Sunday, March 3, 2013

A Matter of the Heart

One thing that really gets your attention is when your doctor calls you at 9:20PM and says, “Go to the emergency room NOW. Do not drive yourself, have someone else do it!”
I’m a writer. Therefore, I sit in front of my computer a lot, tapping away at the keys. Mindful that this is not exactly a healthy activity, I make it a point to get up periodically and move around. I go for daily walks which I jokingly refer to as “my commute.”
Everyone gets an occasional heart palpitation, when your heart skips a beat or gives a double thump. Some people it hits a little more often than others. I happen to fall in that category. Over the years, I learned to ignore it. Ignoring it came back to bite me on Wednesday.
I had noticed that I was experiencing these palpitations more frequently the past couple of months, but my conditioned response to ignore them made me push them to the back of my mind. It wasn’t all that concerning. I was pretty healthy. I only drink lightly, I don’t do drugs, overeat, or have an unhealthy diet. I exercise regularly, walk a couple of miles each day. I wasn’t all that worried.
There were a couple of odd episodes in the past several weeks where I noticed I was a bit short of breath. It was easy to dismiss: I just walked up the stairs, was moving things around, etc. But with that in mind, there were a couple of situations that were not easy to dismiss. I was bowling a couple weeks ago, and found myself a bit breathless while we were all chatting. Another when I was driving around with my father, and for a while all I could do was give short quick answers.
The incident when bowling was really the only indication I had that something was wrong. It did make me think. The problem was, I didn’t have much time to mull over it.
Wednesday morning I noticed I was a bit short of breath. Sometimes when you get up in the morning and get moving right away, you might be a tad winded for a moment while the body ramps up to meet your activity level. Only, this time it didn’t stop.
And I noticed I was getting heart palpitations. And they didn’t stop. For the rest of the morning, all I kept feeling was “thump…thump…………thumpTHUMP………………th-thump.”
Through all this, I was short of breath, a tad light headed, and I was getting a slight headache. It is important to point out, at no time did I ever have any chest pain.
And on it went.
I spent an hour-and-a-half cleaning the Lodge building for the meeting that night, and felt a bit winded.
I got home, sat in front of the computer and relaxed a bit and got to writing.
And still I felt winded.
I checked my blood pressure—hypertension runs in my family so I do watch it—and it was normal.
I still had the palpitations and felt winded.
By the afternoon, it finally began to occur to me that something was not right. I called my doctor, who pointed out that palpitations were not worrisome, but suggested I set an appointment for the next day to for a check.
I sat and relaxed and tried to ignore the palpitations as they were really annoying me by that point. I decided something wasn’t right and I wanted to get hooked up to an EKG so I could catch whatever was going on.
I checked my blood pressure, and now it was 165/114.
I called my father and asked him to drive me to the emergency room.
In the end, the palpitations were starting to subside. My blood pressure, was amplified by my stressing over the symptoms I was feeling. The decision to do something about this was a great stress reliever, and I’m sure that took a lot out of the system that was causing my distress.
At the ER, when someone walks in complaining about a potential cardiac issue, they don’t play around. I was hooked up to an EKG as quickly as possible and they drew blood for a number of tests.
The EKG reported that my heart was healthy—it did spot one or two of the palpitations which had really subsided by that point—and the blood tests came back negative.
Deciding that the episode was over, and all indications showing that I was fine, I was sent home. The next day, I went in on the scheduled visit with my doctor.
He noted the results from the emergency room that he had received and decided it might be wise to do another blood test to double check. He also noted there were a couple of tests that were not selected, due to the lack of symptoms that warrant such tests, and added those. Another EKG in his office showed no abnormalities and I was sent home with the suggestion that we arrange for a more complete test with a cardiologist, just to be sure that there wasn’t something going on.
It was that extra blood test that was the key. In that test, the enzyme troponin showed up. Troponin is an indicator of heart damage caused by a heart attack. Because I didn’t complain of having any chest or other pain associated with a heart attack, they didn’t bother to look for that result in the first round of tests. Basically, I had a very atypical presentation for a heart attack, showing no pain.
So, several hours after my appointment with my doctor, my phone began to ring very late at night. I ignored the call. I just don’t answer the phone after a certain point at night. Especially if it is a number I don’t recognize. It was 9:20PM.
Then the phone rang again.
I ignored it, but then I noted it was the same number that rang my phone the minute before.
Then my email chimed in with a phone message from the previous call.
It was from my doctor.
I immediately called back the number.
“Go to the emergency room immediately. Don’t drive yourself, have someone else drive you over. I’ve already called them and they are expecting you,” said my doctor.
Now that’s a wakeup call!
The extra blood test he wanted to do and considered a long shot came back positive. It showed a potential false positive of troponin, indicating that there may have been heart damage.
Several minutes later, I was on my way to the hospital.
All the tests that were going to be done over the next few weeks were all crammed into one morning: blood tests, stress test, echocardiogram, high definition EKGs.

§ § §

In the end, it was determined that I did not have a full blown heart attack. But something did happen that caused my heart enough stress that it leaked out a trace amount of troponin, which was caught in that blood test.
What exactly caused the arrhythmia has not yet been located. I still have more testing to do to find it. So I’m wired up to a small heart monitor that I’m going to wear for the next month in the hope it will catch the next arrhythmia event.
By catching the erroneous signal causing the arrhythmia, they can better determine where it it being generated from in the heart. Once that is determined, they can then use more precise and invasive means to locate the exact spot using a catheter. And then, they can short out the node that is causing the problem, curing it.
One thing to remember: the number one reason heart attacks are so deadly? Denial. Often people try to dismiss the discomfort as indigestion, a light cramp
The good news in all this is my heart is actually in pretty good condition. So, all that walking has certainly done me good.
Now, I just need to stay healthy and catch this arrhythmia so we can move on to the next step.
…And get caught up on the writing I have missed over four days because of this. I’m trying to keep to this last deadline.

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