06/11/2004 Archived Entry: "Keeper's Krazy Hospital Adventure!"

Blog update. Huh.

So, I spent all Wednesday night in the ER and most of Thursday at Clear Lake Regional Medical Center. And, let me tell you, it was exciting. By "exciting", I mean "not exciting and actually quite crappy".

For most of Wednesday, I was feeling a fluttering in my heartbeat. Like, it would be beating along in my chest in a totally non-spectacular and normal way--thump, thump, thump--and then it would suddenly skip, or flutter--thump, thump, dadada-thump, thump. I've felt this before, but never more than once. This time, it was going on all day, every few minutes. I was kind of concerned, and mentioned it to Pete, my personal trainer person, since Wednesdays are Pete days.

He's a licensed physical therapist, and he said it sounded strange, so he took my blood pressure and monitored me during our workout. Everything seemed fine, and the workout appeared to vanquish the fluttering for the next few hours. KK had a lot of work she had to bring home, so she was busy from the time she got home until about 23:00 and I didn't want to bother her. Silly, I know, but it's easy to be more concerned with others than you are with yourself.

As we crawled into bed, I mentioned what was going on to KK, and she got rather alarmed. She insisted that we go immediatley to the emergency room, to which I at first objected, but she won me over after a few minutes and a few more heart flutterings. We drove to the medical center, which is about two minutes from the apartment, and checked in.

I described what was happening to the nurse guy, and he immediately hooked me up to an EKG and ran a tape, which showed an arrhythmia. So, they then moved me into an exam room--and wired me up to an EKG monitor thing and a BP cuff and oxygen, and shoved a catheter in a vein on the back of my hand and started sucking out my blood to check for stuff. I spoke with the doctor who initially said that I appeard to have an SVT--superventricular tachycardia--and that it was nothing to worry about and that they'd release me in a few minutes, as soon as they got the SVT recorded on the monitor.

Well, my heart refused to cooperate for a few minutes and beat in a stalwart fashion, but it eventually started acting funny again and they got it recorded. The doctor poked his head back in and said, "No, we're not seeing an SVT, but we are seeing you have several PVCs"--pre-ventricular contractions--"and we're going to admit you for a twenty-three hour observation period."

KK and I were immediately distressed, since it was at this point past 01:00. We got even more distressed when they told us that they don't actually have any beds in the main hospital right now, but that they might in "a few hours". So, we waited in our exam room and got to listen through the closed door as others got admitted throughout the night, including a rape victim and two teenagers who were vomiting blood because they'd massively overdosed on ecstasy. It was just KK and I, crowded onto the single-sized exam bed, while my BP cuff inflated every thirty minutes and prevented me from getting anything except a very fitful sleep.

I made KK go home at 03:00, and they got me a bed in a "semi-private" room at 06:30. My roommate was snoring like a buzzsaw, but KK brought me earplugs, so I was out like a light--for another half-hour, when a nurse came in and drew more blood--and then for another half-hour, when another nurse came in and we started talking about admissions and policies and when I could see the doctor and tests and all that jazz.

Throughout the day, I had all kinds of stuff done. I had a chest X-ray, an echocardiogram, an abdominal ultrasound--not pregnant!--and a cardiac stress test, which sucked because you have to lie down and keep your arms raised over your head for fifteen minutes, TWICE, and your freaking arms go to sleep.

I got to talk to the cardiologist for about a half-hour, and he was a really nice guy. He told me that there wasn't anything in my bloodwork that couldn't be explained by recent activity--like, my blood sugar was a little high on my initial samples, but that was because I had eaten a piece of cake at around 21:30. My muscle enzymes were elevated, but that was because I had worked out that day. He speculated that my problem might be a congenital heart defect, because I might be exhibiting wide-complex tachycardia. This might be because my heart was improperly passing electrical impulses from one end to the other, or because I had a secondary passage between my atria and ventricles. He said that there was no reason for any kind of surgery and that there were numerous treatment options, if that's what it was. Further testing would, of course, be necessary, but he said there was no reason why I couldn't be released that evening, since I wasn't in danger of having a heart attack or otherwise immediately dropping over dead.

