(Phaysis)

To the concerned, I am bruised but not broken. My heart is ok, but you should see the veins on my left arm. Yesterday’s trip to the ER was humbling but yielded a potentially positive outcome.

It started with a sip of soda; some went down my windpipe and caused me to cough forcefully. This is a bad thing — with me, coughs almost always end in hiccups (after smoking for 9 years, I can’t cough anymore – I have to hack). So, the hiccups inevitably began and I could not silence them soon enough. The unfortunate chain of events ended in tachycardia: the sudden, sustained doubling of my heartrate.

I’ve had this before, too many times. Went to the ER for it on one extremely long case. Usually lasts five to thirty seconds until my heart finally settles down. But yesterday morning, after I tried all my doctor-recommended tricks to end it, I knew it was going to last, so I called to my roomate to take me to the ER.

All the signs, cars, stop lights, people, activity – you notice the absurdity of it all when you’re sitting in a passenger seat and your vehicle is going in slow motion, your pulse is 180bpm and your heart feels like it wants to die. You feel completely unimportant; the world goes on regardless of your emergent health.

Tachycardia is not fatal; there’s a 1% to 3% chance of death from cardiac arrest. It feels like it’s eminent, though; the heart is on a freewheeling feedback where it still pumps blood but does so incredibly inefficiently. When your pulse returns to normal, you almost can’t feel it anymore, but you’re still alive. It’s otherworldly to not feel your own pulse, but you’re glad it’s settled down. You can relax.

I went to the ER hoping that they could get the ECG leads on me before it settled; sadly, my heart once again returned to normal before I could see a triage nurse. For a proper diagnosis, they need to see it happening. I considered trying to induce it, a potentially dangerous proposition, but it’d be the best place to try that kind of thing.

The doctor on staff mentioned that it might be a condition known as WPW, or Wolff-Parkinson-White Syndrome; the cardiologist on call suggested it, and the staff doctor seemed to agree. Basically, the heart has a nerve bundle between the upper and lower chambers which is responsible for transmitting the heartbeat impulse between halves while in the process delaying the beat of the lower chambers.

People with WPW also have a rogue nerve elsewhere between the halves that causes the impulse to be sent too soon and on rare occasion will cause a circular impulse loop, resulting in tachycardia. WPW is treatable with medication and in most cases (I’m assuming) curable with a procedure called radio-frequency ablation where heart surgeons run a catheter to the site of the rogue nerve and burn it with radio energy.

This errant nerve is formed at gestation but its effects are generally not seen until the person is between 11 and 40 years of age. I’ve had this problem for at least since 25. I had always associated it with smoking or too much caffiene; although that exacerbates the situation, it is not the cause.

The ER doctor recommended I see the cardiologist for a follow-up. Gave me his pager and office numbers. Since I have new insurance, I need to check with my provider to ensure I can see this specialist without referral from my primary physician. Politics and money first, health second. As much as I hate using the phone, I will start making some calls tomorrow morning. Even if the ER trip was a wash, this important lead makes it worth the effort.

Two weeks ago I looked forward in time to this three-day holiday weekend and saw a bit of fun, frivolity, high times. Now that there’s only about 4 hours left of it, there’s still hope for the weekend delivering on those visions.

My fingers are crossed.

Today, scratch that, this weekend has found me in a weird mood. Restless, trying to escape the pervasive heat, trying to deal with parts of my body that let me down. Last monday I was getting dressed for work and inhaled some saliva after brushing my teeth. So I coughed. And each cough was punctuated by a hiccup. The coughing stopped, but the hiccups stayed. A few minutes later, I was bent over to pick up some socks in the closet when a hiccup hit me, sending my heart into another of its famous tachycardiac fits. Pulse shot to 180bpm (it’s normally 80~90bpm at rest). And it was rough. Lasted longer than usual (30 to 90 seconds). Much longer.

I had my roomate drive me to the E.R. where no sooner do I finish the paperwork and sit down to wait on my name to be called the tachycardia stops, my blood pressure drops, and I settle down. Total time: 15 minutes – the longest spell to date, and that’s scary. I was sore, and pissed that I couldn’t get an EKG before it was finished (that’s the only way to diagnose the cause of tachycardia). So I wasted time at the ER. And money.

The past two weeks have been kinda shitty moneywise. It was good that I did some math on my expenses because after all five of my autodebited bills come out of my checking account I’ll have around $150 left, and that’s to be spent on food, etc. I’ve been living skinny, and it’s scaring me. Always one paycheck from disaster. I want a job that pays better than my current job. I’m considering taking a part-time job in addition to my regular gig; put my wasted nights to good use.

