Many years ago when I was in highschool I was at home in the apartment I grew up in, alone and watching television. I don't recall what I was watching, but I remember the phone call I was about to get very clearly.
The phone rang. I answered.
Keep in mind, kids, this was well before everyone had a cell phone.
It was my mother. Not an unusual thing to happen, since at that time she was in a relationship with a guy who lived not too far from us and would often stay at his place.
This call, however, was a bit unusual.
"Scott, don't worry but I'm in the emergency room."
Reader, I worried.
My mom had been feeling under the weather for a week or so, and went to see her doctor. The doctor examined her for a bit and said, "How did you get here?" She told him that she had driven herself there. His response?
"I'm driving you to the emergency room."
It wasn't the flu, but rather a heart attack!
She had a stent put in and lived to tell about it (until cancer got her).
Anyway, this has been a sort of running joke with me. I'll go to the doctor and say to Marisa, "I bet I'll end up in the emergency room!"
I'm the Cassandra of jokes
I've been wearing a smartwatch that measures my heart-rate for years now. And my heartrate has been pretty stable... until a couple of weeks ago when my average heartrate suddenly went up significantly.
I thought this odd, so I fished out Marisa's blood-pressure monitor and took my blood-pressure. It was fine, but this little icon appeared. I didn't know what it meant, so I Googled it.
That little icon stands for "Irregular heartbeat detected" and the manual suggested that I go see my doctor.
Not troubling at all, blood-pressure monitor.
To the PCP OMG
I called my PCP (who I had never actually visited before. I know, I know) and asked for an appointment. I was told they were taking appointments for the end of November. I didn't think waiting that long was a good idea, so I explained my situation. The office coordinator agreed and made me an appointment for last Wednesday (I called on Monday).
I showed up at the office, saw the doctor and explained my tale. He hooked me up to his EKG machine and said, "Yep! You have atrial fibrillation." He, and his nurse, asked me if I felt light headed or anything. I was honest and said I felt fine. In fact, I had run 4 miles that very morning!
They were impressed.
The doctor didn't seem too worried. He explained that the biggest risk with afib is that a blood clot could form in the heart and if it dislodges it’ll go straight to my brain and I'd have a stroke.
Not troubling at all, doctor.
He followed that up by telling me that I am in the lowest risk pool for that to happen. He prescribed a beta blocker to slow my heart rate down and told me to call a cardiologist.
I asked if I had to change anything in my life and he said, "Nope! You can still run as long as it doesn't make you feel lightheaded."
I was relieved that there was a reason for the change and while it was serious, it wasn't deadly.
I picked up my prescription (do you know they don't write you a prescription anymore? It just magically appears at the pharmacy! Who knew?) and headed home to call the cardiologist.
They didn't have a free appointment until Nov. 11th, so I made the appointment and asked that if something opened up sooner to please let me know.
Since it was about 12:30pm at this point I went to work with the intention of grabbing lunch and working the rest of the day.
As I walked into Wawa (a frequent destination of mine) my phone rang. It was the cardiologist's office. Seems an appointment opened up today, and would I want to see a doctor in 40 minutes?
Thinking this was a very rare occurrence I agreed and hastened to the doctor's office (after grabbing a wrap for lunch).
They should soundproof these rooms
I arrived at the office to see Dr. Goldberg. A tech came in and took my bloodpressure and do my second EKG of the day. She had me take off my shirt to do the EKG, which makes sense, and she told me that Dr. Goldberg liked people to take their pants off as well. But I could wait until she brought me a robe to remove my pants.
She brought a robe. Off came my pants and I sat in a tiny room by myself waiting the arrival of Dr. Goldberg.
Now, I had googled Dr. Goldberg so I would have an idea of what to expect. He is an older gentleman. He was most definitely not two younger women... and that is who came into the room after one of those "polite doctor knocks."
They explained that they were medical students working with Dr. Goldberg and asked I would mind if they examined me and asked some questions.
I'm a fan of higher learning, so I was game! They listened to my heart and my story. They took my pulse and told me that my heart was beating faster than my pulse... which seemed concerning to me.
Then they left. I assume to confer with Dr. Goldberg.
I sat. In a robe. With no pants. Waiting.
Another quick knock and the man himself, Dr. Goldberg, appears. He takes my pulse and asks me some questions about my life (where I live and so forth). Then he says, "So, I'm sending you to the Emergency Department." That's what's commonly known as the Emergency Room.
This seemed to have escalated quickly!
He said that not only did I have AFib but I also had Atrial Flutter. Which sounds cute, but isn't. And it was concerning that my heart rate was clocking in around 150 beats per minute (which one of the student doctors explained meant that my ventricles were beating 150 times but my atrium were going at 300 beats a minute. Not good.).
He said, don't worry this is a simple procedure! And I was like, "what procedure?" He was talking about a cardioversion: they shock your heart back into a normal rhythm. He said it is basically an out patient procedure and we could fool around with drugs for weeks but why bother?
