Searching for the Causes of Syncope
This week has been one of tests - the kind that I don't know how to study for.
Tuesday morning I had a light breakfast around 7am, and arrived at the hospital around 11:15am for round one of tests. After checking in at the main desk I was taken back to registration where a sweet lady named Lorraine asked me to present my ID and insurance cards, make a payment on my balance, and sign a bunch of forms. Eventually I was sent out to the waiting room to wait until they were ready to take me back. A short time later, a young woman in blue scrubs and her blond hair in a ponytail came in and called my name. She introduced herself as Jesslyn, and I followed her down a hall, through a locked door that she had to open with a key card, and down another short hall through the last door on the right to the room where the tests would be done.
If you stood in the doorway we entered, on the right there were a wall with a few hooks where I was told to hang my purse. Straight ahead along that wall, but facing the door, there was a computer monitor on a cart (I discovered later it was an ultrasound machine). To the left of the cart was a low bed, with the head at the far wall and the feet towards the door. Standing to the left of the head of the bed was an IV stand. To the left of the stand there was a treadmill facing the far wall. On that wall above the treadmill, there was a long horizontal photograph of a park with a lake and downtown Denver's skyline and the mountains in the background. The view looked fairly familiar, and I think it might have been a park near the Denver Zoo. Below the photograph on the wall there was a bunch of medical equipment. To the left of the treadmill was another cart with a computer screen, and a printer below it. (This was the EKG machine.) To the left of that computer screen was the far wall, with a large door that they could wheel a bed through if they wanted to. To the left of that door, and to my left as I stood in the doorway I entered, there was a long desk covered in papers, equipment and a desktop computer. There was also a trash bin and some other gadgets on that wall.
When I entered, I was asked to change my shirt for a hospital gown with the opening in the back. She left while I did that, and then returned. She explained the procedure for the tests I would be doing and asked if I had any questions, then she put the blood pressure cuff on my right arm and proceeded to attach a bunch of adhesive circles with snap attachments to various spots on my chest. Then she connected wires to each of those snap attachments. Each wire was connected to a small box (about the size of a paperback book), which she strapped around my waist. Then she made a couple phone calls - one to have someone do an IV, and the other to my doctor. The lady for the IV arrived first. She chatted with a pleasant eastern European accent as she had me lay down on the bed and inserted the needle into a vein in the back of my right hand. She was just finishing when my doctor arrived.
They made sure I was laying on the bed comfortably with my feet against a board at the base of the bed. Then Jesslyn strapped me in, with one strap across my legs a little above my knees, and the other strap across my chest, below my arms. Then they pushed a button and the head of the bed began to swing up so I was standing at about an 80° angle. The lady who had put in the IV sat in a chair directly in front of me and chatted comfortably. Doctor Haffey stood by the EKG machine, monitoring the zigzag lines as they tracked across the screen measuring the electrical impulses in my chest. Jesslyn sat at the desk or stood. And I stood there, strapped to the bed for twenty five minutes as the blood pressure cuff gave my arm a squeeze every three minutes and occasionally the IV lady or someone else would ask how I was feeling, or if I was feeling nauseous or dizzy. (They hadn't wanted me to eat for four hours before the test so I wouldn't throw up.) It wasn't incredibly comfortable, but I wasn't feeling sick or dizzy or anything. Finally the twenty five minutes were up and they lowered the top of the bed down again and they unfastened the straps. The IV lady left at that point and I was allowed to stand up.
As they were printing out the EKG pages and preparing for the treadmill test, they asked how I was feeling and I mentioned that it seemed like all my blood was pooling in my right hand. It was looking purple and puffy and felt weird. Jesslyn and Doctor Haffey said something about it being the blood pressure, and Jesslyn moved the cuff to my left arm instead, easing it over the needle which was still embedded in my right hand.
Then I was told to get on the treadmill. They started it slowly and horizontally, but every few minutes it would go faster and rise to a higher elevation. Every three minutes the blood pressure cuff would give my arm a squeeze, and the lines on the EKG machine would bounce along regularly. My heart rate got up to its target 157 bpm, and continued for a while, until I had been on the treadmill for about 12 minutes, my hands were sweaty and I was worried about keeping my grip on the bar in front of me. At last they stopped it and I was allowed to sit down and let my heart rate return to normal. It slowed down slowly but surely, and then the doctor left and Jesslyn removed the blood pressure cuff, the IV needle, and the electrode wires and stickers on my chest. She left so I could change back into my shirt, and then I was allowed to go home.
