I've been debating with myself for a few days whether or not to write about my eventful Tuesday at the University of Michigan. Afterall, I'm taking it easy resting at home. (I lie! I couldn't resist reading emails and working just a leeetttle beeeet.) Plus in the course of making my decision, I couldn't find much about others' experience online - maybe I could offer some personal thoughts as others think through their options. I'm of course not a medical professional, but here's what I know and why I decided to do what I did, with the full support of Leon.
For this story, I've to go back a little in history. I did mention briefly bits and pieces in previous blogs but here's the full version.
In 2003, while Leon and I were driving around Kallang Industrial Estate one lazy Sunday visiting factory sales, I bent to pick up my dropped wallet and stood up to my heart racing and pounding against my chest. You could see the throbbing through my tee-shirt and nothing lewd is meant here. I've had such palpitations on and off, but none which persisted and didn't go away by itself. We decided to drive quickly to our family doctor, who's in Yishun and opened on a Sunday. Now that's a 45 minute or so drive, and Leon hadn't have his license yet so I was at the wheel. We managed to get to the clinic safe and sound, and an ECG reading (the twiggly lines on a graph paper) shows a clear pattern of supraventricular tarchycardia (more about this later). That's why we still go to the same doctors and keep in touch with them because those folks know their stuff. We'll excuse their excitement at encountering something more unusual than the common flu in their clinic. We were sent promptly to the hospital in an ambulance.
At the Emergency Room (ER), I was given a medication that stopped my heart (yes, my chest went quiet), and restarted it again. When it was restarted, my heart beat was back to normal.
About six months later, I had just finished a press event for a client (I was a PR consultant then) at Raffles Hotel and was bending down to pick up a dropped business card when again, I stood up to a racing heart. Ok, maybe I should have stopped bending to pick up stuff but... Anyway, this time around, I called for an ambulance myself and away I went to ER with Leon joining me later. At the ER, I was given a different drug (apparently they alternate drugs on different days) and this medication slowed my heart down in a gradual manner. This trip though, I was surrounded by medical students while I was being attended to and I was part of their class for the day. The attending doctor asked about my previous ER visit, and I remember there was this girl who couldn't take notes fast enough and dropped behind to ask me for the name of the medication which stopped my heart. Like I remember.
Now all these must sound scary. The ER experiences where I lay separated by curtains from moaning victims of brutal injuries were frightening. And to this day, the sound of an amublance's wailing siren can cause my stomach to sink, just a little. However, this condition is NOT FATAL, and has been described by my doctors as a LIFESTYLE INCONVENIENCE. I WON'T DIE from it, but it's going to be a bother.
Enter Dr Teo Wee Siong. He's a cardiac electrophysiologist in Singapore. As I understand from a friend who's a doctor, he's the best in Singapore. He wasn't the friendliest kindest doctor, so I learned most of what I know about supraventricular tarchycardia (SVT) from Wiki via Google.
SVT is one of the most common form of atrioventricular nodal re-entrant tarchycardia (AVNRT). It affects women more than men. It is a condition where an extra/errant pathway in an upper chamber of the heart causes electrical pulses to misfire, thereby causing rapid loops manifesting as palpitations. During an episode, my heart rate can go up to 245 beats or so per minute. Such episodes can usually be terminated using the valsava maneuver - bearing down like you're helping a no.2 move along while pinching your nose - or the carotid massage - massaging the vein on your neck where you feel a pulse.
In April 2004, I underwent an electrophysiology study and burned away (ablated) the errant pathway. This is a process where catheters are threaded through major veins via puncturing them at the groin area, traveling to the heart, and attempting to trigger the abnormal heart rythmn. By the way, I didn't realize that at a point in the procedure, they needed to lighten the sedation and I might be awake. I woke up and found myself in the middle of men in white shouting loudly at each other. What I remember most vividly was someone shouting, "Pull it out! pull it out! You've already triggered it! Can't you see?!"
Sigh. Anyway, following that ablation, the symptoms were vastly reduced and any episodes lasted no longer than 3 minutes because they were easily terminated with either the valsava maneuver or carotid massage.
Fast forward to 9 years later. Leon and I had moved to Michigan. Before we left, I went to see Dr Teo again. He's now in private practice and I just wanted to check in and inquire about the infrequent episodes I've had. When he knew we were moving to Michigan, he suggested that consult Dr Fred Morady at the University of Michigan. Dr Morady is a respected leader and one of the pioneers in this field. I kept the name but didn't think too much about it...until we started playing tennis very actively sometime in May this year.
