TALES FROM HEART LAND

What do you do when your body starts beeping?

[Advance note: Feel free to add even a short Comment to let me know you were here. And if anyone makes it all the way through, let me know that as well. (g)]

A while back, on a dreary, overcast afternoon, I was sitting on the couch wondering what to do next.

I’d finished my breakfast (brunch? late lunch?) and finished reading that day’s newspaper.

Unlike the previous two days, the sun was NOT shining so bright it made watching TV difficult. But I’d had enough TV and I lacked the energy for puttering (writing, playing, posting?) on the computer.

Though I’ve been spending too much time in bed, a nap was starting to sound the best.

Then I heard a truck backing up outside. You know, that “beep-beeep, beep-beeep” signal they have to use to warn people who might be in the way? I figured someone was getting some new furniture and I was just nosey enough to wonder who.

As the truck got nearer, I expected it to slide into view where the curtains were opened. When the “beep-beeep, beep-beeep” got strong enough to suggest the truck was right out front, I was surprised I still couldn’t see it. So I stood and kind of leaned forward to one side to peer around the edge of the curtain. Still no truck but even with my poor hearing, the signal seemed pretty loud and steady.

As I sat back down it dawned on me. The signal was so loud because it was COMING FROM ME!

Flash back to Christmas Eve seven years ago. I’d had my second heart attack, one that was totally different from the first.

Update before flashback

Oops. Forget the flashback. I just finished writing most of it, and it goes on forever explaining my heart attacks and defibrillator/pacemaker implant and, well much of my cardiac-related history. I decided if anyone is interested, they can read all the fascinating, first-hand, background stuff, after I post the current update. (g)

Due to technical issues detailed later on here, I tested the battery in my implant every week by running a painted magnet, the sized of a small donut, over the bulge in my chest. If this triggered a 30-second tone — which it always did — this meant the battery was still good.

This “beep-beeep, beep-beeep” didn’t sound the least like the test tone. So I grabbed my magnet and tested and the tone I got was no longer steady. It was alternating. More like a “bee-beep, bee-beep” which was new, but still different than that “beep-beeep” thing, which had fortunately stopped just after I finally realized it was coming from me.

So I called the Pacemaker Clinic at the Heart Institute but by then it was too late in the day and they were closed.

Now my last regular visit to the clinic had been less than two weeks prior to this. At that time I had noted that while it could be a product of my faulty hearing, the test tone had sounded a bit fainter and had seemed to cut out and then resume after a handful of seconds.

Surgery on the horizon

They tested and things were fine but they decided that I should probably get it replaced this summer. So they’d have me back in two months instead of three and at that time they would start the paperwork to set up day-surgery to replace the implant.

They assured me that even if the battery started going the very next day, I was guaranteed it would keep functioning for three full months, well past the two-month timetable for me to return.

So, frankly, I didn’t panic when I figured out this new beeping thing.

It came back the next day around the same time — close to 5 p.m. — but then didn’t come back any more.

By then I was distracted by the arrival of another medical problem — the return of the dreaded sciatica — which wasn’t as bad as the worst-case which triggered a back operation way back when. But it was painful, on top of my usual, chronic, um, discomfort and it did leave me partially immobilized.

But several days later when the sciatica finally STARTED to fade a bit, I was back to thinking about my implant.

This time I called the Clinic during work hours and got an appointment for the next day.

Turns out the “beep-beeep” thing was a signal that the battery had dipped below a certain charge level. Oddly enough, after sounding this warning, it went back up, which is why the beeping stopped.

Keeps going and going . . .

Anyway, they decided why bother to wait. These implants are supposed to be good for five to seven years and I passed the seven year mark last December. So we did the paperwork to set in motion a call, which I eventually received, to set up a date for minor surgery to replace the unit. (To replace the battery, they have to replace the whole unit.)

Barring complications, it would be a 30-minute job under local anesthetic. Open the pocket they made in my chest wall — not that far under the skin, so the thing does bulge out a bit. Unscrew the leads — which are two wires, each going to a particular chamber inside my heart. Remove the implant and replace it with a new one. Reattach the leads and close me back up again.

Right now the leads look good under external testing. But if there are any complications with the leads, then they’ll put me out and do whatever extra they have to do.

Fortunately I don’t take any blood thinners, which can make things more difficult. Also, they turned off (down?) the pacemaking function of my implant at the Clinic to see what my pulse is on its own. To see if I have a high enough pulse for when I am on the table or whether they’ll have to attach me to a temporary, external pacemaker.

At around 36 and 37 bps, they figure that I will be fine, especially as I’ll just be resting on the operating table.

If everything goes well, which I expect it will — I’m about 90⁺ per cent confident, just enough to prevent overconfidence — it’s simply a matter of go in early in the morning and home later in the afternoon.

