Heart of the matter

This is what happens when you pass out in the shower.  I did this in May.  And my ribs still hurt.  The good thing is, I can't remember how bad it hurt...initially.

Yes, I broke the faucet.  And the tile.

And this is how we have temporarily fixed it...redneck style :)

Back story: 

For the past couple of years, I have been getting "dizzy spells".  I would have regular check-ups with my gastric bypass dr (thinking that there had to be a connection between the two) - and I would complain of these dizzy spells.  I was instructed that I needed to drink more water (I was already drinking 72 oz a day) and consume more protein (was already consuming 60 grams a day).  Every appt would come, and I would complain about the same thing.  My blood work looked great, and other than these episodes, I felt great.  I was told to just "give it time" and my body just needed to adjust.

Well it wasn't getting any better, and it was starting to happen more frequently.  And by dizzy spells, I don't mean that light-headed feeling you get if you stand up too quickly.  No, it's much more than that.  I can't see, everything goes black, the nausea is instant, and I can barely stand.  If I am not holding onto something, I will fall.  I don't loose complete consciousness, but it gets close.  Sometimes these episodes can last 10 seconds, sometimes 60 seconds.  I can have it happen just a couple of times a day, or it can happen up 15 times a day.  On the days that it happens often, I am exhausted, and I have no energy.  It usually happens upon standing, but not always.  It has happened at Walmart.  It has happened going up the stairs...loading kids into the car...getting out of bed...carrying my kids from one place to another.  Basically everyday life kind of situations.  The problem is, when it happens, if I am holding a kid, or walking upstairs, or in the store - it gets real dangerous, real quick.  If I go down...kind of scary.  

Anyway, I was finally able to convey to the dr what I was feeling.  Honestly, I think it was because they could no longer blame the dizziness on malnutrition or lack of fluid.  He thought it was some type of vasalvago syncope (basically a misfire or trigger/malfunction of the vasal nerve which helps regulate the heart-rate causing my heart-rate to drop and me to almost pass out).  It has nothing to do with the gastric bypass, so I was referred to a cardiologist.  This cardiologist specialized in the electronic functions of the heart.  

The cardiologist, Dr. Marks thought it was be some kind of orthostatic intolerance (instead of my blood vessels contracting when I stand up, they would dilate - causing my blood to pool in my extremities and not leaving enough blood to pump to my brain).  My blood pressure was on the the low side of good, and my heart-rate was lower than normal, but that was expected due to my physical activity.  So she set me up for a few tests.  EKG - check.  Echocardiogram - check.  Tilt table test - check.  And the results?  Everything looked normal.  There were no abnormalities in the heart.  No heart murmurs.  My heart function was great.  The table tilt test could not recreate the symptoms like we had hoped, so that was inconclusive.  A couple of thousand dollars later, and still no answer.  She still felt is was orthostatic intolerance...they aren't sure what causes it, but can treat the symptoms with medication.  By this time, it was January 2012

She did put me on some medication that might help - but it didn't (although the great side-effect of it, was it made my migraines go away).  We tried another medication, and I ended up being allergic to it.  So, I was out of options at this point.  We needed to play the "wait and see" game.  We needed more information.  Because I couldn't recreate the episodes on demand, she could not tell what was going on with my heart.

So fast forward to Memorial Day weekend.  We were invited to go camping with some friends, and we were super excited...even though the weather didn't look like it was going to cooperate.  Yep, it rained on us, and it was freezing at night (like frost on the sleeping bags kind of cold).  But the days were nice, and the kids had a blast.  Me, not so much.  And it's not because I don't enjoy camping, because I do.  I just couldn't seem to get warmed up.  I froze the whole time.  And for me, that's highly unusual.  I don't get cold.  And if I do, I'll throw on a coat and warm right up.  But this was a different kind of cold.  Chilled to the bone kind.  And no matter what I did, I could not get warm.  We ended up leaving a day early because I couldn't take it anymore.  And eventually, the nice warm heat of the van thawed me out. 

We get home, get the kids unloaded and I have first dibs on the shower.  I was still feeling weak, but very much looking forward to washing all the camping grime off.  So I just get in the shower, and the warm water feels nice...and then I feel it coming.  The episode hit, and I tried my hardest to get supine (level my body out with my heart), but I wasn't fast enough.  The next thing I know, I hear Aleana knocking on the door.  At first, I remember being a little irritated, thinking "10 minutes alone is all I ask...10 minutes".  And then I realize  she is asking me if I am okay.  Well of course I am okay, why wouldn't I be okay?  Then the fog begins to lift, and I realize that I am laying down in the bathtub, the water is turned off, and my head is right below the faucet.  Then the pain hits.  Still groggy, I told her I didn't think I was okay, and to go get dad.  He comes flying through the door (almost breaking it, as it was locked).  The look on his face scared me more than anything.  Okay, so this was serious.  I start taking stock of everything.  My head? Okay - not bleeding, not hurting.  Good.  My back, it hurts.  And oh man, my ribs - don't tell me I broke my ribs again.  Legs feel good.  Arms?  What is in my hand?  A razor.  Oh ya, I was just about to shave when it all hit.  I look at my husband, as he asked "What happened".

"Well from the looks of it, I think I passed out".  Although I don't remember going down.  He asked if I could get up, and I told him not yet.  I was too shaky.  I asked for some water.  I laid in the tub for about 10 minutes before I was able to get up without fear of going back down.  Talk about a vulnerable situation.  I am so glad the hubby was there to help, and that my kids didn't have to deal with it.  Or see me in all my glory ;).  Oh the questions they would have...

