Me: Hi. My name is CDH in Brooklyn and I've given up smoking.
You: Hi CDH in Brooklyn.
Or something like that.
My convoluted marginally death-defying GUS story after the squiggle.
Sometime in mid- to late February, I was at work one day when it seemed that my office was starting to spin. Yep, definitely dizzy -- time to push back from my multi-tasking day and go get some fresh air. 15 minutes (or so) later, I was back at my desk feeling normal but thinking to myself "that was weird".
A day or two later, it happened again.
And a day or two later, again.
Then, at some point during this random period of dizzy spells, it happened once when I was on my way back from lunch. The difference with that episode was that my legs started feeling heavy, and I literally stood at a corner and let a "Walk/Don't Walk" pattern cycle by before I felt confident that I'd be able to force my legs to get me across the street without getting run over.
Again to myself "that was weird" but with a growing sense of dread.
Throughout this period, I was still a pack-a-day smoker (at roughly $12 a pop here in NYC).
A day or two later, I went to one of my favorite nearby diners on 2nd Ave to have fish & chips at the counter. I was fine when I placed my order, but having trouble sitting upright on the stool by the time the food came. I struggled to ask him to bag it "to go", put down $15 and stumbled out without waiting for the change.
I stood outside leaning against the building and watching people go by. It wasn't an "out of body" experience, but I defintely felt disconnected from the mid-day rush of activity going on around me.
So after those last two somewhat scarier incidents, I decided that I would try quitting smoking to see if that would put an end to all of it.
I started out with nicotine gum. For several days, I changed my routine to one cigarette with my morning coffee, then switch to the gum after my shower. I'd stick with the gum through my hour commute each way, and through the full work day. I'd have one (or maybe two) more cigarettes once I'd get home and/or after finishing dinner.
I was still on that routine on March 9 when I flew from NYC to Atlanta for the SEC men's basketball tournament, an annual tradition for my family and an extended network of family friends from Univ. of Kentucky and other SEC schools. My mom has been after me to quit smoking for years (thanks, Mom!) and Dad has been a non-smoker since he passed out in his office sometime back in the mid-70s. Before then I remember how much I HATED it when he would smoke in the car on our vacation trips from Ohio to Florida or whever. Many moons ago.
So, knowing I was flying down to join up with some solid support, I had purchased the patch and was ready to make the leap. I quit the morning and evening cigarettes and was full-time on the gum until it ran out. On Saturday, March 12 I started my day by putting on a 21mg nicotine patch. Mom was very pleased!
During the gum period, it did seem to help. It didn't completely eliminate the dizzy spells, but they became less frequent. On Sunday, March 13, just before I was supposed to meet up with Mom & Dad, as I was digging through my toiletry bag for my toothpaste, I experienced my worst case of vertigo ever. I put both hands on the wall of the hallway in my hotel room from the bathroom to the bedroom to support myself, and ended up on the floor taking a series of deep breaths until it passed. Then I brushed my teeth and went to watch UK beat Florida in the championship game without saying a word about it to anyone. Studid, stupid me.
The following week was relatively uneventful, until Sunday night, March 20, when everything changed. That night, while eating an awesome lasagna dinner that my partner/significant other/"husband" of 20 years had made, I had another of the wicked vertigo episodes. For the first time, there was a witness. And, for the first time it was accompanied by a tightness in my chest and tingling in my left arm. I was literally thinking how stupid it was of me to be resisting the thought that I should be asking him to call 911. I was thinking that I should be changing my socks and shoes. And then it passed, but he was NOT happy that I had not gone to see a doctor at any point during this month-long ordeal.
So, despite the fact that I've avoided going to a doctor for over a decade, I stayed home from work on Monday, March 21 and made an appointment to go see a doctor at a family practice medical center in my neighborhood here in Brooklyn. After some debate as to whether he should cancel his annual post-Christmas vacation trip to see his family in Kentucky, partner/SigO/"husband" left for the airport for a 5pm flight to Cincinnati.
At 3:30, I signed in at the doctor's office and completed all of the forms. Shortly thereafter, a nurse was weighing me and taking my temperature and pulse. The first "uh oh" moment came when she did a blood pressure check on my right arm and said "wow, that's really high...let's check the other arm". Which she did. Still really high (something like 166 over something 100+).
