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 thing 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 a monitor 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 five 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 300… Clear… 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 that I have large visible veins. A blind nurse 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 who had to do the ‘honors.’ I tried my best to keep it light and she said she appreciated that. But it was 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 eight people standing around. I was thinking, “Aall 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 two and six hours. I ended up on the table for eight. The worst part about it was that my bare feet were resting on that shelf for all that time. Remember the Delayed Pressure Urticaria? My right heel was swollen and painful for days afterward. 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 at least I could breathe, afterward. 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 eight 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 impossible. Between all the other people around, the constant beeping, and the automated blood pressure cuff that takes the BP every 15 minutes, it was one long-ass night. Plus, it seemed like everyone on the floor found it necessary to come in and “check the wound.” 

Great… more people that need to examine my wang. Over these two 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 who 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 here… The 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…