Then it’s take it easy — yeah, something I’m good at — be careful with that shoulder and manage the dressing as the site heals.

Though they remind one that surgery is surgery and nothing comes with a 100% guarantee, I’m not that nervous. In fact I probably leave that 10% or less for nervousness just to keep from possibly jinxing myself (tongue-firmly-in-cheek) from being overconfident. (g)

So why even write about it? Well I don’t expect or want people to be concerned, but they might be curious about what it’s like, having a heart condition, defib/pacemaker implant, and all that stuff. You know me, I like to share.

And with that in mind, here at last is the flashback and, as promised, all that history of how I got to this point.

The first heart attack

The first one hit while I was playing ball hockey with friends on a rather warm spring day. When the chest pain persisted, I decided to drop my hockey stick from one hand and my cigarette from the other, and head over to sit a spell in the car, sideways, with the door open.

After a bit my pal Steve called over, “Bill, if you want to go home, I’ll drop of the nets and stuff after the game.”

I thought that a good idea, except, by now my arms were so numb I didn’t think I could drive. And my chest was so sore I was afraid I’d lose my breath if I tried to shout back, or call anyone over.

When I didn’t do anything in response, Steve came over. One look and he pretty well guessed what was happening. “Just drive me home,” I croaked.

Which he did, trying to do a five-minute drive in two minutes or less. As we bounced over the railway tracks on Greenbank Road, I begged him to slow down. “Christ Steve,” I whispered. “Slow down or you’re gonna kill me before I even get to the hospital.”

“Should you be swearing when you may be dying?” he asked.

Well, he didn’t say that. I just made that line up right now. But he SHOULD have said something like that, and probably would have if he hadn’t gone almost as white as, and a little more freaked out than, his passenger.

Steve-o, my real-life hero

What he did do was slow down a bit and get me home safely. So, right now, I give public and heartfelt thanks to my former colleague, good friend, smoking-, drinking-, video-producing partner, Steve Proulx for keeping it together in what must have been a scary moment.

My dear wife Mariette the nurse says she took one look at my pale, sweaty face as I got out of the car and shuffled up the laneway and KNEW I was having a heart attack.

When I insisted I wasn’t going to the hospital in my holey, tattered, ball-hockey jeans, she knew enough not to argue and had my lie on the couch while she grabbed me some more presentable trousers and quickly arranged for someone to look after the kids.

When we got to the Emergency Department, they were a little annoyed that we hadn’t called and waited for an Ambulance. Hell, once I had the pants I wanted, I was too impatient for that. (g)

No waiting

Anyway, there was no waiting. They took me right in and a host of medical types started hovering all around me doing Lord all knows what. But there were TWO things I most remember.

First, they gave me morphine for the pain BUT it didn’t seem to work. That is, it didn’t make the pain go away. When I asked about it, I was told that contrary to what I assumed — make it to the hospital, quick shot, no more pain — the pain could last from an hour to 24 hours. Yikes! (Fortunately it eased soon enough.)

The second thing was the sight of the paddles. Everything was happening half in a dream and half in super reality. I was too fascinated to be really scared. Until someone wheeled over the crash cart and I caught sight of the paddles. You know. Rub ’em together. Someone says “CLEAR!” And ZAP! the patient bucks under the sudden jolt of electricity. I was gratefully relieved when they didn’t have to use them.

In fact things turned out fairly well when after a slightly scary stay in ICU, no further medical procedures were required. Oh, I went through all the post-heart-attack rehab and stuff. And did everything a heart patient has to do, forever more. But it seemed that while a small segment of my heart’s outer wall died during the heart attack, my heart, on its own, created a web of tiny arteries to detour around that spot so no further medical intervention was needed. Not like with the second heart attack.

The paddles — round 2

My next heart attack years later was much different. I wasn’t doing anything at the time and there was no chest pain. But I did feel fluttery as my heart seemed to be racing more and more.

So again we headed to the Emergency where again we were taken in right away. This time, though, things were markedly different.

For one thing, looking into the eyes of the doctor and nurses gathered around me for reassurance, I saw real apprehension. THAT made me nervous.

They moved real quick and the doctor gave me a quick explanation as they brought in the paddles. He informed me my heart was racing out of control. Nowadays I like to think of it doing some wild, innovative but impromptu drum solo. But it obviously wasn’t a laughing matter then.

I also learned something else new. I’m used to seeing doctors in movies and TV shows use the paddles to try and restart a person’s heart. I thought that was what they were for.

After informing me my heart was racing out of control, the doctor explained they had to, in the next few moments, put me out and administer the paddles to STOP my heart. The thought being that when it, hopefully, restarted, it would restart with a proper rhythm. In other words, the paddles were to reboot my heart. And they’d do it again and again, with ever higher charges, till my heart responded properly.