Next the doctor saw me and we discussed my dizzy spells briefly, along with my high blood pressure. When asked if I had any allergies to meds, etc, I told her about an incident roughly 12 years ago where I had collapsed into unconsciousness and seizures after a doctor had given me a steroid shot in the vicinity of my left shoulder-blade in an attempt to alleviate some post-auto-accident muscle tension. Duly noted.
Since I'm wasn't on any meds and preferred to stay that way, she said that they'd draw blood for tests and hold off on prescribing anything for the blood pressure until we'd had a chance to try changes to diet, exercise, no smoking, no drinking, no salt, no caffeine, etc. But first, she wanted to run an EKG. She left and the nurse was back attaching the necessary electrodes. She ran it, looked at it, and ran it again. My second "uh oh" moment was when she came back in saying that the doctor wanted to run another EKG but with my lying completely flat. OK. The nurse ran it twice more and left the room again. She returned with a concerned-looking doctor (uh-oh), who ran it once more herself.
"I don't want to scare you," she said, "but we're going to send you to the hospital, and I'm going to call 911 to have an ambulance take you there."
That, fellow GUSers, is why I had not been to see a doctor in 10 years.
First came the NYFD, then the paramedics and ambulance from Lutheran Medical Center, a Level 1 trauma hospital in Sunset Park. Oxygen, IV, a flurry of activity, lots of questions, lots of concern. I called partner/SigO/"husband" and told him to cancel his flight (which was getting ready to board) and that I was on my way to the hospital in an ambulance. He - how do I put this? - FREAKED.
Gurney, lights, siren, emergency room, bypass the waiting room (a perk of arriving in an ambulance) and directly into ER room A1, where I was informed that my EKG readings showed an irregularity in my heartbeat typical of cardiac events such as stroke or heart attack. Odd, I thought. I had just walked from home to the doctor's office and I was actually feeling pretty good that day.
So, for the next several hours I was attached to a machine in the ER that automatically monitored my vital signs. One of the paramedics had me sign off on his paperwork and left me with the words "you cheated death today." Really? Damn. Partner showed up a couple of hours into this wait-and-see period.
Finally, a room opened up in their cardiac care unit and I was moved out of the ER. Partner stayed until visiting hours ended, nurse brought me a halfway decent meal, and Monday, March 21 ended with me (still wearing a 21mg nicotine patch) in the hospital.
I awoke on Tuesday, March 22 to the good news the overnight blood-work had produced three consecutive "negative" results for the type of cardiac event they'd feared, which was very good news. More tests were in order. I had to repeat all of the Q&A stuff about family medical history, smoking, drinking, drugs, allergies, etc with every shift change. Kind of annoying. Don't they have computers?! Partner came back at the start of visiting hours with a fresh nicotine patch, some toiletries, magazines, etc, and words of support and concern from his family in Kentucky.
That afternoon, I went for an EEG (24-electrodes attached to my head, then close my eyes for a series of strobe light patterns to monitor brain activity), and then an electrocardiogram (like a sonogram for babies, except looking at the heart in 3D instead). Needless to say, these were very new experiences for me.
Tuesday night in the hospital, fighting boredom, waiting for the results.
Wednesday morning. Good news. Nothing abnormal turned up in the EEG or electrocardiogram results. So, today perhads an MRI, stress test, visit with an ENT (ears/nose/throat) specialist, blah blah. For the first time, the possibility of a pacemaker was mentioned in conjunction with the need for an MRI. Huh? A pacemaker? I'm only 45!
First up came the stress test late Wednesday afternoon, and that's where all hell broke loose. Because I'm a relatively fit, youngish man, they decided against the pharmacological version of the stress test and opted for the treadmill version. The goal, apparently, being to induce a very elevated heart rate and then to inject dye through my IV tube to track it through my bloodstream. The only problem is that the speed and incline of the treadmill, after two days of being flat on my back, was more than I could handle. I complained of overheating and exhaustion, so they ended the test and injected the dye to see if they could still get results. I complained of dizziness and asked/begged for water. Water denied due to the dye. The nurse sat me in a chair.
