Happiness is...

You’ve used a lot of terms and acronymacronyms that I don’t know. I’ll have to do some googling. I think you wrote that you were a nurse? So you’re a smarty pants with medical terms! 😁

I suppose that I am, @unclewilbur ; I used to take a perverse pride in writing my nursing notes in a form that only a nurse or doc could interpret.  I always figured maybe I’d throw the lawyers off in case I ever got sued.  But I guarantee you that this technique wouldn’t work.  Anyway, I’ll save you the google, NSR=normal sinus rhythm which is what we all want, v-tach is ventricular tachycardia which, if it devolves to pulseless v-tach, is a bad thing (lethal) and usually if not always devolves into v-fib which is ventricular fibrillation which is always lethal unless corrected (and v-tach and v-fib are the only two rhythms that the text books say are shockable, but since I’ve never been a glory nurse, I only know what the textbook says, so I do not know what they might actually try in the ED or CCU).  (But by the text books, flatline, aka asystole, is NOT shockable, contrary to what many of the shows on TV show.)  (And the battery operated AED will only let the user shock v-tach or v-fib, so if a doc was going to try to shock a flatline, it would have to be with the paddles.)  Anyway, premature ventricular contractions are PVCs and my understanding is that they show up on a rhythm strip as an upside down QRS complex and I had always THOUGHT that they came off as a skipped beat when listening with a steth, but maybe I was wrong, because the ED doc said I was perfect (which I do not believe).  SVTs are supra ventricular tachycardia which is a junctional rhythm meaning that it starts somewhere (I believe) above the ventricles and NOT in the sino-atrial node (SA node) which is the normal pacemaker for the heart. After typing all of this, keep in mind that I was never a glory nurse and I NEVER had a patient on a monitor (except in school) so basically this is, for me, all theoretical I am passing on.  Except for the few times I have administered CPR, and in those instances there was something going on that had resulted in cardiac arrest (a patient in pulseless v-tach is NOT theoretical nor in v-fib).   Anyway, if I left any of the acronyms I love to use out, let me know and I’ll elaborate on those as well.

to me, @immatthewj sounds like a hypochondriac :)

@gano , I think that’s what the ED doc was thinking, and maybe my VA doc also.  My VA doc would listen to my heart with his steth and tell me it sounded perfect.  I told him it was like "the dancing frog,"  which was that old cartoon about a guy that had a frog that would tap dance when they were alone, but when he brought it out in public to show off, it just sat there.  I may, in fact, be a hypochondriac, but it is honestly not that I want something to be wrong with my heart, I actually really and truly want my heart to operate within the parameters of a normal rhythm, and regardless of what the docs have told me, I know what " lub-dub/lub-dub/lub-dub [abrupt pause] lub-dub/lub-dub. . . ." sounds like.  But in all honesty, I’d rather be a hypochondriac than experiencing an arrythmia, so if it is the former, I can happily live with that.

A warm gun?

Going way back, I used to live like I had a death wish, and although I didn't (have a death wish), I am surprised that I didn't screw up and actually do something that wound up killing me. Therefore, I guess happiness is: looking back on the years that have followed since my misguided youth and being thankful for those years, because, all and all, they weren't too bad.  

And now I live out on a mountain top
And I'm almost thirty-five
And I've found my peace and I've found my release
And I'm happy just to be alive

Andy Pratt/Avenging Annie/1973

About three and a half years ago I was experiencing some intermittent sensations in my chest that felt a bit strange, so I convinced my VA doc to write an order for a cardiac stress test.  The results did not indicate blockages, and regardless of that not being definitive of good coronary health, at the time it made me happy. 

Atrial Fibulation?

It’s an irregular heart beat, check into it.

It feels like a flutter in the heart.

Mine is controlled fairly well by a few pills.

No, @unclewilbur , the 10-lead they ran at the time of the stress test showed a perfect NSR.  A bit over a year later, I felt as if I was having palpations and I could actually take my own radial pulse and feel a skipped beat and confirm that by listening with my steth, and I initially thought of PVCs.  I called the VA and they said they would pay for me to go to the ED and get checked, and there they ran a 12-lead for a while and told me it was perfect . . . no A-fib or PVCs or anything else.  I said, "But doc, I can check my pulse and feel a skipped beat intermittently," and the ED doc said, "You want my advice?"  And I was like, "Of course I do!"  He said, "Quit checking your pulse!"  Anyway, whatever I was experiencing was not happening when I was hooked up to the monitor.