I agreed and off Dr. Goldberg went.
Then I heard the nurse in charge of the office talking to the Emergency Department. She was like, "Yeah! He ran 4 miles this morning. Can you believe it?"
Pennsylvania Hospital, the nation's first hospital, is where my mom was treated for her cancer and where Marisa gave birth to our sons. There are lots of memories in that place for me and now I can add:
- My first ER admittance
- My first IV
- My first ride in a wheelchair and in a hospital bed
But I'm getting ahead of myself. My cardiologist's office is 2 blocks from the hospital. They were sending me to the ER and I felt fine. I wanted to walk. The nurse wanted me to take a Lyft.
Checked myself in and took a seat in the same waitingroom where Marisa and I waited that fateful 3rd of July with my mom as she started her cancer journey (which had already started but none of us knew that!).
It was weird is what I'm saying.
A nurse had me run through my story again and had a tech run another EKG on me. She apologized profusely as she ripped the previous EKG stickers off of my increasingly less hirsute chest (and marveled that no one had shaved my chest yet).
The EKG confirmed that I was in the right place and I was popped into a room to be visited by 4 cardiologists over the course of a few hours. Fun fact: one of those cardiologists was the son of Dr. Goldberg. His name? Dr. Goldberg.
I asked one of them how worried I should be. I mean, it is serious enough for me to be in the Emergency Room but should I be totally terrified or mostly concerned? She told me that I shouldn’t be that worried. They see this all the time and given that I am “young and fit” this shouldn’t be a big deal.
That made me feel better, though I was still in the emergency room.
I was told that I needed to have a transesophageal echocardiogram (TEE) and then a cardioversion. Scary sounding stuff! But the TEE basically involves them shoving a probe down your throat so they can get a better look at your heart. You just need to have your throat numbed, and I was told it doesn’t take long. Though I don’t think it is pleasant!
Dr. Goldberg had explained the cardioversion to me before, so at least I knew about that. It is an outpatient procedure which is nice, though they couldn’t schedule it for me until Thursday which meant I got to stay overnight in a hospital room!
Another first for me.
Your room, sir.
They pumped me full of beta blockers (to slow my heart rate) and anticoagulants (so a blood clot wouldn’t break off, float to my brain, and give me a stroke) and we waited for my room to become available (by this time Marisa had arrived!).
They hooked up a portable heartmonitor so they could make sure nothing else was going on with my heart and removed the IV which was nice because that meant I no longer had to pee in a bottle.
We made it to the room, though I must say it is odd being wheeled around while you’re laying down in a bed, and settled in. I didn’t have a roommate (woo!) and since Marisa had been in the same hospital for 2 weeks with preeclampsia she had some pro tips (mostly around moving the computer monitor away from the bed as you slept).
I hadn’t eaten anything since 1pm or so, and now it was about 6:30pm. Once they figured out they weren’t doing the procedure until the next day I was told I could eat but shouldn’t eat or drink anything after midnight. Marisa went and bought me a lovely chicken quesadilla and we ate a quick dinner together before she had to go home and take care of the boys.
As we were eating a nurse came in and checked my heart because the monitor told her that it reset to normal rhythm all by itself (well, with the help of the drugs). This was exciting and Marisa went home slightly less worried about me.
Being in the hospital is super boring, and not very restful! The nurses are chatting with one another just outside your door, people pop in and check stuff, there’s lots of beeping, and someone in the next room was moaning rather loudly. I was hoping to get some reading done, and I did a bit, but the environmental factors, and my own stress, made it difficult to concentrate. I decided I should try and sleep a little.
Now, I never have trouble going to sleep, and that held true. I was fast asleep when at 2am a nurse came in and woke me up. “Your heart rate is below 40 BPM. Do you feel ok? Are you dizzy?”
I was bleary eyed, but felt fine and let her know. She seems satisfied and left me to my own devices. I opted for more sleep.
The day starts in the hospital at 5:30am. Who knew? That’s when a tech came in to take my vitals. And since I was up, and people were coming in and out of the room (2 nurses came in, didn’t say anything to me, and took the other bed that was in the room after moving all the furniture. Later, someone came with a different bed and set it up where the other one had been), I decided to stay up.
They call him Dr. Feelgood
I hung out in the room for a bit and then my new cardiologist (not Dr. Goldberg) visited me and told me what the plan was. Since my heart had corrected itself there was no need for a cardioversion today, but he wanted me to do a stress test (with ultrasounds before and after) to make sure there wasn’t a blockage causing the AFib.
He also assured me that while these conditions are serious they are mostly just annoying chronic issues for someone as young and fit as I am. It would seem that two groups of people, in general, get AFib and Atrial Flutter:
- People in their 60/70’s who are overweight and diabetic
- Endurance athletes
Basically, he said you’re either really unhealthy and you get this or you’re very healthy and you get it. The people in the middle tend not to have to deal with it. I asked him if that meant I should be less healthy, you know so I could be more healthy. He was not amused.
