Friday, May 13, 2011

Arrhythmia ’n Bluz

I can’t say that there weren’t indicators that my ticker was becoming troublesome.  I first noticed when I was playing hockey, back in the mid-90s.  Some days, when I’d take a shift, I’d be completely gassed within 30 seconds.  One trip up the ice and back and I’d have to come off.  I felt fine, except I couldn’t breathe.

One of the doctors on our team gave me some great advice.  He said, “You know what the most common warning sign of a heart problem is?  A sudden, fatal heart attack.  Get that shit checked out.

That scared the shit out of me, so I did.  But the problem was that I was moving out of state in a matter of weeks.  Plus, my insurance was not very good.  I went to the doctor, but owing to the sporadic nature of my problems, he couldn’t pick it up.  He sent me home with this monitor that I was supposed to use when I had the problem.  Naturally, the one time I thought it was happening, the recorder didn’t show any irregularities.  Then I moved to Baltimore.

Life went on pretty much uneventfully.  I wasn’t really hampered in anything I tried to do.  But after the first couple of years, I wasn’t exercising all that much either, so I didn’t have too many opportunities to notice being out of breath.  Well, except walking up all the steps coming out of the subway.  I noticed that was getting harder and I was puffing more than I used to.  I chalked it up to getting older and being out of shape.

So, when I finally saw a doctor for the hive problem I wrote about in the last post, the doctor listened to my heartbeat for about 5 seconds and said, “Did you know you have an irregular heartbeat?

I was like, “Um, OK.”

Next thing you know, he’s setting me up to see a heart specialist and putting me on Warfarin.  I was like, “Yeah, that’s all well and good, but what about my fuckin’ hands?

He gave me an Rx for some Zyrtec, plus a handful of samples, and with that, I stepped onto the never-ending carousel of cardiac care.  This was the end of February, 2002.

What I had was atrial fibrillation.  That means instead of the atrium giving a strong squeeze to send blood to the ventricle, it just kind of fluttered along.  The problem with that is that blood can collect in the atrium and clot.  That’s bad.  That’s a stroke waiting to happen.  That’s why they give you blood thinners like Warfarin; to keep you from clotting.

Right off the bat, the doctor scheduled a “cardioversion” for me, a month later.  That’s where they shock you with a couple of paddles to jolt your heart back into rhythm, the way you used to see them do it on “ER.”  You know… “Clear… Zzzzzzzap!  Now crank it up to 300Clear… Zzzzzzzzzap!  He’s OK, now do me…Zzzzzzzzzap!”

So here I am on the day I was going to get zapped… took the day off work, had my brother bring me to the hospital, I’m all ready for zappage.  I’m gowned and have an IV in my wrist.  The parents are back in Wisconsin, worried sick.  The doctor comes in, looks at my chart, and says, “I can’t do this now… your INR is off.”  (The INR is the degree of blood ‘thinness’.)

What I know now and didn’t know then is that it takes a while to get your INR to the proper level and keep it there.  There’s a lot of trial and error and it requires an endless number of blood tests.  The original doctor didn’t set up any of that, he just sent me in for the Frankenstein treatment.  They explained that they could still do it, but I’d run the risk of a clot breaking free and giving me a stroke.  It took me about .75 seconds to decide that maybe we should wait, so after all the worry, that day ended up as a false start. 

It took another three months before we could stabilize my INR for the required interval, so I got very used to having blood drawn.  I tell you, I knew who the good blood technicians were.  With some, they were in and out “like buttah.”  Others… yow.  I’m fortunate, though, that I have large, visible veins.  You could hit my veins with a lawn dart from across the room.

So ultimately, I had the cardioversion done and it was more or less uneventful.  It didn’t take long at all.  I wasn’t “under” for more than 15 minutes.

Ever the archivist, here is a copy of my chart when they did my first cardioversion.
You can see where the line flutters before the charge, and takes a solid dip before the big beat, after the charge.

