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Flatlining

On November 5, 2021, my heart stopped beating. My heart stopped beating every 20 to 40 minutes for 4 to 14 seconds for most of the day. I thought my AFib, diagnosed in 1996, was acting up. I had a laser ablation in 1998 that held really well for more than 20 years. However, from July to November, maybe longer, I was having the kind of dizzy spells that led me to grab the nearest piece of furniture. When I saw the cardiologist the last Monday in October, I told him I did not feel well and had not felt well for months, at least since August, maybe longer. He told me I was in AFib and likely had been for weeks, maybe months. He scheduled a cardioversion for Wednesday. By the time I arrived at the treatment center, I had straightened out on my own—the third time I had scared myself straight.

On Nov. 5th, we arrived at the ER at 6:00 am. The nurse hooked me up to the heart monitor and was just finishing the blood draws when I had another “dizzy spell.” Although I was lying down, I grabbed the bed to stabilize myself. The nurse looked at the monitor and asked me if that was what I was feeling. It was. She ran out of the room. Within minutes another nurse arrived with a cardioversion unit and two large pads that she adhered to the front and back of my upper torso. The Dr. soon followed with a syringe loaded with Atropine. I have watched ER shows on television.

The monitor was behind me so I could not see what they were seeing. When the Dr. mentioned that my heart was “pausing,” I did not freak out. I am good to have around in a crisis, even if the crisis is mine. I knew panicking would not help. Nevertheless, as each episode gripped me, I grabbed the bedding and called my husband’s name. He and the nurse responded in unison, “Breathe, Dawn, Breathe.” And I did, using my consciousness and my breath to keep me alive until my heart started beating again.

The nurse walked me to the bathroom and stayed.

And my heart kept stopping.

By noon I was transferred to Thoracic ICU. The head of the department came to see me. I must I look like I can take a joke because his opening line was, “Well Dawn, I guess you think this is all about you?”

We both chuckled, and then he said, “I want you to know that up here we don’t panic so much when your heart stops.”

“My heart is stopping? In the ER they said it was pausing?” I responded.

“Up here we say stopping.” Then we chatted about the on-call cardiologist, when he was expected to check on me, and what my options might be. He asked if I needed anything.

“Water?” I was hopeful.

“How about ice chips?” he offered. I accepted gladly, knowing that food was out of the question until we had resolved the next steps.

And my heart kept stopping.

Shortly after the ICU head left, my book group friend Kismet popped into my ICU suite. A nurse practitioner in the Heart Rhythm Clinic, she arrived in her lab coat with a stethoscope draped around her neck, having rushed right over when one of the other bookies called her with my news. She arrived with a 3D cut-out floral bouquet, the only kind allowed in ICU, looked at my monitor and said, “Wow, Dawn that is some serious shit you are throwing up there.” And then she said, “Mind if I take a pic?” We chatted a bit, she took a selfie of the two of us and sent it to our bookie group chat, reporting to all that I was in good spirits.

And my heart kept stopping.

The on-call cardiologist arrived just before 3:00 pm, giving me a detailed explanation of what was happening--conversion pauses when my heart tried to get back to normal rhythm. He wants an echo cardiogram before he decides on options. After he left, I remarked to my ICU nurse, Tomas, that the Dr. seemed arrogant. Tomas said, “Don’t you think he has to be to do what he does?” Tomas has a point. The highly skilled cardiologist may not be as highly skilled with people.

And my heart kept stopping.

A little before 4:00 pm, a PA in training stopped by to interview me about what kind of personal or interpersonal issues might be impacting my heart. We talked about my long and difficult year, the second year of the pandemic: foot surgery for me in January with 6 weeks on crutches—no weight bearing—and 6 weeks in a boot; Robert’s 98 year-old mother died in March—he made it home to PA before she passed; emergency back surgery for Robert in April; cataract surgery for Robert in May with mild complications; his son’s wedding in SoCal in September; and through much of this time screaming pain in my shoulders from severe arthritis in the left joint. I need a shoulder replacement.

And my heart kept stopping.

The PA conferred with the cardiologist and a couple other PAs in the hallway, and the group enters my ICU suite en force. The on-call cardiologist begins to explain my options. His download takes about fifteen minutes. Ten minutes in, I ask him if I need to make a choice. He tells me not yet; he is not done explaining. Eventually he comes to a conclusion. I can try another medication. I can try another laser ablation. Or I can try a pacemaker, which will increase the options for medications. I ask him how long to schedule an ablation. Two weeks. I look at Robert. We have not discussed these choices, but I know he wants the surer intervention. I tell the cardiologist I want the pacemaker. He confirms my choice and then says, “Well, let’s see if we can get it done tonight.” Within ten minutes he has confirmed the arrangements.

And my heart is still stopping.

I have gone all day without food or water, but I tell them, “I get to go to the bathroom before surgery.” They are not thrilled because I have to unhook the heart monitor. I accomplish my business between conversion pauses.

At 5:00 pm they wheel me down the hall for the relatively minor surgery. While I was still in the ER my sister Judy sends me a text recommending the Medtronic Pacemaker. I am amused that I have a name recommendation for the technical device. The Medtronic is in fact the one he plans to use. I do not need general anesthesia; they will do the procedure with a twilight medication. For the most part it works, but I am aware when the doctor is threading the wires through my veins into my heart. I cannot figure out why he keeps pushing the device into my open wound, but I cannot wake up enough to voice my complaint. I am done and fully awake in less than an hour--done in time to order dinner from the room service menu. I thought I would always remember the meal, but I have no idea what I ordered or what I ate.

Just before lunch the next day, they move me out of ICU. I walk down the hall to the cardiac recovery unit. I stay two days, long enough to receive four doses of my new medication. On this floor, the heart monitor hangs around my neck. I am relatively mobile. A physical therapist comes by twice per day to take me for walks. I finally have a shower and wash my hair. On the morning of my potential discharge, I am once again, or still, in Afib. They schedule a cardioversion. Once again, by the time I make it to the treatment suite, I am in normal rhythm. Dave, the PA, and I decide that for me, the cure is the walk through the hallway.

Before this crisis, I was already consulting an on-line counselor. At our two-week appointment, I admit feeling more vulnerable. I did not freak out at the hospital, but I tell her that on a deep, deep level the experience was terrifying. I tell Robert that a part of me needs to curl up in a little ball and have him hold me. I spend more time on my yoga mat in Bound Goddess and Basic Relaxation poses. At my two-week post-op, I am still in Afib, but my regular cardiologist does not want to shock me right now. We hope that the medication will kick in. Eventually the medication starts working most of the time.

At our December book group meeting, Kismet shared the photo of my monitor. I saw my name on the screen. Kismet explained to all of us that the zero at the top right corner means I had no, zip, nada electrical activity in my heart during those episodes. It spooked me a bit. Nevertheless, I start going to the gym, walking a mile on most days, riding the stationary bicycle for ten minutes. I recognize that I feel better than I have for months. I can go a day or two without cocooning for an hour on the yoga mat. After Christmas, I start thinking about a couple of writing projects. I see that my life will go on.

On New Year’s Eve I text Kismet, asking her to send the pic of the heart monitor. She sends it on New Year’s Day. I did not ask for it before because I did not want that image to have power over me. At my appointment on Jan 4th, I told my on-line counselor that I knew I was going to be okay. “I am writing again.” I am conscious. I am breathing. My heart is beating. I am alive.

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