Still sitting in that chair, I opened my eyes to a room full of anxious cardiac care professionals. I hear the PA system announce "Cancel RRT (Rapid Response Team) to cardiac stress test." I hear someone ask "how do you feel" -- I hear myself answer "OK." I hear someone explain to someone else that my heart had completely stopped beating - flat-lined - for nine seconds before someone else had administered chest compressions to get it going again.
I hear the cardiac folks come to a consensus that I need to go straight to the cardiac cath lab for an angiogram. Do not pass Go...do not collect $200.
Remember earlier when I said that Partner had freaked when he got my call at the airport? He was upstairs in my room in the cardiac care unit when my heart stopped beating. After they helped me from the chair to a gurney, they gave me a phone to call him. It was, without any doubt, the hardest call I've ever had to make. I started out saying "it didn't go well" and then I just couldn't speak. Finally someone intervened and told someone to bring him downstairs. He and a cardiac care nurse rushed in a few minutes later and someone explained what had happended and what was about to happen next. Then everyone but Partner left the room and he and I looked at each other and started crying. I'm sitting in a Bay Ridge Starbucks right now tearing up remembering how powerfully emotional those few minutes were.
After giving him assurances that angiograms are a relatively routince procedure these days and that "there's nothing to worry about" we were separated as I was wheeled off to have my groin area shaved and doused with iodine in preparation for the insertion of the catheter into my artery.
I did mention that I hadn't seen a doctor in a decade, right?
I was conscious but mildly sedated during the angiogram, and the support crew was awesome in involving me in witty banter to keep me calm and distracted. 45 minutes later, I was in the recovery room with the news that I have a mild build-up of plaque in my arterties, but nothing out of the ordinary given my age, etc.
Oh yeah, I temporarily forgot the point of this story.
While I was on the gurney in the stress test room, after my heart had stopped, and before Partner had made it down for our emotional moment, someone came back into the room and removed my nicotine patch saying "this has to go."
I have been nicotine-free since then.
To wrap up this overly long story, the cardiologist who did the angiogram was a "plumber" and he wanted me to see his "electrician" colleague at Mt. Sinai for another cath procedure to see if he could pinpoint any problems and to make the final determination as to whether or not I got a pacemaker.
Thursday was spent at Lutheran waiting for a bed to open up at Mt. Sinai. Another ambulance ride to get me there, during which the paramedic asks Partner his relationship to me, to which Partner responds "Partner", prompting the paramedic to ask "Co-worker?" which caused the driver, Partner and me to bust out laughing. One of the few good laughs of the week. "No" I said, "Signficant Other". "Oh" he said..."OH OH...OK." in thick Eastern European accented embarrassment. Classic.
An awesome nurse at Mt. Sinai brought me a 10pm cheeseburger (!) after the Nurse Practitioner had pretty much confirmed that I'd be getting a pacemaker the next day. She informed me that my pulse had dropped to 20bpm in the first ambulance ride from the doctor's office to Lutheran, before it completely stopped after the stress test. That's dangerous, she informed me. I didn't really want a pacemaker but she dismissed my argument that we still hadn't found the cause of the dizziness, which started this whole mess. "Your heart wants to stop beating sometimes...that matters more". Hard to argue with that.
The "electrician" cardiologist came in before visiting hours on Friday, March 25 (Partner's birthday) and asked how I was feeling. I told him I wanted to go home. He said "OK." I about fell out of bed. He had looked at my entire medical record from the doctors office through overnight monitoriing at Mt. Sinai and determined that it's probably something like Miniere's Disease causing the dizziness. He recommended that I consult with an ENT specialist for a diagnosis. But, from his professional opinion, the Miniere's or whatever is causing the dizziness/vertigo is triggering in me a physiological reaction known as vasovagel syncope - a slowing of the heart rate accompanied by a drop in blood pressure and expending of blood vessels resulting in the heart not being able to get blood to the brain.
I don't need a pacemaker yet, in his opinion. I need to not smoke, drink only in moderation, no caffeine, limited sodium, cholesterol etc. In other words, diet and exercise. And, if I start to feel overly dizzy, I need to get down and elevate my legs so that gravity can help my body get blood to where it needs to be. Heh - who knew?
And that, fellow GUSers, is how I gave up smoking. A little more dramatic than I'd expected (and more expensive, as the BC/BS payment denials start to accumulate), but today's day 36 of no nicotine, if my math is right, and it feels great.
Cheers!