AKA:   Ticker Update #2

You can read the beginning of this story here and an update here.

Since this fiasco began, my heart has continued to thump around in my chest, apparently oblivious to the fact that it’s caused me no end of grief and probably countless new charges and line items on my hospital bills which, thankfully, the insurance company gets to shoulder the brunt of.  One has to wonder why your organs don’t have more sympathy to your own plights, especially when they cause it.

On Thursday of last week I finally got the results from both my echocardiogram and my Holter EKG monitor that I wore for 24 hours to record my heartbeat.    The echo came back with the following report:  “If you weren’t so fat, we could have gotten a better picture.”    Gee.   Leave it up to a doctor to say something nice, eh?   Actually, the written report said, “Due to the patient’s size, we were unable to obtain a clear picture.”    But I think we all know what was implied here, don’t you?

The Holter’s results were more definitive:   “occasional PVCs”.    This does not refer to polyvinyl chloride plastic, as I am more commonly dealing with when I partake in a plumbing project in my basement, but to premature ventricular contractions, a form of heart rhythm abberation.

Normal heartbeats are initiated in the right-hand atrium by something called the SA Node.   This is the “pacemaker” of the healthy heart.   All parts of the heart have the built-in ability to fire an electrical signal to beat their own part, but the SA node is the biggest and fastest, so it usually goes first and causes all the other parts to cascade in order, triggered by the signal from the SA node.   Thus, a normal heartbeat.

In PVC, for some reason, one of the ventricle’s own firing centers goes ahead of the SA node.  This “odd” signal causes the heart to beat backwards for a second, thoroughly confusing the poor thing and making it shake its head around like it just biffed itself on the cupboard door after trying to raise its head to hear what its wife was yelling from the other side of the house.    In essence, it misses a beat entirely, then comes back in with a vengence on the next one, and resumes the proper course towards the horizon.

Would you like to see my EKG from today and a PVC in it?   Ok, here ya go:

Oh, is that hard to see?   Here’s a closeup of my EKG:  2 normal beats, a PVC, and 2 more normal beats:

They’re one of the most common forms of heart arrhythmia and are usually benign, but of course, I had no idea on mine.   So my doctor scheduled me in for a stress test.

Yup, this is the stereotypical man running on a treadmill with wires suctioncupped to his nipples, except that they are adhesive, not suction, and very tightly on my chest hair, not my poor little nubs.

I did this today at 8am — quite the wakeup!     The nurse informed me that they had to get my heartrate up to a target level, which turned out to be 161 beats/minute, 85% of my max heart rate of 190.   It took me 7 minutes to get there and then I held it for another 3 minutes, running at 4.2mph on a 16% incline.     While this may not sound at all impressive to you folks out there in Jogs-To-Work-ville, it was a heavy breather, and not the good sort, either.

All the while they were taking an EKG and the nurse, a PA, and a resident were watching the progress, both to evaluate the results and in case I were to keel over and assume a horizontal position.

Thankfully, my PVCs decreased as my heart rate went up, and all but disappeared during the highest portion of the test, which is great news.    This is exactly what you want to happen, as it means that the heart’s own pacemaker is overpowering the faulty electrical activity and forcing the regular rhythm, even if the ventricle is still generating the irregular beat, a phenomenon known as overdrive suppression.

In layman’s terms, it means that my heart’s not fucked up.

I have to wait to really call it an “all clear” until my doctor gets the opportunity to review my test results, but that’s probably the case — a benign case of the bumps.    The next task will be to see if it’s worth even bothering to treat them or if it’s simply better to learn to live with them, which I am getting MUCH better at.

But for now, I can live with the knowledge that it looks very positive for me and my ticker.   Three cheers for pumpers that take a licking and keep on ticking.

Just a brief update — I wore my Holter monitor for the 24 hours, took it off, and then had an echocardiogram at Mercy Medical Center North Iowa at 3pm on Friday.   While the technician couldn’t say anything about it (they’re not allowed, legally, to comment), she at least had the heart to tell me that if she saw anything bad, she wouldn’t let me leave, and she let me leave, so….

Unfortunately, because of the weekend, I won’t hear anything till Monday at least, if not later, because people have to read the monitor output and the echo and get an analysis to my doctor, blah, blah, blah….

Meanwhile, my chest continues to jump around like a rabbit on crack and I am trying desperately to ignore it.   I’m doing fairly well, I think, although my resolve and ability to distract myself varies at times.   Oh, to feel normal again…

I can’t say that right now I’m in the best position of my life.    At the moment, I have a Holter heart EKG monitor hooked up to my chest to monitor every beat of my heart for 24-hours so the doctors can try to figure out what’s going on with my ticker.

Hellloooo, 30.

Saturday night as we raced home from Cedar Rapids after a lovely weekend that had a bad ending (kid puking), I started feeling my heart doing odd things.   After feeling it for awhile, I realized that it was missing a beat every so often.   It would be going along and then there’d be this long pause where a beat would normally hit in the rhythm, and then a HUGE beat would hammer my chest and it’d continue on its way.

Most disconcerting.   But I chalked it up to a lack of sleep, lots of adreneline from the situation, and so forth.   I wasn’t worried.

Until it continued the next day.   And the next.   And the next.

It only happens in periods, of course — an hour here, an hour there.   Never when I’m doing intense work.   Never when I’m sleeping (that I know of).   Only really when I’m wound up (anxious) or coming down from doing something heavy-breathing (not that, you twiddlehead).   To be honest, I’m not really sure of the triggers, only that it happens far, far too often.

There’s no other symptoms of a heart issue, thankfully.   No pain, tightness, sweating, dizziness, nausea, etc.   If there had been, you can bet my ass’d be in the ER quicker than a how’s-your-uncle.  I’m not completely stupid.   I just have these random feelings of emptiness and then a big BOOM as my heart comes back to life.   It really screws up my concentration.

So, I went and saw the doctor today, like any good paranoid patient would, but not before I had researched the possible diagnoses on the web, of course.   Dangerous, I know, but…my curiosity wouldn’t let me otherwise.   In this regard, my suspicions match the doctor’s analysis that I probably have a PVC or PAC — Premature Ventricular Contractions or Premature Atrial Contractions — both conditions that aren’t horrifically serious as long as they aren’t coupled with other heart disease.   But who knows about that?

Doc gave me a look over, listened a bit, popped me on the short-term EKG (didn’t show anything — heart didn’t act up, go figure), drew some blood to check hormonal and mineral imbalances, and then slapped this Holter monitor on me to record what’s going on for the next day.   I have wires crossing all over my chest and little sticky patches that will surely rip a ton of hair off my chest when we’re done, rendering me into a polka-dot painting.   I can pick up 56 channels and my bellybutton can tune in Howard Stern.

Noon tomorrow I can take this thing off (it has a little recorder box that has a countdown — I’m at 12 hours, 45 minutes to go) and then at 3 I have an echocardiogram to look at the structures of the heart and make sure it’s not a blockage, a bad valve, etc.   That should be interesting and nervewreaking all at the same time.

At this point, I’d just be happy to know what I’m up against, to know if I’m likely to drop dead randomly (the doctor says very unlikely, but…), and what my options and possibilities are for treatment, if any.   Sometimes the above conditions are simply untreatable and non-threatening, so you just have to live with them.    Let me tell you — trying to do anything useful when your heart is stopping every 3-6 beats for a pause and then slamming back into gear is damned near impossible.

I dunno.   I’m out of shape, overweight, and just was talking to my wife this past week about us both getting in better shape and weight.   I guess if this is a wake-up call for anyone, RING RING.   Sheesh.