Yesterday I returned for round two. I had been instructed to only sleep from 12 to 4am the night before, and I arrived at the hospital at 7:15am feeling very sleepy. After checking in at the front desk I went back to the waiting room to wait for the next available registrar. It wasn't long before Lorraine invited me back to her desk. This time, she was able to reuse most of the forms from the day before so I only had to sign the permissions for the tests I was doing that day. There was some difficulty finding the order for one of the tests, but eventually that was figured out and a tall bald man came to take me back for an EEG. He introduced himself as Tim Murphy as we walked down one long hall, turned left and then walked down another long hall and eventually he used his key card to open a door into a small area with an office and a few small rooms with beds. He directed me into a room at the end on the left.
This room had a bed and an armchair. There was a small desk in the middle of the room with a computer monitor on it and an office chair next to it. I think there was a long, low table along one wall where I was told to leave my purse. Then he had me sit in the armchair. He explained the procedure to me and I tried to listen and pay attention, but I was so very sleepy that it was difficult to really grasp everything. Then he started to attach wires he called electrodes to my head with wax. I couldn't see what he was doing, but it felt like he was rubbing each area, then pressing the wax tipped wire to my head until it stuck. There were probably about 20-25 wires in all - all over my scalp with a couple on the ends of my eyes to measure eye movement and a couple on my chest to measure my heartbeat. As he attached them, he spoke very low and soothingly about apes grooming each other and how this should be relaxing, like a head massage. When all the wires were attached, he led me over to the bed where I carefully laid down and made myself comfortable. He got me a blanket so I would be nice and warm and secure. He encouraged me to relax. Then he asked me to open and close my eyes a couple times, and then I could leave my eyes closed and try to go to sleep - while he flashed bright lights in different patterns at me for a few minutes. Eventually the lights stopped and I really tried to sleep... in a strange room, on a strange bed, with wires attached to my head and chest, with a man I didn't know sitting in the room with his chair creaking whenever he shifted his weight, and the hospital intercom announcing a "Code H" or something every once in a while. As exhausted as I was, I didn't actually get to sleep before he turned on the lights and told me we were done. I returned to the chair so he could remove the electrodes, and then he walked me back to the waiting room to await my next test.
It was maybe 20 minutes later that Sarah came to get me and led me back to the same room I had been in the day before. She asked me to remove my upper clothing and put on a hospital gown and left so I could do so. When she returned, she had me lay down on the bed, and then she sat down at the ultrasound computer next to the bed to do an ultrasound of my heart (aka an echocardiogram). She attached three of the little adhesive snaps to my chest - two high up over my lungs and one below on the right side of my abdomen and then attached wires from her computer to the snaps. She smeared some gel on the little magic wand and then pressed it to my chest over my heart. For the next thirty minutes she moved around the magic wand, causing the computer monitor to show different angles of my heart, in the fuzzy black and white images that usually when I see them, contain cute little aliens that will be born to be babies. I did see one alien - from one angle, it looked like there was a dalek, complete with eye stock, bouncing up and down rhythmically inside my heart. Sarah measured distances and volumes, and finally she was done. She told me that she didn't notice anything unusual, but the doctor would get the results back in a couple days. She removed the wires and the stickers from my chest, gave me a towel I could use to wipe the gel from my chest, and then left the room so I could clean up and dress.
And then I went home and took a two hour nap. And then took another half hour nap later in the afternoon. And then went to bed early. And I was still tired when I woke up this morning. I'm left to wonder if there was a point to all this. As far as I know, none of the tests have shown anything abnormal. After the treadmill test, Dr. Haffey said I don't need a pacemaker. I didn't have a seizure from all the blinking lights yesterday morning, although I didn't hear any specific results from that test. I imagine I'll have to make another appointment with Dr Haffey to learn if they found anything, and see about getting a monitor that will track my heart rate over time so when I do pass out again, whenever that might be, there will be something to determine what is going on at the time.
Meanwhile the whole ordeal is just frustrating. It reminds me very much of a car we had back when we lived in California. We called it Casper because it was white, and every once in a while, while we were driving down the street the engine would suddenly stop and we'd have to pull over and start it up again. We took it to a mechanic, but the mechanic couldn't figure out what was going on because it didn't happen when the mechanic was in the car. It wasn't until it started happening more frequently that it finally occurred once while the mechanic was driving and he was able to figure out what was going on. Then he fixed it and it never happened again.
I only pass out about once a year, and it happened last month. I'm worried that I'm going to have to wait an entire year before it happens again. I can only hope that I will have a monitor of some type when it happens next so the doctor can find out what causes it and fix it so it won't happen again.
