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Healthy Heart for Valentine's Day, pt. 1

Friday, February 15, 2013

What a couple of days this has been. I mentioned this in a forum post in my BLC#21 ONYX OUTLAW team's thread and really nowhere else until I updated today's status.

Starting on Sunday evening, I noticed that my heart would race for a few beats (6-12 was typical) before slowing back to normal. I just shrugged it off - maybe I was laying wrong and just shifted, maybe I just got a dose of adrenalin for some reason, maybe I got too much blood sugar. It happened a few times, but I didn't really worry at that point.

Monday it happened sometimes at work sitting at my desk and I started to also notice an occasion harder beat. Actually, what it felt like was a brief stop then a firmer push. It didn't cause me any issues in my workout or walking the dog later, so I was still mostly shrugging it off.

Tuesday it seemed to be happening more often - still very short episodes, still very random. I couldn't decide if it was normal and I was just getting hyper aware of it or imagining it meant more. So I turned on my HR monitor and started watching the numbers.

In the last month since I got it, my resting HR has been amazingly consistent. The lowest I usually saw was 58-59 if I was laying down. Sitting at my desk was more commonly 62-65. Getting up to walk down the hall to the restroom could go up to 72-75. Brisk walking took me over 110 (to a little over 60% maxHR). Instead of the expected 62-65, I saw 72 ... while I was sitting still at my desk. Then I felt an episode and the watch read 83 for a few seconds, then dropped down to 58, then leveled out.


After seeing that happen (with varying numbers) more than a couple of times I felt the episodes -AND- not seeing the consistent 62-65 I was familiar with, I started to get a little concerned. So I started looking online. The moment heart is involved, a lot of things just tell you to ... call 9-1-1. No, that's not the information I want. I want to know likely causes, things to watch for, ways to reassure myself that I don't need to get involved in medical expenses.

Tuesday's workout went normally. While I was active, my HR was more stable and I was reassured that nothing major was wrong.

Wednesday I was really starting to notice the episodes were more frequent. I probably should have kept track by times or something, but didn't. However, it was more than a couple an hour. About this point is when I wrote the thread post for the OUTLAWS. (Honestly, while I said I didn't need to be told I needed to see a doctor ASAP, part of actually posting that at all publicly was telling MYSELF to get my butt to the doctor. Because I knew if I read someone else saying this, I'd be right there telling them to get checked.)

By around lunch-time, I was really internally arguing with myself over getting it checked out and waiting it out. I'd had one episode where the HR monitor decided to call the racing heart episode 168 bpm. I figured that had to be off, but still meant it was definitely going too high for me just sitting. I called the nearest hospital's appointment line and talked to someone about what options other than ER were available. They have an Urgent Care clinic, and at that point I was thinking to leave work early and go ... but at the same time not really wanting to waste the time and money.

Then I did my usual hop up from my desk to go to the front lobby when one of the delivery guys showed up - only to stop halfway into the room saying "head rush" as I went very briefly light-headed and my sight fuzzed/blurred. It cleared very quickly, and may really have been nothing abnormal, not at all connected to the heart racing, but by that point ... I was just getting really self-argumentative about going to the doctor or not. In fact, something I had written right at the end of that post to the OUTLAWS was the tipping point at which I think the "go see a doctor" voice won: "being carried to an ER in an ambulance if it goes bad would cost more". I was gambling with my life. If it was bad and I ignored it, the costs wouldn't just be monetary - and would all be higher than I wanted to pay. If it was good and I was seen, the costs would primarily be monetary and I could eventually pay them off.

I finished out my work day and had talked myself into going to the hospital, knowing I'd be there too late for the clinic to be open, and walked to catch a nearby bus. Actually, once I turned the corner I could see the bus coming in the distance and the stop was at the very end of the long block and ran for it. (Again, no heart symptoms running but it did seem to take a little longer to settle after I was on the bus.)

