Did he think we were early-adopters at the cutting edge of technology?
As mentioned Sunday, the week turned out busy again, with me, Nancy, still run down, but at least I am keeping down food. I spent many hours searching records of former grads that were on the alumni list at CWU marking people to email the invitation of the celebration to, that will occur on Oct 2, a Saturday afternoon, meet and greet and eat and drink. Also went to a music event at the Rehab center where I spent 6 weeks. They all call me by name when I walk by, or come stick their head in the door and wave.
There was no exercise class and although I didn’t probably have much energy, I stopped by only to find it was cancelled, Monday. Wednesday and Friday I was not able to go because Wednesday I was still involved with getting the heart event monitor (supposedly for a week) installed. John will tell about that, inserting it below, but meanwhile, I just read his treatise (and it is worth reading), and see he wants me to describe the second unit.
The first unit meant for a week is what he describes. It only had two connections to the relatively light unit, but it was for a week, with a button I could push when I felt stress or to generate a recording. There are only 9 tracks. It was too sensitive and picking up (without the ability to filter out) something we already know I have, atrial fibrillation.
We changed to a unit that was only for 24 hours, but weighed a LOT more–really heavy hanging in my pocket and connected to me in six places. The first top place was poorly placed by the installer on top of the worst, deepest part of scar tissue from my original scar down the middle of my chest (at the top). This guy needs to be told, and I will. Where it made the difference was taking it off 24 hours later – when I pulled the tape and the connector I had the worst pain I have had in many months. I screamed and scared John, and probably everyone else on the Naneum Fan. I got the dogs’ attention and probably the horses as well. At least John was not out lifting one of their feet when I screamed. After getting over that removal, the other five were not over scars, and did not hurt coming off. But I was worn out from the experience. My next visit to the cardiologist is 2 weeks away and we’ll get results and suggestions then.
Check below for a nice write-up by John explaining the first old technology I was supposed to live with for a week.
Meanwhile, I will insert the nice things that happened Saturday and Sunday, that also were very taxing on my system. First thing we did was Saturday, drive to a restaurant on the Lake, at Moses Lake to meet our 40 year long friends (from Iowa) who helped us move to Idaho in 1974. That trip we were quite a rig, with canoe atop and inside a station wagon, my driving and Ann as a passenger, two dogs, theirs and our Brittany, and two cats. John and Fred drove a large Ryder van with all our belongings, pulling their VW bus with more belongings that wouldn’t fit in the van. There are stories with that to remain in our memories. Anyway, each year they come to Spokane to visit family and either drive to Ellensburg, or last year we tried this place, to which we returned. The visit was wonderful and the food and the trip took about 5 hours total. It took me a 4 hour nap to recover and then I slept all night as well.
Sunday was another busy afternoon with a potluck with our Trail Riding Club. There were 43 people there. I kept down all the food from both occasions, so that hurdle is over till I have to get a refill on the Reglan.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
John says:
It is not easy keeping track of what is happening to you as you go through the labyrinth of modern medical technology and practice. Consider the simple suggestion of the cardiologist to wear a heart monitor for a week. Sometimes the expressions used are historic relicts with no connection to modern understanding of the thing being talked about (for example, sinus rhythm – normal beating of a heart). Also, one finds old and new equipment intermixed because the technology of data recording, storage, and transmission has been advancing rapidly.
There is the problem of terminology. Nancy was fitted with a “King of Hearts” unit. What’s that name mean? Nothing! It is the Instromedix company’s name for a device described as an event monitor. It is a bit like telling someone you went to the “Golden Arches” for lunch. Most everyone you know today would understand that you went to McDonald’s and got a cheeseburger or some other fancy fare. If a person does not associate McDonald’s and Golden Arches that person could only guess, maybe thinking that you went to an expensive Thai restaurant. Likewise a King of Hearts unit conveys no useful information.
So the idea of and event monitor is that leads attached to your skin pick up electrical signals and when your heart does something rare (key word) that it is not supposed to do, then signals just before, during, and after the event are stored in the unit for analysis at a later time. The unit may also have a set of beeps to alert the wearer that an event is triggering the recording of the signals. I should mention that the unit is about the size of a deck of cards but not as heavy. They do not have a lot of storage, anticipating that the events to be recorded are rare. With regard to such assumptions, Nancy rarely cooperates.
