Tick Tick Tock

I've vaguely complained enough about health issues, mostly in real life but sometimes here, that I figured I'd have to clarify things once I figured out myself what was going on. This was, and still is, not an easy process.

There were a few instances last year where I collapsed or was close to it. They mostly came out of nowhere, and the last time this was a noticeable issue was well over a decade ago. Back then, I never did find a clear explanator or known family condition that tied back into this.

What's more of a concern is the heart problems that now bring on the syncopes^[1]. Without trying to sound too cliche, feeling your heart try to punch its way out of your chest is fucking uncomfortable. It kicks off with a small wind-up of chest tightness and breathing difficulty, giving you a few minutes' warning to get into a comortable position, then keeps building and building into a debilitating heartbeat rhythm that has nearly knocked me out from the sheer discomfort of it.

Sometimes the episodes are weaker, and any sharp drop in blood pressure during/afterward is enough to send me at the floor. I've been guessing that the stronger episodes are painful enough to keep me conscious throughout. Not sure which is preferable, frankly.

Recovery can take up to 1-2 days, where I'm effectively out of action for anything more strenuous than walking around my house. Walking back up the stairs has been almost too much in these cases.

My doctor has been good to me about this. Upon hearing any patient complain about anything in the realm of chest pain, they're obligated to run entry-level tests to identify the most immediately severe possibilities. None of these materialised. So she referred me to a cardiologist, who ran some more advanced tests, but again nothing concrete came out of those at the time. If the episodes are sporadic enough, a 48-hour ECG isn't going to pick up anything of note.

There's no major avenue of investigation that hasn't been explored, so I can't fault them for their work, as frustrating as it's been over the past few months. The main relief is that there's nothing structurally wrong with my heart. I did a rather cool echocardiogram that highlighted all of the major atriums/valves/arteries all look fine. Having something less serious than major heart failure is preferable to a moderately serious undiagnosed issue, for the record.

On her advice, I bought a mini portable ECG, which is a cute little thing that enables me to run ECGs while out and about, and when I'm experiencing episodes. Tachycardia - an erraticly high heartbeat - immediately emerged as a persistent issue for me. What's become more prominent recently is increasing symptoms of atrial fibrillation, the most common form of arrythmia. I'm mostly bothered about this because there's no history of it in the family, and I'm too young for this shit.

The cardiologist's main thought now is that I'm in a rare-ish cohort of people, where erratic electrical pathways from the pulmonary veins can throw off the timing of the sinus node (pacemaker). In studies, it shows as erratic or additional heartbeat signals that the cardiac muscles are forced to follow. In practice, it feels like a mini earthquake preceding or following each heartbeat^[2].

In slightly nicer instances, it feels like a double heartbeat in quick succession. Or sometimes the cardiac muscles jolt in a way that you never expect until you feel it happen to you. The panic from your body fighting you from the inside is often enough to stress-force the heartbeat higher again, which just makes it worse.

I'm lucky in a few different areas. One, the episodes are paroxysmal^[3], which is the least frequent and/or shortest duration type of artial fibrillation episodes. Two, it's been spotted early. I despite people shoving their problems under the carpet, and have lovely people around me I trust to talk about this stuff. And three, there's scope for me to fit cool homemade tech into me - maybe a permanent ECG into my side that beeps whenever AFib symptoms are spotted. This is rad to me^[4].

This is where I'm at today. Increasing clarity of the likely condition, though just short of a formal diagnosis. One of the main frustrating elements is that this happens infrequently enough that it's hard to diagnose when using hospital-grade equipment, as this needs to be booked in advance and I don't schedule my cardiac tantrums that far in advance.

The other frustrating thing is that it's increasingly getting in the way of my daily life. I already did a small amount of exercise, didn't smoke, barely drank, cut out caffeine, and didn't do any insane blood-pumping activities outside of the annual track day. But these incidents, and the fear of them happening, increasingly pull me back. Pub trips, weekend breaks, even board game nights - if I don't have a management plan for how to manage an incident if it kicks off, then I hold back from the event. Or sometimes I'm already out of action before an event even kicks off.

In the grand scale of things, it's fine and manageable. I'd rather not have this, but there's plenty worse out there. Which is a diplomatic way of saying that I'm far too used to minimising my own problems in the past. But I'm rather motivated to fight for myself now, and a little bit of bitching about this is relieving, in a way.

The follow-up to this post will either come in the form of rad homemade tech that I made to spot cardiac issues quicker, or a selfie of me in the most insane medical machine that I think is cool as hell.