The Real LJ Idol - Wheel of Chaos - Wk 11 - Tiger Team

[bleodswean]

This is very long. 3300 words. It is the story of September. The story of my daughter's cardiac ablation. If there are signs and omens in the universe, then this week's prompt is one of them. For me. 

My thirty-five-year-old daughter and I check in with one another every morning by text. We will chat later, most probably several times throughout the day, but choose to text while we both are beginning our day. I work from home running our family business, she and her husband work in the Public Defender’s office. They live an hour and a half’s drive from here.

Good morning *smiley face*

Helllloooo!

Even though September 1^st was Labor Day and a holiday for them - we never take time off - I started our morning with a text knowing that the two of them would be up early to do yard work. It was 7 a.m. and I didn’t get an immediate response. Maybe they decided to sleep in after all.

I put the phone down and began brewing my first Flat White. Several minutes later the phone alerted me with her text signal.

I don’t feel well. Something’s wrong.

Tell me.

The phone rings in my hand. I can hear a strained panic in her voice. What is it? I ask. My heart is racing, she tells me. We watched a scary movie last night and I made D turn it off, but I guess it made me more scared than I thought? What do you mean – your heart is racing? I can tell my heart is beating so fast. Since last night? Yes. Take some deep breaths. Can D take your pulse? He’s mowing the lawn, but I don’t need him to do that, I have my iWatch. Okay? It says 193.

Standing in my morning-lit kitchen, holding a cup of espresso, I felt all the blood drain out of my head and into my feet. My girl, her heart, my heart. I steadied myself with my own advice - a deep breath - put the coffee down. S, I told her, you need to get to the hospital. Has it been beating that fast all night? That’s just not possible. Please sit down and take some deep, holding breaths. You should call T and R and have them come over.

The next-door neighbors are General Practitioners with their own local practice and the same age as my daughter and her husband. The two couples have been weekend buddies for the past five years.

Let me call you back.

NO! Please go next door or call an ambulance or get to the ER.

Okay.

I crouch on the floor. The floor needs to be washed; I can see that clearly from this angle. Why is there so much caked dirt beneath the cabinets? Why isn’t the new mop doing a better job against the baseboards? The tile grout obviously needs a good on-your-hands-and-knees job with a bristle brush. My head feels strangely emptied. I could easily lower my entire body to this dirty floor and close my eyes. The phone alerts.

We are in the car on the way to Mercy.

I abandoned the coffee and jumped in the shower. She began to text me updates, her husband begins to text me updates. She was triaged immediately and bypassed the insurance check-in and a waiting room filled to capacity to be rushed into the back and hooked up to a cardiac crash cart. She is a tachy patient and the cardiac nurse prepares the Adenosine. The pronunciation will soon roll off our tongues without hesitation for the next three weeks. Uh-den-oh-seen. We will grow intimately familiar with this IV administered drug and the flat line it produces on the monitor and how the nurse’s hand holding yours above your head is the only anchor you have to everything. Everything.

It gets her beats per minute back to 88. In less than three minutes. The defibrillator pads stay on, chest and back.

The ER physician pages the cardiac hospitalist and an OBGYN laborist.

Four weeks ago, after two years of a hard-fought battle with infertility, my child was fourteen weeks pregnant with her first child.

One hour later, her heart beats itself back up to 190 bpm. Two more doses of Adenosine and they admit her.

 

My 85-year-old mother has begun a slipping. Out of her personality and into a more childlike demeanor with a significant and concerning amount of short-term memory issues. Her daughters have decided to protect her from stress or burden her with over sharing. I decide that first day not to say anything to anyone. My daughter and her husband assured me that everything is fine, they are being reassured that everything is fine. A blip, a glitch, a one-off. They ask if I can come up the next morning and take her home when she’s discharged so that her husband can get into the office. Of course I can. And I do.

