Talkin’ ’Bout my Palpitations

My off-kilter ticker: Why I might die before I get old.

The ER doc made a pathetic attempt at a reassuring smile. “It would be a shame if a young guy like you had a heart problem,” he said. We were both watching the heart monitor screen as each unnerving skipping sensation I felt inside my chest appeared as an irregular spike. I was convinced that the zig-zagging white line running across the screen would suddenly go flat as I went into cardiac arrest. I wondered how long I’d be able to watch myself flat-lining before I lost consciousness.

I was 21 years old and having my first episode of premature ventricular contractions (PVCs) — a cardiac phenomenon I was told could be serious or completely benign. Often referred to as a palpitation, a PVC is simply when the ventricle contracts before it should. For me, it feels like my heart pauses and the next beat comes as a serious thump. As I have been told, if the heart is structurally normal, the PVCs aren’t a problem. It was clear the ER doc had no idea what was causing my PVCs and offered me absolutely no theories — just a sedative and the name of cardiologist. “I suggest you get a full cardiac workup,” he said as he signed my release form. Brilliant idea, I thought to myself. This guy must have bloodlines to Christiaan Barnard. As I walked out into the hospital parking lot, the PVCs disappeared as if a spell had been magically broken.

Over the next few days, I felt occasional skipped beats, but nothing like the cardiac chaos that drove me to the ER. However, I couldn’t rid myself of the fear that my heart would suddenly go haywire — like a Keith Moon cymbal-crashing, drum-smashing, concert-closing solo — never to regain its regular rhythm.

So I saw the cardiologist, a rather blasé guy — which was rather comforting to me, because I was in an excitable state and needed all the blasť I could get. His staff performed an EKG and echocardiogram, and hooked me up with a Holter monitor (like a portable EKG) to record my heart rhythm over a 24-hour period. Through all the tests, he and his staff did not pick up any irregularities, not even one PVC. The prognosis: My heart was normal and I shouldn’t worry about any skipped beats. “Go home and forget about it,” was the cardiologist’s final comment to me as I left.

So I went home. But forgetting about it? Not so much. Well, sometimes. Regardless of what the cardiologist said, I had a hard time dismissing the irregular beats that appeared to come and go without rhyme or reason. I was told to avoid caffeine and sugar, and to relax and get enough rest, but I could never draw any strong correlation between my PVCs and lifestyle habits. Furthermore, while the cardiologist had told me the irregular beats were nothing to worry about, he also acknowledged that he had no explanation for what was causing them. That uncertainty never settled well with me.

This condition wasn’t like tennis elbow — it was my ticker. The heart is the top banana in the hierarchy of organs, and you only get one of them. Isn’t it ironic that our most important organs — brain, heart, and penis — we only get one of? Maybe our creator found it more exciting if he didn’t back-up our most critical systems.

In the coming years, I would go for months without PVCs — or at least without noticing them — and then months when they seemed to occur daily, sometimes every minute. They came as little wake-up calls. There’s nothing quite like the fear of sudden death. Because, well, it would be death, and it would be sudden. Watching sporting events in sudden death is great entertainment, unless you are the team or athlete that suddenly “dies.” Those distraught folks always fall into a zombie-like state of dejection as they walk off the field only to go home and listen to their Carole King “Tapestry” album over and over again. Me? I’d prefer a little overtime or extra innings. Give me a two-minute warning and chance to call a couple of time outs. Maybe even the opportunity to throw a challenge flag if I think the Grim Reaper stepped out of bounds before intercepting my pass on fourth and long.

I’m a devout agnostic and wouldn’t begin to take a stab at the probability of an afterlife or knowing anything beyond what we can learn through a telescope, microscope, or a Woody Allen film. I don’t have any investment in the hope and promise provided by traditional faiths and religions. In fact, I have a hunch that if there is someone or something that put us on this planet, they have purposely made it really difficult for us to figure out what lies beyond, because if we did, life on Earth would go to hell in a handbasket. I think many of the problems on our planet are due to the fact that too many people are distracted by the belief that they will ultimately end up in the arms of Jesus or a harem of virgins.

