Swimming in the Sink

by Lynne Cox

  Wow, I thought, he’s smart. It was surreal.

  It had been my job to evaluate my parents and figure out if they needed help. Now someone else was doing that for me. I didn’t like being evaluated, but I told myself, He’s a professional, and he’s using everything he knows to help me. Be grateful for that.

  Joe was asking if I had been following the news. We discussed world affairs and politics. His views were similar to mine, but his arguments were stronger.

  I checked my watch. We had been talking for an hour. I told him that I appreciated his time, but I was sure he had things to do.

  He said, “I have nothing more important to do than to talk with you today.”

  “Joe, I’m just exhausted.”

  “Have you been feeling this way for a while?”

  “I don’t want to be sick. I don’t want the doctor to find out there’s something wrong with me.”

  “You’re going to be okay. Your energy levels are low. When did you last eat or drink anything?”

  “Last night,” I said.

  “You need to eat something. Your blood sugar is low. The food will give you fuel, and that will make you feel better.”

  I told him I would eat after we hung up.

  He insisted that I eat right away.

  I felt like a child being told what to do but realized that I wasn’t thinking clearly and that he was trying to help me feel better.

  There were a couple of tangerines in the refrigerator. The tangerines were sweet, cold, and tasted good. They reminded me of the orange trees my dad planted in the backyard. He loved those trees. He grew up in rural Maine, and on Christmas Day he always found a Florida orange in his Christmas stocking. The orange was the highlight of his Christmas.

  It was almost Christmas. I always missed him more at Christmas. Why did all of this have to hurt so much?

  I walked into the kitchen to fill a glass with water.

  “Are you okay?” Joe asked. His voice was on edge.

  “I just got up to get a glass of water,” I said.

  “You sound breathless,” he said.

  “I do? I don’t feel breathless.” Was he being that attentive? What else was he hearing?

  “How’s your heart rate?” he asked.

  “It’s slower. Talking with you helped bring it down. Thanks for being here, Joe.” I almost started crying and told myself to pull it together. “I’m feeling better now; maybe I don’t need to see the doctor.”

  “You need to,” he insisted and then he gave me a pep talk.

  It was strange to hear him recount my history, but he knew everything I had written about. He reminded me of my channel swims, how the tides and currents sometimes pushed me backward, and how I had fought them and succeeded. He told me stories about my swim across the Strait of Magellan and the Bering Strait, how I did things that people thought were impossible. He said I inspired him and that I needed to remember who I was and what I had achieved.

  He psyched me up.

  “What time do you need to leave for your appointment?” We had been talking for more than three hours.

  “In about fifteen minutes.”

  He told me to pack a bag with a set of clothes, a book, a pen and writing pad, and earplugs. The earplugs would help if I had to spend the night in the hospital and share a room with someone. He asked me to let him know what the doctor said and to call anytime.

  “Thank you, Joe, for holding my hand,” I said.

  “Happy I could help. Look forward to hearing what the doctor says,” he said, and his voice sounded bright.

  Just as I was leaving home, Laura King called. She said she would meet me at the cardiologist’s office, if that was okay. I was grateful and relieved. She would be able to translate anything the doctor told me that I didn’t understand and she would be able to ask questions; I wouldn’t know what to ask.

  7

  DECEMBER 18—DOCTOR’S OFFICE

  Taking a deep breath, I opened the door to the cardiologist’s office and let the breath out slowly. It was what I did the moment before I jumped from the side of a boat into the ocean. One last breath to carry me through the transition to the shocking cold.

  The room was filled with elderly men and women. Some were sitting in chairs and others in wheelchairs. They looked tired, resigned, and frightened. I wanted to step backward and let the door close, turn and walk away. There were a couple of people on oxygen. It was so sad. I wanted to bolt out of there. I had been in too many doctors’ offices with my parents. I lived with them and cared for them. They had been on the edge of life for so many years. My dad got bladder and prostate cancer from smoking, and he had to have those organs surgically removed.

