Thursday, May 04, 2006

SVT

Last week my heart started skipping a beat. That’s how it felt. It would beat fifty-six times quite regularly, and then - the fifty seventh wasn’t there. I had to wait for the fifty-eighth. At first I thought I’d just missed it, moved my finger or been distracted. I asked J to take my pulse. She confirmed the phenomenon though, as we never see anything in quite the same way, she described it slightly differently.
I’ve had trouble with my heart before, but it’s been straight supraventricular tachycardia where the heart beats between 140 and 240 times a minute, sometimes for several hours. (Should you already be touching the corner of a handkerchief to you eye, deeply affected by my matter-of-fact heroism, I should mention that am no more on the verge of death, or even debility, than normal, which is not much so far.)
A slight digression about death. Daughter T and son M were up for Easter with their children. This being a 1790 merchant clothier’s house (of which we inhabit a third), the second storey was once a weaving room, with something like twenty six windows, and is now our living room. It covers the whole of the house, with the main chimney stack, a substantial block of masonry, going up through the middle.
Every night in the summer J goes into the garden last thing to hunt for slugs. This particular evening as we’d sat long at the table, she decided to go out on her slug hunt as I was clearing up the kitchen. She told me she was doing that. I registered that she was doing that. I then, when I had finished in the kitchen, a quite automatic routine, completed that routine by locking the outside door, and I went upstairs to join everybody else.
After maybe fifteen minutes M said, “Is that the bell ringing? Where’s Mum?”
“She’s out in the garden catching slugs,” I said. Then I connected two parts of my brain which had been out of contact.
J has many wonderful qualities. Sweetness of temper under all circumstances is not one of them. I was down the stairs, two flights, spiral, in 1.7 seconds (possibly the onset of the ectopic superventricular episode, though I haven’t made that connection before). J had been standing in the cold night for ten minutes. I made my peace with her, referring to the romantic beauty of the stars &c., as best I could, which was imperfectly.
An hour or so later, when we were again relaxed together, M had said that while we were downstairs T, the eldest, had instructed him and A that when we got back up again nobody was to, under any circumstances, laugh. Everybody had agreed that this was a good plan. She had then, as J and then I crested the rise, run to hide behind the chimney, making strangulated noises, and only emerged two minutes later, eyes wet.
The kids got into recounting difficult moments with us. E.g., the day before M and I had been up at a quarry on our mountain bikes. There was a particular drop that I wanted to try, but only when someone else was there to pick up any remains. It turned out to be straightforward, but from above, about a metre and a half of it looks vertical - nothing to the hard guys, but scary enough to the likes of me. M said that while I was doing it he was thinking to himself, “I hope he doesn’t kill himself now. In the general scheme of things it would be no bad way for him to go, good in fact. But - I’ll have to tell Mum. How do I do it? Do I ring her on the mobile and say, yes, yes, we’re having a great time, but, oh, and by the way.... Or could I sneak back, take the car and drive back to London, abandoning wife and children, and wait for things to sort of sort themselves... or... And wine being the trigger to much invention, we joined him in this amusing speculation.
So my death, like everybody else’s, is a permanent possibility.
The first time I had ectopic superventricula tacychardia our GP gave me a special note for A&E which got me straight through the waiting drunks and sports injuries and onto one of those hi-tec beds from the starship Enterprise, connected to a machine that went beep-beep-beep twice a second.
The young registrar - I use that term at random, I know nothing about the hierarchies of doctordom, but he wasn’t a consultant - was beside himself with delight. He was going to administer a massive (I may have added the “massive”) bolus of drugs straight to (I may have imagined the “straight to”) my heart. There were many, many doctors, young nurses, auxiliaries, cleaners (OK, OK) who had never seen this procedure, and when they had all been summoned, which might take some time, the maestro would proceed.
I liked this idea. I am one of those quite shy people (my family don’t totally agree with this characterisation) who doesn’t mind getting on a stage and acting. This was both live theatre, and just like being on telly. What more could I want?
Then the other bit cut in. Bolus. Massive. Drugs. To the heart.
I saw Dracula. I saw the stake. And the breast was mine.
A whumppff! of sheer horror.
Which clearly hit my sinoatrial node a violent wallop and jolted it back into action.
By which time the crowd was gathering. The registrar was just out rounding up the stragglers, and then the circus would begin.
He re-entered the theatre glowing. I didn’t know how to mention it. “Look,” I said, “I’m terribly sorry, but... you know, it’s stopped.”
“Stopped? Don’t be silly. You’d be dead.”
He pointed to the monitor for confirmation that I had not passed on.
Gradually the awful consciousness of what his ears and the steady 64 a minute beeping must have already told him, registered, and the joy drained from his face.
The news went round the crowd. Disconsolate and muttering they began to drift off.
“I’m sorry,” I said, “I really am sorry.”
“Well, I suppose... not really your fault,” he murmured.
What a colossal-hearted man.
(To be continued).

4 comments:

Pedro Terán said...

It's a very fine story. The "I really am sorry" part is great.

But do you know more about the missing beat?

Jago said...

Yes, I got distracted, I'll do the next bit soon; basically it seems to be when a signal other than from the sinoatrial node triggers a beat before the right ventricle is full, so the heart does not beat. Most people have at least one a day. It becomes disturbing if you're getting one every five beats. It feels as if your heart is trying to waltz.

Chloe said...

the heart is a scary muscle. my son thinks that each heart has a certain number of beats in it and when they are over you can either a. die b. have a heart transplant
and this can go on for many many centuries.

Jago said...

I think he might be right, Chloe. Don't the elephant and the mouse have roughly the same numebr of heart beats in their lives? Maybe that's a myth. Need more on your son's theory. Will the rest of the body go on for centuries once it has a new heart? I'm not sure mine would.
Anyway, it's all a great argument against unnecessary exercise.