The only problem was that within a month, I started going in and out of rhythm again.  When I went in for a follow-up in July with another specialist, he recommended doing a “catheter ablation,” which we scheduled for October.

A catheter ablation is where they snake a wire up from a blood vessel in the groin and into the heart.  There, they burn out the electrical packets that cause the heart to misfire. 

Before that, though, they have to do a Trans Esophageal Echocardiogram (TEE).  That’s where they put a tube down your throat that takes scans of your heart, from the inside.  This is done to look for clots before surgery.  They keep you awake but sedated for that, so it was kind of weird.  I don’t remember too much from it, other than it being awkward.  I liked nitrous oxide much better.  And I hated that I had to keep having my brother take me to and from these operations.  But they won’t let you go after you’ve been sedated, without someone else to pick you up.  Bastards…

Two weeks after the TEE, it was time for the Big Show, the catheter ablation.  They had me in there at the crack of 6 AM.  The first order of business… shave the patient.  This was absolutely mortifying.  I had this squat little nurse that had to do the ‘honors.’  I tried my best to keep it light, and she said she appreciated that.  But it’s so unnerving when she’d have to keep adjusting my personal private parts so that she could get into all the corners.  She’d work on one side, then move things around so she could do the other side.  My things.  She shaved me from my knees to my navel.  Everything in between looked as bare and hairless as a hot new boy band.

My work wife “Sunshine” questioned me intensely about that once I was back to work.  She was like, “Did you get… excited?”  I was like, “Hell no!  I’m surprised it didn’t retreat completely up into my chest cavity.”  There was nothing exciting about that process. 

I was just lucky that we were past the end of bathing suit season.  All the different electrode patches I’d had stuck on my chest had left me looking like I’d been attacked by an octopus.  In fact, I thank my lucky stars for that because between my thighs and my chest, I looked like a patchwork quilt.  The things we endure to become heart healthy…

They wheeled me into the OR and I could see about 8 people standing around.  I was thinking, “all this for ME??”  I hate being the center of attention, but I suppose it was, in this case, unavoidable.  I was too tall for the operating table, so they pulled out this unpadded, shelf-like extension for my feet to go on.

The surgery was supposed to go between 2 and 6 hours.  I ended up on the table for 8.  The worst part about it was that my bare feet were resting on that shelf for 8 hours.  Remember the Delayed Pressure Urticaria?  My right heel was swollen and painful for days afterwards.  That alone left me hobbling the rest of the week.

I remember waking up in the recovery room feeling very cold.  My sinuses felt all congested, so I asked to blow my nose.  You don’t even want to know what came out of there.  Bleah…  But I could breathe, afterwards.  But I was so cold.  In fact, I’ve never felt so cold in my life and I’ve been to playoff football in Pittsburgh in late January.  This was worse.  They piled 6 inches worth of blankets and a hot water bottle on me and still, I shook like a leaf.  It took about 30 minutes for me to start to feel warm again.  They said that was a common side effect of long surgeries. 

The next order of business was to remove the catheter inserts from me.  Because they were having trouble locating and getting at the trouble spots in my heart, they went in on both sides of my groin and also up under my left collarbone.  The upper one came out easily.  The other two… OMG.  It felt like they were trying to pull my balls out through the ¼ inch incision.  And then they have the nerve to tell me to relax!  It was excruciating. 

I’ll be happy to relax once I can stop screaming!

And then as an added bonus, they had to remove the catheter from my urethra.  That one didn’t take as long… the nurse yanked that one out like she was rip-starting a lawn mower.

It was weird how the entire day had vanished.  I guess being unconscious for 8 hours will do that.  My brother was still there (he had come in with me and went to work during the surgery) and he came in to see me.  It was good to see a familiar face.

