as soon as i think i've finally run out of tears, i'm hit with a rushing flood.

couldn't have said it better :)

beep. beep. beepbeepbeep. beeeeep.

i'm clearly pretty terrible at keeping this thing updated. oops. maybe i should work on it.

i suppose i could do a better job keeping track of all the things cardiac related - things in that area are all kinds of crazy! or i could track just how painful it's been trying to get a job...but other than saying i keep hearing "no", there's not much to say. you're caught up. haha. (ps - on that note, anyone looking for an incredibly awesome peds RN? hit me up.)

it'd be more exciting to write about the other things i'm doing while waiting for a job to appear. (that makes it sound like i've just been waiting for one to come to me - know that's not the truth. i stopped counting the number of applications i've submitted after #265)

maybe i'll make it my goal to document the fun hobbies and projects i've been working on since graduating nursing school. in the mean time, i'll update below about where things are health wise...since that's kind of how this all came to be anyways.

since my pacemaker was implanted last march, i've developed a rare complication called pacemaker syndrome. unfortunately, my cardio np said that it's good in that it's not life threatening, but it's bad in that it really just makes you feel like crap. to which i attest to the truth behind that. sigh. we've been trying to find a balance between my metoprolol and flecainide and the settings on my pacemaker. what we're trying to combat is the retrograde arrhythmia that has developed. there's also suspicions that i've got another accessory pathway causing troubles. if you've read the last few posts from forever ago you might remember that i grow accessory pathways like crazy.

we're really hopeful that the increase in meds & higher pacer rates will be enough to keep the arrhythmia in control to where it's not bothersome. it's hard trying to be productive when i keep getting dizzy & have chest pain. we've got some plans in case this course doesn't work, but i'm crossing my fingers that it does. the last option would be another cath/ablation - but because i've been so incredibly overablated i'd have to go out of town to get it done :/

we'll see what happens i suppose.

this is the song that never ends...

...it goes on and on my friends...

i spoke with the NP from EP (ha.) about the swelling in my arm since my pacemaker was implanted. the last time we spoke, the ruling was the increase from 1 baby aspirin a day and a trial blood thinner to just 1 full aspirin a day (325mg vs 81mg).

it helped some, not enough. the verdict is i'm either throwing intermittent clots (since my ultra sound the other day didn't show a stable one) or it's due to my subclavian vein being notably small. it could be causing insufficient venous return.

the game plan:

increase to 2 full aspirin a day until monday. i'm to watch and document episodes of swelling.

if that doesn't work, we'll go back on a blood thinner (most likely plavix)

if thaat doesn't work, we'll go onto coumadin. the reason we're waiting until almost last ditch for that one is due to me being only 24 and still having a relatively active life. she doesn't want me having to worry about diet, activity, etc if we absolutely don't have to.

those are our pharmacological efforts that we're using as diagnostic methods really. should they not work, we know it's def insufficient return due to vein size and there being the two wires in there.

to fix that? we're lookin at invasive methods. either removing one lead and using a different route for that one; taking them out from an internal route and placing them on the outside of my heart; and the last option being a subclavian vein balloon angioplasty.

i'm really really hoping for the pharmacological methods to do the trick. i was REALLY trying to make it one semester of school without being sent to the cath lab or the OR!

EDITED TO ADD:

oh, i also went and had my CT today to R/O a pulmonary embolis. i knew i didn't have one, but due to being so short of breath lately and this whole swelling debacle, they wanted to just double check and have assurance. they got it; no PE! it was confirmed, once again, my veins are shot though. it took longer to get an IV in than the to get the whole scan. oiy.

60 to 100.

what a week.

i had some troubling symptoms the last - oh, i don't know - couple weeks? maybe a month.

i called my cardiologist...i knew individually they could have been/be anything, but coupled together? my instincts said call cardio.

i was supposed to be on 6 months between appts with my regular cardiologist, 3 months with my EP.

i made it a month between EP appts, and 3 months now with cardio. sigh.

anyways. after discussing symptoms at length with him, and reviewing meds, we made a plan.

echo.

blood work.

chest xray.

all relatively standard, but i had a stat in office echo for him to review later that night, and then the rest today.

i go back in a week. as his assistant told me, "oh, you must be acting up."

from what i could tell, and what the tech could tell me, my echo showed tricuspid regurg, mostly likely to my pacemaker.

and speaking of pacemaker, i'm now paced 100% of the time. that's up from 60-70% just in march when they implanted it.

few thoughts on that:

1) i'm super thankful i pushed my new EP to implant it, this proves it was, in fact, necessary.

2) not only is my degeneration of my sinus node extremely rare for someone under the age of 60, it's severe. it's supposed to take years and years to progress as rapidly as mine has in 2 months.

the plan is to review size/function of my heart, chemistry levels and kidney function, and compare my chest xray from the hospital stay in march to see what my sneaky lungs are up to.

my cardiologist has a few ideas as to what's going on, but he isn't 100% certain on any of them. he even said he's kinda stumped. swell.

we'll see what the plan is on wednesday. in the meantime - it's thinking happy thoughts and realizing all of this has already been committed and known by God.

'he heals the brokenhearted and binds up their wounds. he determines the number of stars and calls them each by name. great is our lord and mighty in power; his understanding has no limit.' - psalm 147:3-5