• Tony Dymock

Heart 01 - Diagnosis: PSVT

Come, children, have a seat. Allow me to regale the story of Tony's heart failure, where it came from, how it happened, and what it actually is. So. Many. Syllables. I'd like to thank Google for helping me with this one. It's called PSVT. Pa-rox-sys-mal Su-pra-ven-tri-cu-lar Ta-chy-car-di-a. My Year 2 teacher would be proud of. At least I hope so. I THINK I broke that up right ...


Let's do a timeline of this. I think that'll help best.


The Timeline of TERRAHHHH!

Wednesday - January 23, 2019


After a month of pain and misery from a tear in my right AC joint (translation - shoulders fucked), I succumbed to the wishes of the sports physician/wizard and had a cortisone injection. Now, I don't like needles. I also don't like painkillers or drugs. So mixing the two of them together is a double dislike. Still, within hours of the shot, my shoulder started to feel a heap better. Great stuff. 14 days off weights entirely, and then get back into it lightly.


Lurking deep in the heart of my molecular structure, something else was awry. About 10pm this night a strange thing occurred. While watching TV, this fleeting rumble in my chest occurred. And I felt hyper alert. Like I had 10 Red Bull's and I was jacked, ready to take on Conor McGregor in the ring. But I'm sitting on the couch. Did I imagine it?


Huh ... It's late. Time for bed.


Thursday - January 24, 2019


Man, what is sleep? I didn't get any of that. 515am. Time for the gym. Get my ass to the gym, and we're working hard. I'm doing ring rows instead of pull-ups, sit-ups instead of toes-to-bar, keeping the shoulder inline.


And there it is again. A huge adrenaline dump, followed by a fluttering in my chest. Dr Google tells me that palpitations could be a side effect of cortisone but should resolve on their own. It was just one, and maybe I'm imagining it. Meh, off to work.


Friday to Sunday - January 25-27, 2019


Ok, something's not quite right. This feeling is hitting me a few times a day now. The best way I can describe it is like this ...


You know when you're being a moron and not paying attention, but you want to cross the road? So you don't look, you just step, and all of a sudden there's a car there on the horn, and you nearly unleash the Kraken in your pants. That spike of adrenaline, the fight or flight response, that primal instinct that's supposed to keep you alive. And it's gone in less than a second. Back to normal. That instinct kicked in for NOTHING.


Now imagine you're standing at your super ergonomic standing desk at work, or sitting on the couch at home, and you're getting random fight or flight responses. Weird, right? Fitbit isn't showing anything. Maybe it'll wear off ...


Monday to Thursday - January 28-31, 2019


Like the endless drum beats of a shitty garage band, my heart went from misfiring a couple of times a day to a couple of times an hour. At the gym, my Fitbit is tracking from 120bpm to 200bpm and back down. Every, damn, session.


By Thursday night, I was ready to admit something was pear-shaped. Maggie and I were watching TV, and I had to lie down on my side. We're at adrenaline dumps a couple of times a minute now. I'm exhausted. Life is a struggle. But maybe, just maybe it'll be okay tomorrow ...


Sleep eluded me tonight ...


Friday - February 1, 2019


I really wanted to go to the gym today ... But ... Somethings not right. Busy day at work though, so let's get after it.


The workday starts at 0830 for me. By 0930 I'm light headed, my heart is breaking, adrenaline dumps are now every 10-15 seconds, my chest is ready to burst. I tell the HR guy, and he drags my sorry ass off the to hospital.


So adding to my trauma is white coat syndrome. My usual resting heart rate of 55bpm is now around 128bpm. Fitbit doubled my resting heart rate in 48 hours.


The triage nurse is feeling my pulse now, and the flutters are doing their thing. I can see a look of amusement shoot across her face. I could tell this was going to be the start of a fun ride ...


I'm rushed into the resuscitation bay and connected to an electrocardiogram (ECG, or EKG for our American friends), and within seconds the alarms are going off in my bay and the nurse's station. The words TACHY are flashing across the screen, and for the first time, my heart flutters are visualised.


At least I wasn't imagining it!


