Yesterday, we thought that Joe's problems had been solved. His aberrant heart rhythm had been identified as ventricular bigeminy, and he was just hanging out in the peace and quiet of the hospital, wearing a heart monitor and relaxing until the elecrophysiologist came in on Monday to evaluate and treat the faulty electrical activity in his heart.
Turns out that was too good to be true.
Joe had a neurology consult today to definitively rule out a stroke. Just like the doctor yesterday, the neurologist said it was almost certainly not a stroke. She did, however, rule something else in. If that turns out to be the case, Joe will have to manage it for the rest of his life.
Joe's more private than I am, and I've probably already shared enough details to make him uncomfortable, so I'm not going to share exactly what she's looking for. I'm sorry I can't share more, Dear Reader!
The neurologist scheduled some tests in the coming days, and said that we'd need to make an appointment with her in two or three weeks to go over the results. It was bad news, but it's manageable.
Unfortunately, her bad news was was quickly eclipsed by worse news.
The cardiologist who came in from home to see Joe yesterday passed the neurologist in his doorway. His booming voice clashed with his soft, kind face “You're having intermittent episodes of ventricular tachycardia, so we have to change our plans for tomorrow.”
I felt like I'd been kicked in the chest. Joe cried.
I read about ventricular tachycardia last night while I was looking for information on bigeminy, and I knew it meant that Joe's condition had deteriorated. Or maybe that it hadn't, but they didn't know the whole picture at first.
Remember in yesterday's lesson, I told you about PVCs. PVC stands for premature ventricular contraction, and they happen when the chambers of the heart fill up with blood and contract in the wrong order. When the contractions occur in the wrong order, blood fails to push through the arteries and veins.
Bigeminy means that every normal, productive beat alternates with a PVC, reducing the heart's effectiveness to half.
Ventricular tachycardia (“V-Tach”) can mean many things, but in conjunction with bigeminy, it means that there are more PVCs than there are normal, productive heartbeats. It can be as few as 3 PVCs in a row or as many as 200 beats per minute.
At its worst, V-Tach can quickly degenerate to ventricular fibrillation (where the heart vibrates instead of contracting fully) and sudden cardiac death (that's exactly what you think it is – heart failure).
And that was tonight's heart lesson (but remember that I am not an expert. I looked this up on Wikipedia, which my school librarian says is unreliable. Don't sue me.).
The doctor explained some of this, including the fibrillation and sudden cardiac death part. He didn't go into specifics (and the monitoring of Joe's rhythms takes place at the nurse's station, so I didn't see them for myself), but he made it clear that Joe's heart is going into and coming out of V-Tach frequently enough to cause concern among his doctors.
Furthermore, he said that the electrophysiologist could not evaluate Joe until other coronary diseases have been ruled out as the cause of the V-Tach. Apparently, the EP study is dangerous if other problems exist in the heart muscle or the arteries surrounding it.
Grace was weary, and she began to kick the heating unit on the wall. She was making a ruckus. We had to go.
I wanted to stay. I wanted to comfort and encourage my husband. I wanted to hold his hand and pat his arm. I wanted to be strong for him and help him to see that he's going to be okay.
Grace had to go. There was no way around it.
We left Joe crying in his room and walked to the car.
I think I felt more alone in those moments than I ever before in my life. Needing comfort and conversation and companionship, I called a dear old friend and asked if she'd meet me for an early dinner.
We talked about hearts and love and God and prayer. Grace ran around and played and laughed. After we'd finished, Grace and I headed back to the hospital where we visited with Joe and his parents for another hour or so.
God isn't too good to be true, and He has a plan. His plan is good. Maybe this is happening now so that Joe's heart can be fixed and he won't have other more serious problems later on.
I'm scared, and I'm sad, but I believe that He is going to bring Joe through.
Please pray for us.
Photo courtesy of gumdropgas on Flickr
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