Today...

It happened today!

I missed the photo of Firewood Man digging out a foot of dirt to create a base for the paving stones.  Now, if it were me, I would have maybe taken it down a bit, tossed down some sand, and stuck the bricks on top.  Firewood Man is all about doing things correctly.  So, after digging out out all dirt, Firewood Man then laid down 4.5 tons of crushed rock as a base.

Spreading and tamping and spreading and tamping and spreading and tamping happened until after dark, so I had to take a photo with flash.  Even though it is a bit fuzzy and dark, is this not a lovely sight?

He left a pile of crushed rock on the right side in case we needed a bit more to level a spot here or there.  And then he installed the final panel.  I about near wept.  I really like that we extended out the fence on the right to make a proper corner instead of the angled corner that was there.  Otherwise, that post right behind the tree would have been the back corner.  And I think that having that corner makes the tree look more like it is in a space than just ... there.

Before he left, Firewood Man moved the bench back so I could enjoy the space.  I have 1,001 ideas of how I might make it my little haven.  Right now, I am leaning toward eventually having a fountain on the right hand side against the garage.  Then, I would have the bench across from that.  And beneath the tree a small table with chairs.  To eat out there ... or blog.

[I currently have not a single clue how I might fund a fountain and a small table with chairs aside from stealing from my grocery and household budget funds.  I'd call them "medical expenses" for mental health, but that line item is vastly underfunded as it is.]

I am not sure which kind of pavers I should get or even the pattern style.  I like the idea of cheap pavers and I like the idea of a pattern to how they are laid, but beyond that, I think I mostly would like some that look old rather than straight edge bricks.  Mostly, though, it is all about how cheaply I can do this, especially since I will have more Menard's money to use on them.

Firewood Man is willing to build some planters, if need be. He plans to move the downspout on the right to the other side of the fence.  Another change in plans because of how it turned out.  I have no problem with moving the downspout!

We were both concerned Amos might try to get out beneath the panels since there is extra space there right now until the stones get put down, but Amos showed only a passing interest to the space.  I am sooooooooo happy I no longer need to have Amos on a leash in the back yard, for he was not so much interested in tending to his major business on a leash.  When he cannot go outdoors, Amos has no compunction about going indoors.  SIGH.

Today was a long day because I had my cardiology appointment.  I think the main point of the visit was that he has been surprised and concerned by just how much the pacemaker (Georgie) is pacing me, well over 90%.  He would like for my heart to work on its own and has not really experienced persistent bradycardia amongst his other dysautonomia patients.  He actually turned the bottom setting of the pacemaker down from 60 beats per minute (BPM) to 50.

I actually brought up the subject because I think I am feeling the base pacing when I roll over on my right side at night.  Sleeping on my left hurts because of the pacemaker pocket ... still ... so I would like to sleep on my right side.  But when I roll over, I feel this funny quivering inside.  My thought was that if we turned it down a bit, maybe my heart would beat on its own and I wouldn't feel it.  I mean, bradycardia as a response is different than persistent bradycardia.  So, my hope was/is that a setting change might help.

He agreed, though not hopeful about my theory.  However, sitting on the sofa this evening, when checking, I have not see my heart rate below 56.  That means, when checking, my heart has been working on its own all that time!  Woo Hoo!  Sleeping, though, would be longer odds.  My heart rate and BP drop quite a bit when sleeping.

He asked how he could help me, given all that is going on (I LOVE that he read up on my chart before I saw him, going through the notes of all my specialists).  I mentioned that Georgie still doesn't really pace when I am on stairs or other times of physicality where I wish she would.  It is hard to be physical when your heart is beating so slowly.

With pacemakers like mine, there are two options:  1) use a setting based on motion or 2) use a setting based on how hard your heart is working.  The latter is more important for fainting because it kicks in when your BP is plummeting.  It also, be it for good or ill, kicked in other times your heart is working hard ... like when you are emotional.  Yes, well.  Georgie often lets me know I am upset before I realize I am upset because she starts firing.  Your heart also works hard when you are excited, like the last two minutes of a Dallas Cowboys game or the end of a NASCAR race.  Yep, Georgie also goes nuts when I am watching football and racing.

The motion setting would help with the physicality, but the other setting (CLS) is safer for patients with dysautonomia.  What he decided to do is increase the sensitivity of the CLS and increase the jumpstart BPM from 110 to 120.  So, that means I can potentially have my heart driven from 50 BPM to 120 BMP in just a few seconds!

I am to live with the changes for a week and then report back.

We also talked about the fact that the metoprolol is blunting my reactive responses to my emergency inhaler, but more with my heart rate than my BP.  My last attack was 156/71 HR111.  Having a heart rate of just 111 at such a time is great, since I use to leap up closer to 200.  However, when my body is stressed, my systolic tends to jump, but the diastolic lags behind.  When the difference between those (pulse pressure) widens, I feel this sense of doom and I feel like crap.  BUT the cardiologist has a plan!

I LOVE ME a plan!

He said to take half a pill of the metoprolol and then wait 5 minutes before using my emergency inhaler.  Since I start coughing before wheezing, most of the time, I have the time to wait.  That will boost the blunting effect.  I am almost sort of maybe looking forward to my next asthma attack.

We talked about a walker (he brought it up), thinking that if I had greater stability and safety whilst walking Amos then I might could take a break mid-way and be less miserable whilst walking.  He's all for me walking, although he understands why I cannot do that for very long.

We talked about this fearful thing that happens:  When my heart is really working crazy hard, I feel my pulse in my lower back and it HURTS.  As my heart slows, the pulsing in my lower back slows until it goes away.  No more pain.  Just like that.  I have worried that I have an aneurysm or something.  But he has a much more likely answer:  it is a sympathetic response (our autonomic nervous system is divided into the sympathetic and parasympathetic).  Or, to put it another way, "it's your dysautonomia."  So, I have mixed signals causing the muscles in my back to contract as my heart is contracting.  Fun times, eh?  I am thankful to better understand this thing that happens to me. And to see him so very unworried about it.

Seeing him worried about how much Georgie is working for my heart is a tad disconcerting.  I'm not sure what to do with that.  SIGH.

He also explained that when my BP plummets and the blood begins pooling in my legs and it feels like my neck is being squeezed, that's my body going into preservation mode since one of the most fascinating designs of our Creator is that our body will automatically seek to protect the blood flow to our brains.  In a way, it actually is being squeezed, just from the inside.

That, I think, is one of the worst aspect of dysautnomia.  You feel so very many processes of your body that normally go unnoticed.

And we talked about the cost of having a quarterly review of the reports Georgie takes and then sends to his office via the home monitor (which I nicknamed HAL).  I would like to skip the reviews to save money.  He totally and completely understands.  Since HAL will notify him if I have abnormal heart activity (aside from the arythmias I get that are par for the course for dysautonomia) or if one of my leads breaks, he is fine with skipping the quarterly review.  Of course, I still have to come in once a year for the dreaded interrogatory because hooking me up to the computer in the pacemaker lab will generate more extensive test reports than what Georgie is capable of doing.  It is really, really, really great  when your doctor understands the need to keep expenses down.

Anyway, that was my today.  A today filled with compassionate and careful medical care by my cardiologist and compassionate and careful construction by Firewood Man.