Tics,
Botox Shots, and
A Broken Heart
I went for almost thirty years with arrhythmia and never took it seriously until a couple of years ago when my heart beat dropped to one over two (eg, it was missing every other beat.)

I wouldn't have done anything even then but for the fact that I felt a little woozy driving in the afternoon. These things can drive you crazy, or off the road ... make you dead.

So I went to my friendly local emergency room at what they call the Green Hospital and the doctor on call, Dr. Sandburg, looked at my EKG and listened to my heart and heard my story of passing out on the way home and she said I might have to have a pacemaker installed. Dr. Sandburg looked like she had just gotten out of high school. She had the face and hair of the young Carl Sandburg; studied pre-med at Indiana U., too.

I told her I wanted to think about having this thing stuck in my chest so to convince me they kept me overnight in an uncomfortable swayback hospital bed there at the Green Hospital so I could have enough time to make up what's left of my mind.

I called my brother the lawyer. He got a pacemaker installed back in 1988 and said, laconically, "I suppose it saved my life." He's like that: understated, but I trust him, after all these years --- he doesn't beat me up anymore, hasn't for years and years --- so I told them to go ahead, do whatever they had to do to do a pacemaker insert.

Later I looked pacemakers up on the internet and found several --- too many --- notices about recalls, especially my own personal brand now a part of me and I remember thinking it's not like buying a refrigerator or a Hummer and getting a notice from GE or GM that you should take it back in so they can fix the freezer. With pacemakers it's another story.

Anyway Dr. Sandburg put me under the next day and intertwined this new part with my ailing heart and I left the hospital twenty-four hours later. She did a fairly crappy job I suspect (never trust anyone under fifty) because the day and night after the operation I had a fair amount of internal bleeding and when the nurse's assistants came at 2 a.m. to take my blood pressure the cuff left an ominous black ring there on my upper arm that stayed there for a month. When I showed it to Dr. Sandburg, she just shook her head and said that she had never seen anything like that before.

§     §     §

We always figure it out later, don't we? Consumers Reports --- now I find out --- said that if there was a lot of blood probably Dr. Sandburg didn't know fiddlesticks about plugging wires into the atrial or atrium or wherever the hell they are supposed to go and I now know she wasn't responding to my question about this ominous ring on my upper left arm. She was probably thinking about a lawsuit although she didn't know that I know after all these years that lawsuits aren't worth a hill of beans. My father was a lawyer, used to cross-examine me over the dinner-table, so I'm not about to be suing anyone anytime soon. I've already told you about my brother who is also a lawyer and sues people for a living.

I still get to meet with Dr. Sandburg from time to time, or at least until last month. After they fix you up with a pacemaker you have to go back every few months so they can see if your battery has died or if you have died or if you have bad connections. For instance last year when I was away from here and the icy winter, my heart went into atrium (or atrial) fibrillation while I was resting in the blessedly warm sun there on a blessedly warm beach. My heart was aching, but I wasn't about to cancel my winter there on the sand for Dr. Sandburg or anyone else to rewire my ailing heart.

Fortunately it fixed itself, but she told me later that if I had let it go for twenty-four hours they may well have laid me in the grave somewhere near there on the warm, soft, bright, coconut strewn, breeze-rattling-in-the-palms hot sandy beach.

The reason I liked Dr. Sandburg was that when she draped not her arm (what are you thinking?) her pacemaker reader over my shoulder, it let her computer talk with my pacemaker and its built-in computer. Her computer and my computer told her that when I was on the warm beach that I had had what she referred to as an "atrial fib." I then asked if she could look at the computer and know that I had fallen in love (at this time of life! Is nothing sacred?) but she was preoccupied, worried about her family and her future and even possibly my atrial fib.

She was heavy with child and had just announced her pending retirement (at 42!) so she didn't respond to my question about love and my being so Long-in-the-Tooth even and possibly being In Love ... at my time of life.

§     §     §

Her name is not really not Dr. Sandburg but I call her that because I don't want you to think badly of her I think she did the best she could even though she blew it when she was jamming those silver-plated $40,000 cables into my heart, me bleeding all over inside when she did it. I found out $40,000 is what she (or the Green Hospital) billed Medicare even though she blew it ... my left arm now gets numb all the time and in Modern American medicine they never give you a discount when they deliver a faulty product or a faulty doctor. I probably didn't ask enough questions right after she told me they were going to open up the part of my chest where my heart lay in waiting and stick this time-bomb in there which, now I know, if you don't replace the battery every few years can poop out on you and leave you just beyond recall there on the warm, sandy, hot coconut-strewn wind-swept soft beach, can leave you far beyond recall or time or memory ... at all, at all.

§     §     §

When I was over at the eye doctor's office recently (like most ancients, I spend a lot of time waiting in doctors' waiting rooms) they had me check the things that were wrong with me and my body. I notice that I check too many boxes now, this dying in bits and pieces is for the birds.

I thought about lying, pretending I didn't have diabetes, high blood pressure, arthritis, migraines, cataracts, fungus, piles, acne. I'm just joking about this last; I haven't had acne for sixty years now.

Dr. Eye was on vacation so they assigned me to a tall young man, about twelve or fifteen years old. He didn't look like Sandburg, though ... more like a very tall Akira Kurosawa. He said his name was Dr. O. As in "Oh" or "Ough." Or "Owe." He said he did his undergraduate work at Johns Hopkins and stayed on there for his MD. I was going to tell him that I went to a college, a good college not so much further up the East Coast, but then I would have had to admit that I had been in school a few light-years ago, long before he was born.

Instead, I told him that my first cousin twice-removed is now in a nursing home and has a doctor named Dr. U. Or "You." Or "Ewe." Only they don't call them "nursing homes" now. "They are "extended care facilities" or some such.

Speaking of names, my friend Anna has names for everything: not only her daughter and her son, but her car, her stove, and her washing machine. She even named my Quickie II wheelchair so I wouldn't have to do it myself. She calls it "Rupert." Or "Rupurt." Or "Hruperrt." (She's from Sweden so she speaks English with a slight accent).

The last thing I want to tell you is that the reason I went over to the eye clinic was to have botox shots. On top of everything else, I got tics. I have tics that twist the left side of my face, make it bunch up. You would think I have enough troubles, I do, but then these tics came down the line about two years ago, start up in the morning, making my eye-lid jump around so it's hard to read, at least in my one good eye.

Dr. Oh told me that after the FDA approved botox 20 years ago for hemifacial spasms --- that's what tics are called (officially) --- that his clinic there in La Costa was one of the first to do botox for these spasms. Not to get rid of the wrinkles, botox parties and such but to stop this jumping around so you can't see, so that you want to hide your face from people. However, I don't think he was the one that did the first shots, since he was probably still in kindergarten at that time.

When he got through with my shots, I was thinking of those fish that they eat in Japan. They can kill you if the chef at the restaurant doesn't cut out all the poisonous parts. It's said to be a great delicacy, but I can't help but think that part of the charm of it is because it is there on the edge of fatality. Like botox, which is also known as "food poisoning."

I asked Dr. Oh (or Ough or Owe) if I would be young and beautiful again after my botox shots but just like Dr. Sandburg and my questions about love, he wasn't about to answer such a silly question. He just said I would have to wait a week or so to see if the shots worked.

Then he winked at me.

--- Carlos Amantea
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