I am starting this piece on the word “Touch” with the lyrics to a great Warren Zevon song about the ravages of aging:

Well, I went to the doctor
I said, “I’m feeling kind of rough”
He said, “I’ll break it to you, son”
“Let me break it to you, son”
Your shit’s fucked up.”
I said, “my shit’s fucked up?”
Well, I don’t see how-“
He said, “The shit that used to work-
It won’t work now.”
I had a dream
Ah, shucks, oh, well
Now it’s all fucked up
It’s shot to hell
Yeah, yeah, my shit’s fucked up
It has to happen to the best of us
The rich folks suffer like the rest of us
It’ll happen to you
That amazing grace
Sort of passed you by
You wake up every day
And you start to cry
Yeah, you want to die
But you just can’t quit
Let me break it on down:
It’s the fucked up shit

As you may have guessed the song is titled “My Shits Fucked Up” by the late Warren Zevon. He died young at the age of 56 on September 7th 2003 from pleural mesothelioma usually caused by Asbestos exposure.

Based on recent events in my life the past week or so I am able to say emphatically that my shit may very well be fucked up. The message would seem loud and clear when the majority of “touch” I have received in the past 10 days has been from people in the medical profession.

Long story short I ended up in the ED at St Joe’s last Sunday, on March 17th my feast day, following a week of irregular heartbeats. Having had sort of similar episodes in the past I did not feel the need to run to the doctor. It would really be nice if your shit could get fucked up on Monday morning but it almost always seems to happen either late at night or on the weekend. Though I must say that a Sunday morning is often not the worst time to go to the ED and this proved to be the case for me.

The initial set of vital signs with a heart rate of about 160 beats per minute got me into a room quickly. The ensuing EKG was definitive for atrial fibrillation. I wont bore you with the pathophysiology here but suffice it to say that extra and erratic impulses from the top part of your heart are being transmitted haphazardly to the ventricles below that do the pumping and take their direction from the atria. Too many impulses getting through makes your heart rate fast and eventually the heart can poop out – never a good thing.

Luckily I responded quickly to an IV medicine that blocks some of these impulses getting through and my heart rate slowed quickly. So after three hours of well meaning but often less than pleasant “touch” from numerous health care providers I was discharged home with two new medicines to add to my already robust pharmacopeia. One med was a beta-blocker to slow things down, but doesn’t fix the arrhythmia and one to prevent blood clots forming which can then get tossed up to your brain and cause a stroke in which case my shit would truly be fucked up.

There are numerous reasons why someone can go into atrial fib. One strong association is with diabetes. Perhaps my diabetes is fueled in part by the metabolic syndrome caused by the HIV meds and then the diabetes somehow predisposes one to atrial fib. Blah, blah, blah. Who knows but it is just a bit disconcerting that the medical establishment is not at all clear about this either.

I am feeling pretty good right now and thanks to years of HIV training I am a pretty good pill taker. So let me leave you with two bits of wisdom. First from me –never pass up well meaning and loving touch from another human being and the second bromide from Warren Zevon – “Eat every Sandwich”.