Wednesday’s Words/Nonfiction: What Goes Here, Woman?

Okay, this direct question could be put to anyone, bold, commanding. But for me the question has several interpretations that slink around my brain lately. The inquiry is a twist on the common one: “Who goes there?” Except that I know who goes there–it is I, just Cynthia. The woman in question. One who has reached her 69th year, still sentient and fully conscious (on the mostly good days, anyway, as long as I don’t bring alcohol into it), and who likes supple black boots, fabulous scarves, books bent over into deep of night and spontaneous dancing with a little song now and then. A writer. A lover of family and loyal to friends. An introspective person who sees the world like a changing canvass of rich art. A woman who loves to talk with strangers anywhere I happen to be. Someone who has had several terrible things happen; nonetheless, they can and do happen to anyone, and I am sad for their sorrows. And I walk 2-3 miles daily if at all possible.

This much I cannot dispute.

But the rest–what is going on now with me as a result of what came before; what is more likely to occur based on present moments; and what is an intelligent response, though wait, why bother?–the rest is under review.

Not that it never has been before. How often I–in fact, our collective of humanity–revisit the status of personhood, often and perhaps that is embarrassing to confess. Are we who we think, do we prefer to be more, or less, or another altogether, and what the heck does all of it have to do with the routine and demands of daily living? There is always work at hand, little enough time to consider things. Yet how acutely we do engage in the study of ourselves. We are a species of the ruminative sort. We must prod and question to sort things out.

My state of mind is mixed. It’s akin to being close to a good fire, wrapped up in a soft and tensile blanket of contentment–while being aware of a feisty and potentially miserable porcupine outside the campfire. It may shoot its quills with or without provocation, with little preparation to deal with its displeasure. It might be a person with conflicting attitudes, a random car swerving too close, the relentless news with its fists up, my body’s jagged messages. Even how the wind already blows so cold the heating bill will be a tough thing. One more quill to eye, here and there. One must stay aware even in coziness. It is a matter of learning how to navigate life yet it feels harder this year. Would that we were prepared from the onset of our initial yowl. But we grope and gauge, try to figure it out.

Today I would quite rather write of all things good and true. I just came in from a glorious walk in surrounding woods. The sun is beaming, all the hues and tones of autumn transfix, the breeze is almost frosty, refreshing. I enjoyed the hour out as I do every day, rain or shine. So one part of me is steeped in such peace that a passerby might suspect I move from an ultimate calm. The other part is, though, laboriously picking apart knotty threads and connecting elegant strings of others so all may cohere. It is the same most days. And I don’t quite get why, though logic informs me there are several reasons.

Recently I hiked down to Bridal Veil Falls in the Columbia Gorge. I do this every fall. It commemorates my survival of a likely heart attack, not sure, I did not get to the hospital in time to know definitively. I write of it enough that old followers of this blog know it too well. Half-carried out by my husband, then we sped…home. I thought it was congested lungs even though I was brought to my knees, flattened by deep, intense squeezing in the chest area, the weight like an elephant–yes, it is that–on top of ribs and the feeling I was going, going, gone. I’d quit smoking the same year, had often run out of breath when hiking. So I went home nauseous, breathless, so exhausted I suspected I could not get off the bed again. Heart never entered our minds then–who has a heart attack at 51? I was strong and fit, especially since not smoking. I looked in my earlier forties, not fifties then–who worried?

The next morning I awakened with one phrase buzzing in my brain: It is my heart. I got on the phone and found my own cardiologist and got in a day later. Why do it that way? Usually a doctor refers a patient to specialists. But my primary doctor had thought nothing was wrong with me a year prior when I’d complained of very rapid heartbeats and feeling breathless on and off. “Anxiety and menopause,” he said and patted my hand. Would I like drugs to help calm me? No. I held back angry tears all the way out of the building, then lay my head on the steering wheel and wept. What was wrong with my generally healthy and strong body?

A year later: two stents over 18 months (first one failed), rehab stints and I started to make progress that was noticeable and trustworthy. Ever since, I’ve felt more well than not and last December another look in my arteries showed lovely pathways with no clogs or narrowing. It was about then I heard I’d already outlived my expected ten years so keep doing all I do. I respect and love my cardiologist, the same one who told me often in the early days of recovery when i got scared that we’re all going to die so stop worrying and just live. To that point, I reminded him heart disease killed my parents and two siblings already. He leaned forward, his handsome face smiling, that last visit and said, “Well, I say your heart is even stronger than before.” He did not say I was not going to die of heart disease. But it is a great thing to be this much better until…whatever.

