Hospital weekend with ventricular tachycardia
The short: Friday night (April 28), my hubby Scott took me to the Kaiser emergency room, where I was admitted with a high heart rate (about 190 beats per minute) and had premature ventricular contractions. I just got out this afternoon (Wednesday, May 3); feeling much better now, mostly back to normal.
Friday, April 28
I walked on the treadmill of our apartment complex for about a half-hour, then suddenly stopped due to an immense pressure in my chest, as if someone had blown up a large balloon. I rested and tried to continue walking, but couldn’t, so I sat still for about 20-30 minutes. Back at home, I showered and was still out-of-breath; I laid down for a nap and was still out-of-breath. So I looked online for symptoms of a heart attack. Women usually don't have the same symptoms as men; women's are often more vague, such as shortness of breath, weakness, or unusual fatigue. I almost didn't go to the emergency room (ER), but my husband said we should, so we drove over to Kaiser.
(Side note: some folks complain about the Kaiser medical system, but it's just like any other large organization. Once you learn how to work the system, you can get almost anything you want.)
The Kaiser hospital in Santa Clara has a triage nurse who interviews you to determine if you need to see a doctor, or if someone else will do (like a nurse). We stood in this line after two other persons. Using the notes I found online, I told the nurse my symptoms; he sent me to an Electrocardiogram (EKG) technician who immediately set me up and did the test. The EKG tech made a printout of about three seconds of my test, then ran it outside to the triage nurse; Scott says the nurse looked at it and yelled, "Holy crap!" The EKG tech came back and made another printout.
Suddenly, people were barrreling my gurney down the hall. My hubby Scott and I were shoved into a large-ish room filled with one ER doctor, two or three medical residents, a couple of technicians, and two nurses trying to insert IV lines into my arms (I have poor veins under the best of conditions, so this was a tough job). They were all talking technical stuff to each other, but I got the impression they were pushing two concentrated bursts (boluses) of medication through the IV lines.
Then everyone stood and stared at something above my head. When it got quiet, I asked what they were looking at. "We're watching the monitor tell us your heart rate. You came in at 190 per minute, it's only gone down to 180." And the problem is? Because people can only sustain a high rate for so long before they have a HEART ATTACK! (That tidbit came from an excited resident with little experience in bedside manner...) From 180, it started trickling to 170; boring.
So folks began leaving the room, although one tech was still in sight; everyone was hanging around the area for my rate to continue lowering, and I was laying quietly. Suddenly, I just felt something bad is going to happen to my heart - I told my husband to get the doctor. That's when I went into an episode of something called "premature ventricular contractions" when my heartbeat was disrupted by the heart's electrical system.
What this looks like: think of those TV scenes where the doctors place the electrical cardioversion paddles over the patient's heart and someone yells "Clear!" Then the patient's torso leaps about a foot off the ground. Well, just add a loud "ACK!" (from me) every contraction, and take out the paddles; my heart was wigging out all by itself. Very scary. The doctors could only watch while the contractions continued; eventually, things stopped on their own, and I was hustled upstairs to the Intensive Care Unit (ICU). They continued me on the same medication, but this time on a regular IV drip, rather than boluses.
Saturday, April 29
Scott later told me I had a sign over my bed saying "NPO" (nothing by mouth), meaning no food or water. This was because Saturday morning, the doctors used the cardioversion paddles on me - three times. Didn't work; it was supposed to shock the heart out of ventricular fibrillation and back into its normal rhythm. The doctors said it works in about 95% of all cases, but I'm special (rolls eyes). Good thing I was under anesthesia and can't remember anything. Heart rate still high, around 140 to 170, despite new medication (Amiodarone, if I remember correctly).
Whiny note: the nurses didn't remember until 9:00 p.m. that I could now eat and drink. With the kitchen closed, the only food they could find was Jello and applesauce, my new favorite foods. After midnight, nothing again, because:
Sunday, April 30
Again with the paddles, another three times. Still didn't work. Doctors now recommended doing an Electrophysiology study (EPS) that would most likely lead immediately to the surgical procedure, ablation. This way, they would run a needle up my leg and into my heart, then use radiofrequency energy (heat) to burn the bad heart cells.
(By coincidence, my father-in-law has atrial fibrillation, and is getting his bad cells frozen next Wednesday, May 10; he's a retired physician. Mine is ventricular tachycardia and is potentially more dangerous. The heart's atria are the two chambers above the two ventricles.)