We did chat about long term management of my conditions. He said they like to start with drugs first. And he prescribed me a beta blocker that I only have to take when my heartrate jumps or I feel palpitations. There’s the cardioversion which is good for folks who just need their hearts adjusted once and never deal with AFib again (that’s not me, sadly). And then there’s lasers.
Well, there might be lasers. The procedure is called a cardiac ablation. They basically put some catheters into your heart, by way of your upper thighs I think, and destroy the clusters of nerves that cause your heart to miss fire. This procedure is another one that is outpatient, though it would require me to be under for about 2 hours.
Why aren’t you wearing pants?
He left, and I assumed I’d get my stress test right away and be discharged shortly thereafter. Foolish Scott.
Several hours past. Several people told me that they were working on getting the stress test setup up. And I waited.
Then at 2pm my chariot, in the form of a wheelchair and a orderly to push it, arrived. Now, I had never had a stress test in my life at that point. I didn’t know what one should wear, so I just had my hospital gown, socks, and underwear on. Seemed reasonable to me, especially since I assumed someone would tell me if other things were required.
I got to the stress test room and two very nice techs were waiting for me. They had me hop up on a table and then asked me, “Don’t you have shoes and pants?”
“Umm, in my room! I didn’t know what I should bring with me!”
Turns out I should have brought shoes and pants. But they gave me some rather fashionable scrub bottoms and one of the techs ran to get my sneakers from my room.
I put on the pants, took off the robe, and hopped onto the table. The tech looked at my chest and said, “we’re going to need to shave some of this.”
“Do what you need to do!”
And so they did. And yet another set of EKG stickers were affixed to me.
A nurse came in and it was time to do the stress test. After, that is, they told me all the ways - highly unlikely ways - I could die thanks to the test. I signed a waver acknowledging the danger because I’m cool like that and onto the treadmill I went.
After 3 minutes, I was told, the speed and incline of the treadmill would increase. They needed to get my heartrate to 151 for their tests, and so we began. Their calculations told them I would last 9 minutes, which meant I wanted to beat that! So I went for 12 minutes and considered it a win.
The stress test was clear (and told me I am in above average shape for a man my age.. and shape one assumes).
After completing the test I, along with my slightly shorn chest, were wheeled back to my room. To wait and wait and wait. Luckily my nurse ordered me a tray of food because I was quite hungry. But I could have went without waiting 4 hours for them to tell me the stress test was fine and I could leave. A doctor didn’t even come in and talk to me. My nurse just said, “You can go! Sign this. See ya, later!”
I left the hospital with a heart beating in normal rhythm and another prescription for beta blockers (you may recall at the start of this very long post my primary doctor also prescribed a beta blocker, but he told me to take one a day. With this new one I only take it when needed which is nice. Though it also means I have to carry this medicine around with me in case I need it!).
Leaving the hospital is sort of anticlimactic. This huge life event happened for me... but for everyone there these things happen all the time. And my issue was relatively minor, so it wasn’t a big deal.
Doctors weren’t there to see me off. No one said, “Keep on beating! That is a reference to your heart. Sheesh, I should have said something else because now that I think about it that can be readily misinterpreted. Can we start over? Hey, where are you going?!”
I just walked out of the hospital and headed home. My plan was to walk home since I thought I would be nice to clear my head a little, but the twins were melting down and Marisa was outnumbered so I hopped into a Lyft and arrived to some very cranky babies and a relieved Marisa.
I don’t know if the babies noticed I was gone for longer than usual, but Sammy greeted me with several minutes of cooing, which was certainly an upgrade from the hospital. Nary a doctor cooed at me! Not even once!
What’s the plan going forward?
Well, I’d like to say this arrhythmia was a one time thing, but it has already happened again since Thursday (and the drugs fixed it. Hurrah, modern medicine). It seems likely that this is a condition I’ll have to live with which means at some point a doctor will be firing lasers IN MY HEART. That’s kind of awesome.
However, I’ll leave those sorts of decisions up to the medical professions. For now I am going to make sure to go to my primary care doctor more often than once a decade and have regular visits with my cardiologist.
There’s also been some changes on my wrist. Thanks to my Fitbit Versa 2 I knew something was up. Now that I know what the issue is, I decided to spring for an Apple Watch.
Why? Well, it includes a feature which detects AFib occurrences and allows you to run EKG scans (which I’ve been doing a lot!). Lest you think I’ve abandoned my beloved FitBit I say nay! I have two wrists, and I have two trackers! An Apple Watch and a FitBit Charge 3. My streak of over 10,000 steps continues!
My running also continues. I ran 8 miles today, and felt fine afterwards.
This was a scary event but I’m glad it happened. We caught it early and it seems like it’ll be an easy to manage set of heart conditions.
Now, I’m off to check my heartrate and run another EKG on myself.