Wednesday, December 7, 2011

Becoming the patient - part 2

If you didn't get a chance - read part 1 first so this all makes sense.

So by this point, I had received the med to stop my heart and another iv med to hopefully prevent it from happening again.  I was supposed to get an oral med as well.  Given the chaos of the ED, it took awhile to get the oral med.  I sat up prior to getting the med, and my heart went back to racing mode.  Up to this point, they were actually going to let me go home.  (By the way - this was actually the day of our first snow fall- 32 degrees out - and roads were a total mess).  Well after my heart went back to crazy mode, we all decided that staying overnight would be the best idea.  I got the oral med and another push of the iv controller med.

One would have guessed that after all the meds that my heart would have taken a hint.  It got the hint, but not quite the message.  Drinking a glass of water threw me right back into svt.  And then when I sat up in the morning, it did it again.  So the cardiologists decided to get the special heart rhythm team involved.  And when one of the most senior heart rhythm/electrophysiologist (EP) specialists states that he has no idea what is going on with my heart, well - that just can't be good.

Normally when people have a heart that beats too fast, it comes from the right atrium - the side that the normal electrical wiring comes from.  It is kind of like adding a jumper wirer in- you fix it by removing/burning the jumper wirer.  I already knew that mine wasn't from the right side due to the previous attempts at fixing my heart.  You can have the same problem just in the left atrium.  I already knew that wasn't the only thing wrong.  When they tried to burn the left side of my heart before, they found numerous "wires".  You can only burn so many before you cause too much damage.

So the EP dr said he thinks I have a jumper wire and some other shorting wires in my left heart.  The problem is - one may be overlying my sinoatrial node (SA) - the normal pacemaker of the heart.  Not good.  And the left side is bad because the aorta is in such close proximity that things can go bad quick.

So the game plan is I take meds for the next 6 weeks.  I have to have a bunch of other things looked at outside of the heart to make sure none of them are contributing.  And then we will make a plan to go back for another ablation/burning of the heart.  He said they have a 95% success rate here.  So we will see.  I can't take the current meds and be pregnant, nor does he want me to stay on them long term especially if they can fix it.

My heart rate was in the 40's to mid-50's when I left the hospital.  That alone makes me feel like a slug.  I am hoping and praying that this can be fixed.  I don't like these meds.  The side effects are not pleasant.  I can't have any more babies until this all done with.  It is a bit scary to think of moving away from one of the few places that can deal with it.  And it is even scarier to think about having another ablation given how badly the last one went.

Until then - I just live with it.  And I was reminded by someone today that not everyone survives crazy arrhythmias in the ED.  So I am glad that mine can be relatively controlled, and that I CAN live with it.

Monday, December 5, 2011

Becoming the patient -Part 1

Well I once told a friend that maybe at some point he would see me write about being a patient.  I guess that will be now because of current events.
 So here is a bit more about what has happened over the last few days.  I have a history of super ventricular tachycardia - my heart beats too fast.  I have had since medical school. It used to beat at 210/minute.  I had it controlled with meds and eventually with an ablation (burn the inside of your heart to remove the extra electrical paths).  I actually had 2 of these done during medical school.  Mine turned out to be a bit more complicated.  They knew at the end of the 2nd one that it wasn't completely successful.  I also had major complications from it and lost half of my blood into my abdomen from one of the wires they had used.  I spent 4 days in the cardiac icu in Baltimore.   I refused a blood transfusion because I knew where that blood pool came from.  (it wasn't really life or death, I was just going to be extremely weak and fatigued without it).  I was so short of breath for the next month.  I couldn't walk up a flight of stairs or more than one block at a time.  But overtime I got better.  My cardiologist told me that there were only 3 places in the country that he could send me to for my crazy heart.  Mayo happened to be one of them and I had just matched there for residency.

This is what mine looked like (not my actual one but very similar).
For the next 7 years I was ok.  I was on meds for 4 years and I would occasionally have some short runs of the fast heart rate.  But I could get it to stop.   I stopped taking the meds for it and my heart was still ok.   That is until this past Saturday.   Then it started going crazy.   After the ablation, when I did get svt my heart would usually beat at 140-160 and not the 210.  After being stuck in it for over an hour, I started to get short of breath.  We figured out a plan for the kids, and I got dropped off at the ED.   I could barely talk, just said "I'm in SVT" and handed them my Id card so they could look up my info.  I was whisked off to the critical bay in about 3 seconds.  I was soon poked, prodded, placed on oxygen.
The ED happened to a bit busy with lots of really sick patients.  In order to get my heart to slow down, they wanted to give me a medication that stops your heart for a few seconds.  Then the heart restarts and hopefully at the normal rate.  I have had this before while I was under deep sedation.  It is a very unpleasant feeling and caused me to actually wake up out of sedation to see my heart flat lined on the monitor.  Needless to say, I wasn't really looking forward to this.  So after a few hours of dealing with sicker patients, they finally got back to me.  They pushed the med.  The only way I can describe it is - you feel like you are laying on the bottom of a 12 foot deep -but empty pool.  Then the medicine pumps through you and it feels like the pool is suddenly being filled with hot water - like a giant hot wave is crashing down on you.  You feel like you can't breathe - that you are kind of being crushed.  But then your realize you can breathe and your heart starts to beat again.  Well - I felt all those things - but my heart didn't stop.  Just kept going.  Not good.  I got another med pushed through my IV, and after a few minutes my heart finally slowed down (it had been stuck for 4 hours at this point).  If that hadn't worked, I would have had to be shocked.  Also not pleasant and would require some sedation to do so.

More to come later....
What a normal ECG looks like.

Saturday, December 3, 2011

Proud (or not so) Parenting Moments

Hmm.  For those of you who don't have kids, they call it the "terrible twos".  I think most would agree that it really isn't the terrible twos so much as what I call the "tantrum threes" which has crossed into four for us.

The Munchkin is four.  She has a type a personality.  Maybe a bit too much type a.  This past year has been a challenge with her.  The Tank was born a month before her 3rd birthday.  He spent a few weeks in the hospital.  And then he came home and life was different.  The Munchkin started throwing huge temper tantrums.  Luckily (or not so) she only has them in front of us.  Never at school or in public.  But dang it takes a toll on us.  She usually gets set off by being tired and frustrated.  She has it in her type a mind that things have to be just so.  And when they aren't, watch out world.  In her four year old mind, things can only be just one way.

We tried different methods to curb these tantrums.  Not much worked.  And then she decided that she didn't need to nap anymore.  One word.  Disaster.  She would start to fall asleep at school, and then would wake herself up saying that her body wasn't tired.  Yeah right.  We tried everything to get her to take naps.  Nothing worked.  Until I came up with the most brilliant idea.  Money.  Yep.  I pay her to take naps.  Proud parenting moment.  She doesn't have much concept of money, but just likes putting it in her piggy bank.  So she'll get a penny or whatever change I have if her daycare sheet says she took a nap.  And guess what.  It has worked.  She usually takes a nap most days at school, and even is taking longer naps.  My coin purse no longer weighs a ton.  It is a win win.

The other method that has helped - happy face chart.  There was a recent weekend that she was in time out at least once/hour.  Not a good situation.  I made a smiley face chart.  So for every hour she went with out whining or screaming at us, then she got a stamp/sticker on the chart.  The next day - she got a stamp every hour she was awake.  There is no end to the chart.  She hasn't asked what she gets.  But the type a in her just wants to have as many stamps on the chart that she can get.  And it has been 3 weeks.  She is having maybe 1 tantrum a week instead of several/day.

Life is better.  I may not have a quarter to feed the meter anymore, but I have my sanity.