From Human Microchip to EP Study and Beyond

In the 24 hours leading up to my EP Study on Monday, I asked myself quite a few times if it made sense to go through with the procedure, especially since my high heart rate episodes only occurred when I was running. In other words, even though the risks are minimal, is it worth having a doctor thread a catheter up through my groin into my heart in order to figure out what was going on in there and to possibly “ablate” any problem areas?

For a recap of the history leading up to Monday, click here.

Now let's talk about EP studies.

Now let’s talk about EP studies.

To get to the point of today’s blog, we will fast forward past the referral process to get to the electrophysiologist, the initial appointment with the electrophysiologist, the implantation of my loop recorder, appointment number one with the electrophysiologist’s nurse, a between-appointments phone call with the nurse where I was instructed to begin taking two baby aspirin every night (I was already taking one) and appointment number two with the electrophysiologist’s Physician Assistant (PA), where I was given the choice of medication or an EP Study with Ablation. Because I was hesitant to settle for a medication-only option (I was concerned medication would make me more tired than I already am all the time and would not yield any answers), I agreed to proceed with the EP Study and Ablation on the premise that a) at least I would have answers and b) if I did get an ablation, I would be able to return to running with a likelihood of less risk, more satisfaction, and a relieved mind.

I reported to the hospital at 7 a.m. on Monday, and did a combination of laying around, prepping (there is some cleaning with grown up baby wipes to be done), having a baseline EKG taken, having baseline vitals taken, chatting with the anesthesiologist, a visit from the PA, and a final visit from the electrophysiologist before the process began.

From an anesthesiology perspective, the goal with an EP study (at least with this team) was not to keep the patient completely “out.” I did have them promise not to share any crazy tequila stories I told while I was in and out (apparently either I didn’t give them anything to work with or they are very discreet people!). I was given oxygen. I remember nothing of the actual insertion of the catheter. I remember significant parts of them manipulating my HR to try to replicate the issues I have been having. One of the cool parts of an EP study is that they essentially “GPS” your heart. I had stickers all over my chest that were a part of the mapping process (and is it a good thing when they say they don’t have much real estate to work with?!). The anesthesiologist told me that he could tell at a certain point that I was really getting anxious (and I was trying to stay calm but I guess “trying” is a relative thing in that situation) so he put me farther out.

Fast forward to the recovery room. and beyond. I remembered how still Wayne (my husband) had to be after his catheterization, and how we had to bring Wayne’s dad back to the hospital when he began bleeding from his insertion site after a catheterization so I was determined to be the perfect patient on that front. But I think the process and technology have both improved. Although you are told to remain very still, there wasn’t a nurse yelling at me when I moved my head a millimeter (as one did with Wayne).

All of that to get to this answer:

I do not have Atrial Fibrillation (this is mostly a good thing!). My issue involves SupraventricularTachydardia (SVTs). The good news is that SVTs, even though they feel totally bizarre and abnormal, do not usually lead to adverse cardiac events or fatalities.

Dr. Silberman chose not to ablate – he found two “hot spots” that activate at around 160 bpm, but they return to normal as my HR rate escalates and several other spots activate. It was taking so much medication (isuprel) to get my HR up enough to replicate the issue that they were afraid they would run out mid-procedure and apparently there is a manufacturers’ shortage of it so they couldn’t get more. One option is a different (more involved) procedure with a balloon that can discover/ablate more surfaces at once, but that is not necessarily that obvious route to go. For now, the recommendation is that I take a beta blocker before running and keep my HR to below my zone 4.

Here are the takeaways for now:

Technology is pretty awesome

I am still in awe at what medical professionals can find out via technology. From my Garmin which provided preliminary data about the patterns of my heart rate issues, to the loop recorder that provided more specific information, to the map of my heart and its electrical patterns, we have access to so much data.

Physicians with good bedside manner are pretty awesome

I am grateful for the way in which Dr. Silberman has explained everything at each step of the way. I appreciate the fact that he respects the role of running in my sanity (even though he does say, repeatedly, “you know, you don’t have to exercise at 170 bpm to be fit”).

dr-silberman-rotated

Good nurses are pretty awesome

I am a little fuzzy on my ability to evaluate the performance of some of the nurses, but all the ones I was “with it” for were great. They were patient, answered my questions, and provided plenty of attention (along with a nifty “discharge note” (below) and a follow-up phone call the evening I was discharged. My last nurse had an interesting mantra — “be assertive” — she said it ten times if she said it once. She’s right of course but it still struck me as interesting.

cardiac-nurses-rotated

 

Remember that post I wrote about how hard it is to get a wheelchair at TMH?

I have to admit, when I remembered (duh) that I would need one of those very same wheelchairs to transport me out of my room and down to my car, I was a little afraid the staff would see my name and all of a sudden develop a very lengthy d e l a y! But my complaint was never about the transportation staff themselves, just the challenging process of getting a wheelchair for my father-in-law, and I am happy to report my chariot arrived to sweep me away from the hospital relatively promptly.

Frequent naps and permission to “take it easy” are awesome

I was told to avoid running/exercise (sigh) and not lift anything heavier than ten pounds for a week. As much as I have missed my usual high-intensity, rapid-fire life, I have to admit having permission to take it easy has its bonuses too. I have probably taken more naps in the past week than I have in the past year (or five…). I think I needed the rest.

