The lack of blogging has not been because I’m dead, fortunately. But I was hospitalized for a few days for atrial fibrillation (AFib). I’ll tell the story in case it helps any readers.
We were getting ready to go to the store when I suddenly felt my heart flutter in a very strange feeling way. If it had just been a second of that, I probably would have dismissed it. But it lasted long enough that panic set in. I knew something was wrong, but I was not sure what. I had no chest pain or shortness of breath, but my heart felt like it was going to jump out of my chest and run off to New Jersey.
“I think I need to go to the ER,” I told Bitter, as I got to the top of the stairs, “Something isn’t right with my heart rhythm.” Then she starts to panic. In the car I start to calm down and debate whether I’m just having a panic attack. But I was feeling my pulse and felt like it was off.
We got to the hospital, and I told her to pull into a parking spot near the ER so I could get a better sense of how I was really feeling. I took my pulse again now that the car was stationary, and it was all over the place. Strong, weak, weak, strong, and not in a steady rhythm. I start thinking “I wonder if this is AFib? Is this what AFib feels like?”
To me, going to a hospital for treatment is one of my big phobias. It’s probably more acute than Indiana Jones laying in a pit of snakes. But when your pulse has all the rhythm of two nerds dancing at the prom, you tend to think in terms of lesser fears, and dying is the greater fear. Yes, please be sure my bed has extra snakes! I’ll take it.
I told Bitter to pull up to the ER and went up to the check-in desk and very calmly announced “Hi, I’ve never been to an ER before, but I think there’s something very wrong with my heart rhythm. I have a racing and irregular pulse.” They immediately took me back to the EKG and I was on an ER bed in minutes. I later saw on my chart the computer had flagged “Atrial Fibrillation” on the EKG, which I thought was pretty neat.
First they got me IV’d up and started me on Heparin, an anti-coagulant. AFib is not generally a life threatening arrhythmia, but it is a big stroke risk because the irregular rhythm can send clots flying around.
Then they started me on Diltiazem, a calcium channel blocker, to get my pulse rate and blood pressure down, both of which were sky high, the former from the AFib, and the latter from the sheer terror I was experiencing. Later the first blood work came back and showed I had very low potassium, so they started another IV for that. That shit made my hand feel like it was on fire until they dialed back the rate.
My pulse and BP did indeed come down, but I didn’t come out of AFib, so they admitted me for the night so I could consult with a cardiologist in the morning.
The Cardiologist said probably the best thing you could say to a phobic patient, or at least this phobic patient: “This is a pretty common thing. It’s a little less common in someone as young as you, but you have absolutely nothing to worry about. I will fix you. I’m going to start you on an anti-arrythmetic, and I think that’s going to get you back to a normal sinus rhythm probably on the first pill because you’re young and have never had this before. Worse case scenario, I have to do a ‘Cardioversion’ which is a slight electrical shock of the heart to bring you back into normal rhythm. But I’m really confident medication will fix you and you won’t need that.”
And that’s basically what happened. Within 6 or so hours of the first dose of Sotalol the night nurse came by before his shift ended he told me “Your heart is trying. I can see it go normal for a bit, but then go back into AFib. But I’m betting when I come back you’ll be in a normal rhythm,” and I was. Great. Can I go home now?
No! I had to get an “echo” ultrasound of the heart. But the main reason, I think, was that any person starting on Sotalol has to be monitored continuously for three days in a clinical setting because it has a serious but rare side effect of, well, killing people. Yeah, OK… you can keep me for three days then. Though by the second day I was thinking I’d rather take my chances.
Anyway, I’m back to a normal rhythm, though I’m on a blood thinner and the Sotalol at least until I follow up with the cardiologist, but probably longer.
Hospitals suck. The staff were very attentive and caring, but there are always communication issues, and I found it’s very important to keep mentally aware of what’s going on, what they are doing to you, and what they are giving you. Be able and willing to communicate that to staff as shift’s change, etc. You effectively cannot sleep in a hospital. I decided to sleep with earbuds in playing white noise, which helps, but they still come in to take vitals and that wakes you up.