I got out of the tub, and immediately knew I was going to be sore for a very long time.  It's a good thing I can't remember how I got hurt.  There was enough trauma already.  I turned back around to look at the tub and survey the damage.  And even though it was an inconvenient place to pass out - it could have been much worse.  No head injury.  All major body parts were avoided.  My ribs would heal.  Tailbone?  It's not like I haven't hurt that before.  Somehow, as I slumped down the wall of the shower, my back/ribs were able to turn off the water.  And that was a good thing, considering where my head was at when I came to.  And I don't even want to think about the razor I managed to keep holding onto.

I turned back around and looked at Trace.  His expression echoed how I felt.  Fear.  And the realization that I am okay.  He felt helpless, and me?  Well, I felt like crap.  We both knew it was connected to my heart issue.  We knew the symptoms were getting worse.  And we knew we still didn't know what the heck was going on.

So I did what anybody would do, and called Dr. Marks.  I expected to have to wait a month to be seen, as she is a specialist.  Much to my surprise she could see me the next day.  It's amazing how things change when you get taken seriously.  Or when things are finally serious enough for the drs to pay attention.

I left the dr's office with this: a loop event recorder.

I would have to wear it for 30 days, and push a button every time I had an episode.  The purpose was to record my heart-rate for 2 minutes prior and 1 minute post the episode.  I asked the dr what she expected to find.  She thought it would be an irregular heartbeat.  She just needed to know whether the heartbeat was too slow or too fast because the medications used to treat each one is different.  The wrong medication could make the symptoms worse.  I asked what the worst-case scenario would be.  And she told me that I would need a pacemaker, although she didn't suspect that given my symptoms and age.  

I walked out feeling better, thinking that I was finally getting answers.  And annoyed because those sticky things they use for the node connections are quite irritating...and I would have to wear them for 30 days.  Oh well, all will be better soon.  It's nothing too serious that can't be handled with medication.  I am not going to die, my heart is just fine.  Thank goodness for modern day medicine.

6 weeks later, I go back in to see Dr. Marks to get the results.  Well, it appears that I do have an irregular heartbeat.  But, it's not that simple.  It's both brachycardia (too slow) and tachycardia (too fast).  What?  So she broke it down for me.  At rest, the a normal heart-rate is anywhere between 60-100 beats per minute.  I already knew my average was at about 54, low - but still okay.  She explained, on average, if a person's heart-rate dips to around 40 - they'll pass out.  On the flip side, anything above 100 is considered high and makes the  heart less effective at pumping blood.  So what did my results show?  What was going on before, during, and after the episodes?  Well, my resting heart-rate before the episode would sometimes reach as low as 32.  THIRTY-TWO!!! (how did I not pass out?)  Then, as I would stand up, the rate would jump from 32 to 160 bpm.  That is 128 beat difference.  Anything larger than a 30 count difference is considered abnormal.  Holy crap.  I was taken back a bit.  But it explained a lot.  And it was proof that I wasn't just making this stuff up.  I asked her what causes this?  She said it could be a lot of things, but most of the time they just really don't know.  I told her I thought that this kind of thing happened to old people when things quit working right.  She explained to me that was usually the case, but that she had patients my age clear down to babies that have this same problem.  In fact, she told me she suspected that I was born with this.  It is something that is progressive, and that what we were finally seeing were the big markers that make us pay attention.  

Looking back at my symptoms, I think she is right.  I have had heart palpitations since I was 18.  I went to several different drs for it, and they couldn't explain why it was happening, so I just gave up.  It didn't seem like anything serious.  My lack of endurance.  I never understood why I couldn't run as long as other athletes.  We all did the same workouts.  I put in 100%, I never gave up.  But I would always hit a wall that I couldn't get over.  I thought it was just my asthma.  Nope, this is very much connected, I just didn't know.  Shortness of breath.  I figured that was asthma too.  No, now I have learned to recognize the difference.  It's crazy how everything all started to make sense.

I ask the dr what it all means.  She told told me that medication wouldn't help.  Because I have both kinds of arrhythmia.  She couldn't control one without making the other worse.  Okay - well what now?  Yup.  Remember the worst-case scenario we had discussed earlier?  That's the solution.  I need a pacemaker.  Evidently, my natural pacemaker is wonky.  It's a type of sinus node dysfunction.  

And of course, I found all of this out two weeks after I got the positive pregnancy test.  We had discussed having more kids, and since at the time we thought it was nothing serious with the heart, that we should start trying.  With my history, we didn't know how long it would take to get pregnant.  Well, it happened the first month.  And so I told the dr. But I waited until after I heard the results and prognosis.  I asked her how the pregnancy would effect everything.  Her attitude was very kind.  She explained that my symptoms would be worse, and I would feel it more, but that it wouldn't cause damage.  I would need to be monitored.  The delivery would be different.  But she assured me.  She has had patients with far more life-threatening issues that have healthy pregnancies.  

I am now 26 weeks along.  I have to say, so far she is right.  I have a lot more symptoms.  It affects my energy level.  Being pregnant is exhausting enough, but this makes it challenging.  We take it day by day.  I am excited about this little one joining our family.  I am grateful things are going as well as they can be, and that the baby is healthy.  I am also grateful that we got pregnant when we did.  Because the idea of a pacemaker (which obviously has to wait until after the pregnancy) is a little daunting.