Monday morning I felt weak as I ever have. I've been slowing down over the past few years, but this was something else. I get regular check ups, eat well, put on a lot of weight in spite of that (first clue) and have had swelling in my legs for a while (second clue). The trip to the mountains in October was delightful but the altitude had a much bigger effect on me than ever before (third clue). Finally, my wife and I took on the job of data entry for the Obama Campaign at the Gloucester, VA office. We'd go in around 9:30 PM pick up the sheets that had been used to record the phone bank responses and the door to door canvassing, drive the half hour back home, and then key in data for a few hours or sometimes more. Towards the end I was getting sick and we did little for the campaign even though it made us feel guilty as hell. Well Obama took Virginia so we were absolved. Look below the break and I'll tell you what this is all about.
I have sleep apnea and sleep with a CPAP machine to pressurize the air I breath. Otherwise my sleep test said I had been stopping breathing twice per minute on the average. Sunday night, I had the thing full on and I felt like I was being water boarded. I got up Monday morning and was trying desperately to get my painting equipment together since I had to do my monthly stint being storekeeper in the cooperative Mathews Virginia Art Gallery. I finally gave up, since I could not catch my breath, woke my wife, and we went to the Walter Reed Hospital Gloucester Virginia Emergency Room.
I have been a teacher of Medical Doctors, Nurses, Pharmacists, Dentists, etc since I started graduate school in Physiology at The University of Chicago in 1963. I have seen good ones and bad ones, know when they are putting out less than they might, and am usually very cynical about the whole thing. I guess I have reason to feel that way about my own personal physician, but not the team that took care of me in Gloucester. The first Nurse was open with me as soon as she knew my background. She did not say it dogmatically, but she saw congestive heart failure. She warned me not to get upset until I got the "routine". The ER doctor also suspected the same and then he looked at the ECG and noticed the funny rhythm and missing "P" waves. Again, no dogma but a serious conversation about my history and a second ECG of longer duration. We looked at the tracings together and the lack of steady reliable atrial rhythm was too obvious to miss.
I realize that I am not a good test case for evaluating the level of medical proficiency at a place like this, but what is unmistakable to me is that I was dealing with well trained professionals who were not ashamed to expose the limits of their magic powers and were willing to engage me in their thinking process. For me as a professional as well as a patient, this was medical care as it should be.
The next conversation was even more revealing. What next? Do I stay there in a small hospital for first stages of treatment and further tests? My knee jerk response, in spite of the good treatment up to that point, Was to be apprehensive, which was not hard for them to detect. So we talked about the other options, going to larger hospitals either in Richmond or Newport news. Knowing that I was Professor Emeritus of Physiology at the Medical College of Virginia, they wondered if I'd rather be transported there. I was given some time to think on it and I realized that it would be silly to head all the way up to Richmond to my favorite Hospital. I do prefer teaching hospitals and I worked at one of the best. When they came back, I decided to stay, was admitted as in inpatient, and spent Monday night there. My heart was monitored continuously, as were other important parameters and on Tuesday morning I had an echo cardiogram which uses ultrasound to image the heart in action. To make the story as short as possible, I had an echo cardiogram a year ago and it was normal. This time there was a significant lack of emptying of the atrium which is a logical consequence of the messy rhythm observed earlier. That explains my symptoms completely. Difficult breathing due to fluid in the lungs and swelling of the legs and belly because the heart's pumping action was far less than optimal.
So I was sent home with a bunch of prescriptions yesterday afternoon and have some choices to make. I have to find a Cardiologist and I have to decide whether I will ever trust my primary care physician again. My inclination is to stick with these folks and even see if the wonderful female Family Care physician who took over when I was admitted to the regular hospital will take me on as a regular patient.
So the new year approaches and I find myself looking forward to a very different year from all the others. I know there is much more to learn about my newly discovered disease. It is somewhat satisfying to know that there were reasons I felt the way I did. Every once in a while I get treated by someone I taught. This time they are a new crew for me. I look forward to seeing what they can do.
This is going to be some year! Best wishes to all of you and to our country and world collectively.