At some point during nursing school, I actually noticed my heart and it wasn't after the scant exercise I was able to steal from my schedule. I'd be sitting in class and feel a "thud", as though my heart was jumping up into my throat. It never happened more than once at at time, but it might happen several times within an hour, so much so that I would notice it. But there was no pain and it never happened during strenuous activity, so I didn't give it a second thought.
Then it started happening after a glass of wine or two. Drinking alcohol has always disturbed my sleep, but I noticed that when I woke up after drinking and falling asleep, the heart-thud thing was there, more intense and uncomfortable to the point where I could not fall back to sleep.
At work, I noticed it would happen in conjunction with other symptoms I would loosely call panic. And that was very uncomfortable. I have heard people describe cardiac symptoms in conjunction with panic attacks, but I never felt panic until I started working as a nurse. These episodes were minor, really. I felt confused, light headed, unable to "process" what was being said to me, felt like I was going to fall over. Yes... lovely and safe. I would excuse myself for 15 minutes until I could talk myself down. But the heart-thud thing was still there.
I finally got sick of it after Thanksgiving when the symptoms were really interfering with my ability to enjoy the spirits of the season. I finally went to the doctor and sheepishly described my symptoms. Very matter-of-factly she said "Let's draw some blood and do a Holter monitor study."
Holter monitors were something I had seen on patients. Members of my own family have had studies done. I was hoping it was just reflux. But apparently, I have reached an age when any cardiac symptoms result in action.
A Holter monitor is a small, portable device that measures the electrical activity of your heart in order to determine if you're having abnormal heart rhythms. Electrodes are attached to your skin, the electrodes are attached to a recorder that is no bigger than an 80's vintage beeper. You wear the recording device for 24 hours, going about your day, but writing down your activities. So if you climb three flights of steps to do laundry, you write it down. You also write down the time you feel your symptoms and what activity you were performing when you felt them. I diligently recorded my activities and symptoms and turned in the device on the following day.
About a week later, my doctor called with the results. "I think you are fine, but you did have some abnormal rhythms, which is normal for healthy people but I really think it would be best to have a cardiologist review the results and evaluate you." Huh. "So you're saying I'm fine, but I should see a specialist?" I reiterated. "Yes. I'll make a referral for you," she said.
One New Years Eve later and I am sitting in the office of a cardiologist. I'm not a person who runs to a doctor with a hangnail. I've got enough medical background to handle most garden variety illnesses. But here I am, sitting in a cardiologist's office. A few minutes later, I am in an exam room with a nurse getting my history, taking my (very low) blood pressure and running an EKG on me. Nothing abnormal during the EKG. Woo hoo.
Finally the doc comes in and introduces himself. He gets more of my history, does a thorough physical exam rivaling what we learned in nursing school (and have yet to see again). Then he proceeds to sit down with my reading and shows me where my PVCs are. PVCs are premature ventricular contractions. It just means that the electrical impulses of the heart are initiated from a part of the heart other than from where they are "supposed" to be initiated. It's normal when it doesn't happen more than once at a time. He ruled out a thyroid or any electrolyte imbalance as a cause due to my blood work. He suggested it could be "hormonal", as women of a "certain" age often report palpitations. He suggested limiting alcohol, avoiding any decongestants and continuing to exercise, as a conditioned heart is a healthy heart.
What I came away with is that I am "of that certain age" where I can't count on my body to just do what it does without asking me to take notice. In my case, it doesn't want alcohol, it doesn't want paralyzing stress and it needs exercise. Message received.
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