Sunday, March 13, 2016

When AFib comes to town

The Cheyenne Regional Medical Center Telemetry Lab staffer called me Friday. She wanted to know how I was doing. I said "fine" but knew that this wasn't a courtesy call. The Telemetry Lab monitors my Implantable Cardioverter Defibrillator (ICD) remotely. I have a home transmitter at the side of my bed. It picks up my heart signals and transmits them to the lab, which then takes a look to see if I am in sinus rhythm, which is what we want, or in atrial fibrillation (AFib), which we don't want.

The lab said I was in AFib on Thursday morning. "Did you feel anything?"

"Yes," I said. "I was light-headed all morning."

"Anything else?"

I had to think about it. "I just felt weird all morning. Had a hard time at physical therapy, was tired and out of sorts all afternoon."

The Telemetry Lab person (sorry I don't remember her name -- blame it on the irregular heartbeats and lack of oxygen to the brain) told me that I needed to be aware of these symptoms as a long-duration AFib is dangerous. "Next time you're feeling that way, please send me a manual reading from your monitor."

"OK," I said, feeling a bit scared. I tend to ignore my heart difficulties most of the time. I exercise, take my meds, maintain a good attitude, am kind to animals, etc.

She made me an appointment with my cardiologist. She is able to access my MyChart files at CRMC which shows a calendar of my appointments. She puts me down for a March 15 appointment with Dr. Nienaber. As long as I'm dealing with a CRMC physician or group, my records are online and we can carry on these types of conversations. It's a bit spooky, all this electronic data-keeping and accessibility. My fiction-writer self thinks of all the ways that this system can be abused. Let's say a U.S. politician has an ICD with a bedside monitor and someone, say, an ISIS terrorist, wants to murder that politician. He hijacks the signal and causes the ICD to shut down. Even scarier, he causes that ICD to activate its defibrillator. Bam! -- a big shock to the heart to get it back into rhythm even when it doesn't need it. And another shock and another and pretty soon, the heart gives up. Remote-control assassination. Because I am postulating this as sci-fi means that the possibility already exists and the U.S. or the Russians or even ISIS may be preparing an attack.

For me, though, right now, the threat is more from AFib than it is from some shadowy hacker. AFib can cause strokes, blood clots, heart failure. My heart attack of three years ago created the cardiac scar tissue that sometimes misfires as AFib. My pacemaker activates to get me back into rhythm. If catastrophic heart failure threatens, the defibrillator will kick in with a debilitating jolt. This has never happened to me, and I hope it never does.  I could be driving down I-80 at the time. Or I could be napping. Anything is possible.

A big thank you to the CRMC Telemetry Lab. A big shout-out to the researchers and engineers and technicians who put these gizmos together. I freakin' love science.

To watch AFib in action, go to the American Heart Association web site. You can compare an AFib animation to one of a normal heartbeat. My heartbeat was normal for 62 years. Cholesterol and inflammation and stupidity led to my heart attack, which almost killed me. I was pulled back from oblivion by EMTs, cardiologists, surgeons, and nurses. I'm 65 now, retired, someone who knows how blessed he is every day. Or almost every day.

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