I felt more exhausted and weak walking out with a normal heart beat than I felt going in with an abnormal one, and all I needed was some drugs and observation. I can’t imagine what it’s like for someone like the 88 year old gentlemen I shared a room with. He was also in AFib, but he had so many other problems they couldn’t safely cardiovert him until those problems were death with. I’m half his age and don’t have 1/4 of his problems, and I feel like the process chewed me up and spit me out.
The nursing staff strongly suspect I have obstructive sleep apnea, and since they have me wired up and check on me all night, I believe them. They referred me to a doctor for a sleep study. The Cardiologist said, “The stress you’ve been under, your low potassium level, and the fact that you have sleep apnea, were probably a perfect storm and your heart is now basically just pissed off.” He seemed skeptical of how much diuretic I’m on for blood pressure control. I have a feeling he might change out some of my BP meds during the follow up. Fine by me as long as it works.
Ultimately I’m glad I made the decision to face my fears and anxiety about over being poked and prodded, and the loss of personal control that comes with being in a hospital. Eventually I was telling the numerous phlebotomists I was introduced to, “Use the hand. You won’t get anything out of that arm. If you want to try, that’s fine, but I’ll wager you good money you won’t succeed.” Didn’t get any takers once they started looking at it.
Anyway, that’s my story. I hope someone finds it helpful.
Be able and willing to communicate that to staff as shifts change, etc.
^This.
Seriously, I was shocked at how many nurses during certain shifts didn’t read anything in his charts or records. I’m pretty sure the only thing that would have stopped us from walking out of there with 3x the number of pills they prescribed would have been the insurance company not paying if I hadn’t spoken up and repeatedly reminded them that they already filled them – and sent them home with me.
I’m slightly appalled by the fact that they sent a dietician around to give a lecture and she was so absorbed into giving a standard lecture for heart patients that she never once looked at his records to suggest making an effort for potassium – a documented contributing factor to his stay that can be addressed in diet. I purposefully left her paperwork on the table while taking everything else with us. I doubt they’ll get the message that was intended to leave about how worthless her visit was, but eh, it felt like a little relevant rebellion.
Not nearly as serious an issue, but I basically had an unending flare up of gout from late March until about two weeks ago. Every time I went to the doctor all he would tell me is to stop drinking so much beer. And then Inwould tell him I hadn’t had any beer since the first gout flare up over Labor Day weekend. His response: yeh yeah. Stop drinking beer. You need to cut back on the beer.
Unbelievable.
Glad to hear your still alive and improving.
FWIW, my wife and I pay through the nose, just for Medicare “Part F” supplemental insurance, but we have no complaints about our medical treatment besides the expected “bedside manner” kinds of quibbles. But, several of my contemporaries, and even some younger, working family members have been telling incredible stories of run-arounds and delays in treatment with issues that were virtually crippling or debilitating.
I would suggest that your medical insurance could be to blame; in some way your doctor may be prevented from doing anything at all for your gout problem until certain time constraints have been satisfied.
That said, I think gout correlates with diet very strongly; read up on what foods are especially bad. An acquaintance of mine claimed good results for a health issue by making a spreadsheet recording everything he ate, and seeing what correlated with flare-ups of his problem.
My dad had a dietician tell him that cow liver and peanut butter was the best thing for his heart condition.
He didn’t have a heart condition.
And he was a Cajun. No hot sauce or file, no Bueno.
Dieticians are the education majors of the medical field. In other words, they couldn’t get a job in medical any other way.
A good friend of mine experienced afib last year, it took a bit longer and more intervention to get control of it but he’s finally in good shape.
Best wishes.
Cool story bro. Can I have all your guns if you die?
Wow. What’s in a name?
Woah. Glad to hear that you’ve made it out all right.
“I have to do a ‘Cardioversion’ which is a slight electrical shock of the heart to bring you back into normal rhythm”
Slight my ass.
I had one for Afib after my heart attack a year ago, it feels like you’ve been hit by lightning!
You’re lucky the meds worked…..
I used to build electrical shocking devices as a kid, so that prospect doesn’t scare me as much. Looking back now, and knowing what I know now, it’s amazing I didn’t kill myself.
FYI my Father-in-law had Cardioversion several times. These days they give you Propofol so you aren’t around for any of it.
Just so happened I found a great video of it recently.
https://youtu.be/uCETUw0Bssw
Some blood pressure meds can deplete one’s potassium levels, hence one likely reason for the cardiologist’s skepticism regarding your dosage, and one unlikely but possible reason for the dietitian’s skipping of the subject.
