Matters of Heart

A friend called me last night. Her heartrate is consistently running above 180, she's passing out from low blood pressure, totally frustrated with her doctor. She has long QT syndrome and has a pacemaker/defib, taking betablockers, diuretics & ca channel blockers. She's young, in her thirties. Ugh. 


She called me for advice. It's been a long time since I was a cardiac nurse. I have no idea what to tell her. I told her to get a different doctor. All of them are on vacation, she's afraid she won't live long enough to get a second opinion. To add to this, she is doing all this passing out, trying to die stuff in front of her kids. They are freaked out. She's been taken to the hospital by ambulance twice in 10 days. They get her stable & tell her to follow up with her own doctor. She had to switch to Kaiser this year. Before that, she had been seen at UCSF, CPMC & Stanford.


I'm scared for my friend and feel helpless. I just had a little boo hoo with Mr. Misha.


But with her, I tried to make her laugh. Told her I was going to get a custom helmet for her since she insists on falling down all the time. I told her I would make sure it was sparkly and pink, maybe even put a unicorn on it for her. She laughed. It was a good sound. 


I wish I was better with matters of the heart.

Ack.

I had a doctor appointment Wednesday afternoon at 4pm.

Guess what time I was finally seen?

6pm.

How long did she spend with me?

5 minutes.

What happened?

Nothing. "Keep doing what you are doing, come back in a month."

But when I got out of the exam room at 6:05 pm. The receptionist had gone home- AT 5PM. So I will have to make my appointment another time.

Two hours and five minutes I will never get back.

I Know What James Was Talking About

I returned to physical therapy Wednesday. Last time I went it was not so pleasant. I would spend the first part trying to do exercises and stretches that my muscles just wouldn't let me do without protesting loudly. Then I would go back to the treatment room. My muscles would be stimulated with electrical pulses or soothed with ultrasonic waves. Then heat or ice would be applied. Then some massage. Most of the time, my physical therapist would try and break up the knots in my muscles only to irritate some nerve and send me into a 24 hour, light sensitive, brain-melting, puking migraine headache.

This time, it was different. My physical therapist's assessment showed that my range of motion has improved. I am having less headaches. We sat and formulated a plan. We are going to focus on increasing my strength and stamina. My left arm is quite week after 50 weeks of limited use. She gave me some simple exercises to try.

I went home sore, but a different kind of sore. A soreness that tells me I am getting stronger and better. I feel good.

I Need Some Sort Of Sedative

I spent all day Monday with my mother. In a hospital. (Hospital, on my day off.) Around the sick and injured. (I don't do sick and injured.) All day. (I certainly don't do sick and injured and hospital IN THE DAY TIME.) Gah! With a crappy signal on my iPhone. (NO INTERWEB?) This was not looking good.

My mom is having spinal surgery next month. Today, we drove to Oakland Kaiser Hospital for her preoperative consultations. I seriously considered smothering myself with one of those plastic, patient belongings bags on several occasions during the day.

The first meeting was with her surgeon. He was, like most surgeons tend to be, an arrogant ass. When I discussed some concerns that had arisen during her previous surgery, he became a bit pissy. Rather than address our concerns, he blew us off. One thing he did do that I liked, he lowered my mother's expectations for the surgery. She had been thinking that this surgery would SOLVE ALL HER PROBLEMS. He made it clear that it might NOT solve ANY of her problems. I just want her to be prepared.

Then we met with anesthesia. The dude was nice. He seemed to understand my mom's long history and complex medical problems. Then we met the education nurse. Her accent was so thick, my mom could not understand her, and I had to translate. I could have done that meeting at home, in my pajamas, sans bra, all comfy like. One hour I will never get back. Then we went for lunch.

Since it took us 40 minutes to find a handicapped parking space that morning, there was no way we were going to forfeit it. I wanted to eat in the hospital cafeteria. My mom wanted to walk. This is the woman that falls down all of the time. She wanted to walk. She is having surgery primarily to improve her gate. She wanted to walk. JUST FUCKING KILL ME NOW. You know how parents walk with their hands encircling their just walking toddler as they stumble along like a drunk? I did that through the streets of Piedmont with my mother.

