Thursday, June 3, 2010

Wearing My Heart on My Sleeve (Or on My Blog, Anyway)

First things first: I didn't get admitted to the hospital.

Okay, now that we've gotten that out of the way, I think I left a few details out of the last post, which is probably to be expected from an attempt to post a blog immediately after returning from the ER. So, backing up a bit, let me explain why I was in the ER in the first place. I think I mentioned that I had a resting HR of 225 bpm for over an hour before I headed in, which probably sounds completely insane, but for me is, well, only mildly nuts. I also know that I mentioned SVT, which stands for supraventricular tachycardia. In my case, this is caused by something called an "accessory pathway" in my heart. When triggered, this accessory pathway kicks in shortens my heartbeat circuit. So think of it this way: an electrical impulse travels around your heart by a predetermined pathway in order to cause a heartbeat. I have an extra pathway that cuts off some of this normal circuit, and when that pathway is switched on it causes my HR to speed way up, because obviously it takes less time for the electrical impulse to travel the shorter circuit. It's kind of like a heartrate shortcut, I guess. And when this happens, my HR jumps from its normal rate of about 100 all the way up to 225 in literally and instant. And when it stops, it drops back down just as quickly.

The good news is, SVT isn't usually a major issue. It can cause problems, and some cases can even be life-threatening, but I've been lucky enough to always be able to break the attack and switch "off" the accessory pathway by myself, at home, without medical intervention. It normally takes 10-20 minutes of lying down and performing things called vagal maneuvers. These are a series of progressively more and more embarrassing tricks to try and slow my heartrate by stimulating the vagus nerve. And the really cool part is that it's best to have someone with you as you perform these circus acts (examples of which include bearing down like you're trying to make a bowel movement, forced gagging, and submerging your head into ice water), because if you pass out at any point or feel dizzy it's probably time to head into the ER. Fun stuff.

I didn't pass out, but I wasn't able to stop it either. So after an hour and 15 minutes of groaning on my mom's bed with ice packs over my eyes, I finally gave up the ghost and made my way toward a downtown hospital (read: not my CF center), with strict instructions to call or page my CF doc with any developments.

Upon arriving at said nameless downtown ER, I checked in at registration and headed to triage, where I used my pulseox to try and convince the triage nurse that my HR wasn't playing around. No go. She told me I would have to wait "at least an hour" but that in the meantime she had orders to give me a quick EKG. I counted that as a partial victory and headed back with yet another nurse, who, upon running the EKG immediately paged several doctors and led me straight back through the waiting room and into the patient area waving my EKG and tapping any doctor we passed on the shoulder to whisper "SVT!" in a hurried voice. I may or may not have smiled smugly as I was led past the triage nurse who demanded I wait, although I'm the first to admit that it's hard to look smug when your heart is beating faster than a marathon runner's. I like to think I pulled it off though, because I'm just an overachiever like that.

Once back in the patient area I was treated to a bevy of concerned professionals assisting me with everything from changing into my hospital gown to covering me with those annoying heart monitor things, all while asking questions like "why are you on oxygen?", "are you short of breath?", and my personal favorite "oh wow, is that cough normal for you?" To be fair, they didn't have a chart on me since they were working extremely quickly, and I was only able to explain about the whole CF/transplant thing in between other questions about the real issue: my heart. And when they asked about drug allergies and I gave them my list the nurse responded "well good, those are all antibiotics and we won't need any of those." Definitely an odd statement to the ears of a CFer.

I have to hand it to the staff of the unnamed downtown ER, because they got the SVT stopped incredibly quickly by an advanced technique known as . . . taking my blood pressure? Um, yeah, you read that correctly. They put the BP cuff on to take vitals before beginning treatment, which was going to be a quick dose of heart meds via a peripheral IV that had already been placed, and low and behold the squeezing acted as some sort of off switch and suddenly my HR bounced right back down to 110 bpm. And let me tell you, there is no better feeling than that moment. Imagine having your PICC pulled after 6 months, and then double the relief. No joke.

So, moral of the story: SVT sucks, but not as badly as CF, because after all that they decided that due to my cough they might like to keep me in house. And obviously this made no sense to me, seeing as 1) I wasn't at my CF center, 2) I had the cough pre-SVT, and 3) I had already spoken to my CF doc earlier that day and knew I was scheduled for clinic and to start IV abx in the morning. I told them as much, and luckily they agreed with the plan of attack, though I was told to "make sure [my CF doc] gets everything checked out" (as if that were ever in question anyway). And then I left, about 2 1/2 hours after arriving, making it one of the shortest ER visits of my life and, thanks to a drunk man celebrating his birthday, also one of the more entertaining.

I'm not going to drag you through all the CF stuff that went down the next day at clinic, but I will say this: I ended up on IV merrem and levaquin, with no residual symptoms from the previous nights' episode aside from a general feeling of exhaustion, and -- the most important detail -- back at home. Which kind of brings this post full circle.

So there's the back story that explains the madness. I know I should count myself lucky that my only ER visit since October has been for an unrelated and fairly benign heart issue, and I definitely do. But at the same time I'd be lying if I tried to say that this latest experience didn't shake me up a bit, because as long as I've known about my SVT I've always been able to control it myself. I would slip into it suddenly (ironically coughing and PFTs are major triggers for me, since both involve sudden, forceful movements), and then know that aside from the humiliation of "bearing down" in front of whichever poor soul happened to be closest to me at the time, I was going to emerge unscathed and not much worse for the wear within a half hour or so. And I know, of course, that one episode of uncontrolled SVT that was eventually stopped without meds anyway isn't a big deal. I know that, and I'm treating it as such. It's just that on top of everything else, I really wish I didn't have to worry about the now very real possibility that a racing heart might send me to the ER with no warning.

So you know, there's that.

But the good part about all of this is that I'm here with my Sampsonbear, currently SVT-free (a great way to be), and hoping that these IVs kick in soon and help me feel better so that I can get back to the business of more fun activities, like my mother's upcoming birthday. And in the meantime, trust me, I'm not looking for any more shortcuts.


  1. Oh wow, Piper. Another "adventure" to add your your list. So glad you are home with your sweet Sammy. One of the kids asked the other day - When are we going to NY to meet Piper? The kids are right. We need to start planning that trip!

  2. I thought SVT was another Law and Order spinoff:)


  3. I thought SVT was another Law and Order spinoff:) Glad the high tech method of taking your BP worked. Relax and enjoy the nice summer weather.


  4. I am so sorry you had to go through this :( I'm so glad to hear you're home now!!! HUGS!!!!

  5. I knew the bearing down was a vagal maneuver, but I had no idea submerging your head in ice water was one. wow. Never the less, I am glad you are home safe and sound with your pup.

  6. Geez, you think you have enough excitement in your life with your lungs alone, but now the ticker wants attention too!
    I agree, SVT is annoying, I too have it..are you on anything to suppress it? I am on beta blockers to control mine. I have a few bursts daily, but they only last seconds to a few minutes and then I am fine. And like you, infection makes it go nuts!
    I sure hope you don't have anymore don't need anymore than what is already on your plate. As always, I am thinking of you and keeping you close in prayer.
    Hugs, Jenn (JustDucky)

  7. Aww...the joys of SVT. I too have CF and have had numerous episodes of SVT,only one time was I able to stop it on my own. Every other time I have had to have medicine, let me tell you, that is a bizarre feeling. I hope that you dont have any more troubles and that your lungs come soon. I found your blog from Somers, hope you dont mind. if you ever want to email me my email i
    Good luck with everything.