The Way Things Were---Briefly

 To be sure, there was once a  very active, if that word can apply,  group  of mothers of young children in Valley Falls--- if being active in a group means going to each others' houses with babies and young children for coffe or tea.  It's odd, looking back, a long way back, how some things come about with no specific beginning and certainly without  noticeable ending. 

  When my first child was born, there lived in the village, mothers of other young children: Nancy, Lorraine, Sandy, Sharon, Sally and I came to meet at each others' homes. I don't remember if they met before I joined with them, but I think the coffee klatches began after I was in association with them. Some  of us, including myself, and probably Sandy, may have been working part-time, but most likely they were not working during their early motherhood years. Most of us brought our kids  to those meetings, the older kids playing on the floor or outside if the weather permitted, while an infant slept in a baby carriage on the porch.

  It's uncertain how the meetings came to be, but they were an accepted and ordinary practice in the village, a happening that seemed a normal and permanent part of life. I don't think any of us even thought about how or when the last such meeting would be;  it was just a natural and self-evolving part of our lives. I suppose we talked about our kids. I remember some, if not most, were looking forward to the time their kids would be starting school. I was not of that mindset, really not wanting to turn my children's' lives over to others. But besides preferring either coffee or tea, I don't think there were ever any disagreements, certainly not about politics or government. And as per the culture of the times, the kids, though present, were not the center of discussions. The trend then seemed to be to downplay them, not to glorify them, as in present times. 

So I don't know what we could have talked about, or how it came to be decided to hold the get-togethers, or who determined whose house was next, or what time would be good. I only know, that while we had to have known these meetings would not last forever, they were such ongoing if insignificant life happenings, that their ending was  like  a cloud of smoke, drifting away with nobody being aware. 

  The point, if I have one, in addition to my adding to the 30,000 November words, is that our very lives are subject not only to surprise devastations, but in addition, to those  changes wrought by the inevitable passage of time. 

Moral of story: Nothing lasts.

Rant #3 Time Line

 As indicated, knowing that time affects outcome, I'll post here an example of a single case. (30,000 words are in the making) 

November 4, 2023, around 8 a.m.  I have been on the computer as usual, with no problems or issues. My cardiac history is unremarkable. I take one prescription,  HCTZ, for borderline hypertension, which seems to be controlled. I had a routine,which means brief, scheduled visit with cardiologist Dr. P. a few weeks ago, with no issues. I had recently gone to NYC with my daughter to see Neil Diamond's "Beautiful Noise" and had walked around the city a little, to restaurant and parking garage.And I had participated in Mechanicville's October Breast Cancer Walk, as usual. All seemed normal.  I realize that at my age I can't be surprised at any health issue arising, but that doesn't mean I can't be shocked by such.

   Back to the computer. As I sat there, my upper back started to hurt. It's kind of chilly in the room where the computer is because the windows are at my back. The pain persisted so I went back to bed  to warm up, but I soon got up and went back to the kitchen area. The pain was so intense that I knew something was really wrong and that I needed to get help. I sensed that  I was having a heart attack. There are cautions and warnings about how to recognize a heart attack. But I had no shortness of breath, no nausea, no dizziness or faintness, no arm pain, no jaw pain,  not even chest pain. The image of a large rectangular shoebox came to mind, as if it had been inserted in my chest area and had been pumped full of pain. There was no room for anything else. So I knew.

I looked at the clock.The time was about 8:30 a.m. I thought I'd wait until 9 before I called my daughter to tell her I  needed to go to the E.R. It was Saturday and their day off. But then I was afraid they would leave to go somewhere, so I called, probably shortly before  9 a.m.

  M. called 911 before she got to my house. I don't know how long it took, but Pittstown Volunteer Emergency Company, about 12 or 13 miles away,  arrived at my house and then drove me to Samaritan Hospital. I remember the attendant's shirt read J. Lebarron and I asked him what the J. stood for. He said Jay. He was very calm, comforting, and sent in all the testing results to the hospital, electronically. 

So a certain amount of time has elapsed since the onset of "The Event":  My delay in calling, the call to the Rescue Squad, their travel time to my house, then travel  time to the hospital. 

PVEC has only Basic Life Suport services, but they did a thorough job of alerting the E.R. of my condition, and I  bypassed the hospital emergency room entrance and was brought directly to the floor, where a doctor  soon appeared. She did a short evaluation and I was brought to a room where Dr. Benton appeared, as described in my previous rant. And then, I was hurried to the Cath Lab,where, evidently, Dr. M. had placed his orders. 

