Bradycardia

The appointment with the local PCP was epically long yesterday—2 hours—even though it was technically just a follow-up. While that may sound like she spent a lot of time listening to me, discussing options, and examining me, our face time only comprised about 1/6, or 20 minutes, of that time. Over 40 minutes were squandered waiting in the waiting room and then in the exam room prior to being seen, which, although unfortunately typical in the medical industry, usually isn’t quite that bad for a 9:30am appointment because doctors aren’t typically that far behind schedule so early into the work day. Alas, that was not the case yesterday apparently. The other hour of accumulated wait time occurred because this primary care provider isn’t actually an MD; I believe she’s a nurse practitioner, though she might be a PA (physician’s assistant). Either way, the ramifications of that differentiation is that she routinelyseeks counsel with her supervising doctor  during the appointment, either because that’s the legal requirement or because I’m tricky and she needed guidance; I’m not sure which. While the education she underwent and the degree she received is less important to me than her bedside manner, knowledge, willingness to be patient and think outside the box with me, and take the time to actually listen, the constant pauses in our appointment so she could go discuss things with her supervisor were dreadfully annoying. He was seeing his own set of patients, so it would take time after she left to pin him down and then come back. Most of that time was just spent idly with her at her desk and me alone in the exam room bored and cold in my gown.

There was also an issue with my heart rate. While I nearly always have bradycardia (a heart rate less than 60bpm), it was abnormally slow yesterday, hovering around 40bpm. However, I told her I wasn’t concerned about it because it’s not atypical for me to have a slow rate. She wasn’t convinced though, and decided to review the ten years of my medical records she had on hand to verify that my vitals on those days were indeed nearly as slow.

I sat there while she scrolled through pages of digitized records, and she saw that it usually hovered around 53. She decided we needed to do an EKG, which is no big deal, except it took the medical assistant 15 minutes to come in to the room. After she hooked up all the electrodes, the scan took all of five seconds, but then she too had to leave and run it by my provider before unhooking me. They decided to run another one because after lying down, my heart rate further dropped to 35bpm. The second readout was similar.

Other than the rather extreme bradycardia for someone my age, no abnormalities were found. The electrodes used were so sticky, they left a gummy residue that I couldn’t remove. With tactile sensory problems, this was a lingering nuisance the rest of the day.

Even though I don’t run anymore, and really don’t do much of any aerobic exercise, the supervising physician and my provider decided we could chalk up my very slow heart rate to being fit and years of endurance training, just like I initially told them. The whole process, which I guess can be classified as “better safe than sorry,” felt, at the time, like a big, useless hassle. I didn’t come with any cardiac complaints anyway.

The only other outcome of the appointment is that I’m getting a brain cat scan and being referred to a neurologist for some brain activity I’ve had my while life that I just learned last week is technically a type of seizure. These episodes are occurring a lot more frequent lately, so it seems that they might as well be checked out. They are nothing like grand mal convulsing seizures, but that doesn’t necessarily mean they are totally harmless. I’m not worried about it though simply because I remember having them my whole life, extending back to some of my earliest memories as a three-year-old. It’s not a new problem and I’ve been “fine” until now. Still, I’ll follow up with both the brain scan and the neurologist.

By the time my appointment was over, I was freezing and so ready to be home. I wasn’t budgeting nearly that amount of time for the visit, so I felt harried and pressured to catch up on work when I got home. My shirt kept sticking to my chest from the tacky adhesive, and in the humidity, this all made me so uncomfortable. I hit my sensory overload point yesterday by 1pm. After that, things were painfully overwhelming and I was utterly exhausted from a brain standpoint. Two hours in fluorescent lights alone will do me in, let alone all the stress, tactile discomfort from the EKG, and talking with the PCP. I need today to be easier.

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