Not running is not awesome

Double negative that may be … but if you know me, or if you have had your own period of enforced non-running, you know what I mean. All of a sudden everyone’s off-hand remarks on social media about their “quick three-milers,” “couldn’t help signing up for another race,” and “awful run but I am glad I did it” seem like they are coming from a completely different universe. My paper workout chart, my Training Peaks, and my Daily Mile are all completely blank this week. So is my endorphin quota. It’s odd and not awesome.

So much of your running mojo is in your head

This has messed with my mental status. As much as I have advocated endlessly for the power of the back of the pack, for the fact that every mile matters, for the fact that runners should all support one another, the truth is that I have felt very close to the edge of being excommunicated from the runner fraternity (and I know if anyone else said all that to me I would immediately jump on them and tell them the thousand reasons why they still belong). I’m just keeping it real here. I have finally gotten a little tiny bit of traction and credibility as a Fitfluential Ambassador and am having to work hard to convince myself I still belong.

Not running messes with your nutrition

One beautiful thing about running combined with relatively clean eating habits was that I had a little wiggle room to treat myself to “fun food” occasionally. A few weeks prior to the procedure I announced to my coach that I was “tired of logging.” although I knew what to do to maintain my weight, I also know how easy it is to wander once you are no longer making yourself accountable. Logging and reporting my food logs to my coach every night incentivized me to, for example, have salads on hand for lunches, to skip bread in the evenings, and to keep the long-term goal in mind.

And I think that’s the rub now: there is no long term goal now that I have ditched the sub-30 5K. The things I run for still exist: Gareth, Charity Miles, my team at KR Endurance, my running friends, my health and my sanity.

The challenge is getting my head (and my heart) back in it.

EP Studies

****NOTE: I really hate talking endlessly about myself like I have ended up doing throughout this cardiac health  journey. I continue because I know it has helped me to read of other people’s experiences. It’s a scary and lonely feeling to feel like “the only one” facing this type of issue. A lot of people have helped me, especially Mary Jean Yon. While I don’t feel ready to be anyone’s lifeline yet, it is important to know you are not alone, and to be your own most assertive advocate when it comes to your health. That’s why I keep talking about it. Maybe next week I’ll post about dancing unicorn kittens or something lighter!

7 Quick Takes – My World for a Wheelchair and Other Observations

I don’t usually blog on Fridays, but when I saw the “7 Quick Takes” format on Filling My Prayer Closet, I thought I’d give it a try!

1 – My World for a Wheelchair

Twice this week, I have had the responsibility for taking my father-in-law to the hospital for diagnostics followed by a neurosurgeon appointment. Our hospital has an awesome (and affordable!) valet service, but the “valet service unit” and the “wheelchair unit” are completely disconnected from one another. Wednesday, after the valet said it usually takes 30 minutes to get a wheelchair, I was trying to walk my father in law in when it became clear that he could not continue; fortunately another patient got me a wheelchair. Today, the valet staff said they would call one for me. It “only” took 14 minutes this time but, honestly why is it so difficult?

2 – I Am The Parent of an Adult

My daughter, Tenley, turned 18 yesterday. EIGHTEEN! With all the emotion that brings up, I have to admit I kind of love it that one of the touches she liked the most about the day was the “Frozen” balloon I had put in her car to surprise her when she left for work.

2014-06-25 19.53.07

3 – SUP Boarding Rocks

I read in Jennifer’s post that she is going to have an opportunity to do SUP Boarding soon. I had an opportunity to do it while I was at the beach last week and it was so much fun (and, surprisingly, quite the upper body and stability workout!).

All in the family ... staying afloat (mostly!)

All in the family … staying afloat (mostly!)

4 – Cycling Sure Would Be Fun

Even though my bicycle on vacation was a basic non-descript getting-around-the-beach bicycle, I was reminded of how much fun cycling is. I have always said I’ll wait and add on another sport once I reach my running goal of breaking 30:00 in a 5K but that’s taking quite a while, so I may need to sneak some cycling into my life pretty soon, not just when on vacation.

5 – My Heart Had Left My Job Long Before My Body Did

I left my job on May 2, 2014. When I had to return to the office earlier this week to drop off some paperwork, it was difficult to walk into the building. But not difficult in a sentimental way. Difficult in a “how did I simultaneously separate my mind and heart from this place while I kept coming day after day?” Now on to pursue that legacy I want to leave my kids.

6 – What Else Can I Do For Silvia and Christopher?

After my Unbound Blogger Trip to El Salvador in early June, I was asked to share details about Silvia, an adult with special needs including epilepsy, and Christopher, an adorable 3 year old, two individuals who would benefit from sponsorship through Unbound. I am searching for ways to expand the reach of my blog post. Does anyone have feedback about other methods I could employ to get the word out? (And even if you don’t have feedback, prayers would be mighty appreciated!)

Silvia, Age 21

Silvia, Age 21

Christopher, Age 4

Christopher, Age 4

***UPDATE*** Silvia has been sponsored (as of 7/2/14). I am so happy to hear this and grateful to whoever sponsored her!  ******

7 – Give As Much Praise As Complaint

After reading Laura Petrolino’s blog post about customer service the other day, I shared it on Facebook along with the suggestion that people should make sure and commend the good at least as often as they condemn the bad. Even in the midst of the wheelchair-challenged day (see #1), I encountered moments of professionalism and compassion, such as the other patient who found a wheelchair for me and the staff member (Delvin) who stayed with my father in law until I could bring the car around. Literally, each one was a godsend!

St. George Island, FL June 2014

St. George Island, FL
June 2014