Apparently, times aren’t tough just for me: I found out two weeks ago that my mother is sick again. The woman was too proud to call me to let me know (“I didn’t want to bother you…”). She’s unable to work and is down with full-body pains. Can only walk around with canes and walkers. So she has no money coming in, and the V.A. doctor will only give her pain killers instead of trying to give her quicker access to getting tested for Multiple Schlerosis. She has to be diagnosed with MS to be given the essential drugs she needs to minimize the MS attacks and get on with life. And things are moving glacially while she’s living the bad life on the skids.

It bothers me that I can’t afford to help my mother more; I shipped her two books, a card, and $40. She has food stamps, so she’s not hungry, but nobody visits her, hardly anyone calls her, apparently my sister will have nothing to do with her – and she lives in the same town (I need to get to the bottom of that) – and my mom’s just too young to be going through this kind of thing.

So I guess I have a few issues to deal with. Normally I am able to have good weekends and even better 3-day holiday weekends, but it’s not possible this year. Not at all. Don’t expect me to celebrate much.

I don’t like the direction I’m heading. At the present course, I’m due for a heart attack by 35. If even that late.

This month, I turn 33, and I am already feeling the touches of the “iron hand,” common among cardiovascular sufferers, on my heart. That’s the feeling of sections of my heart not getting enough oxygen due to constricted or clogged blood vessels. Sounds crazy, but it’s what I’m feeling. I remember when I had my radiological heart scan in October of 2003 that the cardiologists found absolutely nothing wrong and found only the normal flow in my heart’s blood supply. I got a clean bill of health. But things can change in a year and a half. Things can accumulate. Things can go south in a short amount of time.

I think it’s time I took care of what needs to be done: I need to have a complete physical. I’m at that age where it’s important to have one every year. There are way too many unknowns. What is my cholesterol level? What about my triglycerides? How can I lose this excess weight hanging on my abdomen, and how much should I lose? And what is with this heart murmur I have and the occasional arrhythmia? Maybe I’m being a tad bit too dramatic, but I live in fear of my heart. Every day. A physical can give me proper guidance.

Yesterday, I didn’t feel well at all. Woke up with my left arm tingling, and my right one was wanting to follow suit. It all started subsiding later in the day, but it was made apparent to me that I was treating my heart bad with all the caffeine I was drinking almost every night in the form of coffee. Recently, I have renewed an interest in, and a craving for, coffee and coffee drinks; love the stuff. But I have noticed the overstressed sensations, the iron hand, the aquatic breathing, the tingling — too much caffeine, too late in the day. Nighttime is the only time I drink coffee, and that’s not good for sleep; I don’t rest, my dreams are screwy, and I wake up with a hangover. That’s just not right.

Yesterday, I did something different. Instead of sitting around the house or driving to a coffeeshop, I decided to walk. Walked to Flightpath, which is in my neighborhood. Walking there isn’t foreign to me, have done it several times and found it enjoyable. But I got there and found there was almost no place to sit; it was way too crowded. So I concocted a plan: dig up the bus schedules, hop on the #7 and head down to near the college, get off, and walk up the hill to Spiderhouse, one of my other hangouts. I would then take the #1 home after spending time there with friends or laptop. And that’s what I did, and somewhat regretted.

Most of the walk from the bus to Spiderhouse was uphill, and I had my full backpack on. I’m not accustomed to that kind of exercise; my life is too sedentary to just “get up and walk” like that. It was a rough walk, but I handled it ok. My heart was beating hard, but I think it was thankful for the exercise. This morning I felt like hell, though. Shoulders were tense – not just shoulders, but shoulder sockets, from carrying the backpack across both shoulders. The hangover was pretty intense – I deprived myself of caffeine last night, and drank stuff with lots of water and sugar, but I was still depleted and spent. And then today I did a lot of work that involved picking up wide handfuls of paper to cut them down into smaller sizes. Shoulders still feel rough. And soon my legs, feet, and arms will, too.

In just the same way that I started realizing that smoking was slowly killing me and I made the commitment to quit smoking, I think it’s slowly dawning on me how badly I’m living with my bad diet, little exercise, and poor maintenance. There is a lot of stuff I need to relearn about feeding myself right, about paying attention to what I’m shoveling into my mouth. There’s a lot I need to make myself do to keep active. I grew up hating sports; I disdained all manner of competitive athletics, so for most of my life I’ve been relatively inert and sedentary (walking and bicycling were my only enjoyable activities). That sedentary bit won’t work anymore. I need to do something. It’s been said that doing only 30 minutes of an activity like walking daily can reduce serious health risks. Doesn’t take much. A friend of mine told me today that, according to his doctor, the baseline limit for what qualifies as an “active, non-sedentary lifestyle” requires no less than 10,000 footsteps a day. That’s a high number, if you ask me, but if it takes 100 steps to get from my car to my apartment door, I think it can be easily achieved by just DOING STUFF.