I ran into a fond acquaintance who had a serious heart event recently with emergency surgery. We both were walking along the river. Feeling grateful, I spotted her and gave her a big hug. She had been in the hospital again with chest pain but was later released, deemed okay. I get how that goes. She is an admirable person, a VP of a commercial real estate company, a talented writer (met her in writing groups), a loving mother. After we parted, I thought: she is about the age I was. How did this change her? You learn that life can be torn from you in an instant, that it is a flimsy thing we carry our small lives in–even though it again surges with power, and heals.

So here I am, also still living as the days and nights come and go. But is that enough? Is the success of staying alive and grateful enough? What does it all tell me about the quality of my choices and actions? And what in those elicits appreciation from others? Or am I partly invisible, as we all can be invisible, even when we need to be seen? Is the hard work worth what I am now? Isn’t there much more I can and ought to contribute?

The hike down to the beauteous Bridal Veil Falls was easy. Hard to think it hurt so much 18 years ago. But this time it was going back up that was hard. I managed the incline of steep trails fine. Marc and I had a discussion that turned difficult; it was perhaps foolish at first glance. He hates taking photos. I like to commemorate the yearly hike with one: victory! Yet I am often displeased with his results–blurry, off-kilter, too far off. One reason I like him to get me in a photo is that I always take pictures of family plus snap away at the tons of other scenes that intrigue me. I have few shots of myself taken when I was a kid (my family took few)-or even older, when our children came along, as I was taking their pictures for photo albums, of course.

Truth was, I felt a bit hurt after that last hike. Why did he not see how important it was for me to well document that I am still here and could manage the trail well once more? He got the importance of the hike; he did not get the importance of a picture being clear and nicely aligned. I said, “I want my children and grandchildren to be able to see it and know that, yes, our mom/grandma so loved hiking amid nature’s wonders and she did the trail one more year, a triumphant hike.”

We fell silent and I was sorry I felt so sad about it, and he so irked.

I think I get tired from all the laboring and even reaching goals, including small ones. I usually have a handle on what matters most when the chips are down and when all seems well. But how much can a life mean and how can we give it, share it, transform it endlessly? A I get older and closer to that still-nebulous but undeniable finish line, the reassessment is in earnest some moments. It is not the same sort of review as when I was 30, 40, 50, when there seemed decades left. In fact, it is this year of age 69 that has impacted me so differently.

It has been a time of surprises, shocks and reorientation. Of setting new courses and not having a clue where this may take my husband and myself by the next year. Of letting go of places (moving from a comfortable home to a very different place) and people (grieving others’ passing or grave illnesses), of greeting the glorious twins and wondering if what I have to offer my daughter and her family is enough. How to draw the line, too, when I am worn out. Of worry about money, how much to give and how much to keep. Of coping with emotional blows from any who shut me out of their lives–this has happened so rarely in my life, it c mes as a shock, the events flummoxing me. And I’ve dealt with my discomforts behind the scenes as mush as I can, as a responsible person, a wife and mother from my culture was taught to do when I grew up. I have discovered more flexibility and strength than expected–that has been an insight gleaned. caring for yourself doesn’t necessarily come more easily when older; you just see more quickly what is needed and get to it.

Where I was confident before, there has been some tentativeness. I do not want to pressure anyone. I don’t want to assert opinions not wanted. But, too, I’ve found that physical and psychic pain still may cut perilously deep …and the power of healing can occur even when not looking. It’s like limping along and suddenly you find sturdier legs, so you walk as if well, with shoulders up and head up. The soul is buoyed again.

So maybe I am getting a better handle on the changes and learning to ride the bumps. Resilience is our friend. Inspiration comes in funny places. You know how you think you have had just about enough for awhile and then you see a hummingbird visit the feeder, and it pauses mid-air before you? How you forgot the shopping list, wander about like an idiot until the important items come forward and it feels like a win? Then you go to the cash register and the cashier looks right at you, tells you how much she enjoys the fall color and sunshine, do you?– and she likes your jacket and really, have a good day because today is what we’ve got, right? It is the commonest things. It is the wisp of light that plunges into shadows, how one finds one’s way.

Every portion of my faith in God and living is based on the real likelihood of something good and rejuvenating that will counterbalance the difficult and damaging. Just when it doesn’t seem likely, it arrives– or I can create it. We are meant to always do creative work, inside and out, at home and at work, in our dreaming and thinking. Mending, altering, finding new parts for old fittings, unique solutions to knotty problems. No one lives without this gift. And how wise a thing that we are given a brain and will to use it–if we just do use it.

Most of the time I do know “what goes here.” I do not sleepwalk; I am in slumber or I am awake. I get up and open the blinds, take in the trees and sky. I make a mug of steaming chai and meditate. What is happening is simple: moving through another year, addressing its needs. I choose to surmount tough times and appreciate the value of each fulfilling moment, and the most ordinary ones. It is choosing kindness over being right or having the last word. It’s letting hurts heal and welcoming people who can care better. It’s finding ways through or around blockades. And holding close the blessings in person, in prayer, in actions. I can’t know what tomorrow will bring–health or illness, wealth or poverty, disaster or protection, triumph or defeat. It is still, at this age, a step-by-step dance, alone or with one another.

