..and, again!

Almost identical precursors for this week's episode. Watching TV--we just started to stream The Americans. This is a spy drama about two Soviet-era spies posing as a happy family (which they are) while Mom and Dad do their nefarious business. Half way into the first episode I felt the now familiar palpitations of my heart doing more than pitty-pat. The sensation seems to move my body away from the back of my easy chair--it is that strong. My oximeter read 174 bpm. I tried some val salva maneuvers in place to little effect. So, off we went once again to the ER. The receptionist saw me coming and said, high heart rate? And I said yes. (The joys of small town living.)

This time the episode continued into the ECG. The ER doc decided to administer a med via IV that would briefly pause the heart--within a couple seconds--to allow the heart's own pacemaker to re-assert itself. This worked. The rest was the usual. Blood draw to check for unusual stuff. None detected. Lie there until vitals are stable. Home after a couple hours. Call the regular doc this morning to see how to proceed. The night's sleep was foreshortened but good, probably assisted by a small dose of Xanax administered in the ER to aid my anxiety.

Self-Analysis

We had a pretty big weekend prior to this. It involved a couple large meals and more than usual alcohol intake. We did our annual pilgrimage to Jackson WY to visit Signal Mountain Lodge where Lisa and Stephanie used to work. This meant dinner at the Blue Lion in Jackson where I ingested a full rack of lamb chops. This meal was preceded by a Manhattan and appetizers and accompanied by a bottle of wine shared with my wife and daughter. Of course it was followed by a shared desert. Later at our cabin by the lake I drank a beer with our host. I slept well on the usual BIBPAP and O2 combination, unlike the preceding year when we left in the middle of the night and my downward slide into heart failure really began.

Breakfast was a granola bar and oj in the cabin. Lunch was back in Jackson at the Wort where we all had their superb corn chowder and I followed that cup with a beef pot pie. No alcohol. We walked the streets a little and then I repaired to the car to read while the women shopped.

Dinner was in the bar at Signal. It consisted of appetizers--wings and nachos accompanied by a couple margaritas which were followed by fish and chips. You can see that this is a seriously compromising nutritional set of affairs.

Sunday morning was the full breakfast in the Lodge--eggs, sausage, hash browns, etc. The big meal at 3 pm in the dining room is their seasonal opener. Appetizers were a cheese board and trout cakes followed by prime rib and a shared desert. The three of us shared a bottle and a half of wine while our host confined himself to beer.

Monday morning on the way home we had breakfast at The Bunnery in Jackson and that again involved the full meal deal: eggs, sausage and pancakes.

All of this detail is provided to show that I was seriously off the rails in many respects. But the weekend was relaxing overall. We read and slept. I felt little anxiety.

We all had a look at our new property upon return to Logan and watched the beehive of construction activity on the development. Wow! Lunch was a Cuban sandwich at Even Stevens. Thereafter I had a good one hour nap.

Late afternoon I sat at the piano and started to practice. Almost immediately things did not go as well as I would have liked and I felt frustrated and angry. Since I have a lesson on Wednesday I could feel anxiety well up inside. I continued to play. Jan was packing boxes around me and I was tasked with deciding which of a number of generations of cords, computer parts and etc we should keep and which should be sold and which should be given away. I did it, though I could still feel the frustration and anger.

We had a pleasant supper of a couple croissant sandwiches we had brought from The Bunnery with a glass of wine. I watched an hour of Rachel Maddow on the daily Trump miscues and didn't feel especially energized by it. Then came the Americans and the rest is history.

So what in all of this is relevant to my condition? Who the fuck knows? I have not had this internal welling up of frustration and anger that seems to follow or is caused by an adrenalin bump before. Somehow this appears to set the stage for a later trigger--hot news or a thrilling program or some such to lead to the PSVT.

And it is not at all good that the interval between these events is decreasing and the events are lasting longer. 

Stopping now and calling my regular doc, though I expect little help. I am on schedule for the Heart Failure Clinic and the Rhythm Specialists early next week in SLC. Can't be soon enough.