Got to the hospital, found the ER, and signage was confusing. Misread one thing that said to talk to the officer on duty, only to have him tell me I needed to stand behind a line that said Start Here in the other room. There was NOTHING in that other room that said Start Here. (Now that I know what he meant, no it doesn't say that - it's says to remain behind the line and not block the doors.) Ten minutes of standing in that room not sure what I was doing, I walked out. I walked about halfway back to the bus stop arguing with myself every step of the way.

Having written the post for the OUTLAWS, I kind of knew I ~HAD~ to follow through and get seen. I didn't need their lectures because having announced the situation, now I was majorly lecturing myself. I turned around and went back, waited and when my turn came got started in the LONG process. The first person took basic information, hooked me to a little pulse monitor and had someone set up the first EKG they did. The EKG didn't catch one of the episodes, so looked as wonderfully healthy and normal as could be. (However, I think from the speed of the beeps of the pulse monitor, and having one of the episodes there before the EKG, they knew something was happening.)

From that point, however, it became a very very long waiting game. It was around 6:30 pm - 7:00 pm that I first got signed in. It was around 1 am when I got called in and established in a bed. That means after cafeteria hours. They had two vending machines - one for drinks, one for food. At $2.25 for a 12 or 16 oz bottle of juice, I passed on that. I tried to get a granola for $1.50 only to have the machine not accepting bills and me carrying no change. In my backpack I had a liter of water and an 8 oz container of chocolate milk. That was all I had for dinner.

I was C-O-L-D. I have no idea why, maybe it helps with germs, but ER is chilly and that was compounded by my body's natural shutting down around midnight that always leads to me feeling colder than normal. Luckily, I did have my running jacket - the one from the picture - so I got that put on under my normal jacket and did feel a bit better for a while.

It was a very weird feeling to be sitting / standing for hours in a room full of miserable people retching, coughing, sniffling, trying to calm screaming babies, and more ... and look perfectly healthy other than a rare sniff or cough that had nothing to do with why I was there. I was noticing my heart doing its little episodes more often, though. Just nothing anyone else would notice.

Around 1 am, I was starting to worry that I'd missed hearing my name. I got up and walked around toward the first desk where I'd signed in to ask how I could be sure I hadn't missed it, only to have her pick up her phone and call my name just as I was walking up. emoticon Quite the coincidence.

From there I was taken in to a room and bed and hooked up to a monitor - pulse, blood pressure, and some heart monitoring (like the EKG, but not as many points). That was enough to let them watch it from outside the room and catch some of the episodes. The racing itself didn't seem to be their biggest concern. Instead, after the race, my heart rate was dropping really slow, then picking back up. Their tracking saw it bouncing as high as 138-142 and as low as 38-42. My resting HR was also staying a bit too low for comfort in the 40s much of the time. Work out regularly, I might, but I am not an athlete to be in that realm normally.

The ER doctor came in briefly at that point and said he'd caught those and would be having another EKG done so he could get a clearer look at what was going on than the few leads could catch.

Somewhere in there, one of the nurses drew blood and got me blankets. Warm, oh so wonderfully warm like they'd just come out of the dryer, blankets.

The EKG was done for long enough that she caught several episodes and managed to get the ER doctor what he needed. At that point I got the preliminary diagnosis: a benign arrhythmia and, separately, atrial fibrillation.

The first was the symptom I was feeling less often that seemed like a missed beat and stronger push following that. What it really was, as he explained, was that one beat would come normally, the next would come a little early, then the third would come normally -- but feel like there was a longer gap because the second had been early.

The second was the racing heart feeling. As he described that, the electric signal to tell my heart to pump either wasn't coming from the right place or wasn't producing the desired result -- the top half of the heart contracting to pump blood into the bottom half. Instead, the signals are more chaotic and the top half seems to vibrate rather than pump properly. The bottom half also ends up pumping faster because the signals passed along are chaotic.