I do have a solid sense of who I am. There are a very few regrets lingering. Mysteries unsolved. Moments ahead that will ask much. Failures still occur despite best efforts. So then, what goes here, woman-person? What if I am getting older (even the leaves grow old and flare bright before the end, are wonderful as they drift and twirl back to earth) and it’s not the best or the worst of times, but a satchel full of curious odds and ends belonging to me? It is what I make of it; I will poke about and see what comes together. Maybe I need to pause, review again and again. I’ve survived, have had great times, grown the past ten months, and once more have counted God as my one irrevocable constant. And I expect more to come. As far as I know. I am open to highs and even lows, the many in-betweens.

That is my view of things today. It may always be the main stuff I know. (And I write what I know, so stay tuned if you like…)

Friday’s Quick Pick: The Falls that Felled Me

The Columbia River Gorge (All photos, Cynthia Guenther Richardson 2018)

Every year I revisit Bridal Veil Falls where, in 2001 while hiking, I experienced the heart event that garnered me a diagnosis of aggressive coronary artery disease. I was literally brought to my knees by the proverbial “elephant on the chest” that gorgeous early September afternoon. I was 51; my doctors were not optimistic about the future. After stent implants I entered a difficult period in body and soul, but labored long and hard to regain health. It’s possible to take this disease in hand, and for the heart to become even stronger.

It’s been a thrill to once more vigorously hike the trails in Columbia River Gorge as I please. As I trek to the Bridal Veil Falls especially, it is easy to count abundant gifts of life with deep gratitude. The pictures posted are of that waterfall. At the top of the steps to a viewing platform, I collapsed. For a couple of years following my fateful hike this trail frightened me and I could not face it down. Soon I had had enough of intimidation and began to seek it out in August or September to celebrate staying alive. I am about set to head out this year once more.

Columbia Gorge, Cascade Locks, misc 114
Last visit in 2017, so glad to be there again

I love it there: the heady scents of damp earth and dense forest, the rush of water and wind-singing leaves, the birds chorusing and my heart and feet and legs carrying me up and down the rocky paths. I love that the place remains in its wild variations, its cyclical nature and its impartial acceptance of my visitations. I am filled with more joy each year I set out on the trail to Bridal Veil Falls.

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(If you are interested in learning more about heart disease, as well as recovery and health maintenance please search for my series entitled “Heart Chronicles” on this blog.)

Finding the Rightness in What Seems Wrong

Photo by Cynthia Guenther Richardson
Photo by Cynthia Guenther Richardson

I could hear the birds softly chiming in the new morning but my attention reverted to throbbing pain in my neck and head. Just another morning dominated by flagrant nerve responses to deteriorating discs. I eased myself from bed, first legs and feet, then pushed up with hands until I was upright. To the bathroom cabinet for a last pain pill though it was 50% effective, if that.

Want to get this under control before the nuclear stress test in a few hours. Hope I can get more sleep.

But my heart must have heard that thought, as its earlier steady rhythm began a rapid increase on the way back to bed. I lay down a few moments; it rushed onward. I pressed the carotid artery on the left side of my neck to verify what I already knew.

Tachycardia…not now! Quiet, heart, keep things running well so I can rest another two hours. 

I resurrected meditation breathing, those slow, metered breaths in and out that can (somewhat) help control a rapid heart rate. After what seemed a long while, the heart rate calmed a bit, fell from around 130 beats per minute to around 90. I turned over, relieved. I thought it must have been the sudden movement from bed to bathroom to bed, as sometimes–not for a couple years, however–the motion from happy repose to ambulatory action can set my heart roaring. Temporarily, mostly. I plumped up my pillow and smoothed the pillowcase.

Rest. I need to be ready in a few hours for that test.

I had had unusual chest pain three weeks prior. A nuclear stress test had been scheduled after an emergency room doctor determined it would be wise. Since I’ve lived with coronary artery disease for well over a decade, I don’t wait too long to get help but neither do I believe all arrhythmias (irregular heart rhythm) need to elicit panic. All had turned out well enough that day but the attending doctor decided it would be helpful to obtain more complex images of my heart’s inner workings. We would see what the arteries were up to fourteen years after two stent implants.

I hadn’t been thrilled about the upcoming procedure. I couldn’t explain why. I have had plenty of stress tests involving treadmills and ultrasound but not a nuclear test. There is always some risk. I had been in the hospital at least a dozen times over the years. Yet a feeling of unease about this time hovered in my consciousness.

