Dr. Rap

Samuel A. Kojoglanian, MD, FACC, FSCAI

Codes come in many colors, depending on which hospital you serve. One code is universal and ominous: Code Blue, as one’s skin turns blue due to the lack of oxygen during a cardiac arrest.

I remember rushing to save my patient in a Code Blue. He was in his young 80’s, placed on a blood thinner to prevent clot formation after I opened his 100% blocked artery with a stent. Unbeknownst to me, the VA hospital later stopped this medication because he was “too old.” Shortly, a clot formed in the stent and my patient was dying. I reopened the artery emergently. His heart muscle was weakened and a man who played golf daily has become bed bound.

Our national debt is 13 trillion dollars, which increases by 2 million dollars every 60 seconds (Google: national debt clock). The newly passed health plan will cost in excess of 3 trillion dollars. Code Blue U.S.A.

This bill was passed, not by representing the peoples, but by telling us what we need; that is called arrogance, as pride does not listen. This bill was passed, not by promised transparency, but behind closed doors; that’s called deception, as it is conceived in fraud, is pregnant with evil, and will give birth to disillusionment.  Code Blue U.S.A.

If you want this health care, then you must welcome rationing. You must accept waiting in lines as one would at a County Hospital, only to find out you will not be seen that day. You must accept that either you are too old and will not receive appropriate care, or too young and haven’t suffered enough. This is deemed suitable by a government worker, who is on a break and refuses to listen to you because his job is secure despite poor performance.  You still say yes?  You will be like a thirsty man dreaming that he is drinking, but awaken faint, with your thirst unquenched. Code Blue U.S.A.

How do you fix this problem?

1)      Punish MDs who practice recklessly

2)      Shackle malpractice lawyers who sue frivolously

3)      Extend state lines for insurances to compete openly

4)      Toss out all czars who are but flesh and work unjustly

5)      Get the government out of medicine, who can’t even budget Social Security

6)      Pour money into preventive teaching and reap health exponentially

7)      Most importantly, invite God to heal our land, who loves all unconditionally

Code Blue U.S.A. Everyone clear? Shock and shock again, till truth kicks out arrogance, justice overrules greed, hope tramples lies, and life returns with humility and dignity.

For further information on your cardiovascular health, contact Dr. Kojoglanian, the Mender of Hearts, at (661) 259-1711; 24868 Apple Street #103, Santa Clarita, CA 91321. Website: drrap.com

Samuel A. Kojoglanian, MD, FACC, FSCAI

It was an innocent adjustment. The chiropractor took a hold of her neck and directed the muscles and bones in a way that was unfamiliar to her body. A loud crack was heard and there was silence by both parties. She said she felt better and he was pleased.

Mrs. T then contacted me regarding a severe headache after her adjustment. Because she was taking Coumadin, a notorious blood thinner, I was concerned. An MRI was done and bleeding was noted on both sides of the brain. The cause of her bleed could be assumed but not with certainty.

The neurosurgeon wanted the Coumadin held due to the bleed. I cautioned that Mrs. T had a mechanical heart valve and the blood thinner was essential.  

We could continue Coumadin and chance to worsen the bleeding, which would require burring holes in the scalp for drainage.  Or stop the Coumadin and take a chance that the mechanical heart valve may form a clot and cause strokes and heart failure.  No pressure!

The medical literature was scant. It said you could hold the Coumadin or you could continue it. Hello!  At times books, experience and education don’t have the answers.

I then had to weigh the situation. The valve was in an area with enormous pressure, in the aortic region, which was to our patient’s advantage. The pressure generated would hopefully provide enough “lubrication” that we could chance being off the blood thinner.  I tapped into my colleagues experiences and asked for their advice. Above all, I asked the good Lord to help me provide the best care for my patient.

During the tough moments in life I encourage you to do 3 things. Weigh, Stay, and Pray. Weigh the situation, give the pros and cons, and attempt to find a resolution with what seems to tilt the balance. Stay the course; don’t despair, don’t give up, don’t turn back, ask (the right people) for advice. Pray, above all, pray that the God of mercy, goodness, and love will guide you to make the appropriate choice for the given situation. Coumadin was held for 2 weeks, a small dose of aspirin was given daily, and by God’s grace, our patient did well.

Samuel Kojoglanian, MD, FACC, FSCAI

Rushed to the ER, his heart was racing out of his chest.  He had an arrhythmia that could turn fatal. Medications were given with no resolution. I was called and we gave another medication that aborted the bad rhythm.

Our patient had been well, but days before, his son and the son’s girlfriend were getting drunk and doing drugs in Dad’s front yard. The girlfriend said something about the son’s previous wife, and laughter turned into violence. He kicked her until her jaw and nose broke. Dad tried to run after his son, but fear whispered its caution. Police were called and his son was incarcerated.

