Friday, December 11, 2009

Be Still My Heart

Yes, I’ve been letting the blog slide. I’ve been cranking out a couple thousand words a day since December 2nd, and writing for recreation has taken a back seat.

I’ve jotted down a gaggle of ideas for my blog, but right now the only thing going through my head is my miserable heart. More specifically, this damnable irregular heart beat that has me so freaked it’s hard to think of anything else.

The whole arrhythmia thing started back in 2001 or so. I was exercising a lot, and had lost around 70 pounds (don’t worry, I gained it all back and ten of its friends). I smoked a LOT back then, and ingested rather astounding quantities of caffeine. When the “palpitations” started, I was a bit floored. See, I was born with a congenital heart problem, so to have my heart suddenly go nuts on me was a scary proposition. Being me, I tried to ignore it, but after four days (yes, DAYS) of increasing discomfort, panic, and pain, I wound up in the emergency room. The INSTANT I hit that ER, the problem resolved itself. No kidding. I threw exactly ONE PVC in the four hours I was hooked up.

Do I have to tell you how embarrassed I was, what with all those ER docs and nurses raising their brows and blinking in my direction? One doctor muttered something about taking magnesium supplements, and that was that.

I had zero problems for over six months, and then came another bout of PVCs. Those are “Premature Ventricular Contractions” for anyone wanting to know. It means a little part of my heart is jumping the gun and contracting before it should, which leaves it playing a little game of catch up. It’s an incredibly unnerving sensation. My new bout found me staying home, steadfastly refusing to go to the ER again. I cut back on the smokes, ditched the caffeine (a ditching that became permanent), and after two days, things mellowed out again. For about six months.

The next swarm? Astounding! I lasted five days before I was finally so terrified that I went to the ER again. And again, the instant I walked in, the PVCs STOPPED. I didn’t know whether to laugh or cry—on the one hand, GOOD! I’m glad they stopped! On the other? Well, once again I look like a contender for Miss Hypochondria. Isn’t my insurance company going to start raising a stink? After all, these hospital visits ain’t cheap.

My third ER visit came yet one more year later. I’d been suffering through the PVCs every few months, but once again, they hit a fever pitch that couldn’t be ignored. And once again, they jumped ship as I walked into the ER. Try, for just a moment, to imagine how incredibly humiliating and frustrating this was.

After two more years of three or four times a year patches, I had another beaut (about six months after quitting smoking, in fact). But instead of going to the ER, I went to the local clinic. They hooked me up to a portable EKG, and the tech said, “Wow, that can’t be fun!”

What? Someone can SEE this? Hallelujah!

The clinic physician came in, watched the EKG readout for a few minutes, whistled, and told me that we’d talk after they unhooked me. He handed me a folder with my EKG readout, and told me he’d made an appointment with a cardiologist for the next afternoon. That, of course, panicked me worse than anything else—I must be terminal if I scored a NEXT DAY appointment with a cardiologist!

Next day found me still heart-skippy and miserable, sitting in the cardiologist’s office being rigged up to a Holter monitor. Yes, it is HOLTER, not halter. Named after Dr. Norman J. Holter. No, I’m not making that up. I was given a little notebook and a pencil, and told to push the button on the monitor every time I felt a THWACK in my chest, then write down what I was doing and what time it was. I had to wear this thing for 48 hours. I was then to return to the office, let them remove it, and they’d let me know where we would go from there.

That’s 48 hours without bathing. Nasty.

I did everything I normally do (except bathe). I even rode my incumbent stationary bike for 45 minutes each day. The only problem I had was the whole “push the button/make the note” thing—see, I was having palpitations so frequently that I’d have five more while I was writing about the first one.

The day I dropped off my Holter monitor, they did an echocardiogram. That’s an ultrasound, minus all the cooing and blushing. The echo looked great, they said. What a pretty heart!

Two days later, they called back—all the information had been sent back to the clinic, and I was to call them and make an appointment for a follow-up. Hmmm. What does that mean? I don’t need help, or they can’t help?

Made my appointment and staggered in. The doctor said that, according to the Holter results, I was tossing out around 3500 PVCs a day. A few PACs (those are Premature Atrial Contractions) thrown in to keep things interesting. Almost none while sleeping, which I thought (and still think) was supremely unfair. I was horrorstruck, but the doctor smiled and said, “3,500 isn’t really anything to be concerned about—we don’t really start to worry until you top 10,000, and we’ve got some folks who pop with 35,000 a day.”

What does that MEAN?

Well, in a nutshell it means “idiopathic arrhythmia.” No underlying pathology, everything looks lovely, so sorry, sucks to be me. When I asked what could be done about it, the doctor shrugged and said, “Well, that depends. The aggressiveness of treatment really depends upon your ability to put up with it.”


Turns out that some PVCs respond pretty well to Beta Blockers. Some don’t. Some respond fairly okay to Calcium Channel Blockers. Some don’t. Some can be eradicated via ablation. Some can’t. And some freak out when faced with Beta Blockers or Calcium Channel Blockers and create the emergence of a second, competing arrhythmia, a condition called a "proarrhythmia." This is more common in women. It’s more likely to occur in someone like me with PVCs and PACs. It can be fatal, and it's not something I’m eager to flirt with.

And it turns out that my irregular heartbeat isn’t likely to kill me any time soon. Go online and search the hundreds of cardio forums. Millions of people live with this, millions deal with it on a daily basis. As time has passed and the frequency of spates has gradually increased, I’ve become one of those millions of daily sufferers. If I get a two week break, I count myself lucky these days.

So I opted to let it do its thing. And it does, pretty frequently and sometimes, like tonight, pretty scarily. I’ve had the old ticker looked at since, including shambling through 20 hours of continuous in-hospital monitoring, a “Cardiolite” stress test, and two 64 slice CT scans (Is that you, Cancer? Hi! How are you? Yep, yep, see you in a few years!). My heart looks perfect.

Utterly flawless.

So why am I’m sitting here with pains in my chest and shoulder blade? Why am I suffering PVCs so intense it feels like I’ve got no normal beats going on at all? My heart feels as though it’s squirming in my chest, and I can feel myself ramping up to a full blown panic attack. What's that you say? Get to the hospital? I don’t think so—felt like this four nights ago, felt like it a week ago, felt like it three weeks ago, too. When that BIG ONE comes, I’ll totally miss all the warning signs, because I experience them half the time, anyway.

Wow, look at me whine! I know, I need to learn to relax. I need to meditate, take up yoga, and learn to let go what I can't fix. I'm a "stresser," and stress makes this worse. So does focusing on it. But you try having your heart dancing a tango in your chest and then take a shot at relaxing. Go ahead, try to ignore it. It’s a lot easier said than done.

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