Wednesday, May 26, 2010

Wimpy Tries to Live with it

In a pouch strapped around my waste, a device about the size of an iPod sits, capturing the electricity from my heart through five wires that hook up to pads on my chest. The adhesive from the pads and the tape that secures the pads are very uncomfortable and usually cause sores and rashes on my sensitive skin. This is part of my cardiologist's annual check-up to make sure my medications are working properly and check for damage that could develop due to frequent heart racing. Damage is unlikely, especially because the meds work well enough that I only have short episodes (max. a few hours) and seldom have dangerously fast resting rates anymore. My heart also usually responds beautifully to exercise with the strengths of my medications. I mean, standing and walking sometimes make my heart race, but not crazily fast. Well, not by my definition anyway.

My arrhythmia has kind of skewed my perception of what is fast. 100-120 beats per minute is fast to me, but I probably wouldn't go to the doctor about it because it wouldn't alarm me. 130-170 beats per minute doesn't happen much anymore, but even when it does it doesn't scare me. I would see my doctor about it, but only if it didn't slow down on its own or if the episodes were frequent. Maybe not even.

I waited a year before going to see my cardiologist about really fast week-long periods that would come at least once every few months. To begin with, I didn't even know my heart was chronically fast -- sometimes dangerously -- when I was diagnosed with this problem six years ago. In grade eleven and  twelve, doctors had noted that it was fast a couple of times, but it was written off as a side effect of extra Ventolin inhaler puffs before a pulmonary function test and another time, as part of a fever when I was in the hospital. I just assumed my heart was just a bit touchy -- that's all.

Then during my allergist's exam in the summer after high school, he told me my heart rate was 160 beats per minute. He consulted the family doctor who took a listen and an electrocardiogram, then ordered me to the emergency room. I was shocked because I felt fine! I had been a little nervous, as I often get at the doctor, but it was mild -- certainly not an explanation for 160! At the E.R., they ran a chest x-ray and monitored my heart for a few hours. When I slowed to 140, they sent me home without an answer. At the follow-up hospital appointment, the doctor determined the rapid rates were just a side effect of an asthma controller inhaler called Advair.

The family doctor I saw again was unsure if he was going to permit me to go on holiday in England because he was afraid I would have a heart attack -- in case I had some serious condition we didn't yet know about. He let me go on the condition that I avoid heat and steep hills.  My family doctor said, after running some tests and examining me again, that it was time to see a cardiologist! Bah.

My cardiologist ran a holter monitor, only back then (six years is a lot time when it comes to technology!) it wasn't digital. I actually had to flip over a cassette tape to record my heart for the second day! After my consultation with him and looking at the results of my monitor, he put me on a heart medication called Tiazac to slow it down.  His explanation: "I think in a few months, your heart is going to start to get tired."  This is when I clued in that I had probably been feeling sick because of my heart for some time: the racing was probably the root of frequent tiredness and "dazed" feelings I'd written off as being caused by recurring sinus infections and allergies.

I've been on this medication ever since, my doctors having increased the strength so often that nearly two years ago I reached the maximum strength, but it wasn't enough, so my cardio put me on another pill: Digoxin. Each strength of the Tiazac worked for a few months usually, or even a couple of years. Then my heart would start to get crazy often.Well, for nearly two years, I've supposedly exhausted my medication options, according to Dr. Heart. He said "We're not there yet," but if my heart becomes poorly controlled, he will refer me to an electrophysiologist (heart rhythm specialist) to evaluate other possible options, which will likely include an ablation, which is basically putting a tube up the thigh and cauterizing the naughty part of my heart and possibly implanting an artificial pacemaker.

I suppose I started noticing crazy heart after the E.R. visit. I noticed them even more after medication brought the rate down. Then I had perspective: I knew what a fast heartbeat felt like because I was now able to compare it to a normal one. In the first year of being medicated, I found it hard to tolerate a rate of 120 beats per minute. I would get this regularly for about a half an hour during eating or in the heat. I would feel so awful I'd have to lie down until it was over. Then about four years ago when the crazy and also long episodes started, I began to tolerate 120 -- so much so that it wasn't even a big deal to me. I guess my body adjusted and my mind became desensitized.

For nearly two years, since my heart has been great on average, I have had a hard time tolerating 110 beats per minute at rest, even though I have gotten much higher rates occasionally. I feel like a wimp. By the way, when I say "tolerate" I mean  that I can feel well with a fast rate.  "Intolerant" means that the rate makes me feel weak and sick. It also means the sensation is really uncomfortable,  where as when I'm "tolerant," I can fairly easily distract myself from it.

So I'm guessing the results of this holter monitor I'm wearing now will be great: I don't feel sick like I do when my heart's racing and I can't feel it beating. I love being this way, I really do. Unfortunately, though, my cardiologist seldom does anything for me unless my heart is chronically too fast. So! If I want a referral to an electrophysiologist, I will have to ask him for one, but probably not beg. I mean,  it's silly that I'm still getting episodes on two heart medications, the max of one and the max for my weight of the other. I just want to get this appointment over with! I will see him in June. He's a nice man. He's done a lot for me and he wants me to feel well. I'm sure if I'm clear that I'm unhappy with my current treatment, he'll help me. Still! I feel like such a wimp for wanting to ask him. I feel defeated, like I should just buck up and shut up. 

I think I'm finally ready to ask my cardio for the referral because my heart is one of the few medical issues I have that I can control with treatment. I don't just have to "live with it." So why not do whatever I can to make myself feel better? I keep imagining myself going in for an ablation and then being told that there is nothing to be done to fix me. I have this fear about all of my health issues: that all I can do for the rest of my life is "live with it."

4 comments :

  1. I am concerned because we don't want to wear out your heart...I hope you are able to get a handle on this, I think you have enough things to monitor besides a fast heart!

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  2. Thanks Joe! I completely agree. I'm so tired of dealing with this and feeling sick and tired with it!

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  3. I'm proud of you for coming to that conclusion so rationally. I know we talked about it last year in class, about surgery and other treatments, but you weren't ready then.
    Good luck with everything, Ash!

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  4. Thanks Laura. You're so supportive! We'll see what the cardio has to say... I will definitely put an update on here!

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