Dysfunctional Heart Now Functions, Thanks to Valuable Skills
by Mary Ellen Stepanich
You haven’t seen my posts for a while, and here’s the reason why.
I’ve been struggling with atrial fibrillation, or A-fib, since the turn of the latest century. A-fib is an irregular heartbeat that can cause blood to pool in the lower heart chambers and coagulate, later sending out clots that could possibly cause a heart attack or a stroke. As a result of A-fib, I had a massive stroke in 2006 that would have killed me, but for a little help from my friends in San Diego Sweet Adelines who got me to Sharp Memorial Hospital quickly, and a visiting stroke specialist doctor from Germany, whose immediate use of a new “clot-busting” drug saved my life. I survived with virtually no ill effects (except for occasionally calling the toilet the dishwasher). This was followed by several years of care under the watchful eye of a brilliant electro-physio-cardiologist, Dr. Jesse Sethi, at Cardiac Solutions. And, of course, there were the trips to the ER every three to six months to get my discombobulating heart whacked back into normal rhythm.
On June 8, 2015, I suffered another A-fib attack, but I was sure my heart would convert on its own after a few days. (Silly, optimistic me.) Finally, I admitted defeat and on Sunday morning, June 14th, I drove to the hospital emergency room and turned myself over to the capable nurses and doctors there, who had always brought by heart back to normal sinus rhythm in the past. However, this time the outcome was different.
After working diligently for more than 24 hours to restore my normal heart rhythm, I knew I was in trouble, especially when the handsome Dr. Sethi appeared at the door of my hospital room on Monday morning. I could predict what he was going to say, so I pleaded and bargained with him:
“I know, I know. I’m going to need a pacemaker. And I promise I’ll do it after I get back from my trip to Indiana next week. My high school is having a reunion and I’m giving a reading of my book at the hometown library and I’m going to sing with my old quartet. I’ve been interviewed by the local newspaper, my picture’s in the paper, everything is all arranged, and I can’t miss it,” I continued to wail. “And, I have to get my hair done!”
My tears and my pleading fell on deaf ears. “You’re not leaving this hospital without a pacemaker. No argument.” Dr. Sethi had spoken.
Orders were given: No food or drink after midnight Monday, with surgery to follow on Tuesday. However, the nurse came into my room early Tuesday morning to tell me that the procedure had been delayed and I could have some breakfast. About four hours later, the operating room staff came to collect me and prep me for surgery. When they double-checked that I’d had no food or drink since midnight, I said, “Well, the nurse gave me a little breakfast about 7:30. She said the procedure was delayed.”
Oh my, what an uproar! I thought they were going to fire the poor nurse on the spot. Typical organizational misbehavior – the OR blamed the ER staff, the nurses blamed the doctors, and I had to lie in the pre-op cubical for five hours while the food digested. (That’s worse than waiting for paint to dry.) The anesthesiologist told me they would have to put a tube down my throat and into my stomach to prevent aspiration. Again, I begged and pleaded, citing my avocation as a singer and the possible damage to my vocal cords. He was adamant, so I requested the smallest tube possible. (By the way, the first thing I did when awakening from the anesthetic was to take a big breath and sing a long, loud, pure A.)
I was released the next day, and Dr. Sethi told me I could take my trip to Indiana, but I had to be careful of certain things. I couldn’t raise my left arm, which meant I couldn’t fix my own hair. (Wal-mart Style Salon, here I come.) Also, I could not go through any metal detectors at the airport or be in the proximity of any electro-magnetic force. (Oh, my, the dreaded “pat-down.”) Also, I couldn’t lift more than 10 pounds. (But my purse weighs more than that!)
Nevertheless, one week later I made the trip with no mishaps. Well, except for one. As we were landing in Indianapolis, on the final approach with the ground just dozens of feet below us, suddenly the plane roared and took off, straight up into the sky. The passengers looked at each other, faces white with panic, hearts racing, fingers gripping the arms of the seats. My heart, of course, was beating at the steady rate that had been programmed by Dr. Sethi. My only reaction was, “Gee. We must have almost hit someone on the runway.” As it turned out, there was an indicator light saying the brakes were not functioning, so we circled for a half hour while they “rebooted” the computer, and we landed with no mishap.
My brother said, upon hearing what happened, “Huh. Usually, you would’ve freaked out. Must’ve been the pacemaker.” Hmmm, does that mean I’m never going to be able to experience anything that might cause my heart to beat faster – such as the sight of a gorgeous hunk of manhood leering at me with lascivious thoughts? (As if that would ever happen.)
I did experience some problems, however. Dr. Sethi had set the rate too high for me – 80 beats a minute versus my normal 60. Also, the voltage was too strong in the four nodes on the wire that had been implanted in my heart muscle. In addition to sending electrical impulses to the heart muscle, they were also zapping my phrenic nerve, which caused my diaphragm to spasm – 80 times a minute, day and night, no let up. I imagine that’s what a mother feels in the ninth month before delivery with the baby kicking her in the side. But 80 times a minute?
As soon as I returned to Arizona, the first thing I did was to contact Cardiac Solutions and beg the triage nurse to get a message to Dr. Sethi about the baseball bat that was thumping my side – 80 times a minute. It was so bad that my cat, Cookie, who loves to sit on my abdomen before going to sleep, looked like she was enjoying a ride on a pony, galloping up and down – 80 times a minute.
The triage nurse called back later and said I had an appointment to see the representative from the company that made the pacemaker. I thought, “I don’t want to talk business – I want relief!” Nevertheless, I was eager to see what the rep had to say and to find out what could be done to help me to live a more normal life.
I arrived a little early for my four o’clock appointment and was soon greeted by a pleasant, 20-something young man dressed in crisp “scrubs” with a logo on his shirt pocket proclaiming “Four-ward thinking.” He directed me to an examining room that held one chair and multiple computers. After a few opening pleasantries, he asked me to sit and then placed what looked like a round computer mouse on my chest and began tapping keys on the computers.
I explained my problem, and he seemed to understand immediately. He told me he would conduct a few tests. Well, he tapped some keys and then waited for my reaction. I yelped. I hiccupped. I jerked. Finally, I felt nothing but calm and peaceful. He did this for all four nodes on the wire in my heart until he was satisfied that the voltage was set high enough to do its work, but not so high that it caused me discomfort. He also reduced the heart rate to a more sedate 70 beats a minute. I left the clinic with a lot more spring in my step.
This success made me think a bit about the notion of value – or cost – versus worth. Which is more valuable, or worth more – the expensive physician who uses his skills to extend life, or the lowly wage earner who uses his skills to make that life more “livable?” Well, as we organizational behaviorists often say, “It depends.”
I’m thankful for Dr. Sethi’s skill in implanting the pacemaker that will perform the work for a dysfunctional heart. But I’m especially grateful to a young technician named John whose skill made the heart more functional and me more comfortable. But more than that, I’m grateful to the scientists, computer jocks, and manufacturers whose skills have created the technology that helps people like me to continue to live and contribute to society for more years than our parents and grandparents were allowed. Now, I just have to make sure I contribute something – maybe even something of value.
Dr. Mary Ellen Stepanich is a retired professor of organizational behavior who always told her students at Purdue, “I’m very organized, but my behavior is a bit wonky.” She has published articles in academic journals (boring), show scripts for barbershop choruses and quartets (funny), and an award-winning radio play, “Voices from the Front,” for Sun Sounds of Arizona (heartrending). Mary Ellen lives in Peoria, Arizona, with her cat, Cookie, and blogs on her website, MaryEllenStepanich.com.