Following Up

 

On with recovery, one day at a time...

 Two weeks before my follow up appointment in the Electrophysiology Lab and my memories were are still not clear. The little things are still setting me off, and I felt disconnected. unable to even read 2 sentences in a book.  But at least I'm off the pain meds.  There was just an emptiness to my brain that I do not believe I have ever experienced.  I could sit on the deck for hours just staring into the back yard, or binge on Hulu for hours without eating.  Even more unsettling is that it doesn't seem to be disconcerting for anyone else. They keep telling me that I went through a lot and it will resolve on its own, but I mean really, not only did I allow ramen noodles in the house, but I even ate some myself.

 

And then the insomnia started...

Since I wasn't needing to get up in the morning for anything, I felt there was no need to force myself to sleep.  I applied all my essential oils that typically help me fall asleep and ended up still unable to close my eyes.  My body seemed to want to be awake till 3am then sleep till 10:30am.  It was like I was reverting to my night shift nursing hours! My precious temperpedic mattress was even uncomfortable, so I would end up on the couch multiple nights.

 

Did I mention my kids were eating ramen, running amuck all over the neighborhood and I rarely saw them?? Yeah, they probably we're thinking it was the best summer ever!  I even mentioned to my MD about my lack of interest, and she shared it was pretty normal.  I was encouraged to start increasing my exercise and increase my stretching, hoping the extra activity would help me fall asleep sooner, but with minimal medicinal help. 

 

To no avail... 3 days before my last EP study, I was staying up til sunrise... On a Hulu binge. And shows I normally wouldn't watch, like Shadow Hunters and Shameless. Just crazy. Randomly watching the first episode of many series to find one that was at least a little interesting.  At least I didn't pick up a snack habit in front of that TV! I would have gained like 50lbs!

 

I will never forget the night before my follow up appointment in the cath lab. I did not sleep even 5 minutes. Had something to eat at midnight, as instructed... then just stared at the TV. nothing was left to watch that was interesting, so I went with Captain Jack Sparrow and the Black Pearl. Wishfully thinking that the swash buckelin that I've seen a million times would pull my monkey mind to sleep, but to no avail.  I found myself fearing things that I knew were completely irrational, and NOT crying about them.  Feeling sad, but numb to it at the same time.  As the sun came up, I was still staring at pirates and hearing the darkness of my mind wonder wither or not I was going to walk out of the hospital the that day.  This was utterly ridiculous.  I even have a short stent of my nursing career in the cath lab, so I have personal knowledge that people don't just die in there during routine procedures.  Why was I obsessing NOW about being afraid of the hospital??!?!  I just didn't seem to have the emotional fortitude to shake it off.  My irrational thoughts of dying seem irrelevant now, but were there all the same. 

 

As I saw the beginning of the dawn come, I was hearing my husband's alarm goes off.  Yep, no rest for the wicked... lets get this over with.... I still hadn't slept and was not actually very tired.  I kissed the kiddos goodbye that morning with that irrationally draining thought that I would never seem them again, tearing up and trying to hide it. 

 

After the long drive to the hospital...

It wasn't long in the waiting room until I was escorted to the pre-op area. I had no time to think about hunger, poor outcomes from the procedure or not getting to going home again. I was so excited to be able to take that Zoll off, and get this all over with.  

 

And this is where it got hard for this nurse to be in the flip side. To not know the plan, or the timeline, or what was taking so long. To not be able to just jump in and help get myself prepped.  We began promptly with an IV start that went poorly. Sure, I was probably dehydrated a little, after all... and I am obviously not a skinny little thing that has veins lying over pure muscle.. so all is forgiven.  As the nurse left to call the IV team with the vein finder, the tech followed to get my EKG and labs drawn.

 

Clearly my relationship with needles was being tested today. Sure enough the tech missed on the first stick and needed to reposition the needle to collect the blood, then came back an hour later to announce the need for a redraw,  as my first sample had clotted faster than expected.

This is where the day went down hill rather abruptly.

Pre-Op Rooms, Awaiting Procedure

The tech threw the tourniquet around my forearm, took approximately 2 seconds to assess my veins... And swipped the alcohol swab ON THE JOINT connecting my pointer finger to my hand. I remember looking at Inoke like he was going to have to hold me down if this went south... And it did. The tech immediately hit my knuckle with the needle and I had to everything in my power not to move. No wonder patients jump so bad, making it impossible to draw blood or place IV's.  I was able to control my jump, but not the tears that ensued.

The tech was able to readjust his needle and get the tube of blood, but all I remember was the sense of vulnerability - of shooting pain stabbing through my joint- and then the irrational fear about not coming home from earlier in the day came over me like a wave and I lost it. Right there in front of the Tech. I was convinced that the lab draw was no good and that he would be back to torture me and I was sobbing. I was running on no sleep, no food, no time frame for procedure start and no logical reason for the irrational thoughts that I was never going to go home... That my body would be rolling out feet first.