Dr. Maroney, Interventional Cardiologist,  entered the Catheter Lab at;

 11:49 AM Case Start (His notes)

12:26 PM His final entry before he left. 

 I never saw him, before or since, except "through  a haze darkly" in the Cath Lab, where the conscious sedation that was administered made his dimmed figure seem a mile away. He had spoken to my daughter; I was just the helpless blob.  

The point is  that since time is of the essence in complete heart blockages, any delay in treatment is dangerous to heart and life. In my case, the time from recognition to treatment was about 3 hours, but it was  probably about a little over an hour between  arrival at the E.R. and treatment.

It may be unwise to  pre-judge the decision made by Capital Cardiology Associates to no longer  perform inpatient services, including emergency catheterizations, at Samaritan, because I don't know all the conditions.  But they say they will continue to perform scheduled catheterizations. And, for instance,  it does not seem feasible or professional for a doctor from CCA  to perform such a scheduled procedure  without anticipating that the patient may need to be admitted. Then would the patient need to be transported to Albany?  

  This post is a reminder that just because higher management issues a statement about policy changes (transitions) that are for the benefit of their patients, it might not necesssarily hold true in real time.

  

Rant #2

 CCA has more than 35 Board Certified Cardiologists, as they advertise. The Burdett Avenue office in Troy has at least 8 Interventional Cardiologists affiliated with the Troy office, which is practically just across the street from Samaritan Hospital.  

A great many heart attacks occur suddenly and severely, and require emergency treatment and/ or intervention. It would seem that interventional cardiologists, with their specialized training, must have to respond to  many emergency situations. Of course, I don't know anything about the protocol, whether there is an interventional cardiologist always available for emergencies for patients whose optimal treatment would be in the Cath Lab.

 (Correction, I do know that interventional cardiologists are not always  available, not in any of the 3  Capital Cardiology hospitals. Dr. Benton was at Samaritan Hospital  when he recognized the  urgent need for a patient (known to me) to be sent to the Catheterization Lab at Samaritan. He ordered that the patient receive such a procedure, remarking that it was the best possible treatment the hospital could offer. Soon after, he returned to say that optimum treatment could not be provided  because there was no interventional cardiologist available. It was Saturday. We said we would go to another hospital, but he said no, he had made 8 calls and no one was available at any of the 3 hospitals, and offered the  treatment of an injection of some kind. The accompanying daughter spoke up, "You mean she's getting the second-best treatment?" Dr. B. left the room, then returned, with good news he said. He was able to contact a doctor who had just finished a procedure at Albany Med., was in his car, and he'd agreed to come to Samaritan's Cath Lab. Another  life to save, even if he would be late for lunch.  Dr. M.  verified the patient's condition and issued his procedural orders, all from his phone so when he arrived, everything was in order for an emergency procedure. Success!) 

 So it seems that interventional cardiologists can act quickly, and successfully perform procedures at a moment's notice. And I think several more cardiologists in the practice have completed their certification in intervention; they are the elite among doctors, as they are very well compensated. And after all, there is no heavy lifting in that job, only minimal physical contact;  the doctor does his work through the computer.

Capital Cardiology claims that the Troy office will remain open, and will serve outpatients at Samaritan, but red flags arise. If a doctor encounters a patient in his Troy office that needs medical care, maybe even suffering from symptoms of heart attack or heart failure, does it make sense that he would have that potentially critically ill patient transported to Albany when he could literally just cross the street to the state of the art Catheterization lab at Samaritan? 

 My suspicion that Cardiology  Associates is not being forthcoming about their future TRANSITIONS  is supported by the gossip I've heard from what seems fairly reliable sources-that for some reason, they are going to pull out of their relationship with Samaritan Hospital. I don't know if there are any other  interventional cardiologists who perform procedures in their Cath Lab. Probably not very many. My gossip source also says Samaritan is considering a Schenectady Cardiology group, but something about it is problematic. 

  This may seem like a lot of words spewed out about policy, but anybody who has a heart, especially an older model, should know what their options are, and that those options are subject to change, in sometimes mysterious ways. 

Enroute to 30,000 words,  but who's counting

Next:  Rant 4 Time Sensitive

 

30,000-- Minus "This is the part that doesn't make sense."

