Coma sucks

josephbt · Post by **josephbt** » Sat Oct 04, 2008 4:00 pm

Hey there.

So there i am, it's the beggining of August, i'm driving home after buying a new mattres and some other stuff with my gf. The weather is nice, the car runs smoothley, but for some reason, my heart doesn't. And it stops. Luckily, my gf sorta notices that i'm swerving down the road, tongue hanging out and all that stuff, unconciouss like...something very unconciouss.

She stopped the car, started CPR, called paramedics, all that. They took me to the hospital, standard stuff happened, not to get all technical, i woke up some time ago.
And i remember nothing(very little) from the last 2 months(also i got some electronics in my body to stop my heart from stoping). It's all comas fault.

What i would like now, is somebody to tell me what's been going on lately(RPGvise). Thx in advance.

Username17 · Post by **Username17** » Sat Oct 04, 2008 4:43 pm

Ouch. So do you have a defibrillator that actually stops your heart every time it goes into unproductive tachycardia or do you have a full-on pacemaker that actually sets your heart rhythm?

In other news, I got to catch my father as he fell down with a fatal pulmonary embolism. The last thing he saw in his life was me performing CPR on him. Although in his case, the thrombosis prevented blood from pumping from his heart to his lungs rather than actually having a heart that wouldn't beat. Ted represents the first patient of mine that I couldn't save.

Then I went to do hurricane relief, and I was ultimately sent home because the government decided that they would rather send all the people I was sheltering to cities without clean water or electricity than declare it to be a disaster zone and authorize federal resettlement money.

Then the world financial system fell off its axis and is busily rolling off the table while on fire.

But in gaming, I think the biggest news is that WotC admitted that their skill challenge system for 4e didn't work at all and gave it a complete overhaul in errata. And the new version still doesn't do anything good, but at least they set it from "auto fail" to "auto succeed."

Meanwhile, White Wolf continues to sort of spiral into oblivion. Game stores aren't even stocking a lot of their product lines and no one seems to notice or care.

Various noises are being made about making new game systems. Many of the big name 3e d20 products are being revamped for completely new systems. No idea how many of those will totally suck, but it's actually kind of exciting.

-Username17

josephbt · Post by **josephbt** » Sun Oct 05, 2008 10:30 am

I got this http://wwwp.medtronic.com/Newsroom/Imag ... lang=en_US .

I sorta know what it does(reboots my heart if it stops, slows, speeds or starts wobbling, so i guess it's the first option)), but I mostly educated myself bout things that i must and can use and things that i can't and shouldn't do. No more chainsaws for me. And no more lifting anything above 2,5kg(9lbs). No clue why that came along, but it's doctors orders.

My sincere condolences about your father. I would try to say something deep and thoughtfull, but i'm not like that.

Sorry bout your country and government, i see you're bout to change it so that's okay, i guess.

I'll comment on the gaming in other forum sections.

Username17 · Post by **Username17** » Sun Oct 05, 2008 11:12 am

OK. To understand what your ICD does, you need to understand a little bit about how your heart works. So let's give a simplified version to get that out of the way. The heart has four chambers that perform the following functions:

Receive blood from the entirety of your body (this blood has little oxygen in it because it has already delivered oxygen to your muscles and organs).
Pump blood to your lungs (here oxygen gets put back into the blood).
Receive blood from your lungs (this blood has oxygen in it again).
Pump blood to the rest of your body (so that the oxygen can be delivered to your muscles and organs to keep the cycle going again).

OK. Now the pumping mechanism works by the mechanism where cells in your heart contract when exposed to electricity, and also conduct electricity. Normally your body has a system where it sends electricity through the heart at regular intervals, causing it to all contract at once, and squeeze blood out the direction it is supposed to go (the heart uses one-way valves to keep the blood from going backwards when it clamps down). When your oxygen needs increase, the rate at which electricity is sent through the heart (and thus the rate at which the heart squeezes and the blood is pumped) is supposed to increase, when your oxygen needs drop, the rate is supposed to decrease.

There is a thing that can happen where the electrical signals come out of sequence on different parts of the heart. This means that while part of the heart is squeezing, another part is relaxing, and your heart just sort of twitches there at half-way squeezed without really pumping any blood. This is bad, because it means that your muscles and organs aren't getting any blood, so they don't get oxygen, and they start to die. Including your heart muscle, because that oxygenated blood from the lungs has to physically be pumped through it or the muscle cells don't get fed.

Now what the "defibrillation" does is sends a huge electric shock through the heart - causing it to clamp down all at once. This hopefully breaks the cycle of partial clamping and allows it to beat regularly and start pumping actual fluid again. Your device can do this, and that's what happens in medical shows when they shout "Clear!" and put the shock paddles on someone. However, your system for self regulating your heart pumping obviously doesn't work very well or you wouldn't have been in this situation in the first place. Which brings us to the other thing your doohickey does: which is to send regular electric shocks into your heart to set a rhythm. We call that function a "pacemaker."

