This was a hard one to write. Hopefully our experiences will be helpful to others. Where to begin. Maybe covid. My wife and I both got covid in March 2020, at the very beginning of the pandemic. Judy had attended a sewing expo in Puyallup, Washington with thousands of other older women. Due to my sewing machine phobia, I stayed with her brother an hour away, about as close as I dared. When the expo was over, the powers at be shut down the whole state, followed a while later by the shutdown of the whole world. Judy came down with the “flu” a few days later. She was miserable. I got the same bug a week later. I was just as miserable but have leaned after 54 years that it is best to not claim equivalency. The symptoms persisted for over a month but were somewhat inconsistent with the ones the CDC were telling us to be worried about at the time. After we got to feeling somewhat better, we both developed persistent diarrhea that lasted another three months. A while later when the first and unreliable covid tests became readily available, we both tested negative, so I can’t say for certain we had it, but I am 99% certain we did. Why can I be so sure? Judy’s use of spices radically changed, using a lot more. I thought that her pallet had finally matured. Stupid me. A year later when her taste came back to “normal” it had changed. She had hated chocolate all her life, claiming it tasted like dirt. The only chocolate she could tolerate was white. But after covid, I couldn’t keep enough real chocolate in the house and now she won’t touch the white shit becaused it “tastes like grease”.
I could live with all of the above except the taste bud changes were not the only change in her. Periodically she would go into atrial fibrillation. A-fib is a fairly common heart problem affecting between 3 and 6 million Americans. For those unfamiliar with how the heart functions, here is what you should have learned in high school. The heart is essentially a double pump. The left half pumps to the body, the right half pumps to the lungs. Each half is composed of a primer pump, an atrium, and the real pump, a ventricle. The atria fill with blood from lung or body veins then pumps it into a ventricle which then pumps to the body or lungs. Both sides of the heart pump in synchrony. This is why your heart goes thump THUMP. In A-fib, the atriums don’t pump. So instead of thump THUMP it goes …THUMP and the THUMPS are not regular.
The causes of A-fib are shorts in the heart’s electrical system. The bioelectrics in the heart depend on specialized heart muscle cells (Perkenji fibers) which conduct the “current” to the heart muscles which then contract. Damage to these “wires” results in uneven electrical conduction, or the current splitting off into a different circuit, or there even may be a loose wire nut in one of the hearts conjunction boxes which are called nodes. This can result in unsynchronized contractions and /or in A-fib with the atria acting like a flickering light bulb that needs to be screwed in tighter. I think the precise medical term is a twitchy fit; picture an uncoordinated Milly Cyrus twerking only less disgusting.
By now you have probably noticed that I am using house wiring as an analogy for heart electrical transmission. This is because I understand house wiring. Although I am not an electrician, nor do I play one on TV, I have completely rewired my house, sometimes twice, with the help of “Wiring for Dummies” and advice from Ace Hardware clerks. This explains why I have four light switches in my bathroom (only three of which actually work), and no heat. I have a wall heater in there but it’s for decoration only. When it gets really cold in the shitter, I can look at it and think warm thoughts. Now that is the essence of art. But I digress. OK, I lied about the heater, but I thought about putting one in, and probably would have but was talked out of it by a friend. “Bruce, if you don’t electrocute yourself or start a fire when you first turn it on, you will surely die the first time you step on the floor with wet feet. You might as well try and balance a toaster on the lip of the tub”. I think I digressed again.
The main problem associated with A-fib is an increased stroke risk as the irregular THUMPS result in turbulent blood flow out of the ventricles which is much more likely to cause clot formation and bad things can happen to your brain and lungs. Clotting risk is lowered by drugs such as warfarin or a host of more expensive alternatives. Warfarin has been around since 1948 when its first use was as a rat poison. I can only speculate on how or who discovered that in lower doses it has medical benefits in humans, but I would bet paychecks that the wife trying to slowly poison her husband to collect on his life insurance was pissed.
Contrary to what Karem Abdule Jabbar tells you, many people have no external symptoms of A-fib. Due to Graves’ disease, I was in A-fib for two years. I had no debilitating effects, other than I got a little short of breath while walking up hills at high altitudes or while running in the Boston marathon. As I live on the coast and think that people who run marathons are sick mothers, I had no real problems. After they killed my thyroid gland with radioactive iodine (AKA what a terrorists would put in a dirty bomb), I was cardio converted (CLEAR!, ZAP) and for the last 20 years my heart has been in normal thump THUMP rhythm.
Judy on the other hand had real problems with A-fib. This was because she, possibly due to covid, also developed a left bundle branch block. This electrical wiring malfunction meant that the two ventricles were not in synchrony. So instead of thump Thump, she was more of a thump TH THUMP. The result was that her heart pump was less efficient. Her body was fine with this, but when she went into A-fib the pump function was even lower. Coupled with a tendency for her heart rate to skyrocket during A-fib to 200 + beats per minute, the result was that her heart could not pump enough blood to feed her liver, kidney, muscles and brain. When this happened, she not only became a world class dizzy blonde but as a side effect she was dying.
