Cardioversion, Part III

I couldn’t sleep at all this morning. Between anxiety about the cardioversion procedure and chest pain/pressure, there was no way I was going to fall asleep. By staying up, I noticed that my heartbeat was pretty regular at 61 bpm since midnight. When 8:00 am rolled around, I called the cardiologist office to ask what I should do. The receptionist took a message and said my cardiologist would call me back. Actually, during the call, my a-fib started up again. Dang it.

I ended up going to the hospital at 9:30 am as scheduled. My sister dropped me off since they were not allowing visitors for outpatient procedures. Check-in was pretty efficient; they came out with completed paperwork so I didn’t have to talk to the admitting person for very long. On the way back to pre-op, I saw my nephrologist doing rounds at the hospital. She was surprised to see me. I thought I was a bad sign I’m recognizing random doctors walking around in a hospital.

*Pre-op room. They ended up doing everything in that room.*

The first thing they did was to get a swab for a COVID-19 test. I just had an antibody test done Friday but this was the antigen test so the nurse crammed a swab way up my nose until it felt like she was digging out some brain matter. Ouch! Thankfully it came back negative. They also drew blood for labs. Since I have a fistula in my right arm, they were limited to the left arm only. The first nurse managed to draw enough blood but took several tries. Then she tried to put in an IV but failed so another nurse came and did it after several tries. Later they said my blood sample clogged and they needed to draw more blood. The IV seemed to be one way (in only) so three nurses tried 10+ times to put in a butterfly needle but failed. My left arm was covered with gauze and bandages. Finally they called the lab for a real phlebotomist. With about 15 minutes prior to the procedure, my cardiologist showed up and the nurse said labs weren’t done because they could not draw blood. The cardiologist said, “I saw the results at my office.” Turned out he original draw was fine. I even had the results on my patient portal app. I got poked those 10+ times for nothing.

Anyway, it was pretty smooth after that. Cardiologist said she was going to set the machine at 150 Joules; not sure if that’s a lot or not but seems to be similar to a defibrillator. The anesthesiologist came and put me to sleep at around 1:00 pm and I woke up right before 2:00 pm in the post-op recovery room. The nurses there gave me some juice, crackers, and peanut butter since I haven’t eaten in 12+ hours. My sister picked me up at ~2:30 pm so I was at the hospital for a total of six hours. I went home and took several naps, probably due to the anesthesia, and heartbeat has been fine so far.

My cardiologist also stopped my Metoprolol medication so hopefully the Multaq can maintain the steady heartbeat.

Cardioversion, Part II

I spoke with my cardiologist over the phone Friday over Zoom. She thinks I definitely have a-fib and need to reset my heart rhythm. First she prescribed an anti-arrhythmia medication called Multaq. It’s like amiodarone but less toxic. Then she arranged to have me go to the main hospital Monday for electric cardioversion. Since it requires full anesthesia, I have to be there at 9:30 am for a 1:00 pm appointment. They will also test me for COVID-19 and need to wait for results before proceeding. I think the procedure only takes a few minutes but I need to be there the entire day.

Ironically, my heartbeat has settled down a few hours ago. I ran my portable EKG twice and both times it came back “normal” at 66 bpm. Previously, it would give me either tachycardia or possible a-fib. Not sure what happens if the steady rhythm holds? Can I have the procedure if heartbeat is regular? Can I reach someone early enough on Monday to change the schedule if everything is “fine”?

New Dialysis Time

I just got a call from the dialysis social worker. She also seems to manage the dialysis center. Due to COVID-19, they need to clear out an isolation ward even though there are no cases yet. At the dialysis clinic, we have four “pods” with different number of dialysis chairs. D-pod is the smallest with four chairs, and they’re making it the COVID-19 area. To do so, they need to shuffle the schedule around. Currently I am in B-pod during second shirt. Since I drive myself, she thought I would be more flexible. I told her I didn’t care what time I have to go in so starting next week, I need to be there by 5:30 am. Since I’m not getting any sleep anyway, this way I can get it over with and maybe even go to work or other appointments on Tuesdays and Thursdays. And whenever we get out of quarantine, I can have Saturday lunches again. Yay!

