On Ambulance rides and Atrial Fibrillation

I can’t quite call it a fascination, but since I was young, I’ve had more than a simple passing interest in ambulances. Hollywood producers have done their part to draw my attention with their car chases, explosions, and high drama emergency situations, but a simple comment by my Grandfather many years ago planted a seed in my young mind that over the years, watered by my own observations and experiences, has grown into something more than a passing interest. Riding down the road one afternoon many years ago we passed an ambulance at full sprint, engine roaring, sirens blaring and lights flashing like we each have all seen hundreds of times. My Grandfather mentions that we should ask a quick prayer. I asked why… we didn’t know the occupants, the drivers, their destination, or anything about what was going on with their situation. He smiled the “Grandfather Smile” and replied something to the effect of, “no we don’t, but we can sure bet that they don’t want to be there.”

I certainly didn’t want to be in an ambulance past midnight on Tuesday morning, but I was comforted by the potential of a high speed dash to Birmingham with the “lights on.” An old friend of mine’s Dad used to tell us stories from his days as an ambulance driver. He would marvel us with his tales of the road and boast how he could be from the old St. Clair Hospital to downtown Birmingham in just sixteen minutes! He could also eat more pancakes than any man I’ve ever known, wrestled as a villain wrestler behind a mask, and from just those three memories alone, he stands in high order as a figure from my childhood. With those stories in mind, our experiences early Tuesday morning failed to rise to the challenge of my boyhood fantasies.

I got home from the hospital Saturday afternoon and didn’t do very much for the rest of the day. Sunday, I got up and walked around a bit, sat outside and watched the water, had a friend come visit, and had a pretty good day enjoying being home. Monday wasn’t quite as good of a day. I felt “off” all day, not quite as good as I had felt Saturday and Sunday, and by sundown Monday evening, I had a feeling that something wasn’t quite right. I ate a little supper and started feeling really lightheaded and dizzy. We monitored my blood pressure and pulse closely for an hour or two with no significant changes, however, I started feeling faint. I never lost consciousness, but about fifteen times over two hours I would fade out before snapping right back into things. We had been cautioned about atrial fibrillation upon discharge on Saturday, and I had some experience with elevated heart rate from a condition that I had treated over twenty years ago. What I was experiencing was familiar, but still quite unsettling, so we decided to take a ride to the Emergency Room.

I’ve spent hours sitting in Emergency Rooms all over the South for various things from stiches to x-rays, but I’ve never quite experienced what happens when you walk through those doors and say “funny heartbeat” followed by “bypass surgery on Wednesday.” It was a whirlwind of activity for thirty minutes or so, until the doctor and nurses decided that my heart was likely trying to start an aFib cycle. The fainting episodes had stopped, I felt as good as I had felt since the surgery, and we decided that the best course of action would be treatment and observation. We sat there for an hour or so, and then, quite out of the blue, it started. Jennifer had been watching my heart rate like a hawk. I felt a funny heartbeat and watched her face react to what she had seen on the monitor, I asked her, “did you see that?” She replied with a simple, “I’m going to get the Doctor.” So I slipped into aFib just like that. The doctor examined me and gave me “THE LOOK.” I asked him, “I’m not going home now am I?” She shook his head. “I’m not going to Birmingham in my own car am I?” He shook his head again, and with as much empathy as he could offer, confirmed that I was going to be transferred by ambulance to UAB immediately.

The disappointment of going back to the hospital was tempered a bit by the intrigue of an ambulance ride. I was finally going to see what it was all about! As casually as I could muster, I asked the driver, “Are we going to ride with the lights on?” He explained that as it was 2:30 AM, traffic would be easy, we wouldn’t NEED the lights, and that the speed machine of my dreams had a top end limitation of 80 MPH. It was a soul crushing revelation, and as the ride didn’t quite develop as to my expectations, there was nothing remarkable whatsoever about being strapped down to a gurney and ridden backwards into downtown Birmingham well past my bedtime. As my Grandfather so presciently predicted so many years ago, I certainly did not want to be there.

The occurrence of Atrial Fibrillation is common in patients following heart surgery with as many as one in three experiencing symptoms. The symptoms, while unsettling, are not dangerous, and the treatments are relatively benign. Oral medication and IV medication are given and the if the heart rate doesn’t slow and go back into rhythm in a couple of days, they sedate the patient and use small jolts of electricity to shock (pun intended!) the heart back into rhythm. We ended up going back to the same floor and only three rooms from where we had just left on Saturday. I was bummed, really bummed, but UAB again did a remarkable job of nursing me back to normal and did their best to keep me sane. We stayed in the hospital for two days, and were just about to face the possibility of the electric conversion, but about thirty minutes after being informed of that possibility, I felt a funny couple of beats and then the nurse walked in and said that I was back in rhythm. The doctorfollowed an hour or so later and asked the magical question, “What pharmacy do you use?” We were going

home....

We got home Wednesday afternoon the 16th, and I have been resting and recovering here and getting stronger each day.