Perspectives

Decaf for You


 

It was the coffee that did it to me. “You can’t have real coffee,” the room service dietary person said, “decaf. You’re on a cardiac diet.” She had already refused my request for orange juice, for waffles, for a short stack of pancakes—“You’re on a diabetic diet.” But, I remonstrated, my sugars are normal and at home I eat a regular diet. “Not on your life,” she replied. You have to get your doctor or your nurse to change the diet order. “You’re on a cardiac-diabetic diet.” But I’ve talked with my cardiologist and he says a couple of cups of coffee a day are OK. “Nope, not from us, it isn’t.”

My last meal was the evening before. Nothing to speak of for breakfast and then no lunch, of course, since my cardiac angiogram had been scheduled for 2:30 pm and then started an hour late. It was now dinner time and I was famished. I especially wanted that cup of coffee. My doctor had gone back to his office and in a hospital staffed with many many nursing people, I didn’t know who my nurse was. Worse yet, I had sent my eyeglasses home with my wife along with my clothes. I couldn’t see the button to summon help (although it wouldn’t have been much help, I also couldn’t see the TV up on the wall). Besides, flat on my back, after strict instructions to lie flat for 12 hours after the angiogram femoral stick, I couldn’t even find the nurse call button.

I tried pulling rank. “I’m a doctor myself, you know.” No luck. The dietary limb of this new hospital stood firm.

Eventually, many hours later (maybe ¾ of an hour), maybe days later, my real nurse came in. She introduced herself, “Susan,” and told me she was to be “my main man” and that “she had the keys to the kingdom.” Specifically, she could change the dietary order. Breakfast appeared at 8 pm. Yum! Real coffee, not decaf.

I was in the hospital to figure out why my angina pectoris had returned.

It arrived about 20 years ago. A diminution in the distance I could run without stopping because of a new sensation, a heavy rock in my chest. No big problem; I could pause for 15 seconds and the pain would subside. So I still ran, just lopping off a few miles each day. And finally I went to see a cardiologist who put me on a treadmill until the ST segments dropped and then he stopped me with an ominous “the test has gone positive.” What does a cardiologist do when his middle-aged physician friend has a positive treadmill test? An angiogram of course. So we soon had pictures of my coronary arteries and yes, there were blockages, but not very severe, maybe I could keep jogging.

It took a few years for the angina to become really disruptive. Another angiogram led to an effort to open up the main obstruction, one-half way down the anterior descending artery, known familiarly as “the artery of sudden death.” OK, let’s do something! And that something was a stent, placed with difficulty and a great deal of chest pain. I think my 2 (now 2 to do this difficult procedure) cardiologists were fearful that they would end with a patent vessel and a dead patient. After the procedure I noted no change in the chest pain trouble but surprise, a belated blood count showed an anemia. So we treated the anemia and the angina got better. I began to wonder if we could have avoided the stenting if we had just checked a hematocrit before the angiogram. But of course, insurance didn’t include that test for that diagnosis.

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