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| Aug. 2005, Carnival Cruises. Passing the time. |
"Extreme exercise induced cardiac arrhythmia" was the cause of Roman's death.
For those of you without a medical background, a cardiac arrhythmia is an electrical problem in the heart where is does not coordinate beats properly. In layman's terms, the final cause of death was basically, "his heart stopped when he was running."
The autopsy report concluded that other factors contributed too. Specifically, a congenital small right coronary artery, left ventricular myocardial hypertrophy, and terminal hyperglycemia. Though, in all, I was struck by the simplicity of the report. Mostly it just confirmed his overall health, with the exception of three contributing factors. All of which were determined based on the autopsy exam itself. So when I finally received the report just after Christmas in 2007, I could not believe it took so long to complete.
"They must have been too busy to complete a decent report.." I thought; especially since I'd called several times to let them know Roman's history of physical oddities. The investigator I spoke to was the same one I'd yelled at the night of his final collapse. The same one who left me a pamphlet on bereavement along with her business card. The same investigator who delivered the reality blow that night. Roman was really gone. Deceased. Roman was now officially "the decedent." And I called the number on the business card several times for information. Mostly, though I called to give information, not to receive it.
"Roman was a vegetarian," I told the investigator. "His hands were cold a lot..he used to say 'cold hands warm heart' a lot...He was always tired before he died."
I probably rambled on and on. In truth, now I remember little about the conversations other than the snapshots taken in my mind. My memory of that time is like a movie played on a screen behind a flashing strobe light. It's choppy. My scribbled notes are what I have as reminders for this post about what I said on each call.
Apparently I wrote down bullet points before calling so I wouldn't forget. Yet inevitably, after finishing one call, I'd remember something else..so I'd call back and tell her. I'm sure I sounded neurotic. She'd probably heard from crazed widows thousands of times. Nonetheless, she was polite and seemed interested in what I shared. Taking down the information, she consistently assured me she would share it with the forensic pathologist conducting the autopsy.
"He hadn't been eating well before he died...He had a really fast metabolism," I told her on another call. "It was really, really, really fast.." I explained.
When Roman and I got married, I gained 20 pounds right away. I'd started cooking dinners and eating more regularly than I had in the days when Roman and I were just dating. Extra calories stuck to me, but had no visible impact on Roman's weight. We assumed the difference was due to the five year age difference I had on Roman. Plus, he was a runner..We thought nothing of it....Sort of. We just didn't know what we were looking at.
But when we went out for sushi, Roman could eat so much food that servers regularly asked if he was sure he wanted to order so much. They mistook him for a sushi newbie who was without knowledge of how filling sushi rolls are. Roman already knew that though. He loved sushi and could easily eat five rolls himself, in addition to soup, edemame, and dessert. He ate so much once in Vegas that the server showed the cleaned plate to the other employees. She probably lost a bet on account of him. He didn't look like it, but Roman could eat. It was funny how much he could consume, but afterward he often got what I termed, "the hacks." Roman developed phlegm in his throat after eating and cleared his throat to the point that it was gross for an hour after a meal. I never hacked like that. Not only did I find it unappetizing, I also thought it was peculiar.
The investigator wrote my input down. I could tell by how she paused and asked questions. When she was ready, I continued onto the next bullet on my list...
"And he used to make this smell..It was the weirdest smell.."
Readers, believe me when I tell you, as a self-proclaimed potty humor enthusiast, I know how that sentence sounds. Roman and I used to joke about his "smells." Yeah, Roman made smells alright. He even had a special corner by the front door that I'd relegated him to whenever he was inclined to make said smells. But I wasn't talking toots when I called the investigator. I was referring to something chemical that came from his pores after he ran. It was alarming to me because it was so unusual.
My best description of it is bleach mixed with smog. That's what it smelled like. It wasn't nose pinching like punky B.O. It was more caustic, like a diluted Clorox mixture.
Roman couldn't smell it on himself. However, on occasions when he left his sweaty running clothes in the empty washer and the scent fermented; then he could smell it. It reeked! The neighbors could probably smell it (okay, not really, but it was strong..) True to form though, Roman thought nothing of it. I did however, and as long as I live, I'll never forget that smell. In fact, knowing how I burst into uncontrollable tears when memories are triggered, I would not be surprised if the odor reduced me to sobs upon recognizing it again.
