Sorry for the lack of recent updates! I've been busy with teaching and other projects and activities that occupy my time. Please bear with me.“I didn’t know you are a runner...” Actually, to be entirely correct, the appropriate verb should be in the past tense--“were” instead of “are”. But this is usually the type of response I get when people discover more about me.
There are certain days that some people won’t ever forget in their lives...their birthday, anniversary, etc.
July 31st, 2010 won’t be a day I will ever forget. This year had been another forgettable year, but finally on the mend from injuries of the past two years. On that day, I had the strength and intention to do a medium, long run around Lake Merced. As my training this year had been less than ideal, I went at an easy pace. About half way around, I was fatigued but was able to continue. With less than a mile to complete the loop around Lake Merced, I decided to just complete one loop instead of continuing to add extra mileage.
The instant I stopped running, the rush of dizzy spells and breathing difficulties became apparent. This instance compared to others worried me because I would be teaching in Korea within a couple weeks. As I hoped to recover from this bout, there was no end in sight. I sat in my vehicle parked at the lake to attempt a method in calming and relaxing myself down as much as I could. I changed seating/resting positions, turned on the radio, opened the window, and got out to stretch; with each action, nothing seemed to subside my rapid and violent heartbeats. I also drank all the Gatorade and water--four bottles, thinking that would help.
Five minutes turned to ten minutes, ten minutes turned to a half hour--and eventually to one hour. As a runner, I was still stubborn to think of a much worst prognosis regarding my condition and drove home, which in hindsight is NOT the best thing to do. But somehow, I did make it home and I was conscious if not freaked out still. The risk of driving could’ve produced really terrible outcomes that I don’t want to contemplate, and it was a stupid decision on my part.
I rested on the couch and told my parents to check if my palpitations were still violent. My mom said yes, but reasoned that it would probably go down with liquids and rest. Four to five hours had passed since the attack at the lake, and I told my parents to call the doctor now. They did, but were still not too concerned; I, however, had reached my limit and felt like I was going to die. So I yelled at them to just call 911 if the f-ing doctor didn’t call back soon. I was completely nauseous and vomiting during this time. 7 hours had passed and the doctor called back. He asked if my parents could find a blood pressure reading; they told him that they were unable to get ANY reading from my dad’s blood pressure device. Then the doctor asked if they could find a pulse. My mom couldn’t find any--not on the wrist, neck, ankle. At that point, the doctor told my parents to call 911 and have me sent to St. Mary’s Hospital.
It has been a really tough time for the family. Usually bad things happen in three’s and in this case, this was certainly no exception. My next door neighbor, who had been in poor health for the past 20 years, was rushed by ambulance to hospital where he died. My godmother’s niece also passed away a couple days following that. And now, another ambulance (and a couple fire engines) was being sent for me within 30 seconds of that 911 call. Certainly, the block and neighborhood was abuzz with speculation and rumor about what went on in our house. They probably thought that the “kid” took drugs or did something stupid.
My first ambulance experience--you’re probably better off thinking what it’s like than actually being in one. I also thought about what the cost might be (thank god for insurance). But the EMT guys were extremely patient and calm and even discussed the possibility of what my condition might be. They did a 12 EKG lead on me, and during that time, they also found out that my heart rate had exceeded 240. This would be almost certain death in any ordinary person. At my peak, my HR was around 200. While the EMT didn’t want to make any diagnosis because that is not their job, they did show me that there was something definitely going on in the heart. The ambulance put me on an IV drip as they whisked me without the siren on to the St. Mary’s ER.
History of my Condition
My first apparent sign with dizziness and shortness of breath happened during a short run from the adidas store to AT&T Park. As I approached the ballpark on a January 25th evening, I couldn’t fathom the overwhelming feeling concentrated on my chest. Was it asthma? It couldn’t be a heart condition because I only felt my throat and lungs constricting.. I had trouble walking back to the store so I needed two of our runners/walkers to take me back; if it weren’t for them, I would’ve been in deep trouble. When I returned I was in a cold sweat, almost passed out, and could hardly get up from a sitting position on the floor. Only a week earlier, I had completed the Houston Marathon without any problems other than lack of training, but definitely no dizzy spells or airways closing up.