After that the VA ordered a monitor for me to wear for a few weeks, and the results came back as occasional runs of SVT, which is a junctional rhythm but generally benign.  However, I do remember from the classroom that V-tach (which is "usually" NOT a benign rhythm)  usually devolves from a junctional rhythm.  

Anyway, I am still here, but as I typed previously in this thread, I do not have a death wish, and most days when I wake up, I’d like to live until at least the next day.

Some of these arrhythmia types can be nasty and just mess up the heartbeat to a point of no return

Yup.  If you go into V-tach and then V-fib, if you are not in the right place and around the right people, that is generally the end of the line.  And even if you are (around the right people in the right place) it is still a crap shoot.

. . . what I used to describe happiness as being was: firing up the charcoal grill and pounding a ice cold beer while the coals started burning down and then singeing a 2" thick slab of New York strip and washing down that blue-rare piece of beef with some more ice cold beers.  It has been at least a few years since I have done that.

@unclewilbur , I am assuming that you are on medicare (I just started on it a year ago, and I still don't know all the ins and outs) but if you already have a cardiologist, I'd say try to schedule an ECG and have him interpret it.  I am going from memory on this (I can get the textbook out in a bit) but as I recall, if it is a PVC, that is another rhythm originating somewhere other than the SA node and what happens if I recall correctly is it is one signal for a heart beat from somewhere other than the SA node landing on top of the SA node signal (but I will look that up).  What I do remember for sure is that this is another generally benign rhythm unless you get too many directly in a row (I'll look up how many) because that can turn into v-tach.  As far as A-fib, that's a bit of a different animal, and my understanding is that strokes are one of the big risks as the atrium is fibrillating which is a recipe for potential clots to form.   I would also think that  fibrillating atria wouldn't be properly (completely) emptying into the ventricles that therefore the output (also known as cardiac output/CO) from the ventricles would be reduced and that this could result in certain physiological sensations and possibly an increased heart rate as maybe the response to  decreased CO.  I do know that when one's blood pressure drops (as in one of the early stages of shock) the heart rate elevates as a response to compensate.

But don't take anything I type very seriously--I am NOT at all qualified on this subject and the best thing to do is to get in to see a cardiologist.

Anyway, I hope you're ok!!!

Thank you for the good thoughts.  Generally I feel okay most of the time, but having seen what happens when someone's heart ceases to produce an adequate pulse has made the concept seem real to me, and in all honesty, I have not completely come to terms with it on a personal level.  Although sooner or later it is inevitable for all of us.

Best thoughts back at you, and talk to your PCP and or cardiologist.

That is interesting, @asvjerry , and similar to this:

going back to around when the tale I recounted started, a friend of mine who I had worked with from ’85 through ’87 called me to touch base, and to make a long story short, he had just got a stent put in the, from his description, I believe may have been the  left anterior descending coronary artery.  Unlike me, he eats good food and exercises, but he also drinks and smokes pot and there is a family history of coronary artery disease. Anyway, he said he had been feeling like something wasn’t right when he was riding his bike and his doc set him up with a stress test and they told him he had a major blockage going on and needed a stent asap.  So he got it and he said he felt great afterwards.

I frequently feel as if "something is not quite right" but I also know how a little knowledge can create a psycho somatic experience.  However, I got to thinking that my own sedentary lifestyle and eating habits may have caught up with me also, so therefore, during one of these spells where the left side of my chest was "feeling a little funny," I got the VA to do the cardiac stress test.  Which they said I passed with flying colors.  Which is not a true indicator of everything going on in there, but it did make me feel better at the time.

Then a couple of years later was when I started palpating and listening and hearing a skipped beat, and the more I listened and felt my pulse, the more frequent it seemed, and I also thought I was feeling mild palpations.  Which is about the time my neighbors 50 some year old wife, who appeared to be in great shape (but she did smoke cigarettes and I think there may have been a family history), went into cardiac arrest and died.  It was then I decided maybe I needed to have another check done which prompted the call to the VA where they put me on with a triage nurse who played 20 questions with me and decided to error on the side of better safe than sorry and hence, I went to the local ED.

This was the doc that told me to quit checking my pulse.  And for the most part I have quit checking my pulse, and when I do, I haven’t picked up the skipped beat.  So I am willing to concede that the mind is a funny but powerful thing that can have funny but powerful effects.  And as I also typed previously, I think having a tiny bit of knowledge on my part is not necessarily a good thing.

Oh well . . . ramble on. . . .