Tuesday, August 5, 2003

An Adventure of a Different Kind

It's amazing how sometimes things just snowball out of control and one leads to another. Soon you're somewhere you didn't want to be.

Yesterday was my day off. I got up, about 8:00 or so. I felt a little tired, but nothing too unusual. Since it was a day off, after having worked on Labor and Delivery over the weekend, I had a list of things to do. Most were yard things, so I started getting things done. Nothing too strenuous, just spreading some fertilizer, pulling weeds, replacing a couple of sprinkler heads. That kind of stuff. My new mower is not working, so I took it in to Sears for some work too. I was REALLY tired when I got back.

Kathy wanted to go out for breakfast, so we headed out to try a new place in Littleton, but it was closed. So we went to old reliable, El Tejado. Got the usual, huevos rancheros and chilequiles.

After we got back from breakfast, about noon ( a late breakfast, it turned out to be) I went out to do more yardwork. After about an hour I came back in and was exhausted. I sat next to Kathy and said "Feel my pulse." It was very erratic with a lot of skipped beats. She asked what we should do and I, characteristically said we should wait (which means, usually, wait until it gets better or I die, whichever comes first).

But it didn't get better, and I said that I guessed if I had a patient with this I'd send her to internal medicine to get checked out. So, Kathy loaded me up and off to the clinic we went. Without even an appointment! But I figured my doc could work me in, would do an EKG and tell me it was nothing to worry about and tell me to get out of there

I was right about doing the EKG, but I had the second part wrong. He looked at the EKG, asked a bunch of questions, and the next thing I knew they were loading me up in an ambulance and taking me to the ER. Uh, I hadn't planned on that part at all.

So, we got to the ER. There they did another EKG, drew some blood for lab tests, asked me all the same questions, poked on me for a little while and then left us alone, with me hooked up to a bunch of monitors and with oxygen tubes up my nose. Kathy had been able to ride in the ambulance with us, but had to leave the car at the clinic.

Nothing happened for a while, and I was feeling better, ready to go home, though my heartbeat was still a little irregular.

After about 30 minutes they said my labs looked okay and my EKG was showing nothing serious. But to be sure, they ran some medicine in my IV. It was magnesium sulfate. Epsom salts, to many of you. We use it a lot in OB to stop premature labor and to prevent seizures in women with toxemia in pregnancy. It's also a laxative, if taken orally. I didn't know they used it also for irregular heart beats! Made me feel crappy. Now I know what my patients feel like when I give it to them.

So, the medicine worked, my heart rate straightened out, and now I was even more ready to get out of there. Well, the resident, who had been taking care of me turned my care over to the staff doc, who came in to talk to me. She told me all my labs were normal and that my EKG has straightened out. But, I couldn't go home.

She wanted me to spend the night in the "Obs" (observation unit) area so they could watch me for the night, and to draw more blood. So off we went.

The Obs unit is actually in the ER, not on some quiet ward away from the crowds that appear all night long. I did have a room (fortunately) that had a door that closed. A lot of folks I saw were in open bays with just curtains. It was a scary place with a lot of strange looking folks there. Kathy stayed with me until about 10:30, but there really was no place for her to sleep, so we sent her home (with friends who were there also), and I tried to get to sleep. But it was not easy. They came in periodically to draw blood, to get vital signs (pulse, blood pressure, etc.) and to replace heart monitor leads that fell off as I tossed and turned. I finally fell asleep in the early morning hours, only to have them come back in at 5:30 to wake me up! They drew some more blood, did another EKG and took more vital signs. I decided to get up, put my contacts back in and see about breakfast, since I couldn't sleep anyway.

Breakfast!! Well, they wanted me to have stress test, done on a treadmill later in the morning, so, no breakfast for me. They did bring me a tray of "Clears," you know, the jello, chicken broth and juice tray.

Kathy appeared in the room again before seven. She must have really left home early! We turned on a TV they had brought in to me so we could get some news. But we kept falling asleep.
About 9:00 or so they came in to get me for the stress test. I was wheeled up to the fourth floor where the treadmills are and parked in the hallway. They wouldn't let me walk up there. Strange, I thought, since in a few moments they were going to put me on a treadmill and really give me a workout. But I waited, quietly.

Soon they took me into the room, made me sign a permit that said I might die during the testing process, and hooked me up for yet another EKG, which was still showing a number of irregular beats, but not quite as many as the day before. We started the treadmill, I walked, faster and faster. The doc wanted to get my heart rate up to at least 138, to get a good test. I was able to get it up to about 156 which gave her even more info, all of it good. No chest pain, no EKG abnormalities at all!

So I was finally cleared, after all that testing. Twenty four hours later, after I told Kathy my heart was acting funny, we were back home and competely tired out. My heart is still skipping beats, but not nearly as many as it was yesterday. I'll see my doc again and he'll probably do a 24 hour monitoring just to see what it shows.

And I've learned not to mention an irregular heartbeat unless I'm having chest pain with it...it's just too much trouble!