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| One of my reminder notes for a call to the coroner. Oops..I scribbled "vegetarian" wrong. |
In an earlier post I told how I bought new clothes for Roman on my credit card shortly before he told me of his affair. His first sweating episode occurred that day, before we went shopping.
He'd gone running that afternoon. As usual, he came home and showered once he returned. About 30 minutes out of the shower, after getting dressed to go, he burst into beads of sweat all over his chest and back. The temperature was comfortable and he had been home from his run for an hour or so by then. Yet, for some reason beads of sweat burst from his pores like pellets. I could see the roundness of the beads of moisture in the way that his t-shirt became soaked with it.
Odd, he thought, though he didn't make much of it initially. Instead he simply changed his shirt and left the house with me to hit the mall. And then it happened again.
"Fuck...What the hell?!?" I remember he said as he turned around to go inside and change his shirt for the second time..
I told the investigator all about that. I also told her about his deteriorating vision and how we thought he just needed new glasses. Then there was the constant water drinking that I figured was healthy, and the bottle of Advil we found in his backpack the night he died.
"Roman never got headaches.." I continued, "...he must not have been feeling well."
She thanked me and assured me she'd pass it along. However, when I got the final autopsy report there was no mention of my calls or of Roman's history. Nothing about the hacks, the smell, the sweat, the vision, thirst, or anything. It simply states their examination and toxicology findings in a matter of fact fashion. The final conclusion being arrhythmia. His heart stopped.
Well, duh.
But obviously, I needed to know WHY for certain, even though after his death, his symptoms became painfully clear. He definitely had diabetes. Actually, my theory is type 1 pre-diabetes.
In retrospect, I think he was teetering on the edge of it for a long time. Our separation was stressful though and he wasn't eating well. In our parting words before he died he mentioned that he'd lost weight. It was something that haunted me and part of why I think I was so intent on informing the coroner of every single detail I could recall. Guilt ate at me. I was trying to do the right thing, even if it was a day late and a dollar short.
Roman's "hacks" were due to his difficulty metabolizing carbs. The smell was ketoacidosis, the sweating was an adrenaline misfire, and thirst, vision, fatigue, poor circulation, and body aches - all common in diabetics. Some symptoms were typical while others were not; though all subtly indicated a serious diease. And in hindsight, I think Roman felt worse than he let on. Roman was stoic. Complaining about ailments would have been too pedestrian - too human.
These days, I wonder if his declining health contributed toward his irritability. Partcilarly because he was so quiet about what he was feeling psysically. For me, I know I get cranky when I get sick. Considering all of the symptoms he had, it makes sense that it would've affected his mood. Who knows? I'll add it to the list of questions that will never be answered. Although, in my gut, I feel there is truth there.
In the end, it didnt matter that I called the investigator with his history. Well, it didnt matter to the outcome of the autopsy report at least. The autopsy report was slim, however, I suppose it was sufficient in doing it's job of identifying the cause of death. Diabetes came through in the toxicology reporting like it was being highlighted by a giant spotlight. He ate a peanut butter and jelly sandwich, washed down by a Gatorade. Roman said he was told by the doctors after his first collapse to drink Gatorade prior to running, to maintain electrolytes. Fine for a person in good health, but for a diabetic, that meal was practically arsenic.
Normal blood sugar is around 100. Roman's postmortem blood sugar was 596; a number that high is lethal all by itself. Never mind the added heart problems he had in addition. Without medical intervention, Roman's days were probably numbered.
It's possible that I helped prolong his life by cooking healthy food for him for so long. I'll never know for sure. But no doubt my crazed calls to the investigator were part of my guilt as well as my continued need to take care of him. Perhaps they were also my intuition repairing me to better understand Roman's hidden killer. I wish he would have listened to the signs. He didnt though, so the rest is history. He chose to be silent and stoic. Nothing can be done for Roman, "the decedent," now; but for readers today, things could be different.
If you are reading this thinking his symptoms sound familiar; consider this the whisper you've been waiting for. It's time to do a favor to you and those you love, and follow up. Doing so could save your life. You've been nudged. Now go.