One Saturday, we played multiple games from 9am to 2pm and I had 3 or 4 palpitation episodes in that time. Now that was truly an inconvenience because every time it happened, we would need to pause the game.
I've already set myself up with a cardiac electrophysiologist in Midland, a doctor from Nigeria who studied in New York, then moved to Midland. Interesting guy. He wanted me to go on beta blockers, but that stuff has a bad rep and I'm still young so I didn't go pick up my prescription.
By July or so, we decided to make an appointment with Dr Morady to seek a second opinion. Dr Teo was supportive of not taking beta blockers by the way - I emailed him with updates regardless of whether he was interested, but he was. Ha. Beneath the tough exterior, he's a softie at heart lah.
We finally met Dr Morady in September and he dispeled our doubts about repeating the procedure - there's no increased risk from re-doing the electrophysiology study or an ablation. He will supervised the whole thing and make a call on whether/how much to ablate once they get in the heart and have a better idea of what's going on. What sold me the idea was the immense self-confidence he exuded. If this man is so sure of himself, I'm willing to submit myself to his team.
So on November 12, that's when we went back to the University of Michigan for my adventure in the Cardiovascular Center's electrophysiology lab. The entire experience was so very different - I went in with more knowledge from all my readings, plus I kinda sorta knew what to expect, and I'm now almost 10 years older and more mature.
Reporting time was 6:30am so we stayed Monday night in Ann Arbor. We were greeted by Noreen the hospitality liasion person, who told Leon when he'll get to see me (before I go in and after a briefing by Dr Morady to him following my procedure), where to buy food, where to wait, and when to expect updates (every 2 hours).
Thereafter, a huge team of nurses and technicians took over, prepping me for the procedure and explaining each step of the way what's going to happen to me. It was very crowded each room I was in. Before I was wheeled to the lab, nurse Carrie told Leon to "come give your wife a hug and a kiss".
During the procedure, I woke when I needed to, and mumbled really astute observations such as "my heart is racing", "there it goes again", "that didn't feel right", "are we done yet?", "I'm sleepy", "thank you for keeping me warm", and so on.
The next time I was lucid, this huge man was bent over me and I swear his whole weight was centered on his hands pressing against the wounds in my right groin area. But I was out and alive! This man, I can't remember his name, was trying with all his might to cause my blood to clot and achieve hemostasis, which he finally did after 40 excruciating minutes. Still shaking off the effects of the sedatives, our conversation went something like "ouch! that hurts!", "What's hurting?", "your pushing is hurting me", "sorry lovely, I've to stop your blood from shooting out", "your accent's familiar", "I was from Syria"...
So what I gathered from Leon who came by to visit shortly, is that they couldn't trigger palpitations using the first route their took to my heart. Dr Teo had done a great job and it wasn't a recurrence. Taking a second route via an arterial, those high pressure bloodways, they found a second errant pathway in a hard to reach corner. Dr Morady's team couldn't remove it entirely but he's confident of greatly reduced symptoms and if it were ever triggered again, the palpitations would be a lot milder. He knows, because he tested it. OMG.
The better news is that this is the same AVNRT condition I had, which if you recall is NOT FATAL and WON'T KILL ME. The bonus is nothing was damaged, which if something was, I'd have to install a pacemaker.
Since they had to take the arterial route, I had to lay flat for 8 hours without moving. My back was so sore I needed 4 painkillers to bear laying still. To make me feel better Nurse Jim brought me diet Vernons in a cup with straw, and set it up next to my shoulder so I could turn my head and sip it easily.
We finally left the hospital at about 9pm at night and Leon drove us home. As our house came into view around the bend, it felt so super good to be home. I am alive, on the mend, and will feel even better and stronger. I can't wait to continue our life adventures!
For this story, I've to go back a little in history. I did mention briefly bits and pieces in previous blogs but here's the full version.
In 2003, while Leon and I were driving around Kallang Industrial Estate one lazy Sunday visiting factory sales, I bent to pick up my dropped wallet and stood up to my heart racing and pounding against my chest. You could see the throbbing through my tee-shirt and nothing lewd is meant here. I've had such palpitations on and off, but none which persisted and didn't go away by itself. We decided to drive quickly to our family doctor, who's in Yishun and opened on a Sunday. Now that's a 45 minute or so drive, and Leon hadn't have his license yet so I was at the wheel. We managed to get to the clinic safe and sound, and an ECG reading (the twiggly lines on a graph paper) shows a clear pattern of supraventricular tarchycardia (more about this later). That's why we still go to the same doctors and keep in touch with them because those folks know their stuff. We'll excuse their excitement at encountering something more unusual than the common flu in their clinic. We were sent promptly to the hospital in an ambulance.
