Some months ago, February 2007, to be exact, I experienced my first of what was to be 3 episodes of supraventricular tachycardia (SVT). Simply put, the heart begins to contract at an excessively rapid rate. As a result of this high rate of contractions, the circulating blood does not get to the brain and other vital organs and a fall in blood pressure generally accompanies the fast heart rate.
The condition is well known in younger individuals (which I am not) and among those who have hyperthyroidism (not me), smoke excessively (never), ingest too much caffeine (I stopped drinking coffee 2 years ago) or who take crack cocaine (NEVER). Thus, the doctors and I were somewhat puzzled when at 6:30 AM on an early February Saturday morning I went to my computer, experienced lightheadedness for less than 2 seconds and felt a “fluttering” in my chest (I was too stupid to think it was my heart). I stood up, walked around, felt better and sat down again only to have the fluttering recur. The little walk was repeated, the symptoms where no longer noticed, but when they recurred a third time, a voice in my head said “Go the hospital, because this is not normal.”
I walked in approximately 7:30 AM and found the ER empty. The usual Friday night crowd of post alcoholic vomiters, members of the well-known street gangs who were bleeding from assorted knife and gunshot wounds (aka the Friday night knife and gun club) and the assorted neighbors who use the ER as their primary care facility all had been cleared out. My reception by the nursing staff was instantaneous, as was the loud cry, “CODE PURPLE,” from the nurse who had taken my blood pressure and pulse. An aid instantly appeared with a wheelchair and I asked what all the fuss was about. The nurse, who knew that I was a physician, looked at me as if I was from Mars and commented: “Your pulse is a 180 and the blood pressure is 70/30. And you walked in?”
Within minutes I was in a treatment room surrounded by staff, and EKG pads were placed on my chest and legs. The resident (I could tell by the color of the coat) stated calmly “SVT, get an IV line and adenosine.” More minions gathered around me and needles started entering my body. The chief of the ER stood by me and said, “When we shoot the drug, you will have a burning sensation throughout your chest for about a half a minute.” They shot the drug, but I felt nothing (I could not help but wonder if this was all a dream), the EKG and pulse rate converted and I felt like a new person. But clearly I was not, because the TEAM insisted that I stay overnight and be tested. I asked for what and they responded “for STUFF” and to get a rest. (Ha, ha, read below.)
“STUFF” meant blood tests, one for cardiac enzymes to determine if there had been cardiac damage (every 4 hours), and another for blood sugar (because I was diabetic), another for general chemistries (this is how hospital makes money), etc, etc, etc The long and the short of the story are quite simple. Although I was in a private room, I got absolutely no rest throughout the night because of the frequent blood draws and, if you can believe in the need to take my temperature and other vital signs at four in the morning. Needless to say, I was delighted to leave at noon the next day, with a sincere desire never to return. I left the hospital thinking, “How is it that no doctor ever asked if I got the rest they said I needed?”
A second episode occurred in June, with pretty much of a replay except that I insisted to return home after the medication had been administered in the ER and before any talk of hospitalization. This time, the talk centered on my meeting a cardiologist and obtaining advice for long term care. I made my appointment for much later in the month amidst an arising level of concern. At this point, fate decided to intervene. A friend called and invited me to dinner at a local club. Within an hour I found myself sitting across from an absolutely beautiful lady cardiologist in the same Department where I had my appointment. As she listened to my story, her eyes grew wider and she said doctor voice: “Come to my office tomorrow, at 12:30 PM; you need surgery and the sooner the better.” In due course, I was examined, made more aware of the risks and problems that would have occurred if I do not have the surgery and scheduled for the procedure.
As luck would have it, I was seated at the dinner table of Dr. Alexander Golbin, Editor of the Sleep&Health, exactly two evenings before my scheduled procedure, when I had my third and final episode of SVT. I toyed with an idea of rushing into the hospital but thought better of it when I looked at the caviar and other goodies waiting at the table, thinking that if I do have to go I might as well go with a full stomach.
I did go to the hospital directly from the dinner table with my brother. By the time we arrived, the episode broke, because I put some ice on my forehead and bore down like I had been reading on Google. Regardless, they thought it best to keep me in a holding room until the procedure on the next Tuesday morning. Remembering only too well the past adventure and how tired I was because of the lack of sleep, I was much more wary this time. First of all, a sleeping pill was requested. Second, and perhaps more important, orders were given on my part that I did not want to be wakened for anything, let alone a blood draw because they already had my chemistries. The nurses had a fit and said they had orders for a 4 AM blood draw. My reply was to tell them to find someone else because I was not about to submit. My thinking was that it was better to be forewarned than forearmed. And it worked for two whole nights. I really rested until the procedure on that Tuesday morning, and considering that I had done absolutely nothing until the time of surgery, I really was in good shape.
The big day of surgery on my heart arrived and so did the big sleep. I knew that surgery was to be performed under what is called “conscious sedation,” a combination of two drugs: one for pain and the other to make the patient not remember. This, or some variation, was given to President Bush last month when he had his colonoscopy and it is widely used throughout the world. I had somehow expected that the nurse would tell me that she was going to give it, but as it turned out, I was looking at her one minute and then awoke in the recovery room. Talk about a deep sleep. This was it, everyone. No dreams, no counting sheep, just sleep or what I perceived and still perceive as sleep, even though from a technical point of view I might have been in some form of wakeful state. I must have been able to talk and hear, because I had moved from the operating table to the gurney and then back to the recovery bed. I called various people to inform them that all was well, and invariably they said when I next spoke to them that it sounded as if I had been drinking heavily.
The next day was a day of recovery, and there must have been some of these chemicals still circulating, because I took a nap after breakfast, another after lunch and a third, albeit much shorter, before dinner. However, on day two I finally woke up and had a wonderful day, feeling full of energy and reflecting back on the events of the past months.
In closing, readers might wonder if I am happy that I had it, my drug induced sleep-like state during the surgery. The answer is an unqualified yes, because my level of energy is back to what it was before all of this started. Writing this story was only one of the things that I accomplished today, and I look forward to writing many more.