I should not have attempted to write yesterday’s post, while moderately incoherent and under the influence of painkillers and sleep deprivation. Using my one-finger typing on my cell phone, to boot, made the message doubly irrational and laced with typos.

But I am home now. I was released from the hospital yesterday. I came home and almost immediately got in bed and went to sleep for a few hours, then took a brief break from sleep and did it again, the second time dozing in a recliner. Then watched an episode of The Sopranos. Then back to bed for another six hours. I’m awake now, my back sore from so much time in bed over the last few days.

The sound of my heartbeat is loud in my ears, loud enough and sufficiently disturbing that I almost wish it would stop. I don’t know why I sometimes can hear it so loudly. Perhaps it’s a message to me that life is loud and upsetting. That life interferes, intentionally, with serenity. An unwritten memorandum that life is, indeed, messy and noisy and troublesome.

But there’s no counterbalancing message in these noises. No competing theme that asserts the beauty and joy of life. It’s as if tinnitus, if that’s what it is, is a tool of the suicide fairy, working hard to convince me that the only way to silence the incessant whooshing, throbbing, beating, hammering, whirring of heart noises is to swallow a handful of deadly pills and let them do their magic.

Do not worry. I have no immediate plans to swallow a handful of pills and drift into permanent serenity. I have thought of plunging an icepick into each ear to put an end to the noise…just kidding. I’ve never thought of consulting a doctor about these heartbeat noises, because in the past the throbbing noises have been relatively infrequent. But lately they are more common and more maddening. So I may consult a physician. Yet if I consulted a doctor about every little physical annoyance, I would be labeled a full-on hypochondriac. And if I consulted someone about every little mental disturbance, I’d probably be confined to a protective padded room and denied the use of metal utensils for my meals.  If only medical doctors—the ones concerned with one’s physical well-being—were like psychologists, they would charge an exorbitant fee for a couple of hour’s worth of consultation. But the patient would, at least, have the doctor’s undivided attention for a while. Instead of three to seven minutes of a deeply distracted, not-entirely-present, person busily typing notes on an iPad for insurance defense purposes. In my experience, visits with medical doctors generally are restricted to two or three patient “complaints,” as if insurance or Medicare reimbursement were based entirely on limiting both the time and the topics allowed for each patient.

On occasion, I get the impression that doctors may not be entirely non-judgmental in performing their functions. During my brief time in the emergency room last Friday evening, one of the doctors—a hospitalist—seemed especially unfriendly. He seemed suspicious that I really have Crohn’s disease, which is what I had thought was the source of my pain. After my release, in reviewing the online tests ordered during my ER stay, I discovered that he had ordered a urine toxicology screen for:

    • Amphetamines
    • Barbiturates
    • Benzodiazepines
    • Cocaine
    • Opiates
    • Cannabinoid
    • PCP

Surprise! They all came back negative. Why, though, when the ER doctor before him who already had diagnosed the problem, did not to my knowledge suspect anything untoward, would this guy decide I might be chock-full of drugs? Oh, I was wearing an earring and I have a beard, reason enough. Okay, I may be overreacting…but I’ve never (to my knowledge) had a drug toxicology screen run during any medical encounter, whether office visit, emergency room, visit, or otherwise.

The bottom line for me, now, is that I have to change my lifestyle. Better food choices. Fewer calories. More exercise. No booze. The most common causes of pancreatitis (the hospital doctors’ diagnosis) are over-use of alcohol, high levels of triglycerides in the blood, belly injury or surgery, obesity, and various other triggers. Though I have a history of very high triglycerides and belly surgery and I am admittedly (though shamefully) obese, the doctors immediately came to the conclusion that I need cut down on and eventually stop drinking alcohol (which, incidentally, can cause high triglycerides). I am confident they are right. I’ve probably used alcohol as a means of dealing with issues that would have been better addressed in other ways. Self-medication is the term I’ve seen used with some frequency when describing others’ tendency to over-imbibe.

I think it was the same doctor who decided on the urine toxicology test who prescribed that I be given librium, a drug used to treat anxiety and acute alcohol withdrawal. I doubt his rationale involved anxiety. He never bothered to ask whether I had ever had any negative reactions to refraining from alcohol; if he had, I would have answered, honestly, that I have not. Not for a night or a week or a  month. But he did not ask. So I was given an unnecessary medication to treat a non-existent problem.  But, aside from never having problems with “withdrawal,” what if I have a problem I did not know about or acknowledge? I suppose the best response is to listen to the doctor who, when she signed papers to release me, said it would be best to “cut down and eventually stop.” But, instead, I think it’s best to simply stop. It’s cleaner and clearer. And, in the future, if I have any flare-ups of Crohn’s, suspicions of alcohol abuse will have no part to play.

But this tinnitus, or whatever, could drive me to hard drugs in the morning. Just kidding. I can just play loud music to keep my mind off my heartbeat.

About John Swinburn

"Love not what you are but what you may become."― Miguel de Cervantes
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