I think on the days where I don’t go to get my allergy shot before work or need to cash my paycheck during lunch I should walk to work. Hell, I live only 4 blocks from my job, and I’ve walked or ridden my bike there only 3 times. It needs to be a regular habit; I’d get my 30 minutes of walking taken care of at least 3 times a week, guaranteed. That requires discipline and drive, which I apparently lack. But it can be done. Please, wish me luck.

Poked, prodded, stuck, bled, shaved, scraped, patched, shot up, scanned, pushed, run to death. A night on Sixth Street? An evening in the LAPD hotel? A bad time in a Tijuana brothel? Nope.

I had my stress test yesterday.

I went in for my 1pm appointment at a local cardiovascular specialist office for my nuclear stress test. In a nutshell, this kind of test involves radioactive dyes and a little bit of exercise. They brought me in, shot me up with a radioactive isotope drug (the gamma-ray dosage was much less than a typical X-ray) which binds to my heart muscles. After a 30-minute break, to give the drug enough time to find my heart, where I read some angry literary bitterness from Henry Rollins, I was laid down on a sensor machine and slid into this set of rings which contained these huge boxes loaded with sensors. I had to get really comfy, because for the next 15 minutes I had to remain motionless. Thankfully, it was over sooner than I had thought.

After the scan, I went to another room where my chest was shaved in patches with one of those single-use razors they love to use in operating rooms (the guy was kinda rough). Then he swabbed the shaved patches with rubbing alcohol and followed it up with something resembling 400-grit sandpaper. Oouuuch. Apparently this was to make my skin completely conductive for the ton of sensor patches that were stuck on me. (Regardless of all the shaving, some hair was *still* pulled when those were taken off.) I was wired up to the EKG machine, everything worked and checked out, then the doctor came in to monitor the machine while I worked out on the treadmill.

Clunk! “Ooh, that wasn’t a good sound,” said the Doc. The first treadmill we tried was broken. Crap. I had to be taken to another room and get wired up again for a different treadmill. :sighs: At least this corner room had a much better view of the scene around the office tower.

The treadmill started out at 1.7 mph at a 10% incline. That was equivalent to a decent walk down the street, and this stage lasted for about four minutes. Then the treadmill got a little more difficult – it sped up and the incline stepped up to 12.5% grade. This went on for two more “stages” where by the time my heartrate reached the target of 160 beats per minute I was running up a serious hill. It was at that point that the doc injected me with a final dose of isotope and needed me to run for one more minute. This is to make sure the drug gets a good circulation through my bloodstream.

Off the treadmill, the physician’s assistant removed all but three of the EKG pads and took the IV out of my arm. I was then sent into the break room to eat the high-fat lunch I was told to bring, which I did gladly and with much gusto after having to fast for six hours before this test. Mmmm. Reheated Sonic burger and tots.

After lunch, I had to lay down on the sensor again, this time for a shorter session. The EKG was attached, I was slid into the rings, and this time I managed to lay with my head turned enough to see the computer monitor. What I saw was pretty interesting – after every small motion of the sensors around my chest, the computer would accumulate more scans together into a final image for that angle. When the sensors moved again, the process repeated. It was really interesting seeing inside my chest; looked kind of like a ghostly glow shot with a security cam in low light. And it doesn’t matter that I’m at a cardiology specialist’s office, my geekhood still rides high because as I’m looking at the scanner’s monitor I noticed that according to the look of the “widgets” on the graphical interface the computer was running Gnome on some version of X-Windows (Linux or Unix) or plain-ol’ Microsoft Windows using a Gnome widget library. Heh.

When the second test was done, the docs helped me up, disconnected me from the machine, shook my hand and told me to expect a call later this week for the interpretation. From everything I heard and gathered, my heart was acting normally for them. Everything was normal. But the interpretation of the many EKG readings while under stress and while at rest, and the interpretation of the images from my chest, may tell the doctors something different. I dunno.

Last night I took some pleasure in explaining to my buddies that I was full of gamma-ray radiation. Should’ve seen the looks and the backpedalling.

Time to get ready for work. Later.