Was I just anxious, was that the issue? Be calmer, I told myself.

The anvil of pain in my head didn’t help. But it failed to keep my attention as my heart began once more to race, the heartbeats to gather more speed each second. Then decreased. It was an internal equivalent of a siren becoming very loud and then becoming quieter, up and then down, over and over. It was getting tiring. I was breathless and dizzy.

What irony! A heart stress test in a few hours and I am having unpleasant heart stress right now…It has to be not taking my beta blocker for over 30 hours in preparation for the test, right? So I have a galloping horse of a heart now…what now? My life is always in Your hands, Lord.

I reached for my phone as the heart rate cranked up once more. Dialed 911.

The fire engine came, then the ambulance with EMTs and they hooked me up for an EKG as they encouraged me to go to the hospital. But I hesitated. Did I really want to go to emergency again? I had a big bill from last time. My heart was settling down. They stood in my living room with arms dangling, patience their strength as much as medical skills. I knew this: they wouldn’t advise otherwise, especially when you are a heart patient. We headed out to the hospital where my cardiologist practices.

On the way to the emergency room I glanced out the back windows at a man driving an SUV. He looked at me, I, at him. What is that man thinking about? Being late for work? An important dinner date later? Is he wondering what I am doing in the back of this ambulance, grateful it isn’t him? I was wondering why I was there, too, as my heart rate was getting closer to livability again.

At the emergency room, I insisted, “It has to be the absence of the beta blocker, I had to discontinue it about thirty-two hours ago for a nuclear stress test appointment later this morning. It was intense. But I’m not sure why I’m here now.”

It bothered me, the time it was taking, the money it was costing, my heart seeming less imperiled. I worried about missing the nuclear stress test across the street at my cardiology clinic.

The energetic nurse with short blonde hair positioned more adhesive patches and wires to me chest and legs.

“Those beta blockers are powerful, so could be, but you never know for sure until we can check you out. We’ll get you fixed up here. Better to be here than in trouble at home.”

My beta blocker medicine ordinarily has this wonderful power–it slows and steadies heart action so I can live a life that is as close to normal as I can likely get. I had not been off it for fourteen years until this occasion.

Things did not get better just because I was in the emergency room. It was overcrowded as they were remodelling. The patient next to me had severe abdominal and stomach pain with nausea. Strangers poked their heads in and out. There were needles that finally found my veins. The heart monitor showed every little variance and I tried in vain not to watch.

I did not want another procedure; I wanted to get up and leave. My chest was alright so far, high blood pressure was coming down and heart rate was no longer threatening to take me under. Further, I wanted my head and neck pain to stop but there it was, the one constant in the background.

But it was determined I would have the nuclear stress test in the hospital. I would be admitted, likely.

“I want to get up and just walk over to my cardiologist’s office now,” I insisted. “I can have my test there. They’re expecting me. I’ll have to cancel it if I don’t go now.”

“I cannot advise your leaving the hospital; you have had significant tachycardia; you have heart disease. But you can choose to leave as an adult, of course,” a pressured, kindly doctor stated.

My sister arrived. After some discussion it was decided I would stay. I was already there, and more answers were needed to evaluate the state of my heart health. I cancelled my appointment with apologies which the receptionist seemed to find odd.  Maybe I was operating from an altered state; things did feel a bit askew. Adrenalin, maybe.

My spouse was on a business trip in Mexico and it seemed he was in another galaxy. I texted him and he said he’d get a flight as soon as possible and he was praying for me. I was notified of the stress test since my heart rate had stabilized.

A nuclear stress test is generally deemed safe but has potential, if rare, complications including, per Mayo Clinic info: allergic reaction to the small amount of radioactive dye given intravenously for imaging; abnormal heart rhythms; heart attack; flushing sensation in upper body and head and/or chest pain. A substance called an arterial vasodilator is administered to patients when unable to use a treadmill; this chemically increases stress on the heart for data gathering. It dilates arteries to allow more blood to flow to and from the heart, which also allows for good images of the heart muscle as well as arteries.

The first part was simple and easy. I was injected with radioactive dye; it seemed strange that something we associate with deadliness was not even noticed. The amount was no more than when one has an X-ray. Images were taken for twenty minutes without any heart stress. Th stress part came second, when my heart was to be agitated by medicine in a way that exercise might. More images were then to be taken.

And then, as the vasodilator medicine was infused into my arm, I developed sudden, intense tachycardia, a thunderous, chest-pounding very rapid beat that was so fast it nearly took my breath away. In a few more seconds I felt as if I was starting to detach from my body.

This is what I was afraid of, I realized, and that I might have a heart attack and die.

“I am having trouble breathing. My chest hurts,” I told the attending cardiologist who was not, unhappily, my own. She was studying the EKG monitor.

