Tuesday, September 9, 2008

What's wrong with Rich?

Let me break it down for everyone reading the blog not entirely up to date with what's going on with me. I'm not sick, and I'm not dying. But here is why I keep ending up in the hospital.
Since I was a teenager, I've been having these 'episodes' where I get tightness in my chest. It's kind of like when you've eaten a lot of dry food (like mashed potatoes) and don't drink water. It's uncomfortable, and usually happens when I am relaxing, not very often when I'm active. The episodes will last 20 - 30 minutes, then pass, and I'll be fine again. I'll usually just sit it out until the feeling passes. I never thought it was heart related, just a digestive anomaly that plagues me every few months. And I've never bothered to do anything about it.
On Amy's insistence, I made an appointment to see a Dr about this, maybe back in March or April. I called on my way into work, thinking I'd get an appointment later that week, or maybe the next week, and the Dr asked me to come in that morning. So I did. One of the first things he did was to run a EKG test on me, which is a computer with a bunch of sticky pads that connect to your chest and extremities. He got really worried when he saw one of the graphs, which looked like I'd had a heart attack.

Now, I've never been able to get too worried about any of this, because I feel fine, and I've always been generally healthy. But the Dr's were getting crazy about this. Since my normal office didn't have cardiology offices, I was referred to another office that did. I went to an appointment there, and they ran several tests on me, which included me running on a treadmill with EKG leads attached to me, and me drinking nuclear juice and sitting under a 10-ton imaging machine that took pictures of my heart. The technicians kept noting that I was the youngest person they'd seen in those facilities in some time, and how well I did on the treadmill test. I'm not in great shape, but I can certainly run on a treadmill for 10 minutes with no issues.
Those tests ended up being inconclusive. My treadmill test came out with great results - my circulatory system is working great, and I get excellent oxygenation in my blood, but there was still that EKG reading. As far as the imaging, it showed a slight bulge in one of my heart chambers, but nothing to indicate heart damage or any reason why my EKG's could be so strange. One cardiologist mentioned that my EKG readings were characteristic of Brugada Syndrome, also known as Sudden Death Syndrome. It means that some people's hearts suddenly stop and they die. Wonderful.
My normal hospital network didn't have facilities to further test this theory, so I had to be referred to another, which ended up being very nice. They first ran something called a Procainamide Challenge Test, which checks for certain electrical systems in the heart. I still had inconclusive tests, so they had to run a pretty serious test on me - an Electrophysiology Study (EP Study).
The EP Study wasn't fun, and was actually the first thing that slightly concerned me. Wires would be inserted directly into my heart, via the femoral vein. Then they'd record and pulse signals to my heart to measure the response. There was a chance that they could cause my heart to stop, but they'd have shockers hooked up to me in case they did. I checked into the hospital last week to have this done, and maybe the worst part of the test was the hunger. I couldn't eat anything all day, and I only had a light dinner the night before. They kept pushing the procedure back, from 1 to 3 to 5, then finally 7pm, at which I was pretty hungry. They lied me on a table and shaved me (how embarassing) in the crotchal region, then numbed me up, and inserted the wires. I could see the wires travelling up my body on the x-ray display above me. Very surreal.
The test was a very strange experience. They told me they kept giving me medication that would make me happy, indifferent to what was happening, and would make me forget the experience. I didn't experience any of these. While the procedure didn't hurt much, I did feel what they were doing to me. I'd watch my pulse rapidly accelerate on the monitors, then go back to normal. At one point, I told the nurse that I felt something very strange, then black. I'd passed out. I found out later that my heart had gone into fibrillation, and I'd passed out due to the lack of blood to my brain. They shocked me with 2 very large defibrillator patches, applied to my chest and back, and told me it was actually a pretty significant amount of electricity. Even today, 4 days later, I still have red marks from where those pads were on me. I'm not sure if it was due to the burn or my skin's sensitivity to the epoxy. I remember waking up with a start, wondering why I was in bed without Amy. Then it came back. They told me the test result had been 'positive' and explained what happened. They took the wires out of me, and wheeled me up to a recovery room. It was midnight before Amy could finally take me home, she and Drew kept me entertained for my last 2 hours at the hospital.
Right now, my crotchal area is severely bruised at the insertion point. It's a mix of greens, blues, and purples. A picture would probably be in poor taste.

Today, I scheduled my next appointment - the installation of an implantable cardioverter-defibrillator.  I held one in my hand that looked nearly like the picture, it's about the size of a thick silver dollar.  They told me I have the option of getting it implanted just under the skin or below the muscle, so I'm opting for the under muscle option, just so it will be less conspicuous.  It's very strange to think I'm going to have this in my body, but it's probably for the best, and will give my heart bionic anti-fibrillative powers, which makes me less prone to death than your average person. I'm scheduled to have it implanted on Sept 22, which gives me two free weekends to get stuff moved into the new house before I go disabled.
It should be noted that the diagnosis of Brugada Syndrome doesn't really mean I have anything other than a funny EKG reading, which might just be an anomaly of my body. Brugada Syndrome is still something new, and even my electrocardiologist thinks that Dr Brugada, who it is named for, is a bit quick to lump cases similar to mine under this heading. Still, this is a preventative measure, and should ensure that I will be alive and kicking, well into my 120's.

6 comments:

Anonymous said...

glad to hear your heart won't stop anytime soon. bummer about all the tests though. hope your femoral artery is almost back to it's normal coulour!

Unknown said...

My leg is mostly a blue-green color, with 2 very deep purple splats on either side. They must have really been beating on me when I was passed out.

Anonymous said...

yeah, us nurses are cruel like that when we have people sedated.

MamaJulie said...

jesus, i am glad amy insisted that you go to the doctor to get this thing checked out to begin with. You see! Men should always listen to their wives!! :) I love how you told the story...very serious issue but patched with humor.

Ashley said...

You're kinda freakin' me out, man. My great uncle (late 60's) has a defibrillator in his chest. Crazy...You're less than half his age. I know I shouldn't worry, but I will. You know me. :) We'll be thinking of you!

Ginny said...

Hi Rich, on a whim I "googled" Brugada Syndrome tonight and up popped your blog. My son, at 16, and my husband both had defibrillators implanted because of Brugada Syndrome a few years ago. They are doing great. Five years later, and no real problems. I have a blog at www.brugadasyndrome.blogspot.com if you ever want to read about their experience.

Take care!