Souplantation Is No More

Ugh. I just saw the news that Souplantation restaurants are not opening post-COVID-19. I guess in the post-virus era, the buffet business model will be hard to sustain. Since all the food is just sitting out there, it’s hard to prevent contamination.

There is a Souplantation about 15 minutes from my house that we go to a lot. Mainly I would get their Asian salad and chicken noodle soup. I get coupons emailed to me regularly so it’s a cheap meal and we usually end up eating too much. Now I’m worried about all the other buffet-style restaurants. Also, what about Las Vegas? Each casino has a huge buffet restaurant, some of them pretty expensive.

Antibody Testing at Work

I came to work again today, mainly to participate in a COVID-19 antibody testing study. Our workplace is partnering with some Harvard-affiliated group to test a bunch of employees to see the prevalence of COVID-19 at the workplace. The email came out last Friday while I was in the office but I signed up too late and all the time slots were filled so I came in today.

Since the antibody test requires a blood sample, there was a conference room set up with several blood drawing stations. The guy that took my sample was a med student from Mt. Sinai in New York. Since I had a fistula in my right arm, I told him that he could only draw from the left arm. It took him two tries to try and hit a vein. We’re supposed to get results back in a week.

Cardioversion

About two weeks ago, right before my UCLA cardiologist appointment, I had an episode of arterial fibrillation. It ended up going away after about a day and since then, I’ve had very short cases of fast heartbeat, most lasting a few hours. However, this latest episode started this Monday afternoon, and hasn’t stopped since.

When the heart rate is high, or when my heart skips beats, the Fitbit tracker has problems picking up the right pulse rate. Usually, the plot is a straight but slightly squiggly line but the above shows random fluctuations between 60 and 130 bpm.

I went in to my cardiologist’s office for an EKG yesterday and the doctor said it definitely looks like a-fib. She asked me to double up on my Metoprolol pill but so far, it has no effect. The other option is cardioversion, either through medication or electro-shock. For some reason, she thought I had this done before but it’s all new to me. I have a 3:00 pm Zoom call; let’s hope we can restore my heart rate with medication.

Cardiac Rehab Re-Opening

I got a call from the Cardiac Rehab Program at St. Joseph Hospital. They were asking me if I was interested in finishing up the program. Not really… but I said yes. Evidently they are opening up the gym to 4-6 patients at a time for 45 minutes. You have to wear a mask and maybe surgical gloves to enter. I have 10 out of 24 sessions left to complete the program.

I’m really there because it was required by UCLA Transplant Center. Now that they’ve put me back on the active list but my donor was rejected, I don’t know if I need to finish up. I could do all the stuff at home without the costing me (or my company) anything. I guess I better call UCLA to see if they’re okay with me not finishing the program.

Fistula Working Again

One of the older techs came by to insert the needle in my fistula. He was on vacation for the past two weeks and I heard he’s been at that dialysis center the longest. Anyway, it still took him about 3-4 tries to get the right vein. They still used only one needle at 250 ml/min, but dialed the time back to 3:45. My nephrologist was doing rounds today and she didn’t want to bother with the extra 15 minutes.

You can kind of tell the vein is getting larger in my arm. There is a definite bump in my lower arm where you can feel the blood rushing by all the time. And it’s noisy. If I sleep on my right side and my arm is anywhere near the pillow, I can hear the blood whooshing by.

Nextdoor Covidiot

No, stupid woman. It’s a public forum. If you get to ask stupid questions in public, then we get to comment on how you’re an idiot. Of all things to risk your life for… a pedicure. In the comments, she keeps throwing out the strawman of either going out now or staying home forever. No, you can also stay home a bit longer until medical professionals tell you otherwise. I imagine her name is Karen.

Park Parking

When I left to go to dialysis this morning, the tiny street in front of my house was packed with cars parked on both sides of the road. I live pretty close to Peters Canyon, which is still closed. The parking lot entrance is blocked off. However, people are here anyway. When the lot was open, we get some stray cars parking on my street because cheapskates did not want to pay $3 to park. Now everyone is parking on the street, to the point that some residents want the city to issue resident parking permits.