I don’t pack an overnight bag, I don’t make arrangements for the little dog, I don’t leave on a light or leave out extra kibble. It’s an hour and a half drive each way but that’s okay and we usually visit for just the day. I will drive up early and be home before dark. In time to walk the little dog.

We are told this is called SVT. Supraventricular tachycardia. Something somehow is misfiring somewhere. We have a name but no reason. Pregnant women have an increased blood volume, we’re told. The discharging nurse is dismissive of fears, and we feel suitably abashed for our paranoia. Although I was told that my daughter had another episode the night before but was taught a vagal maneuver of blowing into a syringe. It worked and brought her heart rate down to normal. She’s been put on a beta blocker which we are told is fine for Baby, too. It’s a time released medication and may take a day or two to get fully on board. No one expects another episode but IF one were to occur, here’s a syringe, blow into that. And, I ask, if that doesn’t work? Come back to the ER after ten or fifteen minutes.

We trust the medical professionals and leave the hospital. Leisurely shopping at CVS and Holiday Market, back at her house I clean the kitchen and make her a grilled cheese and encourage her to hydrate. We eat outside and find comfort in the ultrasound report from the night before that says Baby is fine. She seems tired but content.

At five p.m. her husband returns home and I’m getting ready to take off when she gets a distant look in her eyes and taps her chest. This too will become a touchstone of familiarity and a source of trauma response. Her iWatch begins flashing a red heart and she says, it’s happening. She blows into the syringe. She holds her breath. We time the episode. Ten minutes, fifteen minutes. I’m frightened seeing my child frightened. We load up and return to the ER.

Again, she bypasses the overdosing, the RSVing, the chronic, the shoppers, the frequent flyers, those dying alone. She’s hooked up to the crash cart and another dose of the Adenosine. She must lie prone for a half an hour after, the staff confer in the corner of the room, her husband ill-advisedly acts too upbeat, and she breaks down. None of this feels safe anymore. I get on my knees beside the gurney and hold her hand and stroke her hair. One thing we know, she needs to find a way to remain calm.

There are no rooms, they make do with a wound stitching room. No bed, she’s on the gurney. And we have no answers. Neither does the staff. They want an ultrasound of her heart in the morning and the hospital cardiac doctor to look at it.

I’m supposed to have breakfast the next morning with my mother and local sister. I have not told either one what is happening. A nurse brings my daughter a crappy turkey sandwich she wolfs down. I move into the hallway and call two of my sisters. I need to begin assembling a familial tiger team.

My daughter is our first attorney. Our family consists of military and medical folks and some medical folks in uniform. My son is an EMT. His face becomes my Polaris throughout this ordeal. My local sister is a Trauma Social Worker, her networking and friends on the inside will provide the advocacy and answers we need. Her husband is a Fire Medic. My niece is a High Risk Laborist, an OBGYN, her husband a Navy Seal Medic. My East Coast sister is a Cardiac Triage Nurse.

We get to work. My sister contacts her friend at the Mercy Heart & Vascular Institute two hours away. World renowned cardiac surgeons. My niece empowers us to insist that there are two patients in the bed. My brother-in-law explains adenosine and how and why it’s working. My sister goes to the books and reports back that this drug does not cross the placental barrier.

We all decide to keep our mother on a need-to-know basis.

At ten p.m. exhaustion is setting in. S needs to sleep, desperately. So does her husband. The two of them are trial lawyers. She is missing work. He cannot. He has jury selection the next day. We agree that he and I can return to the house and I will return in the morning. This does not feel good to me, but I’ve also seen how he is her rock and that his optimism is her life jacket. I don’t want to question his proclamations. I swear to her that I will have my phone on me at all times if she needs anything.

At eleven she texts into a group with the three of us that the police had to pepper spray someone in the room next door and it made her cough. She’s not sleeping. I text with her a bit, her husband remains silent. We lol that he is asleep. I fall back to sleep and at midnight the phone wakes me up.

It’s happening.

Okay. Breathe. Did you try the syringe?

Yes. It’s not working. I’m scared.

