Posted by: wrmcnutt | September 19, 2011

Friday Night – Light’s Out


When last we left our story, I sat enthroned on a robotic chair/bed that I could bend to my will.  I could summon handmaidens who would do my bidding – bringing food and medications and my whim and will.  But there was something else – remember that intermittent afib? That came up from time to time?  Frequently?  Well, at this point, I’ve been wired up to the heart monitor for two days, and the EKG was showing nothing but atrial fibrillation.  Not a normal heartbeat to be seen for three days now.  Apparently, the half of the maze procedure that was finished was either the wrong half, or we’ve pissed something off.   And my heart rate kept – dropping.  90’s – 80’s – 70’s – 60’s . . . .

Let me tell something about me – I own what I say and do.  So I’m pretty careful.  There’s maybe a half-dozen things I’ve done of which I am ashamed.  Oh, don’t get me wrong – I’ve don’t a boatload of things I don’t sky-write across the city.  But those are things I’m only embarrassed by. It’s shame I’m talking about.  And that number went up by one that Friday night.

It was a long day Friday, watching those numbers change, and watching my afib flatly refuse to show any P-waves.  P-waves represent the normal atrial depolarization as it winds up to beat.  No P-waves.  No atrial contraction. My half-done maze procedure had not done me any good, and, in fact appeared to have made things worse. When my heart rate went into the 50’s, I called the nurse, and asked her to contact my Cardiologist and have an emergency pacemaker installed.  I got a rather firm and professional response from the night nurse that she would page my Doctor, but there was no way that she could promise me that he would order even a temporary pacemaker installed.

It was shortly after that that my heart rate dropped to zero for the first time that night.  If your heart stops beating, you’ve got about five seconds before you lose consciousness from oxygen deprivation.  It’s a really bizarre sensation – your looking at the monitor.  You’re breathing.  Really hard.  But the lights go out anyway.  I woke up a few seconds later when my heart spontaneously re-started.  When my eyes opened, I saw thousands of black dots swimming around my vision.  They clustered at the edges of things.  I tried to picture spending the rest of my life trying to read through all of those ball bearings and make my living.

The dark came again.  This time when I swam up from the black I thought I’d been having a nightmare.  I tried to get out of bed and go home.  But then I got to realize that it wasn’t a nightmare. It was real.

My extremities were numb, I could feel nothing in my face and lips.  After about five or six of those, the appropriate Doctors were, in fact, paged, and my opinion regarding a pacemaker was validated.  And so it came to pass that the lamps were rubbed to summon the catheter lab genies. (Genies not normally working weekends you see.)  And they began to gather from all parts of the city that I might have, at least, a temporary pacemaker installed.

Now comes the humor.  This is the third time that a specialist team has been assembled specifically for me, and someone else has show up with a worse problem than I have.  Just as the cath team was ready to go, an ambulance rolled in with a guy who had a tear in his heart wall.  Apparently, afib with pauses, while scarey as all hell, isn’t dangerous.  The guy with the heart wall problem, he was dying.  But that means that instead of a pacemaker now,  I will get one in three hours.   While all the time I lay in my bed, watching my heart rhythm gyrate and my rate sit around the fifties, periodically dropping to zero, and losing consciousness.  It was not my finest moment.

Sailboats have an issue powerboats do not share – they require water flowing past the rudder to control direction.  Accordingly, they must set courses that are more about enticing the wind than getting to their destination. This gets harder, the narrower passage you try to go through.  If there’s a problem, there’s no place to go to solve it. That’s why it’s important to have the sails set properly and the helm set to sail cleanly through on the first pass.  This is occasionally referred to as going through the narrow passage, or being in dire straights. A sailboat in dire straights has a number of things that need to go right for it to transit the narrow passage safely, but two components are critical.  The first is the keel. It’s the spine of the ship.  It holds everything else together, and keeps the ship traveling in a straight line.  The second is the helm, which steers where she goes.

I was in dire straights Friday night.  There was no one to fight, and nowhere to run.

My training is in the use of words.  I’m pretty good.  I can make them grind.  I can make them cut.  And I can make them burn.  You don’t get exposed to my weapon’s-grade vocabulary here, but I have one.  And Friday night, with no one to fight and no where to run, to my eternal shame I turned on the two women who were trying hardest to keep me alive.  My poor wife would wait for me to wake up, smile at me, and tell me that everything was going to be all right.  I would snarl, and ask her what the fuck she was talking about.  Nothing was “all right,” and it wasn’t going to be.  I read the monitor to her (which she can read better than me).  I explained in detail why things weren’t “all right,” and looked around for a pencil and paper to draw her pictures.  MJ, my duty nurse, got the worst of it, though.  I questioned her training, her competence, her ancestry back unto the seventh generation, and the likelihood that she would beget any descendants.  I challenged her decisions, insulted her parents – I held back nothing. She got both barrels and the extra bucket (to mix a metaphor). Each time I woke up, MJ would explain (again) how I was not going to be allowed to lie on her table with a heart rate of zero.  If necessary they had steps they could take that would force my heart to beat, but if they used them they would get in the way of what the cath lab boys would need to do later.

Do you know that neither one of them ever flinched?  Each time I woke up,  my keel was there, hanging on to my hand and clearly never, ever letting go, and my helm was calling the numbers and keeping my doctors advised.

I suspect that eventually MJ got tired of listening to my crap, because she showed up with a syringe.  “Here Mr. McNutt, this will take care of those pauses you are so concerned about.” They call it dopamine. I call it “charging rhino.”  “WHAM-WHAM-WHAM-WHAM”  That was my pulse, all of a sudden.  I could hear it in both ears as my revved-up into the one-fifties.  I ended up bridging back with my head and butt trying to find a spot where I could here something other than my own pulse.   Then she offered me some anti-anxiety medicine, and I was prepared to wait for the cath lab until such time as they were able to install my pacemaker.

I have been through the narrow passage.  But I did so because two women lifted me up and carried me through it.

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Responses

  1. Bill,
    I am not sure any of this will make any sense to you as I do not have your gifts, nor verbal tool box.
    It has not been so long in the scheme of things, that I held the hand of one of my best friends as he died. I got out of the way of the nursing staff, and went into the hall. Only a few hours earlier we had talked about this, what we meant to each other, and that he was ready if the Grim Reaper had him on his list of pickups.
    A few years later I held another friend as he lay dying of bone cancer, and helped walk him towards those veils. He had reached the points where few things mattered except for friends, his wife and his son. It was not easy to reach this point, but early in the morning, when my husband and I finally slept in our own bed together for the first time in weeks, he crossed over.
    Now, you may sarcastically ask, what do any, or either of these have to do with you. They had time, time to adjust and time to be angry. They had notice. I could be wrong but I don’t think you had the time to process all that was happening to you. You went in the hospital for a procedure that was suppose to fix a moderate problem. In the middle of all of this the bargain we make with a situation changes and we are left angry because this was ” not the deal we made.” You were fighting for your life, and more time. In that, there is often anger, frustration, and the feeling that not everyone is feeling the urgency that you are feeling. I am sure your dear wife and the nurse in question, have seen similar before, and noticed the symptoms; just the same as I knew when my daughter was going through Transition when she was in delivery. It is something you recognize when you see it. It is part of the human condition when we are at our most fragile. I am sure that they will readily forgive you for being human; you will only have to ask.
    By the way, we are thankful you have survived your walk through the shadow, and hope your time in the sunshine is long and happy.

    • Ginger –
      Thank you very much. You are very kind. When I apologized to Kelly I was so ashamed I could barely force the words out.


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