Friday, May 05, 2006

Why I didn't make it to Las Vegas this week

As a Board member for the STC, I was naturally planning on going to the conference in Las Vegas. Not only do I have a mess o' Board obligations, of course, but I'd really been looking forward to seeing any number of dear friends who I usually only have a chance to intersect with geographically at the annual conference. And, damnit, I like Las Vegas. But instead, I decided to have heart problems. As John Lennon said, "Life is what happens to you while you're busy making other plans."

The problem appears to have been atrial fibrillation, which is nominally benign but can in extreme cases cause dizziness, shortness of breath, and even fainting. If it goes on for an extended period (more than, say, 8-12 hours), it can also cause blood clots to form that can then get thrown directly into the brain, which is very bad indeed. A-fib is, however, normally a fairly benign condition as long as it doesn't happen too often or for too long. Its biggest problem is usually one of annoyance rather than an actual health risk.

Wednesday night/Thursday morning around midnight, I started having a very serious atrial fibrillation. I've had them before, but not for some years, and this one was much stronger than any I'd had in the past. My chest was pounding heavily and I was a little short of breath. Knowing that I've had a-fib before and recognizing it for what it was, I wasn't overly concerned, but the strength of the symptoms did give me pause. I double-checked the symptoms online and it seemed that I was having severe case, but nothing that was an actual heart attack, so I didn't worry too much.

Typically, my atrial fibrillation would stop after a few hours and my heart would kick back into a normal sinus rhythm and that'd be that. Going to sleep would usually do it. I was having trouble getting to sleep because it felt a bit like I had a baby in my chest trying to kick its way out, but it wasn't painful—a lot more annoying than anything else. (A-fib is like that.) It calmed down enough that I was able to fall asleep eventually.

I woke up about 6 hours later. My heart was still pounding but it seemed a whole lot less. I'd felt a lot better on other occasions, too. I rattled around on the computer for a bit, made coffee for us, and made a to-do list for the day. If I was flying out at 7:45 Thursday night, I had a lot to do in the way of packing and transferring files to the laptop and so on.

I got the Babe up and drove her to work. I still wasn't feeling good and I figured it'd be a good idea to schedule an appointment with the doctor before I got on the plane. I'd dropped her off and I phoned the doctor's office as I was driving away to the cleaner's to pick up my shirts for the conference. I explained that I was having a-fib and really wanted to have someone look at me before I left just to make sure that everything was okay. Bless 'em, they had an opening about 20 minutes later at 8:45. I got the shirts and started driving towards the doctor's office. I noticed that I was having dizziness and kept losing a bit of focus, sort of like I was drowsy and catching myself before falling asleep at the wheel. Not good: dizziness and fainting are listed as symptoms of severe a-fib, but I had never had anything like this before.

Driving carefully so I didn't endanger anyone if I really started losing consciousness, I made it over to the doctor's office. (It was only half a mile away and I was still thinking that it wasn't that serious as it was part of what I knew a-fib symptoms to be.) I headed inside, checked in with the receptionist, and sat down. Things were running late already. I played Yahtzee on my cell phone and noticed that I was getting drowsier and less focused. That wasn't good, either.

The nurse called me in. I got up and walked across the waiting room to where she was and suddenly had to steady myself. If you've had a bad case of flu and you get up suddenly and you feel like you're going to pass out or fall over, it was like that. Except I knew it was my heart. Okay, I thought, this is definitely getting serious.

They get me to the room, listen to my heart, get a pulse and a b.p., and leave me there. The doctor was running late, as I mentioned, but every couple minutes, the nurse would poke her head in and say "Are you feeling any worse since the last time I checked?" Well, yes, I said, each time: my dizziness was increasing and I was generally feeling worse.

After the second time she'd asked me this, I heard her outside in the hall talking to the doctor. His part of the conversation was along the lines of "mumble mumble Oxygen right away mumble mumble paramedics mumble mumble transport to the ER mumble." I thought Oh, fuck, this is really serious!

The room got very busy: they gave me oxygen at 6 litres (a fair quantity if I understand how this works; I think 2 litres is the more normal quantity for maintenance oxygen), which made me feel a lot better rather quickly. Not surprising, though, as I figured that since my heart was having trouble pumping adequately, I wasn't getting enough blood. Simple enough, but still a pretty bad idea.

A bunch of paramedics showed up and they got me moved onto a gurney for transport. Actually, I was able to stand up and settle myself down; I wasn't that far gone. I asked if they were going to have to take me out through the lobby or if there was a back way. No, it was the lobby. Damn, I thought, I'm going to be lying here with my shirt off, wired up for monitoring, and having to get schlepped out through the lobby and a bunch of patients. Well, I figured if nothing else, this'll make 'em exercise and eat their Wheaties!