Is the nurse helping you? Is the doctor there?

No. Please come.

I’m on my way.

How?

Everyone knows I can no longer drive in the dark.

I’ll figure it out.

I’m out of the bed and dressed and when I open the bedroom door, my son-in-law is standing waiting in the hallway. Let’s go! he says and we run to the car.

Security waves us in, we are familiar to them now, opening the door. We round the corner and into Adenosine being administered. My heart cramps. They settle her back into the gurney, tuck her in with warmed blankets and make room for us.

I sit at her feet, and he sits beside her and holds her hand. She tries to tell us how she had to scream for the nurse, and the monitor begins beeping. We implore her to stay calm. She rage whispers the story. We are stricken. We decide we can’t leave her again and agree to take shifts. He leaves and I take the vacated chair. My heart aches as she begins to quietly very quietly weep and weep and beg God for this child. She cannot do this in front of him right now. I realize she is the wisest and bravest person I’ve ever known. A nurse comes in and turns off the light. The rails are up on the gurney, and I move to the end so that I can lay my head down beside her feet and sleep.

At four-thirty, her husband appears. Time is a different dimension in the Emergency Room.

He wants to take me back to the house and will return to the ER with breakfast and his suit. I can sleep a few hours and relieve him at eight so he can get to court.

Later that morning she has an ultrasound of her heart. I cannot bear this and must step on the other side of the curtain. An existential curtain inside my own mind draws closed and I recite the Lord’s Prayer and A Hole is To Dig, her favorite childhood book that we both learnt by heart, and the last stanza of TS Eliot’s Four Quartets. All shall be well and all manner of thing shall be well. Julian of Norwhich’s off-quoted assurance. The scan takes twenty minutes.

She is uncomfortable in the gurney. The hospital chaplain stops in and is perfectly suited to his career. He tells us that cardiac patients are different than other patients. His explanation is both Jungian and physiological and she bursts into tears. I leave the room so he can sit beside her for a few minutes.

A resident appears and informs us that the scan is perfect, and the cardiac hospitalist says there’s no reason to see her, this is an OBGYN issue. She is to be discharged again. It appears that we are waiting for the Metoprolol to get on board.

That evening, while we are chatting on the phone, she will have another episode. This time she does go next door and the two doctors who live there take incredible care of her and get the episode resolved. They become part of “her team”. The next morning, she will see them in office, and they get her into the local cardiologist’s office, Dr. K.

The next night, my phone rings at 2:30 am. I have 86 missed text messages. Somehow the text alerts have been turned off. She’s having another episode. I call her and tell her - why do I have to be the one to tell her? - to get back down to the ER. That Friday morning, I drive again to Mercy. I find her in a real room in the ER, surrounded by dying pensioners. She has a nurse who believes in vagal maneuvers before the Adenosine and this new method works. The two of them resolve an episode on their own.

My local sister calls her and uses a legal analogy to empower her. You are the client, she says. You must represent yourself. No one else can do this to the degree you can. Become your own counsel, Counselor.

Something shifts and I watch as my daughter begins to advocate for herself, but I know it’s for her unborn child. She firmly instructs the staff to refer her to the Mercy cardiac unit in Sacramento, they balk, she gives them one of the surgeon’s private fax numbers, they do as she asks, she texts the local cardiologist, he changes the med to Sotalol. Dr. K will call her at home that Sunday and tell her he thinks it’s an urgent ablation, but the next evening in his office, he takes a more reserved approach and says to stay on the Sotalol and revisit in December. He reassures her by telling her that this is the drug given to women whose unborn baby has SVT. Everyone wants to feel reassurance; everyone wants this to be the answer.

But it isn’t.

Over the next five days, she will have a few breakthrough episodes that she manages with the feet-over-the-head maneuver. Her birthday is on the following Tuesday, and we go up to celebrate with her. I’m deeply concerned by how exhausted she looks. Living with fear and the unknown is draining her.

