Wednesday, May 31, 2006

A heart day's night

The last time it happened was December 2000, but it stuck with me enough to know exactly what was going on.
I motioned my wife over to me. "Listen," I said, pointing at my chest.
She, too, remembered. “It’s gurgling. We need to go.”
The gurgling she referred to was my ticker, which had just gone into what is known as atrial fibrillation, an incredibly annoying condition in which your heart beats all goofy, and it feels like there is a squirrel trying to escape from your chest.
Well, I say that it’s annoying, but I suppose other words could be used, since, left untreated, it can lead to stroke, which most would categorize as slightly beyond a simple annoyance.
I told my wife that I wanted to give it a little bit of time to see if it would get in line on its own. She did not think this was a wise course of action. I reminded her that the last time it happened, I waited all day, and even drove myself to the emergency room, so I would appreciate it if she would describe the decision as “less dumb than less last time.”
After a few hours, my heartbeat was way too irregular for my liking, so I conceded it was time to go.
When we walked into the emergency room, I could not believe my eyes ¬-- total number of people in the waiting room: zero. I have never seen a bored triage unit in my life.
I walked in and said, “Hi, I’m in atrial fibrillation, and I’d like not to be.” Certainly no doubt in their mind why I was there.
When I got to the back, I was hooked up to a machine and, indeed, very clearly in a-fib. My heart pattern on the computer looked as though my 3-year-old had drawn it.
The first course of action was an IV-drip of the medicine that was used last time. In 2000, I had been admitted to the cardio ward, and spent the night in the hospital. From the get-go, I made it very clear that I would appreciate it if they knocked this out, unplugged me and let me go, thus avoiding the whole admitted thing. “I am not a captive,” I told my nurse.
“Well, when you check into ER with a heart condition, you’re my captive,” she said.
The first dose of medicine slowed my heart rate down some, but it was still irregular. Apparently, an irregular heartbeat makes for great television, because I had a steady stream of people stopping in to check out my monitor. Eventually, I stopped watching, because it’s awful trying to figure out what it means when someone raises their eyebrows and says, “Hmmmmm.”
A second round of medicine was administered to try and get the heartbeat regular. After about 15 minutes, it was clear that it was not going to work. By this time, the cardiologist had come in, and it sounded an awful lot like he was planning on admitting me for the night. He told me we could try one more dose of medicine, and, as a last resort before admitting, he said, “We can shock you.”
Getting shocked, it turns out, would be exactly what I thought it would be. They would sedate me and stick two paddles on my chest, and shoot me full of electricity, supposedly getting my heart back on a normal rhythm. I asked him if it would be like on TV. He told me that I would jump a little -- and maybe get a couple of burn marks on my chest -- but that I wouldn’t flop off the bed like on TV. Bummer.
Much to my wife’s surprise, I told him that, if the last round of medicine didn’t work -- shock away. (In 2000, when the idea of shocking was presented, I was only calmed with the help of our good friends in the pharmaceutical industry.) But for some reason, I was ready to rock. Let’s do it.
The doctor said he would give the medicine 15 minutes to work, and then it was shock time. The doctor, nurse and my wife stood and watched the monitor. I watched the clock. At the 13-minute mark, the look on the doctor’s face changed. He turned to me. “I don’t think I’m gonna get to shock you,” he said, almost seeming a little sad. My heart had gotten back into gear, and I would be checking out soon.
The doctor has named caffeine as the main culprit. And I can see that. I love some coffee. As it is now, I am on day three without caffeine, and it’s actually not that bad. The last time this happened, I adjusted a few things here and there (such as NOT drinking four pots of coffee a day and extending my hourly sleep to at least four hours) and was on the mend in no time. I like to think of this as an isolated incident, and hopefully it won’t happen again. For one thing, no matter how tough I tried to act, I REALLY don’t want to get shocked.

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