The Recall

Sigh...finally, here I am, the most delinquent I've ever been in posting a blog entry. This time I have the mother of all excuses. As mentioned in my previous post, I had surgery on Monday. It was because of this little thing.

This, my friends, is a pacemaker. A real, live, actual pacemaker. Actually it's not live any more, but it is real and actual, and actually, this was the pacemaker that was connected to my heart until just last Monday.

A quick lesson in biophysiology for those of you who do not frequent the pacemaker scene:

What: A pacemaker is a device that tells your heart when to beat

How: It has two parts: the generator, which is pictured above, and leads, which are like wires. The generator can be placed south of the collarbone (in children, it's generally in the abdomen, as my previous four have been). The leads are attached to the clear part you see at the top of the generator; the other ends of the leads are connected to my heart. The generator sends impulses through the leads (no, I cannot feel them), and this is what causes my heart to beat when it's suposed to.

Why: Okay, grab a cup of coffee and sit down. Ready? Okay. When I was born, I had many, many extremely large holes in my heart, among some other problems. They were able to patch the holes with some freaky-awesome medical fabric stuff, but there was still a problem. A normal heart has pacemaker cells that tell the heart when to beat. Mine were mostly wiped out from the holes that were there. Therefore, my heart has a very slow, and had a very irregular beat. For the first two years of my life, I would be so tired that I couldn't get around much on my own. I would crawl a couple of steps, then lay my head down on the floor because I'd be so tired. How sad is that?! This was in 1981, when pacemakers had only been used in old people. Because I was born at the right time of medical advancements, because I had awesome cardiologists, and 99% because of the grace of God, my medical team decided to try putting a pacemaker in little me. Um, it worked. My parents said I was completely wired (no pun intended, people) and they haven't been able to slow me down since. So ladies and gentlemen, you are reading the words of a pioneer. I was the first child in America to ever receive a pacemaker. Admit it. You totally want my autograph. Here's the part that blows my mind, though. Like I said, in addition to the holes in my heart, I had a bunch of other things that were not structurally sound in my heart. I had surgery and procedure after sugery and procedure; and two open heart surgeries before that first pacemaker. At that time, my heart was about the size of a pecan. A pecan! Crazy.

When: Pacemakers, like everything else, run on a battery. It's hidden in that little generator thing. And no, it's not rechargeable, at least not yet. So they need to be replaced; I had one that lasted 11 years, but most of them last around 8, depending on the model. Yes, the model. Pacemakers have models and types just like classic cars. I have now had six classics. But here's the kicker: my pacemaker did not need replacing because of old battery life. It was recalled. Just like a Toyota. There had been reports that my particular make and model of pacemaker were linked to sudden failure. With this particular problem, they just turned off, on all its own, and very suddenly. The incidence of this happening is very, very low, but for me, if I was in that tiny percentage, it would be very, very bad. Take five years ago, for example. Remeber the two parts of a pacemaker? Very good, way to pay attention. So the lead part stays in place when the generator is changed out; the lead is acutally attached to the heart muscle, so it carries significant risk when it needs to be replaced. So there it stays, until it wears out. And five years ago, it wore out. The lead was about 25 years old, which was apparently some record for longevity. I had just gotten home from tap dance class, feeling just fine and getting ready to take a shower, when I felt like I was going to pass out. I crumpled to the floor. (Note: this was a time in my life when I was unmarried, and lived alone in an apartment.) I checked my pulse. It was 80. Then 40. Then...I couldn't find it for a few seconds. Then 84. Then 60. I called my Mom. Yep, my Mom. Not 911, not my cardiologist, my Mom. She listened close, and in a very sweet, gentle voice, suggested that perhaps I should call my cardiologist, and reminded me that my pacemaker only allows my heart to get to as low as 60. In other words, something about my pacemaker wasn't working. She also gently suggested or rather told me that she and Dad would be picking me up in a half hour and I would be spending the night at their house. The next day, we went to the clinic and they discovered that my 25-year-old lead had developed a crack, out of old age. (And who could blame it? That's about the time when I started cracking, too). The signal couldn't get through to my heart all of the time, which is why I had near-fainting and sometimes all-the-way-fainting spells. I just can't function on a sporadic heart rate that sometimes dropped to 40 in a matter of seconds. All of that to say, should my pacemaker fail suddenly with no signal at all, and if I were driving, or taking care of Oliver, or whatever...well, use your imagination. We decided it best to have the darn thing changed out.

Where: Here's the funny part. My life cannot become any more intertwined with Children's Hospital. I have been a patient there since I was two weeks old, and all of my subsequent surgeries, yes, even the one last Monday, have been at this establishment. I am 31 years old. Almost 32. To be perfectly blunt, I am in the first generation of "heart kids" that have survived their congenital defects. I was born on the cusp of significant medical advancements in the world of pediatric cardiology. I, along with countless other "pioneers," am part of a new era that requires physicians to care for adults who survived their defects. There are new clinics and new physicians who are specializing in this field, but while they are still getting established in this specialty, many cardiologists tend to "keep" their cardiac patients right where they are, as they know them best. Things have come full circle for me. I have worked as an RN at Children's for 9 1/2 years. Oliver was a patient there last winter for two weeks. And...are you ready for this? This is where I met my husband. Yep. Perhaps the full-circle thing is more like a figure 8 at this point. Michael and I worked on 6th floor together several years ago. After some time had passed, as our relationship grew, enter "The Cracked Lead" incident. Guess who was monitoring my EKG strips while I lay in the hospital bed? Yyyyeah. Could it get any weirder?

So that's the story, the story so far. I didn't feel up to doing much of anything this week, not even staring at a laptop screen, until yesterday. The pain isn't too bad this time around, but I am absolutely exhausted. I haven't been out in four days, and I couldn't care less. Pajama pants, pain meds, and chocolate summarize my week pretty well. You sure can't get that with a Toyota recall.