"When I live in the past, I live in regret. When I live in the future, I live in fear. When I stay in the NOW everything's always OK."
This is a follow-up on yesterdays theme. You should not live in the past - look at it, remember, cry and move on. As I said-- living in the future will make you project and have expectations that might not happen. Live in the moment. Live in the NOW. Yesterday I have to apologize to you the reader. I didn't have the energy to write more. I couldn't. I was paralyzed with emotion. Yes, I am a doctor. It becomes difficult at times.
I am very grateful for what I have--health-wise especially. I do not mind the time spent with patients, but watching them get older can depress me. A patient of mine for more than 15 years is struggling. He is now 97 years old. A Count from Austria. A brilliant portrait painter who is now blind. A loving wife. I want to make all comfortable for him. Sometimes I cannot change the outcome. Then I go to the other extreme, where a young brilliant vibrant man must deal with the thought of chemotherapy. Not a pleasant thought. Think of how lucky you are. I guess it is hard to imagine that because you do not encounter what I see on a everyday basis. BE GRATEFUL. You also need to have a Purpose in Life. Check out the song from the play Avenue Q called PURPOSE. We all need a purpose in life.
Continuing with the heart...
Two days ago we discussed the atrioventricular valves: tricuspid valve on the right and the mitral valve on the left. These are the valves that separate the top chambers from the bottom chambers. All valves can develop disease. Diseases of the valve can result in valves that are too tight, called stenotic or too loose or leaky, called insufficient or regurgitant. For example when you have a leaky mitral valve it is called Mitral Valve Regurgitation. If you have a tight aortic valve due to rheumatic fever or calcium on the valve, it is called Aortic Stenosis. Usually the natural progression of valve disease will lead to a Valve replacement.
There are medications and supplements that can keep the valves in check and delay a possible replacement. The only valve that will definietly need to be replaced if it gets too stenotic is the Aortic Valve. This is the valve that separates the movement of oxygenated blood from left ventricle to aorta, thus to the whole body. As I describe valvular heart disease to a patient, I relate it to a Kay Kyser song Slow Boat to China. (I'd Like to Get You on a) Slow Boat to China is a popular song by Frank Loesser, published in 1947. The song is a well-known pop standard, recorded by many artists including Rosemary Clooney, Ella Fitzgerald, Jimmy Buffett, Fats Domino and Liza Minnelli. Bette Midler and Barry Manilow recorded the song for Bette's album Bette Midler Sings the Rosemary Clooney Songbook (2003). Miss Piggy performed the song with actor Roger Moore an episode of "The Muppet Show". This song is featured prominently in the Peter Greenaway film 8½ Women.
I tell the patient they are eventually heading to China (the operation for the valve), so we just need to know the right timing of the replacement. If they reach China (with cardiac symptoms) before a valve is done the valve might be not needed. There is the correct timing to replace any valve. Surgeons like to replace valves before major cardiac symptoms appear.
More on valves this weekend...
SLOW BOAT TO CHINA
I'd love to get you
On a slow boat to China
All to myself alone
Get you and keep you
In my arms ever more
Leave all your lovers
Weepin' on a far away shore
Out on the briny
With the moon big and shiny
Melting your heart of stone
Honey I'd love to get you
On a slow boat to China
All by myself alone
[Instrumental]
I'd love to get ya
On a slow boat to China
All to myself alone
A twist in the rudder
And a rip in the sails
Drifting and dreamin'
Honey throw the compass over the rail
Out on the ocean
Far from all the commotion
Melting your heart of stone
Honey I'd love to get you
On a slow boat to China
All to myself alone
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