The second episode of this stressed me to the max. We were dry camping at an isolated lake which has trophy size trout. She thought she had the flu, but by the next day it became obvious that it was more serious. In retrospect, I should have called an ambulance but her Cardia (a device which allows you to easily check for A-fib) would not work without cell reception, so maybe it was just the flu. To be safe, I decided to cut our camping trip short even though Judy wanted to stay another day so that I could catch a “big one”. Damn I married well! I admit that I was tempted, but we needed to head home where we would be nearer a hospital. All I needed to do was load the generator into the back of our truck then put the canoe on top. Fifteen minutes tops. Normally Judy would help me with both of these procedures, but she was having problems standing. No problem, I could do it myself. It soon became apparent that I could do neither without help. I walked down to get help from the campground host, but he was not there. As it was a Monday, the campground was empty. Then I started to panic. Just then a couple from California drove through the empty campground and offered to help me load it all up. I am not sure that I prayed, but they were certainly an answer to one. By the time I had got her to the Newport Hospital she was so bad that ER docs were about to put in a breathing tube and were arranging for a life flight to a bigger hospital but then settled on an ambulance ride to Corvallis instead. Damned HMOs. Lucky for us and them that by the time she got to Corvallis she was back in normal rhythm on her own. They kept her there for four days just to make sure. After she was released, we stayed an extra night in Corvallis just to be safe. In the middle of that night she went back into A-fib. Another trip to the ER and being zapped back into normal rhythm.
After that near death experience, her cardiologist referred us to a heart electrician who suggested she needed an ablation and a pacemaker. Ablation uses heat or cold to create tiny scars in the heart muscle to block the faulty electrical signals. It is most often done using thin, flexible tubes that are inserted into the heart through the veins or arteries. There are risk associated with this, such as: bleeding or infection at the site where the tube is inserted, blood vessel damage, heart valve damage, new or worsening irregular heartbeats, slow heart rate, blood clots in the legs or lungs, stroke or heart attack, narrowing of the veins that carry blood between the lungs and heart, damage to the kidneys from the contrast dye used during the procedure, and death. At this point in the fishing season, it was too late to go back to the trophy trout lake. Might as well go ahead with it.
She survived. Then a month later a pacemaker was added to fix the left bundle branch problem and to substantially increase our medical bills. After nine months of normal heart rhythm, she had her worse episode of A-fib to date. Had to have an ambulance transport her to the local hospital. Halfway there she crashed. Her heart rate set a new record, 27O beats a minute. They pulled the ambulance to the side of the road and zapped her while she was still awake. Ouch!
Our next step in this four-year ordeal was to try adding a rhythm control drug to the mix. I have been on th same drug for almost 20 years to prevent me from going back into A-fib. The original drug name, Tykosyn, was fairly new when I went on it, and extremely expensive. Eventually the patent expired, and a generic came out, dofetilide. However, the price did not come down because Pfizer, the greedy bastards, is still the only maker. Dofetilide has strong and possibly dangerous interactions with several other drugs and minor interactions with some foods such as grapefruit. I tried to convince Judy that eggplant, brussel sprouts, kale, parsnips, and asparagus were also on the list. Maybe I should have stopped at eggplant. She checked it out. Fucking Google!
Some people have a little problem with this drug when they first go on it, like death. To be safe they require you to stay in the hospital for a bit when they start you on it just in case. I was wired up to a heart monitor with Post it notes and on a IV for four days. I was fully prepared for this extended stay with movies to watch on my laptop. I might have enjoyed them but every four hours they woke me up for an EKG and less frequent blood work. I was sharing a room with an older gentleman who was undergoing the same procedure. He snored and was also being woken up every four hours for EKG and less frequent blood work. This was scheduled such that these tests occurred every two hours, day and night when the sadistic nurses came in to poke and prod us. Did you know that sleep deprivation is considered to be torcher? To make matters worse, of all the movies I had brought, the only one that would play on my computer was “Kill Bill”. This is really a stupid movie, and they don’t even kill Bill. Apparently, they killed Bill in the sequel. Could have saved a lot of throw up in your mouth moments if they would have killed him in the first one. All of this crap coupled with the bad food, my skinny ass hanging out of the hospital gown and the absolute boredom of being confined to a hospital bed while not being sick, is something that I will not remember with any fondness for the rest of my life. Twenty years later Judy only had to endure two days of this hell and complained with equal verbosity. Women are such complainers.
A month has gone by since that procedure with no recurrence of A-fib. I have hopes that we can risk going back to the trophy lake this spring. I did make a teeny winy bit of an error though. I asked her what it was like to be zapped while awake. She said it hurt like hell and that “a purple flower came out of her chest then went right back in”. Then she asked me what I thought that meant. Trust me, “the exorcism didn’t work” was not the answer she wanted to hear. The doctors tell me that my double vision will eventually improve.