“It will peak and fade in a minute or so, the heat and discomfort you are feeling is normal,” the technician reassured me.

“I don’t think so,” I said. It was getting harder to breathe, my chest feeling heavier, the ache deepening, spreading. “The pain is worse.”

Lord. Help. Breathe. Lord.

“Reverse vasodilator now!” the doctor commanded. “This tachycardia isn’t relenting, EKG shows …other signs. Cancel the last imaging set for now.”

She instructed another drug be injected. And in less than a minute the “reversing” medicine was spreading throughout and my heart rate quickly slowed. The pain receded, leaving a tender feeling. My head hurt more. It was as if I had been pounced on by a giant, ravenous cougar, my adrenalin wiped out in less than a couple of minutes, and then that cougar melted into the sun streaks that filled the room. It was as if a dream. But I felt unable to move, despite reassurances. I had seen terror again and it had left traces behind even though my heart rate magically returned to normal and the chest pain finally was erased.

I felt as if I had been having a heart attack all over, like that afternoon when I had been hiking in the forest, climbing up ancient railroad ties that led to another pristine waterfall, each step suddenly impossibly hard as I climbed, my chest crushed by an enormous, formless weight, mind numbed, spirit overtaken. The agony of it. I closed my eyes.

It’s over, Lord. I’m okay for now.

“Even without the rest of the nuclear stress test I would admit you to hospital. I need to find out more after that,” the cardiologist informed me and then left.

I rested for an hour, then returned to have the second set of images taken, as my heart was still stressed, so more could be documented.

The hospital admittance was for the next-day angiogram, which requires cardiologists to enter a femoral artery with a tiny camera to look for any blockages or other anomalies. The doctor wanted to see if there was anything further to be addressed, due to the response I had during the stress and the earlier tachycardia. I had had six of these before; I was not worried about this test, but I could not sleep. The headache was by now a familar, like a shadow of myself. I was given more pain medication which did nothing. But with relief I resumed beta blocker medicine to help my shaken heart pump steadily.

I wasn’t hungry. I waited through the night between doses of light sleep, wondering what the new day would bring. Prayed. “The Lord is my Shepherd, I shall not want…” Lay on cool white sheets listening to the music of my heart, thinking of my husband far away in a land I didn’t know at all. Thinking of my children and grandchildren, the shapes of their faces, the designs of their lives. My heart stayed tranquil, as if telling me it had already endured this long and rather much; it could endure longer, more.

The angiogram felt like old home week. I relaxed and chatted with the nurses, feeling the haze of an anesthesia that left me conscious yet with little memory when done. I floated while they worked.

Someone said. “No new stents today…lack of beta blocker likely provoked tachycardia….extreme response to vasodilator…”

When I awakened fully I wondered if what I had heard was right. I was hesitant to to hope all went well.

“Yes, that’s what the report says,” a chipper, brunette nurse confirmed. “I think you’ll be home by evening.”

She read me the rest of the report but I had no interest. I could go home again after two days of confusion and fear and relief. My son came to get me. I looked terrible, wan and dishevelled and exhausted but he hugged me and told me he loved me and we left.

When my husband arrived at midnight from his trip, I was half asleep on the easy chair but his smile and hug all but dismissed ongoing aches and utter weariness. In the morning we lay in bed for hours, often silent but our arms about each other, noting blue sky through the blinds and the chatty robins, sharing stories and dozing. I hadn’t felt so safe and joyous in a long while and I praised God for it.

It has been four days since this latest heart adventure. I’ve pondered it, replayed how it unfolded, what might have been done better by myself or the staff.

Then, yesterday, I had a follow-up with my own cardiologist, Dr. P. It seems I am one of a fairly small number who have such a reaction–“rebound tachycardia”–to stopping a beta blocker that long. I am also one of “approximately five to seven percent” who are noted as having an extreme reaction to a vasodilator. Well, it was no real surprise, I responded. I have had many adverse reactions to medicines, including those for the heart. And I had had a feeling it might not go well.

“But I feel foolish for calling 911. I should have waited it out since I suspected what was wrong.”

“No. Too many people wait to get help too long, ignore the symptoms or are in denial that worse could happen. They’re the ones who are found dead in their homes when everyone thought things were just fine. You even waited until the next day to get medical help when you had a heart attack in the forest, remember? You never should regret calling 911 when your heart is acting up. Give yourself some grace on that one, alright?”

“Alright, I get it.”

“You know, all this told us that your stents are still holding well after fourteen years, that your arteries are clear with no new blockages, and that your heart itself is strong. You are doing so well, still a star patient of mine! It’s all because you’ve taken my advice and done what you needed to do. You exercise daily, you eat healthily, take care of your stress levels.” He paused and leaned forward. ” So what’s wrong?”