  During the surgery, the doctors noticed that he had an aneurism on his descending aorta that could have ruptured at any time. They wrapped the aneurism with Teflon, and that prevented it from bursting. The doctors saved his life that day, and they would thirty or forty more times. He was the strongest, gentlest, brightest man I knew. He was a Navy Corpsman in World War II and saved many lives but lost all of his friends. He was someone I could always depend on, but the chemo that saved his life started to break him down, and the scars from his bladder surgery created blockages in his intestine. They were life threatening, and I never knew when they would flare up. My mom was with him most of the time, but she needed help. It was hard being on alert all the time, wondering when the next emergency would happen. And each time we were in the emergency room I prayed, hoped, and wished my dad would live, and somehow he always rallied. His will to live was amazing.

  I went to some doctor visits with him and my mom and listened to the news. He needed open-heart surgery. He needed it immediately. We were afraid he would die; he had been through so much. He looked so small and pale on the gurney, but when they brought him to the recovery room he had color in his face. His recovery was a painful six months. He worked so hard. We did too.

  But my dad’s health continued to decline. My world became small and compressed, and I wondered how much longer I could be there for them. One time when my dad had to go to the emergency room for another blockage I didn’t want to go. I didn’t want to watch my dad struggle, to see him in pain, to see him squirm, to hear the other people in the emergency room moaning and crying and fighting for life. I wanted to run away, but no one else was there to care for them. My siblings lived far away. I needed to be strong for him and for my mom. She always had a positive attitude and was cheerful. She looked at me with her dark brown eyes and said my dad was the one who was sick. He was suffering. But I felt like I was too. It was so hard to see him struggling all the time.

  My mom never cried in front of me, but she started to break down physically. I think it was from the stress of caring for my dad. Her heart started beating erratically. My dad and I were afraid the doctors wouldn’t get it under control and she would die. The doctors put her on medications that helped for a while, but sometimes her heart started beating fast again and it became an emergency.

  I didn’t sleep well. I was always listening for the next emergency. I wondered what my dad would do if he lost my mom. And I wondered what she would do if she lost him. I could see how much they loved each other and I knew it was the love they had for each other that kept them alive. But it was hard for me. I realized I couldn’t have a life. I adopted Cody, a six-year-old yellow Labrador retriever, who became one of my best friends and also helped my parents. My dad was always in pain and was often worried about a blockage. Cody helped him relax.

  He would put his big yellow head in our laps and look at us with his golden brown eyes and wag his tail. He helped me deal with the stress. Still, when one parent was just getting out of the hospital and the other was going in, and I was trying to take care of them both, I would wonder if I would go crazy.

  One day my mom and dad were walking Cody and my mom tripped over him and broke her hip. She said he suddenly stepped in front of her. She never blamed Cody for her fall, but she had to have a plate
and pin put in her femur to hold it together. And the day after surgery, she was transferred to an assisted care residence, and when she moved she worried we didn’t know where she was. When we walked into her room her heart was beating at 198 beats per minute.

  The nurse thought she was going to have a heart attack. My dad caressed her soft gray hair and calmed her down and promised that neither he nor I would ever leave her. He tried to keep his promise.

  When my dad died, I felt pain I had never experienced in my life. It seemed to pierce my soul. My mom seemed okay until she was given his ashes. Then she broke down. It was heartbreaking to see her like that. And it was heartbreaking not to hear my father’s voice, touch his hand, see his face, or give him a hug. I missed him. I asked my mom why she wasn’t sad all the time. She said she missed my dad very much, but she had a choice: she could be sad all the time or she could live her life. She remodeled the house, went through a new phase of painting bright abstracts. She went out with me and my friends and they became her friends.

  When Cody got sick and I had to have him put to sleep, I couldn’t stop crying. My mom told me that Cody had had a good life. It was important to remember the joy and happiness he gave us. She was right. But I missed him so much. It was strange not to wake up with him and take him for a walk. It was strange not to have him near me.

