Saturday, July 23, 2016

Round Three

Mark was back in the hospital yesterday, July 22, 2016.

Sooo... Mark had an ablation to fix his atrial fibrillation at Banner University Medical Center in Phoenix on July 11. Everything went well, and when we left the hospital the following day his heart was finally beating normally. The Phoenix cardiologist, Dr. Bahu (a specialist in ablation procedures), told us to make a follow-up appointment with Mark's local cardiologist, Dr. Ata, in 2-3 weeks. We could wait 4 months before we saw Dr. Bahu in Phoenix again.

I called Dr. Ata's office and left a message on Wednesday morning, July 13. That's the day after we'd returned from Phoenix, as well as the day before we left for Utah. Since they didn't call me back that same day, we went off on our five-day trip and forgot about scheduling Mark's follow-up. When we returned home late Monday night, I found three messages on the phone from Dr. Ata's office. Still, I waited to call them back until Mark went back to work on Wednesday so I could see what his work schedule would be for the coming week. Unfortunately, Denny's only schedules their employees a week at a time. Mark finds out on Monday what his schedule will be from Wednesday to the following Tuesday. It really sucks for planning events ahead of time.

I finally called Dr. Ata's office again after Mark came home from work on Wednesday afternoon, July 20. Between Mark's work schedule, the fact that I will return to work next Thursday, July 28, and the last-minute nature of my call, the receptionist and I were having a hard time finding an appointment time that we could get to without missing more work. While we were trying to figure it out, I asked Mark again, "Your only day off this week will be Friday?" Hearing this, the receptionist said excitedly, "Wait, I do have an opening on Friday morning!" I pointed out that Friday would be only 11 days after Mark's ablation rather than the two- to three-week period Dr. Bahu had specified, but she said that would be fine. So, 10:50 on Friday it is!

I only mention all of this to demonstrate how things sometimes work together in strange, complex, and often difficult ways to produce the blessings we didn't even know we needed. Mark felt perfectly fine when we arrived at Dr. Ata's office at 10:50 yesterday. It was perhaps twenty minutes later that they took us into an examination room and the nurse stuck a device on the end of Mark's finger before updating his medical history. Half an hour later, everything was in an uproar and Mark was in the emergency room. If we had waited another week or two for his appointment, who knows what might have happened?

After the nurse took Mark's medical history, she looked at the little monitor on his finger and her eyes got wide. She moved the device to a different finger, saying, "I hope that's not right." She waited a few seconds, checked again, then stepped out in the hall and called to someone to bring Dr. Ata to us right away. When she walked out for a minute to get the EKG machine, Mark looked at the device and said, "Is 172 bad?" Then my eyes got big. I'd never known of anyone having a heart rate of 172!

The nurse returned and ran the EKG, then she stepped out in the hall to speak privately to Dr. Ata, who had just arrived. When he came into the room, he gravely asked Mark how he felt. Mark said he felt fine, and the doctor looked totally stunned. "Really? Are you sure?" he pressed. Mark insisted he felt perfectly normal. Then Dr. Ata explained that Mark's pulse was up to 174 and his EKG showed that he had an atrial flutter. I didn't know what that was, so he briefly explained that it was similar to and related to atrial fibrillation, and was every bit as dangerous, so I needed to drive Mark across the street to the emergency room right away.

Dr. Ata alerted the hospital that we were on our way, so when we walked into the ER they immediately put him into a wheelchair and took him back while I stayed to fill out paperwork. Then I joined him in room 1. The emergency room physician, Dr. Whiting, also asked Mark how he was feeling. Mark shrugged and gave a little laugh, saying, "I feel fine." Dr. Whiting was just as shocked as Dr. Ata. He told Mark that, with his heart rate that high, he should feel like he just finished running a marathon.

Dr. Whiting and a team of nurses (including sweet, young Brooke Larson, who once went on a snowboarding date with my younger son) set about getting Mark's pulse down below 100 beats per minute. It took a while, but they were able to accomplish getting it down and keeping it down. By then, an hour or so had passed and Dr. Ata came in to check on him. He had consulted by phone with Dr. Bahu and now, with Mark's pulse under control, they were ready to try a cardiac conversion, where they shock the heart back into a normal rhythm. Just like on TV shows where the EMTs whip out the paddles and charge the machine, shouting "Clear!" before the unconscious patient shudders convulsively on the gurney.

Except this time they shaved the middle of Mark's only-mildly-hairy chest and stuck an adhesive pad in the bare patch and another one on his back. Then they gave him a mild sedative to put him to sleep for a very short time. As the room filled with people--two doctors and about five nurses--I kept waiting for them to wheel Mark away to an operating room. When I finally realized they were going to do it right here, I thought that surely someone was going to send me out in the hall to wait. They didn't. I sat there watching, partly fascinated and partly horrified that they were apparently going to let me watch.

There was a humorous delay when Dr. Ata tried to apply the electric shock but the machine didn't work, and one of the nurses tried to show him what he was doing wrong but it didn't work for her either, and everyone laughed when she realized she'd forgotten to plug in the machine. Then, the next thing I knew, Dr. Ata had the machine charged, he pressed the button, and Mark's body jerked about an inch straight off the gurney while both his arms flew straight up toward the ceiling, dislodging a couple of the heart monitor wires attached to his chest. Mark, who'd been lightly snoring before the shock, opened his eyes when his body jerked, but when it was over he closed them again and continued snoring. He doesn't remember any of it.

It certainly was less dramatic than it appears on TV shows, but it was nonetheless shocking to see. It's also pretty miraculous what medical science can do. Mark's heart went right back to a normal sinus rhythm and held it--at least until we left the hospital. He never feels symptoms of his heart issues, which is both a blessing and a curse. A blessing because Mark experiences no pain or worry, but a curse because there is nothing to signal that a problem exists.

After about four hours in the hospital, Mark was recovered and they released him to go home, with yet another new prescription. I told him he's got his own in-home pharmacy. Between his heart issues and spinal stenosis pain, he takes six pills every morning, nine at bedtime, and two more during the day. 

Today Mark was back at work and tells me he feels really good. Hopefully that means he is still in a normal rhythm. However, Dr. Ata and Dr. Whiting both expressed their belief that Mark may be that one-in-four patient who requires a second ablation procedure. With the atrial flutter, his heart was not circulating blood properly and it caused the out-of-control heart rate. The doctors concur that a second ablation would resolve the issue for good, because the flutter is easier to ablate than the fibrillation. Mark is less than thrilled with the idea, though.

For now, we'll hope for the best. It is possible that this shock was all he needed to get his heart back on track for good. This was actually Mark's third cardio-conversion. The first didn't work at all and the second worked for about a week before Mark's heart reverted to a-fib, but maybe third time's the charm?  We'll see Dr. Ata in a week or so and move forward from there... Meanwhile, wish Mark luck!

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