cardiversion

Not Just Another Monday!

On Monday, March 7, 2022, I left my Zoom Writers’ Group meeting and got into the car to be driven to my cardiologist appointment. In October, because of a heart irregularity, I was having breathing problems, so my daughter Michelle called 911. After the EMT found I was in atrial fibrillation and my heartbeat was160, I was off to the hospital. There, a heart echo revealed that I had an ejection fraction of 10-15%. I didn’t know anything about ejection fractions, but was told by the hospital cardiologist that he had never heard of a conscious person having an ejection fraction that low, the normal range being 50-75%.

After receiving excellent care, including cardioversion to get me out of atrial fibrillation, I breathed better and we were sure that my ejection fraction had vastly improved. Four months after my first heart echo, cardiologist Dr. Virgilio ordered a second echo, which was performed. An appointment was made to go over the results, and that was the reason for the March 7th visit.

Dr. Virgilio discussed the results of the latest echo, which showed an ejection fraction of 45%, close to normal. After asking me a series of questions, she was pleased that I was feeling good and back to normal activities and routines. After listening to my heart and noting a heart rate of 40 beats per minute, she ordered an EKG (electrocardiogram) which revealed a sinus arrest with a slow ventricular rhythm. Dr.Virgilio was very concerned and said I needed to go to the hospital at once to get a pacemaker. She explained that I was suffering from heart block, and because my natural pacemaker had stopped doing its job, I needed a new one. After checking, she advised us that the cardiologist who performs pacemaker implantations was on vacation, so I would need to go to a hospital near Eugene, an hour and fifteen minutes away, for the procedure. She arranged for me to be under the care of a cardiologist at that hospital. Then she added that because I take Eliquis, a blood thinner, I’d need to wait 48 hours before the operation. Stating that my situation was precarious, Dr. Virgilio insisted that I couldn’t spend those two days at home, but needed to be in the hospital where I could be closely monitored.

Michelle drove me to the PeaceHealth Sacred Heart Medical Center in Springfield. We arrived there around 6:45 PM. I was admitted into the E.R., awaiting a hospital room. I was put on a monitor that revealed that my heart rate averaged 35 beats per minute, a far cry from the 160 beats per minute that I had experienced when I went to the hospital in October (the normal range is 60-100). In addition to the heart monitor, I had a 12-lead EKG, got a chest X-ray, and blood was drawn for testing. External pacemaker pads were placed on my chest and back to be used in case temporary pacing was urgently needed. At two minutes after midnight on Tuesday, March 8th, I was moved from the E.R. to a hospital room.

When I awoke at 3:00 AM Tuesday after a short sleep, I was hungry, having had only a light dinner before coming to the hospital. When I requested food, I was advised that doctor’s orders called for fasting, which made no sense when the surgery wouldn’t be until the following day.

Later in the morning the cardiologist who was to implant the pacemaker, Dr. Karenem, came into my room and advised me that he would perform the surgery on this day. When I inquired about the 48-hour wait because of the blood thinner, he told me that the danger of bleeding was less than the danger of waiting. Then Dr. Karenem explained exactly what would be done, in terms I could understand. Before our discussion began, I called my daughter, Michelle, and put her on speakerphone so that she could be a part of the conversation and, based on her knowledge as a former Cardiac Intensive Care nurse, could explain anything that wasn’t clear to me. I was also shown a pacemaker so that I’d know what I would be wearing (what alien being would be inhabiting my body).

For the surgery, I was given a sedative and a local anesthetic, so I was awake but groggy. I marvel at what a wonderful invention the pacemaker is and the amount of skill it must take to be able to string wires through veins to the atrial and ventricular chambers of the heart. The surgery took a little over an hour.

After the post-procedure chest x-ray, I was delighted to learn that I could go home – the same day as my surgery! I didn’t need any time to decide. Funny thing, after I was admitted, I was asked to sign a form stating that I had been told I could decline leaving when a doctor cleared me to go home. This was a new Medicare requirement. I was incredulous to think that anyone would want to stay in the hospital when allowed to go home. In thinking about it now, I remember cases when patients were released and reluctantly left before they were ready and became dangerously ill.

On the way home, Michelle asked if I wanted to stop to see my granddaughter’s new home in Springfield. I was tired but didn’t want to miss this opportunity and, after all, I could do lots of resting when I got home, which is exactly what I did.

Shortly after returning home, I experienced a side effect from the agent that was used to cleanse the area prior to surgery. I developed a rash and the area itched, keeping me awake several nights. So it appears that there is yet another substance that I have difficulty tolerating.

On Wednesday, the day following my surgery, I accompanied Michelle when she was walking Banjo. After going just a short distance, Michelle noticed that I was shuffling instead of picking up my feet, so she suggested that it was time to turn around and go back home. We did this and, although it was a really short walk, I was exhausted. I grumbled a bit because of my incapacity to walk farther, and was reminded that I was expecting too much too soon. Two days later, I was capable of walking farther without getting winded.

Now that I’m healed, I have more stamina and my life is back to normal. It’s strange that the two times in the last six months when I’ve been in danger because of my heart, I felt generally good and had to be told that my situation was precarious by medical professionals, who then proceeded to get me out of those precarious situations. God bless medical professionals!

                                    Lois McKinney