He couldn't really tell me a lot more, saying he was just an ER doctor and the data and more would need to be reviewed by a cardiologist. I was scheduled to be admitted. Only problem? It's one of the busiest hospitals, to the point that the hospital did not have any empty room/bed available. So I'd be "sleeping" in ER. I got an hour or two of sleep there, very scattered and broken. I was thirsty (had not had any water since finishing off my liter in the waiting room) and hungry. Worse, every time I did doze off, my head would slide to one side or the other - as I was on my back and inclined. That led to a very sore neck that would keep me from getting any more asleep.

I was still more awake than asleep at 6 am, but had managed to get mostly to sleep by the time my phone alarm went off at 7:15 am. A phone sitting in the pocket of my backpack down on the floor, out of easy reach.

(And being 12:30 am, I really need to crash and sleep, so I'll continue this with pt. 2 tomorrow. The long story short so no one worries is I'm home, checked out healthy, and have a "prescription" to take an aspirin a day for the next three months. Cardiologist said I have nearly zero risk of stroke, the only risk factor for me being my gender.)
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Member Comments About This Blog Post
    What an experience glad you decided to go back and get checked that is the big thing . take care of your self.
    1853 days ago
    While I'm sure the E.R. experience was completely unpleasant, I'm so glad you sought help. Glad you had your hrm with you too. No second guessing number variations like that. Good luck with your follow up visit with the cardiologist. It may be wise to have them check your potassium and B12 levels. My mother had severe cardiac issues until it was found she was potassium deficient. A close friend had an even worse experience from a B12 deficiency. While both are extremely serious issues, the "fix" for either is simple. I hope yours is a simple fix!
    1855 days ago
    What a frightening experience. I'm glad that you're ok! If you need anything, let me know -- I'm about 40 minutes away.
    1855 days ago
    In Australia Atrial Fibrillation is treated with Warfarin (blood thinner) due to the risk of thrombus (blood clot in the atrium, which is not contracting properly, causes flow through the heart to be turbulent) and subsequent risk of stroke (if a piece of clot breaks off and heads up the carotids). If it is a new onset AF ( less than 48 hours) or you have an echocardiogram to prove there is no thrombus we can 'cardiovert' you, that is- we put you back into normal rhythm. This can be done with either medications or DC shock (like on the movies, defibrillated under anaesthesia)- then you don't need to be on blood thinners).

    AF is an arrhythmia, your story is classic of intermittent AF where you have palpitations, tachycardia (raised heart rate) and episodes where you may feel light headed or even faint due to the fact that your heart isn't pumping blood very efficiently due to the abberant conduction pathways.

    Additionally, it seems they haven't investigated the cause of your AF. There are many causes, the most common is ischemic damage (such as a mild heart attack), dilated heart (lots of causes including longstanding hypertension/high blood pressure).

    In summary, aspirin is not enough to prevent the risk of stroke. AF is treatable. The cause of your AF needs to be investigated. I'm not entirely up to date on how the American health system works but you need to get this checked out. Strokes are not fun, and it is certainly not worth the risk of sitting around hoping that the aspirin prevents it when you could have it treated properly.

    From Doveseyes daughter- final year student doctor in Perth Australia
    1855 days ago

    Comment edited on: 2/15/2013 10:01:46 AM
    Wow Dearie, I'm so glad that you went and got checked out. So wise of you and you're such an inspiration to us now. Good luck to you with your aspirin. That's a really smart move too!

    emoticon Karen emoticon emoticon
    1856 days ago
    Good for you not ignoring your symptoms! Glad you are not in immediate danger! emoticon
    1856 days ago
    Glad that u did not ignore the syptoms and went to the hospital, U did the right thing! emoticon mm emoticon emoticon emoticon emoticon emoticon emoticon emoticon emoticon
    1856 days ago
    We've been worried sick at the campfire, Blue! So glad you went in!!
    1856 days ago
    emoticon I am glad that everything is OK, it is a scary feeling when you don;t know what's going on. emoticon
    1856 days ago
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