I may have had early signs in December, but I ran hard up the Powell Street hill so I attributed that effort to my shortness of breath. However, after that January evening, it became ad ordeal to complete even short runs and the recovery times of my bouts got longer and longer. It was so bad that I really had no motivation to run anymore. I did do the Seoul Marathon with no symptoms in March, which remains a mystery. But I’ve done a ton of ultras that gave me at least one incidence of discomfort; however, my saving grace was that ultras are substantially lower in heart rate effort so the symptoms were mostly hidden during the races. Ironically, the shorter distances that were less than 12 miles always seemed like an effort of marathon proportions.
For months, doctors and the internet were sources of confusion and fear. Over this 7-8 month period and at one point or another, I thought I had asthma, exercise-induced asthma, syncope, an undefined heart condition, vocal cord dysfunction, vertigo, a virus, GERD, diabetes, stress, allergies, etc.
During the month before my emergency, that time was the scariest and most precarious. A similar incident the Tuesday before that 911 call on Saturday transpired into an event that would be a segway to Saturday. I did a run from Great Highway to GG Park and back. I was now used to breaking up my runs into segments of run/walk or fartlek sessions because I could no longer complete my longer runs. When I returned to my vehicle, the palpitations were there. But I figured that I over hydrated and took too many salt tablets because it was warmer earlier that afternoon and the fog shrouded the evening, which lowered my sweat rate. I drove home uncomfortably and almost in a daze, which was yes, I know--stupid. But I got home safely and rested on the couch and had to vomit into the toilet. After many bouts of vomiting, I got dizzy and the palpitations were so bad that I had to lay on the living room floor to rest. It was so bad, I had to crawl to the toilet to vomit; standing up was too much. Walking to my room to sleep was too hard, so I slept on the floor but recovered the next day with no symptoms whatsoever.
At this point, I ruled out asthma or vocal cord dysfunction as my problem and cancelled those appointments, but I still had no idea which doctor to call. My general practitioner didn’t know what I had; I needed help, but I was really not sure who to contact.
In the Hospital
After waiting in the St. Mary’s ER for hours, I was told that I would be under careful watch for the night and maybe a couple days thereafter. I was very concerned, but I was more determined to find out what has been plaguing me for much of this year. Yes, fear did cloud my mind many times, but I was more focused on overcoming this problem. In hindsight, I really wouldn’t know how I would have reacted if the doctors told me that I would only live for a couple years or a set time frame of my life was made. It’s entirely possible that the condition that I had may have been more grave than what I now know. The irony is that if I were to die from suffocation, shortness of breath, or losing consciousness from severe dizziness (if one can die from such a thing)--I would know what that would be like and realize that it’s not a painful death as one may think. Would you know what that feeling is like? After dealing with those types of feelings many times, I don’t think I will be able to forget it.
I sat in the ER for a couple hours as my family hours waited anxiously if I would be out of the hospital sooner or later. Finally, an attending nurse told me that I would be sent to ICU for observation. Hearing ICU was a scary prospect to my family. To me, I didn’t think much of it but in hindsight it’s a scary place to be because only people who are gravely ill or with a terminal illness get sent here. The added pressure that it costs $25,000 a day in an ICU room doesn’t bring much consolation. However, and I’ll repeat this in due course, I’m glad to have medical insurance; whatever you do, don’t be caught without it!
That night, I got very little sleep for obvious reasons. I also received a prostate exam to check if my other organs were affected during my episode. A urine and blood test were taken every couple hours. As my resting heart rate is 32. The The unknown--my condition after I leave the hospital, when I’ll leave, and if I’ll be able to teach in Korea in a couple weeks--were boggling my mind.
The next day, Sunday, my family and I were worried that it would be a wasted day because most doctors would be taking the day off. But my nurse was adamantly opposed that I should be left alone. So we called to see if it was possible to have any and all doctors come in, after all, isn’t that the reason why they get paid so much?