Despite Dad’s faith and happy disposition, his heart tasted a moment of jagged despair. The calm in his heart turned into a troubled storm and a hospital admission was required.  Once stabilized, he was released.

Moments before, I had visited another patient in the ICU with a stroke in his young 50’s. He could not move his left side nor articulate his thoughts.  He wore a nicotine patch, which was a sign of his smoking history. His clothes had a stench which signaled heavy smoking. His family was crushed.

At the end of the day, I was speaking to one of my patient’s wife. She stated that his legs were cramping. I had already opened up his leg arteries with stents and advised him to stop smoking. He continued to smoke. My patient asked why he had the pain. “You’re ruining your life with your smoking.” “They blame everything on smoking,” he said. “Yes, and whoever they are, they’re right,” I said.

Decisions over a split second or a lifetime can adversely affect a person, families and communities. Drugs mess up someone’s heart, brain, and body. Affairs mess up families. And lies mess up relationships. This is not a judgment. It’s simple life-mathematics.

No college degrees are needed to figure out this math.  If a farmer sows for watermelons, he won’t run out to reap corn at harvest. This life-math doesn’t add up; it multiplies. Lies hurt many. Drugs hurt families. Decisions slash the hearts of communities. Get out your calculators. It’s time to take an inventory of the seeds we sow, toss out the bad, and cling to the seeds of patience, kindness, goodness, gentleness and self control.

Samuel A. Kojoglanian, MD, FACC, FSCAI

The branches had mightily grown over the years, peering over the wall from my neighbor’s trees, and had encroached on the roof and gutters of my home. I asked my neighbor for permission to cut some of the branches and she consented.

With the help of my friend who stood fearlessly on his scaffold, the branches tumbled down and invaded the grass completely like a band of locusts that could cover up the skies.  In less than 10 minutes the chain saw cutting was complete, but the cleaning was to follow.

We’d finish filling a bin, and start on another. Surely this was not taking over 3 hours, but the sun’s heat got stronger while the pile of work seemed to get larger. The grass was saturated with leaves, twigs, and berries, while gloved hands were used like rakes as large twigs were scooped, stripped bare, and tossed.

Cutting seemed so simple, yet the cleaning seemed so tedious. It’s strange that the whole event reminded me of words that are spoken.  Offered in split seconds, words have the potential to tear, demean and slash, delivered with chain saw like power. We seem to applaud people who are shrewd and quick with their words, yet to dissect it may simply reveal a cloth of sarcasm laced with malice, envy and anger.

It’s not so much the quickness of the cut, but the berries that stain and the lost green leaves that are tossed. Words may be words, yet their harsh voice which streams from the heart, causes deep sorrow to those around us. I often wonder why some of my patients have heart problems, yet they have not smoked, nor have diabetes, nor hypertension, nor are enslaved by gluttony.  Is there such a thing as a broken heart?  Judging from the berries on the ground, I think there is.

Reckless words pierce like a sword, but the tongue of the wise brings healing according to Proverbs 12:18. I’d like to challenge you and me to be known as peoples, families and communities with words of kindness, compassion, truth and grace. For in the end, there will be less berries and twigs to toss in the bin.

 Samuel Kojoglanian, MD, FACC, FSCAI

A couple of months  ago when the winds ruled the land of Santa Clarita,  I found the backyard basketball goal, once firmly secured in concrete, face down on the ground. Rust had revealed its ugly face and undermined the integrity of the steel pole on which the manufacturers had proudly stamped “Lifetime.” 

The water from the sprinkler system had gently jabbed at the pole over years, softening the steel, and allowing the winds to deal the last insult. The backboard that read “Shatter Proof” was in 100’s of pieces.

Because of my schedule, I left to see my patients, the first being Mr. H. He had been playing golf and smoking his cigars when he felt back pains. He ignored it, as he had been for 2 months, finished the round and played another 18 holes. The next day, the Arizona weather didn’t allow another swing . He set out to go home, but felt ill. His friend who was driving him asked if he was alright. “No, you better stop.” He got out of the car and collapsed on the road.

Mr. H was rushed to the hospital where he was diagnosed with an abdominal aortic dissection (tear in the biggest artery, causing internal bleeding). He was rushed via air to a hospital that could handle an emergency of this magnitude. The surgeons found the problem and saved his life.