The doctors don't think my condition is related to my heart murmur (mitral valve prolapse), which was repaired in 2003. I asked if I'd had a heart attack Friday night; the doctors don't know, because while my blood samples did show the presence of an enzyme that indicates a heart attack has occurred, the enzyme could've leaked into the sample because my heartbeat was so fast. They also told me that I'd had an earlier episode of tachycardia (fast heart rate) right after I had the open heart murmur surgery, but I was unconscious and didn't know it. In hindsight, that was a warning that I had the condition; back then, the surgeons thought the tachycardia was just one of those things that happens sometimes after open heart surgery.
No food or drink for me after midnight because of the upcoming ablation. I dream of beef-vegetable soup.
Monday, May 1
The ambulance transferred me to the Kaiser hospital in Santa Teresa (south of San Jose), which has the equipment for ablations, angiograms, etc. Normally, there is a six- to eight-week wait for an ablation; some folks (including the ambulance team manager herself) control their tachycardia with medication alone for 20+ years, and occasionally massaging their carotid artery, before ablation. (Ablation has a few risks, like heart attack, stroke, and the doctors accidentally perforate the heart.)
However, since ablation was my last hope, I got put on the list immediately. So the team of three doctors did their usual scheduled three-a-day ablation procedures, then me after about 4:00 p.m. (My heart rate was now about 170.) They did a total of 78 ablations (burns) in my left ventricle; I thought they said seven-to-eight, but they spelled it out: seventy-eight (78), and that wasn't even a record. I woke up under the sedation, so I actually felt a few: think of a miniature Jedi lightsaber burning a straight line at the bottom of your heart. Repeat. Hold still, don't move, don't twitch.
The last doctor stayed with me after the procedure and personally stood for 40 minutes, pressing down on the puncture wound in my groin where all their equipment entered. The bruise area was considerable, but thanks to his efforts, it’s going down nicely. I'll have bruising for about three weeks.
Then I had to lay still and not move for six more hours. I made the poor nurse promise to wake me at 2:30 a.m. so I could have Jello, applesauce, juice, anything - and move from my back to my side. (Ouch, those hospital beds!) He did, bless his heart.
Tuesday, May 2
So the nurse and the Electrophysiology Physician's Associate are telling me I can go home today. My husband shows up with my clothes. I'm ready to go home (and get online), until the Electrophysiologist shows up and says I have to do a treadmill test tomorrow, to see if they can cause another episode. Drat! The ICU is now full and I am no longer on IV drips, so I get moved downstairs.
My new overnight digs: a Telemetry unit, where I am constantly monitored - but on wireless! So I can walk up and down the hallways, instead of being tethered to a base monitor three feet away. Scott played with the computerized bed, which adjusts to your weight and movement. It was scary.
There is a funny guy in this unit who is like a black-market dealer, supplying desperate patients with Jello, applesauce, and extra blankets. He slips me a red and a yellow Jello before midnight, when I go NPO again due to the upcoming treadmill test. My husband also ceded to my demands to bring me Snapple to drink, but his conscience made him confess to nursing staff, so I only got to put one bottle in the nursing fridge.
Confession: I was so desperate for anything to read, I read an old movie magazine about people and movies I care nothing for. Cover-to-cover. Blecch.
Wednesday, May 3
There was a failure to communicate: the Electrophysiology people never got the message from the Treadmill people that I had to have shoes, pants, and bra for the test. Oh well… so the Treadmill lady had me wear the usual backless "gown" frontwards, hooked me up to the monitors, then used Scotch tape to fasten the openings. No naked people on hospital treadmills.
So I walked. Nothing happened after six minutes - no contractions, no flutters, nothing. (Okay, the Treadmill people complained they couldn't even hear my heartbeat, because it's so quiet. Fast, but quiet. Think of German cars.) That's when I got clearance to go home, and without any medications or warnings, other than to "take it easy" for a while. And to not be surprised if I get some chest pains and "phantom ablation pains" in the next few weeks.
Snapple time! Chocolate pudding! Applesauce and Jello binge!
Thank you to everyone who included me in your thoughts and prayers; things went amazingly well, including my getting to the top of the emergency ablation list, and most of this happened over a weekend. According to the Merck Manual, "Of those who die, 60% die of primary ventricular fibrillation before reaching the hospital." I do not exaggerate when I say we almost didn't go to the emergency room. The nurses had trouble running lines into my veins, but the seventh time worked! Even my hubby was able to sleep at night (he says it's because I wasn't there to keep him awake by snoring), and he's a worrier.
Thank you, Betz, for the beautiful flowers!! They arrived Monday and cheered me immensely! (Shh, they made it past the ICU staff!) And thanks for passing on the request for prayers - much obliged!!
Thank you to the folks who wanted to visit! The ICU nurses did not allow visitors, but I appreciated your thoughts.