The next night she wakes me up just past midnight. This time the iWatch is telling her she’s in aFib. A new symptom. In the ER, the alarms go off as well. A physician takes the time to tell her it's a false alarm because her heart rate is so high and her blood pressure is so low. This is not comforting, but we are learning how to decipher the hieroglyphic monitor. 

My friends, this will continue off and on until Tuesday, September 16^th. Sixteen days. Emergency rooms. Exam rooms. Ultrasounds. Baby is FINE. EKGs. Phone calls and texts. Finally, on the 16^th, she has episode after episode that aren’t resolving. We are in and out of the ER twice that day. For the hour we’re home she jokingly quotes Captain Beefheart and says she’s been driven away from her own steering wheel. On the way to the hospital for the second time, she texts the cardiologist that she’s going to have a mental breakdown and by the time we arrive there’s a life flight waiting for her.

After that everything gets handed over to God. And God-things begin to happen. My husband and son inexplicably finish work in one day and are home late that night. This happens maybe once every two years. Now we can go together to the Cardiac Institute the next morning. We are going to the very hospital that our daughter was born in. Across the street from the house he grew up in. His mother still lives downtown and keeps us company for that long day.

We see our daughter for just half an hour before she’s wheeled down to surgery. But we are there for the baby ultrasound and our son-in-law slips and we find out it’s a boy! The staff are outstanding. We settle in for an hour and a half wait. We walk over to the old house and marvel that it’s now worth millions of dollars. My husband gets deeply and quietly sentimental. He used to ride his bike here up and down these sidewalks. We can’t find his name carved into the Dutch Elm.

Back upstairs, we grab chairs in the waiting room, beside the statue of the Virgin holding her baby, Christ. We get a text from our daughter. I’m awake! Her husband disappears into her room for some alone time. We text back and forth with her for thirty minutes. She sounds great. We laugh at how nervous we have been. Silly. Then she goes quiet for ten minutes, fifteen minutes. I text. Can’t wait to see you! It remains unread.

Suddenly, our son-in-law is moving fast down the hallway to the elevators. He rushes past us. Punches buttons. D? we call to him. He turns and his face gives him away. I jump up. He says he’s going downstairs we need to wait a little while more. The elevator swallows him, and I descend and ascend into the most painful minutes of my life.

My husband’s phone rings. I hear him talking but can’t make out the words. He gives me a smile and a thumbs up. My legs are asleep from kneeling on the hospital floor.

She’s had another episode. In the recovery room. The procedure didn’t work. They are going in again in two hours’ time. She is downstairs and we can see her one at a time.

In the elevator I experience a full-blown panic attack when an orderly rolls a huge cart into the tiny space and I move between him, the cart, and the open door, out onto another floor while the elevator doors close behind me. I’m lost. The hospital is a labyrinth of corridors and strange faces, and I wander. For days. Trying this hallway and that hallway and then the stairs. I cross deserts. I hear my husband’s voice calling my name, and I’m found.

 

The second catheter ablation worked. The world-renowned electro-physiologist told her: in cardiology they don’t always know why but they do know how to fix it, whereas in other areas they know the why exactly but there’s nothing they can do.

Right now, and maybe for the rest of our days, we’ll take that. Everything continues to test normal. Everyone is okay. The month has collapsed, a black hole in a sky full of bright stars. Residual trauma is being managed, lessening. It serves no one. We are grateful to so many, all of them on her team.

We are all learning to breathe again. Deep into the diaphragm. Hold for six seconds. Exhale. Inhale. Hold. Exhale. Life is good. 

Comments

[muchtooarrogant]

Thank you for sharing this with us, I'm so glad your daughter and her baby are okay!

I felt like I was riding the roller coaster with you, and then, so perfectly illustrated here, there are those moments where everything stops and becomes surreal.
I crouch on the floor. The floor needs to be washed; I can see that clearly from this angle. Why is there so much caked dirt beneath the cabinets? Why isn’t the new mop doing a better job against the baseboards? The tile grout obviously needs a good on-your-hands-and-knees job with a bristle brush.

