What happened.

The short version: I blacked out in a restaurant last Sunday. While being monitored overnight, my heart stopped for 13 seconds. I spent the next four days being continuously monitored around the clock and…nothing happened. There’s absolutely no indication what caused the incidents on Sunday.  I got a pacemaker as an insurance policy, and was discharged on Friday. I’m fine apart from recovering from the surgery, and there are no significant lifestyle modifications going forward unless I decide to take up a career in welding or as an MRI technician.

The longer version:

Last Sunday, we took a day trip to the suburbs to visit the Little Red Schoolhouse nature area and have lunch at a place that had promising vegan options. I was hungry by the time we made it to lunch, but not overly so, and probably hadn’t had enough water, but I wasn’t dehydrated by any means. We ordered lunch, and as it arrived at the table, I had a moment of feeling weird, and the next thing I knew, I was being picked up off the floor, having hit my head on the table or the floor or both.

I was convinced to be transported to the ER by ambulance, where I promptly threw up my virgin Bloody Mary (thanks, motion sickness). We waited for more than an hour in the hallway of the ER before being moved to a room, where they checked me out, did blood work, etc. More hours of waiting in the hallway and – nothing. No idea what had caused the blackout. Nothing wrong with my blood sugar, blood pressure, electrolytes, etc. No signs of concussion. Annette and Liz drove out to rescue us, taking the boy out for ice cream while we waited for news.

They wanted to keep me overnight for monitoring. Panicked at the idea of an out-of-network hospital stay, we called my parents (my dad is a doctor), who strongly encouraged us to stay. I was admitted, and Annette and Liz drove the guys and our car home.

Once I was settled in my room, I called N to video chat. While were on the phone, I blacked out again – except this time I was hooked up to telemetry devices, and they could see from the readout that my heart had stopped for 13 seconds. Over the next few hours, I had what could best be described as hot flashes – a temporary rush of heat, nausea, and dizziness – that they correlated with sharp drops in my heart rate (into the 30s – my resting heart rate is around 55 normally). The on-call cardiologist was called in. Family friends came to see me and got the doctor straight talk, which was relayed to my anxious parents. The decision was made to transfer me to the University of Chicago, which is where I would’ve preferred to be the whole time. I arrived by ambulance (no throwing up this time) around 5am Monday morning.

I spent the next three days waiting for something to happen, first in the SICU, then in the cardiac ICU. Nothing happened. No more hot flashes or pauses. No more nausea or dizziness as long as they let me eat. Nothing. Not only was I the unusual young patient in the cardiac ICU – I was an otherwise completely healthy one. It was surreal to say the least.

Meanwhile, my family was scrambling to cover things at home so that N could spend time with me at the hospital. My sister and the baby dropped everything to drive in for the first night. My mom flew home early from vacation, and took turns with N visiting me and wrangling the boy at home or in the hospital lobby – he couldn’t visit due to flu season. Everyone was amazing and did their absolute best through an exhausting week.

I met with more doctors than I can even possibly remember, especially since some of them stopped by in the very early morning or while I was trying to eat, or called while I was in the middle of talking to other doctors. The attending cardiologist happened to be the head of the electrophysiology team and a “rising star in the field of arrhythmia management” – exactly the sort of person you want on your case if your heart is doing something weird. He was mystified, as were the colleagues he consulted at top rhythm centers around the country.

He presented me with several options, all of which he said he felt equally comfortable recommending, both for my health and in terms of his responsibility: I could go home after several days of monitoring. Or I could go home with an implantable chip that would transmit my telemetry data to them for longer term monitoring. Or I could get a small pacemaker that would “catch” my heart if I experienced another pause or dip.

We talked it over extensively, and came to the conclusion that the pacemaker was the safest choice. I kept contrasting this choice with choosing to wear a bike helmet. If I don’t wear a bike helmet and have an accident, generally I’m the only one affected. If my heart crashed again, however, it could be disastrous. We got exceptionally lucky that it happened while I was sitting in a chair and lying in a bed. The thought of it happening while driving, or crossing the street with the boy, or walking down a flight of stairs, or cooking dinner – any of those could be catastrophic.

So on Thursday, I got a pacemaker. The surgery was done under sedation, not general anesthetic. A small injection in my groin allowed them to access a vein to place a sensor that would allow them to generate a map of my circulatory system. After making a two-inch incision just below my collarbone, the pacemaker lead with a tiny sensor was introduced. The doctors used the 3D map to thread the lead into my heart, attached the device, and closed me up. It took about three hours from start to finish.

I was rolled back to my room, where I spent the next four hours flat on my back on bed rest. I wasn’t allowed to move my left shoulder or my right leg. They angled my bed up to about 30 degrees so that I could eat for the first time in 18 hours (I didn’t order wisely, but managed to finish my veggie burger without too much mess). The plan was to discharge me after the period of bed rest, but neither N nor I thought that would be safe, so they agreed to keep me another night. I spent my last night in the hospital zoning out and watching Battlestar Galactica and trying not to think about the previous few days, or the days ahead.

So what is life for an otherwise healthy 38-year-old like after getting a pacemaker? A few more days without showers. No driving for two weeks. I can’t lift my left arm above my shoulder for 4-6 weeks. I’m very sore, though the soreness has as much to do with strange motions compensating for my range of motion as it does with the surgery itself. I have a box under my bed that downloads data from the pacemaker and transmits it to the doctors and the device company. I can’t climb radio towers, or take up welding, or hang out between loss prevention gates at stores. I can’t play football or any other sports where there’s a risk of hard contact to my chest. I can’t get an MRI.

But I can have an almost completely normal life – once I figure out what normal feels like for all of us after all of this.

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