After lunch, back to the hospital. Met with the general medicine doctor. He had no grasp of my mom's cardiac history or bleeding disorder history. He freaked out about her low blood pressure, even though it has been that low for four decades. He also had an accent my mother could not understand and I had to translate for my mom. Great. Back to the waiting room.

The waiting room was so full that we had to go sit in the children's area. All I could think of while we were sitting there was that it was probably covered in snot, poo and puke cooties. Sitting in there was seriously creeping me out. All we were waiting for was labs and pre admissions. I offered to draw her labs myself if I could please get out of the germ-infested waiting room. They wouldn't let me.

Finally just as rush hour traffic was about to start, we finished. Then I got to spend an hour in bumper-to-bumper traffic with my neurotic mother. I just kept breathing deeply. I started to plan my evening: change into my jammies, pet the dogs, hug the spouse, watch RuPaul's Drag Race, then Dancing With The Stars, play on the internets, maybe have some dinner at some point, take some allergy medication and get into my comfy bed. It worked. I got home in one piece.

But after Drag Queens, Dancing Queens, etc. I am still wound up. I can feel the day sitting right where the shoulder and neck meet. And cooties. I still feel the cooties.

I'm Scared

I am going to the doctor later today to get "Trigger Point" injections of corticosteroids into my left upper trapezius muscle. I think it's gonna hurt. I am a big baby.

Plus, I am not even convinced it is going to work. My neck still hurts and both of my hands keep going numb. I am not sure how a shot in my muscle will help alleviate these symptoms. Maybe I will have a better attitude after I get some sleep.

PANIC! (on the airplane)

Mr. Misha and I had been wanting to visit Las Vegas for quite sometime. But being of the fair-skinned and squishy persuasion (we don't tolerate desert sunshine and heat well), we had to wait until the fall. When we found out that two other couples we dig were going on Veteran's Day weekend, we decided to book our trip.


The day before we were set to leave, our friend and adopted "Noni", Babe, passed away. Paul and I really didn't feel like partying in Vegas. I checked to see if we could postpone our flight and hotel reservations. Changing the plane tickets...no problem. Changing the room reservations, no such luck. So we talked with Babe's family and they told us to go. They reminded us that Babe loved traveling, gambling, cocktails and a good time. They told us she would be pissed off and would quite possible haunt us if we didn't go and have a good time. We decided to go and party in Babe's honor.


I woke up early Friday morning with puffy eyes, lingering tears and a headache after Thursday's events. I finished packing, showered and dressed and then headed to

for my usual drink. I decided to get Mr. Misha some coffee and a snack too. He likes the egg salad sandwiches from Starbuck's,

so I picked one up along with a butter croissant for myself. I got home, woke him up and we had our breakfast together. We drove to Erika's house. She was going to drive us to the airport and then patrol the greater Sacramento area for the weekend riding in the "Misha-mobile".


Erika dropped us safely at the airport and we checked our bags and headed through airport security. All of a sudden, Paul didn't feel good. He said his stomach was upset and wanted some meds for it. I went and bought some water and tums. He took them, along with some pepcid I had in my purse. I was thinking I could nip this ailment in the bud. He seemed okay as we boarded the plane.


As soon as we reached cruising altitude, something happened to my husband. He looked pale, he started to sweat, he kept clenching and unclenching his left hand. He told me he was nauseous. I started to freak out. These symptoms, added with his family history of cardiac problems......made me think he was having a heart attack. I took his pulse, it seemed fine. But there was no way to be sure without putting him on a cardiac monitor. I didn't want to panic the flight attendant, so I just waited. Paul just kept looking paler and paler. He said he had to go to the bathroom. The other guy in the row and I got up and let him out. It seemed like he was in the bathroom forever. Our aisle-mate tried to distract me with small talk. It turns out he is the stage manager for a Ska Band called Reel Big Fish. He was a really nice guy and offered to go and check on Mr. Misha for me. As he got up to go check on him, Paul was on his way back to his seat.


He sat down and seemed okay for a moment. Then he grabbed the airsickness bag and hurled. I have to say, my husband is the best airplane puker in the whole world. He did it silently, with no spillage and sealed the bag quickly so no one smelled it. I was still really scared, but proud of my husband's stealth-puking abilities. The RBF dude kindly got the attention of the flight attendant, who gave us a garbage bag and some extra airsickness bags. Paul thanked him with an apologetic look on his face and RBF dude replied; "Dude, no worries. I travel with a band. I have seen it all."