  My mom’s health declined. She slipped in the lobby at the movies and broke her pelvis and shoulder. When she could walk I took her shopping. She loved to shop and to see new things. We went to the large food and clothing stores, and I gave her a shopping cart for support so she could walk on her own and get strong. Then she tripped and broke her wrist at home. I was upstairs and heard her fall downstairs. I was right there, but I wasn’t close enough to help her. The bone in her wrist was poking out and it was bloody and deformed. She said it didn’t hurt that much, and at least it wasn’t her right arm. She could still paint pictures. I felt so bad for her. I couldn’t keep her from getting old, keep her body from falling apart. I was so sad, but I couldn’t let her see my sadness. It wouldn’t help her.

  She fought to regain her health and her life. And I fought each battle with her. But her heart valves started to fail. We went to see the cardiologist often and to the emergency room when her heart started racing. The medications she was taking couldn’t control her heart anymore. She was wheezing all the time, and I wondered if that was congestive heart failure, if her lungs were filling with fluid and if she was drowning.

  At night I rubbed her back and talked to her softly so she could relax and sleep. She was eighty-four years old, too elderly and weak for surgery. I don’t know how many doctor visits we went to. I held her hand tightly, always wanting her to know that I was there for her and I loved her and believed she would get better. She was like Dad. She never wanted to die. She never gave up, but her body gave out. She was my best friend. It was so hard to never again hear her voice, see her smile, hold her hand, or hug her. It was so strange that she was gone. The pain of losing her stabbed my soul, and I felt like everything in my life was dying.

  And now there was something wrong with me. I didn’t want to begin this decline. I didn’t want to start falling apart piece by piece.

  Couldn’t I pretend that nothing was wrong? Life was so tough. I didn’t want to see the doctor. I wanted to turn around and run. The people in the waiting room were my parents’ age. I didn’t want to enter that world. It was terrifying, and painful.

  I took another deep breath and walked to the reception area. I was trying to calm my heart, but it was beating fast.

  A woman at the front desk asked me my name, told me to sign in, and handed me a medical history form. It didn’t take long to fill it out; I didn’t have any preexisting health conditions and I didn’t take any medications. The reason I was seeing the doctor was because my heart was beating fast. I wanted to bolt.

  A woman in her mid-twenties opened the door to the back rooms and called my name. My heart beat faster. I wished that this was a bad dream.

  She opened the door to the exam room: white walls, floor, and ceiling. There was a poster on the wall about varicose veins and an exam table covered with a white paper sheet.

  She asked me to roll up my sleeve so she could take my blood pressure. It wasn’t elevated. That surprised me. I thought it might be high.

  She asked me to take off my shirt and bra and put on a gown that opened in the front.

  She applied the twelve EKG patches to my chest and attached the EKG leads.

  I watched the machine record my heartbeats.

  Dr. Rawal would read the results and discuss them with me. I returned to the waiting area.

  It was good to get out of there. I went out to the hall to wait for Laura and paced from one end to the other. I had to walk slowly. My heart was beating fast and I didn’t want it to beat faster.

  Laura texted me. She was stuck in heavy traffic and would arrive soon.

  The office door opened, and a young-looking man with short jet-black hair and dark brown eyes stepped into the hall. He was wearing a white coat. He looked like an athlete. He looked fit, and he had that glow.

  “Are you Lynne?” he asked.

  “Yes,” I said, embarrassed that he had to come out and get me.

  “Hi, I’m Milan Rawal.”

  He reached out his hand and I shook it.

  “I need to talk with you about the EKG; can you come back with me to the exam room?” he asked.

  “You can’t just tell me what’s going on out here?” I asked.

  He shook his head. “We need to go back to the room. I need to listen to your heart.”

  I hesitated.

  “Is Dr. King here yet?” he asked.

  “She’s on the way. She’s caught in traffic.” I thought I would embarrass her if I bolted. I couldn’t do that.