I stared at bruised skin on my arms where needles delivered medicines that both hurt and helped me. I didn’t want to cry, not then. “My sister passed from congestive heart failure, had a heart attack just a month ago. It has been unsettling.”

I almost added: How is it that I can live while she does not? And when will I have to pass on?

“Oh, I’m sorry. That’s hard, more so right now.”

“I loved her so much; she was vibrant, talented, so good.” I looked at his tired hazel eyes. “Do I show any sign of congestive heart failure?”

“No, none.”

“She died from multiple heart attacks…she was only 78….and my brother has arrythmias that worry me but insists on travelling all over the world…My parents had heart disease, too, as oyu know. It’s everywhere.”

“It’d not just genetics, but many factors including general health and stresses. And it’s how we can help heal ourselves.” He leaned back.” I know mortality gets close and personal when you lose someone and could lose others.. Nut remember, Cynthia, we’ll all die from our hearts stopping. That is the organ we must keep well if at all possible. It is the one that gives up the very last when all other organs are giving out. It fights. It keeps on beating till it cannot, anymore.”

I am silent, in awe once more of this remarkable reality, this heart we all have that propels us through life.

“And I would say that you have many more years of life ahead, as your heart is glad of the work you do to keep it beating strong.”

“Okay.” I smiled  and sighed, let go of the last ounce of weightiness. “Wahoo!”

He laughed. “Right–wahoo is right!”

“So I can try river rafting, more strenuous hiking, salsa dancing and whatever else I want to do.”

“Go for it, sounds good,” he said and pressed my hand, “and keep on taking such good care. Call me if you need help, though.”

Then he left, on to the next patient. I thought how he had also aged since I first met him, and how many people he would not have good news for that day. He would tend to them each with compassion and straight talk. I have been blessed to have such a heart doctor.

I had thanked God many times since getting out of the hospital. Yet I still had wondered, why did I have to undergo the trials of the last few days? And then it turned out that the tests showed nothing remarkable. It would cost me more money, as well.

But the fact that I got the message that my heart is working well is certainly something to celebrate. Despite the coronary artery disease diagnosis that seemed an early death sentence in 2001–per doctors then–I am thriving thus far. I have become stronger and healthier because I still had too much to do, have so wanted to live it with vigor and enthusiasm. I have a stubborn streak, and it has guided me well in this. I am on intimate terms with my heart as well as my soul and will not back down from hard work to ensure saving both. I have followed recovery instructions. But God has been right here through the messiness, the times of doubt and error, eluding death’s pursuit, finding new ways to care for myself and others. Resetting my compass. Just going on.

I had a dream last night. Three people came to me in good cheer who have passed one: my mother, my sister and my ex-husband, the father of two of my adored children.

“You’re watching over me, aren’t you?” I whispered as I came up from sleep, to a light-imbued room. And they smiled, then drifted off and my heart, it was at peace.

Photo by Cynthia Guenther Richardson
Photo by Cynthia Guenther Richardson

Postscript: I am not a professional health care provider and can only attest to my own experiences. I am familiar with tests, procedures and medications noted as well as my own heart conditions. You may have greater knowledge or different experiences. But if you have troubling heart symptoms, please do not delay in seeking proper medical care and prepare yourself with your own knowledge. Women often exhibit different symptoms of heart attack than men.

I Still Have Tulips for My Heart



How does any one of us live knowing he or she will eventually die? And how does a family plagued by a genetic predisposition to a particular disease say farewell to those who pass on, recognizing our own ends yet to come?

Looking at several pictures taken recently, I linger on one photograph. A familiar woman is bent over in the glare of intrusive sunshine, shoulders rounded, holding on to her youngest daughter’s arm and clutching her husband’s hand. A sister wraps her arm around her black-jacketed waist from behind. The woman’s brown hair is streaked with silvery strands, her face creased with sleeplessness and sorrow. She looks unlike I imagined, haggard in the daunting heat of a Texan afternoon.

It is myself I study.

Our large family was standing prayerfully by the church’s columbarium, a wall with recessed areas for urns filled with cremated remains. It would soon hold my oldest sister’s ashes. And it felt almost unbearable to reckon with the truth of it. Marinell, my oldest sister named after our two grandmothers, passed from the serious effects of a massive heart attack. She rallied, failed and rallied again for ten days. She had a pacemaker, had had a heart valve repaired years ago, but developed congestive heart disease. She was only seventy-eight.

I have lived sixteen days of nothingness and dreaminess, of times racked by weeping so deep there were no tears, and tears that fall without sound and with thunderous outpouring. It is simple grief. Nights of wrestling with sheet and quilt, Marinell’s face coming forward, then fading. I awaken feeling she is a phone call away and go back to bed whispering her name. Her lush, eloquent cello playing arrives on a sigh. I felt her hands slip onto my shoulders and her soft smiling as I wrote a poem for her memorial service. I know she has gone on ahead of us. She is just not really here now.

