A Good Day, Courtesy of Suntory and a Cute Cardiologist
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I had the most pleasant hospital experience today. (That's not something you hear often!)

For the last 15 years of so I've had occasional bouts of atrial fibrillation (a not-particularly-dangerous arrhythmia, or “irregular heartbeat”), where my heart suddenly can't keep a steady rhythm. In older folks it's often accompanied by tachycardia (“super-fast heartbeat”) which is bad, but I've never had that problem, so my A-fib is not directly dangerous. However, if left untreated for more than a day or two, the irregular flow of blood through the heart could allow clots to form, which are directly dangerous, so when it starts (and no one knows what sets it off), I take an aspirin to thin the blood, and look to correcting it.

When I lived in The States, “correcting it” involved being put under with a general anesthesia, having electrodes attached to my chest with ridiculously-strong adhesive pads, then receiving two well manicured electrical shocks in quick succession, one to stop the heart and another to restart it, hopefully with a good rhythm.

The worst part of this experience was the removal of the electrode pads, because they would take a few layers of skin with them, so I got into the habit of asking that they be removed while I was still under.

Anyway, the first time this happened after moving to Japan, it was late on a weekend, so they did the shock thing in the ER, but later the cardiologist suggested I try the drug “Sunrythm” (サンリズム, pilsicainide hydrochloride) the next time it happened. “Rhythm” in the name, of course, comes from the regular heartbeat it tries to restore, with “Sun” coming from the company that developed it, “Suntory”, which tends to be more famous for its beer and whiskey production.

It worked well every time since, until today when it didn't correct the problem that started yesterday morning, so I went to the Kyoto Prefectural Teaching Hospital here in town, expecting the many-hours wait that always accompanies a visit to a clinic or hospital. I got there at 8:50am and was talking to a doctor by 10:00. Wow, that was fast (made faster by Bill Bryson's At Home on my iPad's Kindle app, courtesy of a gift from my mom).

An hour later I'd had an EKG done and was chatting with a cardiologist. He suggested that they should do the shock thing, since it had been more than a day since the arrhythmia had started. That was fine with me, but I suggested that we try the Sunrythm again, since it turns out that the stuff I'd been taking had long expired, so maybe a quick shot of the good stuff would do the trick.

So, half an hour later (11:30) I was on a bed, still reading my Kindle, with an IV drip of Sunrythm, being attended by an incredibly cute cardiologist whose attractiveness did nothing to help steady my heart. We waited a while to let the Sunrythm work, but it didn't, so at 1:04 she gave me an injection of 1% Propofol, a short-term general anesthesia to put me under.

At least it was supposed to.

She said that it would be painful around the arm where it went in, but it wasn't. Rather, I felt it first in my chest as an odd (but not unpleasant) sensation, then I noticed my vision start to blur. I was giving them (the cute cardiologist had been joined by another cardiologist and two nurses) a running commentary of the effects, but after the vision started to blur, the progression stopped and I remained in a somewhat-blurry-vision not-unpleasant limbo. After a short while I commented to the nurse that it had stopped progressing at blurry vision, and then a minute or so later I noticed that the heart monitor's beeping had become regular, so it seems that the Sunrythm did kick in, just in the nick of time. The whole shock thing wouldn't be needed.

I pointed out the steady rhythm to the nurse, who then commented “yeah, because we shocked you”.

Doh! I had one continuous three-minute memory of what turned out to be a 20-minute span.

I asked whether I'd said anything while I was under, and apparently I said “Ouch” once (probably when they were taking the shock pads off my chest). It turns out that I said it in Japanese, which both surprises and delights me.

Anyway, half an hour later I was waiting in line to pay the bill. With the socialist insurance over here, the bill was 19,140 yen, about US $240.

I had expected a long day of waiting and inaction, but things moved along quickly, the doc was cute, and oh yeah, I didn't die. All and all, a good experience.