 I just saw that title elsewhere, but it applies in so many ways. When it comes to health care, for instance. Any time you receive a notification from an organization that carries the word "transition," you can be pretty sure that sonething not to your benefit is in the works. And medical organizations are no exception, though the stated premise for the transition is always to better serve the client or the customer or the patient. (Take warning.)

  I was sent a notification from Capital Cardiology Associates, from whom I've received care for over 20 years, though minimal to be sure, for borderline and controlled high blood pressure, until sudden escalation in the year 2023. 

    The message read that CCA , always re-evaluating how they can continue to bring the gold standard of cardiac care to their patients, and in order to fulfill that ongoing commitment, are making changes to how and where to provide certain inpatient services. Thus, the TRANSITION begins. Starting on Jan. 1, 2026,  routine inpatient cardiology services will be provided at Albany Medical Center Hospital and St. Peter's, no longer at Samaritan Hospital in Troy. Thus, they say, they can provide more consistent, comprehensive services with the full strength of team and resources. 

The Troy office at Burdett will remain open, they say, to continue to provide patient care and services. I would say that it seems their staff of more than 35 certified cardiologists is not keen on the idea of traveling to Troy. If so, then Samaritan would be a second rate choice of doctors. 

The Board  says the reason for the change is to consolidate care at AMC and  SPH, which  allows the delivery of more  coordinated care. 

(Whoever set the practice in that location in the first place should have recognized that it was not a good idea for cardiac patients to have to make a left turn to enter the parking lot, while driving uphill and stopping for downhill traffic from the RPI Fieldhouse, but that's beside the point in my diatribe here.) 

 Of course, all upper management, Board of Director decisions are made from the viewpoint of finances. We all have to accept that decision. What we shouldn't have to accept is being insulted as to the reason for that decision. 

  Here is the insult to our collective intelligence and,  even more than insulting, a disregard for the health of patients needing critical care:                                                                                                   "We will no longer provide routine inpatient cardiology services OR EMERGENCY CATHETERIZATIONS at Samaritan Hospital,but will continue to perform outpatient cardiac catheterization at Samaritan Hospital."

  I would propose that of the large staff of cardiologists present at the 2 Albany hospitals,  a qualified cardiologist might consider a presence at Samaritan in the fully functioning Catheterization Lab there when an emergency room evaluation results in the diagnosis of a severely blocked coronary artery, for which the preferred treatment is coronary catheterization and stent insertion. In such cases, time is of the essence, with a time window of 50-90 minutes before the heart is severely damaged or death ensues.

Capital Cardiology has about a dozen of the elite Interventional Cardiologists who perform heart catheterizations and stenting, as well as other cardiac surgeries. Their "large presence" could include those who are willing to travel 10 minutes to Troy to work their magic. And save a life.

  Scenario: A person is at home when he or she feels as if  they might be having a heart attack. Ideally, they don't wait too long before calling 911 Emergency Services. In more rural areas, depending on which district that person resides in, and the distance from the designated Responder, it may take 20 minutes or longer from the time of the call until the ambulance arrives at the afflicted person's home. 

I was informed by a spokesperson from the local Rescue Squad that they are  obligated to transport all cardiac cases to the nearest hospital, so off to Samaritan Hospital, maybe a 15 minute trip, and evaluated there for their condition. If it is deemed that the proper treatment is a trip to the Cath Lab for potentially life saving treatment, and while Samaritan has a state of the art Cath Lab, the patient's Capital Cardiology medical practice will no longer  perform emergency catheterizations there, only scheduled procedures. 

   I have no information as to what  arrangements, if any, are made to transport the patient to one of the Albany hospitals for treatment at their Cath Labs. I called the telephone number included in the email from Capital Cardiology --"Who can I  contact with questions about this change? Call us at 518-292-6000 and our staff will be happy to help."  I called this number on November 5, 2025. The person who answered had no idea what I was talking about, as to answering questions about the change, and said I could call the front desk. 

      TIME IS RUNNING OUT.