Also, no one getting out of their cars were wearing a mask. Stay home, you idiots!

UCLA Medical Billing

Remember my visit to UCLA to see their cardiologist? I saw the doctor for literally three minutes. On the way out, I told the receptionist that I sent in my Medicare card to the Transplant Center, and asked him if he needs a copy. “No, we’ll get it from the Transplant Center” was the reply.

Ha! Of course they tried to bill my work insurance first and got the claim rejected. I guess my transplant coordinator didn’t update my records since they are trying to bill me for the entire amount. Why must everything medical be so difficult?

Also, the cost of the three minute visit? $725. That seems like a ridiculous amount. There’s no way we can reform healthcare costs in the US if doctors and hospitals can get away with billing like that.

Dialysis Recap: 4/25 to 4/30

Lots of weirdness at dialysis this past week. On Saturday and Tuesday, they were unable to hit the vein accurately to use the fistula. I actually got stuck three times in the arm on Tuesday but none of them were good enough. The head nephrologist checked out my fistula on Tuesday and said it felt good; he wasn’t sure why we’re having so much problem using it. On Thursday, they were drawing blood for clearance tests so we only used the chest catheter. However, my dialysis machine broke down with about 40 minutes left in the session so they just disconnected me. The plan is to redraw blood on Saturday so no fistula again.

The nephrologist lowered my dry weight again to 88.5 kg. He thinks I may have some fluids in my lungs and lower legs. I haven’t been eating that well so I should be losing weight; maybe the weight is being maintained by excess fluids. With a lower dry (targer) weight yesterday, my blood pressure was actually in-line during the entire dialysis session. I think I started at 128/70 and ended at 123/71.

One of the patients on the same shift as me was taken out of the clinic two days in a row by paramedics. I hope he’s okay but that’s not a good sign.

Continued Blogging

I was looking forward to not blogging anymore. Since this is mainly about living with dialysis (and heart surgery), once I receive a kidney transplant, I could stop blogging about it. It looks like I will still have stuff to blog about since there’s no transplant anymore.

Since November, I’ve blogged a lot. It was weird not thinking about blogging this entire week.

Donor Rejected (Again)

See, I’m not paranoid.

My friend/donor just called me. UCLA told him he didn’t pass his latest test for kidney stones so they’re temporarily rejecting him as a donor. This is after three years of following up with the transplant center to get this far. They did say he can test again later and if his oxalate levels drops, all he needs is a heart stress test.

Arg! I’ll take kidney stones over ~~fucking~~ dialysis three times a week. I am beyond disappointed.

Fistula: Missed Again

My dialysis clinic tried to stick my arm again today. The tech tried a few times but was able to finally hit the vein. However, it hurt a lot, even with lidocaine. The needle was only in for five minutes but hurting more and more, and the machine was giving low pressure alarms. Finally, the decide to pull the needle since the vein may have collapsed. Right now, both tubes are connected to the chest catheter. The needle insertion point also has sharp pain when I cough. That’s new.

This is my arm yesterday. There are two post-op scars and a bunch of pinpricks. The two higher up in the arm were the original attempts. Then they moved down the arm and you can see at least seven needle scabs.

Tachycardia 4/23/2020

Even through there were some incidences of heartbeat weirdness, most of last week has been pretty consistent. Heartbeat was mostly normal at high 50’s bpm. However, this morning at ~7:00 am, my heart started beating fast again. This time, it’s been going at ~110 bpm for about 30 minutes now. I’m not sure what happened. I was lying in bed, either dreaming or hallucinating about a softball game. I then woke up, sat up in bed for a few seconds, and lied down again. I don’t know if it was the rapid heartbeat that woke me up, or it sped up while I was moving around.

My cardiologist said she wanted me to go in for an EKG. I procrastinated since the last incident stopped after about 20 hours. Not sure how long this occurrence will last. If it’s still beating fast at the end of dialysis, maybe I’ll try stopping by their office.