As my twenty-three hour observational period drew to a close, I started asking my nurses about release, and was immediately told, "No, you're scheduled for more tests tomorrow morning!" This both annoyed and depressed me. We have a family cardiologist who's attended to my parents and grandparents--the inimitable Dr. Rafael Espada--and I'd told them upon arrival that if I had to remain hospitalized any longer than a day, that I wanted to be transferred to the Houston Memorial Medical Center under his care.

So, I started making noises with my nurse, asking her to call my cardiologist and get me approved for transfer to Dr. Espada. I had my mother call Dr. Espada's office and arrange things on their end, and they provided a lot of helpful information on whose strings to pull on my end to get done what needed to get done, since trying to make anything happen at a hospital on your own timetable is, to put it mildly, rather difficult. I was hampered in this when the freaking nurse call-button on my bedside control wand mysteriously quit working shortly after I started complaining. Fortunately, the nurse's station was right outside my room, so I wandered out there, dragging my saline IV rack behind me and with my portable heart monitor dangling from my neck. If I'd been an old man, I would've made sure to untie my robe and leave my pants off :-)

After nearly an hour of frustration, I got handed to a nurse who actually seemed to genuinely care for me. She immediately got a hold of my cardiologist, who did me one better--he told me I could be released completely, immediately, with no further testing necessary. Which is basically what he'd said earlier in the day. Which makes me wonder, who the hell wanted me to have more tests?

This was very good news, so we gathered my things and sat for another hour while they prepared my release paperwork. Upon leaving, I asked for a detailed bill, and then an explanation of what my insurance would cover. My coverage is complete and total, and I apparently have no deductible, which is a good thing. As for the bill--I don't want to talk about money, but I will say that I have never in my life caused anything to happen that has cost as much as that one bill.

So, I have a followup appointment with Dr. Espada next Wednesday, and I feel fine. My heart hasn't been acting up since early yesterday, and got to go home last night and snuggle in bed with my wife--who, except for going home and sleeping for four hours on Wednesday, was with me the entire time--and get a decent amount of sleep. I went this morning and got copies of all my tests and labwork, and it all looks good. For instance, from my echocardiogram:

"The aortic valve is trileaflet and appears normal. The mitral valve leaflets appear normal without stenosis or prolapse. Left ventricular size, wall thickness, segmental and global systolic function is normal. Right ventricular size and systolic function is normal. The pericardium is normal. The doppler study is normal. No intracardiac masses, thrombi, or vegatations are noted. Parasternal views are excellent. Apical views are difficult. Echocardiogram is within normal limits."

And my psyciologic stressed myocardial perfusion study:

"Patient was excercised to a pressure rate product of 313. 12 mCi of Tc-99m Cardiolite was administered at rest followed by 33 mCi at stress. Cardiac scintophotos were obtained by gated SPECT technique.

"Homogenous uptake of the radiotracer is present throughout the left ventricular myocardium. No reversible or fixed defects are identified. Normal wall motion is present iwht a normal calculated LVEF of 75%. No evidence of stress-indused ischemia; normal wall motion and LVEF."

And, finally, my abdominal ultrasound (not pregnant!):

"The liver demonstrates increased echogenicity consistent with fatty infiltration. No focal mass or cist appreciated. The gallbladder is unremarkable. No stones or sludge identified. Gallbladder wall measured 2 mm. No bilary dilation present. The common duct measured 2 mm. Pancreased was not well-visualized. The abdominal aorta demonstrated normal caliber. The spleen was unremarkable. THe right and left kidneys measures 10.7 x 4.5 x 5.2 cm and 9.9 x 5.6 x 3.9 cm respectively. No hydroneoprosis, masses, or cysts idenfitied. Unremarkable abdominal ultrasound."

So, looks like I'll live.

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