Anyway, over the ensuing three decades, I tried to live with my arrhythmia as best I could. I still went to the cardiologist every so often, especially if my heart was more jumpy than usual. In my mid 40s, I had my first stress test, a carotid ultrasound to see if there was any plaque in the arteries in my neck, and a special X-ray that looks at calcium build-up in my coronary arteries. All of these tests came back negative. And my total cholesterol never rose above 140. And given that I had been an avid runner, a practitioner of yoga, a vegan, a non-smoker, and a non-drinker — I was practically a poster child for cardiac health — there was no reason to expect anything to be too out of whack.

The most troubling thing for me was that, really, I had no control over what my heart decided to do. Sure I can take care of it, have it examined, inspected, and even in some cases repaired, but at the end of the day, the actual beating of my heart — the very inner force that keeps me out of range of the Grim Reaper’s sickle — is largely out of my hands.

On the heels of reaching the half-century mark and having finally come to reasonable terms with my PVCs, I developed what felt like a new arrhythmia — more of a jolt than a delayed thump — so I made yet another trip to my cardiologist. At first he gave me that “you again?” look, but then took several minutes to discuss the possibilities. Ultimately, he came to the conclusion that while what I was feeling was probably nothing, he would hook me up to a portable cardiac event monitor, a device I’d wear for several days, to capture the arrhythmia.

What a pain in the ass that was. I wore a battery-operated transmitter around my neck that connected to three electrodes stuck to my chest. The electrodes itched, the wires kept getting tangled, and I had to wear a loose-fitting shirt to contain the whole gizmo. I also had to carry a humongous cell phone in my pocket that sent all the data back to some central monitoring facility. I could only take the contraption off when I showered. Wearing the device to bed was really annoying; I felt like I was camping out on a stockroom shelf at Radio Shack.

I also found it creepy that my heart was under constant surveillance by some omniscient character somewhere. I imagined a disheveled, pot-bellied security guard with a cigarette hanging out of his mouth, dozing off in front of a massive wall of cardiac read-out monitors. He nearly falls over as an alarm goes off signifying that one of the patients is having a cardiac event. “Jesus H. Christ, #825946 in Wichita is flat-lining,” he eventually grumbles into a walkie-talkie. “Another one bites the dust.”

In reality, whoever was watching my cardiac activity was, in fact, asleep at the wheel. I soon began taking the device off before I went to sleep because it was keeping me awake, but no one on the monitoring end seemed to care that I stopped transmitting data. They didn’t try contacting me until well into the following day. I came home from work to a message left around lunchtime that went something like: “Mr. Shaberman, we are no longer getting communications from your cardiac monitor. If you haven’t dropped dead, please contact us at your earliest convenience. Thank you and have a great day.”

Ultimately, the cardiac event monitor picked up nothing new or exciting — just a few PVCs — and after nearly 30 years in my quest for an answer, the cause of my palpitations continues to remain a mystery.

Someday, everyone is going to have an embedded chip in them that will record virtually everything going on in our bodies — every time we fart, masturbate, or fantasize about supermodels. All privacy and dignity will be lost, and it will be just another thing to be obsessed with besides our iPhones and iPads. By then, the experts will probably be able to pinpoint the cause of my PVCs, but at the same time, will find three other ambiguous biological issues for me to be concerned about.

So for now, I need to continue to try and come to terms with Skippy and accept its imperfections, irregularities, and limitations, just like I began to do the day I first went into the ER scared shitless. As a card-carrying agnostic, it is incumbent upon me to accept the fact that I can’t know everything about myself, this life, or what awaits beyond. Though I have to say — I have nothing against Jesus, but if there really ends up being a great hereafter, I’ll take the virgins.

Article © 2013 by Ben Shaberman