The woolen rug in my room has a contemporary design of mauve tulips on it, edged in Wedgwood blue. I stand in the middle of it for moments at a time, remembering when she handed it to me. It had graced her light-imbued home, now is in mine, so is a comfort each morning under my bare feet.

I have resisted writing. What can I write about death, about loss, that makes good sense? We each know the ache of it, that indefatigable longing that follows us around. What can I tell of Marinell that would reveal her not only to your mind but soul? You will never know her as I have and so it must be. Sisterhood is a rich palette of colors, a strong weave of emotion and deed. It is far too soon to share the unique quirks of her personality, the intimacies of her creative, gracious, energetic years on earth. Her loving impact on me, on countless others.

But what I can write about is the matter of shared blood. About our physical hearts, their fantastic and wayward ways, how they act up without provocation and despite tending to their needs. Maybe this way I can face it again, then put it back in its place.

The history of heart disease killing my family members is considerable. My maternal grandmother passed from a cerebral hemorrhage. My paternal grandfather had a fatal stroke. My mother’s days were ended by congestive heart failure at ninety-two and my father died following complications of a quadruple bypass at eighty-three. I have two brothers and a remaining sister with high blood pressure. One brother has had two ablation procedures (one in a Bangkok hospital when travelling) that are to improve and possibly quell a potentially fatal rhythm problem called A fibrillation.

My heart problems reached a critical mass at age fifty-one as I was hiking in the Columbia Gorge. (I have written of living with heart disease in this blog’s “Heart Chronicles” posts.) A crushing sensation sent me to my knees. Before I knew it, I was diagnosed with coronary artery disease. Two stent implants were placed in a major artery to prop it open. I was plagued by tachycardia, a too-rapid heartbeat, before the mild heart attack and various arrhythmias after, one being the dreaded A Fib. I have taken various medications with mixed results, one a common statin that caused severe muscle toxicity. In the first years I was in emergency rooms often. But over the years I have continued to exercise daily, decreasing inflamation, strengthening the heart muscle and, so far, outliving my prognosis.

At the memorial service I noted how much we all have survived of life. Everyone in my family is a “doer,” eager to learn and accomplish things. We do not fit the typical heart disease profile, for the most part. We are physically active, even rather daring. It is fair to note we are intellectually engaged and creatively oriented, with spiritual beliefs that keep us resilient. No one could accuse us of being disinterested in or lacksadaisical about living. All are happy travellers; college educated to various degrees; eat well and healthily, overall. We have had our share of bad habits to overcome, but my cardiologist still thought my smoking years prior to the diagnosis could not have been enough to tip the balance.

Genetics are the common denominator. The family tree is hearty and adaptable as many, if not most, are. We have been seriously ill only to rebound countless times. Being of the mind that attitude makes a significant difference, and prayer guides and even heals, our essential modus operandi is to live lives of full immersion, with faith and hope.

We live with heart, how else would anyone choose to live? Not without errors or some regrets, certainly, but with an expectation of joyful moments shared. Compassion and common courtesies are both important. And there is a belief in vigorous, positive change when there are snags in life to address.

But we get heart disease despite all this. We are getting older, all of us in our sixties and seventies. It seems impossible to me. I don’t feel like the woman in that earlier photograph, nor do my brothers and sister feel slowed by health issues. My various siblings travel worldwide, perform music and shoot and exhibit photographs, go hang gliding and hot air ballooning, ride motorcycles; collect unusual items, make crafts, enjoy an entreprenurial bent and manage real estate. They also engage in quiet volunteer work and entertain friends and family with care and a joi de vivre.

I stop here and realize I am writing like mad in an attempt to stop the inexorable advance of this illness. To at least impede it, to put it off with my words, a fortress against loss. I tell myself: see how people can live despite the heart’s glitches, its failures? How can it harm us when we love life this much?

But, indeed, why not? This is the way of the human body: it is born, it is an instrument of wonder and navigates us through our complicated lives, it gets hurt and heals, it gets loved and reviled, it brings us to one another and separates us. It does its work day in, day out, exquisitely made, harmoniously humming most of the time for the majority of us. Until it cannot. We all pass this way and then, pass on.

It hurts me to say it. Truth reaches into that tenderest place when every bit of life is known to be mighty yet fragile. It is a precarious balance, more than we know–if we realized how delicate, how thin the veil between life and death we would be awestruck as well feel fearful to get up each day, making elaborate plans that can be erased in a breath, a blink. But we do, and too often forget how fortunate we are to have the will and means to do so.

