Monday, July 21, 2008

the Adenosine push

The fifth floor of Utah Valley Regional Medical Center (UVRMC) should smell like newly-sprinkled baby powder or Johnson&Johnson shampoo, but it doesn't. Molly and I figured that out this last weekend, after spending two nights and close to 24 hours in the Labor & Delivery ward at UVRMC. Not that the ward isn't nice, and the staff was a lot more pleasant there than in the Cardiovascular Unit (as we found out), but it still wasn't our ideal weekend location. Molly told me that I was supposed to write about our weekend adventure. Normally I would ignore such a request, but since I worried more than once this weekend that I would end up a widower at the tender age of 24 with not a whole lot to live for, that I would probably throw away the rest of my life pursuing a career that ate up the hours of my existence but could never fill it, that even reading about soccer on the BBC's website would only momentarily divert my attention from the gaping hole in my life...well, it didn't feel right to ignore Molly's request. Plus she looked so cute when she asked me. I am mostly kidding about wondering if I would end up a widower at 24, but there were some touch-and-go moments.
Joe Powell, a good friend of mine, was staying the night at our place on Friday night before heading to Bartlesville, Oklahoma. He is having surgery to repair a tear in his ACL over a break in school. We wish him all the best with his upcoming surgery. So, Molly woke me up at about 1:40 am (I guess this is Saturday now), looking at me like this:

I was like, "Why are you looking at me like that?"
She says, "Feel my pulse."
I am like, "No way!"
She says:

"Fine," I say. Her pulse was fast enough that I couldn't measure it. I would get to about 15 and then I would lose count. Her heart rate was around 230 bpm, we found out later at the hospital. So we went to the emergency room, and we ended up in Labor & Delivery since she is now 31 weeks along. Her blood pressure is pretty low, but the twins both look fine according to the monitor they have strapped to her tummy. Eventually, about 2 hours after Molly's heart has gone haywire (she has a history of heart problems; that is why she can't eat chocolate, caffeine is off-limits) we are finally getting somewhere. Dr. Peterson has a tech doing an ECG, a nurse messing with Molly's IV, and a few other people in the room taking notes or something like that. He is explaining our options, which include a cardioversion and an adenosine push. Both are procedures that interrupt the heart and in doing so, help the heart restart with a normal rhythm. His explanation of the adenosine push goes something like this:
"Adenosine isn't FDA recommended for all cases of tachycardia. They have done clinical trials, but the results of those trials were inconclusive. We basically push x milligrams of adenosine through an IV and it quickly makes its way through circulation and resets the heart. There is a funny feeling associated with it, like everything is stopping but that is normal. Nurse, go ahead whenever you are ready."
I think all either of us hear is "not FDA recommended," so we were like, 'that doesn't sound like a good idea.' Then we were like, oh...they are already administering it. Then Molly gives me a really funny look, that makes me spring to the bedside to hold her hand. I don't have a really good picture of her making a face similar to it, but it is probably the opposite of this one:

This one says, "I'm tough and you better not mess with me," ...or something like that anyway (Molly will probably kill me for posting that one).
The look she gave me was saying, "I think my heart just stopped and I'm not sure that it is going to start again. Why aren't you holding my hand?"
That was definitely the scariest moment of the weekend. She had a 12-lead EKG hooked up to her chest, feet, hands and abdomen, with the wires from the baby monitors and the IV tubing and all the rest hanging about. It was one of my first experiences seeing someone smothered by medical equipment, and all the equipment just made Molly seem all the more frail.
My story is getting a bit long, so I'll summarize the rest. Dr. Peterson did know what he was doing, Molly's heart restarted with a normal rhythm and we are grateful to him despite his not-so-illustrious introduction to the adenosine push procedure. We stayed in the hospital the rest of the night for monitoring, but left mid-morning on Saturday. Sunday night is a story for a different time. Molly was having some contractions, which they were able to bring under control. So after a couple of rough nights, Molly will be able to sleep at home tonight,

and our little crib-thing, though we are excited to have it filled with babies soon, will continue to hold baby clothes.


Jenni K said...

Oh my gosh! Molly I am so glad you are doing better. You are always in our thoughts and prayers. Paul, good job on the post! Your a good story teller :) Hopefully someday soon you will have a better story to tell though! Maybe one consisting of 2 baby girls?? :)

wayne said...

Man, it must be part of the training to swish through what the adenosine does and administer as they do it!!
They gave me once for SVT last year and nothing happened.
I went in on Sunday there with atrial tachycardia and they said they were going to give me adenosine which I though would do nothing.
Far from right, it worked this time for them to get a reading on restart, but the feeling is most awful. Really is just like death sweeping through your body and then coming back...sadly mine starting again was as 220bpm still!! They did it again to try and get a better reading on restart with higher dose, so longer lasting feeling. Still fired back up to 200+ bpm so ended up with Bisoprolol and by morning back to normal.
Thanks for your shared story...
Trust all health is good for you now.