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Tuesday, May 24, 2005

Never Make a Speech on Friday the Thirteenth

If you follow this narrative regularly, you may have noticed a gap between the last entry on the 11th of May and the burst of recent activity (some backdated, but without intent to mislead--read on for details).

There are few things I detest as much as giving speeches, and given that proclivity you'd think I'd be doubly averse to signing up for a speech on Friday the Thirteenth, but DEWS and its ancestors have contributed mightily to my career and combobulation in the last decade and a half, so I'm always willing to do my part to explain why high technology companies should put Western Switzerland at the top of the list when they're considering a place to base their business in Europe. I'm not a great public speaker; I look at speaking engagements the way pilots regard landings--any one you walk away from is a success--and I hope that if the audience doesn't understand a single word I said (because I tend to speak a bit fast to get it over with), they'll at least think my heart was in the right place.

Never sign up for a speech on the Friday the Thirteenth! It's like crossing the NCGA. Anyway, after spending far more time than I can explain or justify on this speech (I usually budget about one hour of preparation per minute of time at the podium), I buttoned up the speech and went off to enjoy three hours of sleep before departing to give it. The next morning, I got up, got ready to go, walked up a flight of stairs to get a copy of the transcript of the speech from the printer and . . . woke up about ten seconds later looking at the floor. This was bad. Apparently my heart was not in the right place, and this was one I might not walk away from.

The show must go on, so I called the organisers of the conference and FAXed the transcript to them so somebody could read it in my absence or copy and distribute it to the attendees. I then put the site into minimal unattended mode and took a taxi to the hospital where they wired me up like a lab rat, inserted tubing as appropriate, and confined me for the night en Soins intensifs--which is kind of like sleeping in a video game parlour, except that the wrong kind of beep really means "Game Over".

At first, all the evidence pointed to an isolated incident precipitated by my life-long "extrasystole" arrhythmia, which manifests itself when I'm short on sleep and exhausted, which I certainly was at the time, probably compounded by high blood pressure, which an impending speech and rushing out the door to give same certainly exacerbated. So, having blown off the speaking engagement, swallowing pills for the aforementioned conditions, I was released from Intensive Care with a portable heart monitor to wear around my neck and encouraged to run up and down stairs and other activities to see if the condition repeated. How very much like debugging an operating system!

After about 8 hours wearing the monitor, the smoking gun appeared. This is your heart (the weirdness in the line at the bottom is the "extrasystole"). This is your heart on ventricular tachycardia. Note that at the bottom right of the latter image the "watchdog timer" kicked in and reset the heartbeat to normal (which you can see extending to the right of the zoomed box).

There are many things which can cause this, but the way to bet, at least for somebody my age, is a constriction in a coronary artery (in other words, "walking heart attack time bomb") which obstructs blood flow to the heart's internal pacemaker, provoking the irregular heartbeat. These days, one investigates and deals with such a problem with angioplasty, for which I was sent to Inselspital Bern, where a tube was inserted in my femoral artery, through which a probe was directed up, around the aorta ("aorta make it straighter, so it's easier to navigate!"), and down into the coronary arteries, where a 75% blockage was found just before the branching off of the artery on the right side which feeds the internal pacemaker. You're wide awake while all this is going on, and can watch the whole thing in real time on television--cool--"straight from the heart!"

Having found the blockage, a balloon was sent into the nearly blocked artery which, after inflation, seems to have entirely opened it, so there was no need to insert a "stent" to hold it open. In three months we repeat the procedure to fix another minor blockage on the other side of the heart, at which time there's an opportunity to check on the first one and insert the stent if it's closing up. (In about 80% of the cases this isn't necessary, but you never know.) The good news is that these appear to be isolated incidents, not indicative of general problems.

In any case, I feel just fine; the entire procedure took a little more than an hour and involved less pain than a typical dental filling. As you may have gathered from my other scribblings, I do not obsess on health and, absent surprises, this is probably the last you'll read of this topic here. Having nothing else to do, I read lots of books in the last week, which I've only been able to add to the reading list and this chronicle in the last 24 hours. I've back-dated the reading list entries here so they don't prematurely scroll off the list; in the reading list proper, they are entered with the date I completed them, as usual.

Posted at May 24, 2005 00:22