Nancy’s heart has very frequent episodes of atrial fibrillation, the most common abnormal heart rhythm or cardiac arrhythmia. [This is partly the reason she feels tired much of the time.] After being fitted with the unit we headed for the car and to a Costco warehouse store. The unit recorded 2 events before we were into the car and 7 more by the time we were in the check-out line at the store.
Here is why that is important. First: The unit makes two beeps to let the wearer know it has been triggered but this one recorded silently. When recording is completed, if there is sufficient memory to record another event, the King of Hearts recorder emits a double beep and automatically restarts normal scanning mode on a loop-type scan. So in the first 40 minutes we heard 18 beeps. Second: The unit will only record 9 events and then one has to “upload” the data via a telephone. One has to call a place in New Jersey (they thought), talk to a live person, send the info, talk to the person again, reset the unit, and start again from scratch.
Did you notice the use of the words telephone, person, and data all involved there? If you are old enough and have had the experience of using an early connection to the internet you know where I am going with this. That’s right, the unit uses an acoustic coupler of the sort found in the Novation CAT:
http://en.wikipedia.org/wiki/Novation_CAT
See the picture. Notice the cord. We are talking Apple II ® and 1980.
A device that modulates an analog carrier signal to encode digital information, and also demodulates such a carrier signal to decode the transmitted information – thus a modulator-demodulator — is called a modem. The key idea here is modifying a sound into a digital signal so it can be sent over a copper line. There is that telephone cord to think about.
Do you still have a phone in your house that is connected with a cord to a line that physically runs from your home to the rest of the world, including New Jersey? If not, the King of Hearts isn’t for you. Maybe a neighbor or friend does. Check to see.
Okay. So once the phone connection is made, one has to lay the telephone on to the small holes — see:
http://www.fcminc.com/KOHPatientManual.pdf
Scroll down to see the image of the phone handset on the unit drawing. Here is an official company site:
http://www.instromedix.com/cardiac_event_recorders.htm
Then sounds are fed into the telephone from the unit’s speaker – such as beep, de-beep beep, beep, de-beep beep, and so on . . . for about 15 minutes per 9 recorded events. What an extended racket.
[Funny story: one web site has a comment by a person that did the above and freaked out – thought all those high pitched sounds were caused by his heart exploding or some such. He was too young to have heard an acoustic coupler modem.]
We did the arithmetic. With 40 minutes wear time for 9 events and 15 minutes of telephone modem noise of upload time and 7 days of monitoring we came up with – who knows? We called the heart center and went back for an alternative.
The alternative is called a Holter monitor. I thought the person was tripping over the word holster and was expecting him to give Nancy a leather pouch to wear on a belt. Not so. The name comes from a fellow named Jeff Holter who (with others in about 1961) developed a back-pack size unit containing a heavy assortment of radio telemetry and tape recording equipment. Dr. Holter invented telemetric cardiac monitoring in 1949. So, the Holter monitor (as well known in the halls of the heart center as McDonald’s is in the halls of your kid’s middle school) was attached to Nancy’s body – she can tell you about that – but only for one day. It does a continuous recording, makes no noise, and gets mailed back in a padded envelope. Nice.
Just to pad the story some I’ll direct you to the following sites. The first shows a horse (last image on the page) with a monitor:
http://www.petcardiology.com/placing-holter-monitor-leads
and the next:
http://www.morgananimalhospital.com/index.php?view=pageView&docid=6345
… has the story of Pico, a Miniature Schnauzer with a heart problem.
The story begins –
“ Pico began to have episodes of weakness and collapse that seemed to worsen over . . .”
and then …
“The monitor revealed that Pico had a heart rate that varied from 28 beats per minute to up to 229 beats per minute. The normal heart rate for a dog is 70-120 beats per minute. There were stoppages in the heart rhythm of up to 6.85 seconds long.”
You can read the rest with pictures. John
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~