Down but not out

Staff Columnist

Two weeks ago I began my column with; “During this summer lull on our idyllic isle the pace has slowed.  Out there in the world the pace speeds in this year of 2014.  I know, some of us have trouble realizing that it is really so late, at least for us.”  Little did I know haw prophetic those words might be, and how soon.  On a Thursday morning I awoke to a general unwell feeling.  Now I have been a cardiac patient for many years.  As those of you who share this condition will know, we are trained not to ignore anything regarding our health.  We headed for our fine Sarasota Memorial Hospital and its emergency room.  The ER Doc, Dr. Williams, and his staff did all the things called for, ruling out an MI (Myocardial Infarction). That’s the medical term for a heart attack.  They test for the presence of a particular enzyme.  Wow, dodged the bullet again I thought.  They looked further doing a CT (Computerized Tomography) scan of my head.  Not satisfied they called in my Primary Care Physician.  He was away but a member of his practice, Dr. Varga, responded.  She called my Cardiologist in town, Dr. Mike Mollod. That’s the team called into action; it was to grow.

Now I’m no stranger to cardiologists.  I have met with two of them since my heart attack in Cohasset 23 years ago.  You get to trust a guy who you meet in an ER and who saves your life – Dr. Marks.  His counterpart down here in Sarasota, Dr. Mollod, I’ve known for almost 15 years.  I trust him also, implicitly.  He’s the fellow who responded to that call, and showed up in my hospital room that Thursday am.  He reviewed the chart, asked the right questions and said he wanted to call in a colleague.  The good thing about our Hospital is that there are many good and varied specialists available.  The trick, I guess, is to have a doc in your corner who knows who to call, and gets a response.  In this case we were talking about a cardiologist who specializes in electro physiology.  That’s where we were headed.

Cardiac electrophysiology is the science of elucidating, diagnosing, and treating the electrical activities of the heart. The term is usually used to describe studies of such phenomena by invasive (intracardiac) catheter recording of spontaneous activity as well as of cardiac responses to programmed electrical stimulation (PES). These studies are performed to assess complex arrhythmias, elucidate symptoms, evaluate abnormal electrocardiograms, assess risk of developing  arrhythmias in the future, and design treatment. These procedures increasingly include therapeutic methods (typically radiofrequency ablation) in addition to diagnostic and prognostic procedures. Other therapeutic modalities employed in this field include antiarrhythmic drug therapy and implantation of pacemakers and automatic implantable cardioverter-defibrillators (AICD).         (Wikipedia)

This specialist, Dr. Eckart, arrived in my room in late afternoon.  He explained the problem as he saw it, and prescribed a course of action.  This he said he would perform in the hospital’s cath lab that evening.  I got the message.

Let’s go, I said.  I understood the potential urgency and the need for “insurance” as this procedure was described.  Again we’ll keep it less clinical.

Quoting from the Hospital’s Operative Note, the Electrophysiology Procedure Report on me –  I note the planned and accomplished procedure undertaken by Dr. Eckart and a competent and no-nonesense team of nurses in the Cath Lab Thursday evening;

“Procedure: 1. Comprehensive electrophysiologic procedure with insertion of multiple catheters with right atrial, His Bundle (the bundle of fibres first described by Wilhelm His….),  right ventricular pacing and recording.   2. Insertion of a dual chamber implantable cardioverter-defibrillator with transvers electrodes; atrial and ventricular.  3. Electrophysiologic study with pacing and recording to test effectiveness of therapy, including induction of arrhythmia with testing of dual chamber cardioverter-defibrillator pulse generator.”

This is what they accomplished.  I missed most of it after the draping on the table.  That was fine with me.  I awoke upstairs in the new tower of the SMH about 2 am.  That nursing staff had taken over.  Many of you know the drill.

Various specialties visit starting early.  They draw blood, fuss with the dressing, make you comfortable.  A technical type fellow arrived with computer and gear to document the position of the leads – in the heart.  That was encouraging.  The fine team returned one by one to see me.  One even had a third year medical student from FSU in tow.  Learning is what medicine is all about, after all. I felt pretty good, if a bit uncomfortable.  I even got lunch.  The primary-care  doc returned to say that I could go home.  She tinkered with my meds a bit and wrote an order.  All these reports, etc. are far more legible now in our paperless medical world.

Included in the discharge materials I collected was a small booklet called optimistically “Living with your ICD.”  It  is produced by the manufacturer of the implanted medical device, St.  Jude Medical.  This 50 page guide looks a lot like the manual with a new electronic device – which it is of course.  It tells the new patient, me, a great deal about the heart, the implanted device and what it does (or never has to do), and a few logistics details.  The manufacturer provides a temporary patient identification card, with the promise of a sturdier permanent card to follow.  For some reason these are only provided to North American patients, language maybe.  This they say is for those TSA stations at the airports.

There is also an electronic device to read the defibrillator’s performance remotely and transmit it to the cardiologist’s office.  I have the device but not the training on it as yet.

This is in an engineer’s experience: super, almost space-age stuff.  It is available right here in our City, in our Hospital.  I was impressed with the care I received at all levels.  The scar is healing nicely, pain gone.

Follow-up care is underway.

I wrote here that I was impressed; I’m  grateful !

My editor wrote me that “it shows a lot of humanity the way you talk and write about your life.”  I’m honored to see that.  I do these short essays hoping that my experience might help others.






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2 Responses for “Down but not out”

  1. Peter O'Connor says:

    Robert, Thanks for your positive comment.

  2. Robert Jones says:

    Hi Peter. Good of you to record your experiences and publish to the online world! All people effected by the long process of heart disease/problems need all the reassurances the can get. I had two MIs by age 25, by-pass surgery at age 47, ICD after a near fatal arrhythmia nearly 5 years ago age 67! When you find yourself in such medical circumstances, it is great to be able to look online and see that people can and do survive such issues and still live productive, happy lives. Many thanks.

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