At The Heart of It All

It’s a funny thing about hearts.  The human heart holds all the joys and dreams, love and anger, laughter and tears of our lives.  I have them all in droves.  The funny thing, though, is how they don’t leak out when you have a hole in your heart.

It’s called ventricular septal defect, or VSD.  It’s not uncommon, present at birth in a large number of individuals.  Most close without issues during the first three years of life.  For some of us, it doesn’t.  It’s no big problem for those who grow up with these tiny perforations, but occasionally it can be discovered when one visits a hospital under cardiac duress. 

I was on my way to work last Wednesday when I decided I’d drive to the ER instead.  You see, I was having palpitations.  This is not unusual for me.  I’ve had them all my life, but they usually go away within a few minutes.  The odd aspects of this episode were: 1. I woke with the condition, which has never happened before, and 2. the condition did not resolve on its own.

I started getting concerned when each irregular beat seemed to rob me of my breath.  It’s a very disquieting sensation.  Sitting at a red light, I took stock of my risk factors.  I’m a smoker, my job is sedentary and very stressful, I spend many hours sitting and writing, and I’m not as young as I’d like to think I am.  Hmmm…

I turned right instead of left and headed to the med center.  A man smiled at me in the parking lot as I walked to the door.  A woman eyed me suspiciously as we passed when I entered the ER.  The admission clerk asked the nature of my complaint.  When I told her there was a bird fluttering around in my chest and I was having a hard time catching my breath, I was summarily placed in a chair.  Machines were attached to my body and it was nearly impossible to get a blood pressure reading.  They tried so many times my arm was bruised. 

As it turned out, my blood pressure was low-normal and nothing to be concerned about, but the heart monitor was bleeping out of control.  The nurse looked at the clerk and a wheelchair was ordered.  They trucked me into an exam room and left me to the tender mercies of the waiting staff.

I have no training in medicine, but I do know human nature.  The look that passed between them was not a good one.  Okay, so this is probably a little more serious than I thought.  Maybe it was a good thing I decided to blow off work in favor of a quick check.

Tests were ordered, nurses and technicians entered and left.  I was hooked up to a heart monitor and then an electroencephalograph and a ginormous tube shoved into a vein in my left arm.  It hurt.  I hate the nurse who did it.  Even more fun was the lovely forked tube that was shoved up my nose to deliver oxygen.  Seriously?  Was all this necessary?

I didn’t think it was but the EKG showed a different picture.  Aside from the 100+ beat differential in my heart beat second-by-second, it also showed a distinct absence of the all-important “P-wave”.  The on-call physician wandered in.  He seemed friendly, not bad to look at, had a winning smile.  He didn’t seem too concerned, but I know how they are trained to keep panic-stricken heart patients at ease.

I don’t do panic.  It’s really not in my nature—unless you count the time I saw my three-year-old daughter tumbling head-first from the top of a tree.  She caught herself and I yanked her out, vowing to whip her backside if she scared ten years off my life like that again.  Come to think of it, she may be the reason for my now-present heart condition.  I may go in there and smack her just on principle.

So, when the nice little doctor said he wasn’t too concerned but after discussing with the resident cardiologist, they were going to admit me, I nailed him to the proverbial wall. 

“Spill it, doc.  What’s happening to me?  And don’t sugar-coat it.”

“Atrial fibrillation, that’s what we call it,” he said.  As he explained it to me, he continued to watch the monitor.  He was watching for signs of alarm or undo stress.  It didn’t happen.  He seemed satisfied and walked away to have a room ordered.

After he left, a gorgeous young resident walked in with his equally stunning student.  They didn’t really have anything to do with my case, but they were there to learn.  I didn’t mind.  They were real eye candy.  Mmm-mm.  As they chatted with me, their eyes wandered to my heart monitor.  They both suddenly looked as if watching an exciting football game with their favorite teams running neck and neck.  Whatever was happening, it was fun to watch. 

“You think that’s cool,” I said, “wait until you see what happens when I raise my arm.”  When I did, the beats-per-minute jumped from 69 to 185.  I lowered my arm.  It went down to 80.  I raised both arms and it was off the chart.  Their eyes were huge.  They really began asking questions then.  I told them it was their faults.  Good-looking men get me all excited.  They both blushed a bright crimson.  It does a woman good.

By the time they finally had me upstairs in the cardiac wing, the situation had resolved itself.  My heart went back to its regular rhythm.  When I told the nurse it had stopped, she looked at the monitor and went in search of the cardiologist.  Without even talking to me, he had signed a plan of treatment.  Not sure how I feel about that.