As we got into the elevator, one of the paramedics pulling the gurney said to another "Did you put your money in?" He said yes, he was all in. "Money?" I asked. "Yes, the fire station is having a big lunch today and we're all putting in $20." "Oh!" I said, "just as long as you weren't betting on me." They both laughed and said that they've done things like that but that most people didn't understand their sense of humor when they heard about it. No worries, I said, I knew all about this and that a friend of mine who was having a major heart attack had been bet on by the paramedics (they told him later that he'd been their heart-attack-of-the-week and they'd had $10 on him that he wasn't going to make it--thanks a yahoo!).

I phoned the Babe from the ambulance on my cell phone. She'd known that my a-fib was giving me grief and that I was going to check it out, but she didn't expect it was going to be anything like this, either. Worse, I'd been using her car, which was now at the medical group office parking lot. I had the paramedics leave her keys at the front desk and she snagged a ride to the ER. I also phoned Paula Berger, incoming president on the STC's BoD and let her know I probably wouldn't be there.

At the ER, I wasn't having a heart attack as near as we can tell. The oxygen was definitely helping me out and it didn't look from the ultrasound like my heart was damaged, but I was still having problems with a very serious atrial fibrillation that was resisting drugs. Hmmmm…. The EKGs showed the possibility of something else as an underlying cause, but we couldn't see what. After about an hour of being monitored, I asked the ER doc if I was going to be well enough to fly out that evening for the Board meeting. "Definitely not," he said. Well, okay, that's that, I guess.

Several hours went by while I was being treated to see if they could get the a-fib to convert to a normal sinus rhythm. Nope, no luck. I got checked into the cardiac unit overnight for observation and further treatment. (No, I absolutely wasn't going to be going anywhere that night.) Nice room, actually, and I lucked out and had a good view. The Babe stayed with me for a while, then Susan the Wonder Child showed up and they both hung out. The Babe brought me a large book of Will Shortz's sudoku, always a good way to pass the time.

I was wired up heavily for wireless EKG/pulse/blood pressure monitoring that constantly displayed at the nurse's station, and an IV that was running a long variety of drugs into me, trying to get my heart to convert to a normal sinus. They'd slowed the rate down and the blood pressure, but it was still kicking odd beats. Not to worry, they assured me, if the drugs don't do it by morning, we'll knock you out and hit you with the electric cardio paddles and that'll probably do it. I worried.

Things were actually rather uneventful for the rest of the evening. I slept a lot, woke up to watch the new episode of ER, followed by some Adult Swim stuff on the Cartoon Network, then fell asleep again. I woke up around 7:15 this morning feeling reasonably well. The nurse came in and told me that I'd converted around 3:30am (yaaaaaay!) so there was no reason I couldn't go home today. (YAAAAAAAAAAY!!!!!!) The Babe showed up and, after we got paperwork and a final EKG out of the way (no visible problems), we left. I should mention that the Babe took an obscene amount of pleasure in ripping EKG pads off of my chest, which left large bald patches in the hair and looked for all the world like I'd been attacked by a giant squid.

Follow-up: I didn't "almost die" but I was definitely in bad shape and it's a darned good thing I went in the doctor… although I have to say that if I hadn't and I'd been degrading as fast as I was, I'd have called 911 within an hour, anyway. We still don't know what caused this. It wasn't an MI, thank goodness, but there's a possibility that there's an occluded artery or some other cause. The cardiologist was very clear that it would be a poor idea to travel until I got a stress test, so I go in next week for a nuclear medicine stress test to see if there's an external cause to all of this. And next time, if my heart's kicking up this hard, I go straight to the ER. And next time, I won't drive myself to the hospital. Fair enough.

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4 comments:

sarah said...

Wow, John- that sounds so frightening! I'm sorry that you had to miss out on the conference in Vegas, but I'm really glad that you're alright. Is there anything you can do to reduce the chances of this happening in the future?

Herb said...

Scarey stuff, John-boy. Glad to hear you are okay, I hadn't heard about this until tonight when I was playing catch-up on blog-reading.

Take care of yourself, and let me know next time you are up this way. Sorry we missed the birthday bash, we both spaced it due to sturm und drang around here.

Ealasaid said...

Yikes! Am catching up v. belatedly on your blog and just read this. Holy crap, dood. So glad you're doing well now.

Alice Moore said...

Hi! My Sailor son is only 24 and is having the same problems and receiving the same treatments. Nothing showed up on stress test, but Navy's Chief Medical officer at Jon's base is putting in for him to receive a medical retirement from the military. His case goes before board in D.C., and we will know in approx. a month. Did anything show up during your stress test, John? My ex is a nurse and says Jon has no heart problem because nothing showed up during stress test. I don't argue w/him, but I feel that it's not going to show up as a heart problem on stress test unless he is having AF during the stress test! PLMK about your stress test results and anything else you know and care to share at toyladyzep39@hotmail.com. Thanks! Alice Moore in Missouri