All 8 comments so far, oldest first...

Hi Jeffrey,
Glad to hear you go the A-Fib sorted. I think I’m around the same age as you and I’ve also had occasional bouts of fibrillation over the last 5 years. I was diagnosed as having “lone atrial fibrillation” (i.e., it occasionally fibrillates, and they don’t know why). What works for me is the “pill-in-the-pocket” approach with a drug called Tambocor. Just in case you’re looking for something less than shock treatment, and you’re looking for a good excuse to chat with that cute cardiologist, you may want to ask what she thinks of this “pill in the pocket” approach (it’s medically documented in journal articles, but Tambocor is a strong drug that in some patients can have adverse serious reactions).
I enjoy your blog photos and your Lightroom plug-in…

That’s Flecainide, and I’m one of those who have had a serious adverse reaction that almost killed me, apparently. Luckily it was while I was admitted and under close care (about 15 years ago in California), though, alas, the doc was not cute and a 500lb pound guy in the next bed had the most amazing sleep apnea I’ve ever heard of (and I heard it all night). For the last six years I’ve had great luck with Sunrythm in pill form that I keep at home, but perhaps because my stock was long expired, it didn’t work this time. I’ve got fresh stock now. —Jeffrey

— comment by stefan on June 6th, 2011 at 8:02pm JST (13 years ago) comment permalink

I’m glad to hear that it all worked out without too much pain or trouble, but I can’t be alone in expressing disappointment at not getting to see the photos of this cardiologist! (And the hospital… um, of course.)

(Just kidding – photos shouldn’t be the first thing on your mind in a situation like this, and if the hospitals in Japan are anything like most are back in the USA, they get pretty upset if they catch you taking photos.)

— comment by David K on June 6th, 2011 at 10:02pm JST (13 years ago) comment permalink

“…and oh yeah, I didn’t die.” Glad to hear it Jeffrey! Love to see your images from Japan, a country I’m unlikely to be able to visit, thanks for making them available. If you even visit Ireland make contact

— comment by Patrick Mc D on June 7th, 2011 at 5:52am JST (13 years ago) comment permalink

I have discovered recently that apparently I have tachycardia, confirmed by an EKG with an echocardiogram. It only starts when I make a physical effort it and stop when I recover, about 20 minutes after the effort. It’s annoying since I can’t run marathons or race on The Tour but I was never an athlete. I’m not sure why I’m telling you this, other than to say that tachycardia is not life-threatening per the docs and that it doesn’t concern old people exclusively.

It’s the combination with arrhythmia that becomes prevalent as patients get older, and is more dangerous because it can leave someone suddenly light headed and prone to fall. —Jeffrey

— comment by Guy on June 7th, 2011 at 5:59am JST (13 years ago) comment permalink

I’ am glad to hear that all went good. I enjoy your blog notes, tech. notes, images and the Regex Book, too. And at the same time, I’ am training and learning more English. Sorry, if it is not all understandable. 😉

My mother had problem with “super-fast heartbeat”. In the 1997 she underwent an operation. And since that date, she does not have more problems with this. I know not the same thing.

Take care of your!

Greetings Ralph from Cordoba, Argentine.

— comment by Ralph Gierling on June 7th, 2011 at 9:46pm JST (13 years ago) comment permalink

Happy to hear that everything goes well ! Hope you won’t do this too much !

Frédéric Klee

— comment by Fred Klee on June 9th, 2011 at 3:23am JST (13 years ago) comment permalink

Cute cardiologist, but no picture?! Jeffrey! XD

— comment by Chan on June 9th, 2011 at 12:31pm JST (13 years ago) comment permalink

Very glad to see you are still alive and reporting with your usual sense of good humor. Having only recently discovered your many LR add-ons I selfishly do not want to see you disappear.

from San Francisco

— comment by Robert on June 15th, 2011 at 3:15pm JST (13 years ago) comment permalink
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