Tuesday morning I had a light breakfast around 7am, and arrived at the hospital around 11:15am for round one of tests. After checking in at the main desk I was taken back to registration where a sweet lady named Lorraine asked me to present my ID and insurance cards, make a payment on my balance, and sign a bunch of forms. Eventually I was sent out to the waiting room to wait until they were ready to take me back. A short time later, a young woman in blue scrubs and her blond hair in a ponytail came in and called my name. She introduced herself as Jesslyn, and I followed her down a hall, through a locked door that she had to open with a key card, and down another short hall through the last door on the right to the room where the tests would be done.
If you stood in the doorway we entered, on the right there were a wall with a few hooks where I was told to hang my purse. Straight ahead along that wall, but facing the door, there was a computer monitor on a cart (I discovered later it was an ultrasound machine). To the left of the cart was a low bed, with the head at the far wall and the feet towards the door. Standing to the left of the head of the bed was an IV stand. To the left of the stand there was a treadmill facing the far wall. On that wall above the treadmill, there was a long horizontal photograph of a park with a lake and downtown Denver's skyline and the mountains in the background. The view looked fairly familiar, and I think it might have been a park near the Denver Zoo. Below the photograph on the wall there was a bunch of medical equipment. To the left of the treadmill was another cart with a computer screen, and a printer below it. (This was the EKG machine.) To the left of that computer screen was the far wall, with a large door that they could wheel a bed through if they wanted to. To the left of that door, and to my left as I stood in the doorway I entered, there was a long desk covered in papers, equipment and a desktop computer. There was also a trash bin and some other gadgets on that wall.
When I entered, I was asked to change my shirt for a hospital gown with the opening in the back. She left while I did that, and then returned. She explained the procedure for the tests I would be doing and asked if I had any questions, then she put the blood pressure cuff on my right arm and proceeded to attach a bunch of adhesive circles with snap attachments to various spots on my chest. Then she connected wires to each of those snap attachments. Each wire was connected to a small box (about the size of a paperback book), which she strapped around my waist. Then she made a couple phone calls - one to have someone do an IV, and the other to my doctor. The lady for the IV arrived first. She chatted with a pleasant eastern European accent as she had me lay down on the bed and inserted the needle into a vein in the back of my right hand. She was just finishing when my doctor arrived.
They made sure I was laying on the bed comfortably with my feet against a board at the base of the bed. Then Jesslyn strapped me in, with one strap across my legs a little above my knees, and the other strap across my chest, below my arms. Then they pushed a button and the head of the bed began to swing up so I was standing at about an 80° angle. The lady who had put in the IV sat in a chair directly in front of me and chatted comfortably. Doctor Haffey stood by the EKG machine, monitoring the zigzag lines as they tracked across the screen measuring the electrical impulses in my chest. Jesslyn sat at the desk or stood. And I stood there, strapped to the bed for twenty five minutes as the blood pressure cuff gave my arm a squeeze every three minutes and occasionally the IV lady or someone else would ask how I was feeling, or if I was feeling nauseous or dizzy. (They hadn't wanted me to eat for four hours before the test so I wouldn't throw up.) It wasn't incredibly comfortable, but I wasn't feeling sick or dizzy or anything. Finally the twenty five minutes were up and they lowered the top of the bed down again and they unfastened the straps. The IV lady left at that point and I was allowed to stand up.
As they were printing out the EKG pages and preparing for the treadmill test, they asked how I was feeling and I mentioned that it seemed like all my blood was pooling in my right hand. It was looking purple and puffy and felt weird. Jesslyn and Doctor Haffey said something about it being the blood pressure, and Jesslyn moved the cuff to my left arm instead, easing it over the needle which was still embedded in my right hand.
Then I was told to get on the treadmill. They started it slowly and horizontally, but every few minutes it would go faster and rise to a higher elevation. Every three minutes the blood pressure cuff would give my arm a squeeze, and the lines on the EKG machine would bounce along regularly. My heart rate got up to its target 157 bpm, and continued for a while, until I had been on the treadmill for about 12 minutes, my hands were sweaty and I was worried about keeping my grip on the bar in front of me. At last they stopped it and I was allowed to sit down and let my heart rate return to normal. It slowed down slowly but surely, and then the doctor left and Jesslyn removed the blood pressure cuff, the IV needle, and the electrode wires and stickers on my chest. She left so I could change back into my shirt, and then I was allowed to go home.