I’m on a ACE-HCTZ combo. The ACE inhibitor is supposed to keep up potassium, even though hydrochlorothiazide isn’t potassium sparing.
Not enough potassium and too much can kill you. Good thing you went and got is straightened out However because of the meds, you are now getting to the point a little different either way can change your body chemistry badly. Arrythmia can cause an enlarge heart and that leads to congestive heart failure Too much fluid and then lasix and too little that stresses out the kidneys. My brother had been on this roller coaster for a long time. Take care of yourself and good luck
Glad you got it taken care of. We had a similar scare nine months or so ago when my husband had some chest pains and then passed out (heart stopped and everything) in the car while I was driving. Fortunately it turned out not to be too serious and as of last week he’s finally off of all restrictions per the doc. It’s good to have the diagnosis though and know what we need to watch for.
They tried to stick a pacemaker in him seven months ago, fortunately he put his foot down and did his research and went up the doctor-chain until he found someone who would actually listen to him.
What’s the condition? I had a coworker whose heart would stop for a few seconds and restart again. She did get the pacemaker but always felt she got screwed by the doctors.
neurocardiogenic (vasovagal) syncope. He’s got a very mild case of it, as well. He’s had maybe three episodes over the last ten years. The first two got written off as other things, so it was just this last one that triggered all the tests. The pacemaker might become necessary down the road if the condition worsens but, among other concerns, it would pretty much screw him over from working in his career field ever again, so the longer it can wait the better.
Sinus pause, sick sinus syndrome or sinoatrial arrest: https://en.wikipedia.org/wiki/Sinoatrial_arrest
Sick Sinus Syndrome
If forced to choose, A-Fib is what I would pick. The least lethal and the easiest to treat without electricity.
Glad all is better.
I have had chest pains for nigh onto 30 years now that they have never been able to diagnose, and therefore no treatment for something that is a mystery. It’s too the point now where I just ignore it. One day I may keel over from a heart attack and never know what went wrong. :-)
I heard a flight paramedic give a talk that started the same way yours did, but he decided to go to shopping with his wife for a new mattress (his wife was a nurse) and 4+ hours later, after he loaded the new mattress in the truck at Costco his wife bagered him enough about what was going on for him to mention that his heart was beating like 150 bpm. He ended up in the cath lab getting ablation.
Denial isn’t just a river. Glad you didn’t do that.
There’s much to recommend a cogent – and alert – patient advocate in attendance while incarcerated in a hospital. A lot goes on, some gets documented well, some doesn’t, and as you found out quite a few of the staff don’t bother reading what is documented.
The patient is at great disadvantage – to term it “victimized” by the medical processes isn’t far off – so having an individual not directly affected by the ailment or its treatment who can ask relevant questions and take notes adds value.
The staff won’t like it, but it’s your ass that’s trying to avoid leaving in a box, not theirs.
Learning this even in follow-up care situations.
I totally threw off the discharge nurse who was tasked with doing nothing more than reading papers in front of her. I didn’t want to seem like a bitch, but she messed up which doctors needed to be seen in follow-up.
As I said below in my “This. Again.” comment, I’m even seeing the same things with schedulers who aren’t interested in actually reading the documents in front of them to do their jobs. I would have been fired for this kind of attitude in far less important areas of life – like when I worked as a soda jerk.
Hope that you feel better soon!
Get better soon.
And remember, never pay a medical bill without challenging it. Since you are not old enough to be on Medicare, the big problem will likely be with providers, not the insurance company. Doctors rarely have any clue as to what goes on on the business side of their operation except ophthalmologists, for some reason. Dentists and veterinarians are good too but I know the reason there.
Damn. Hope you get better soon!
Glad you went into the ER to have it looked at.
I’m glad to hear the you got prompt and fairly thorough attention.
Advice I have encountered occasionally is, call 911 for anything that entails the slightest suggetion of heart issues. The reason being, the ER will not take walk-ins seriously; even though the prevailing medical advice is that if you are having heart symptoms, you should.