My nurse was terrific.  She took such good care of me and saw to my every need.  She fetched more and more blankets when I was cold and got me glass after glass of water when I was thirsty right after the operation.  When it was time for her to go for the day, I pulled her over and thanked her for taking such good care of me.  She must not get that very often because she gave me a big hug.

That night was pretty uncomfortable.  All I wanted to do was sleep, but that was pretty much impossible.  Between all the other people around and the constant beeping and the automated blood pressure cuff that takes the BP every 15 minutes, it was a long night.  Plus, it seemed like everyone on the floor found in necessary to come in and “check the wound.” 

Great… more people that need to examine my wang.  Over these 2 days, more people saw my dick than throughout my entire life.  By the end of the night, I wanted to stand up on my bed, pull up my gown and yell, “Is there anyone on the floor that hasn’t seen my dick?  Hey you over there, want a look?  Come one, come all, step right up and have a look at my junk.  Then please leave me the hell alone!

Mothers always say that when you have a baby, there are so many people all up in your stuff, you lose your sense of modesty.  After this experience, I feel I can relate as well as any man can. 
“Hey, is there anyone down here that hasn't seen my willy?”

Peeing in the bedpan was another adventure.  One thing I learned is that it’s not a quiet process.  I swear the sound acted as a beacon because the second I’d start, someone would appear at my bed, ready to whisk it away. 

Here you go, how about some nice warm pee?

I thought it would be funny to have the pan in place and then wait for someone to come in, engage in conversation and then go “Wait a second…(eyes roll back in head)…  ahhhhhh.  Um what were you saying?” 

My recovery was uneventful.  The wounds healed up quickly, once everyone in the cardiac ward quit rooting around in there.  The worst part was that I had to give myself injections of a blood thinner called Lovenox.  They said I had to inject it right into my belly.

I was like, “Yow!  In the belly?  Really?

The nurse said, “Well, it can really go into any area where there are fat deposits, like the belly or the bottom of your arms.”

I said, “Fat?  In these guns?  (Throwing a Hulk Hogan pose…) Ain’t no fat up in hereThe belly, it is.”

It’s really unnerving, though, giving yourself a shot.  The nurse showed me how to do it, but it proved to be much easier seen than done.  I couldn’t do it without leaving a big bruise.  Of course, the bruises proved to be useful because you weren’t supposed to use the same place twice.  The marks were like my footprints.  But again, I was glad it was no longer bathing suit season.  Between my patchwork chest, bare thighs and hairy shins, and a belt of bruises around my midriff, I looked like a genetic experiment gone wrong.

Anyway, following the procedure, my heart beat regularly right up until it went back out of rhythm 17 months later.  Gah!

And back on the Cardiac Carousel I went…

26 comments:

  1. Director’s DVD Commentary: I apologize for the length of this post, but I felt this story had to be told in one session and not split up between posts. As it is, I’ll need another post to wrap up the 2nd surgery. That one won’t be nearly as long.

    Also, this was supposed to post last night but Blogger had other ideas. It was so frustrating, I was tempted to stand out on the corner and recite it to passersby.

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  2. Oooh, Coumadin. Did anyone ever tell you it's rat poison? If not, now you know!

    It's cute, reading this and knowing everything you're talking about. For the first time in a long time, I got to see how a patient puts things.

    And don't worry. I've seen more penises than I care to remember. And if it makes you feel any better, I'm sure that nurse enjoyed seeing yours since it's more youthful than the every day 90 year old shriveled balls we see on a daily basis. Or at least I would be.

    There's nothing I enjoy more than to put a catheter in a boy. Gets the RAGE out, yanno? Nothing like sticking it to the man - ha!

    Now take care of that heart damnit. Or I'll come down there and give you something to have a heart attack over.

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  3. Catheters are no picnic for the ladies either, my friend. You have my complete sympathy. Take care of the ticker. You don't want to end up a heartless son-of-bitch like Dick Cheney.

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  4. Cassie,
    Rat poison? Whatever works, baby!