Beat ... Beat ............... BEATBEATBEATBEATBEAT ............... Beat ... Beat


With every BEATBEATBEATBEATBEAT, the air raid sirens would blare, and the nurses would swoop in like the Luftwaffe at the Battle of London. More text was appearing on the monitor now. TACHY, BRADY, PVC, AFIB. Pretty sure that's not normal.


"When you do the gas analysis, make sure you put it through the narcotics panel too" - said some doctor to a nurse, who then comes in and draws some vials from my arm. Hey now, that's some A-grade stereotyping. Just because I'm chatty while my heart is trying to kill me does NOT mean I'm a raging coke fiend on a comedown from a 3-day bender.


Shortly after a doctor comes in with some news. "So we can't find anything wrong in your blood, I've called a cardiologist, and we're going to do an echocardiogram to see what's going on in your heart. Try not to stress, you're in good hands. We're going to give you some beta blockers to calm your heart."


I mentioned before that I don't like drugs. I don't like not being in control of my own body. Well, I don't have the years of knowledge to describe what beta blockers do, but I can tell you they are the exact reason I do not like medication. Sure, it calmed my heart rhythm. But it may as well have killed me. All I wanted to do was lie there and be left alone. No motivation to read, or talk, or do anything. What a shit existence that would be, if those meds would be required the rest of my life ...


So it's now 3pm, and this huge ass machine is dragged into my ward. It looked like a Dalek from Dr Who with all these cables and hoses coming out of it. This is the Viewer of Hearts, the Lord of Echocardiogram. A lovely older nurse is here to do an ultrasound of my heart.


45 minutes of clicking and whirring and pushing on my chest, popping my aorta through my throat, and really digging into the underarm, this nurse leaves without giving me any more info. "Don't worry, you're in good hands" I have to keep reminding myself ...


The beta blockers are in full flight now, and I'm ready to melt away like a slug in a bucket of salt. And BAM! A wild Doctor has appeared! "Ok Tony, the cardiologist is on his way in to see you. We're going to take you up to the ward."


Still won't tell me what they think is wrong. Fuckers ...


I'm lying in the ward for a bit more, I have a few visitors from work and some lovely friends who saw my random rants on Instagram pop by. I wish I could thank you personally, but I was so spaced out I can't remember who you were ... In fact, the rest of the afternoon was a blur.


By 7pm the cardiologist has arrived. My meds are switched from beta blockers to something called flecainide, which targets my issue explicitly, and I'm going to be kept overnight. While he's talking, the ECG is spitting out its silent alarms which I can see right behind him.


"The way the heartbeat works is a node in the top of the atrium shoots a signal to the top of the ventricles, which causes the heartbeat." TACHY. "What appears to be happening in your case ..." TACHY "... is the signal is re-entering the bottom node ..." TACHY "... which is causing your tachycardia." TACHY PVC "Oh and that is a Premature Ventricular Contraction, which helps us understand what's going on."


Let me tell you, it is a surreal experience to stand around a monitor talking about your heart, when the monitor is showing you how fucked your heart is. For the doc, this is his daily routine. For me, it feels like life and death.


By 9pm I've graduated from space cadet to full-fledged astronaut. The drugs are doing their business, and I'm sorely missing my Friday night cuddles with my cat, Tyson. Maggie has come to visit and brought me a little stuffed kitty. Super touching, given the state I'm in. We chill for a bit, watch some shows before she goes home and I get a chance to start this here blog you're reading.


Saturday - February 2, 2019


Rise and smell the ashes, Tony. It's 6am. I wanted to sleep in, but my body once again begs to differ. The Doc is back at 7am so at least he's also an early riser.


"The ECG shows several flutters throughout the night, but it's stabilised. We're down from every 15 seconds to every 30 minutes or so. Stay on the Flecainide, we'll see you in a few weeks and plan our next move. You're going home soon. You're ok to go back to the gym but don't push it."


Relief. It's as if Arianna Grande had just serenaded me. I'm going home. Not in good health, but at least I'll be in my own bed.


I'm left with discharge paperwork that says "Diagnosis: PSVT".


Now that I've finished this long ass post, I'm going to research precisely what all this means.

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Prahran, Victoria, Australia

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