Archive for month: June, 2014

I’ve been debating whether or not to write this post for a while. At first I didn’t think the topic was relevant, but now that it’s started to affect my behavior I figured it’s worth addressing. Anyway, about two months ago Dirk and I had gone out for sushi with a few friends of ours, a weekly ritual. After dinner I stood up to go to the men’s room and didn’t feel quite right. It felt like my heart was racing, even though I’d been sitting still for over an hour. I had a little trouble finding my pulse, so I asked Dirk to do it. He didn’t feel anything unusual, and after a few minutes I felt normal again, so I shrugged it off and ate my green tea ice cream.

The next day I went to Starbucks to work and write in my blog… another daily ritual. After a couple hours, I got up to refill my coffee and again felt… off. So I took my pulse again, paying much closer attention this time. And this time the rhythm really freaked me out:

thump…. thump…. thump……… thumpthumpthumpthumpthump………………… thump…. thump………
thump…. thump…. thump……… thumpthumpthumpthumpthump………………… thump…. thump………
thump…. thump…. thump……… thumpthumpthumpthumpthump………………… thump…. thump………

I double-checked… then triple checked. No doubt about it. I didn’t feel light-headed or anything… just weird… a little “fluttery,” sort of like the feeling when I get nervous. I went back to my seat and again asked Dirk (who was with me) to check my pulse. No mistaking this time; my heart was acting really weird.

“I don’t feel dizzy or anything,” I said to Dirk. “What do you think… should we go to the ER?”

“I dunno, probably. Couldn’t hurt.”

“Yeah, I guess we’d better go.”

So, feeling fine other than having a freaky rhythm, I went to the ER. (Dirk drove.) The triage nurse immediately sat me down in a wheelchair. “Protocol,” she said. “so you won’t hit your head if you pass out.” Then she hooked me up to a heart monitor.

“Looks like a-fib,” she observed.

“What’s that?” I asked.

“Atrial fibrillation. Not too bad though, you’re only up in the 180s.”

She was referring to my heart rate. Atrial fibrillation, or “a-fib” as it’s commonly called, is a condition in which one of the atria — the upper chambers of the heart, in my case the left atrium — isn’t receiving the proper nerve impulses, so it ends up “twitching” at a rate of up to three hundred times a minute. This disrupts blood flow to the rest of the body. The heart tries to compensate — hence the irregular rhythm — but cardiac output is typically reduced by about 20%. This means you get tired easily and can feel a bit light-headed. Some people live with a-fib for the rest of their lives, while some people flip in and out of rhythm. People with a-fib also have a five-times-greater risk of stroke; the reason for this is that blood can collect in the atrium and form a clot, and if the clot is released into the bloodstream, it can block blood flow to the brain.

Some scary shit.

The good news was that I wasn’t in any immediate danger (an ultrasound revealed that I hadn’t formed any clots… more on that in a sec). Since there was a chance that I would go back to normal “sinus” rhythm on my own, the ER docs put me on a beta-blocker (which limits the heart’s rate and can encourage it to go back to NSR) and sent me home with instructions to come back on Friday for a rather serious procedure… cardioversion.

Cardioversion is pretty intense. First they do an echocardiogram to make sure that you haven’t formed any clots in your heart. If you don’t have any, then they sedate you and — get this — shock your heart back into rhythm. I had two concerns about this:

1. Before they shock you, they shave off patches of your chest hair… and I had a gig in Kansas City the next week.

2. THEY WERE GOING TO SHOCK MY FUCKING HEART.

My appointment was at 8 am on Friday morning, April 18, less than 36 hours after I’d gone into a-fib. I stopped eating at midnight the previous day (as instructed) and went to bed nervous as all hell. But when I woke up, I felt different. Stronger, more energy. So I checked my pulse.

I’d reverted to normal sinus rhythm on my own. Phew.

I went to my appointment anyway (just in case), and the docs confirmed my self-diagnosis. The beta-blocker had done its job beautifully. No need for the cardiac echo, and no need for cardioversion. I left the hospital about an hour later, unshocked and with chest hair intact.

My cardiologist — I have a cardiologist now, which is kinda strange — thinks that I had something called isolated a-fib… that is, it’s not likely to ever recur. (Thankfully, it means I can keep making porn!) He’s not sure what triggered it… my understanding is that athletes can develop a-fib as the heart grows stronger and nerves have trouble adapting. Dehydration is also one of the known causes, so maybe the salt in the soy sauce (plus the fact that I’d just done an hour of cardio before sushi) or the diuretic effect of the coffee had something to do with it. So I’m trying to cut back on sodium (easy) and curtail the coffee intake (not so easy). I have to say, though, that I’m now acutely aware of my heart rate… an effect that one of my nurses called the “ticking clock” effect: once you notice the tick of a clock in the room, as she explained it, you’re aware of it all the time. And I am. That’s a good thing, I guess.

I also have a couple of new medications. My doc prescribed something called propafenone, in keeping with a newer form of reactive treatment called “pill in a pocket.” I carry it with me everywhere; I’m supposed to take it at the first sign of an arrhythmia as it’s been shown to help with the immediate conversion back to normal sinus rhythm. If it doesn’t work, then I’ll head to the ER for cardioversion.

The second medication — and the reason for this blog post — is the beta-blocker, which I’m continuing to take. My cardiologist prescribed metoprolol tartrate, otherwise known as Lopressor, as a safety net; I’m supposed to take it for three months just to make sure I don’t go back into a-fib. It’s been a little over two months now. A few people — including, I suspect, many of you who are reading this post — might have noticed that I haven’t been contributing to the blog or to Facebook much over the last couple of months. There’s a good reason for this. About 5% of patients on Lopressor experience depression as a significant side-effect. I appear to be one of those one-in-twenty. My energy and enthusiasm are way, way down, and I’m getting discouraged by it. The things I normally love — writing and lifting and hanging out with friends and being social and stuff — have been a real struggle for me. IML, for example, was a lot tougher than I let on (but I got through it). Dirk and I are bickering more than usual. My sex drive is down, too, which really sucks (I’m usually super-duper horny, but not much at all lately). And this whole ordeal has placed me in intimate contact with my own mortality… always a sobering thought.

So the reason I’m writing this is to apologize for my relative lack of sociability over the last couple of months. The end is in sight, though… I only have a month to go on my beta-blocker regimen, and I just asked my doctor if I can either curtail the dose or switch to a different medication. So please… bear with me! I’ll be back to normal in no time, I promise.

A couple of final thoughts:

1. If you ever feel “off” or have any questions about your health, please for heaven’s sake talk to your doctor. I’m a stubborn SOB, and part of me wanted to go to the gym instead of going to the ER. I’m glad I didn’t, because now I know about my condition and am doing something about it. Who knows, if I didn’t get it checked out, I might have blown a clot. Knowing is better than not knowing.

2. Dirk, as always, has been wonderful through all of this. I haven’t been myself since April 16th… far from it. I’ve been kind of a wreck because of the depression brought on by the beta-blocker. But Dirk’s been right here with me the entire time, taking me to the doctor and sitting with me at the hospital and toughing it through my mood swings at home. I hate putting him through this, perhaps more than any other part of the whole ordeal… but he’s done so much for me, and had the patience of a saint. This’ll all be behind us pretty soon, thank goodness.

So thank you Dirk, and thank you everybody, for sticking around while I get through this. I mean that… from the bottom of my heart.