Postictal Asystole

n.  a way to make nurses jumpy.

A complete explanation is not currently available, but it would seem my adventure in Billings had some unexpected consequences.  One, a 5-mile hike in low humidity with wind and not packing any water can, quite predictably, result in dehydration.  Second, not having one's BID seizure medications during an unexpected overnight stay means two straight missed doses.

The first part caused me to wake up at 0230 with a spike through my chest.  I've known some pretty good pain in my life, including a few good double over chest pains, but this was my first one not brought on by strenuous aerobic exercise.  The last time I had pain like this was when I broke 1:15 for a 440 on the indoor track at TTU.

Having three kids and a SAHM wife, I felt that I should spring the money for the ER trip.  I am quite glad I did.

An ER nurse hooked me up to an EKG and started taking my history.  A second nurse set up to start an IV and draw labs.  I told the first nurse that if she had any pressing questions for me, she should ask before the IV start, because I was probably going to pass out.

The second nurse was just about done with the IV when I started feeling fuzzy.  Seriously, the needle was already out and she was just drawing the labs when I said the bed rail should probably be up.  As she was busy, I pulled it up myself.

When the world went from black to two nurses moving rather quickly, I realized I probably should have told them I would also seize when I passed out.  What came next, though, was a bit of a surprise.

Apparently, I get post ictal asystole.  For lay people, that means when I seize, my heart stops.  I never knew that, mostly because I never seized while hooked up to a heart monitor.  It's also not guaranteed that I have done so every time.  But for 7 seconds this morning, I had a flat line.  Much longer, and I would have been in the middle of a code blue.

But hey, my chest pain went away!

Then it came back.  Two nitroglycerin later, I had traded my chest pain for a headache.  My cardiac enzymes were normal, but I was told I would be on telemetry and if anything wonky happened or I had a recurrence of chest pain that wasn't relieved by a single nitro, I was getting another flight to Billings.

Well, crap on toast.

My follow-up cardiacs were at 0930-ish.  Per the PA, I drew my own labs, since I do not pass out when I have the needle.  Unfortunately, I had to stick southpaw since my left AC was taken with the IV.  I suck sticking lefty.  It took me 3 sticks and a little digging, throughout which I stayed fully alert, just going to show that needles truly do not bother me as long as it's in my hands.  This probably says something about me.

Follow-up cardiacs were normal, so I was discharged at 1200.  The hospitalist doesn't think I really need follow-up, but I choose to err on the side of caution, so I will be following up with both my neurologist (who just told me I was free to not come back for two years), and possibly a cardiologist.

After all, I have three kids.