Wednesday, April 25, 2012

It's Complicated

Last Monday I thought I was so clever to write a note and refer to an old I just think it was kinda lame. Specifically because it turns out that neither taxes, nor death, seem to be my biggest concern.

The short of it is that I'm back in A-Fib and scheduled for my second Cardiac Ablation this Friday the 27th. Because of this, I had to postpone tests with the transplant team until late May.

The long of it is as follows:

Following my visit to the hospital on Monday, the 16th (the last time I posted a note update), I came home and struggled to regain any energy. While my rhythm had returned to normal, the symptoms continued to bother me. Sure enough, on Friday evening, my heart flipped back into A-Fib. I called the hospital and was counseled to wait through the night and if there was no change, to take myself to the hospital the next morning. I woke up early and traveled an hour south to the Provo ER hoping that might increase my chances of seeing my actual doc, even on a Saturday.

The ER staff was clearly freaked out by my case, but treated me well, as they replenished my potassium and prepped me for another Cardioversion. Dr. Hwang happened to be in the middle of a procedure in that hospital and, after being notified that I was there, asked that I just be kept for observation so that he could determine then administer treatment.

Dr. Hwang soon arrived, and the Cardioversion was successful after one attempt! My breathing was immediately improved, but my vitals were not rebounding as quickly as they would have liked and I was admitted for bed-rest and overnight observation.

My "frequent flyer" miles on the Cardiology floor won me a corner suite and I really do get the royalty treatment from the staff! (Although, I'd rather be nobody at home, than royalty in the hospital.) After an uneventful night, and 24 hours in a hospital bed, I was thrilled to be discharged and back in my own bed by 10:00 a.m. Sunday morning.

All of that relief disappeared in an instant when at 6:30 p.m., Sunday evening, just 34 hours after the last Cardioversion, I WAS BACK IN A-FIB!!!!!!!!!!

Since Sunday evening I've had changes to my medications, and a cardiac MRI, and Dr. Hwang has scheduled my second Cardiac Ablation for this Friday evening. I remember that I didn't love recovery from the procedure back in September, but the specifics are hazy against today's discomfort. It's funny what we're sometimes willing to "forget" for a little relief.

Through all of this chaos, my greatest disappointment is that the Heart Failure clinic has determined that the testing and transplant list placement must be put on hold...again. And I'm suspicious that this won't be the last time that I have to adjust my expectations and timelines. In my clinic visit today I was told no less than a dozen times that my case is really really, really complicated. I don't have a medical degree, but I think that translates to "nobody is sure what is going on".

The only thing that I am sure of is that for nearly every person who has a transplanted heart, there is a story of delay and discouragement before the happy ending. I guess I am in that part of my story.

Tuesday, April 17, 2012

Death and Taxes

Oh...the irony!

Yesterday, with today's deadline looming, I finally got around to completing my 2011 taxes. How fitting then, that I also spent a portion of the day at the hospital casually flirting with death.

Late Sunday night, my heart slammed out of rhythm...again. It was a restless night spent convincing myself that it was probably just a minor set-back, maybe something that could be treated with medication?

Given recent conversations about a possible transplant, I'd begun to think of the Heart Failure Clinic as my one-stop shop to all things Cardiovascular...I was wrong. When I called them first thing Monday morning, I was surprised to be quickly dismissed to Dr. Chun Hwang.

Disappointed, but driven, I called Dr. Hwang's office determined to do anything necessary to end the feeling of an elephant resting on my chest. Dr. Hwang was in surgery all was Dr. David Cragun...but the clinic down south agreed to squeeze me in with Cragun's PA in the afternoon, and I began internal chants of the "you can do this!" sort.

When I arrived, an awkward nursing student performed an awkward EKG, and after a couple of attempts, they had the information they needed...I was back in Atrial Fibrillation. I was certain that they were wrong. I had my Ablation September 15th and everything I understood about the results told me that if I went 6 months without another event I was in the clear and Sunday marked 7 months exactly so I COULDN'T POSSIBLY BE IN A-FIB AGAIN?!?!

The PA and I discussed possible medication adjustments that might improve things over a week's time, but I wasn't feeling that patient and I pushed for another Cardioversion. Truth is, I think the procedure is kind of creepy. But it worked 3 months ago and I craved the immediate relief it could bring. The PA obliged, contacted Dr. Cragun, and got me into the admit queue at the hospital.

I should probably speak with a professional about the cavalier attitude I've developed about being admitted to the hospital. It really shouldn't feel as common as running to the store for a gallon of milk. But there I was assisting the little admission lady and helping her realize to which tower and floor I was to report. And a few minutes later I was informing the nurses that I had something in the crock-pot and somewhere I wanted to be at 7:00 p.m,. and that we needed to make this quick.

The staff was most accommodating! I was hooked up and ready to go within minutes and Dr. Cragun appeared before I had a chance to send an update text to family. I don't think I'll ever get over how quickly they knock me out and run the procedure, but I will always be grateful for how quickly I feel the relief.

I was even the lucky recipient of a drop-in from Dr. Hwang who had recognized my name on the patient list. He was very kind and seemed as disappointed as I was that the Ablation back in September wasn't sufficient. He and I will follow-up in a couple of weeks to discuss another procedure if I don't qualify for transplant next week.

All totaled, I was only in the hospital for 2 hours so maybe it was a little dramatic for me to say I flirted with death yesterday...I did have an army of doctors, and I did receive the very best care, and I woke up this morning with a constant resting heart rate of 62 (down from 130).

2012 taxes are due an entire year from now...I think I can cheat any run-ins with fatality for at least as long.