Monday, February 02, 2009

Unexpected Confinement

How's that for a title? And no, I didn't get arrested and spend time in jail. I spent most of the weekend in the hospital, which is why there were no posts here. And every minute of it just plain sucked. I have no other adjective that I can use to describe this. It simply sucked....

Last week I got a stomach bug - you know, the kind that goes around and comes around - the kind with the cramps, the loose stools, just the general feeling of weakness that's part of this virus. That was Wednesday. Along with all of those symptoms, my heart rate went up into the 120s. I figured this was happening because I might have been dehydrated, so I took measures to make sure I rehydrated myself and I felt better the next day. However, the next day my heart rate didn't come down. Nor did it come down the day after that, or the day after that. Plus I was noticing shortness of breath when I even thought of doing anything that might look strenuous, and I was intermittently light-headed. No chest pain, no nausea, no vomiting. A little bit of pain under my shoulder blades Thursday that I attributed to chipping snow. It went away immediately after I was done.

Finally, after all is said and done, we come to this past Saturday. Martha and I had a commitment in the morning that we went to, and we got home at around noon. I promptly parked myself on the bed because I was really tired. But it still felt like I had a Japanese Tabo drummer in my chest beating away at high speed. So, feeling like I was a little kid that had to fess up to doing something I shouldn't have (and that's how this was handled, in fact) I told Martha that something was wrong. I explained my symptoms and told her my concerns.

I got the look. Big mistake on my part. I should have told her two days before.

So she dragged me by the collar (almost literally, in fact) to the Emergency Room at CMC. As it happens, one of the nurses I know quite well (and trust greatly) was in charge, and she saw us come in. Once we got through triage (maybe 10 minutes including registration time) I was brought to Cardiac-1 without passing go.

Personally, I thought that this was overkill, but at the time it must have seemed like a good idea to someone. I got the million-dollar workup: serial labs, serial 12-lead ECGs, a chest X-ray, and 6 hours of observation which actually lasted about 4 and 1/2. Funny thing was that I was seen by a PA instead of one of the docs, but in the end that didn't matter because I was admitted to the telemetry floor and spent just over 36 hours there so that  cardiac event could be ruled out. During my stay, I got 25mg x 2 doses of Metoprolol (one of its trade names is Lopressor) as well as 110mg x 3 doses of Lovenox - 2 Sunday and 1 today.  This was in addition to my regular regimen of medications minus the Adderall because they didn't want to chance stressing my heart if there was a problem. Two things happened: first, I bled really well whenever I got labs drawn thanks to the Lovenox, and while my heart rate came down nicely, my pressure went soft on the Lopressor and my other anti-hypertensives. So I had to watch what I did for that time - getting up was a slow process as was most everything else. This was not helped in any way by what I am already dealing with, so I had to be extra-cautious.

My last blood pressure (at 2:30PM) was 98/54. My baseline is usually around 128/74.

I was also scheduled for a Dobutamine MIBI stress echo which was done this morning. That was a new experience for me; last April I had a stress echo done that was an exercise tolerance stress test as a condition of continuing to work. I spent 12 minutes on the treadmill and we got my heart rate up over 180/minute. It came back negative, no problems found. This time, however,  the Dobutamine was the stressor agent instead of exercise. I was started at 5 mcg/kg/min and the dose was increased every 3 minutes until either my heart rate hit the target they were looking for (147/minute) or the maximum dose of Dobutamine, which was 40 mcg/kg/minute. If I hadn't gotten to the target by then, the squeeze balls came out and I had to actively exercise my hands. After that, 0.5mg of Atropine was to be given if my rate still didn't make the target.

I got all of the above. After being put up to 40mcg of Dobutamine my rate was only in the mid-130s. So the folks running the test handed my two squeezable cushy balls and told me to have at it. Three minutes later I got 0.5 of Atropine, and that was the act that pushed up my heart rate to the target. At that point the echocardiogram was done and they stopped the Dobutamine drip.

I can report that everything came back clean. The echo was perfect, the 12-lead ECGs were all totally non-diagnostic, and all of the labs were good; no elevated cardiac enzymes to have to deal with. Plus all of the other labs that were drawn looked good as well.

The conclusion that the docs came to was that the bug I picked up last week probably affected my heart in some way that it couldn't resolve immediately, and it probably would have corrected itself in any case. But they all agreed that it was a good thing I was evaluated because it could have been different. And they cleared me for everything so I can actually start the PT that was supposed to happen today. It's now going to be Thursday instead.

Basically, that says to me that they don't have any idea what caused my problems and this was a lost weekend. On the other hand, if I hadn't and something were to go bump, Martha would never have forgiven me for my obstinacy. So I got cut loose at about 3:00 this afternoon, and I am home looking forward to sleeping in my own bed tonight. And I feel much better.

Just the same, I have no desire to repeat this experience.

8 comments:

Karen Brook Westhaver said...

Sounds like this is something they could have labeled as an ideopathic cardiac event of some kind...you know they have a diagnostic code/s for it somewhere so they can bill the daylights out of your insurance :-) BUT I'm really GLAD you got it checked out and that you're OK!! Welcome home!

Laura said...

What an ordeal. Glad your okay. Enough now! Spring will be here soon enough, time to get well and out of the house.

Elizabeth said...

Walt,
how terrifying !

I have to say, I am not surprised you got The Look from your wife.
My husband would have got The Look too if he had suffered that for several days and not said anything ......

I am very glad to hear that you now have a clean bill of health :-)
Good luck with the PT !

Evil Transport Lady said...

Eeeek! I can understand that fast heart rate. My kid has it....but since we know what is wrong we can deal with it. YOU on the other hand learned a lesson, don't wait next time!

Hope you continue to feel better!

Ninja Medic said...

Holy cats, dude! We both were in the hospital...!

Hope you're feeling better. I know I am.

TOTWTYTR said...

Well, there's some suckitude for you. Glad it all seems to have resolved, at least for now.

Jen said...

Glad to hear everything came back okay, I was worried for you!! Good luck at PT tomorrow.

Nick Stabile said...

I'm sorry you had to go through all of that but glad to hear your doing better. And thank you for the kind words on my blog, I appreciate it. Feel better and stay strong and safe

NS