A correction to a previous assumption is in order. Our thoughts on the ICD have focused on V-fib and that is what we assumed happened. Upon reading the data stored by the unit we now know the thing fired-off because it sensed a too-rapid heart rate, namely, 188 beats per minute. This is called tachycardia. The term tachycardia comes from the Greek words tachys (rapid or accelerated) and kardia (of the heart). The gizmo on the dash of a car that gives RPMs is a tachometer and has the same Greek word origin. Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate – for folks over 15 years this would be any rate over about 100 bpm.
Nancy’s rate had been running a bit high (I thought) during the past few weeks, frequently 80+. She has had frequent atrial fibrillation …
from the Mayo Clinic:
http://www.mayoclinic.com/health/atrial-fibrillation/DS00291
“During atrial fibrillation, the heart’s two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart. Atrial fibrillation is an irregular and often rapid heart rate that commonly causes poor blood flow to the body and symptoms of heart palpitations, shortness of breath and weakness. Atrial fibrillation can also cause fatigue …”
Monday’s report explained how the “King of Hearts” monitor was rendered useless by the frequent A-fib, and the need to switch to a Holter monitor.
[Small world story: Friends (Brittany related) write:
“Hi. Just read your latest comments and thought I’d share a bit of trivia with you guys. Dr. Holter was born and raised in Helena, MT. In fact, his home was 2 houses south of ours. . . he was a native son, the local history museum had a special display with his old stuff, photos, etc….”]
Now back to the main story:
When (on Tuesday) the ICD sensed the tachycardia it pulsed twice and converted the abnormal rhythm to a regular sinus rhythm. Nancy was on the kitchen floor and shifted about until she was leaning against the oven. She thought I was outside and sat there awhile thinking I would come back. That plan didn’t work because I was down the hall sleeping. From where she normally spends her time (a recliner overlooking the back forty**) she gets me awake or from the computer by activating the ringer on the house phone. There on the kitchen floor she didn’t have that capability, so, after about 45 minutes of rest and frustration she yelled for me hoping I was near enough (outside) to hear her. Had I been outside that likely would not have worked but being only a room away, it did.
**————skip, if you know “back 40”———————–
“back forty” is a reference to plots of land of 40 acres established by the USA’s Public Land Survey System (PLSS) –good explanation here:
http://www.nationalatlas.gov/articles/boundaries/a_plss.html
The settlers house would be located close to the public road that went by the ‘front’ of the property and frequently near the better farmland. Some claim that if a salesman or other intruder visited the house and the spouse felt there was no need to bother her husband, she would tell the person that the entire crew was out on “the back forty” – far from the house and could not likely be found. (no cell phones then)
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Now it is Thursday afternoon — several phone calls later. The INR is coming down but the colonoscopy won’t be done until Saturday. At 1.7 INR the doctor can remove any suspicious polyps. So we wait on that. She has had antibiotics, blood infusions, and other liquids pumped into her. Her fever is gone and her heart rate lower and steady in the high 60s. She called after having the TEE (see Wed. posting) that did confirm something (filaments of bacteria or ‘vegetation’)
http://en.wikipedia.org/wiki/Endocarditis
on the mitral valve (donated by a pig) .
Here’s an assumption: When bacteria in the blood inflames the heart it is called endocarditis. Nancy’s medical problems flared last spring when this happened and she went to the ER in Ellensburg. If you look at the list of symptoms on this site
http://www.mayoclinic.com/health/endocarditis/DS00409/DSECTION=symptoms
there are several that she has been experiencing (again), namely, fatigue, fever, weakness, and weight loss, blood in urine (microscopic). To me, this appears to be a slow-motion version of sepsis and septic shock.
http://www.mayoclinic.com/health/sepsis/DS01004
http://hopkins.portfolio.crushlovely.com/reference/article/septic-shock
The cocktail of antibiotics has been upped to four (to cover all possibilities I assume). She is feeling much better except for a bit of raw throat from the TEE. That and a liquid diet in anticipation of the colonoscopy. She isn’t happy with the lumpy Jell-O just served and she questioned me on how one screws up making Jell-O. I don’t know. Too little stirring or the water is not hot enough, I guess.
It is almost 6 P.M. here so I have to send this to the cloud.
Bye.
John