Yesterday I returned for round two. I had been instructed to only sleep from 12 to 4am the night before, and I arrived at the hospital at 7:15am feeling very sleepy. After checking in at the front desk I went back to the waiting room to wait for the next available registrar. It wasn't long before Lorraine invited me back to her desk. This time, she was able to reuse most of the forms from the day before so I only had to sign the permissions for the tests I was doing that day. There was some difficulty finding the order for one of the tests, but eventually that was figured out and a tall bald man came to take me back for an EEG. He introduced himself as Tim Murphy as we walked down one long hall, turned left and then walked down another long hall and eventually he used his key card to open a door into a small area with an office and a few small rooms with beds. He directed me into a room at the end on the left.
This room had a bed and an armchair. There was a small desk in the middle of the room with a computer monitor on it and an office chair next to it. I think there was a long, low table along one wall where I was told to leave my purse. Then he had me sit in the armchair. He explained the procedure to me and I tried to listen and pay attention, but I was so very sleepy that it was difficult to really grasp everything. Then he started to attach wires he called electrodes to my head with wax. I couldn't see what he was doing, but it felt like he was rubbing each area, then pressing the wax tipped wire to my head until it stuck. There were probably about 20-25 wires in all - all over my scalp with a couple on the ends of my eyes to measure eye movement and a couple on my chest to measure my heartbeat. As he attached them, he spoke very low and soothingly about apes grooming each other and how this should be relaxing, like a head massage. When all the wires were attached, he led me over to the bed where I carefully laid down and made myself comfortable. He got me a blanket so I would be nice and warm and secure. He encouraged me to relax. Then he asked me to open and close my eyes a couple times, and then I could leave my eyes closed and try to go to sleep - while he flashed bright lights in different patterns at me for a few minutes. Eventually the lights stopped and I really tried to sleep... in a strange room, on a strange bed, with wires attached to my head and chest, with a man I didn't know sitting in the room with his chair creaking whenever he shifted his weight, and the hospital intercom announcing a "Code H" or something every once in a while. As exhausted as I was, I didn't actually get to sleep before he turned on the lights and told me we were done. I returned to the chair so he could remove the electrodes, and then he walked me back to the waiting room to await my next test.
It was maybe 20 minutes later that Sarah came to get me and led me back to the same room I had been in the day before. She asked me to remove my upper clothing and put on a hospital gown and left so I could do so. When she returned, she had me lay down on the bed, and then she sat down at the ultrasound computer next to the bed to do an ultrasound of my heart (aka an echocardiogram). She attached three of the little adhesive snaps to my chest - two high up over my lungs and one below on the right side of my abdomen and then attached wires from her computer to the snaps. She smeared some gel on the little magic wand and then pressed it to my chest over my heart. For the next thirty minutes she moved around the magic wand, causing the computer monitor to show different angles of my heart, in the fuzzy black and white images that usually when I see them, contain cute little aliens that will be born to be babies. I did see one alien - from one angle, it looked like there was a dalek, complete with eye stock, bouncing up and down rhythmically inside my heart. Sarah measured distances and volumes, and finally she was done. She told me that she didn't notice anything unusual, but the doctor would get the results back in a couple days. She removed the wires and the stickers from my chest, gave me a towel I could use to wipe the gel from my chest, and then left the room so I could clean up and dress.And then I went home and took a two hour nap. And then took another half hour nap later in the afternoon. And then went to bed early. And I was still tired when I woke up this morning. I'm left to wonder if there was a point to all this. As far as I know, none of the tests have shown anything abnormal. After the treadmill test, Dr. Haffey said I don't need a pacemaker. I didn't have a seizure from all the blinking lights yesterday morning, although I didn't hear any specific results from that test. I imagine I'll have to make another appointment with Dr Haffey to learn if they found anything, and see about getting a monitor that will track my heart rate over time so when I do pass out again, whenever that might be, there will be something to determine what is going on at the time.
Meanwhile the whole ordeal is just frustrating. It reminds me very much of a car we had back when we lived in California. We called it Casper because it was white, and every once in a while, while we were driving down the street the engine would suddenly stop and we'd have to pull over and start it up again. We took it to a mechanic, but the mechanic couldn't figure out what was going on because it didn't happen when the mechanic was in the car. It wasn't until it started happening more frequently that it finally occurred once while the mechanic was driving and he was able to figure out what was going on. Then he fixed it and it never happened again.
I only pass out about once a year, and it happened last month. I'm worried that I'm going to have to wait an entire year before it happens again. I can only hope that I will have a monitor of some type when it happens next so the doctor can find out what causes it and fix it so it won't happen again.
Comments
Post a Comment