The nurse could hear me from the desk and came to try and help, but I couldn't even stop studder-breathing long enough to answer her questions as to what was wrong and what happened. I was able to get my break-down under control, but as I did the team showed up to place my IV.  Worse of all?  My poor husband was sitting in the corner knowing I was struggling and not knowing what to do.

The IV went in without a problem but as soon as I was mentally reconnected again, and then a wave of sorrow hit me again. This continued for 2 hours... Relaxing, deep breathing and collecting myself - followed by uncontrollable weeping.  Luckily, my loving husband knows that music has a way of centering my conscience and he handed me my wireless headset so this whole fiasco. With Lauren Daigle cooing in my ear and my Vetiver essential oil permeating the room, I was able to relax (and actually sleep for a little while) before the cardiologist finally arrived mid-afternoon.

 

Sure enough, the nurse had shared with the cardiologist my little mini mental breakdown. He came to do my pre-op assessment and shared that I had every reason to be fearful and to cry whenever I needed to. He reminded me how extremely fortunate I am to still be alive and that most likely I was experiencing something similar to PTSD (post traumatic stress disorder). It really helped when he reminded me that God did not create our bodies for such invasive procedures, therefore he did not prepare our minds to be able to comprehend the stressors that go with all of these medical miracles. I found his bedside manner to be very calming, and appreciated his references on his views of how God ties in to modern medicine. Before I knew it I had a new calm over me that I had not experienced that day. The doctor assured me that he was very confident that no additional work would need to be done today. He also shared with me again that my first ablation took all four cardiologists 9.5 hours to successfully complete.  And because of this he would probably have me come back a different day if there was additional work, so that we didn't burn the midnight oil again.




Somehow this was not as reassuring as it was intended.

Before long I was saying goodbye to my husband and rolling down the hallway to the cath lab. My face felt warm and puffy from sobbing all afternoon, but I felt reassured by the medical staff that all was well. They did an amazing job of asking me questions about why I smelled so good, which essential oils I loved the most, what kind of nursing I have done in my career and overall distracting me from their work setting up of the lab. 
 

The procedure....

I wish I could say I had enough drugs to not remember this procedure, like I did the first two. But this one was uncomfortable, or maybe it was just my residual over emotion from the entire day. I will not tell you it hurt like actual surgery would, because it didn't... but it wasn't a cake-walk either.  Electrophysiology studies are conducted to assess the electrical pathways of the patients heart and find the origins of arrhythmias (funny little beats).

I did not put much thought into how the patient feels during this procedure when I was the nurse pushing the drugs.  I had originally always thought that the discomfort came from the groin, were the catheters where going in and out. I was clearly wrong.  I certainly do remember feeling something moving around in my chest as they advanced and readjusted the catheters.





After much manipulation of my groin and internal tickling of my chest, I suddenly was feeling my heart racing.  It only lasted a couple of seconds, and it was only three times, but it was not something that was particularly comfortable.

Example of what a Cath Lab looks like (not the one I was in)

The most vivid thing that I will never forget is the feeling of the drug adenosine running through my body.  I have personally administered it to many patients over the years, under vigilant supervision of the on-call physician, to help slow someone's heart rate in an urgent situation. This medicine essentially stops your heart from beating long enough to let the electrical pathways reset and then allows the heart to start beating again on its own. Kind of like unplugging your computer, then plugging it back in.  The pause is only 2 to 3 seconds long, but what I didn't expect was the pain. It had felt like an elephant sat on my left chest and rolled across to my right shoulder and then sat up over my legs, manifested by a warm pain shooting through my body.  I think this is how dying tissue must feel like.  It was over in a matter of seconds, but then I heard the physician call for a double dose to be prepared.  Having given this drug in the past, I knew that this was part of protocol in those situations, but didn't know this dosage combo was used in electrophysiology procedures as well... and I really didn't want an encore. I have a new level of empathy for every patient that I've ever administered this drug to.

This was by far the worst part of the procedure, after that final push of adenosine it was easy-breezy and I was even able to snooze a little bit here and there. The doctor had great news by reporting that the area of the ablation had healed well and no electrical pathway had re-grown.  No further procedures would be needed to burn more pathways, and I was not going to need an internal defibrillator.  My heart appeared to be recovering well. Unfortunately, he reported that my internal blood pressure readings were still slightly elevated and I would need to remain on my cardiac meds until my next clinic visit (though I attributed this anomaly to emotional distress)... Relief washed over me the next moment when I was told I no longer needed the Zoll Defibrillator.
 

The best part of the day was that evening when I was able to walk out on my own. Face puffy and warm from all the tears; my eyes had that burning sandpaper reminding you of how bad the day was.... but I felt more at peace than I ever have. 






Can't wait to tell you more <3


Angie