Paul continued to look like shit. He continued to clench and unclench his left hand. I knew that airplanes were outfitted with AEDs (Automated Electrical Defibrillator) and you need some room to use one of those things. I had no idea where I was going to find the space!

                      
The last 20 minutes of the flight were scary. We would be landing at Long Beach International Airport for a 1 hour layover. I just wanted to get him off the plane. I knew if I could get him on land, I could get paramedics to him quickly. I also knew that we had family in southern California, so if I had to get him to a hospital, I would have some family support.

We landed and de-planed. I got Paul situated in a quiet area and went to inquire about a first aid station, local hospitals and changing our flight. Paul continued to puke in the barf bags I got on the plane. He didn't want to go to the hospital (which is quite common for someone having a heart attack). I tried to convince him that he needed to be seen by a doctor. He wouldn't have any of it. He said he just wanted to get to our hotel room in Vegas and lay down. While Paul went to the bathroom, I changed our flight for a later one and texted our friends to tell them we would be late or might not be there at all.

When he came back from the bathroom, he told me not only was he still puking...but now had problems down south too. I instantly felt relieved. He seemed a bit annoyed that I was happy that he had diarrhea. I told him that the added symptom reassured me that he was not having a heart attack, but probably food poisoning. I was relieved. I medicated him with some anti-nausea medication, some Immodium and some Tylenol. I figured he would be safe to fly in a few hours.

The flight to Vegas was uneventful, thank goodness. We rescued our baggage that had arrived 6 hours before us and headed to our hotel. Paul still wasn't feeling great....but I was pretty sure he would be okay. I was also pretty sure that he would never eat another egg salad sandwich from Starbucks.

Stay tuned for the next Vegas blog post tomorrow.

If you ever find yourself in a similar situation...

here is some info.

Heart Attack

Each year over a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get help immediately. It's important to know the symptoms of a heart attack and call 9-1-1 if someone is having them. Those symptoms include

* Chest discomfort - pressure, squeezing, or pain

* Shortness of breath

* Discomfort in the upper body - arms, shoulder, neck, back, stomach

* Nausea, vomiting, dizziness, light-headedness, sweating

Food poisoning

Definition 

Food poisoning is the result of eating organisms or toxins in contaminated food. Most cases of food poisoning are from common bacteria like Staphylococcus or E. coli.

Symptoms 

The symptoms from the most common types of food poisoning generally start within 2 to 6 hours of eating the food responsible. That time may be longer (even a number of days) or shorter, depending on the toxin or organism responsible for the food poisoning. The possible symptoms include:

* Nausea and vomiting

* Abdominal cramps

* Diarrhea (may be bloody)

* Fever and chills

* Weakness (may be serious and lead to respiratory arrest, as in the case of botulism)

* Headache

Treatment 

You will usually recover from the most common types of food poisoning within a couple of days. The goal is to make you feel better and avoid dehydration. Drink any fluid (except milk or caffeinated beverages) to replace fluids lost by diarrhea and vomiting. Children should be given an electrolyte sold in drugstores. Don't eat solid foods until the diarrhea has passed, and avoid dairy, which can worsen diarrhea.

If you have diarrhea and are unable to drink fluids (for example, due to nausea or vomiting), you may need medical attention and intravenous fluids. This is especially true for young children. If you take diuretics, you need to manage diarrhea carefully. Talk to your doctor -- you may need to stop taking the diuretic while you have the diarrhea. Medications should NEVER be stopped or changed without discussing with your doctor and getting specific instructions.

For the most common causes of food poisoning, your doctor would NOT prescribe antibiotics. Antibiotics can actually prolong diarrhea and keep the organism in your body longer.

If you have eaten toxins from mushrooms or shellfish, you will need to be seen right away. The emergency room doctor will take steps to empty out your stomach and remove the toxin.

Expectations (prognosis) 

Full recovery from the most common types of food poisoning usually occurs within 12 and 48 hours. Serious complications can arise, however, from certain types of food poisoning.

Complications 

Dehydration is the most common complication. This can occur from any of the causes of food poisoning.