At the Emergency Room (ER), I was given a medication that stopped my heart (yes, my chest went quiet), and restarted it again. When it was restarted, my heart beat was back to normal.
About six months later, I had just finished a press event for a client (I was a PR consultant then) at Raffles Hotel and was bending down to pick up a dropped business card when again, I stood up to a racing heart. Ok, maybe I should have stopped bending to pick up stuff but... Anyway, this time around, I called for an ambulance myself and away I went to ER with Leon joining me later. At the ER, I was given a different drug (apparently they alternate drugs on different days) and this medication slowed my heart down in a gradual manner. This trip though, I was surrounded by medical students while I was being attended to and I was part of their class for the day. The attending doctor asked about my previous ER visit, and I remember there was this girl who couldn't take notes fast enough and dropped behind to ask me for the name of the medication which stopped my heart. Like I remember.
Now all these must sound scary. The ER experiences where I lay separated by curtains from moaning victims of brutal injuries were frightening. And to this day, the sound of an amublance's wailing siren can cause my stomach to sink, just a little. However, this condition is NOT FATAL, and has been described by my doctors as a LIFESTYLE INCONVENIENCE. I WON'T DIE from it, but it's going to be a bother.
Enter Dr Teo Wee Siong. He's a cardiac electrophysiologist in Singapore. As I understand from a friend who's a doctor, he's the best in Singapore. He wasn't the friendliest kindest doctor, so I learned most of what I know about supraventricular tarchycardia (SVT) from Wiki via Google.
SVT is one of the most common form of atrioventricular nodal re-entrant tarchycardia (AVNRT). It affects women more than men. It is a condition where an extra/errant pathway in an upper chamber of the heart causes electrical pulses to misfire, thereby causing rapid loops manifesting as palpitations. During an episode, my heart rate can go up to 245 beats or so per minute. Such episodes can usually be terminated using the valsava maneuver - bearing down like you're helping a no.2 move along while pinching your nose - or the carotid massage - massaging the vein on your neck where you feel a pulse.
In April 2004, I underwent an electrophysiology study and burned away (ablated) the errant pathway. This is a process where catheters are threaded through major veins via puncturing them at the groin area, traveling to the heart, and attempting to trigger the abnormal heart rythmn. By the way, I didn't realize that at a point in the procedure, they needed to lighten the sedation and I might be awake. I woke up and found myself in the middle of men in white shouting loudly at each other. What I remember most vividly was someone shouting, "Pull it out! pull it out! You've already triggered it! Can't you see?!"
Sigh. Anyway, following that ablation, the symptoms were vastly reduced and any episodes lasted no longer than 3 minutes because they were easily terminated with either the valsava maneuver or carotid massage.
Fast forward to 9 years later. Leon and I had moved to Michigan. Before we left, I went to see Dr Teo again. He's now in private practice and I just wanted to check in and inquire about the infrequent episodes I've had. When he knew we were moving to Michigan, he suggested that consult Dr Fred Morady at the University of Michigan. Dr Morady is a respected leader and one of the pioneers in this field. I kept the name but didn't think too much about it...until we started playing tennis very actively sometime in May this year.
One Saturday, we played multiple games from 9am to 2pm and I had 3 or 4 palpitation episodes in that time. Now that was truly an inconvenience because every time it happened, we would need to pause the game.
I've already set myself up with a cardiac electrophysiologist in Midland, a doctor from Nigeria who studied in New York, then moved to Midland. Interesting guy. He wanted me to go on beta blockers, but that stuff has a bad rep and I'm still young so I didn't go pick up my prescription.
By July or so, we decided to make an appointment with Dr Morady to seek a second opinion. Dr Teo was supportive of not taking beta blockers by the way - I emailed him with updates regardless of whether he was interested, but he was. Ha. Beneath the tough exterior, he's a softie at heart lah.
We finally met Dr Morady in September and he dispeled our doubts about repeating the procedure - there's no increased risk from re-doing the electrophysiology study or an ablation. He will supervised the whole thing and make a call on whether/how much to ablate once they get in the heart and have a better idea of what's going on. What sold me the idea was the immense self-confidence he exuded. If this man is so sure of himself, I'm willing to submit myself to his team.