All the best to you and your family.

Dan

[bleodswean]

Thank you, Dan, for reading and your good wishes! Yes, isn't there always a surreal moment in the middle of these sorts of crises? Glad you could identify with that!

[kradeelav]

so very many hugs to you and her and everyone involved.

I haven't had the chance lately to read here on DW but so grateful to hear there's a little bit of stability at the end of this post. may that and the peace hold.

outside of the heaviness - "familial tiger team" made me smile as a line in a morbid way; intimately familiar with how that goes with many a medical crisis back in the day.

[bleodswean]

Hugs, hugs, hugs!!!

Thank you. Watching so many people so very alone during those weeks really brought familial tiger team home to me!

[dadi]

Oh dearest, this is so very scary. My heart is with you all <3

[bleodswean]

*HUGS* Thank you!

[vriddy]

Thank you for sharing. I'm so glad things are now okay.

[bleodswean]

Thank you for reading! Human connection, it's the key!

[mallorys_camera]

My God, E, this was so scary to read! That arrhythmia seesaw—VTach, AFib, back & forth—must have been so terrifying to experience & then the fears about the little guy—and your daughter was able to hold it together 90% of the time???? Wow! RESPECT.

And RESPECT to you for doing all that you did, coordinating, being the glue.

And the whole thing went on for a month???? Good for you & S for demanding the hospital transfer. You want a surgeon who can do the ablation in their sleep.

I am so, so, so glad S is okay.

[bleodswean]

Thanks, P. I am traumatized. She is traumatized but more inclined to get past it because she needs and wants a rhythm to her life more than I need. I didn't realize how traumatized I was until the day after she got home, and she sent me a pic of the wound care for the femoral woundS! I lost it. I insisted she not take the bandaging off without her neighbor being there. But everything turned out fine with that. I also began to realize I had PTSD at night with the phone and talking to her on the phone. Finally I drove back up there and spent the day with her so that I could see with my own eyes that she is OKAY!

What a piece of time. I'm happy to be in a new month with new hopes and promises!

[earthspirits]

My god, E.! What a nightmarish experience for your daughter, you, and your entire family.

I'm very relieved to hear that she and the baby are now okay, and sending good healing vibes that they continue to be so, and good vibes to you and your family.

As always, your writing is incredibly evocative, I felt like I was right there beside you and your family, sharing your fear and worry. So very, very glad that the outcome was a happy one.

*HUGS*

[author_by_night]

*Hugs* I'm glad things are better. How scary.

[bleodswean]

*hugs* Thank you!!!

[legalpad819]

I'm so glad this had a happy ending. You do an excellent job of explaining how a health crisis feels, as I went through something similar over the last few months while my best friend was diagnosed with cancer and had to go through surgery and treatment. It becomes an all encompassing blur of ins and outs of the hospital and time taking a whole new form while you wait for some sign that it's going to end.

Sending lots of love your way.

[bleodswean]

Thank you so much for reading and leaving such a wonderful comment! This medical experience is common and one we should be talking about more.

[dr_zook]

Thank you for sharing everything here. You guys are a Tiger Team indeed. *hugs* 💫

[halfshellvenus]

What a harrowing experience for all of you! Just a nightmare from start to finish. I'm so glad they finally got something working for your daughter, and that she and her baby are safe.

And I'm glad they brought her to Sacramento instead of leaving her in Redding. *Whew*

[roina_arwen]

Wow, that sounds SO scary! I'm glad to hear the ablation worked and that all is well right now. Best wishes to the entire tiger team!

[fausts_dream]

Powerful piece, so glad mother and baby are doing fine.

[inkstainedfingertips]

What a horrible roller coaster to have been on. I'm glad to read that everyone is doing better and that everyone is all right and testing continues to be normal. I couldn't imagine having to endure all you guys did.

Your last lines are especially poignant.