Mind games with myself

The Thinker by Rodin

It was just over three weeks ago that I was hospitalized and here I was in a hospital again. The emergency room had changed. Last time it was Fair Oaks Hospital, this time it was the smaller E. R. at the Reston Hospital Center. At least this time I did not black out and break my nose. This time I was in physical therapy when I felt dizzy and asked to be laid flat. Donna, my physical therapist immediately started taking my blood pressure and felt my clammy skin. Within a few minutes, she had called the paramedics. Within half an hour I was in the Reston Hospital Center’s Emergency Room, my vitals being constantly monitored, the compulsory bag of saline already dripping through a tube into my arm.

This time though I was getting oxygen right away. My number was 85 when it should be close to a 100. My blood pressure trended toward the lower side. I could stand up briefly for some X-rays but most of the time I wanted to be horizontal on a gurney. I kept wanting things to improve, but it seemed no matter how much pure oxygen I was breathing my oxygen levels only rose modestly and my blood pressure stayed low.

Earlier that morning I met my cardiologist. She detected an abnormal heart rhythm that hadn’t been there three months earlier. She took my blood pressure lying down, sitting and standing. She ordered a Doppler ultrasound of my carotid arteries. And she sent me home with a heart monitor and a journal where I had to describe my minute-by-minute activities for twenty-four hours.

Why I felt dizzy while in physical therapy is something of a mystery, but it may have had something to do with simply explaining to Donna what had happened earlier that day with the cardiologist. It was weird to be there doing stretches with probes all over my chest and box hanging off my belt. In any event, some mental wire tripped in my brain and told my heart to slow down when it needed to speed up and that triggered the dizziness.

Yesterday’s afternoon and evening events had a surreal feeling to them. I was being ferried in an ambulance and trying to talk through an oxygen mask with a helpful female EMT. Most surreal of all was lying on my back in an emergency room again constantly moving between lucidness and feelings of being faint.

My wife eventually showed up, having first checked for me at the Fair Oaks Emergency Room. “Breathe deep,” she is telling me and I try. Bring in the full rush of pure oxygen and exhale but it seems to be of limited use in elevating my oxygen levels and pushing up by blood pressure. By now three weeks ago, I was nearly back to normal. Today I was still wondering if I would just pass out. If so, would I go into cardiac arrest? Would I simply die there in the Emergency Room? It seemed unlikely but holding on to consciousness seemed a challenging willful act. Breathe in. Breathe out. Don’t panic.

I learned a few things from the experience. At some point, worrying about what is going on becomes impossible. You have more immediate things to do, like stay in the present, breathe in, and breathe out. When I lapsed into moments where my oxygen levels hovered close to normal then I could worry about things. Was I skipping heartbeats? It rather seemed that way but in actuality, every third beat was not so much skipped as double-repeated. Had I developed heart disease? Was there some sort of medicine they could give me to make me feel normal? Curiously, no one wanted to administer any medicine. My cardiologist instead wanted to finish the complete twenty-four hour test, which left me lying there with oxygen gently hissing up my nostrils, mostly feeling lightheaded and more than a little helpless.

Hospitals, like the Army, runs on its own time. Hours pass in E.R. More hours pass in a staging area where for an hour or so I feel better and I eat a Wendy’s Grilled Chicken sandwich that my wife had fetched for me. Finally sometime after nine o’clock I am wheeled upstairs to a private room where many people of color are looking into my eyes, adjusting saline drips, carting me downstairs for a CT scan of my chest, and helping me to the bathroom.

A hospital night passes uncomfortably. I asked them to come in as infrequently as possible so I could sleep. One might was well ask the tide not to come in. A battery monitoring my vitals fails and must be replaced. Despite measuring my blood pressure and oxygen levels constantly via telemetry, every few hours they feel the need to wake me and take these reading manually. I awkwardly try to sit on the bed and pee into a urinal bottle. This alarms them and they rush in because my heart rate spikes to 140. Sleep is sporadic and fleeting. In the morning, I still feel weak and dizzy perhaps in part due to lack of sleep. My bag of saline is nearly empty. A walk down the hall with a nurse has me feeling wobbly-kneed.

Back in my room, I sit in a chair and try to breathe without the aid of oxygen. I still feel weak and lightheaded, but I really want to go home today. Suddenly, the cardiologist on call arrives. He has good news, of a sort. Your abnormal heartbeat is actually not dangerous and is not related to your symptoms. I do not have heart disease. Basically, I am fine. I was just having vasovagal symptoms again. My brain was telling my heart to slow down when it should not. The good news is that most episodes can be controlled through awareness and proactive strategies. My salt level is low. Eat more salt. Drink a lot more fluids. If you feel faint, get horizontal quickly. Ask for water. Train yourself not to panic. It will pass. If episodes recur frequently enough, a beta-blocker might help.

Maybe he is right. I ask the nurse for a jug of water and keep drinking glass after glass. I do start to feel better at last. I take a walk down the corridor and feel okay, but a little lightheaded. Finally, I am discharged.

Was my hospitalization necessary? It is hard to say. My physical therapist did what she thought was prudent, and I cannot say I could have made a better judgment. I did ask to lie down. I did not know I was sodium deficient and at the time, I did not feel dehydrated.

Still, the episode was undeniably scary and in retrospect probably closest I have come to meeting my maker prematurely. There were times in the E.R. when I felt certain I would lose consciousness but at least my wife was around. What if she had not been there? The E.R. people seemed to have more important patients than me. A baby two-doors down cried with a piercing sound that left no ambiguity about how he felt. My wife reported a man in another room who is passed out. He appears to be dying.

Later today after being discharged, I drove my car home from the physical therapists where it had sat overnight. I still felt a need to breathe somewhat deeply. I got it home okay but some part of me wondered if I might feel faint on the way home. I also wonder if I can convince the limbic portion of my brain to stop sending false signals to my heart. A crisis eases. Yet, an ambiguity hangs over my life now that was not there before along with feeling my mortality more sharply than ever. I wonder if my life will ever be the same again.