Going to the hospital is a big event. It doesn’t matter whether you’re there for surgery, a clinic visit, or in my case, preparing for the electrophysiology study with possible ablation. There’s always something to prepare, anxiety to deal with and a bit of the unknown. Will everything turn out okay? Will the cardiologist be able to find the problem and do the ablation?
The morning of my test started well enough. I’d prepared for the procedure, rearranged my work and exercise schedule weeks in advance. I’d stopped my beta-blocker as directed, and even laid out my clothes, breakfast, laptop and a book (to pass the time) the night before knowing I needed to get up and out the door by 6:20 am.
In the morning, I was on autopilot having prepared so diligently; ate my breakfast, had a shower and my wife drove me to the hospital. We parked and paid for parking (Why do hospitals add salt to the wound by making you pay? Isn’t going to the hospital bad enough?).
I checked in at the ward, got into the gown, which isn’t more than a bed sheet with two strings attached, and waited for the nurse to come around for the pre-check. The nurse asked me a few questions and there was a small, yet noticeable pause when she asked when I last ate before continuing on
A few moments later another nurse came by and they chatted. The second nurse turned to me and said I couldn’t do the test as I need to be six hours away from eating. My heart dropped.
Over the next hour, I learned the problem with having food in the stomach was in case something unexpected happened and I needed to be put under or have a tube put in my lungs. Having food in the stomach could lead to vomiting which could lead to choking and further problems. I also realized I didn’t follow the instructions I was given a few weeks back. I did offer to go to the washroom and puke myself, but was told that wouldn’t work. We’d either have to cancel or see if it can be done later in the day.
I felt awful, not just for all the plans I made but also for wasting people’s time and hospital resources. About an hour later everyone on the ward knew who I was as my situation came up in their early morning rounds briefing. Here I am, the person who works not only in the hospital, but in heart research messing up the instructions. Several staff told me this happens more often than one would think, although I didn’t feel any better.
The staff worked diligently phoning the other two patients and asking them to come in early and sure enough, they did (thank you to the staff and those unnamed patients). Fast forward six hours later and a nurse continued the pre-test prep.
When you undergo a medical test or procedure, you’re usually told about the big things that happen; where the tube is going in, how the heart cells will be killed, how long recovery will be, etc. But they don’t tell you about the little things. Like how much you will be shaved; chest, back and groin area. Or that the person doing the shaving is trying to go for a new shaving speed record leaving red strikes across your skin.
Then there’s all the poking, probing and wires. I had a blood test, an IV line put in, electrodes on my arms, legs, chest and back, and pen marks on my feet to indicate where my pulses are. All of this is necessary but I felt more machine than human. Sort of like the Borg from Star Trek.
You also need to check modesty at the door. I think the gown is only there for- actually I don’t know what it’s there for as it doesn’t cover much. Trying to sit up and get off the bed without flashing the entire room is something only a Cirque du Soleil performer could do. Then there’s all the people checking out my groin area; shaving, cleaning and poking after the procedure to see if it’s bleeding.
It’s also the little things that hurt the most. Sure they have to put in four tubes up my groin (three on the right side, one on the left) but it doesn’t hurt as you’re sedated and the area is frozen. No, the most painful part is the ripping off of all the sticky things; the electrodes (especially on the chest), the tape used to hold the IV line in and bandages.
After I was set up I was rolled into the room. Having worked in the hospital for years I’ve seen many patients being pushed down the hall, though had never experienced it myself. It seemed to go much faster than it probably looked and the passing fluorescent lights overhead started to make me nauseous. Fortunately, I had nothing in my stomach.
During the procedure I fell asleep for the first hour, or at least I thought I did. The cardiologist told me I was probably out for half an hour and the other time I was talking incoherently. After a while he said he just ignored me. Hopefully I didn’t say anything incriminating.
I came out of the sedation when the cardiologist was stimulating my heart. In order to identify the problem heart cells, the cardiologist injected isoproterenol into the heart to get it racing. Since my palpitations (arrhythmia) only come during exercise, he had to get my heart rate up pretty high. It’s definitely a weird feeling lying still and your heart racing up to 200 bpm or more. I started feeling short of breath. Even when it went back down to resting, the pounding was so forceful I could feel the bed shake. It was like I had an alien in my chest wanting to burst out.
Within two hours it was all done. The cardiologist was able to locate the problem heart cells (good) but not able to do the ablation (not so good). He later told me I have left atrial tachycardia, which is a more complicated ablation procedure than he could do at the time. The ablation on the left side of the heart is not as sure of a thing as on the right side (75% success compared to 95%) and it carries greater complication risks, including a small percentage chance of stroke.
Since the beta-blocker is working at preventing the palpitations, and I’m tolerating it well, I will go back on that and re-consider if things get worse. The cardiologist thought this was a good idea and he will follow-up with me in a few months. We did discuss because of my palpitations, I may have an increased chance of getting athlete’s atrial fibrillation. Good to know and something I’ll look into, maybe for a future blog.
Now I’m home, all that is left is to remove the taping around my groin area. Somehow I think this will be the most painful part of the whole thing.