My obsession began when I was in my teens unfortunately. A doctor, whom I liked a great deal, added to that obsession, certainly with unintended long-lasting consequences.
In my early teens I had begun to have some incidents of extremely high heart rates, 175bpm at one doctor visit.
That scared me of course, and the fear only worsened the problem. When that doctor who I had been seeing suggested that I seek psychological assistance, my family rejected that notion. Their intention was not to harm me but rather to protect me, perhaps from long-standing stereotypes about mental health issues, but more so during that period of our lives likely from the negative light in which the church we were attending viewed seeking “counsel from the world.”
The doctor we chose next, based on a friend’s recommendation, was a good man, kind, sincere. He ordered a 24 hour Holter monitor and an echocardiogram for me, and he suggested that I monitor my heart rate for one week as well, recording my pulse whenever I felt that my heart rate was becoming rapid. It was at that point that I began to focus intensely on my heart and what it was doing.
The Holter monitored showed PVCs, what he described to me as “the extra beats you feel.” He told me that nearly everyone experiences them, and some of us have the misfortune of noticing them. He also said that the echocardiogram was normal. It didn’t show mitral valve prolapse the primary concern of his as it causes palpitations. My heart was basically healthy.
Throughout my life, that news has never reassured me to the extent that one might think it would, nor to the extent that I would have thought it should.
I was monitored again in 2009 after another round of intense and frequent palpitations with much the same conclusion, basically a healthy heart, PVCs that are inexplicable and just part of my life.
I had another memorable bout in 2013, during a very stressful time in my life while finishing the Bachelor’s degree in exercise physiology at EMU. My doctor suggested a stress echo and monitor, but since she wanted to do the stress echo first, I declined. I had just spent a week doing observation as part of my course work at EMU. Every time someone had a stress echo, they finished their testing session by vomiting. One patient was even taken immediately to the cath lab. No, I decided; nothing good comes from having a stress echo.
I continued to notice the PVCs, skipped beats, or “extra beats” on and off throughout the years, as I have nearly all of my life.
During the last month, they have become worse again, and more recently they began to seem to change a bit. Whereas I used to be able to get them to stop by breathing consciously or changing positions, I could no longer make them stop.
On a recent Saturday afternoon, I found myself walking close beside my husband through the sliding doors of our local emergency department.
The last time I went to the emergency department, we weren’t even married – so over 15 years ago. It was the weekend then as well, and I had a UTI, and I knew it. I just needed the meds. Now, if one has a UTI one can likely do a virtual appointment and get a scrip called in for the antibacterial, no need to go sit at urgent care or the ED.
As I went through check in and triage this time, I kept wondering what I was doing in the emergency department. Last time I knew, this time was different. I believed I would be released that day, but as the triage staff discussed doing an ECG and took me immediately back, I knew that this could go several different ways.
Enough of my family members have had heart issues, serious ones like heart attacks, that I knew that I would have an ECG and a blood draw.
The ECG was done immediately. The blood draw came after the doctor was in, but I saw that troponin had been ordered STAT when I later looked at my lab results in my patient portal.
The nurse who had been assigned to me told me a chest x-ray had been ordered. Transport came to get me for the x-ray. As we wound our way through the dim and deserted corridors of the hospital to the imaging area, I became afraid for the first time during that visit.
I was alone then. I was placed into a curtained area, though for a very short time. I didn’t know when I would get taken back to the room where my husband was. I didn’t know if the doctor had ordered anything else that would call for the need for me to be wheeled through those sterile and lonely hallways to some unknown destination in the windowless world of diagnostic and treatment areas.
But I was returned to my room quite quickly, and for that I was grateful. I was also discharged after about three hours.
The doctor said that I had “checked out quite well.” Several incidents of PVCs registered on my monitor, some even with the monitor alarming at their frequency or pairing. The doctor affirmed that they are real, but they are something that will once again need to be monitored “out in the world” during the course of my normal daily activities.
Soon I will be wearing a monitor again. We will see what comes of that. Often, there is no explanation for PVCs when the heart is determined to be otherwise healthy As one heart rhythm specialist put it in a column I read, “It’s best not to try too hard to understand PVCs. We often don’t know why they come, or why they leave again.”
As I lie in bed that night after having been released from the emergency department, I thought about the emotional toll it had taken. It was not as though it was traumatic. It was much more subtle.
Both my dad and my mom have been in the ED, mom fairly frequently for a time. I thought about them. I have thought that they are braver than am I, and I believe I found my assessment to be correct as I remembered those dim and desolate hallways that I encountered on the way to imaging, how lonely I felt, and how out of my control my life felt in those moments. I wondered how they did it.
Not only did I feel like I wasn’t all that brave, or as brave as I would have liked to be, I also felt like I had left a great deal undone. I started to think about what would happen if didn’t get cleared to leave that night.
Once we had decided to go to the ED, we just left the house, me assuming I would be back in a few hours. But what if I hadn’t come back after a few hours?
We have finally made it to our new town, settled in our forever home. I wanted to go home, to be with the family, and my pets, who would be there without me if I got admitted.
Worse yet, I had started to think just a little bit about the big “what if.”
I certainly wasn’t ready to die, not after being so close to seeing all of the pieces of the puzzle finally coming together like we had hoped, with not only us settling into our new place, but also with my husband’s family and my family having done or about to do the same.
I want to enjoy all of what we hoped was ahead, more time with the people we love, more good memories to make, more success to be found.
Then I thought about the pressure I had been placing on myself, not just recently but really all of my life, and I began to wonder if all of this was my fault. PVCs, like so many health issues, are made worse by stress. What if I was in this surreal space in a strange hospital because of me!
As I tried to sort those things out in the darkness in my bedroom that night, I was grateful that I was able to be back in my own room, but I was also saddened and somewhat confused by the thoughts and emotions that had arisen based on a relatively benign visit to our local emergency department.
As I sort this out through writing, I have no cathartic revelation to share. I suppose I have more sorting and thinking to do. Perhaps my thoughts will lead to some action – and likely – some changes.
I am a person of faith. I am working with a therapist both privately and in group to better my mental health. I continue to work to address my physical health through exercise, nutrition, and this year weight loss.
Perhaps it’s not change but continued progress that I seek, because after all, as long as God grants me time in His broken but beautiful world, I will be a work in progress. Perhaps giving the best I can is all I can ask of myself.
The Listener 