Thursday, September 25, 2014

Sometimes It Takes A Cardiologist To Fix A Broken Heart

In May of 2005 I had heart surgery.  I was on the table for 9 hours and I was awake the entire time.

Now I need to go back a little further.

In the Spring of 2004 X2 and I moved from Isla Mujeres, Mexico to Roatan, Honduras on board the M/Y Aries, a 105' motor yacht we worked aboard.  Our lifestyle was super active.  We rode dirt bikes, played tennis, ran, worked out at the gym, water skied, and were avid freedivers and scuba divers.  I was 34 and in great shape.  One day on the way to the tennis courts I felt something strange in my chest and looked at my heart rate monitor.  My heart rate was 140, then quickly dropped back to the 50's.  This was sitting still in the passenger seat.  I shrugged it off, but then it started happening more and more frequently.

I ignored it for a few weeks before I finally went to a nearby clinic staffed by Dr. Zeni Duarte and volunteers from Washington State.  They hooked me up to an electrocardiogram machine and printed out a ticker tape of my heart's rhythm.  After studying it and discussing it, they told me I needed to go to the mainland to see a cardiologist.  This is not something a fit and healthy 34 year old ever expects to hear.

Next Stop The Mayo Clinic In Jacksonville

Instead of going to mainland Honduras, I got on the phone with the Mayo Clinic in Jacksonville, Florida and booked an appointment there.  X2 and I flew up and spent a few days getting checked out.  We also got our concealed weapon permits, but that's another story.  I was diagnosed with a/v nodal re-entrant tachycardia.  I was told that my options were to take meds and live with it, or have surgery to try to fix it.  I opted for meds and was prescribed a low dose beta blocker.  We went back to Roatan and got back to normal life.  Except that my new normal was a resting heart rate of 44 and blood pressure of 80/50.  I became obsessed with my heartbeat.  I lay in bed and watched my aorta jumping with my pulse.  At night, I'd wake up convinced that my heart had stopped for a moment.  The worst thing though was that I was still having attacks.  All day long.  If I was out for a run and had an attack, my heart rate would spike to 225 and I would have to put ice on my face and use other techniques to bring it back down.  Though the cardiologist told me it wasn't necessarily a life-threatening condition, the meds put me at a higher risk for a stroke and other complications.  Being on a tiny island with no hospital added an element of stress too.

Heart Surgery In New Orleans

After about 6 months of that, I felt like it was time to get the problem corrected.  The Mayo Clinic had been super convenient, because they allow you to book several appointments in a couple of days.  It turned out to be too expensive though, because even though my medical insurance card stated that I would be responsible for covering 30% of any out of network care I received, it really should read something more like this:  "We promise to cover 70% of what we think the bill should be when you are out of network, so you should shop around and find someone who will treat you at the same price as medicare or you will be paying thousands while we pay hundreds and laugh about this misunderstanding when you call to complain."  I got in touch with Mrs. Boss who was a nurse anaesthetist in New Orleans, and asked her to find me a great cardiologist in the network.  I also asked her to do the impossible.  Get me a consultation and schedule me for surgery a day or two later so I wouldn't have to make two trips.  X2 and I flew to New Orleans and met my parents who wanted to be there for the surgery.  The Mayo Clinic didn't send any of my medical records to the new cardiologist, Dr. Abi-Samra at Ochsner so after a brief chat he had me jump on the treadmill for a stress test.  I'm glad it worked out that way.  He looked at the results and a moment later grabbed a colleague who was walking by his office.  They conferred for a couple of minutes and my doctor pronounced me misdiagnosed.  Turns out what I really had was atrial tachycardia and now I needed to rethink my decision.  The surgery I thought I was having would have taken 2-4 hours, been low-risk, and had a statistically high percentage of success.  The surgery I needed would take 4-6 hours, would be riskier because they would have to give me anticoagulants to keep me from having a stroke, and didn't have the same success rate.  These were only the top 3 considerations.  And... I only had a few minutes to decide, after all the Electrophysiology lab was booked and this longer surgery would mean adjusting the schedule.  I quickly decided to go ahead and have the surgery.


Photo Source
Above is an example of a cath lab I found online.  The super high tech lab reminded me of the bridge of the Enterprise  There were half a dozen monitors, a team of about 8 and there was definitely a captain in charge.  The gist of the surgery is that they sent catheters up veins in my groin and then fed instruments up to my heart.  GPS and Sonar to map it, a needle to poke through the septum to the other chamber of my heart, pacing wires used to trigger tachycardia, and a tool that uses high radio-frequency to burn or ablate the bad pathway.  I feel like I'm missing something.  The highlights were: seeing and feeling my heart rate at 280bmp, the doctor cursing because my heart kept collapsing and bending the needle when he tried to push the needle through which meant pulling it out attaching a new needle and threading it all the way up again.  Finally, he was certain he had found the bad pathway and I felt the burn although it wasn't painful, just odd.  Even odder was when the catheters were removed and the guy removing them had to climb up on top of me to use his bodyweight to put enough pressure on the entry wounds to stop the bleeding.  This was because of the anticoagulants they had given me.