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The pessimist in me is again thinking that once a transplant is looking possible, something will go wrong. I thought this was the case last week but my heart was pretty regular when I saw the cardiologist at UCLA. Now that there’s news California hospitals are performing non-emergency surgeries, something will come up to derail my chances at a transplant. Life sucks.

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As soon as I wrote the above paragraph, my heartbeat slowed down. It’s now at 57 according to the Fitbit tracker. Ugh, what is happening?

Raspberry Pi

In the four weeks that I’ve been stuck at home, I haven’t learned anything new. Even old stuff I’ve abandoned; I put both of my guitars and my bass back in their cases and haven’t touched them in months. This week, I decided that since my job has to do with software systems, I may as well learn something new while stuck at home. I purchased a Raspberry Pi 4 kit from Amazon for $99. I got the kit with 4GB of RAM.

Here is the actual computer board. It’s smaller than I thought it would be.

It took me about 15 minutes to put together. There were three tiny heat sinks to stick on a few of the IC’s. That took the longest time. I have it connected to an old Visio 720p TV via HDMI. Let see if I can get it to work.

Mainly I want to learn Python, plus maybe build a few hardware projects. My staff analyst took Python in school and has written a few cool tools. Me, I learned BASIC and Pascal in high school, and LISP and C++ in college. Need to learn a more modern language.

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System has been installed from the included SD card and the computer is connected to my router. It’s now updating the system. I think I’m going to do a keyboard/mouse swap with another computer so I can have wireless input devices on the Raspberry Pi computer. It looks weird with my huge Corsair gaming keyboard attached to it.

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System updated and everything is running. This website on Chromium on Raspberry Pi.

Sleep Update 4/21/2020 (& 4/22/2020)

Yawn. I just slept about four hour, which is the longest I’ve slept in several weeks. Maybe it was the dialysis clearance shortfall causing all my immediate health problems these past two weeks.

After dialysis, I stopped by to get lunch from a Hawaiian take out place right across the street from the dialysis clinic. I ate some of the food for lunch and quickly jumped into bed since I haven’t really slept for the past 48 hours. I think I was out in under two minutes. I did tell my mom not to wake me when I nap during the day (unless I asked her to prior to napping) since it may be the only sleep I’m getting all day. During the past few days, as soon as I fall asleep napping, she would wake me for lunch/dinner or something else.

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After dinner, I went to sleep again since I was so tired. I managed to sleep from 12:30 am to about 4:30 am. Doesn’t sound great but much better than zero. Combined with the long nap from yesterday afternoon, I almost feel normal. I was going to go into work today since it’s easier to work on my desktop. I have a 30″ monitor and two 24″ monitors, which are really helpful for coding and debugging. Instead, I managed to connect another monitor to my work laptop at home so I have a 24″ monitor, a 21″ monitor, and the 15″ laptop display for working at home.

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I sneaked an another nap from about 12:30 pm to 2:30 pm but the Fitbit tracker did not pick it up. I feel well rested for the first time in a long time. Even though the dialysis clinic extended my session to four hours when using the fistula needle, if we still run at 250 ml/min, the extra time won’t be enough for adequate clearance so I may start feeling bad again. Not sure what the solution is if we want to develop the fistula.

Even More Dialysis

Rounding today was the nurse practitioner instead of one of the nephrologists. She said my labs were good except for the Kt/V number and hemoglobin levels. She agreed that when they run slower using the single needle in the fistula, I’m not getting enough dialysis. For now, as long as they’re running one needle and slower flow rate, my session will be extended to four hours. Great! Another 15 minutes with a huge needle in my arm.

As for the low hemoglobin, I’m getting two iron shots this and next week. She also asked about COVID-19 symptoms. I told her that the cough was from surgery and things have gotten a bit worse with the inadequate dialysis. Overall she didn’t seem too worried about my coughing and shortness of breath since there was no fever.

UCLA Transplant Labs

Like they said last week, UCLA send two sample vials to my dialysis clinic. The mailer box was on my dialysis chair this morning when I walked in. The nurse took samples from my catheter so no needle prick needed.

This is probable the fifth or sixth time I’ve provided a blood sample to UCLA. Here’s hoping that a transplant will become a reality soon.