Man, Oh, Mangina!

It's been about two weeks since the apex of this story, and I know I've been a bit remiss in detailing this tale involving my brother; however, I figure I should share (or document herein, as I feel a lot of folks reading this already know what's going on) for continuity.

Brother is three years my junior. He's 6'2" or 6'4" (thereabouts) and at the apex of this story, he tipped in at "four and a half bucks," or as I like to say, he's built like a Berlin Butcher. 

He inherited either/or/both, the RA from mom's side of the family and the psoriatic arthritis from dad's side of the family. 

On or about (BEFORE) Father's Day, he was put on Embrel. We are not sure if this was the tipping point, trigger or what, but he started to withhold/gain a lot of water weight, an alarming amount at an alarming rate. I started getting second hand reports from Audrey and my sister about it. It got to the point where his legs were so swollen, he couldn't bend them, and it was almost to the point where he could not wear long pants.

The fluid started working its way upward around the midsection, and he has had a weird, wet sounding "lungular" type cough. 

All this alone would have been enough for ME to take my ass to the doctor. Not him. Hell. He retained so much fluid, his testicles were the size of grapefruits and his penis had fully retracted inwards, forming a "mangina" (man + vagina = you guessed it). THAT alone should have been the tipping point to get his ass into the hospital.

But, no.

I believe he wanted to keep his perfect attendance at work, and was holding out until Friday, so as to keep his perfect attendance. Things kept escalating. Thursday he went into work, only to have his shop foreman tell him "get your ass to the ER." Despite weeks of all of us telling my brother to go, it took someone with a penis to tell him to go and whaddayaknow? He went.

Each day brought with it increasingly worrisome news. (And mind you, I get it all distilled thru my sister or my mother, and what news I get from my brother is so nebulous, I really don't know what to think.)

At first, allegedly, congestive heart failure was ruled out, and he was waiting to get cleared by a pulmonologist. At this point, he told me he has had his "Come to Jesus" moment and was ready to start the process to get the gastric bypass.

Next day, scratch that! He's got congestive heart failure (at age 43!).

Next day, he's got congestive heart failure and has a paltry 25% heart function left (at age 43!!). I warned him that he should let his nurses know his past history of blood clotting problems. They don't have the compression thingies on his legs and to my knowledge had not put him on blood thinners. He of course, neglected to mention this (sister is convinced he is in full on denial about that time when he was very little and almost died).

Next day (or perhaps the day after), BADABING! BLOOD CLOTS IN THE LEGS!

Next day he gets cleared (allegedly) by the pulmonologist, and no clots in the lungs, but still, what's up with the cough? (Ever since dad's passing nearly six years ago, my brother has had this weird cough, which has been misdiagnosed as pneumonia--it could very easily have been CHF masquerading all those years. The medical "care" where my family lives leaves a LOT to be desired. Again, you can lead a horse to water...)

All the while this is going on, there's a parallel storyline going on, involving the YentaBeast, who was in Florida visiting her mom, and her resistance/reluctance to come home, despite the fact that he was in the hospital, in crisis. We can only deduce it was out of spite, given that my brother refused to pay for her to visit her mom, her mother paid, and the delay of about five to six days before she finally came home just further cements in all our minds (even his) that YentaBeast is pretty much garbage wrapped in skin.

Next day, he gets transferred to a different hospital, and is on deck for a cardiac catheterization. All his focus was on was seeing his daughter, as clearly, he was convinced he was dying. YentaBeast finally shows up with my niece in tow, just in time before he has his procedure.

Next day, he has the cardiac cath, survives it. And as he told me, he didn't have any blockages. Sure, good news, but fuck it! 25% heart function? I guess he'll look for any bright spot he can at this point? 

Next day he gets the news that he is not a good candidate for a heart transplant due to all his other co-morbidities; and the flip side to this coin is, he cannot go in for the gastric bypass which could turn some of this shit around, because his heart is so weak.

Next day, he gets fitted with a "life vest," an external defibrillator he will have to wear for the rest of his life. The subtext of him wearing an external one vs having a surgically implanted one is pretty much he's a lost cause. Not sure why they did not put an internal one in, given that it's no more invasive of a procedure than the catheterization.

Next day, as weak as he was/is, they release him home.

Next day, I get a frantic voicemail at work from Audrey, "Your brother is being rushed back to the hospital. The defib is zapping him."  I text him calmly, "Everything okay?" He says "The alarm won't stop." I said, "Does it hurt, yanno, as it's zapping your heart?" He replies back, "It's just the alarm. It's not zapping me." In keeping with my boundaries regarding the phone as it pertains to Audrey, I don't bother to call her back. This is just her way of  drumming up drama to get a telephone call out of me.  I let a week slide before I called her for my usual call I make every 7-10 days.

It's been two weeks now, and despite my suggestion that he gets a second opinion, and all he has to do is say the word, and I"ll make arrangements with my cardiologist in NYC. Apparently he's lulled into some false sense of security or is in active denial or what, but has not taken me up on the suggestion. Doesn't matter that dad was 20 years older before he was battling congestive heart failure in his 60s, while my brother is enduring this in his 40s. And despite the obviousness that dad's dad died at age 50 from a heart attack (but by all accounts had drank himself to death), and dad had his first heart attack at age 50, my brother doesn't realize the severity of the situation and might not live to see 50 himself.

As I said to Audrey last night, you cannot live other people's lives for them. Dad delayed getting a second opinion until it was too late. My brother is going through this EARLIER than dad, is much worse off than dad right off the bat, and refuses to do anything (beyond getting a hospital bed for the house, and set himself up for a sleep study to get a CPAP finally). I refuse to let this tear me up inside for however long it takes him to die. I was continually destroyed for the final 17 years of dad's life. I don't have it in me to do this again.

As Yoda says,"Do or not do. There is no try." Well, he's not even really trying or doing, and yet in the not-doing? That still is an action. 

All I can focus in on or control is ME. And I am in the full on assessment stage, worrying and wondering if in having my bypass and losing what weight I have managed to lose, was enough to prevent this from being part of my own life narrative.

Two aphorisms/quotes apply herein: "Man makes plans, and God says HA!" and "God helps those who help themselves." I've planned... I just hope it HELPED my own health.