Saturday, October 28, 2006

keep on keeping on

Among other things, I have tachy-brady syndrome. All it means is: my heart has a tendency to beat either too fast or too slow. I'm a woman of extremes and don't subscribe to doing things halfway. What can I say.

The treatment is pretty standard: pacemaker for the sluggish heartbeat, beta blocker for the overly rapid one.

I've had the pacemaker since September 2004. I also take 100 mg of Toprol XL, daily, which should be sufficient. As the cardiovascular surgeon told me before the implant, "Between the pacemaker and medicine, that's as normal as we're going to get, for you."

Good enough.

There are things I've also learned to watch for to help keep the rhythm under control. Don't get dehydrated. Don't get exhausted. Pace yourself (no pun intended). Get enough sleep. (That's a big one.) No caffeine. Make healthful food choices.

The usual.

So it was a huge suprise when, last night, out of nowhere, no warning, watching Batman with the kids, I felt my heart lurch out of rhythm. Big time. I could feel my pulse pushing through my throat. Some keening, too-high-pitched buzz started singing in my ears, the dying whine a fly makes spiraling into a light bulb. I felt lightheaded, breathless, sapped, shaky. My breathing got ragged.

I actually put my fingers to my throat as if to push the heart back down into the cage where it belongs -- as if it were no more than a wild bird struggling to break free and fly. It felt like that, anyway.

Then I tried to count it, the pulse, but it was too frantic and disorganized. Or I was; it's hard to tell. I just couldn't catch it. Steadying my focus on the large face of my Steinhausen watch, the watch with the chronometer and dials for the months and the days and a sun for day and a crescent moon and stars for night. My heartbeat seemed to be galloping ahead of the seconds hand and that didn't seem right. Most of all I just stopped counting to lecture myself sternly: STOP. STOP. STOP THIS.

It did, eventually. I say "it," like my body has nothing to do with me, but when it comes to things like this you do have the sense that actually, it doesn't and you just have to sort of sit there and watch it happen, like being the passenger in a car with an accelerator that has a tendency to stick (and I know what that's like, too).

In short, it scared me.

I've been out of rhythm before. It's really not been that big a deal. This was -- I just didn't see it coming. I was sitting on the couch, completely relaxed, enjoying the film noir style of Tim Burton; hadn't overdone it, missed a step, nothing. It just happened.

Which is pretty usual. Sometimes, it is just going to happen.

By the time I had the presence of mind to tell my husband so he could take my blood pressure, the pulse was even and regular at a vigorous 120. Not so bad. Even still, I felt a wary reserve setting in -- a certain caution in how I got up or sat down, after that, so as not to awaken the galloping tempo again.

I can't even say I've done that much today. I've not had much heart even for drawing; mostly I've just laid around in bed, watching TV and supervising offhandedly as the boys camped next to me and drew their own pictures.

The tachy episode must have bothered me more than I'd care to admit: I realized over breakfast (reaching for the box of pancake mix in the cupboard) that the back of my left hand is dotted in that familiar rash of hives that I've gotten under stress ever since the second grade when I felt overwhelmed and buried by my never-ending coursework (my teacher kept giving me more assignments as I turned them in, instead of rewarding me with free time like everyone else; she mistook my deep-seated need to please her as an enthusiasm for learning instead).

The heart cath isn't until next Thursday, not that a cath is really going to have much to do with improving a tachy rate. But at least I'll be able to see my doctor and tell him about it, anyway. That it happened, and that it was really unpleasant.

Even if there isn't much left to be done about it, it's the telling that helps you feel like there's still some control to be had over it, after all. And that you're not just being held hostage to some unalterable biological whim. I think it's very important not to get caught up in the tricks your mind can play in such a situation. Have to keep on keeping on -- whatever that means -- but rest assured I'm going to do it.