  I followed Dr. Rawal. He asked me to sit on the exam table.

  “What did you do before you came here today?” Dr. Rawal asked.

  “I worked out for a couple hours at the gym. Did the elliptical machine on level sixteen for an hour and then an hour spin class and some weights.”

  He looked surprised.

  “You aren’t manifesting as expected,” he said.

  I guess I didn’t look that bad. I wasn’t surprised. Elite athletes learn to push their bodies as far as they can, and then they push them further. They find a way to eke out whatever strengtrh remains to reach their goal. Athletes mask their pain and fatigue so they don’t look weak or vulnerable to a competitor. I was doing that now. I knew my body was working hard, but I didn’t want to be sick.

  “Have you been short of breath?” Dr. Rawal asked.

  “No, I haven’t.”

  “You tolerated the workout without stopping? Maybe you didn’t feel as good as you usually do when exercising? Didn’t have the same energy?” he asked.

  His questions made realize that I was manifesting. That something was wrong with me.

  “I didn’t stop working out, but I had to do it less intensely. I don’t think I realized I was short of breath. I’ve been stressed, and I thought my breaths were short because of that,” I admitted.

  He put his stethoscope on my chest and asked me to take a deep breath and hold it. He held his breath and listened, told me to take another breath and hold it. He moved the stethoscope to three different areas above my heart and listened.

  Could he hear my heart’s song? Could he hear that my heart suffered? Could he hear that it was tired, stressed, and filled with anguish?

  He asked me to take a deep breath so he could listen to my lungs. He was checking to hear if they were clear or if they were filled with fluid. He was intense and focused.

  I wondered if every heart he heard was different, if each had its own song.

  He studied me. He couldn’t imagine how I had worked out as hard as I had that morning with the condition my heart was in.

  “Your heart rate is one hundred fifty-seven beats per minute,” he said
with concern.

  One hundred fifty-seven beats per minute, I thought. Wow, that’s extremely high. When I’m in the gym and working out faster than my normal pace, it’s difficult for me to get my heart rate above 140. That explains why I felt so tired when I was meeting the Simonelli family at Disneyland and had difficulty walking from and to the parking lot.

  My heart is close to maxing out when I’m sitting, and it was working harder when I walked. No wonder I had to cut back on my workout at the gym this week. No wonder that when I lifted weights I felt funny and had to stop.

  Dr. Rawal was staring at me. “How long has your heart been beating fast?” he asked.

  “It has been beating faster than normal for a month, but it started beating a lot faster two or three days ago.”

  He shook his head.

  Not a good sign. He must have seen something in the EKG and heard something in my heart and lungs.

  Fortunately he didn’t blast me with information and overwhelm me as other doctors did to my parents.

  He took the time to explain what was happening. He waited to make sure I could hear and understand it. It was a lot. I couldn’t have understood or absorbed it if he didn’t tell me in small bits.

  Dr. Rawal explained, “Your heart is in atrial fibrillation. AFib is an abnormal heart rhythm. The heart is a pump controlled by an electrical conduction system similar to this room, where there is a switch on the wall and every time it flips it turns on the lights. There is a control chamber in your heart that houses a similar switch, and every time it flips the heart receives a signal. In atrial fibrillation, that control chamber suddenly develops multiple switches, which are all flipping in a barrage of rapid and irregular signals the rest of the heart is trying to keep up with, resulting in the rapid and irregular pulse.”

  I could comprehend what he was saying. My mom and dad had AFib.

  He looked at me and waited to make sure I understood.

  I nodded.

  Dr. Rawal said, “Patients with AFib can experience many symptoms, including palpitations, shortness of breath, chest pain, exertional fatigue, and dizziness. The long-term consequences of atrial fibrillation can include an increased risk of stroke that would require chronic anticoagulation medication in most patients. Reestablishing normal sinus rhythm—normal heart rhythm—is a strategy that could relieve symptoms by allowing the heart to work in a coordinated manner again.”