Friday, September 4, 2009

SVT? Not SVT? IST? Who knows...

So. Last week, after a flurry of phone calls from my regular doctor, and a subsequent trip to the cardiologist, I was informed that I had SVT. That I would need to either be on a lot of meds for the rest of my life, or have an ablation to treat it. I was told I would be seeing the electrophysiologist from across the state, and he would schedule an electrophysiology study and ablation.

I saw him yesterday.

He said it is not SVT at all. But merely an "inappropriate" sinus tachycardia. Which is not all that serious. Can't be treated by ablation, as that would entail destroying the entire SA node. Can be managed with medication if I want to, otherwise it can be ignored.

Both physicians are 100% sure in their diagnosis. The first has a bit more credibility in my eyes, simply because he actually showed me the test strips that he felt demonstrated SVT. Having looked at them, and looked at sample strips of other patients with SVT, I agree - they look exactly the same. The symptoms I've been fighting for years off and on, and nearly constantly since some time last summer, definitely line up. Right on down to the dusky grayish-purplish-blue hue that my hands and feet and lips take on when whatever is happening, is happening. My feet are actually that color right now. So it really could be SVT. Maybe.

The second doctor, who's opinion I would prefer to believe, says that it's not SVT at all. He thinks I've just got a slightly rogue SA node, which sends out signals way too frequently, causing my heart to beat absurdly fast. But normally. And if he is right, then there is absolutely nothing I need to do. So, if I want him to be right, and if I would prefer to not have an ablation, or EP study, or any of that, then why don't I grab onto his diagnosis?

He provided that diagnosis while staring at the 12-lead EKG he'd just done. While my heart was beating 60 beats per minute. With plenty of medication coursing through my body. He then fanned through the stack of event monitor strips, and commented under his breath, "that one's really fast... hmm..." Which leads me to believe that perhaps he hadn't had a chance to review any of the previous test results. And maybe his diagnosis was based on his own hurried history taking.

Or, maybe he's right. And maybe an EP and ablation would just cause a bunch of useless pain. Maybe it really is just IST. And maybe that really could explain and account for the purple-gray-blue color, heart rate over 200. Maybe.

Or maybe they are both wrong.

To be truthful, I covet your prayers right now. The increase in meds has gotten things under control. I can't take this much for too long (some of the side effects are more than a little unpleasant), but for now, it's okay. It buys time to figure out where we go from here. Do we seek a third opinion? Do we pick one of the doctors to believe? How do we choose? Why have things snowballed since last spring? Why has that snowball effect gotten even more dramatic since May of this year?

I couldn't say. But one thing I can say: My God, He is God. The faithful God, Who shows mercy and keeps his covenant to 1000 generations. It is in Him that my trust and my hope are found. And it is He Who is ultimately in charge. And it is He Who is more than able.

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