Soon enough, I received an EKG sonogram that day to see if I just had a less serious case of tachycardia, rapid heartbeats, or if I had right ventricular dysplasia--more serious. Dr. Klein, a cardiologist, and Dr. Fong, my general physician, came to visit me and tried to explain to me what may happen to me in the future such as an end to long endurance running. however, they also said that I could jog a bit here and there.
Blood work and urine tests every 3 hours were routine for the entire week. I had IV tubes stuck in many places on my arm.
At one point, the doctors were about to put me on beta-blockers as a precaution if my heart rate should skyrocket unexpectedly at any time. Good thing, my nurse was able to cancel the request in time because beta-blockers for someone who had a resting HR of 32 would cause further damage and possibly make me flatline. I’ve heard “Code Blue” many nights during my stay; I certainly didn’t want to be a victim from one of them.
On Monday, I rested for much of the day but Dr. Padovan, another cardiologist, and Dr. Lee, an electophysiologist, came to visit to explain the heart mapping and ablation procedure that I was going to have on Tuesday. In the meantime, a lot of rest and eating diet-restricted hospital meals were the call of the day.
On Tuesday, I had heart mapping done in the morning. This was a procedure to check if I had blocked arteries or other terrible condition that would lead to heart failure. An endoscope catheter was inserted through an artery near my right groin, which extended to my heart so that they can see if the right ventricular wall was really thin and if there was plague buildup in my arteries. Fortunately, the worst wasn’t suspected but there was something else that was troubling them and I had to undergo more tests and this talk of having an ICD seemed to come up more often, which was becoming increasingly scary and more of a possibility. Following that hour-two hour long procedure, I had the 7-8 hour ablation. This time the catheter was inserted through the vein near my right groin. My doctors and electrophysiologist doctor (EPS), Dr. Lee, couldn’t complete the ablation procedure correctly because St. Mary’s didn’t have the advanced machines as UCSF. What was bothering the doctors was this T-line inversion and the amount of VT’s (ventricular tachycardia)I was receiving. T-line inversion is when you have a little hiccup between the normal ba-bump of a heart beat; in between the cycle, there’s a little bump in the middle, essentially another beat that occurs every so often.
In both cases, I felt the piercing pain of the catheter enter my skin and make its way up to my heart. You can feel the prodding and the inch-by-inch tug to get to the primary location.
That night, I was finally out of ICU and into a normal recovering hospital room for the night. Ironically, my nurse is Korean so I had a lot of questions to ask before my possible departure to Daegu in less than two weeks. In return, she was nice to give me a couple of contacts in Daegu who would give me assistance if an emergency called for a checkup on my condition.
On Wednesday, however, the problem is that again, I did not want to waste a day of just doing nothing and paying for another day in the hospital when I could be finishing up one procedure instead of cramming 2-3 in one day. However, the hold up is that I need an ambulance to transport me to UCSF. Due to rules and regulations, it’s not a simple ordeal to just have someone drop me off. The hospital needs to release me and have me sign a bunch of documents stating that it is not St. Mary’s responsibility once I’m out; UCSF also has to have a counter-document stating that they can admit me. The stupid ride cost my insurance company a couple thousand easily.
Once in UCSF, the difference is almost night and day. Patient care at St. Mary’s is much better and it seems cleaner and more welcoming. UCSF is dingy. One RN at UCSF put it best: “You want to be at UCSF because of the research and understanding of your care and treatment. I wouldn’t want to be caught dead at St. Mary’s because they don’t have the tools for advanced illnesses.” She may be right. After all, St. Mary’s may have been nice and cushy by hospital standards but they couldn’t treat me fully and that is why I lost some valuable time when I could’ve had my treatment in less time at UCSF.
Once admitted into UCSF, I was put into a room with an African American man who had a slew of problems including diabetes and heart problems. One thing that is hugely noticeable is that all the patients near and around me are easily 2-4 times older than I am. I am not supposed to be here...
