Thursday, March 3, 2011

Do they offer punch cards at the ER?




So part of the reason I have been MIA for a while is the fact I was in and out of the hospital. The dreaded Del Webb - land of the old and infirm - not fun.

I was admitted into the hospital 3 times since December (and 3 times is NOT a charm) and for a while there I was tempted to ask them to just let me pay rent instead of being billed... It was like a revolving door there for a while. But - for the record - it wasn't too bad and I was (am) fine.

What was happening is something called "Tachycardia" which is a fancy word for Elevated or "Fast" heart rate. Anything that stays consistently above 100bpm is considered Tachycardia. Sinus Tachycardia is when your heart rhythm is normal - but the heart itself is just beating fast. That is what I was having.

You can run into serious trouble if the rhythm is not Sinus (no, not sinus as in your head that causes the dreaded headaches) the sinus node of your heart. The sinus node is the heart's natural pacemaker. The sinus node consists of a cluster of cells that are situated in the upper part of the wall of the right atrium (the right upper chamber of the heart). The electrical impulses are generated there.


If you get a tachycardia generated from elsewhere within the heart, that can be considered more serious. In my case, I got lucky and was having the standard Sinus Tach. Yea Me!!

This tachycardia had actually occurred on a few other occasions before all this fun in 2011. I would notice that if I "over did it" and really pushed myself physically, I would seem to get dehydrated - and being dehydrated can cause an elevation of your heart rate.

I went to the ER on about 4 separate occasions due to an elevated heart rate. Ironically, these events were all after physical exertion of some time , albeit once it was just after power cleaning my house which to me seemed silly, but to the ER I went nonetheless since feeling your pulse race is pretty scary. At the ER I advised that I have Sclero and seem to get dehydrated easily and felt that the elevation of HR was due to dehydration. I was pumped with a few bags a fluids and was good to go, and I WENT..

That was that. No one questioned why I was getting so dehydrated so easily, and since the fluids would work and I wanted the hell out, I was always discharged to home. No biggie and the winter came with no further episodes or dehydration - that is until "the dreaded garage"

Ah yes, the garage. We moved into a new one story home, and while my husband was out of town I decided to clean the garage as a nice welcome home surprise. I decided to do this after walking 4 miles... But, in my defense, when your having a GOOD sclero day, you take advantage of the energy and you go big. So I did.

And MAN did that garage look pretty sweet if I do say so myself... the only problem was, once inside I felt that familiar feeling of dehydration, that heart thumping throbbing just walking to the fridge to get a drink.  I took the old pulse and blammo - there it was, the tachycardia again. About 130bpm resting. As I was alone and did not want to drive myself to the ER like a big dork, I started downing as much Gatorade as humanly possible - but to no avail and my heart rate stayed about 125-130.

I did drive myself to ER thinking I would get a few bags, make a few jokes about getting a punch card and be on my way. I didn't even bother to call my husband, mom or friends. Just went and thought I'd be out in time to get the kiddo at 4:00 - but this time I was wrong and the ER doc didn't like the fact that upon receiving fluids I was still tachycardic when I walked.. and decided to admit me... UG!

This admission, which I want to mention was on my Birthday - lead to no diagnosis and all the cardiologist felt it may be thyroid related as my TSH was way high and/or dehydration or infection as my white cells were high and I was discharged to home - fluid filled - again.

I was doing okay upon discharge to home, although a bit anxious... It's funny... things are nothing (which means there is NOTHING to worry about) until they are something.

So all the previous trips to ER caused no anxiety, no fear, no scare of increased heart rates or fear of exercising... because it was nothing, right. But when they admit you and hook you up to all that stuff, then its something - so admittedly, I was an anxious Annie for a while until my husband came home. But time heals all wounds and there I was again, back to exercising and living my Life, Until.........Admit 2

Ah, yes Valentines Day - apparently I like being admitted to the hospital on all holidays. First my B-day and now Valentines Day. Good times. Again - ER with the tachycardia, only this time there was no precipitating event that caused it - Just sitting on the couch watching TV and whammo - 180bpm which I must say, got me up and off that couch pretty darn fast and this time I was a happy camper to go to the ER since my HR was 180-190-ish. My heart was on a rollercoaster, but my body was in the Ford. Weird feeling. Not fun.

And again the ER Doc decided that was way to fast and this dehydration thing was flying anymore, so admit number two. Great!