I spent the night under observation and was released the following day.  The attacks were gone and the only irregular heartbeats I've had since have been due to anxiety attacks.

Don't ignore symptoms!  If you suspect that something is wrong with your heart, see your doctor.

*Edited 9/28 when my parents pointed out that my surgery was before Hurricane Katrina.  I went back after Katrina to see a neurosurgeon about my herniated disks.  My apologies for the error, but I do have a head injury.

Saturday, September 13, 2014

Birth Story - How Pole Dancing Got Me Through It

Yesterday my friend Rachelle was over with two of her girls, and after I whined about suffering from plantar fasciitis and achilles tendonitis, she did some acupressure on my feet.  I was ready to tap out in about 2 minutes, but I let her do her thing.  While I was writhing in the chair, shrieking and slapping the table, I tried to go back to the place I was 4 and a half years ago when I had a baby without any pain meds.

My daughter is 4 already, and she likes to tell people that we're made for each other, because I made her a baby, and she made me a Mama.  Here's how that went down.

Salsa Dancing in Florida @ 7 Months
I arrived at my parents' place in La Quinta, California on Valentine's Day of 2010.  I was planning to stay until my baby was born, and then return with her to Guatemala City where I was living with my husband at the time.  My sister, who was also my doula flew down from Vancouver with her family in April.  My parents moved to their casita two doors down and I was in their room.  I floated in the pool every day and walked around the ducky park.  I tried to stay active, but I developed plantar fasciitis in both feet and it was brutal.

I had tons of Braxton-Hicks contractions in the weeks leading up to my due date.  I didn't have any fear at all about the delivery, because my mom and my sister both had amazing natural births and it just didn't occur to me that my experience would be any different.  Mom says that my sister and I were both born without any pain or tv style screaming.  My sister had her first at home with midwives, and Mom had to wake Dad up when the baby was born because he fell asleep watching tv, and my sister didn't make a sound!



I didn't take any classes, but I watched this video several times and really put it out to the universe that I wanted to have a similar experience:

When I started having real contractions I could tell the difference, and I breathed and chanted through them.  I also did a lot of pole dancing.  My parents' bed is a big 4 poster and I held onto one of the poles and swayed and squatted.  I probably got through about 75% of the contractions that way. I don't have a single photo or video of it.  None of the contractions were awful though.  They were like really bad period cramps that lasted for about 6-8 breaths and only 4 of the breaths were intense.  I also spend a lot of time on a big pink yoga ball.  Mom and my sister took turns staying up with me and my Dad took walks around the neighborhood with me.  I labored at home with my family for 36 hours before the contractions were finally 5 minutes apart for an hour.  On the way to the hospital my sister warned me not to be disappointed if the nurses checked me and I was only dilated to 4.5 or 5cm.  While I was checking in I had a couple of contractions and I don't think the nurses took me seriously at all because I just breathed loudly and kept filling out the forms.  When they took me in to get into a gown and get checked the nurse yelled through the door that they needed to call my doctor right away.  I was 9.5 cm already!

The delivery nurses were awesome, and couldn't believe how calm and cool I was.  They kept saying that I looked like I was a patient on an epidural.  I started pushing right away, and it took about an hour and a half.  My contractions didn't get closer than 5 minutes apart so even though everything was going just fine another nurse came in and administered Pitocin.  I don't remember it, but my sister told her that I didn't want it.  They ignored or bullied and gave it anyway.  My mom and my sister both took videos which I've watched several times in the years since.  None of the pushing hurt at all, and the nurses were really quiet and let me tell them when a contraction was starting and that I was about to push.  One thing I never realized from seeing fictional births on tv and movies - you can't push and scream.  I didn't make any noise while I was pushing because I was holding my breath and, well, pushing.  As soon as she was born they put her on my skin and I held her while they stitched me up.  My sister got to cut the cord and I tell Ebi that her belly button was a gift from Auntie Jen.

So, aside from the Pitocin and episiotomy, it went as smoothly as I had hoped it would.  Quiet, peaceful, and the only one screaming was my newborn.  I was ready to go home as soon as they weighed and measured her and gave her back to me, but they made me stay a full 24 hours.  That was a drag.

As natural and easy as childbirth was for me, I was totally unprepared for how hard breastfeeding was.  I'll save that for another post.

Friday, September 5, 2014

Natural Ways To Treat Insomnia

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I've had brutal bouts of insomnia for as long as I can remember.  The only thing that briefly cured it was was breastfeeding on demand.  I was so completely exhausted that I was able to wake, change and feed my baby, and immediately go back to sleep without activating that part of my brain that wants to relive every argument with my ex, stress about flushing my life savings down the drain in Guatemala, wonder if my heart is beating too fast, or worry about the future.

As a single parent, I'm not in a position to medicate myself to sleep.  Of course I need to get a good night's rest, but I also have to be alert enough to wake immediately if I hear my daughter in distress.  She has had two bouts of vomiting in her life and both times were in the middle of the night.  As head of security in our house, I also have to be sensitive to sounds of scumbaggery at the doors or windows.