Knock on wood, I have never had personal experience with that, but only a few weeks ago I took a neighbor who was complaining of chest pains to the ER, because they refused to call an ambulance. The best I can say is that 15 – 20 minutes after their arrival, someone performed an EKG, but no one seemed to be displaying any urgency. Meanwhile I was recalling a late friend with chest pains who died behind the wheel driving himself to the hospital a couple years ago, and hit a pole after crossing in front of oncoming traffic on a busy, high-speed highway. The point being, it’s not like 15 – 20 minutes means nothing in “chest pain” heart cases.
In my neighbor’s case, it did indeed turn out to be nothing — “probably” anxiety they said — but what the medical community communicated by their actions in the ER was in conflict with what we laymen are advised to do for ourselves. The neighbor will probably be reinforced in not acting on a problem, if there is a next time.
I used to have occasional arhythmia all the time. In 2011 it got… noticeable. They put me on different pills for 18 months (didn’t want to do the 3 days for the one you’re on). Also had several cardioversions. Those are no problem the way they did mine – they knocked me out first.
The other pills really didn’t do a whole lot to control my rhythm so after 18 months they did a catheter ablation. Took one more reboot after that but I’ve been fine ever since. I am, in fact, an EX cardio patient. Every now and then my heart will try to get out of rhythm but it just can’t do it.
BTW, the Instant Heart rate app turns your phone into an un-calibrated pulse oximeter that’s great for monitoring your pulse. Lets you see the waveform pretty well. Nowhere near as good as what the doctors have but a simple 30-second check I do every morning.
As you work through this you’ll probably have what I had – every now and then it will feel like you’re on Lion batteries that just crossed the line to going flat – your energy just drops. If you can sit quietly for a bit your heart will fix itself and you’ll feel fine again.
Let us know what you find out about the sleep apnea.
I’ve experienced AFib several times from about age 40 but lying down and waiting, it would go away. Had a bad one at age 60 while overdoing it in the hot sun and went to the ER with no insurance. Unless you’ve already been diagnosed with a heart attack, never mention chest pains to the ER unless you have good insurance. 2 hours later, they told me I was fine, never mentioned Afib or anything else, and sent me home with a bill for $12,000. Web MD gave me the diagnosis.
Regular exercise has pretty much eliminated the occurrences, and I guess I’ll have to increase my intake of bananas.
Afib shows up clearly enough on an EKG that the computer can tell you’re in it. So if you got an EKG, and they didn’t tell you that you had Afib, you probably had some other issue or you came out of Afib before they did the EKG.
I didn’t have any chest pains with mine. That’s not usually part of Afib. That’s more heart attack.
Glad you’re ok, health issues suck.
That was a great story. Thank you for writing it.
Glad you are okay!
I hear you with the way hospitals operate. I have a special needs child, and we go to a specific special needs hospital, and its still hell trying A) get information and B) to catch their mistakes before they make it. I don’t get it.
Be able and willing to communicate that to staff as shifts change, etc.
^This. Again.
Good grief. I just called to get his sleep study scheduled, and the scheduler had his file open in front of her. Despite the fact that she later admitted it said clearly and plainly that he is to come in for an office visit and then do an at home study, she tried to push me into scheduling him for an in office study. I challenged her and told her that I won’t apologize for being an advocate based on what the actual doctor who hired her told us in the hospital. Only then did she stop to read the file and admit she had no idea what she was doing so someone higher will need to call back.
I think it’s entirely possible that she won’t call back and is hoping I just get someone different if I do since she asked me to call back after a certain time if she didn’t get back to me first.
She’s paid to do one job – schedule people for the correct visits and studies. She won’t read, won’t do anything outside of the 95% of patient protocol jobs, and most people won’t challenge her on it because she works in a doctor’s office.
If there’s one piece of advice I would give, it’s to make sure you have someone there to be your advocate or pay close attention and take notes when needed if someone can’t be there with you.
Also, if you have an older parent who ends up with a hospital stay, try to get people there visiting as many hours as possible and make sure to pass on any notes between visitors so they can listen to what’s being said and observe what is or is not being done by hospital staff. Even though he should survive his condition, the reality of it is, so many balls were being dropped with Sebastian’s elderly hospital room neighbor that I’m pretty sure he was right to contact his attorney to make sure his will was up to date.
glad you made it out OK – now behave & do what you need to… :)
Merle
I have A-Fib. It was really bad back in 2012. What brings it on for me is severe stress, physical and mental. I haven’t had an attack since the night I was in an industrial accident: 11/18/2013. Good luck with it and keep taking the meds.
