V. Tach

August 5, 2024

Ventricular Tachycardia is a problem for your heart. It isn’t a household name, not in our household. But we want to keep our hearts beating. Then V. Tach, as our daughter Katheen, an R.N., calls it, came up. She monitors my health adventures from northwestern Wyoming, near Yellowstone.

The journey to understanding V. Tach isn’t a long one. It begins with recognition that the heart is, or should be, an efficient and powerful machine. Few manmade devices last as long. We’ve all heard the medical guidance, captured in a few words: healthy diet, hydration, exercise, adequate sleep.

The heart is a pump that, we’re taught, should beat at 60-100 times per minute to keep enough blood flowing through the body. When blood pressure drops the flow diminishes, endangering vital organs. The heart may try to compensate by lurching into V. Tach, which increases the heartrate, potentially injuring the heart.

Here in the choking, sticky Southern midsummer, none of this comes up in conversation. Instead we struggle with twin afflictions, Trump news, a cacophony of lowlife piggishness, and the throbbing heat.  Here and elsewhere the sun casts a hazy, suffocating pall, shriveling trees, lawns, crops. Local governments, schools, and private groups have canceled outdoor activities. Exposure to the brutal temperatures has taken human lives.

Suddenly I was sprawled in a hospital emergency room, getting fluids through an IV. An Urgent Care physician sent me there after declaring my blood pressure too low. The nurses fitted me with a “fall risk” bracelet, led me to a room, and attached sensors to my chest to read heart signals. A device behind the bed, attached to my arm, recorded blood pressure every few minutes. The BP improved, but instead of sending me home the supervising physician admitted me to the hospital.

“You’ve had two episodes of ventricular tachycardia,” she said. “We need to know what’s going on with you. It could be just a heart flutter, or it could be significant.”

“You’re kidding,” I said.

She jotted the term on a Post-It note for me. The distractions of summer faded. An assistant packed me up and wheeled me out of the ER wing into the flow of traffic, past other patients, doctors, nurses, staff people. We made a couple of turns and rolled into a large room with a bed and fitted out with monitors, cables, and switches. I got off the transport cart, sat on the bed, and signed some paperwork. The nurses attached me to the equipment.

I looked around. The duty nurse tapped on a computer on wheels. “Hit the alert button if you need anything,” she said. “Don’t try to get out of the bed, an alarm will sound. We don’t want you to fall.”

Sandy sat with me, both of us in a daze. She recalled the family doctor had put me through a “normal” electrocardiogram or “ECO” a couple of months ago. The hospital couldn’t find the data. She headed home to look for the records.

Through the night the staff awakened me to take pulse, temperature, blood pressure. I stared into the darkness and listened to the muffled voices of the evening shift. Eventually soft daylight peeked through the window.

Sandy returned, daughter Marie arrived. A nurse appeared to perform another ECO, rolling her sensor over my ribcage as she watched the image on her monitor. I slumped, half-asleep. Another nurse conducted an EKG. Heart data flowed into computers.

Someone brought breakfast. The lead physician came by, parsing his words. “I think this probably was an isolated event,” he said, meaning the V. Tach. “But low blood pressure can indicate a number of things. The cardiologist will look at the data and talk to you. Then we can get you out of here.”

The cardiologist, a young good-looking guy, showed up with his assistant. “We did see a couple of things on the ECO, some irregular waves. Maybe nothing, but I need a closer look. We’ll have to get a trans-esophageal electrocardiogram. It’s called a TEE, done under anesthesia. We insert a tube down your throat containing a sensor that will show your heart from another angle. Just a precaution.”

We stepped out of the refrigerator-cold hospital into the late-afternoon heat.  An evening thunderstorm knocked out the power at home, we sweated until midnight. In the morning the storm clouds were gone, the heat returned. Forty hours of intense cardiac surveillance seemed like a dream.

The old buzzwords, diet, hydration, returned. You may think you’re doing the right things. Whether you’ve taken seventy-plus trips around the sun or not, you need to pay attention. When something goes wrong, like V. Tach, you want to know why. The TEE is set for this week.

We persevere, finding sustenance and strength in the good people around us. V. Tach and its mysteries showed up, but nothing else has changed. Sandy and the kids bring their strength and love. Close friends in this town have stepped up to offer kindness and compassion.

We have been thinking about Alaska, that’s back on the shelf. Maine is a maybe. We’ve kicked around another big road trip, replicating the 2022 drive to Wyoming. We have friends in Albuquerque and Austin from the old Virginia running groups. Our New Hampshire cousins are coming to Myrtle Beach. We’ve never been there, maybe it’s time.