My AAA aneurysm

When I lie down on my back and reach across my abdomen a bit to the left side, I am able to detect my heart beat quite easily. In February of 2023 I found out that I can do this so easily because I have a Triple-A aneurysm there -- an Abdominal Aortic Aneurysm. This is a ballooning of the aorta that comes down from the heart on its way to the legs and the lower body. Because it is rather large as such things go, we know that it is old and likely growing pretty fast now. Of course, the problem with balloons ballooning is that they burst.

Since looking at that likely near future entails its own problems, I have been rather preoccupied by those since February and have only now, in early March of 2023, come to a personally peaceful resolution of the problems. One problem for me is just letting others know what's happening with me, and so I'm starting the blog to do that, and to offer those who are interested in knowing more a chance to find out by reading as much as they like of the posts I intend to make subsequent to this first one.

AAA Options

Staying on Track

Casey Jones stayed on track to the very end, and I aim to emulate him.  Unlike me, Casey appears to have been on track all his life. I like to think, however, that I am me, here now, on track until the next derailment, when I'll get back on.

Come all you rounders if you wanna hear
The story about a brave engineer
Casey Jones was the roller's name
On a 6-8-wheeler course he rode to fame
Caller called Casey 'bout half past four
He kissed his wife at the station door
He climbed in the cabin with his orders in his hand
Said "this is the trip to the Promised Land"

Casey Jones, climbed in the cabin
Casey Jones, orders in his hand
Casey Jones, leanin' out the window
Takin' a trip to the Promised Land

Through South Memphis Yards on a fly
Rain been a fallin' and the water was high
Everybody knew by the engine's moan
That the man at the throttle was Casey Jones

Well Jones said "Fireman now don't you fret"
Sim Webb said "I ain't a givin' up yet"
We're eight hours late with the southbound mail
We'll be on time or we're leavin' the rails

Casey Jones, climbed in the cabin
Casey Jones, orders in his hand
Casey Jones, leanin' out the window
Takin' a trip to the Promised Land

Dead on the rail was a passenger train
Blood was a boilin' in Casey's brain
Casey said "Hey, look out ahead,
Sim, jump, Sim, jump, or we'll all be dead!"

With a hand on a whistle and a hand on a brake
North Mississippi was wide awake
IC railroad officials said
"He's a good engineer to be a laying dead"

Casey Jones, climbed in the cabin
Casey Jones, orders in his hand
Casey Jones, leanin' out the window
Takin' a trip to the Promised Land

Headaches and heartaches and all kind of pain
Are all a part of the railroad train
Sweat and toil, the good and the grand
Are part of the life of a railroad man

Casey Jones, climbed in the cabin
Casey Jones, orders in his hand
Casey Jones, leanin' out the window
Takin' a trip to the Promised Land

For a few links into the real story (essentially the same as told in the lyrics) see here.

 

Following up and Moving on

     At eighty-nine now I'm a lot closer to my place of rest than I was back with Grandmother in nineteen thirty-six or seven. In that childhood west of Joplin then I can still hear my grandmother crooning soothing lullaby to me as she walks around the house holding me in her arms. The last and still lingering with me remnants of the cocoon.

     My other memories mostly center around the imaginal process of the dissolving caterpillar creating its own butterfly. An early instance has me careening down a big hill on my new, first bike -- imagining a Superman sort of takeoff soon but discovering that a bike without coaster brakes spins those pedals mighty fast on the way down a steep hill. The spill on that hill corrected my imagining smartly without doing much damage to my limber young body, and it also set the pattern for my future imaginings in the absence of a father's minding presence.

This young lad is about to discover that the heavy door before him swings inward.

    We construct our lives out of discoveries like that, and certainly we all run into doors that open the wrong way. It makes a difference to be in a chrysalis rather than a cocoon, and just what kind of either we are in nourishes and shapes the stories we grow into. So does the fierceness and inventive flexibility of our intentionality. I have a lot of hope for the guy.

     I photographed him and his father at Prescott's Wild Iris Cafe sometime in the early 2020's. I would go there often for the ambiance, as we say, for the connectedness and windings in with others that arise to envelop us from time to time while still leaving us free to read our paper or chat with our friends. And I still do, but this musing is not a memoir, nor do I want it to be an endless mulling over of the last lines of Milton's Paradise Lost. So I'll finish up for now by quoting them from this source and emphasizing a line or two myself.

                                                .... whereat

In either hand the hastning Angel caught

Our lingring Parents, and to th' Eastern Gate

Led them direct, and down the Cliff as fast

To the subjected Plaine; then disappeer'd. 

They looking back, all th' Eastern side beheld

Of Paradise, so late thir happie seat,

Wav'd over by that flaming Brand, the Gate

With dreadful Faces throng'd and fierie Armes: 

Som natural tears they drop'd, but wip'd them soon;

The World was all before them, where to choose

Thir place of rest, and Providence thir guide:

They hand in hand with wandring steps and slow,

Through Eden took thir solitarie way.

Metamorphosis without cocoon

I am writing this on paper with a pen at the Century Lounge on Cortez Street in Prescott, Arizona in late February of 2025.

It is a cafe I visit from time to time, but I had to get up and go look at the door to recall the name. This is what it's like when you make your metamorphosis without a cocoon.

    The cocoon, as I understand it from friend Brenda Lin, who says she heard it from her mother at a young age, is spun by silk worms out of themselves as one long strand of wrapping up into the cocoon.

    She talks about strands and wrappers and umbilical cords in an engaging essay on connectedness in family that is filled with texture, textiles, and the baby's shove of shoulders in the womb. Across four generations.

