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WHO’s THE BOSS?

May 14, 2014

Many of us become a little nervous as we walk through the clinic doors.  We hope the doctor won’t rock the boat and tell us things we don’t want to hear.

Sometimes though, alarming symptoms come on suddenly and increase our anxiety dramatically.  I had just such an experience a few months back…

My heart was doing this jitterbug thing inside my chest.  Every day, many times a day, for roughly two months… right up until the day I was scheduled for cardiac tests.  Then it ceased the dance and behaved itself;  for three whole days.  Once the threat of committing cardiac misbehavior to my permanent record passed, my ticker resumed its jitterbug.  In fact, it partied up a storm inside my chest.

It all began with a couple of falls.  The first time, I awoke to the call of nature.  I stood up quickly, only to find myself breaking a fall a second or two later.  I hit my head on the corner of the closet doorway.  I went back to bed, I wasn’t concerned enough to give up precious sleep.  Later, my alarm jangled, and I arose to shut it off (it sits on my dresser across the room to ensure that I actually get out of bed)… then I fell a second time.

Later that morning Jim took me in to Urgent Care.  We were a little concerned about the combination of cardiac symptoms, two falls (and the resultant bump on my head), and the tired feeling with lack of energy that I had been experiencing lately.  

I was told that I might be a little dehydrated.  Doctor’s orders were to drink more water and go to the emergency room if my heart re-started its jitterbug.  

That didn’t take long…

A mere thirty-six hours later, in the emergency room,  it was determined that I was having many PVC’s (premature ventricular contractions;  extra beats).  PVC’s are usually harmless, but need to be checked out to be sure.  Especially if a person has fallen for no apparent reason.  I needed to consult my primary physician who in turn ordered cardiac testing and referred me to a specialist.  Both doctors wanted me to return to the emergency room if cardiac symptoms returned and they clearly ordered me to avoid stimulants of any kind;  no chocolate, no sugar, and worst of all:  no caffeine.  

I paid them to tell me that…

I offered a compromise;  they could have the chocolate and sugar, but I wanted my coffee.  After all, I reasoned, I had given up alcohol, cigarettes, and sweets.  They couldn’t expect me to give up everything!  

Both doctors were kind about it, but caffeine stayed on the naughty list, nonetheless.

Since it was my heart we were talking about, I begrudgingly followed their advice.  I avoided stimulants and visited the emergency room when symptoms were most persistent.  

The majority of the doctors took me seriously.  Once, when I was having near constant PVC’s, my primary doctor told me to go back to the ER to be checked out..  The doctor there was a bit arrogant… he blew off my cardiac concerns and told me I was suffering from anxiety.  He surmised that I was just upset because my mother died at my age.  He told me to go home and take Ativan… ‘take two if you want,” he said.  

I might have bought that if I wasn’t chemically dependant (clean and sober for 27 years and counting)…  And if I didn’t know that something just wasn’t right.

A week or so later, I saw the cardiologist, a woman who smiled pleasantly as she advised a diet of 80% -90% fresh fruits and vegetables, more whole grains and legumes, and less red meat to improve my lipid profile.  She said that eating dark green leafy vegetables every day would improve my numbers.  She would have liked me to start a medication to lower my cholesterol, a statin, but I wanted to try diet and lifestyle changes first.  She ordered me to avoid stimulants until we knew why my heart was doing the jitterbug. Then she ordered a 30 day event recorder, and referred me to the electrocardiologist for my rhythm issue.

After I finished the event recorder, I saw the next doctor, the ‘electrician,’ who walked in saying, ‘This is real.  I believe you.’  

I nearly fainted with relief!

He explained that my arrhythmia was related to hormonal changes in my body, to which I responded “Menopause.”

“NO!  This is common in your age group, but it is not part of menopause.  The good news is that it is not harmful in any way.”

I was encouraged.  I dared ask, “Coffee?”

He replied, “You can drink coffee.  It has no effect on this condition.”

I listened as he explained three treatment options.  First, I could do nothing, my condition was not harmful but did zap my energy. Second, the doctor could perform an ablation and cauterize the node or nodes in my heart that were causing the extra beats, permanently putting them out of commission.  Thirdly, I could take medication to control the symptoms.  

He advised taking a prescription to control the PVC’s and I agreed to give it a try.  As a result, my quality of life is much improved, and I have my energy back.

Reflecting back, I realize that things were happening over which I had no control and I didn’t like that feeling of being in a vortex, spinning erratically.  For a moment, I even slapped the big red ‘V’ on my forehead and briefly saw myself as a victim.  

I heard people telling me what to do.  They gave me orders.  

And worse yet, I paid them to do that…

Then, I had an epiphany…  

It dawned on me that no doctor could order me to do anything.  They could only make recommendations.  Mere suggestions based on their knowledge and experience.  I knew that they were most likely correct, but it still rankled.   

I sought them out.  I asked for their expertise.  Still, I stubbornly clung to the thought that they couldn’t make me do a darn thing.  I had to find a way to use that stubbornness to my advantage.  The Finns call that sisu.  

Only I can change my diet and lifestyle.  Only I control what goes in my mouth.  I am the boss.

As it happened, I gave the doctor’s recommendations a lot of thought.  I talked to my husband and several close friends.  We carefully weighed the options and in the end, I chose to follow the doctor’s advice.  I chose to avoid stimulants.  I chose to change my diet. Those were their recommendations and my choices;  my life is better because I chose to take that path.  My lipid profile is much improved, my energy is back and I feel good.  I have lost weight, and my body mass index is now within the normal range.  That last doctor actually told me I was not overweight.

And I can drink coffee.  

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