Heartbeats, Part Next

I’ve written about my balky heart and the smart, capable people who attempt to keep it and me ticking. I’m beyond grateful for their efforts and for the fact that in many other places I might have expired by now. My heart doesn’t beat synchronously or efficiently, and I have an abnormally low heart rate, a red flag trifecta that’s resulted in numerous tests, procedures and installation of a pacemaker in June 2022. 

Recent photo of OBX Dave. 
Should get more sun.

To look at me, you wouldn’t immediately think: ‘I hope that guy has his affairs in order.’ I’m not overweight. I eat relatively well. I walk a mile or two almost daily. I do yard work and housework without issue. I’m always up for trips and outings and the occasional pub crawl. Over the past 15-18 months, however, I’ve begun to tire more quickly when I exert myself. 

When I informed my cardiac docs, they suggested that a pacemaker upgrade may be in order. Which is how I landed at the Norfolk (Va.) Heart Hospital recently, on National Tax Deadline Day for what it’s worth, for a procedure that the experts think will help. Check that: for the second time this year for a procedure that the experts think will help. 

I was supposed to have the procedure in January. The electro cardio specialist who performed two ablations on me was going to do the pacemaker upgrade. But when I was on the operating table and he opened me up, he discovered a blockage and tissue tangle that made extracting the thin wire leads and inserting new ones trickier than he was comfortable performing. So he simply closed me back up. He apologized profusely afterward, but that didn’t lessen the frustration and WTF? Factor, starting with: You geniuses had no way of determining that there was a blockage or that you couldn’t perform the operation *before* you sliced me open? 

Anyway, he referred me to a specialist’s specialist, a colleague who was comfortable and experienced with more complicated extractions and procedures. During a consultation with him in March, he said that pacemaker technology had made significant improvements, even since my first installation less than three years prior. He believed that a new device would help my heart beat more in sync and thus improve blood flow and limit fatigue. He allowed that, yes, there are ways to determine if a procedure might be more complicated than expected before surgery, but that doctors don’t employ them often enough for his liking. That said, he was completely on board with his colleague aborting rather than attempting something he wasn’t comfortable with. I was sold, which is how I ended up in Norfolk on April 15. 

A few words about my doctor, a gent named Erich Kiehl: early 40s, about 6-2 and thin, tousled brown hair, boyish face covered by about two weeks’ worth of stubble and facial hair flecked with gray; Brown University medical school; residency at the University of Virginia Medical Center; two fellowships at the Cleveland Clinic, where he studied under the guy who developed many of the techniques currently used for pacemaker extraction and installation; Master’s degree in clinical research from Case Western Reserve University; settled in Hampton Roads and said he's performed about 350 procedures similar to mine, and he and his cohorts have done more than 500; a reassuring confidence in his work and his ability; engaging and persuasive. In short, a professional badass. You want him handling your heart. 

We had hoped for a relatively speedy day that instead became a 15-hour slog, due largely to emergency situations in-house that pushed back my operation, as well as the fact that what the doc optimistically estimated would be an approximately two-hour procedure became 3½ hours. He also paved the way for me to be part of a National Institute of Health-funded clinical trial that will gauge the effectiveness of two different pacemaker install procedures. There's no compensation or costs waived, but patients in clinical trials, he said, statistically do 30 percent better than regular patients because of more diligent monitoring. 

Sure, sign me up. 

We left our house on the Outer Banks at 7:30 a.m. and didn’t arrive back home until 10:15 that night (it will forever be mind-boggling to me that a heart-related procedure can be an outpatient practice). The heart is a marvel, a mechanical pump and electrical organ and if poets and songwriters are to be believed, a wellspring of love and sorrow that makes life worth living. A lot to ask from a 10-ounce organ that’s about the size of a closed fist, don’t you think? No wonder it needs an assist from time to time. 

There’s no telling how my new little battery pack will affect me. I don’t need to run half-marathons or swim 50 laps a day. Even if it only keeps me vertical for a few more years, I’ll count that as a win.