Thursday, January 5, 2017

Free-writing a pensive post (Part 3a of 3)

I am going to break down the third and final installment of this post into several parts (labeled a, b, and so on) simply because I'll be covering some different things and did not want to allow the last post in this series to balloon out of control in size.

In my last post (HERE) I discussed my research trajectory from last year which covered mostly my sojourn through aesthetics and environmental philosophy as well as some of the classes I had been teaching. I also discussed some publications that would be appearing this coming year and some thoughts about those publications.

Before I go into what the upcoming year holds for me in terms of planned publications, classes, and a possible research trajectory I just wanted to mention a more personal situation (with discretion of course) and let After Nature readers know that it turned out well.  I'll try to keep things brief.


Essentially since this past summer I had been having trouble sleeping - whether being kept awake by or waking up from - an incredibly fast and uncomfortable heart rate. Long-time After Nature readers will know about my health issues involving my heart and TIAs, failed surgery for my hip, nerve injury, chronic pain from the failed surgery on my hip, etc. however I don't think I have talked about much what recently has happened. But, because many students actually had been emailing me to see how things went and how I was doing, I thought just to very quickly mention a recent development here.

So essentially this past summer it was discovered that I have a cardiac arrhythmia, which is an abnormal heart rhythm.  While seeking help for my insomnia doctors kept wondering why my resting heart rate was elevated to about 180+ beats per minute.  After some investigating and seeing a cardiologist the initial diagnosis was "stress."  They said that for someone my age it was impossible to have any heart problem and they could not understand my past TIAs or the fact that I was going about three days without sleep at a time.  Surprised that stress could cause such severe insomnia and severely fast heart rate (which I would experience whether stressed or not) I sought a second opinion (which turned out to be quite wise, as it saved my life).

I went to see a second cardiologist and after being assigned a holter monitor (a monitor that watches your heart rate) the new cardiologist found the cardiac arrhythmia. When telling me the specific kind of arrhythmia and what could happen his face went white while looking at the holter monitor results.  I'll spare technical details but the particular arrhythmia that I have/had involved some non-dangerous things such as atrial flutter and atrial fibrillation (one's heart "quivers" and the top chambers do not pump regularly or normally allowing blood to pool in the atria, increasing risk of blood clots), but also it was discovered that I have some not-so-nice things in the heart involving the lower chambers of my heart throwing irregular beats as well. It was determined that because of my abnormal heart rhythm that I was/am five times more likely to have a stroke (which certainly explains past events, no one could understand how someone so young could have TIAs like that) and 50% more likely for cardiac arrest (which is different from a heart attack; for in the former the heart stops - usually from beating too fast and then failing, and in the latter the heart stops from a blockage of some kind, which I do not have).

It was decided that because of the not-so-nice nature of the arrhythmia that an "emergency" heart procedure to attempt to correct the problem would be needed.  In fact, as soon as they found out it was recommended the procedure be performed the following week.  This now was back in November.

At this time also it was discovered during CT scans that I had developed an aneurysm in my brain. An aneurysm is a weak part of an arterial wall that can rupture or bleed easily (and which can be fatal if left untreated).  The cardiologist was nervous that because during the heart operation blood thinners would be being pumped into me that such could cause the aneurysm to burst.  And so a possible brain surgery prior would be recommended if the heart was to be fixed.  Long story short is that the brain surgery was not needed due to the size of the aneurysm and it being controlled. But investigated that took a month.

The heart procedure took place last week. Called a "cardiac ablation," an electrocardiologist inserts tubes into incisions made on each side of the groin and threads the tubes through the veins/arteries up into the heart - traveling up through the leg, through the lung, and into the heart itself.  From there the inside of the heart is "burned" in specific areas on the pulmonary veins so that the erratic electrical impulses causing the heart to beat irregularly are not able to travel over the burned areas.  Eventually the burned areas "scar" and heal and the impulses will not be able to pass over the dead scar tissue correcting the arrhythmia. (For details on the procedure I'd recommend THIS website, which is what I used to educate myself on what would be happening.)

In itself the procedure is not dangerous, however going through it is not exactly "easy" either.  Many people opt not to due to the possible complications but are forced to (like me) because their arrhythmias are so severe.  Mine was not asymptomatic, as many people have no symptoms. However the ones that do (like me) are forced to do the surgery because the quality of life has been so affected they feel there is no other choice.  Many of the anti-arrhythmic drugs are in fact more dangerous than the surgery itself and so surgery seems to be the better option.  At its worst the arrhythmia would make me very,very tired - so tired I could not even get out of bed or off of the couch. I could not walk very far or go up stairs without feeling like I ran a mile. Dizziness, shortness of breath, chest pain, not being able to think clearly or focus was all common. But of course the absolute worst was lack of sleep. Anecdotally afib and insomnia go hand in hand, although one does not cause the other.  But they are linked. Not being able to breath, or chest pain, or waking up with a feeling like your heart is going to blow out of your chest certainly interferes with sleep. And at the time (November to December, at its worst) I rarely slept for more than two to three hours at a time.

The surgery was last week and went well, and I am currently recovering. I am experiencing normal recovery-type things: bruising, swelling, tiredness, pain. But it was worth it as the irregular beat has since been regular. So I am very, very pleased with the results and if anyone has an arrhythmia I would recommend the procedure despite the risks. I noticed a night and day difference in the quality of my life and feel so much better. Just a few interesting things about the procedure.

During, apparently I was "cardioverted" twice. Cardioversion is when paddles are used to electrocute the heart back into a normal sinus rhythm. So to find out where the abnormal electrical activity is coming from the heart surgeon will usually induce abnormal rhythm, then burn the heart, and then wait and see if the abnormal  rhythm continues. If not then they burned the correct spot. If not, they keep burning. This can last up to several hours (my operation lasted I think somewhere between six to ten hours).  What's interesting though is that immediately after surgery I was told that during the procedure my heart rate "went out of control" - not induced by the surgery - and they had to cardiovert to keep it from going dangerously fast risking arrest, but I was cardioverted not once but twice. In my case they took "paddles" and after tying me to the table to keep me from flopping around (I have no recollection of this) they zapped me attempting to restore my heart rate back to normal. I was told the first attempt "did not take" and so they had to try again, which worked. Thus that could explain the burn marks on me from where they zapped me with the paddles.  The second thing which happened was a very strange "dream" I had during the procedure when this happened. Upon waking up I told the nurse about it - right before the two techs slipped and mentioned how they had to zap me with the paddles.

I also found out that, apparently, I have some sort of genetic immunity to pain medicine. I was the only person awake in the recovery room and told the nurse that I thought the morphine being injected into me was water, because it wasn't working. But then I remember that my father, who had a car accident and brain bleed, required triple the amount of pain medicine to control his pain. And he is 74 years old and never took a pain killer in his life.  So, the surgeon on hand had said that I am not "the average bear" and for whatever reason was requiring about three times the amount of meds a normal person required. But knowing that is important because of my hip pain etc., which is another story for another time.

In the end, my recovery is going well. I am very, very pleased with the results and have had a normal heart rhythm/rate since.  For anyone experiencing this sort of thing I'd recommend the procedure (with a good, experienced surgeon of course).  But for as scared as I was  to go through this it was certainly worth it.  Now I just need to rest and recover, which will take about two or so weeks.  But I am doing well and am glad this is over so I can move on and think about other things.