Heart Fixed · Sun Mar 12, 06:14 AM
I went in for surgery. Had to get up at oh-dark-early; I was worried about not waking up, so I set a back-up alarm using my Screaming Meanie alarm clock (which I’d purchased for my polyphasic sleep experiment), but I woke up nine minutes before my regular alarm clock went off, so it wasn’t a problem. Got dressed, packed up a backpack for the overnight stay, and headed off to the hospital. I was having the procedure done at Methodist Hospital in St. Louis Park, at the recently-opened Park Nicollet Heart and Vascular Center. The nurses got me all changed into a gown, drew blood for labs, hooked up an IV, and sent Angel off to the waiting room.
My electrophysiologist, Dr. Guo, came in and discussed the procedure with me again, and was fairly unhappy with the fact that I’d taken my calcium channel blocker that morning—I’d specifically asked about it when talking to the prehospital briefing people, and they’d told me to take it. I suspect a serious ass-chewing in the offing for somebody out there. It turned out not to be a problem, though, as far as being able to reproduce the tachycardia during the procedure.
They wheeled me into the cardiac catheterization lab, transferred me to the bed, stuck about 700 patches on me in various places (for heart monitoring, emergency heart restarts, and who-knows-what else), painted me with some blue-green stuff for sterilization, and told me that I wouldn’t be having any conscious sedation, at least to begin with, as they didn’t want to have any difficulty reproducing the tachycardia. They loaded up my three catheterization sites (neck and both sides of the groin) with lidocaine, which stung a bit, and fed the catheters in. The neck and right-side groin sites were not bothersome, though it was really weird feeling the catheters going in…I could feel little movements in various places in the veins leading to my heart, kind of like fish swimming around inside. Squicky. The left-side groin was pretty painful, though, even after a second injection of lidocaine. Felt kind of like they were digging around inside me with a spoon.
Once they got the catheters into my heart, they started playing with my heart rhythm. This was…an experience. Fast, slow, skipped beats, PVCs, PACs—all got to come out to play, and it was definitely interesting. Sometimes I felt really short of breath, sometimes I got a little chest pain, most of the time I felt fairly uncomfortable, and a couple of times I was ready to black out. They found out what they need to know, though. It turned out that my problem was “AV Reentrant Tachycardia” (AVRT), which is the cause in about 20% of PSVT (Paroxyxmal Supraventricular Tachycardia) cases. AV Nodal Reentrant Tachycardia (AVNRT) is the cause for about 70%. In AVNRT, extra electrical signals circulate through the AV node itself; in AVRT, there’s actually another electrical pathway in an entirely different part of the heart. Generally, the effects of AVRT and AVNRT are the same, though AVRT tends to produce higher heart rates during tachycardic episodes. The extra pathway also turned out to be on the left side of my heart, which meant that they had to swap out some of the catheters, and they had to pierce the septum (central wall of the heart) to get to the pathway. Transseptal ablations also have a higher risk of causing blood clots, and hence thromboembolism (strokes and such), so they had to load me up with Heparin, an anticoagulant.
Once the heparin had taken effect and they had done their catheter-swapping and such, they started the burning process. At this point, I started getting a fair bit of chest pain, and (thankfully) they decided that it was now OK to give me some Good Stuff. I don’t remember much of the actual procedure from this point on, except for a few moments of clarity when discomfort got extreme—at these points, the excellent angel of mercy running the drugs would give me more of whatever it was that kept me from feeling pain 
. From what I was told afterward, they kept burning the pathway, and it kept being quite capable of producing tachycardia. They ended up burning five times. The usual procedure lasts 2-3 hours, but mine ran about five. Go, go, strong heart 
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I came back to sensibility in the recovery room. Angel came in to hang out with me while I waited. Due to the heparin I’d had, they couldn’t pull the sheaths from my veins for a couple of hours—they had to wait until my blood would clot, or I’d spray like the Bellagio fountains. They brought me some food, but it was painful to swallow due to the sheath in my neck vein, so I only managed a few bites of sandwich and some grapes. They gave me some codeine to help with the pain while I waited for clotting factor. Once my blood was able to clot sufficiently, they gave me fentanyl, and pulled the sheaths.
I’ll pause here while you think back, really hard, to the worst pain you’ve ever felt. Depending on your life experience, of course, that could be one of any number of things. However, I’ve found that it’s hard to really get a mental grip on a level of pain you’ve never actually felt, so it’ll suffice (and, of course, you may have felt even more pain than I did at this point…though I’d be think that if you felt it for too long, and had any ability to actually move, you’d have taken your chances on eternal damnation, and committed suicide).
That pain you’re imagining right now may be a good indicator of what I felt when they pulled the sheaths out of the veins (from what I hear, kidney stones and childbirth rank really high on the pain scale, so if you’re mentally there, you’re in the right place). The Good Stuff had worn off long before, as had the lidocaine. They had to loosen up the sheaths, first, as they were a bit stuck in place, and then pull them out. Words fail me: I don’t have any metaphors for it. If there’s a worse pain out there somewhere, I don’t even want to know. Angel said that it was really hard for her to watch, and she works in the ER, so she sees some rough stuff. Fortunately for sanity, it didn’t take too long, and once the sheaths were out, it abated quickly.
The nurses provided direct pressure on the sites to stop bleeding, which was painful, but nothing compared to what had gone before. They bandaged me up, collected up various gear and such, and transported me off to the cardiac monitoring unit for my overnight stay. I was able to eat a full meal here; Angel went and got all the kids to come up and visit me. I managed to keep my eyes open long enough to hug everyone, and passed out for about 12 hours, with a few intermissions for urination.
They let me go home the next morning, and I’ve been recovering since. I’m supposed to avoid strenuous activity for a few days, and can’t lift anything heavy for a week. The catheterization sites are a little sore, the left groin more than the others, but it’s not too bad. The biggest effect at this point is that I’ve been sleeping a lot. Usually I do fine on about 6 hours a night, but I’ve been packing in 10-12 hours/night since the surgery. I’m going to keep giving my body what it asks for, though, as it’s proven quite well that it does what it wants, and I don’t want to give it any cause to smack me around 
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I haven’t had any heart issues since the surgery, so far. There’s supposedly about a 5% chance that the tachycardia will recur in the future, so I’ll be keeping an eye on it, but hopefully it’s all over and done with. Hope you enjoyed reading this a lot more than I enjoyed experiencing it!
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