    I'm glad I could help you remember that the rest of us non-medical professionals are more than just an ass in a bed... we're people that are uncomfortable and un-used to having a crowd of people examine our collective peen. If I wanted to show Bluz Jr to the masses, I'd have it out on the street corner.

    "Stickin' it to The Man"... LOL... good one. But that shit ain't funny! OK, maybe putting it in is, because I was knocked out at the time. But pulling it out? At least do us the favor of not making lawn mower noises.

    Jayne,
    There are no artificial parts in this ticker, so there is no chance of becoming another Darth Cheney.

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  5. Bruises are normal when injecting Lovenox, it's not just you.
    As a nurse, I loved reading this post. You really told your tale well, and I absolutely loved that you included your ECG Before-and-After, something totally worth seeing. If I had to grade you on a post, this one would be an A+, and I think student nurses would have a lot to learn from your experience. The best part of this post is how appreciative you were of your care and your nurse. And you're right, we don't get thanked a lot. Quite seriously one of the best posts I have ever read.

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  6. Sandra,
    Thank you for the grade! That means a lot to me, coming from a rock star like you. And feel free to share the post with any and all student nurses.

    I realized going in that the nurses would be responsible for a great deal of my comfort and happiness, so I was determined to make them love me.

    I'd hate to be in there acting like an asshole and then need them for something important.

    They'd be all, "Ehhh, it's just that asshole in 4B. Let him put his own IV back in... " OK, maybe they'd still do what they had to do, but they could do it easy or do it hard.

    No way I was taking any chances.

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  7. Ok, this is the third time I've tried to comment and it hasn't worked so you're getting the abridged version cuz I'm so irritated with blogger. I wish you all the best in caring for your heart. Conditions like that can be scary and excruciatingly painful. So, hang in there and keep taking care of yourself, we want you around for a long time. :)

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  8. Raven,
    Freakin' Blogger... you'd think that after their troubles this week, they'd be on their best behavior.

    I've never had any pain with this heart trouble... just the treatments... lol...

    Plenty of pain to go around, though, between the hives and the shoulder.

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  9. There is absolutely no way you can say "be completely gassed" right after "take a shift" and expect me not to see "take a shit".

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  10. PD,
    That would bring a whole new meaning to the phrase, "Leaving it all on the ice."

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  11. I had a heart attack and a triple bypass when I was only 46 years old. It was quite a shock, since I was healthy, physically fit, and walked and rode a bike every day. They tell me it was caused by GENETICS.

    Two years ago, Rod was diagnosed with congestive heart failure. He knew he was getting more and more tired, but didn't know why until he passed out on the putting green and fell face down on his putter head. There was a LOT of blood! And then the EMT's took him away. There is no cure for his illness. He takes a LOT of medication so it hopefully won't get any worse.

    As for me? Well, I'm still here.

    Take care of yourself, Bluz! We would seriously miss your cutting-edge humor!!!

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  12. Judie,
    Funny thing, the heart... one single point of failure. We gotta do what we can to keep it running...

    It's funny being so young and going to cardiac specialists... we're invariably the youngest ones in the room.

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  13. Great Title! Laughter is heart healthy medicine.
    This is an amazing account of the cardio ablation which didn't work. I'm thankful for the second successful one.
    The meds are indeed scary. Coumadin is rat poison and Flecanide rhymes with cyanide, probably as lethal.
    My worst atrial fib episode was Nov. 4, 2004, election night. Watching the returns in the emergency room, I had a 200 + heart rate which didn't decrease until they turned off the tv.
    A week or of fasting from news can help a damaged heart.

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  14. Mary Ann,
    So far so good. I'm glad not to still be on the maintenance drugs. I never felt like they did anything anyway. Amioderone, coumadin, atenolol (which sounds like it should be funny but it isn't), digitek... never felt like any of them did a thing.

    Well, I AM still alive, so maybe there was something in there...

