Ricochet is the best place on the internet to discuss the issues of the day, either through commenting on posts or writing your own for our active and dynamic community in a fully moderated environment. In addition, the Ricochet Audio Network offers over 50 original podcasts with new episodes released every day.
This is both a brief story in itself and preface to another tale, “Strategic Logistics Work.” The point of observation: the Valley of the Sun, Maricopa County, the population center of Arizona. The time: summer 2018 and last weekend, March 21-22, 2020.
Foreshadowing: It was a normal summer Saturday afternoon in 2017. Which is to say, it was a dry heat in the Valley of the Sun. I was out for a 2.5-mile brisk walk when I got the urge to sprint. Nevermind that I had not done a wind sprint over a year, I just had the urge. Pulling up at the end of a 200-yard dash, I noticed something was a bit odd. My heart rate was not slowly dropping. I got indoors, sat down, and drank water. No change. In fact, I was getting increasingly light-headed, even with my head down, so I had someone dial 911.
The fellows in the ambulance were quickly on the scene. I had had a complete cardio workup the summer before, and had been pronounced fit as a fiddle. Now the lead paramedic was coaching me through something called a vagal maneuver.
Worked like a charm. My heart rate immediately dropped, rapidly returning to normal, along with my blood pressure. I was cautioned, between the ambulance crew and the great emergency room team, that this episode would likely not be my last, and that sometime I might need medical intervention.
March 22-23, 2020: That time arrived last Saturday evening. At 6 p.m., I was standing in my kitchen, getting together a bit of supper before going out for the evening to visit friends. I found myself lightheaded. I checked my temperature, low normal. I started drinking water, thinking I might be a bit dehydrated. I got no better.
I drove a few miles to my friends’ house anyway, frankly feeling almost tipsy, without a drop of alcohol to drink. My eyes were fluttering a bit, not losing focus but as if I was about to nod off. Maybe it was low blood sugar, although I have no such history. An energy bar and a couple handfuls of chocolate chips did nothing. Perhaps it was a panic attack. I had never had one before, but I went into some square breathing to calm myself. It did nothing. Finally, I just went home.
But, it got no better. I called the triage nurse line, since it was after urgent care hours and I really was not keen on going to a hospital in the time of coronavirus. The line was slammed, and I was getting lighter headed, so I hung up and dialed 911 for the second time in my life.
When the helpful fellows in the ambulance and fire engine arrived, they noticed my words showed a slight stutter rather than slur. Their assessment: likely not a stroke, likely a panic attack. The ride to the emergency room, only four miles away, was without lights and sirens, a good sign of a sort. My blood pressure and heart rate were still way up.
My temperature was checked repeatedly, along with COVID-19 symptom screening questions between the 911 operator, the EMTs and the first staff in the ER. Great work to keep the disease out of the general ER population at Banner Desert Medical Center. A doctor checked my symptoms after blood had been drawn and an IV line set up in my arm. He sent me for a CT scan in very short order.
The CT scan was clear. And then we get to the part of the story that makes American medicine worth defending and keeping. The same ER doctor said he was not satisfied with the CT scan. He was not happy with my symptoms, and not writing them off to a panic attack. While the clear CT scan was good news, there were finer details to be seen with an MRI, and I needed to have my carotid arteries checked for blockage.
I was wheeled up to another diagnostic room for a relatively low technology, low cost, ultrasound scan of my neck. The medical technician was not allowed to interpret the results, but made generally positive noises when I asked. From thence, the fellow who had wheelchaired me to the ultrasound test steered me to an observation ward for the night. I was admitted, not escaping before morning rounds.
The night shift floor nurse was an Army veteran, happy to talk for a bit while running me through a battery of stroke checks, checking my responses with feet, legs, arms, and face, ending with a series of written phrases designed to test for tell-tale slurring. All was well with that. My blood pressure was continuing to improve without treatment. Meanwhile, lab results told them to feed me two potassium horse pills. Yummy.
The MRI came around 0400, that is, 4 on Sunday morning. The fellow who guided my chariot towards the radiology section commented that he saw few people with my body type in his ward anymore. Patients were getting larger and larger, veins harder and harder to find. It is not a virus that is killing us by the scores every year, unless that virus is advertising and self-indulgence.
I spent the rest of the time until morning rounds listening to the worries of nursing staff, lacking good information and apparently having a hospital leadership that had not figured out logistics, generating worries about drastic shortages of N-95 rated protective masks. Their worries were regularly interrupted by mostly very elderly patients in serious condition, there for stabilization so they could return to a nursing facility or home care.
Each time I got up to download the gallon or more of water I had consumed that evening, I noticed my heart rate up as I laid back down. Just standing still, my heart rate ran up from 70 to 100. That definitely was not normal.
Morning brought the neurologist, who pronounced my brain structurally sound and carotids clear. Yet, my heart rate jumped to 123 when I quickly raised an arm as he did a final test for stroke signs, and there was a blip on the EKG. So, he said I was neurologically cleared but needed cardiology clearance.
Another lab tech showed up after a morning blood draw. He brought his instruments with him and ran an echocardiogram bedside. The cardiologist showed up a bit later in the morning and pronounced my heart structurally good. However, putting the whole picture together, including my prior episode, the most reasonable conclusion was that I have a small short circuit in my heart.
Here, again, is what makes American medicine quite superior to all other countries. The cardiologist recommended that I stay the day, overnighting again in the hospital, so he could permanently fix my heart the very next day. The fix would be to sedate me, numb my groin, insert a cardio-catheter into a large blood vessel, then run a set of wires up into my heart on a search and destroy mission. The instruments would precisely locate the electrical short circuit and then burn it out, “ablating” that spot on the interior of my heart.
In the alternative, I could take a very old pill, with a history of few serious side effects for most people. This cheap and reliable pill limits heart over-speeding and has some blood-pressure-lowering effect. This side effect, for me, is not worrisome, as I was on the high side of healthy blood pressure.
Needless to say, I had no intention of staying another day in a hospital. I opted for the cheap pill, and will discuss a possible summer surgery. I defy you to name another country in the world where I would have received this level of choice and speed in treatment. Where else would I have got more than the physical response tests plus possibly the CT scan? And in what other nation’s system would I have been offered this next day, permanent surgical solution? ‘Merica. Let’s keep it that way.
Oh, the little white pill works just fine. And I’m taking a regular strength over the counter aspirin, as directed by the cardiologist, apparently to address possible future clotting concerns. I have indeed been blessed with basic good health and life in an amazing country.Published in