Tuesday, April 02, 2013

The Cardiac Chronicles: Orgasmatron meets Tardis

An ICD in someone else's chest (from ECU web site)
The Cardiac Chronicles continue...

To bring you up to date, I've had several tests and doctor's appointments since my last cardiac post. One test involved breathing into a tube while sitting in a Tardis-like contraption. Actually, it looked more like the Orgasmatron from Sleeper than Dr. Who's machine. Remember how much pleasure Woody experienced in his contraption? My results were nowhere near as marvelous. I just sat in the contraption and breathed into a tube. "Deep breath! Hold it! Hold it! Breathe!" Over and over again. In one series, I was given a solution of carbon monoxide and methane. A small dose, much less toxic than the atmosphere on Jupiter. The goal was to breathe in the solution and see how readily it is absorbed (or not) into my system. This was supposedly a test of my pulmonary efficiency.

When it was all over, this test (DLCO -- Diffusing capacity of the Lung for Carbon Monoxide) showed that I was abnormal but for no specific reason.

I could have told them that before the test.

The second test was an echocardiogram or sonogram or, sometimes, ultrasound. You may know this test from the time that you were pregnant and a tech greases up a sensor and moves it all over your belly searching for the fetus lurking in your womb. I watched many of these tests during my wife's two pregnancies. It was always amazing to see the forms of these strange undersea creatures appear on the monitor. He Kevin! Hi Annie! Those two tiny varmints have now grown into full-fledged adults.

My beating heart was no less fascinating on-screen. I saw the chambers pumping away. I saw the flowing technicolor blood. I heard the soundings of the electronic pulses bouncing off my bloodstreams. The tech, who happened to be my neighbor, explained it all for me. He wasn't allowed to say anything diagnostic, as that's the purview of the docs. But he would make a good teacher for Echo 101 classes.

What did the echo show? My ejection fraction has improved but is not at normal levels. PA Amanda referred me to the gadget guy at Cardiology Associates. Not surprisingly, the gadget guy (hereafter known as Dr. S) wants me to get a gadget. It's called an Implantable Cardioverter Defibrillator (ICD). It would replace the external defibrillator I now carry around like a man purse. The doc implants the ICD in my chest and strings electrical leadsin to my heart. 

This explanation from the East Carolina University Cardiac Psychology Lab web site:
An Implantable Cardioverter Defibrillator (ICD) is a device that doctors surgically implant inside of your body to protect you from irregular heart rhythms. The ICD is working for you 24 hours a day, 7 days a week. It is like having the paramedics with you at all times. An ICD is an incredibly advanced piece of medical technology that is programmed specifically for you and your heart. If you are chosen to receive an ICD, you may have suffered from a cardiac episode in the past and your doctors want to best protect you from another in the future. Or, you may be at risk for experiencing a cardiac event in the future.

An ICD detects abnormal heart rhythms evident through tachycardia and bradycardia. It closely monitors and keeps track of whether or not the abnormal rhythms are corrected by the heart. If the heart is unable to restore a normal heartbeat by itself, the ICD sends the appropriate amount of electrical current needed to return the heart back to pumping effectively and efficiently. This is what is referred to as a "shock." In effect, the ICD shock "resets" your heart. The shock is delivered from the device (about the size of a stopwatch) via electrical leads anchored in the wall of the heart.

Like having the paramedics with me at all times? I'm not that lonely.

This isn't an easy decision. I'd be living with the ICD for the rest of my life. "Living with" is the key phrase. It may be the difference between living and not.

Still, I get a second opinion on Friday. We'll see what Dr. G says.

No comments: