Emergency room madness

Day 1185.

On Saturday I felt terribly run down. At 10 AM I could hardly keep my eyes open. This lasted all day.

By 6 PM I was feeling quite anxious about it. I was worried it might be linked to the VT episode from the Thursday evening. I decided to head to the hospital to have it checked out.

I drove myself to the emergency department and parked the car in the paid public parking area. In hindsight, this was a mistake. Once I was admitted to ED, there was no way for me to move my car to ED specific parking. It cost me a small fortune.

Whisked right in

I entered the waiting room and reported to reception. I explained why I was there: I had VT two days ago, and now felt really tired.

A triage nurse saw me pretty quickly. She asked me lots of questions, including do I have chest pain at least 3 times. I did not have chest pain.

I was hoping to be told that it’s not that serious, and I could head to urgent care instead. I did not want to stay in ED all night if I could avoid it. But it wasn’t to be.

The triage nurse went to discuss my case with the on-call doctor, and when she returned I was immediately admitted to the ED. She gave me a solid talking to about not having come in right after the VT on Thursday night.

I was surprised, as I always thought if you are feeling fine after the ICD treats you that you should stay home.

Telemetry and catching some Zzzs

I was hooked up to an ECG for monitoring. Nothing particularly interesting was showing up.

I almost fell asleep, but a nurse woke me up as my heart rate fell to 39 beats per minute. As usual.

The House Doctor came just before midnight to talk to me and ask me what’s going on. She had spoken with cardiologist. They want to “lay eyes in me” in the morning. She noted down what happened and how I am feeling.

I tried to sleep after that, but really struggled with lots of machines beeping and repeated blood pressure checking. Finally at 3 am I managed to fall sleep.

Speaking with the cardiologist

The next morning the cardiology registrar came to talk to me along with 2 other doctors.

He told me that there is a high chance of me having another VT within the next 2 weeks.

He told me we have three options (and no good ones):

• Reduce beta blocker - Bisoprolol. They can’t do this as my heart rate and blood pressure is already really low. Any lower and I will feel terrible.

• Increase anti-arrhythmic - Amiodarone. They don’t want to do this due to toxicity.

• VT ablation. This is a risky and complex option, as the scar causing the VT is really deep. It will be difficult to get to and it will be hard to trigger to map it.

My case is going to be discussed at the weekly cardiology pacing meeting on Wednesday. They will let me know what is decided in that meeting. In the meantime I should not drive.

I was given the option to stay in hospital, or go home and take it easy. I chose the latter.

Confusion

The cardiology nurse phoned me on Monday to ask if an ICD technician had rung me. I told her no, but that I had been to the ED and was advised by the cardiologist that my case will be discussed in the pacing meeting.

The nurse phoned me back on Wednesday to say that my case was not discussed at the pacing meeting, and that the ICD tech thought everything looked fine with my ICD and how it handled the VT.

So no need for follow up actions. I am okay to drive again, and I must have misunderstood the cardiologist.

I am feeling very confused and a bit agitated.