    That's why I'm writing with a pen on paper -- there is a feel and a drag to it. Tactile. The sort of thing that links and connects in small ways that are important in large ways not usually seen, which is what Brenda writes about.

    Thinking about my own links and connections, I see that I am more like the Monarch flutterby. Not in the way of regal, of course, but for sure in the way of the imaginal.

That's the name the lepidopterists give to the mysterious soup the caterpillar dissolves into after it hangs itself up on a milkweed somewhere and grows its hard-shell chrysalis. Inside that womb, the caterpillar dissolves into a soup of good stuff and its imaginal cells, who figure out just what butterfly they want to make out of this stuff, and then after some shoulder pushing, out they come as the Monarch.

    The tricky part for me, all wrapped up in this metaphor, is to get back home again. We know that the butterfly has a pretty tough time of it, traveling for three or four months as much as three thousand miles down to its great-grandmother's home tree in Mexico, a place she left half a year ago, but where it's never been before.

    My dissolution came in the Great Depression, in 1936 or '37, when I was a year old and my father's still persisting ice-cream shop in Joplin, Missouri dissolved into nothing he owned anymore, and he and my mother decided to head out for Phoenix to look for work. They left me in the care of my mother's mother, whose husband had just passed away, over the state line in Galena, Kansas. This left me without imaginals and I had to make do with my imagination.

 

 

That's me, not long out of the cocoon. My mother and the ice-cream store are in the background, and my life lies all before me, where to find my place of rest.

Why it feels so good to be as good as dead

(I wrote this back in March of 23 when I first got my AAA diagnosis. I update its date so that it appears now as the first thing readers see when they come here.)

The thing is you suddenly feel utterly free from all the fix'em/get'em thoughts.

Fix what you did wrong and fix what or who did you wrong or others or the world.

Suddenly  you have Beginner's Mind. You see that thing that happened, but you are someone looking at it (regarding, as Ekhart Tolle says, your pain body from a higher place). You see it less personally. You see it as that thing those people suffered or you suffered, and you who did that thing or suffered that thing are one of the people there.

This is a freeing perspective, seeing how you felt and how they felt, and not feeling shame or anger. You just see it with a certain sympathetic resonance.

And something like that perspective carries over to where you are now. You can feel that way not just for the happy toddler, say, but for the guy sitting across the table from you or anguishing by himself across the room. Or the gal. It's nice.

Tara Brach calls this attitude loving awareness, and it looks to me very much the same as what Ram Dass calls coming to the world with loving attention.

Just testing how this works after a year

 Hello, this is pretty straight-forward.

Well, I've been watching The Telepathy Tapes by Ky Dickens. Here's a link to her podcast:

https://www.youtube.com/@TheTelepathyTapes

I chose to listen to the ten items in order from 1 to 10. Afterwords I decided to purchase access to some video of the non-speakers' testing from Dickens' website.

The effect of careful listening was to draw me in very close to what was happening. The sense of personal closeness with the people making the documentary and the people being documented was quite strong. This way things seemed real rather than reported.

My AAA choice

I have chosen to do nothing.  When I made that choice, the state of my mind, my consciousness, was hugely altered for the better, happier, quieter.

Not for long, but for an evening. And now I find I can call it up again when I think to do so.

This is not a small thing. It is very large. When I go again to that frame of mind, I am notably more at peace with the world than before when I was somehow always warring with it. I was constantly judging others and recriminating with myself over past actions that could fill me with sudden chagrin. Now, much more, I tend simply to listen to, look at, and learn from both the now and the then.

I call that discerning. 

This new state of mind was not my intention; it just popped in one evening when I decided to do nothing about the aneurysm. I had reasons for the choice -- I didn't want the constant alertness to and testing for the common endo leaks and other issues with the stent. And I liked very much the idea of knowing with good probability that I would die quickly and suddenly when the aneurysm tears at last. If the stent procedure removes that likelihood, what manner of death am I going to discover down the line? And, of course, at 87 I knew I did not have a long ride ahead.

I develop this thinking a little more in my next post, Why it feels so good to be as good as dead.

AAA options

Do nothing. Open surgical repair. Endovascular repair.
Dr. Phong Le (Lay) is the only vascular surgeon in our town. I have met with him twice and submitted myself to the appropriate exams. I like and trust him a lot.
He recommends immediate endovascular repair, a relatively simple procedure that uses the two big arteries at the groin to implant a long stent inside the descending artery. The reasons for this are pretty obvious, the size of my aneurysm, 6.2 cm, my good health otherwise, and the 15 to 20% probability that the aneurysm will rupture on its own within a year. The EVAR as it is called only requires a night in the ICU and you walk out with a little assistance the next day. Within 2 weeks you are able to return to normal activity.
Open surgery is not a good idea for a person of my advanced age, 87, nor did the doctor recommend it.
Doing nothing requires that a person be ready for the consequences of course. The doctor's nurse said the first symptom of a rupture of the Triple A aneurysm was going unconscious. The second is death. The doctor, when I mentioned this to him, pointed out that he did many open surgeries in the ER on people whose AAA's ruptured and were in great pain. The medical literature I read says that up to 80% of the people who are rushed to the ER with a ruptured AAA don't survive the operation.
The EVAR is highly rated for safety and side-effects. However, the attachment of a stent popped open from inside the artery is not as secure as one sutured from the outside in open surgery, so you do a series of follow-up CAT scans to monitor the leakage that can and often does develop over time, and even during the EVAR procedure itself. These ENDO leaks are not generally dangerous, but can become more serious.

 

My AAA choice