Wednesday, March 14, 2012

A Convergence of Factors

       

It certainly does feel like "chaotic signals"


      In January and February when I experienced my first episodes of paroxysmal atrial fibrillation and the Emergency Room physicians asked me why I thought this had happened, I joked that  "Maybe it's all the coronal mass ejections".    It really was meant to be a joke, yet the electrophysiology cardiologists didn' t think it was all that amusing, and now I am wondering if my joke wasn't at least partially true.   A couple of days after there are coronal mass ejections on the sun, particularly powerful ones of late, by the time these energies get to Earth, I seem to have particularly vivid dreams, and then often in the middle of the night, I convert to the arrhythmia, atrial fibrillation.    This is now the fourth time I have converted to this rhythm since January 29th.  I am frankly, sick of mad night dashes to the university medical center some distance away.  I am tired of EKGs, bloodwork to check potassium and magnesium levels, tired of the intravenous drips, being an interesting test case, and of the $250. co-pay now required by my insurance. Most of all I am sick of my heart jumping around like a disturbed fish confined to my chest.
                I am not really sure what happened this time to cause this. It was a busy day.  One of my dogs had surgery recently and she has been a tough customer to care for.  Moving her from barn to outdoors and cleaning up after her has been physically tough when I frankly have not recovered from the second and third episodes of a-fib.  I am still tired and have a lack of energy.    This afternoon, one of my sons and I were doing some target shooting. (I am overdue)    All of a sudden a cluster of sirens were heard.  We didn;t know whether someone had called on somehow hearing our target shooting on the farm, or what had happened, as it's unusual to hear sirens this far out in the country.   Then we smelled it.   There was a brush fire somewhere, on the first warm day of the season, and things are just dry enough and windy enough for it to spread and be a real problem.   The state police and sheriff's office scrambled to look for the brushfire, while a pumper truck and other trucks feverishly drove up and down.   Finally the forestry department drove by.    We did a survey of our farm and were satisfied that the problem was not at our place.   Eventually, this was brought under control, but the running around, all the adrenaline, and the the smoke did not help me.   This no doubt fuelled the asthma which fuelled my nighttime arrhythmia, at least this time.
              Medication can be given orally for most people in order to convert atrial fibrillation.  Unfortunately, even though I have this medication in my possession, it cannot be given unless the patient is on a cardiac monitor, at least the first time.   Taking it without monitoring could result in a fatal arrhythmia outside a hospital setting.
               How do I feel knowing that an arrhythmia ultimately caused my father's passing, and caused my beloved 12 and a half year old son's sudden passing, of an issue no one knew about. and now is afflicting me as well.  I'm not too happy about it.   However, I will do what I am told.  I have talked to the electrophysiology fellow on call, and he is planning to admit me to a cardiac unit in the morning, if I remain in a-fib all night.  I am most concerned that this disorder will severely limit my ability to travel, and that perhaps my ability to do physical things will be limited. The possibility that this will shorten my life doesn't get much consideration since I was never guaranteed a long life anyway, no one is.   I would like to make sure my remaining children are more set and secure in the world before leaving. I also would not want my passing to be particularly difficult for my husband.    I am not thrilled about the possibility of having a cardiac ablation, but this is certainly where I am headed.   So, I sit, blogging away, too uncomfortable to sleep, feeling both lousy, hyperalert and generally annoyed.





"Heart" singing "These Dreams" seemed appropriate

4 comments:

  1. Bradycardia can arise from two basic mechanisms. Very first, decreased automaticity from the sinus node can result in sluggish heart prices or pauses. If sinus node pacemaker action ceases, the heart will generally be activated at a slower rate by other cardiac tissues with pacemaker action.

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  3. Yes, this is certainly true, but I have been fortunate it that I have had no bradycardia, sinus node issues, nor do I have sick sinus syndrome, nor do I, or any of my family members require a pacemaker. Our constellation of collective arrhythmias have included atrial fibrillation caused during stress by the activation of of a focus near the pulmonary artery. This was ablated in one of my sons, and could still be, in myself. My fathers was never mapped or ablated, likely because he had it for 30 years prior to his passing, and was probably not a good candidate for it by then. As for dear Daniel, the theory is that Long QT Syndrome, coupled with excitement of that day, led to a more rapid rate and then to a Ventricular Tachycardia, and likely to a Torsade des Pointes, which explains why rapid help, including medications, sadly, did not improve or rectify the situation.

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  4. I replaced my original post with one with typographical errors corrected. I hope in the early hour and dim light, I caught them all.

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