My apologies to anyone who didn't get an email or call from my hubby; he's not used to being my secretary, but he sure tried. He’s a keeper! He also says if you really want to help, you can do laundry (rolls eyes).
Friday, April 28
I walked on the treadmill of our apartment complex for about a half-hour, then suddenly stopped due to an immense pressure in my chest, as if someone had blown up a large balloon. I rested and tried to continue walking, but couldn’t, so I sat still for about 20-30 minutes. Back at home, I showered and was still out-of-breath; I laid down for a nap and was still out-of-breath. So I looked online for symptoms of a heart attack. Women usually don't have the same symptoms as men; women's are often more vague, such as shortness of breath, weakness, or unusual fatigue. I almost didn't go to the emergency room (ER), but my husband said we should, so we drove over to Kaiser.
(Side note: some folks complain about the Kaiser medical system, but it's just like any other large organization. Once you learn how to work the system, you can get almost anything you want.)
The Kaiser hospital in Santa Clara has a triage nurse who interviews you to determine if you need to see a doctor, or if someone else will do (like a nurse). We stood in this line after two other persons. Using the notes I found online, I told the nurse my symptoms; he sent me to an Electrocardiogram (EKG) technician who immediately set me up and did the test. The EKG tech made a printout of about three seconds of my test, then ran it outside to the triage nurse; Scott says the nurse looked at it and yelled, "Holy crap!" The EKG tech came back and made another printout.
Suddenly, people were barrreling my gurney down the hall. My hubby Scott and I were shoved into a large-ish room filled with one ER doctor, two or three medical residents, a couple of technicians, and two nurses trying to insert IV lines into my arms (I have poor veins under the best of conditions, so this was a tough job). They were all talking technical stuff to each other, but I got the impression they were pushing two concentrated bursts (boluses) of medication through the IV lines.
Then everyone stood and stared at something above my head. When it got quiet, I asked what they were looking at. "We're watching the monitor tell us your heart rate. You came in at 190 per minute, it's only gone down to 180." And the problem is? Because people can only sustain a high rate for so long before they have a HEART ATTACK! (That tidbit came from an excited resident with little experience in bedside manner...) From 180, it started trickling to 170; boring.
So folks began leaving the room, although one tech was still in sight; everyone was hanging around the area for my rate to continue lowering, and I was laying quietly. Suddenly, I just felt something bad is going to happen to my heart - I told my husband to get the doctor. That's when I went into an episode of something called "premature ventricular contractions" when my heartbeat was disrupted by the heart's electrical system.
What this looks like: think of those TV scenes where the doctors place the electrical cardioversion paddles over the patient's heart and someone yells "Clear!" Then the patient's torso leaps about a foot off the ground. Well, just add a loud "ACK!" (from me) every contraction, and take out the paddles; my heart was wigging out all by itself. Very scary. The doctors could only watch while the contractions continued; eventually, things stopped on their own, and I was hustled upstairs to the Intensive Care Unit (ICU). They continued me on the same medication, but this time on a regular IV drip, rather than boluses.
Saturday, April 29
Scott later told me I had a sign over my bed saying "NPO" (nothing by mouth), meaning no food or water. This was because Saturday morning, the doctors used the cardioversion paddles on me - three times. Didn't work; it was supposed to shock the heart out of ventricular fibrillation and back into its normal rhythm. The doctors said it works in about 95% of all cases, but I'm special (rolls eyes). Good thing I was under anesthesia and can't remember anything. Heart rate still high, around 140 to 170, despite new medication (Amiodarone, if I remember correctly).
Whiny note: the nurses didn't remember until 9:00 p.m. that I could now eat and drink. With the kitchen closed, the only food they could find was Jello and applesauce, my new favorite foods. After midnight, nothing again, because:
Sunday, April 30
Again with the paddles, another three times. Still didn't work. Doctors now recommended doing an Electrophysiology study (EPS) that would most likely lead immediately to the surgical procedure, ablation. This way, they would run a needle up my leg and into my heart, then use radiofrequency energy (heat) to burn the bad heart cells.
(By coincidence, my father-in-law has atrial fibrillation, and is getting his bad cells frozen next Wednesday, May 10; he's a retired physician. Mine is ventricular tachycardia and is potentially more dangerous. The heart's atria are the two chambers above the two ventricles.)
The doctors don't think my condition is related to my heart murmur (mitral valve prolapse), which was repaired in 2003. I asked if I'd had a heart attack Friday night; the doctors don't know, because while my blood samples did show the presence of an enzyme that indicates a heart attack has occurred, the enzyme could've leaked into the sample because my heartbeat was so fast. They also told me that I'd had an earlier episode of tachycardia (fast heart rate) right after I had the open heart murmur surgery, but I was unconscious and didn't know it. In hindsight, that was a warning that I had the condition; back then, the surgeons thought the tachycardia was just one of those things that happens sometimes after open heart surgery.