    The 2004 election was enough to give anyone palpatations... that was the night the country stood up and said, "Yeah, he's a moron, but he's OUR moron. And he speaks for US."

    In fact, it still makes me queasy.

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  15. Note to Mary Ann: Some days I have to stay away from the news completely to avoid being driven into "A" fib by the blatant stupidity of one particular group of politicians!

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  16. Oh my gosh. I started laughing with the shaving and kept on right on through the end. And all I kept thinking was, "Oh that was so like having a baby." I can't tell you how many people wanted to examine my lady parts while I was in the hospital. Good grief.

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  17. Jessica,
    I KNOW, right? All my life, my schlong has never been as fascinating as it was that day. Thanks for the backup. Who knew heart surgery could be so funny? (AFTER the fact, that is…)

    Next time, I’m just going to visit everyone in the unit, pull up my gown and just whip it out. “There! Now you can leave me alone later on.”

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  18. oh em gee, bluz, I'm so sorry, but your account has me giggling in my cube. I guess the bright side is that you've got a great story to tell with humor now. Can't wait to read part deux.

    Other observations: A good nurse makes a HUGE difference. I guess I shouldn't say that, because to tell it true, when I had all my babies, I had great nurses, bar none. Also, when you have babies (well, not *you* per se), there is no such thing as modesty. You just give it up. And then you hope that everyone can look you in the eyes afterwards.

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  19. Red Pen Mama,
    Thanks… that was my goal, as always. I’ve had this story in my mental To Write list since I started the blog; I’ve just been waiting for the right time. And since I’m in the midst of other medical stories, I figured I’d make it a ‘theme’. As I’ve always said, comedy comes from suffering. No one ever says, “Let me tell you this hilarious story where everything went just right…”

    My lessons from this story really paid off in the next one, not only with the tangible requests that I wrote about, but in the expectation that everyone on the floor is going to see my dick, so I might as well get used to it. I just realized, I should have done something really special for them, like dipping it in glitter. They’d still be talking about me…

    Lastly, I love nurses. They do amazing work, which is something I tell our Cassie all the time. (It just makes sense to stay on the good side of someone that calls herself ‘Nurse Pain.’)

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  20. Did you have to see the squat nurse with the razor again? Did she buy you dinner? Awkward.

    I had a catheter once after a car accident. I was unconscious when they put it in -- thankfully -- but was very aware when they took it out. Starting a lawnmower... classic.

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  21. Carpetbagger,
    No, I never saw that nurse again, thank heavens! After that, why even wear pants?

    They should totally do you the courtesy of taking the catheter out before you wake up, but I think they want to see the look on your face when they do it. My nurse said, “You want me to take this thing out? Before the final “s” came out of my mouth when I said, “Yes,” she went “ZZZZZZIP” and yanked that sucker right out. Kind of like the “Band-Aid Principle, I guess. By the time I can start to squawk and panic, it’s done.

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  22. I'm going to think really, really hard about this experience the next time I'm in the stirrups at the obstetrician's office. At least no one's tried to shave any part of me yet. YIKES!

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  23. Mrs. Bachelor Girl,
    You know that's probably coming, right? You should do it yourself right away! That way The Guy can reap the benefits! Or even better... let him do it!

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  24. It's interesting to see this stuff from different perspectives. I've actually done transcription reports for a few of the procedures you had done. It's amazing to me that we humans have figured out how to squirm a tube from there to look at something there and all the other crazy things we've discovered and have everyday appointments for now.

    I'm with Katie E. on the "take a shift" quote - I guffawed at that one. :)

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  25. Cristy,
    No question… it amazes me that we’ve figured out how to do that. I can see how they could snake a wire up in there, but I don’t know how they can control it to make the various turns it needs to do…

    Oh, and come on! I was playing hockey. If I took anything other than “a shift” on the ice, I’m sure that would have been a 10-minute major penalty and a game misconduct.

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