of the Iwatch is that Daniel wanted to get me this for my Christmas present and insisted on doing it while his mother told him that it was to extravagant. Now we're all happy with this present. 

My understanding of atrial fibrillation follows. The atriums (2) pulsate and push blood into the ventricle (2) which should be fairly empty in coordinated fashion. The valves associated with the pushing of blood and emptying need to be working well for this symphony of noise and movement of blood to work well. The coordination of the beating to accomplish this miracle of movement of venous blood to arterial blood flow occurs through a network of nerves starting at a node on the heart. At any time in your life this nerve complex can go array so the coordination of beating between atrium and ventricles does not occur. Instead in some the beating of the heart can dramatically slow so uncoordinated slow beating can occur while your exercising. This happened with a good friend of mine while we were hiking a number of years ago. He could go maybe 100 steps then had to stop to catch his breath. We made it up the hill. This type of atrial fibrillation can be associated also with blood stasis a very dangerous condition in which clots can form. Clots forming in the left ventricle can go anywhere in the body clogging smaller arteries and causing severe problems and death. My friend who I was walking with later had his blood thinner stopped due to bladder surgery and suffered a stroke. In my case, I have had two heart attacks with open heart surgery when 55 years old and last year another with stents placed. My heart rate has not fallen but instead is higher than normal because of the atrial fibrillation problem. So I'm on a milder blood thinner which may have to be changed. My node may be causing misfiring so procedures of shock to the node or ablation of the node may be suggested but I doubt it. Pacemaker placement sometimes is helpful and I have a few hiker friends who have pacemakers. The procedures for pacemaker placement is not major surgery. The procedures for node ablation or shocking require venous guided visualizations in the hospital. Well, this Monday I have my appointment with the cardiologist so keep posted. 

I'm still studying myself and our human thought processes and emotional lives as we interact with each other. Certainly life threatening medical problems are a shock to my system yet so far I can do some brooding but I'm easily able to continue to pursue my everyday interests. Yesterday I continued to play Schubert's Fantasia op. 78 his last piano sonata published in his short life. For these reluctant fingers this is a challenge especially since it is hard still for me to memorize the music but when I can get his message translated through my fingers the music is beautiful. 

A friend of mine who is struggling with depression and past traumatic issues so far has refused to allow me to play some of this music for him at my home. He is convinced that his life will continue to cause him to be irritable, want to withdraw from interactions with others, lie at times in his bed for hours feeling dysphoric and have pessimistic viewpoints of our world. I'll continue to reach out but my success rate in intervening with other friends with similar dispositions has been a dismal failure so far. In my professional life as a psychiatrist I had greater success. 

This leads me to my original purpose for today's blog. How can we bridge the divide between ourselves to others? Well, yesterday at home between playing the piano and doing my workout Rebecca and I just hung out. She was going through the albums, letters, and pictures that Lotte accumulated. This was initially hard for her but then she was interested and brought me in to glimpse at Lotte's life. For those in the dark, Lotte was her late husband's paramour before he died and then Rebecca became her executor and caregiver coordinator since Lotte's dementia and emotional stability deteriorated and there was no one else to assist her. She lived at Pohai Nani for the last ten years and passed away a few days ago. Lotte had an interesting life and she traveled, looked very healthy and stylish. She seemed to enjoy herself with freedom of expression and love. Rebecca and I enjoyed looking at her memorabilia and sharing our own memories of past events and people who these pictures reminded us of. There was grief and sadness but interest and joy in our time together. Openness and sharing together was very nice. When hiking with friends I look forward to similar times of sharing. Unfortunately, to some these experiences are much less actualized.

My experiences of the failed interactions with people I wanted to hold close includes my own prejudices getting in the way but also the others unwillingness to trust for whatever reason. So life includes disappointments and failed relationships which I accept, will not brood about, nor attempt to redress or change since the here and now, each day for what it's worth, accepting that I can easily be wrong and want to learn from my mistakes, etc. matter more. Our positive relationships sustain our well being. 

Leonard