No food or drink for me after midnight because of the upcoming ablation. I dream of beef-vegetable soup.
Monday, May 1
The ambulance transferred me to the Kaiser hospital in Santa Teresa (south of San Jose), which has the equipment for ablations, angiograms, etc. Normally, there is a six- to eight-week wait for an ablation; some folks (including the ambulance team manager herself) control their tachycardia with medication alone for 20+ years, and occasionally massaging their carotid artery, before ablation. (Ablation has a few risks, like heart attack, stroke, and the doctors accidentally perforate the heart.)
However, since ablation was my last hope, I got put on the list immediately. So the team of three doctors did their usual scheduled three-a-day ablation procedures, then me after about 4:00 p.m. (My heart rate was now about 170.) They did a total of 78 ablations (burns) in my left ventricle; I thought they said seven-to-eight, but they spelled it out: seventy-eight (78), and that wasn't even a record. I woke up under the sedation, so I actually felt a few: think of a miniature Jedi lightsaber burning a straight line at the bottom of your heart. Repeat. Hold still, don't move, don't twitch.
The last doctor stayed with me after the procedure and personally stood for 40 minutes, pressing down on the puncture wound in my groin where all their equipment entered. The bruise area was considerable, but thanks to his efforts, it’s going down nicely. I'll have bruising for about three weeks.
Then I had to lay still and not move for six more hours. I made the poor nurse promise to wake me at 2:30 a.m. so I could have Jello, applesauce, juice, anything - and move from my back to my side. (Ouch, those hospital beds!) He did, bless his heart.
Tuesday, May 2
So the nurse and the Electrophysiology Physician's Associate are telling me I can go home today. My husband shows up with my clothes. I'm ready to go home (and get online), until the Electrophysiologist shows up and says I have to do a treadmill test tomorrow, to see if they can cause another episode. Drat! The ICU is now full and I am no longer on IV drips, so I get moved downstairs.
My new overnight digs: a Telemetry unit, where I am constantly monitored - but on wireless! So I can walk up and down the hallways, instead of being tethered to a base monitor three feet away. Scott played with the computerized bed, which adjusts to your weight and movement. It was scary.
There is a funny guy in this unit who is like a black-market dealer, supplying desperate patients with Jello, applesauce, and extra blankets. He slips me a red and a yellow Jello before midnight, when I go NPO again due to the upcoming treadmill test. My husband also ceded to my demands to bring me Snapple to drink, but his conscience made him confess to nursing staff, so I only got to put one bottle in the nursing fridge.
Confession: I was so desperate for anything to read, I read an old movie magazine about people and movies I care nothing for. Cover-to-cover. Blecch.
Wednesday, May 3
There was a failure to communicate: the Electrophysiology people never got the message from the Treadmill people that I had to have shoes, pants, and bra for the test. Oh well… so the Treadmill lady had me wear the usual backless "gown" frontwards, hooked me up to the monitors, then used Scotch tape to fasten the openings. No naked people on hospital treadmills.
So I walked. Nothing happened after six minutes - no contractions, no flutters, nothing. (Okay, the Treadmill people complained they couldn't even hear my heartbeat, because it's so quiet. Fast, but quiet. Think of German cars.) That's when I got clearance to go home, and without any medications or warnings, other than to "take it easy" for a while. And to not be surprised if I get some chest pains and "phantom ablation pains" in the next few weeks.
Snapple time! Chocolate pudding! Applesauce and Jello binge!
Thank you to everyone who included me in your thoughts and prayers; things went amazingly well, including my getting to the top of the emergency ablation list, and most of this happened over a weekend. According to the Merck Manual, "Of those who die, 60% die of primary ventricular fibrillation before reaching the hospital." I do not exaggerate when I say we almost didn't go to the emergency room. The nurses had trouble running lines into my veins, but the seventh time worked! Even my hubby was able to sleep at night (he says it's because I wasn't there to keep him awake by snoring), and he's a worrier.
Thank you, Betz, for the beautiful flowers!! They arrived Monday and cheered me immensely! (Shh, they made it past the ICU staff!) And thanks for passing on the request for prayers - much obliged!!
Thank you to the folks who wanted to visit! The ICU nurses did not allow visitors, but I appreciated your thoughts.
My apologies to anyone who didn't get an email or call from my hubby; he's not used to being my secretary, but he sure tried. He’s a keeper! He also says if you really want to help, you can do laundry (rolls eyes).