Good news, this time I had an okay roommate. Admit number one I was roomed with Egor and she was MEAN. I was getting told on for everything (which was actually pretty funny) and my mom actually got escorted out of the room because Egor told on her too. Egor had no upper teeth, a compliments of meth mouth. She also loved the fact that she could order room service and let it be know to everyone that she could eat and order whatever and whenever she wanted. And, she did. If I did something to annoy her, she wouldn't say anything to me - she would walk past me, all 6 feet 7 inches of her and knock loudly on the door and announce to the nurses station what it is that I was doing or had done wrong. Yea - it was fun. But admit number two paired me up with Christine, who was only 35 and already had a permanent pacemaker. She was a great roomie and a wealth of knowledge about cardiac issues and not letting them get you down. But I digress....

Admit number two meant serious business on the "lets just not pump fluids and figure out why the hell she keeps coming back" front. So I was able to get a few tests done there, see a few different doctors and the leading contenders for diagnosis was; me possibly needing an EP study and a sinus node ablation or that this is all autoimmune related and is actually an autonomic issue.

Well, I dodged the EP study bullet as the only EP lab was in a different hospital and I did not want to get transferred. Plus I have heard both good (Christine - Roomie #2) and bad (Internet) stories about cardiac ablation.

The suggestion wasn't new to me, as I do get PVCs and PACs which can get pretty bad if I am sick, stressed or tired, and at their worst, ablation was suggested. Ironically and gladly, once I calmed down the PVCs did too - and me and surgery of any kind are not friends. They were at their worst during the time of my Sclero diagnosis and losing my job, so ummm can you say stress related. Needless to say - I am thankful and now when I get them, I don't let them bother me too much - but they are a PIA

Again.... I digress and ramble, as is the nature of Stacie.

So, this admit led to the suggestion of seeing a neuro about the tachycardia, as it is always sinus tachycardia and it seems cardiologist don't feel sinus tachycardia is a cardiac issue in and of itself, but driven from elsewhere. As my thyroid was now straightened out with Synthroid, my Echo and PFT were normal which determined the tachycardia was not a lung issue driven by the Sclero AND the cardiologist advised that structurally my heart looked good with no fibrosis, so he did not thing the Big S had gotten to the old ticker yet either - but did think the correlation could be an autoimmune or autonomic issue.

After this discharge I was a tad anxious, since the last episode was not precipitated by dehydration - but I could not allow the anxiety and fear to consume me, so I tried to resume a normal routine again and get back to exercise. I've been doing pretty good - but I do monitor my heart rate. I watch to make sure it is normal and if it gets tachy I will make it a point to up my fluids and sit down until it normalizes.

That is the weird part about all of this. My new normal set point has changed and even now, when not dehydrated I will get tachy when I stand and walk. I mean... its a doozy. I can be sitting with a normal resting heart rate of 60 or lay with my normal heart rate of 50 (yes - that's normal for me) and as soon as I stand, I bungee up to 110. If I walk I can get to 117-124 just walking to the fridge.

So basically every time I stand or walk, I am getting a cardiac work out - which if I do anything for a while, can get a tad tiring. I cleaned my house a few days ago and my heart rate got up to 160. Wowzers.. and I cleaned for a good 4 hours. I would rest here and there to get it down to 120-130 but it was still high. I make sure I drink a Gatorade and 100 ounces of water a day, so I know I am not dehydration - this is just the nature of the new beast - so I don't let it get me down or make me panic. I just go with it now.

If my heart rate does not return to normal after sitting a few minutes I have a beta-blocker I can take which will slow my heart rate. It does work pretty darn good, but it knocks me on my booty... and since my normal resting heart rate is already low - when I take the BB and get back to normal, it can drop my heart rate to the 40's which is also a wild ride. You get really tired and dizzy when your heart is on what amounts to Quaaludes. So needless to say, like my life with the Big S, my heart rate is now a roller coaster ride.

I've been pretty good and I did follow up with a neuromuscular specialist to investigate this autonomic issue and he had a few answers......but I will leave that for another blog.

This one is already a novel and I have to run errand and pick up the kidlet.... which I hope to do with a normal heart rate - lol!

Sitting here typing now I am at 59.

Let me stand for you...................106

Nice closing trick for you.

Thank you and good night. I'm here all week... try the roast beef and don't forget to tip your waitress.
Ba Da Bum.

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