It was a beautiful Texas summer day in Texas two days after Independence Day. I and my wife Edith at the Dallas-Fort Worth Airport headed to Washington DC to attend my medical school annual UERMMMC Alumni Reunion and Convention. While on the plane in route, I received a text message from my classmate Neda Ballon- Reyes inquiring who among my classmates had made it to the convention. I text her back that I was in route.
The flight, except for being delayed an hour, was otherwise uneventful. We got to Reagan International airport and after a 15 minute Uber ride; we arrived at the JW Marriott DC hotel. After we settled in our hotel room, I got a call from Neda to meet her and two other classmates. I went to the convention meeting room’s floor of the hotel. It was exciting to meet again Victor Dee and Vickie Barnachea-Casibang who were with Neda. After updating each other, Neda asked if we had tickets to go tour the National Capitol the following day. Victor and I said we would be interested to go, but did not have any tickets. “Don’t worry, there are still empty seats in the tour bus because some who have bought tickets may not make to the tour.” replied Neda.
Following day we all gather waiting for the tour bus at 8:30 in morning and boarded the second bus to the for the capitol tour. It was sunny and humid. When we got to the National Capitol where we got off the bus. The building was about half a mile up the hill. We had to stop to catch our breath a few times. For me, that would have been a simple walk, but for the past six weeks, I have been recovering from a knee sprain and have not done walking exercises. The building rules prohibited us from bringing drinking water.
Finally, it was an enormous relief when we finally got to the Capitol Building. It was cool. We all lined up with our group waiting for our tour guide. Several statues in the visitors reception area represent US history, and many visitors packed the area waiting for their turn to enter. Finally we had a guide, she lead us first into a theater that showed a brief video of the history of capital. Then she ushered us to the huge capital dome. It would be a full story to tell about what was in the capitol building the artifacts and the history behind them. All I could say, the edifice, what it contained and its history was just awesome.
It was noontime when the tour was done and we had to walk about half a mile under the heat of the day. The good thing was, the walk was downhill this time. We were supposed to meet our classmates at our hotel JW Marriott DC hotel for launch. When we got to the hotel, we meet two of our classmates and had a light meal at one of the hotel’s restaurant. After we at we went to the hotel room Neda.
We were having fun reminiscing and catching regarding various things of interest in our lives. After about an hour of joking and laughing, out of the blue I felt weak and lightheaded. I went to the restroom and wash my face and drunk some water. But this did not make me feel any better. I also noted I had palpitations. I had no chest pain, shortness of breath, nausea or sweating. I thought to myself; I don’t think it is a heart attack. But I had excused myself from my classmates and walked back with my spouse to our hotel room.
In our room, I laid on the sofa and checked my pulse and noted it was too fast and irregular in rate and rhythm. I told my wife I think I have atrial fibrillation (Afib). I told her to call 911 and inform Neda that I needed to go to the hospital. It did not take long before several fellow alumni physicians come to my room. Lead by Dr. Norbert Uy, the Dean of our College of Medicine, is a cardiologist. While he was asking me questions, he placed a pocket pulse finger monitor on my left hand. He then affirmed my suspicions that I was having rapid Afib in short.
Atrial fibrillation (Afib), is a type of arrhythmia, or abnormal heartbeat. Afib is caused by extremely fast and irregular beats from the upper chambers of the heart (usually more than 400 beats per minute). A normal, healthy heartbeat involves a regular contraction of the heart muscle. In my fifty years as an emergency physician, I have seen and treated many patients with this condition. I could not recall losing any patient because of this condition in the ER. They usually respond quickly to medications. Sometimes, if they don’t respond to medications, or their blood pressure is very low we sedate the patient, then apply an electric shock to the heart (cardiovert). to reset the heart to go back to normal rate and rhythm.
About after 5 minutes after my fellow alumni physicians come to my room, the Emergency Medical Transport finally arrived. While taking my vital signs, they asked me questions and took an EKG. The EKG tracing confirmed that I had atrial fibrillation with rapid ventricular response (RVR) rate 130 to 140 beats per minute. This is when the rapid contractions of the atria make the ventricles beat too quickly. If the ventricles beat too fast, they can’t receive enough blood. Normal is 60-100.
The paramedics loaded me in their gurney and rolled me to their ambulance, with my wife tagging behind. They loaded me into their ambulance and one of the paramedics started an intravenous fluid infusion. I just could imagine how uncomfortable it would be for a patient, placed in back of the ambulance with 2 very tiny windows on back doors, especially if one was anxious and uncertain about his/her condition. To add to that siren sound, feeling bumps on the road, and vehicle making those quick turns on corners.
One of the paramedics inform us we were going to Georgetown University Hospital ER. Finally, we got to the ER. There were two patients waiting on gurneys ahead of me and after a five-minute wait I was placed on a hospital bed. An ER nurse hooked me to their monitors, drew blood and she started another iv. Shortly after that, the ER physician came in. He introduced himself as Dr. Kevin Reed. After telling him of what happened and a brief medical history, he examined me carefully. I told him I was taking thyroid hormone medication replacement therapy after my thyroid total removal for cancer. I added, the dose is higher than the usual dose because it intended suppress growth metastatic thyroid cancer cells.
Dr. Reed looked at my EKG, and heart monitor, then he said yes you have Afib with RVR and we will give you a iv medication to slow down your heart rate. If your rate and rhythm reverts to normal and the tests don’t show evidence of a heart attack. we will send you home. If it does not convert, we will have to do electro-cardioversion under sedation. After he stepped out the ER nurse came in give me Metoprolol 5 mg IVP and after less than 5 minutes I had normal heart rhythm and rate. I felt completely normal. The medical staff took another EKG and found it completely normal.. The ER physician came back and told me that because my repeat EKG was now normal and the heart enzymes were normal, they would discharge me.
He instructed me to increase my oral Metoprolol I was taking for high blood pressure from once to twice a daily and he also started me on an oral anticoagulant in the ER. Most patients with atrial fibrillation (AF) should receive long-term oral anticoagulation. This is to decrease the risk of ischemic stroke and other embolic events. I was advice to take the anticoagulants till I saw a cardiologist and he could decide to stop it or not. Silently, I sent a prayer of thankfulness to God for His love and care.
After discharge, Edith and I took an Uber transport to take us a back to our hotel. When we got there went straight to the Roaring 20s Alumni Party of our alumni group. We just wanted to show up to reassure our fellow alumni that I was alright. When we got there we greeted by several of our fellow alumni, happy to see me able to be at the party. After eating what they served at the party, we went up to our hotel room to retire for the night after what seemed to be a long, exciting day.
Now, at 77 years of age, I could say I have had my first ambulance ride and my first cardiac emergency. I thank God I did not need to be hospitalized and had to have any invasive procedures done on me. The only thing I needed to do take medications and to arrange for follow-up on an outpatient setting by my physicians.