I have been having difficulty with my local Cancer Center on scheduling my visits. Namely I told that new clerk? that I would NOT take an early morning appointment and she keeps giving me a 7:30 to 8:30 times. So I went and was very firm with her, two RN and my NP telling them one more time and I would be seeing a different set of doctors. Time will tell, Before you ask. Advanced prostrate cancer.
I hope you get better. I’ll take AFib any day over the big C.
They have no cure. The treatments available are worse than the cancer. They totally mess up your hormones and have nasty side effects that linger I have had to give up a lot of activities like hunting. A bad fall could be a killer.
And they don’t kill the cancer they just retard the growth for a while.
Glad you’re doing better. Hope it continues that way and that you have no further complications . I feel for you being stuck in the hospital for three days.
This is a little embarrassing to admit, but when I went for my blood test for my marriage license (dating myself a bit since I think they ended that requirement 20 years ago if not more), I passed out in the doc’s office. When I woke up, the doc had me hooked up to an EKG, and the first words out of her mouth that I heard were “I think he’s having a heart attack.” Jesus, lady, if I wasn’t then I just might now! So they rush me to the ER, where I spent the next three days. Yes, three days in the ER, because there were no beds to be had elsewhere in the hospital (this was Nazareth Hospital in Northeast Philly). So in between tests and worrying about whether I actually had serious heart disease, I listened to screams all day and especially all night from car crash victims, a stabbing victim or two, a few psychotic episodes, etc.
The end result – it wasn’t a heart attack, it was a simple vagal nerve response. Made a heck of a story for my bachelor party, though.
A few years back, I was having similar heart problems. Rapid pulse, erratic pulse, left arm felt tingly, slight discomfort in left chest, light-headed. Driving down the freeway, I decided that turning off a couple blocks to a hospital might be advisable.
Got to the ER desk (looonng walk from the parking garage) and mentioned the symptoms. “have a seat, we’ll call you”. 5 minutes later, they were hooking me up to an EKG machine for what turned out to be a preliminary look. (Friday night, main trauma hospital for San Jose, oh joy… Nothing like beating the rush, they were stacking them out in the hallways after I got my bed.)
They decided I needed to be monitored, so back to the waiting room, to await an open bed. Maybe an hour later, into bed, and a full 12-lead hookup. Six hours in the bed.
Turns out it was due to a reaction to an over-the-counter cough medicine, (dextromethorphan?). I was never able to use it when it only came in syrup form, as it gave me the heaves. Now it’s available in pill form. F’ng wonderful…
Took a few months for my heart to settle down. A complicating factor was my having PVC’s (premature ventricular contractions) sometimes called “skip beats). I think it was aggravating that condition, or triggering it, since I hadn’t noticed that for a long long time. (10% of people have it)
Shame I had to tie up a bed, just to be hooked up. System should just be a fanny pack/wi-fi, so you can free up a room. $4400 for 6hr room. Yikes!
My wife has had occasional Afib — just enough to be concerned about it, but the two times she’s been hooked up to heart monitors for a few days, the monitors caught nothing. If I recall correctly, her sisters occasionally get hit by it as well.
Also, my mother-in-law recently had a stroke, along with a couple of horror stories involved with that. Who knew a little Utah town just north of the Arizona border would have its own MRI? Yet the doctor didn’t use it, despite diagnosing my mother-in-law having had a stroke. Her brother took her to the nearest major hospital in St. George, where they found internal bleeding that needed to be brought into control. She’s had a few encounters with Afib since then.
Scary stuff, indeed.
And the fact that doctors and nurses need close supervision to make sure that they do the right thing makes me particularly angry that the AMA sticks its nose in gun rights business. If the AMA could cut accidental hospital deaths by just 10%, they’d be able to save about as many lives as those lost to gun suicides and gun homicide!
Of course, this isn’t just about guns. Whenever I hear a horror story where a doctor almost did something that would have either killed a patient, or seriously maimed the patient, it makes me angry that the medical profession doesn’t do more to prevent the deaths of their patients from careless medical mishaps and hospital infections!