Is It all in your mind?

I’m in my mid-fifties, the mother of a large family. Most of my children are married, and our two youngest are away in yeshivah. Typically, I’m a bundle of energy, involved in several concurrent projects in my “spare time.” Growing up, I was a happy-go-lucky kid, known to my friends as the “life of the party.” Rarely if ever did I focus on my aches and pains. I do recall an episode, however, that occurred when I was a young girl in sleepaway camp. I was standing during davening when all of a sudden I felt very dizzy and my head began to pound. I started shaking and felt hot and cold all over. My counselor, noticing that something was wrong, immediately sent me to the infirmary but by then my symptoms had disappeared and the nurse who checked me out pronounced me fit as a fiddle. I soon forgot about the entire incident. In hindsight, though, I wonder if this was a portent, an early manifestation of things to come.For most of my adult life I was blessed with perfect health, although I occasionally suffered from mild panic attacks, especially during stressful periods of my life. These attacks intensified with the birth of my special-needs daughter, and they recurred whenever complications arose regarding her therapy or care. Yet I always rebounded and was grateful for my busy life, enjoying much nachas from my growing family.

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About ten years ago my special-needs child was niftar. I went through a difficult period, but with G-d’s help, I eventually bounced back. I involved myself in numerous chesed activities and cooked meals for families in need, which helped lift my feelings. Soon the older children started shidduchim and I was busy making weddings, and eventually helping my married daughters with their own little ones. Empty nest syndrome? Not for me! I didn’t even know what it meant. The years passed and life was full. Perhaps too full. Several months ago, my daughter moved in with her three little ones after the birth of a baby.  During this time I entertained her children, frequently gave her newborn nighttime feedings and tried to get used to my new “house on wheels.” No sooner did this daughter move out than another one moved in, having been forced to vacate her old apartment until her new one was ready. That summer we also married off a son. All this, together with the hectic Yom Tov season, left me feeling more harried and anxious than usual. Late one night, I think it was in early November, I was in bed when I suddenly felt a numbness that began in my legs and quickly spread to my feet. At the same time I felt as if the room was spinning. I called out to my husband for help, afraid I was having a heart attack. “Should I call Hatzalah?” he asked. “No,” I said. “Let’s wait a minute and see if goes away.”

A few minutes later the dizziness and numbness began to wear off, but I was left feeling utterly exhausted. Breathing a sigh of relief, I tried to fall asleep. I did feel better the next morning but I was edgy and irritable for the next few days, anticipating a recurrence. A few weeks passed and the memory of that unpleasant incident began to fade. Then came the day of my long-awaited “mini-vacation.” It was December 9, and I’d taken a break to go shopping in Manhattan. I was hesitant to go by train and my husband graciously offered to drive me, dropping me off on Madison Avenue in front of Barneys. I couldn’t afford their merchandise but it didn’t cost anything to look, did it? My husband went to find parking, and we arranged to meet in an hour. I entered the store and felt myself instantly relaxing. The upscale ambiance and soft music worked their magic and put me in a carefree frame of mind. I spent a few minutes browsing and slowly began to breathe more deeply. Ahh… This was exactly what the doctor ordered. Then, without warning, it happened. I suddenly felt a jolt, as if my heart had skipped a beat, and I was overcome by a wave of dizziness. It was so unexpected that I grabbed for a display rack to prevent myself from falling.

There was numbness too, radiating from my jaw and spreading upward to my face. I didn’t know it at the time, but my heart was racing at double its usual pace. To me, these were all classic signs of a heart attack and I was convinced I was going to die. Terrified, I called out to a nearby shopper that I desperately needed some water or else I’d pass out. She took one look at me and ran for assistance. Soon a solicitous saleswoman was hovering over me, telling me to sit down, asking if she should call for help. I shook my head; I wanted Hatzalah, not 911. In a state of panic I dialed my husband. A few minutes later he ran into the store, flanked by Hatzalah volunteers. By this time I was surrounded by a bevy of gawkers and well-intentioned people, many of whom offered their advice. But I was too weak and traumatized to even care. The Hatzalah guys lifted me onto a stretcher and I was carried into the waiting ambulance. They immediately did an EKG and were shocked to see the results: My heart was racing at 195 beats per minute, more than double the normal rate (65-85 beats per minute for an average adult). “What’s wrong with me?” I implored. “Am I having a heart attack?” “No, it’s not a heart attack,” answered one of the paramedics. “We’ll treat you first and then I’ll explain what’s happening.” They gave me a drug to reset my heart rate and told me that I’d feel “funny” for a few minutes while the medication did its job.

Indeed, within a few seconds I felt my whole body go limp, as if my heart was stopping. Then I felt it start up again and my heart rate became regular. I was weak and shaken from the experience, but otherwise felt completely normal, as if nothing had happened. I begged the Hatzalah member to tell me what was going on. “It’s very simple,” he said. “You’re suffering from something called Supra SVT, or supraventricular tachycardia. It’s not a heart attack. Basically what it means is that there’s an extra electrical signal telling your heart what to do. From time to time, the signal goes haywire and your heart begins to race uncontrollably.” “Is there anything to do about it?” “First let’s get you to the hospital for observation. Then your doctor will discuss your options,” he responded kindly. “By the way,” he added, “the reason I know about SVT is because my wife was recently diagnosed with it. She suffered attacks like these for over a year and the doctors kept on misdiagnosing them as panic attacks. They never caught her rapid heartbeat because by the time she got to the hospital, her EKGs were completely normal. “It’s crucial that you hold on the results of this EKG to show it to the doctors,” he advised. “Otherwise, they won’t believe you.” We arrived at Lenox Hill Hospital, where I spent a few hours under observation. The doctors performed several EKGs, all of which were normal. Had I not shown them the original one taken in the ambulance, I also would have been misdiagnosed.  I went home that day very shaken. The experience had left me traumatized.

