Thursday, October 25, 2018
Four weeks out from open heart surgery: The beat goes on......but irregular
A common after-effect of heart surgery is an irregular heart beat. I had a bout of something called Atrial Fibrillation while in the hospital. For the first two weeks I was home my blood pressure and heart rate were normal.
However, out of the blue, my heart went out of whack--it started racing, my blood pressure dropped, and my blood pressure cuff said I was experiencing Atrial Fibrillation again.
So yesterday I met with my cardiologist who did an EKG and reported that I had something called Atrial Flutter. As Vicky said, "Flutter" sounds better than "A-Fib" because "Flutter" is like what a butterfly does and "A Fib" is what bad people tell.
We discussed options and decided I would get a procedure where my heart was given a mild electrical shock. So I had that today.
It sounded like it was pretty straightforward---just go in and I would lay down and they would put me out for a couple of minutes, give me the shock, and I'd be on my way. However, it is more involved than that. I had to fast for 10 hours, report to the SURGERY center (again), dress up in hospital garb, get an IV, and (worst of all) wear the little yellow booties and shower cap. Vicky teases me about the shower cap---I can see why.
Aren't I the cute patient? Like my shower cap?
Anyway, four weeks from the day of my surgery I was back at the hospital's surgery center, which gave us a mild, slightly unpleasant feeling of deju vu. The cardiologist administered a mild shock and the heart beat went into "sinus," or was "sinus," or something with the word sinus in it, which means good.
Of course when we first heard about this procedure we both imagined it was like in the movies where someone holds two big paddles to someone's chest, yells "CLEAR," and then the unfortunate victim bounces a foot off of the table. Like they did with Frankenstein. But actually it is a very mild shock (and they didn't yell "CLEAR!")....and even though am now up and walking around, I'm not Frankenstein (even though I do have a bunch of metal in me like he did, poor guy).
The staff at Virginia Mason were once again excellent at explaining things and providing me with information. I was shown a print-out of the EKG before, during and after the procedure. I asked if I could have a copy, so they provided one. It's very interesting.
I have divided the output into before shock and after shock. This one shows my Atrial Flutter, and then the mild shock, where everything goes nuts:
The next one sort of overlaps with the first one, starting with when my heart got excited from the shock, and then it immediately went into that sinus thingy, which is good. The whole thing was done in 15-20 heartbeats, or about 15 seconds. Absolutely amazing. The cardiologist said that sometimes it requires several shocks, but it was one for me. I had hoped this meant something better about my prognosis, but she indicated it didn't. Still, I"m proud--only one shock to my heart!!!
And I am taking a new medicine to reduce my heart rate.
All solved? No.
It is a big unknown, which I have found the aftermath of open heart surgery to be. Although my heart immediately went into its appropriate rhythm, this is the usual outcome for this type of shock procedure. The problem is that there are no predictive factors regarding how long it will last. Could last a day, could last forever.
So for the foreseeable future, I am going to be quite anxious about it. But the only way to deal with these things is to meet them head on. I had the option of trying only medicine, and that would have been easier. However, having the "Cardioversion" (i.e., shock) is a more reliable way of getting the heart beating appropriately right away, which has its advantages, so we decided to do that. The sooner you can get the heart beating appropriately the more likely it is that you can prevent the heart from "learning" to beat inappropriately, or something to that effect.
I got to drop one medicine yesterday, but added another--the one to lower my heart rate. If I would take about 10 of these every day my heart rate might be where Vicky's is naturally---she's like a highly trained athlete in that way (and others, actually; she's quite amazing).
All par for the course. I am much better physically this week than I was five weeks ago before the surgery. Although at that time I had no abnormal heart beat and was not in pain from having my sternum opened, I had a time bomb in my chest.
So we deal with the after-effects. I may have them never again, have them for awhile, or have them forever. I feel fortunate that I get to deal with after-effects--some people don't.
But, man is this type of surgery ever a journey that doesn't seem to end. For both of us. I can't imagine taking this journey on my own. I am very grateful.
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