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Sunday, August 16, 2009

A Small Scare

I thought I had enough of the hospital a few weeks ago when I was hospitalized for atrial fibrillation and had received 18 shocks from my internal defibrillator (ICD). But, sitting in bed on Thursday night talking to my dad, I felt my heart beating faster than it had been lately and felt certain that I was about to receive a shock from my ICD. That never happened, but my heart continued to beat at an unusually rapid rate and so I made a decision to take a trip to the hospital emergency room and get things checked out. Instead of calling an ambulance, I relied on my dad's fast, but safe driving.

Upon arrival to the emergency room no one seemed in a particular rush as they filled out the necessary paperwork. Me, on the other hand, well, I was very anxious to see what was going on with my heart. Once I was hooked up to a heart monitor, it indicated that my heart rate was higher than it had been recently but not dangerously so. Next, the nurse put an IV into the back of my hand -- on the first try! Miraculous! Blood was taken and it showed a high white blood cell count and a higher than normal level of a particular heart enzyme that is typically elevated when your heart has suffered a trauma. Based on these findings I was admitted to the hospital, where I stayed until yesterday.

During my hospitalization there was nothing unusal about my heart and doctors were never able to explain the findings in the blood work. As my blood was retested the numbers seemed to come down and no signs of any infection were detected in me. At first there was some concern that I had already become toxic with the amiodarone that I had been taking since my last cardiac scare. Usually side effects take a while to appear, which is why it was surprising that I was starting to show some side effects. In the end, though, it was determined that my symptoms were most likely not due to the medication and I was put back on it.

By 11 am yesterday I was home again. I still think it was a good idea that I went to the hospital even though it seems that everything is fine. After my last scare I'm not taking any chances of getting shocked by my ICD, so if something doesn't feel right I'm heading to the nearest emergency room. I hope this doesn't happen for quite some time!

Special thanks to Lauren for typing this entry.

Thursday, August 06, 2009

Back on the Horse

Nearly two weeks later, I'm still getting over my big cardiac scare. It has been difficult both physically and emotionally. But the way I figure, I'm still here and it's about time to get back to doing the things I love. Like going to Phillies games. Tickets to see the World Champions are hard to come by these days, but I was able to score a pair to today's game, featuring the debut of newly-acquired ace pitcher Cliff Lee.

The only thing hanging in the balance was the weather. But with Fox 29 chief meteorologist and my good friend John Bolaris in the house, I figured we were in good shape. And with Cliff Lee on the mound, the Phillies were in good shape, cruising to a 3-1 win over the visiting Colorado Rockies. It was the first time in five tries this season I witnessed a Phillies victory. I truly enjoyed myself and it was big step for me as I try to get back to normal.

Saturday, August 01, 2009

A Real Shocker!

"He said...he said it wasn't such a good day to die."

Kevin Bacon in "Flatliners" (1990)

Early last Saturday morning, I thought there was a distinct possibility that I would be blogging no more. In fact, as they say, I thought I had "bought the farm". You see, after spending Friday afternoon trying to control what I thought was a simple case of dehydration causing my heart to beat irregularly, the defibrillator in my chest decided to take action.

As I lay in bed late Friday night contemplating whether I should seek medical attention, I heard what sounded like a light bulb popping and saw a blue streak in front of my eyes. It took me a second to realize that "Oh my god, it went off!" I told my nurse to wake my parents up, and as he was exiting my room, the device shocked me again. It felt like being punched in the chest.

911 was called and within 5 minutes (although it seemed like an eternity), EMS arrived to transport me to the emergency room. Though I was really anxious of having my contracted legs injured while being transferred from my bed to the stretcher, the EMS personnel and my nurse were extremely careful. Throughout the 15-minute ride to the hospital, the defibrillator shocked me at least a dozen times. I was wondering why the device wasn't able to regulate my heart and was continuing to fire at will. I looked up at the white lights in the ambulance roof, hoping that wouldn't be the last thing I ever saw.

Upon arrival at the hospital, the first goal was to insert an IV so that medications could be given to me to bring my heart rate under control. Easier said than done with my hard-to-find veins. Meanwhile, my defibrillator was shocking me seemingly every few seconds. Just before a shock was delivered, I would feel a weird crawling sensation near my heart, which I figured was the device charging up to fire again, and the heart monitor above me would show a rate as high as 200 beats per minute. The only thing that seemed to help prevent a shock was when the nurse massaged my carotid artery.

Once an IV was finally inserted, doctors began a drip of a medication called amiodarone, an anti-arrhythmic, which began to regulate my heart. The shocks grew less and less until finally stopping. At this point, I was transferred to the ICU, where I began a weekend-long stay for observation. Later that morning, a technician from the manufacturer of my defibrillator arrived. He interrogated my defibrillator and determined that the device had been shocking me for atrial fibrillation, a serious condition typically treated by medication alone, but not nearly as life-threatening as ventricular tachycardia or ventricular fibrillation. Although devices such as mine are smart, once the heart rate reaches a certain speed, it is unable to distinguish between atrial fibrillation and ventricular tachycardia, and therefore delivers a shock. The technician adjusted the parameters of my device so that it will attempt to better distinguish between the two kinds of rhythms. A cardiologist at the hospital visited with me and my mother and explained the situation to us. They would start me on an oral version of amiodarone, see how I tolerated it, and if there were no problems I would be discharged within a day or so.

Staying in the hospital, of course, is no easy task when you have Duchenne's. To their credit, the nurses, nursing students, and respiratory therapists were extremely caring and kind. Even still, things like turning me are not the everyday situation for nurses who have never cared for someone with DMD. Although I ended up with a few aches and pains, there wasn't a whole lot that anyone could have done to prevent this. I wasn't completely comfortable with the hospital ventilator the respiratory therapists switched me to -- it was also overly sensitive and would alarm constantly -- but I made the best of the situation. Without my own air mattress I was unable to get extremely comfortable in bed, although the bed in which I lay was actually pretty state-of-the-art. Because I had no way of using a nurse's call bell (or a call bell into which I could blow), my mother spent the weekend with me, sleeping in a chair at my bedside at night. It was a good idea that she stayed with me to make sure that my complicated list of medicines was followed, and also to assist with transfers and positioning. I couldn't have gotten through this ordeal without her, as well as the other family members and friends who gave me their support at such a trying time.

By Sunday night, the anti-anxiety medication I had been taking round the clock had sufficiently constipated me. And really, no stay at the hospital would be complete without a delicious milk-and-molasses enema! Very effective, I'll tell you, but I could find a better way to spend a Sunday night.

Early Monday morning, I got the news that I was to be discharged within a few hours. After a sleepless night, I couldn't wait to get home in my own bed and sleep away my nightmarish weekend. The good news is that the medicine seems to be working and I am still here. The anxiety remains and it may take a while until I am not afraid. My life may never be the same, but like the quote above, "it wasn't such a good day to die." So I guess I'll stick around for a while!

Special thanks to Julie for helping me type out such a long entry!