So that was it. Minutes after arrival I was out cold and when I next opened my eyes there was obvious happiness and relief in the eyes of those around me. Turned out they only had to use the paddles once on a small charge and my good old, long-suffering heart responded beautifully.

Christmas Eve, 2002

Which, if you’re still with me, brings me to Christmas Eve, 2002. Turned out that before I could go home, following ICU and all that, I had to get my own set of paddles. But they couldn’t be the regular kind of defibrillator. I mean one can hardly apply them to oneself. How would you hold on to them as your body bucked from the charge?

No, the answer lay within. Fortunately, we now have defibrillators that can now be implanted inside the patient’s chest wall. Not only that, but more fortunately — having seen samples of early, much larger and cruder prototypes and such — they’re now the size of a flat-faced pocket watch.  (Sorry, I thought and thought and that’s the closest thing I could come up with. “A fat cookie” just didn’t sound right.) LOL

Even better, they come with a pacemaking function as well.

Trouble was it was Christmas Eve and they had a full schedule of implants to do and I was likely to have to wait a few days there in the Heart Institute (part of the Ottawa Hospital). But the staff went above and beyond the call of duty and at the end of the day, managed to squeeze me in. I’ll be forever grateful to that young Aussie doctor in Canada to learn all about doing these implants. He must have done a helluva job because mine has served me well long past its due date.

Which brings me back, at long last, to the “beep-beeeping.”

Shocking developments

But first I should probably note that it didn’t take long to learn that the defibrillator worked. There was only one problem. I HATED how it felt when it worked. For two reasons — that there is NO warning and once it does go off, for every second afterwards, you dread it’s going to go off again.

The first time was like a punch to the chest, that drove me to one knee. The pain was fleeting but the shock effect was debilitating. I wasn’t doing anything when it went off and I had no idea when it might go off again.

You can’t believe how hard it is to get over that dread. There is no warning. There is no little man inside to yell “Clear!” You don’t have to be doing anything at the time to trigger the sudden internal shock.

I had a couple of other minor “events” but the telling one came one day when I was sitting in the, um, library. Flash! Zap! It was like an explosion inside lasting less than a second, but oh what an aftermath. Oh what a shock. My arms and legs were instantly and involuntarily flung wide apart. The book in my hand — fortunately a paperback — went flying across the bathroom and bounced off the mirror.

I sagged, afraid to move in case it triggered another one.

That thick layer of dread

I eventually got up and went to inform Mariette, telling her in no uncertain terms that I could NOT take it anymore. One call and we were off to the Heart Institute. On the way, I sat hunched in the passenger seat, wrapped in my winter coat and an equally thick layer of dread. Zap! It hit again. Milder this time, but almost enough to make me cry.

I think there was one more milder Zap before we made it to the hospital.

The upshot was that I was placed on beta-blockers to prevent my heart from racing and my pulse from rising to the point that it triggers the defibrillator.

What a relief. I haven’t been zapped since.

It wasn’t long after that that we got word there was an Alert on the model and batch number of the defibrillator/pacemaker implant I and many others had received. It seemed there had been a couple of cases in the U.S. of the batteries suddenly and prematurely losing much of their charge. No patients suffered in any way, but it was enough for them to send out a warning and propose certain procedures.

So we were called in and given a choice — have a new implant, which wasn’t recommended (for good reasons I won’t go into here), or receive a paint-covered magnet the size of a small donut with which to test one’s implant on a regular basis.

Most, if not all, of us opted for the latter, briefly testing daily and quickly switching to weekly. We also had regular check-ups at the clinic at the Heart Institute ever three months instead of every six months. (In the end, no one else with this particular brand/batch number (whatever) ever had a problem with their implant, including yours truly.)

Each time I visited, they’d connect leads to my wrists and ankles and hang a mouse-like thing over my implant and download three months worth of data. (The funny thing is this is about the only time these days that I see anyone still use 3.5-inch floppy disks. I think they are required by the hardware.)

I always got an “Excellent.” They’d have the doctor double check the results and we’d make any changes we thought appropriate.

So after seven years and an extra three months, this implant, as the saying goes, doesn’t owe me anything. It’s been a tried and true friend on guard inside me and I hope the new one works just as well.

So now I’m ready. Got my new socks, new underwear — ruling out any chance of showing up with fresh-burgeoning holes in either. Got my slippers, housecoat, non-scented body wash for before hand, book (and Nintendo DS) to keep me occupied while waiting. And now I’ve notified family and friends — in case they get wind of “an operation?” —  and I’m all set.

See you guys when I’m back on my feet. Love you all!

[Reminder: Feel free to add even a short Comment to let me know you were here. And if anyone makes it all the way through this, let me know that as well. (g)]