So how does a family–how do I–live with the knowledge of heart disease, the potential for ending our days too soon? We can’t have surgery to excise the heart. We can undergo only so many procedures, in the end. So the conditions are acknowledged. We call and email to check in when we live far away. We come to the hospital when we live nearby. We rally for each other and share information, reassure and embrace one another. We pray and offer healing love. We will likely attend more memorials. But we don’t belabor it, nor do we gather around to bemoan mortality. We must enter this moment with a finely refocused appreciation of all we still can discover, do, be.

I loved Marinell in ways no language on earth can ever entirely and accurately illuminate. It is alright. How little time we have with one another, how we are charged with caring, must practice such love. Let the heart have its due, feed it, fill it, make it your first priority, listen to its music and wisdom and honor it with who you are until it has danced all dances with you, then leads you into a final bow.



Do Not Forget Your Own Heart


I am not wild about Valentine’s Day. Like many, I believe it is a commercial ploy to boost lackluster sales following the holidays. That said, I still made a Valentines’ Day card with two of my grandchildren recently. We love poster paints, acrylics, watercolors, felt tips, crayons and colored pencils–the lot. They are natural artists, finding new ways to make old concepts interesting, into magnets for eye and heart. I just like to play. The card I made included seven hearts for my five children, my spouse and even myself.

Why me? Well, I’m part of the family, after all. But there is more to it than that. You will begin to understand if you look closely at the image I have shared above from the American Heart Association. They posted it on a Facebook page today, and asked how viewers loved their own hearts. And since I was diagnosed with aggressive coronary artery disease at the comparatively young age of fifty-one, it struck me as a good thing. So I want to share with you these thoughts today:

Respect your heart; it’s place in your life is paramount. Adore it. Take it out for a rousing walk every day, even on adventures you think you can’t manage but somehow do. The deeper it beats the greater its joy. It will perk up at the attention and be good company no matter what’s around the corner.

Talk to it. Share your awe at its mighty power. Then tell it stories that are rooted in triumphs over trials, random altruistic deeds and vibrant, far-reaching hopes. Show it the best seat in the house, like an old trusted friend who attends every single show. It will want to see every last scene.

Make sure it has opportunities to be courageous; it has the impulses of the brave and stalwart already. Has your heart forgotten you when you forgot it? If it has even failed to give your sinew and bone the strength that it needs, it is not for lack of trying. It came into your possession already a fearsome warrior.

Let it sing even when you are startled by its plaintive or peculiar sounds and thumps. Tend to it immediately if it falters. The rhythms of its compositions are from the stream of celestial music that powers the spheres and lights our skies. Be reminded that God is the grand composer, you the prefect instrument.

Listen to its wisdom; we are given a heart so that our every plane of existence has ready guidance. Encourage it to laugh so that it expands every cell and finds relief from all its labors. But please also let it weep, for the potent tears of the heart purify its blood; without weeping it will close up and then divide against itself.

Breathe. Breathe the fragrances of your beloved’s skin and your grandchild’s hair, the scent of warm bread, wild and subtle winds from the four corners. Rest among wild things. Revel in the earth’s treasures and the blessed waters. Pull beauty into the heart’s chambers and grant it peace.

Dance with your heart, leap and fling your arms wide so it bounces against your ribs and resettles when you drift along the horizon of your living. Let it carry you into odd moments and release you into wonder. Are you sitting still even now? Get up and move for no good reason. Jump into the center of you; give your heart its due.


Create for it. Expose your dreams, feelings and fascinating random imaginings. The heart likes nothing more than to be moved or flabbergasted by something new. Submitting to the thrill of capturing an idea and giving it structure refuels us. We are born creators because we are part of God. Your heart knows this even if you do not.

Feed it so it runs as well as it can. Not too much, but foods fresh with color and taste that prepare you for greater things. Eat only what fills the need so that your body is grateful for its nourishment and not burdened. And add chocolate or chilies; be impertinent and surprise your body.

Share this heart that you were made to have and to hold all your worldly days. When someone reaches, hands echoing with emptiness or regret or misery, reach back. Don’t be afraid. If there is a lack of grace, just let your heart speak. When someone falls to their knees, let your heart lie down beside theirs and speak to it. This is all that you both will need.

Do you believe you are alone? You will be made ready for love if you tend it and offer it. It may take patience; it does take courage. Your loneliness is the result of forgetting you live here among friends. We all are alone. But we have human hearts that want to know one another. They save us from ourselves. Our hearts know we are in this together.

When your day is done, do this last thing: look to your heart. Unload any weight it carries. Pray for its freedom from resentments. Soothe it with psalms for the living. For this day has brought you to this moment, to this night. And whether hearty or frail, your heart is still beating, beating like the wings of a mighty messenger, teaching and carrying you through this brief life. Be merciful, be kind to it, and it will fill you with strength enough to go the remaining miles.