Ok, It's been a few weeks since my rants about my heart problems. A lot has happened since then so I really owe you guys an update. To reduce any build up to any sort of drama here, i should be ok once i get my heart hacked a bit in a procedure i'm now scheduled to have on May 1st.

Oh, and by "hacked" i'm not referring to the "open up the chest and start hacking at things with scalpels" kind of hacking, It's more like the kind you do with a soldering iron on old old circuit boards.

You can read my previous two rants if you want some background on what led up to this so i'll move on to the heart catheterization i was scheduled to have the day after my last rant. The purpose of that procedure was to rule out external causes for my dilated cardiomyopathy (enlarged heart) by making sure that the plumbing around my heart wasn't the cause. The good news is that i do not have any cardiac disease or blockage at all (which is what usually gives you an enlarged heart - the heart has to work very hard to overcome the reduced flow). This is good, but as the doctor put it, "the problem seems to be the heart itself."

Ah, that's just great. Thanks.

Actually, joking aside, that was what we expected. The catheterization was to conclusively rule out all the other causes. I was referred to an Electro Cardiologist who i saw a little over a week later to discuss what the next step would be. One thing about heart problems is that people usually have a number of things going on and it can be hard to pin down what exactly is causing your particular difficulty. I'm actually a little unique in regards to that since there i'm fine in every way except for one condition that has been generally thought to be benign. I seem to be a model example of how long term bigemini CAN potentially cause heart problems, specifically an enlarged heart. Go me.

As i mentioned before, back in 2004 i was diagnosed as having a bigemini heart rhythm. Every other heart beat i have (literally every other beat) is a 'skipped' beat (sort of like a stumble rather than a full step). These are called Premature Ventricular Contractions (PVCs) and are not uncommon, in fact everyone has them from time to time (even you). Most people can feel them, a heart palpitation in your chest, and people who have numerous PVCs on a regular basis it can be a little alarming. I'm asymptomatic, which means that i don't have any outward symptoms of having PVCs - i don't feel them at all.

Now, as you can imagine, at the time i was a little alarmed at the idea that my heart was operating like a drunken man stumbling down railroad tracks, but all of the doctors i talked to said that Bigemini was essentially harmless and nothing to worry about unless you have any other heart problems - it didn't CAUSE any heart problems. At least, that was the thinking back in 2004.

The thinking on this has evolved over the years and now they are starting to think that people who have a large number of PVCs per day can, over time, develop an enlarged heart. For example, if you have 200 to 300 PVCs per day that could put enough stress on your heart that it could becme enlarged. In my case, as my 48hr EKG halter verified, i'm generally running about 40,000 PVCs per day. Quite literally, 45% of my heart beats are PVCs. And i now have an enlarged heart. Yep.

Oh, i will take a moment to get a bit metaphorically lyrical and point out how funny it is that my heart is all broken but i can't feel it... i'm not sure where to take that, but i totally know where i can use it :P

The surprising thing to me was the fact that this is more than probably, quite actually, fixable, and I am already scheduled to have the procedure on May 1st. It's called a Cardiac Ablation and it's also a catheter procedure. It basically involves going in and mapping out the inside of the heart chamber with a probe, determining where the PVCs are coming from, and then using either a hot or cold to cauterize (burn or freeze) the heart tissue to correct the electrical flow over the muscle and correct the abnormal heartbeats. Like i said, it's hacking with a soldering iron. :P

It amuses me to no end that "ablate" means "to destroy" as in, destroying small areas of the heart that are causing problems. Sounds like some sorta Ghilbi film script.

I wont go into more details about success rates or risks or whatever - i'm already starting to bore you with the details, but it will more than probably make the PVCs go away completely and give me a normal heart beat for the first time in... oh, i have no idea how long. It will take some time, but after a while my heart should repair itself and return to normal. I am looking forward to this very much.

I'm tired of feeling tired and unwell. Really. Very tired of it. It's very frustrating. I know that the main cause is that my heart is operating at a lot less than what it should be (at least in ejection fraction - normal is around 60%, mine is around 30%) and it's been made worse over the past month by the medication (beta blocker slows your heart rate and whatnot) and as such i've been really struggling (and failing mightily) to keep up with things, as you can see. I'm *really* hopeful that once i get things fixed i'll start feeling more like myself, and the general prognosis is that i will. So i just gotta suck it up and stumble along for a few weeks.

That said, thank you with sticking with me through this and being patient. Doing comics and the things that support yourself takes a lot of work and it's scary when you can't keep up with it. I have my good days and my bad days - i can't believe how exhausted i feel sometimes. Then there are days when i feel mostly fine, like today. I will keep doing my best on those days.

Oh, i've learned one other lesson by the way. I remember complaining about how much 2011 sucked, and then how much 2012 sucked and how i couldn't wait for 2013... i'm gonna stop that sort of thing completely. I'm done :)