Saturday, August 20, 2011

Zap

     The truth of the matter is that you really do start thinking and wondering about the strangest things when you're married to someone who's chronically ill with an off-the-beaten-path disorder. Before I met and married my husband, who was born with a degenerative genetic disorder called Marfan's Syndrome, I never really thought about how too many leafy green things in one's diet could be detrimental, rather than beneficial, to one's health. I never considered how you would find shoes to fit a person with size 16 feet and 36x36 pants. I never wondered how someone who is six-foot-five would fit in a regular-sized bed. (The answer to that one is that he does, but his feet hang off the bottom if he doesn't curl up a bit.)  Just recently, I found a new oddity to wonder about - what happens when you use an automated external defibrillator, or AED for short,  on someone with a titanium heart valve?

     I know, I probably shouldn't even entertain the possibility of my husband having a for-real heart attack when we've got plenty of other problems to keep us occupied without throwing hypothetical cardiac arrest into the mix. I've actually only very rarely considered what would happen if my husband did have a heart attack one day because I'm always so concerned with the ever-present threat of an aortic aneurysm and its eventual rupturing. Considering that that particular scenario would most likely be fatal (only a 10-25% survival rate if the victim gets immediate treatment), I've not put much effort into finding other ways to keep myself up at night worrying about my husband.

     We recently took a class, though, on how to use an AED and that's what started the wheels turning in my head. I think I'm like most people in that I always thought of those electric paddles that the doctors use on TV whenever someone's heart stops. You know, when they yell, "CLEAR!" and shock the life back into some poor soul whose body has just been jolted a foot off the floor from the electricity that was sent zinging through them. Apparently, it's not that way.

     There are no paddles; there are instead little sticky pads that you peel and stick like a band-aid. One goes on the chest, the other goes around on the side of the torso. Plug the wires into the main box part of the apparatus and wait for the little voice to tell you it's okay to push the button that delivers the juice. I was told in this seminar that the whole ritual is pretty much idiot-proof, as it's impossible to shock someone on whom a heartbeat, however faint, is detected.

     That's good to know, 'cause I certainly wouldn't want to be responsible for accidentally stopping someone's heart when I was trying to accomplish the opposite. (By the boo, just because I sat through a thirty minute session on how to use an AED in an emergency doesn't mean you should take what I just wrote as gospel truth. I'm not anything close to qualified to instruct anyone on how to use those things, so please don't go skipping off thinking you know what you're doing just because you read this blog post. Don't be dumb.)

     That's all well and good, right? Now I know how to save someone's life if they're in cardiac arrest. Yay me! We were halfway through the session when the instructor pointed out that should we ever find ourselves needing to use an AED on someone, we should quickly scan their chest to be sure there isn't a scar and a raised shape under the skin that would indicate the person had a pacemaker. If that happens, just don't put the pad that delivers the shock over top of the pacemaker, 'cause that's one type of electrical stimulant conflicting with another type and that's bad (or something like that.)

     I remember only the most basic principles of conductivity from my high school science classes, but if it's a bad idea to mess with a pacemaker, it's probably a bad idea to send an electrical current through someone's heart if they've got a piece of metal embedded in it, right? That's what I started wondering as this seminar was progressing.  It goes hand-in-hand with my previous wondering of whether or not his heart could physically withstand a shock like that, since the tissue it's comprised of isn't really as strong as a normal persons. I mean, what if the electricity was too much for a weak spot to handle and my husband started bleeding out?

     Granted, I've only mulled that possibility over in my head once or twice in the whole time we've been together, but it could happen, couldn't it? I know it's a fairly small amount of juice that gets delivered when someone utilizes an AED - it's usually between 150-200 joules, but can be as much as 360 joules, depending on the particular AED that's being used. (No, I have no idea how that relates to wattage or volts. I googled it and found some insanely complicated formula for figuring it out, but I typically don't go much beyond 2+2=4. Words are my friends, numbers are the devil.) So you've gotta figure, if part of his heart needed to be reinforced with titanium and Dacron just so it wouldn't self-destruct during normal operating procedures, surely it's not a good thing to push it harder, even if to (theoretically) attempt to re-start the damn thing.

     It's a bad choice all the way around - either die of a heart attack because you can't withstand the procedure needed to bring you out of full cardiac arrest, or bleed out because the method used caused you to spring a leak somewhere. (I was initially worried that the valve's conductivity would cause the heart issue surrounding it to be fried like bacon, but I think the Dacron seal would prevent that. So my husband's got that going for him.) Now, in all likelihood and with a little bit of luck, this is a scenario which will never come to pass. Heart disease doesn't run in my husband's family (his Marfan's notwithstanding), so I think we'll catch a bit of a break on this one. Now, if I could just train my head to not go off on these little sojourns that serve no purpose but to make me twitchy and stress, we'd be in pretty good shape. Relatively speaking, of course...

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