After his hospitalization, Mr. H visited me in the office. “Man, God surely smiled at you when He got you from the ground to the hospital…and look at you…you’re alive!” He smiled and asked about playing golf. “You still smoking?” “Yes, Dr. K…I know, I’ve got to quit.” “Are you kidding me? You’re a miracle! You are going to stop today! ”

 I told him about the “Lifetime” basketball story and how the water and the wind grinded away at the pole. “It’s that nasty nicotine that’s tearing away at your arteries! Hey bud, do you want to die prematurely, fall and never get up?” He was surprised with my question, and with tears in his eyes, he said, “I quit Doc, I quit!” We celebrated life that day, and I was thankful that the “Lifetime” pole offered insight in helping my patient live a better life.

For further information on your cardiovascular health, contact Dr. Kojoglanian, the Mender of Hearts, at (661) 259-1711. 24868 Apple Street #103, Santa Clarita. Web site: drrap.com

THE RYAN FACTOR
Samuel A. Kojoglanian, MD, FACC

Ryan is a most gifted 10 year old athlete, breaking records set years before him by older kids. Whether he’s on the basketball court, football field, or swimming pool, Ryan excels and rises above the competition. One of his coaches promised to give one member of the team a Wii game as a price for the most improved and the athlete with the best attitude. It was no surprise that Ryan was selected by the coaches.

The head coach called Ryan’s Dad one day before the banquet and told him that Ryan will be getting the price. Ryan already had a Wii and was actually saddened by the news. All the kids had a Wii expect one team member, and Ryan wanted his friend to receive the price. Ryan actually declined the Wii. On banquet day, Ryan was given the honor to pick a name out of a bag. His hand stirred the names, shuffling over and over, as he hoped for a miracle. He pulled the name out and started jumping up and down for joy. “Yes, yes, yes!!” It was his friend’s name, the one who didn’t have the Wii. Ryan couldn’t contain his joy. Those present say that Ryan was more excited that night than his friend who won the price.

I marvel at Ryan’s attitude and heart. If fact, I must learn from it. The Ryan Factor. I believe Ryan’s outlook could change the greed of the corporate world and the calloused and tainted hearts of the czars. I believe that if you and I had a hint of Ryan’s kind and tender heart we would be more forgiving. I believe a gift of chocolate, cookies, Wiis or bigger things are not replacements for the precious time spent with loved ones. I believe that in the world of texting and meeting deadlines, we are missing out on the joy of celebrating life and friendships. The Ryan Factor, and above all, the gift of Christmas, the Father’s sacrifice of His Son, Christ, remind me of this and inspire me to excel in kindness.

 Thank you Ryan for reminding us all. May our hearts change and may we shine in the gift of giving.

For further information on your cardiovascular health, contact Dr. Kojoglanian, the Mender of Hearts, at (661) 259-1711; 24868 Apple Street #103, Santa Clarita, CA 91321. Website: drrap.com

 Samuel A Kojoglanian, MD, FACC, FSCAI

An 18 year old patient was seeing me for chest pains. He hesitantly admitted he was using GHB (Gamma Hydroxybutyric Acid), liquid ecstasy.  “I’ve missed out on so much! I want to live…but I’m careful! This drug makes me feel like I can’t breathe!” “Breathing is a good thing, don’t you think?”  “Yeah, I guess, the other day, I took GHB, mom’s Vicodin, dad’s liquor, and just went wild; I don’t know how I made it, but now I’m better  Dr. K!”

 “Tell me something bud,” I asked my patient, “are you seeking to live, or are you preparing to die?” It was then that my patient began to cry uncontrollably, and admitted that he needed help, which he is now getting.

Prescription pills are more abused by teens than cocaine, heroin, or methamphetamines. Kids who shy away from street drugs believe these pills are acceptable. Harmful drugs can be “legal”, such as Vicodin, and are probably found in your house.  Teens are taking pills from their parent’s or friend’s medicine cabinets, and sharing them at school and parties. Sadly, adults are not any more conscientious.

Most have no idea what they’re taking. It’s not like a teen has a chemistry degree and pulls out the Periodic Table of Elements and recites his dissertation.  I don’t think they’ve seen a previous patient of mine who was alive yet dead after taking drugs in a party when he surrendered to peer pressure. Not only was it his first time, but it was his last time. He was convulsing on the floor while his peers cheered him on, only to find out he wasn’t break dancing, but having a seizure. The music was silenced by sirens. An MRA of the brain revealed an infarcted brain. Eyes open, but no one home, forever in bondage on a ventilator and never to speak again.

The effects of drugs, including alcohol, are deadly. Experiments in this lab lead to maimed brains and tattered bodies. Consider the ventilator jammed down your throat with your eyes open, but not being able to speak, hear, feel or love. Consider your family as they suffer by your bedside.  Consider being alive, yet dead the dead next time you reach for drugs.