So on November 12, that's when we went back to the University of Michigan for my adventure in the Cardiovascular Center's electrophysiology lab. The entire experience was so very different - I went in with more knowledge from all my readings, plus I kinda sorta knew what to expect, and I'm now almost 10 years older and more mature.
Reporting time was 6:30am so we stayed Monday night in Ann Arbor. We were greeted by Noreen the hospitality liasion person, who told Leon when he'll get to see me (before I go in and after a briefing by Dr Morady to him following my procedure), where to buy food, where to wait, and when to expect updates (every 2 hours).
Thereafter, a huge team of nurses and technicians took over, prepping me for the procedure and explaining each step of the way what's going to happen to me. It was very crowded each room I was in. Before I was wheeled to the lab, nurse Carrie told Leon to "come give your wife a hug and a kiss".
During the procedure, I woke when I needed to, and mumbled really astute observations such as "my heart is racing", "there it goes again", "that didn't feel right", "are we done yet?", "I'm sleepy", "thank you for keeping me warm", and so on.
The next time I was lucid, this huge man was bent over me and I swear his whole weight was centered on his hands pressing against the wounds in my right groin area. But I was out and alive! This man, I can't remember his name, was trying with all his might to cause my blood to clot and achieve hemostasis, which he finally did after 40 excruciating minutes. Still shaking off the effects of the sedatives, our conversation went something like "ouch! that hurts!", "What's hurting?", "your pushing is hurting me", "sorry lovely, I've to stop your blood from shooting out", "your accent's familiar", "I was from Syria"...
So what I gathered from Leon who came by to visit shortly, is that they couldn't trigger palpitations using the first route their took to my heart. Dr Teo had done a great job and it wasn't a recurrence. Taking a second route via an arterial, those high pressure bloodways, they found a second errant pathway in a hard to reach corner. Dr Morady's team couldn't remove it entirely but he's confident of greatly reduced symptoms and if it were ever triggered again, the palpitations would be a lot milder. He knows, because he tested it. OMG.
The better news is that this is the same AVNRT condition I had, which if you recall is NOT FATAL and WON'T KILL ME. The bonus is nothing was damaged, which if something was, I'd have to install a pacemaker.
Since they had to take the arterial route, I had to lay flat for 8 hours without moving. My back was so sore I needed 4 painkillers to bear laying still. To make me feel better Nurse Jim brought me diet Vernons in a cup with straw, and set it up next to my shoulder so I could turn my head and sip it easily.
We finally left the hospital at about 9pm at night and Leon drove us home. As our house came into view around the bend, it felt so super good to be home. I am alive, on the mend, and will feel even better and stronger. I can't wait to continue our life adventures!
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| Flowers from the PA&GA family :o) Such a cheerful bouquet! |
Take care, Linda!
ReplyDeleteWish you a speedy recovering. I see you when you are back.
ReplyDeleteThank you :o)
ReplyDeleteOh my, please take care. I love your positive spirit, it is very inspiring :)
ReplyDeleteHai Linda, my name is Yesica Ive had 2 ablation so far and I know the svt still there(and my doctor admit it too).. I have avnrt and avrt both of it but my first doctor ablate the wrong path and he trigger it more often, so I ablated it again with another doctor and thanks GOD, the svt is still there but less in a minute its gone(doctor told me its a new extra path).. But its getting longer now, its getting worse in my pre period too.. Do you have some sindrom with me? How about now? Do you still have svt? Thanks for sharing.. CHeersss
ReplyDeleteHi Yesica, I still have my two AVNRT pathways. The first one handled by Dr Teo was well taken care of so it seems that's no longer a problem, according to my second doctor, Dr Morady. However, the second AVNRT pathway which Dr Morady found, as mentioned in my post, is still active. He did not want to risk damaging my heart so he did not push the ablation fully. It triggers when I over exert myself - it's just that I know how far I can push myself before triggering an episode so there are hardly any occurrences nowadays. When it happens, a Valsalva maneuver will usually tame it in under 2 minutes. I am blessed to have met two doctors who were very confident yet humble enough to know when they have met their "match", and when to draw the line. If you're in Singapore or Michigan, you might want to consider consulting with either doctors. Dr Teo is still in practice (a colleague's son sees him every year), but I'm not sure about Dr Morady. I wish you nothing but the best, Yesica. Be well, Linda
ReplyDelete