After my HMO refused to work up the pain that I had return after my coronary arterial bypass graft (CABG) surgery following a heart attack, I wasn’t daunted. Since I was in a city rich in teaching and research hospitals, I called around until I talked to the principal investigator in a cardiac research unit. His major project was gaining better understanding of atypical chest pain. While my particular issue didn’t quite meet the program recruiting goals, he told me that he needed volunteers, on a continuing basis, both to help evaluate new diagnostic techniques, and to train new medical scientists. I agreed, and never regretted it for the more than ten years in the program, getting literally state-of-the-art care.
This meant coming in, about once a year, for a week of inpatient testing. I didn’t always fit the system. For example, when they did a magnetic resonance imaging (MRI) study of my heart, with some special computer processing, their computers crashed. They had left the intercom open, and, after listening to them curse at the machine, I called out some possible fixes. Once they figured out that the patient was kibitzing, they questioned me, agreed I knew what I was talking about, and we worked together to correct the problem.
A couple of nights later, I awakened, at first frightened. All I could see was reds and oranges. Was I on fire?
Awakening a bit more, and feeling gentle brushes on my face, I realized what I was seeing was the flaming red hair of the night nurse.
She was saying something. My ears picked up, “I want you”. Was a fantasy about to be realized?
Alas, no. Waking up a bit more, I learned that what she was saying was “I want you to wake up and stay awake until I can get a cardiologist here. Your heart has been stopping for up to 15 seconds at a time.”
The cardiologist arrived and diagnosed Sick Sinus Syndrome, where the sinoatrial (SA) node of the heart, its primary biological pacemaker that signals the heart to beat, stops working. There are backup mechanisms that will pace if this node fails, so I wasn’t in serious danger. Nevertheless, SA-related pauses of 3 seconds or more are considered absolute indications for pacemaker insertion.