Indexing Title: HTURINGAN’s Medical Anecdotal Report [04-8]

MAR Title:  Valentine’s Day

 Date of Medical Observation: February 14, 2001

 Narration:

 I was diagnosed with a congenital heart disease, technically called a Wolff Parkinson White Syndrome, simply put it has something to do with the electrical conduction of my heart that determines the rate to which my heart should beat. Aberrant fibers within my heart overpowers the normal pacemaker the SA node, thus I suffered supraventricular tachycardias (SVTs) from as long as I could remember and became a frequent visitor to different ICUs a place I learned to hate.

 These were heart rates going over 270 beats a minute, at this rate my heart couldn’t adequately pump to deliver enough blood to my body as well as my brain.  Well we all know in the medical field what that could do.  What triggers the SVT according to experts, could be anything from getting to tired to as stupid as getting startled.  But from experience it always happens when I least expected it. Except for attacks I get once or twice a year I have lead my life as normally as the girl next door.  The thing that never failed to amaze me was that I usually forget about WPW and SVT until I get the next attack which would remind me I’m not as normal as I wanted to be.  But as my father taught me earlier on, mind over matter.   So I went about pursuing medicine and never thought that my condition would deter me from achieving my goals.

 After getting accepted in residency training, I was told that I needed to sign a waiver that would give absolution to the hospital to whatever happens to me since Surgery is strenuous. This was a novelty to me since I went through school, medicine, clerkship, and internship without my physical condition becoming an issue of my performance.  But I accepted and signed knowing that I can be a surgery resident and be as good in my chosen field as any of my colleagues.  Things went on smoothly without a hitch until I reached my third year, when what was a physical nuisance now became bothersome.

 In 2001, after frequent attacks my work became affected with my absences.  With medications only given to arrest the attacks, I sought consult once more.  I was given a different answer this time, I was offered to undergo cardiac ablation an alternative to open heart surgery. With cardiac catheters inserted in my femoral and jugulars, the team proceeded to identify the aberrant fibers and ablate them one by one.  After what seemed to be an eternity exactly on Valentine’s day I was told that I now have the heart that I always wanted.  I could now do things that I thought I would never get to do like run, climb, jump and as my senior residents teased me without end, make love and have a baby without killing myself.  I was given a month to recuperate but I cut my sick leave short and went back to work after two weeks.

 Then all of a sudden I unbelievably had what felt like another attack only slower this time and not so painful but definitely an SVT, then another.  I went back to my doctors and after several more tests they confirmed it was SVT a slower one going 160 to170 beats a minute that was not apparent when I underwent the procedure because it was hidden by the faster ones.  I didn’t get my wish after all but nothing changed really, I’m still me.

 Insights (physical, PSYCOSOCIAL, ethical) ,Discovery, Stimulus, REINFORCEMENT:

 MAR was created to make the residents analyze instances in their training that affected them most and brought change and strengthen their conviction as they treat every single patient whose lives were entrusted under their care.  My last MAR was about me becoming the patient undergoing training and how I dealt with being a patient and a doctor at the same time.

 I grew up learning that there are limitations to what I can do physically,  but thanks to my father I also learnt  that those I can do, I can do with everything I’ve got and excel if I put my heart to it.  This included my wanting to become a surgeon and hopefully in a month’s time I would have done what some people thought was impossible and crazy, finish my residency training still with a WPW.  It wasn’t a bed of roses, I tire faster and had to work twice as hard.  Having PVCs in the most inappropriate of times, but nothing worth having is without effort. This I have accepted with all my heart.