When something like that happens out of the clear blue, you start to get phobic about going out on the street again. The following day I went to my general practitioner, who listened to my story with great skepticism. Without that paper, he would have surely written me off as a high-strung, neurotic woman in need of psychiatric help. Instead, he agreed with the Hatzalah member’s diagnosis of SVT. “The condition itself isn’t life-threatening, but it can be very frightening,” he said. “Particularly since it strikes suddenly, without warning. It can hit you at any time, when you’re driving or even swimming, which of course can be very dangerous. Some people feel numb and dizzy, while others actually black out for a few seconds.” My doctor prescribed beta blockers to adjust my heart rate and told me to come back in a few weeks. He assured me I’d feel better within a very short time. I believed him, and felt more optimistic than I had in a while. The Hatzalah paramedic had asked if his wife could call me to share her experience, and later that day she did. She was much younger than I, in her thirties, and had been having these episodes on and off for over a year. Each time they occurred she had been terrified and anxious for days, yet the doctors hadn’t take her seriously.

They told her she was suffering from anxiety or should be tested for strep, which can sometimes cause similar symptoms. “Then my husband did an EKG during an attack, and my heart rate was 300 beats per minute! Right away, the doctors started taking me seriously. What a relief!” “Will the medicine help?” I asked her. “Well, you can try it, but it doesn’t work for everyone. You’ll probably end up needing an ablation like I did.” Ablation? I had no clue then what it was, but she was right. The medicine the doctor prescribed worked too well. It slowed my heart to about 50 beats per minute, far lower than my usual 80 to 90. As a result, I was drained of energy and felt as if I was constantly underwater. I would walk half a block and get too tired to continue. Frustrated, I stopped the medicine and went to see a specialist. After a battery of tests, he recommended that I have the procedure. Essentially, an ablation works as follows: Under general anesthesia, doctors thread a catheter through the groin up to the heart. Electrical impulses artificially induce a very rapid heart rate so a computer can read the signals and pinpoint the abnormal tissue  that is causing the trouble. That tissue is then destroyed by freezing. The entire surgical procedure is done by laser, and because the skin remains intact it’s considered non-invasive.

Years ago, the only option for my condition was open heart surgery! Still, recovering from having a catheter inside your body and getting your tissues zapped is n’t a walk in the park. From the way my doctor described the procedure it sounded like no big deal, almost like pulling a tooth. Ha! As if any procedure involving the heart and surrounding muscles is that simple. Don’t get me wrong, I’m very grateful that I had the ablation, but I wish they’d been more realistic about the recovery process. Maybe then my postoperative expectations would have been more on target and my anxiety would have been reduced. The ablation took six hours and I woke up feeling drained. After a few hours in the recovery room I was sent home with instructions to “take it easy.” I was sore all over and black and blue from the catheter insertion. Still, I didn’t realize the extent of my limitations. I wanted to start cooking for Shabbos but wasn’t even able to lift a pot! I had no choice but to stay in bed for the next few days and allow my children to take over. Slowly but surely I regained my energy, yet my anxiety and tension remained. I was depressed and kept expecting to feel dizzy at any moment. The fear was overwhelming, and for a while I was afraid to go out alone. But eventually things began to improve. It’s been a few weeks now since the procedure and, baruch Hashem, my doctors say they’re very pleased with the results. I’m now returning to my “normal” self, grateful for having been finally correctly diagnosed and cured. Since then I’ve been in contact with numerous people who have shared my experience. Supra SVT can affect anyone, from toddlers to the elderly.

One young mother told me that her baby was diagnosed with SVT at 18 months and was operated on when she was three years old. In an unlikely turn of events, after recuperating from my procedure I contacted a woman who’d been asking me to contribute to a worthy cause she was involved in. I told her that I was donating $1,800 as a token of hakaras hatov for my successful catheter ablation. “What, you also had SVT?” she exclaimed. It turned out that she had begun suffering from attacks years earlier, at the age of 23. She was eventually properly diagnosed, underwent the procedure and hasn’t had a recurrence. Another woman told me she kept on blacking out every so often. It would happen anywhere, without warning: in the grocery, while waiting with her children for the school bus, even at a wedding. Until she underwent the procedure she felt like a prisoner in her own home, terrified to go out alone.

Once I realized how common the condition is and how easy it is to be misdiagnosed, I decided to publicize my story in Ami Magazine in order to raise awareness. Here are the lessons I’ve learned: If you suddenly feel dizzy or numb or feel that your heart is racing, call for help and get an EKG right away. With SVT, if you wait until the symptoms subside the EKG will come out normal and doctors will disbelieve your story. Stay away from coffee, chocolate and diet pills. These are all known triggers of SVT. If you don’t feel right, follow your intuition. And if the doctor tells you it’s all in your head, don’t be deterred; see another doctor. SVT is very common, so once you’re diagnosed, seek medical referrals. Ask your doctor to be realistic about the ablation procedure so you’ll know what to expect. Yes, it is minimally invasive but it’s still not a breeze. And finally, daven to the Healer of All Flesh for a refuah sheleimah, and appreciate your blessings. A positive attitude goes a long way. 

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