First Post: Setting the Stage

Let’s clarify. I’m 53 not 50 (still young-ish!). “On Pace at 53” just isn’t as intriguing as 50.

Male.

Back on the volleyball courts a couple years ago!

6’5”, 195 lbs. “Athletic build” (I like that moniker!).

Active in volleyball (played at Villanova in the 80s), and just picked up a tennis racquet recently and found I could play reasonably well. Like to lift weights twice a week to ‘maintain,’ not to get huge (gotta look good for Wifey!).

And now they tell me I need a stinking pacemaker! Ugh.

This blog will track the process—looks like I’m going to get it in next Tuesday, April 23, 2019.

Where to start a blog on it all is the tough part. When I was told last week that I needed one, I of course searched around to see what the process has been like for other folks like me. And of COURSE I peeked to see how it might affect my longevity! Gotta keep my goal of mid-80s intact!

My search for a personal look at the process came up pretty empty, so I thought I’d document the path before, during, and after, in case other folks find themselves in a similar predicament.

The Acute Reason as to Why I Need a Pacemaker at 53 (explained two ways: Medical vs Layman)

I’ve had a first degree AV block for a really long time. I’ll give you more history another day. Average Joe wants a PR interval of 120-200 milliseconds (the time between the P wave and QRS). Mine for the past dozen years has hovered around 240, which wasn’t a huge problem for me, considering all the other things going on in there.

Acutely, which my electrophysiologist finds odd, I jumped from a first degree AV block to a second degree AV block (Mobitz I). My PR interval has jumped to 390! Yikes! This second degree heart block, Mobitz type I, is referred to as the Wenckebach phenomenon, which I find to be a delightful name. My cardiologist, when discovering this in me during a stress test last week, kept saying this term (pronounced Winky-bok), and it helped lighten the mood for me. 

Put a white doctor-coat on and a stethoscope around your neck, look in a full length mirror, and say Winky-bok a bunch of times in various sentences with a stern face. You can’t feel terrible about it! We need more Dutch anatomists to give their names to various phenomena.

Scoot over to this website—Life in the Fast Lane (litfl)—to get a better understanding of these two (first degree heart block vs second degree (Mobitz I):
https://litfl.com/pr-interval-ecg-library/

 

This is all pretty confusing for the layman, like me, so here’s how I describe it to other lay persons:

The upper chamber primes the heart with a squeeze, and then the lower chamber pushes all that blood through the arteries to the veins and whatnot. The interval between those two squeezes should be less than 200 milliseconds. Mine jumped last week to 390 ms. That’s too long an interval!

When that long PR interval happens, eventually there is a P wave conduction WITHOUT the subsequent QRS, so you’re kinda missing a beat (as shown in that second ECG reading in that link above, or in the picture below).

To continue, when you exercise, the heart rate will increase and you can bump out of that second degree AV block (Mobitz I). If you don’t bump out of it, then your heart rate can stay super low EVEN WHEN you are exercising or doing some strenuous activity, like hauling mulch bags, or hiking up tall mountains and finding waterfalls in nature. That’s not really a good thing!

When I did that stress test with my cardiologist last Friday, I didn’t bump out of it. After seven minutes on the treadmill with a gradually steeper grade and faster speed to walk, my heart rate didn’t go above 50 bpm. Should’ve been hitting triple figs at that point. Looks like my activities will be bird watching. Or frog watching. No hiking for awhile. Boooo. No mulch carrying. Yay!

What can correct this?

Pretty much only a pacemaker.

What's next? What will the morrow bring? A trip to the electrophysiologist! After a week of trying to get in, the time has arrived. Update on that coming tomorrow, as well as perhaps some discussion of symptoms, and understanding the difference between chest "pressure" and chest "pain."

Comments are welcome. What else would you like to hear?