{"id":585,"date":"2010-08-19T18:06:50","date_gmt":"2010-08-20T01:06:50","guid":{"rendered":"http:\/\/rocknponderosa.com\/hultquist\/?p=585"},"modified":"2019-05-26T07:54:30","modified_gmt":"2019-05-26T14:54:30","slug":"thursday-progress-i-think","status":"publish","type":"post","link":"http:\/\/rocknponderosa.com\/?p=585","title":{"rendered":"THURSDAY — Progress, I think."},"content":{"rendered":"

A correction to a previous assumption is in order.\u00a0 Our thoughts on the ICD have focused on V-fib and that is what we assumed happened.\u00a0 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.\u00a0 This is called tachycardia<\/em>.\u00a0 The term\u00a0tachycardia 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 \u2013 for folks over 15 years this would be any rate over about 100 bpm.<\/p>\n

Nancy\u2019s rate had been running a bit high (I thought) during the past few weeks, frequently 80+.\u00a0 She has had frequent atrial fibrillation<\/em> \u2026<\/p>\n

from the Mayo Clinic:<\/p>\n

http:\/\/www.mayoclinic.com\/health\/atrial-fibrillation\/DS00291<\/a><\/p>\n

\u201cDuring atrial fibrillation, the heart’s two upper chambers (the atria) beat chaotically and irregularly \u2014 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.\u00a0 Atrial fibrillation can also cause fatigue \u2026\u201d<\/p>\n

Monday\u2019s report explained how the \u201cKing of Hearts\u201d monitor was rendered useless by the frequent A-fib, and the need to switch to a Holter monitor.<\/p>\n

[Small world story: Friends (Brittany related) write:<\/p>\n

\u201cHi. Just read your latest comments and thought I’d share a bit of trivia\u00a0with you guys. Dr. Holter was born and raised in Helena, MT. In fact, his\u00a0home was 2 houses south of ours. . . he was a native son, the local\u00a0history museum had a special display with his old stuff, photos, etc….\u201d]<\/p>\n

Now back to the main story:<\/p>\n

When (on Tuesday) the ICD sensed the tachycardia it pulsed twice and converted the abnormal rhythm to a regular sinus rhythm.\u00a0 Nancy was on the kitchen floor and shifted about until she was leaning against the oven.\u00a0 She thought I was outside and sat there awhile thinking I would come back.\u00a0 That plan didn\u2019t work because I was down the hall sleeping.\u00a0 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.\u00a0 There on the kitchen floor she didn\u2019t 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.\u00a0 Had I been outside that likely would not have worked but being only a room away, it did.<\/p>\n

**————skip, if you know \u201cback 40\u201d———————–<\/p>\n

\u201cback forty\u201d is a reference to plots of land of 40 acres established by the USA\u2019s Public Land Survey System (PLSS) \u2013good explanation here:<\/p>\n

http:\/\/www.nationalatlas.gov\/articles\/boundaries\/a_plss.html<\/a><\/p>\n

The settlers house would be located close to the public road that went by the \u2018front\u2019 of the property and frequently near the better farmland.\u00a0 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 \u201cthe back forty\u201d \u2013 far from the house and could not likely be found. (no cell phones then)<\/p>\n

————————————————————————<\/p>\n

Now it is Thursday afternoon — several phone calls later.\u00a0 The INR is coming down but the colonoscopy won\u2019t be done until Saturday.\u00a0 At 1.7 INR the doctor can remove any suspicious polyps.\u00a0 So we wait on that.\u00a0 She has had antibiotics, blood infusions, and other liquids pumped into her.\u00a0 Her fever is gone and her heart rate lower and steady in the high 60s.\u00a0 She called after having the TEE (see Wed. posting) that did confirm something (filaments of bacteria or \u2018vegetation\u2019)<\/p>\n

http:\/\/en.wikipedia.org\/wiki\/Endocarditis<\/a><\/p>\n

on the mitral valve (donated by a pig) .<\/p>\n

Here\u2019s an assumption:\u00a0 When bacteria in the blood inflames the heart it is called endocarditis.\u00a0 Nancy\u2019s 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<\/p>\n

http:\/\/www.mayoclinic.com\/health\/endocarditis\/DS00409\/DSECTION=symptoms<\/a><\/p>\n

there are several that she has been experiencing (again), namely, fatigue, fever, weakness, and weight loss, blood in urine (microscopic).\u00a0 To me, this appears to be a slow-motion version of sepsis and septic shock.<\/p>\n

http:\/\/www.mayoclinic.com\/health\/sepsis\/DS01004<\/a><\/p>\n

http:\/\/hopkins.portfolio.crushlovely.com\/reference\/article\/septic-shock<\/a><\/p>\n

The cocktail of antibiotics has been upped to four (to cover all possibilities I assume).\u00a0 She is feeling much better except for a bit of raw throat from the TEE.\u00a0 That and a liquid diet in anticipation of the colonoscopy.\u00a0 She isn\u2019t happy with the lumpy Jell-O just served and she questioned me on how one screws up making Jell-O.\u00a0 I don\u2019t know.\u00a0 Too little stirring or the water is not hot enough, I guess.<\/p>\n

It is almost 6 P.M. here so I have to send this to the cloud.<\/p>\n

Bye.<\/p>\n

John<\/p>\n","protected":false},"excerpt":{"rendered":"

A correction to a previous assumption is in order.\u00a0 Our thoughts on the ICD have focused on V-fib and that is what we assumed happened.\u00a0 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.\u00a0 This is called tachycardia.\u00a0 … Continue reading “THURSDAY — Progress, I think.”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-585","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p72iNf-9r","_links":{"self":[{"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/posts\/585","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=585"}],"version-history":[{"count":6,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/posts\/585\/revisions"}],"predecessor-version":[{"id":591,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/posts\/585\/revisions\/591"}],"wp:attachment":[{"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=585"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=585"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=585"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}