Then he came to see me.  He was a nice-looking man, very presentable, with a friendly nature.  I so detest cold demeanors.  When you’re talking about my health, you better have a modicum of empathy or you run the risk of being told off.  He seemed personable enough and told me about my condition as well as the medications he wanted to put me on.  I settled only for the pill that would lower my heart rate.  I’m not one to take a lot of chemicals into my body.

I was to see him again the next day in his office.  He ordered more tests.  More tests?  Seriously?  I was already feeling like a guinea pig and had sores where skin had been removed with the adhesive tabs from all the machines.  Ah, such great joy.

So, I was sent home.  By the time I left, my mother, her husband and my mother-in-law had all been in to visit.  I refused to allow my husband to visit.  I’d spend more time watching out for his feelings than my own, so I told him to stay at work.  When they were ready to discharge me, I called to let him know.  He was relieved.

The next day, I arrived at the doctor’s office at the appointed time.  As it turned out, I didn’t actually see him.  I saw nurses and technicians, but not the good doctor.  Again, I’m not sure how I feel about that.  Actually, it kind of ticked me off.  

The tests were to be an echocardiogram and a nuclear stress test.  Owing to the nature of my condition, they said, I would not be expected to get on the treadmill.  That’s a good thing.  I used to have gerbils when I was a kid.  They would get on their little gerbil treadmills and run until they stopped of pure exhaustion.  No matter how long or how hard they ran, they never got anywhere.  I had no intention of being like a gerbil.

The echo was fun.  Got to watch my heart beat.  The tech thought I had a hole in my heart.  She did a bubble test.  Now, I don’t know about anyone else, but I always thought that if you got air bubbles in your blood, you would die in excruciating pain.  So when she told me what she was planning, I almost went through the roof.  Apparently, one does not get the bends from this little test and it takes much larger amounts of air to cause the condition.  I think my reaction amused the Amazon who conducted the tests. 

I watched the foamy bubbles enter the heart and saw them leak from one side of my heart to the next through the side wall.  Ooo-kaaaay.  Not normal.  Interesting.

Next, it was on the nuke stress testing lab.  It was an assembly line of patients at various stages of the process.  It’s funny that most cardiac patients don’t have much sense of humor.  It would’ve been nice to be warned about that going in.  I think I offended a couple.  Oh, well.  Being the youngest one in the room by a number of years, I think a few of them were somewhat suspicious of me.

Now, as the test was explained to me, I kept thinking about what my mother told me in the hospital.  She had offered a dire warning about this particular test.  She said she couldn’t describe the feeling she had when the chemicals flowed through her body, but it was horrible.  I rolled my eyes.  This is going to be enjoyable.

Okay, so mom was right.  It was a nightmare.  There was a terrible rush, as if I had run a mile flat out.  Only think is, every time I run a mile, the stress of the activity is accompanied by those tasty endorphins that cushion the stress with a feeling of euphoria.  This doesn’t happen when he stress is induced with a chemical agent.  Where the hell are my endorphins?

The feeling came upon me like a blow to the head.  It felt as if my brain was trying to escape through my ears.  The top of my skull needed a pressure valve.  My stomach began a treacherous climb toward my gullet.  My eyes began to cross.  I couldn’t breathe. 

“Michael,” I said to the tech, “get me a bucket.”

“Do you feel sick?” he asked.

Was the man stupid?  Did he have any concept of the poison pouring through my veins?

“No,” I said.  “I thought I would build sand castles on the floor.  Just get the damned bucket.”

Charlie was the other tech.  He just smiled and told me it would burn off soon.  Was he kidding?  How soon was “soon”?  I wanted it gone immediately.  If I could’ve lifted my arms, I would have throttled him.  I never wanted to tell someone to go to hell so badly, but he survived and so did I.

It was over in less than five minutes with my blood pressure not going too high, so no need for the unfortunate crash cart that sat too close for comfort.  They sent me back to the waiting room to put in more time before they took more pictures. 

After several hours, it was all done but the waiting.  I went home to wait without once hitting someone—even though my arm is hopelessly purple and sore from the wicked IV’s.  My mother would be so proud.

As luck would have it, I didn’t have to wait long.  They called me the same afternoon and told me about the VSD, the atrial fibrillation and the thankfully healthy heart and arteries.  No blockages, no disease, only the congenital defects causing my condition.  I’ll be on medication for the rest of my life, but I’ll stop fainting at dinner with my friends or in the break room at work, in front of my supervisors.  It should be a relief to them. The best part is I likely won't have as many migraines now.  That's a relief to me.