Ticker Tape

I remember the first electrocardiogram I had very clearly. I was pregnant with my daughter and was having some chest pains. I had gone to the clinic at the Portsmouth (Virginia) Navy hospital for a routine check-up when the chest pains started. (Turned out to be indigestion caused by fetus turning and pressing against my stomach.) The ECG machine was wheeled in, an enormous thing, dangling wires and leather straps with electrode connectors. It made me think of all the Frankenstein movies I had seen, especially when the corpsman began attaching the straps and suction cups to my body. I was waiting for him to shout, "It's alive! It's al-l-ive."

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Over the ensuing years I've had a few other ECGs - routine check-ups, pre-surgery, that sort of reason. I noticed with each new ECG that the machines were getting more sophisticated, as computer technology made medical exams faster, easier. No more Bride of Frankenstein episodes. In fact, after that first ECG, none of the other tests used such clumsy equipment. Each subsequent test took less time to complete than the one prior, with less goo left behind on my body. Thankfully, results were always normal. My ticker was pumping along just fine, thank you very much.

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Tuesday of this week, I had a check-up scheduled to monitor my diabetes and COPD/asthma. I am a relatively new patient to this family practice, so my physician asked if I had time for a baseline ECG. Sure, I said, remembering the last one I had, which was the zippiest ever. Nurse entered the room with a machine that looked like a laptop computer, with dainty (compared to first ECG machine) wires dangling at its side. Wires were the prettiest powder-blue color. Gone was the conductive gel one used to have dotted at strategic points along one's chest. In its place were adhesive backed pads with the smallest electrodes I've ever seen. Chatting with the nurse, I tell her of my first experience all those years ago.

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"I saw one of those when I was in training," she said. "Technology has come a long way since back in the day."

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I suddenly feel 30 years older than my almost-62. 'Back in the day,' I ask myself. How old is this girl, anyway, that she considers 1970 "in the day?"

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"This is going to take longer to hook up than it will to take the reading," she continues. "Now just lie as still as you can. This won't take long."

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In less than a minute, after adjusting the machine, she ripped off a trace. I thought that was the trial run that would be tossed, and that she would then take the reading that would be kept.

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Nope; she was finished. It took her longer to unhook me than it had taken to conduct the ECG. Amazing!

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Nurse and machine disappeared. Several minutes later, my doctor returns.

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"Your test looks pretty good, Martha," she said, smiling. "However, we found one problem."

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I expected her to tell me the murmur I was born with had become more pronounced, something I was told might happen as I grew older.

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"You've had a heart attack."

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What did she say? What was that about the murmur? She didn't say 'murmur,' did she?

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For the split second it took for 'heart attack' to register in my brain, the world stopped revolving, my heart stopped beating, I drew no breath, nor blinked an eye. Finally, I found my voice.

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"Heart attack?"

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"A myocardial infarct. It shows up on your read-out. You've recently had a heart attack."

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No, no, no...I did NOT have a heart attack! When?

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The only time in my life I thought I was having one was four years ago, in the aftermath of Hurricane Katrina, when we didn't hear from our sister who lives in Louisiana for several days after the hurricane swept over her town. And there were the problems at home and at work, and I couldn't seem to get my diabetes under control. One afternoon I was hit with severe chest pains, like an elephant wearing football cleats was bouncing up and down on my chest; shortness of breath and the most god-awful headache I've ever in my life had. I managed to drive myself to the hospital, where after a battery of tests, including a heart catheterization, I was sent home. My blood pressure was extremely high, as was my blood glucose level, but my heart was fine, no sign of an attack or any other abnormality. Just a lot of stress.

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Last year, I had a couple of days of heavy-duty indigestion which caused some chest discomfort, but it wasn't that bad and it cleared up in less than 48 hours. That couldn't have been it, surely. That was nothing compared to the pains I had in 2005, and those turned out to be stress-related. My heart was fine. The ER doctors all assured me my heart was in very good condition.

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Well, I guess it is until it isn't anymore. Sometime in the last four years, a section of my heart died; quietly, anonymously, with no family at its bedside to mourn its passing. Just slipped away, unnoticed, unrecorded, ungrieved.

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It is still attached to the rest of my now not-quite-so-perfect heart. It doesn't react to the electrical charge that courses through the rest of the heart, doesn't do its part anymore to keep the life-sustaining blood flowing throughout my body. It just lies there, inert. Lacking the power to move. Dead.

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I am in shock. I've been reading as much as I can about heart attack survival rates and post-attack prognoses in the last 36-plus hours. I want to understand what has happened, how it could happen with so little notice. I am also afraid. Afraid another one will sneak up on me, like this one did. How do I prevent that? Do I have any control over it, anyway. Are they going to get worse? What are my chances of surviving the next one, now that my heart is damaged?

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What a bummer, man. I'm going to hold a private memorial service for the section that has died. Just me, and the part of my heart it left behind.

(c) 2009 Martha McLemore