A young doctor, Dr. Wong, old enough to be my sister comes by to tell me about what may happen in the next few days and that if there’s anything I need. What does bother me at both hospitals is that there are always interns coming by to ask me questions at the most inappropriate times, like when I’m taking a piss or having blood work done or when I just go to sleep. The questions that also bug me is the “Is there a history of heart disease in the family?” and “Did anyone die suddenly/have sudden death?”
For many nights in the last couple days, I had to fast for procedures that would occur the following day. However, what has been frustrating is that since there’s a line of patients there’s no definite answer as to when you’ll receive your treatment that day, if ever. So there are times when I would have to fast for 12-15 hours and solely rely on my IV drip to keep me going.
On Wednesday, I didn’t eat for at least 16 hours. But for some reason, I didn’t have an appetite either so the hunger didn’t bother me much. I was more preoccupied about thinking of what will happen in the next couple hours or the next day. I even tried to bug the nurses if they can help find information on the internet regarding my condition and
On Thursday, I had a 2 hour MRI followed by a 2 hour heart biopsy. Knowing that there is advanced medical technology out there is great. Having to use one is not. The MRI is one fine example. If you’ve ever had to go through that long narrow tube for hours, it’s not fun. It’s not like you can just sleep in there. I had to breathe in, hold my breath, and breathe out every couple minutes for those two hours while staring at the roof of the MRI tube that’s probably less than 4 inches from my face. They told me to hold still for that time period too. Fortunately, they got all the video and pictures that they needed and I didn’t have to go through that friggin thing again.
Next up, was the biopsy. It was so not fun. I saw all the tools laid out on the side and the ones doctors were holding. I was surprised but I didn’t have the normal thought process to freak out. I just had a lot of other things on my mind at the time. But things got serious when they told me to not move even an inch! I had to lay on a flat surface and crane my neck to the left at 90 degrees for an hour. That’s because another catheter would enter my neck and take a snip of a heart tissue for a sample. They wanted to see if there was fatty or fibrous tissue obstructing part of the heart where there is supposed to be muscle. I wanted to have the ablation completed following this procedure. But they said that I should rest because it would take at least 4 hours. When the biopsy was completed, it was more like ”Wham, baam, thank you, ma’am.” Nice to operate you, now we’re going. I only realized afterward, that there was an audience of interns and doctors who observed the entire procedure from a hidden window at the opposite end of the room.
That night and many nights at UCSF, I heard the young doctors and interns talk about some of their patients in the hallway. And most of it wasn’t nice. I know they’re young but they should also keep it professional and not talk shit about some of their patients. We’re in the cardio ward, not the hearing-impaired ward!
On Friday, I got my ablation--the one that St. Mary’s couldn’t achieve. The reason why UCSF can do this is that they have a magnets at the tip of the endoscope that will more accurately zap the misfiring cells that are causing tachycardia in the heart. Another catheter in the groin again... What is really demoralizing is having a guy shave your pubic hair before the procedure. I felt vulnerable and almost useless. And then they shove a condom-like tube on your dingy with a narrow tube that they push up through the urethra so that pee can automatically flow into a side bladder. Once the 3-4 hour long procedure was completed, I had the ICD implanted. I was sedated for both procedures but as it was almost a full week in hospitals, I was getting antsy. I was sick of being a human pin cushion. My lower back was really killing me once both have been completed. I also had this really violent urge to pee. The nurse, in the recovery ward, told me to just go. But I felt like I was leaking. she said, “No, you’re okay” But I know for a fact that she was dead wrong. I was leaking, but I was also peeing, I think.
Later that night, I asked my nurse to really get that tube out of my johnson. When it was time, she pulled out the tube which was easily a foot or two feet long. I had to turn my head away and not look at it; I almost passed out seeing how long it was. It could also have been not eating for much of that day that killed my sanity. But I asked for a couple more helpings of ice cream and that helped make me jump back into reality. I now have a foreign object in my body and life as I had known will not be the same.
On Saturday, I had my final chest X-ray before I had my final farewell from doctors and checkup on my ICD. The release forms were signed and I leave the hospital with my new lease in life...