My other issue is that I can't quit coffee.  I know it is a stimulant, I know it is a migraine trigger.  It is part of my morning ritual, and to be honest, my afternoon ritual.  I love grinding beans, making espresso, and frothing a bit of almond milk.  It's just not something I'm willing to give up right now.  Especially the afternoon one that I have around 2pm when I'm so sleepy I start to look around for a hammock to spend the rest of the afternoon in.

image source

What I have had success with is eating one or more of the following in the evening:

I make a small parfait with yogurt, honey, nuts, and bananas, cherries or grapes.  The calcium in yogurt is necessary for increasing tryptophan and melatonin levels, two hormones that help regulate sleep.  Honey has a soothing, calming effect.  Nuts contain tryptophan and magnesium, and also increase serotonin levels, a hormone our brain produces when we are happy and satisfied.  The fruit in the parfait is important too.  Bananas provide tryptophan and magnesium, as well as potassium which can help you sleep.  Cherries and grapes are rich in melatonin.

Sometimes I have a cup of chamomile tea or Sleepytime, and add a spoonful of honey before I go to bed.

One thing I haven't tried, but is supposed to be helpful is eating an egg before bed because it is also a great source of the amino acid tryptophan.

I've also read that we should turn off the tv, computer and put down our tablets or smartphones at least half an hour before bed, because they stimulate our brains too much.  I just don't seem to be able to do that.  I like to put on Netflix at bedtime and relax watching something silly.  What I don't do is watch any news or anything scary that would put me on edge.

Do you have any tips for dealing with insomnia?



Wednesday, August 27, 2014

I Got Hit In The Head By A Bocce Ball

So, I've been too busy living life in the past couple of weeks to have time to write about it.  I am working as a virtual assistant to the event production company that put on the Los Gatos Fiesta de Artes and they kept me very busy leading up to that event.  This gig has led to me being referred to two more clients.  Yay!  I'm delighted that I'll be getting more hours, right when my daughter starts preschool.  I don't think I would have considered taking on more work over the summer.

Our Family Reunion

Last weekend we hosted a family reunion at my parents' place in Canada where we spend every summer.  When my cousin Maria first suggested a reunion we debated where to have it and when.  We settled on August 21-24 because we knew that another cousin, Kiwita, would be in town to run the Sea Wheeze Half Marathon in Vancouver, and that she would be bringing her 3 kids.  Everything started to fall into place.  Maria, my mom, my sister and I all decided we'd train for and run the half marathon too.  A few local friends planned on running it too, and we all got pretty amped up about the idea.  I described my training schedule here.  Training went really well until I got tendonitis in both achilles tendons.  I did a 9 mile run at the track and it took over 2 weeks for me to recover.  It pretty much always hurts to walk now.

I Got Hit In The Head By A Bocce Ball

My parents live on 5 acres, so we set up for badminton, croquet, and bocce.  We have an awesome fire pit for night time bonfires and smores, and enough outdoor tables and chairs for everyone to eat outside comfortably.   All our meals were pot luck and it worked out great.  The kids and adults enjoyed the games and there was no stress and no drama.  As I've mentioned before, my family has the capacity to do drama Jerry Springer style.  Friday afternoon was our main event, with games followed by a potluck supper.  In between dinner and dessert I got involved in a couple of games of bocce.  We had just finished, and I was bent over to pick up a ball when my 7 year old nephew threw one up in the air and it landed on my head.  The sound was sickening, I'm actually sweating and nauseated just typing this.  It also hurt.  I went inside and put an ice pack on the bump that was coming up, and I was grateful that it was a bump and not a caved in spot.  Two of my aunts are nurses and I went into a full on anxiety attack as they discussed the possibility of a concussion and/or brain bleed.  Auntie Ann was staying with us so she decided that she would wake me every two hours to ask me questions and make sure that I didn't need to go to the ER.  I probably got about 3 hours sleep.  And this was the night before our half marathon!

Fun in the Sun!

Running A Half Marathon With A Concussion

Mom and I got up at 5am and my sister picked us up 20 minutes later to drive to Vancouver.  At this point, I planned to mostly walk it because of the concussion.  For a few minutes when I first woke up, I seriously considered rolling over and going back to sleep.  I'm glad I didn't.  Mom and I got into the corral with the last group, along with Maria, Jen and Tina.  The energy was overwhelming and I couldn't help it, I had to try running.  Mom and I jogged with walk breaks for the first 12km and then my achilles tightened up so badly that I couldn't run.  I wanted to quit a couple of times and nearly got off the course before we headed into Stanley Park along the sea wall.  I told Mom to go ahead and run, but she wouldn't leave me.  We limped across the finish line.  Not the result I had hoped for, but I'm proud of us for finishing.  The event was fantastic!  I'd love to try again next year.  I can't believe I'm saying that.  By the end of the race I was smiling on the outside, crying on the inside, and swearing I would never do it again!

Photo Source