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18 december 2003

currently reading

i did it, i did it...i read the davinci code. i couldn't put it down for a week. shut up.

the used the word cure

I'm back. 'Event' free for three days now. I drove today. That was nice.

Thank you to everyone who wrote, especially some long-losts from whom I haven't heard in awhile! It's great to know you're doing well! Now that I'm on the mend, I spent today making Christmas preparations. This year's Christmas is going to be heaps of fun. I'm bummed that I can't go to Florida as I'd planned to see Mom and Kelli; I'm being monitored for the next two months to make sure the surgery 'took'. Until the middle of January, I'll wear a loop monitor. Until I'm fully healed, flying and driving long distances are a bad idea. My legs are very sore when I stand for more than an hour. That makes sense; they accessed three major vessels during the procedure, so I'm still feeling beat up.

As I've dealt with getting the WPW (Wolff-Parkinson-White) properly diagnosed and dealt with, I looked on the Internet for information like every other schmuck. I wasn't looking so much for 'formal' medical information, but for personal stories (especially from women). I finally found a Yahoo group, of all things, that was somewhat helpful. I was particularly looking for first-hand stories of ablations, which is a term that hasn't yet entered the everyday vernacular. Even my Mom, who is a nurse, had never heard it before, so we learned about it as I went along.

Before I write about my (very good) experience at the Duke Heart Center, I'll define some terms:

Radio frequency ablation is a new technique in which a needle-like probe is positioned over the extra pathway. The pathway fibers are burned, and therefore destroyed.

The extra pathway in a person with WPW is a small bundle of extra fibers in the heart that conducts electricity where it shouldn't. By the time you're born, all of these extra pathways in your fetal heart should close. In a WPW person, an extra pathway (or two) may exist because it didn't close all the way. Instead of electricity following a normal pattern, my extra pathway conducted from the bottom to top, creating a circular retrograde pattern. It made my ventricles contract too soon, and too quickly.

I'd been feeling so badly recently because since my body has found this extra pathway, it USED it--a lot. I went from having a spell or two a week, so five or six a day. Time for treatment!

I went to Duke on Monday morning. I was taken into the catheterization prep area, where they gave me a jumbo-sized smock, realized I am not jumbo like many of the heart patients, then got me a smock that fit. I became acclimated to my sterile surroundings, with the help of friendly nurses who kept asking me about a declaration document regarding who would pull the plug if I died. I scanned the area for quick exits. The nurse held me down to prevent said exit.

No death papers today. Maybe next time.

Dr. A. came by, feeling rested and jolly. She explained last-minute stuff to me, the nurses came over, and off I went. Wheely-wheely into the electrocardiology cath lab! Bye, everyone! Meet me at the north exit in three minutes! Aaaaaaaagh!

Upon entering the Star Trek cath lab, they hooked me up to the I-don't-care-woo-hoo IV. Yeah, baby! (Keep in mind that I was AWAKE for this 6-8 hour procedure. Thaaaat's right. Awake.) Friendly nurses swarmed around me, put those blue sterile cloths all around, hooked up more IV stuff, and they placed a bladder catheter in me. I have never had one of those. It was uncomfortable, yes it was. And then Dr. H. made his appearance.

Marilyn, the chief nurse, said, "ain't it great to get a tall, dark, handsome one?"

Yeah, cause I'm totally in picking-up-dudes mode here. Where is Dave in his sooperhero cape to get me out of here?

Dr. H. shot local anesthetic in both groin areas and my neck, where they would thread a total of five catheters into my heart for the EP study and mapping, then planned ablation of the extra pathway. He was right; I didn't feel the catheters going in. Everything was going alright for awhile. Yay, drugs.

Then they got serious. They began to override my own heartbeat electronically, and then with adrenaline. It was awful. Because I had to be responsive for this--they were attempting to induce my arrythmias and get my feedback--they let up on the sedative. So I'm lying motionless, my heart is artificially racing, and the adrenaline for nearly a half hour finally gets the best of me. By the time I pleaded for the eightieth time to stop that please please please, they were finished and had found the extra pathway.

You'd think at this time that they could put me to sleep, right? Or at least numb my heart?

No. Dr. H. told me to hold real still and not say anything. He was going to ablate now.

Hot knife deep in the chest. That's what it feels like. They ablated from endpoint to endpoint. I can't remember how long it took, because I think they did increase the sedation somewhat. Still hurt, though.

After they ablated the area (it was on the left side of my heart, so it took awhile to find), they tried all that inducing stuff again. No arrythmias, none whatsoever. Everyone seemed pretty satisfied, so it was time to yank all of those catheters out of me and press down hard for awhile! Keep pressing! Don't want Kim to bleed to death!

Once blood stopped shooting out of me (I'm kidding. No spurting blood), they wheeled me to my hospital room for the evening--where I was to stay PERFECTLY FLAT and NOT LAUGH for four hours.

Flat, okay. No laughing for four hours--why don't we just plan the transfusion now, hm?

I was not to lift my head or move my legs at all. I was dopey, and when the drugs wore off I was a little crabby because I couldn't move. Linda was there by that time, though, so she would fuss at me every time I tried to move my feet. Lots of people came to visit, and even brought me Chinese food. I wasn't much of a hostess lying flat like that, but everyone was very understanding about it and entertained themselves.

At 9:00 p.m., I was finally allowed to move around, get into my own pajamas, and walk down the hall to bid everyone goodnight. The on-duty resident came by with my new best friend, Sonata the sleeping pill, and I was out until the next morning.

I went home that day, and so far my only problem has been allover leg soreness. The insertion points are still a little sore and bruised, but not much to speak of. I'll be at the gym or working out on Saturday. I'm on aspirin therapy for a couple of months.

The doctors are using the word 'cured'. Dr. H. said there's not much they can cure in cardiac care, but they can now fix these extra pathways for good with ablation. Not bad, eh? Do I feel fortunate to live in this era of modern medicine? You betcha.

The staff was kind enough to give me x-ray photographs of the procedure, with all the catheters in me. They even signed it for my students. I'll scan them in here sometime.

So there you have it. I hope that someone has better luck than I did when Googling for "personal stories of WPW ablation". Here's one. I was lucky; my pathway was far away from the AV node. My only 'risk' was that they had to puncture through the atrial septum to get on the left side of my heart. Otherwise, I was very lucky.

I still am lucky. Christmas is here in a week, and I won't be dizzy. I won't pass out under the tree. Santa did good.