  To be continued in Rant #2 Cardio

 

    

30,000 Words in November

 I almost signed up for this challenge, of writing and submitting 30,000 words in the month of November. That would be about 1,000 words a day, a mere fraction of the words, now mostly unspoken, that flow through my mind in the course of a day. That these words would be unlistened to or unread is irrelevant. Here are some examples of what I might have written if I'd accepted the challenge:

  I had a vivid dream last night but because I hadn't documented it in writing, I'm doomed to having snippits of it insert themselves at random into my mind. Here goes: Marilyn is to come to my house and pick me up to take me somewhere, most likely to a doctor's appointment. Someone else is here with me, I can't recall who, a doppelganger maybe. It seems M. is late as when she enters, she is in a hurry (Big surprise.) I'm not ready, have not showered, so am afraid I may offend the doctor, say I won't bother to go, but I am overruled. We leave, but first must stop at the fairground and as we go by one of the main buildings, we can see that it is a fully stocked store, with all imaginable items on colorful display, awaiting buyers. I remark to M. that I had seen this before, in a dream I'd had. The rest of this present  dream is now lost, presumably never to resurface.

  Yesterday, at my final session of Cardiac Rehabilitation, the daily trivia question appeared on the board on the wall, as usual. I usually pose this question to my sons, one on email and the other in person. As I drove out of the parking lot, I realized I couldn't recall the question, had absolutely no memory of it. No big deal, benign question and probably delivered to patronizing recipients anyway. 

  This morning, as I was waking up, going through the process of what words would flood my mind that day, yesterday's trivia question sprung, unbidden, into my mind. I recalled the question, uncharacteristically trivial even in the spectrum of trivia:  "How many CHUGGAS  are there before CHOO CHOO?"  I had thought only 2 chuggas, but I must have been thinking of the title, because as Chris pointed out, by reciting, there are considerably more. 

(I don't have word count, or if I do, I don't know how to access  it, but this must be several hundred words and I could continue,  but I'll spare you, O Blog.

Ask and you shall receive---

 It's always the tires. And the TPMS light, which likes to stay lit, so I can't be sure if the tires are under-inflated or the light is just wonky. If a grandson is in the area, I ask their help in determining which is to blame. I used to check for myself, but can no longer trust finger dexterity to remove the valves, to say nothing of assuming the position. While the boys are at Stewart's, I may ask them to fill the gas tank as well. That is sweet of them, but can give rise to a complication. G. did both chores last week. This week, when  I went to gas up my car, I at first thought I'd lost my strength. I had to struggle to get the gas cap off, having to use 2 hands to unloosen it, until I remembered G. had fueled up and of course put the cap on. I should have known, because earlier this year, after B. had fueled my car, I was at Stewart's,  totally unable to remove the cap,was low on gas, and, spotting some construction workers crossing the lot, asked if they could help me. One very friendly guy, said sure and while holding his cup of coffee, reached down to remove the cap. He then put his coffee cup on the ground in order to give the cap a good twist, exclaiming, "That was really on there!"  Some people just don't know their own strength. 

  Well, it's now 3:10 AM by the clock on the computer, so Spelling Bee is on.

(Not Very) Much Ado About (Almost) Nothing

 I was out of bread yesterday, Halloween, so I went to sNs to get a loaf. I didn't need other groceries, but I picked up a few yogurts and a bag of candy, for the holiday if anyone showed up. On checkout, I thought the price of almost $13 seemed high, for just 4 items, but chalked it up to those inflationary increases. I don't usually check prices on my grocery receipts, as everything is computerized anyway, but I happened to look at this receipt and saw I'd been charged for 2 bags of candy, at $3.99 each, when I'd only bought one bag. 

  I figured I should have noticed it at the time and reported it, because how could I prove that I hadn't left the store with the 2 bags of candy. I didn't feel like returning that evening, so I almost gave up on going back to the store to claim I hadn't received a paltry $3.99 item. 

But I had nothing else to do today, so decided to try my luck; maybe they'd believe me and tell me to pick up another bag of the candy. I needed some other stuff anyway. So I go to the Courtesy Desk and no one is there, as is usual. But I saw a man with a SNs shirt taking inventory, so I asked him if anyone would be at the desk. Soon a woman appeared behind the counter. I told her I had been double charged for an item and presented my receipt. She spoke not a word, but opened the register, counted out 4 dollar bills, and handed them  to me, along with my receipt. I said thank you and left.   (She didn't say "I came all the way out of the break room for this!"  But maybe she felt that way. 

   As I said, no big deal. 

Here I am at the computer, expecting to open Spelling Bee, which comes on at 3:a.m. While my clock reads 3:05 AM., the computer reads 2:05 AM. I suppose Daylight Savings has come to an end. So I wrote the above account to pass some time.