But here's the deal: your heart rate is set by a machine, regular as a metronome. It's not set by signals from your brain anymore. So if your oxygen needs go up or down, your heart still beats regularly as a metronome. That means that exertion can be a drain on your oxygen levels. So you'll probably never regain the kinds of stamina that you had before. Of course, you might actually have more stamina than you used to, depending upon how bad and how long the original heart problem was before it became life threatening.

And then of course there's the other thing: you have an implanted device in your chest. For some time, it will be physically just floating there, and if you put substantial force through your upper body it can be shifted out of alignment, which would be bad. This also likely means that you're expected to refrain from lifting your left arm over your head, at least for a while. This whole period of babying the left side and the upper body will last until the device is well knitted and fixed into the healing flesh of your body - probably a couple of months.

-Username17

josephbt · Post by **josephbt** » Sun Oct 05, 2008 1:13 pm

Okay, i've talked with my doc. Here goes what she said: the primary function of my ICD is to "fire" if the heart enters VT/VF, and it is also set to "pace"(as a side note, u med people talk like serious weirdos) bellow 40BPM and above 160-180BPM(i forgot). Aparently my heart rate doesn't go bellow 60 or above 180(i only swim, running and crap like that, i hate), so there's a small chance that it will pace.

When the paramedics came, I was in asystoly, and after 3 defibs i went into "VT". I was monitored from that point on and no pathological changes were found in my ECG. But as i was a sudden cardiac death survivor(3rd such survivor in my country this year), they implanted the doohickey.

BTW, this is elementary school stuff so i know how my heart works. At least it was elementary when i went to el.school, we had communists as a government system back then, they wanted you to know all kinds of stuff. Actully, if i remember corectlly, i learned this in high school also, and at university. Damn, i got teached a lot of weird stuff.

Cynic · Post by **Cynic** » Sun Oct 05, 2008 7:45 pm

Yikes, I can somewhat sympathize. I have what's called Psychogenic Non-epiletic Seizures. I faint at the drop of a hat and stay passed out for anywhere between a minute to four to five minutes couple times a day. I know this isn't similar to being in a oma or having a weak heart but hopefully it works out.

As for ways to deal with not lifting more than 9lbs, I deal with that myself as I keep falling into walls and doors and all sort of solid objects and have ended up with a damnably bad back and neck. it'll end up being aggravating in the beginning because you will not realize that something could actually be 10-ish pounds but you'll soon learn to gauge it easily.

josephbt · Post by **josephbt** » Sun Oct 05, 2008 8:56 pm

Sympathies back at you. I don't think my condition can measures even close to yours.

And some updates(been talking to my doc). My heart is A-OK, no problems what so ever with it, at least they couldn't find any(that's freaking me out). The 9lbs thingey is until the cut bellow my shoulder heals. The memory loss it there to stay, but apparently i may be having some brain trouble(epilepsy?), so i'm going to see a neurologist some time this(next?) week.

All in all, weird times ahead.

JonSetanta · Post by **JonSetanta** » Sun Oct 05, 2008 11:01 pm

So that's where you've been. In Neverland.

Welcome back, I do wonder from time to time where various members here roam off to when they don't return.

You probably have the most unique excuse rather than "I found another forum" or "Real life beckons".

Biggest happening: TNE is shaping up. Good reports from the war front against bad RPG design.

Koumei · Post by **Koumei** » Mon Oct 06, 2008 2:14 am

I like how, after waking up from a coma, the most important thing that springs to your mind is "What have I missed on the RPG front?"

Good to know that it's not likely to happen again, with added safeguards.

Draco_Argentum · Post by **Draco_Argentum** » Mon Oct 06, 2008 4:26 am

josephbt wrote:(as a side note, u med people talk like serious weirdos)

Try reading an rpg thread around here an tell me we don't talk like serious weirdos.

Congrats on becoming a cyborg, I hear the super powers are still in development though.

Crissa · Post by **Crissa** » Mon Oct 06, 2008 7:01 am

I had those when I was a teen, Cynic. It sucked.

Also, the docs could never note when I had an irregular rhythm. Luckily, this has ceased after unrelated medical treatment I've received as an adult.

Frank meant that if you heart rate goes up - due to strenuous exercise, etc - the pacing will set in, and you won't get what your body is asking for, even if that's appropriate.

Though, it does seem that once you get to the part where it's set in, you may be able to enjoy more strenuous activities (even video games are considered such) regularly.

-Crissa

My spouse, after smashing a Buick with her skull, is missing a portion of her childhood. That necessitated a bone graph and teeth implants more recently (like, since she's been my spouse.) Yay these are the days of being able to make people better than normal. Did you see the poor guy who missed the Olympics because it was raining? Totally missing things like knees and feet.

socrates999 · Post by **socrates999** » Tue Oct 07, 2008 12:56 am

Not all pacemakers are unresponsive to your bodies needs. These are often placed into older people who aren't exerting themselves very much and don't have much of a need for a more advanced pacemaker.

If your device contains a pacemaker (and the link you provided was to an ICD and not a combo ICD/pacemaker) there are probably a lot of letters associated with it - something like VVI or DDD. These letters represent where the pacemaker is sensing the heart rhythm and where they're stimulating the heart rhythm. So some, more primitive pacemakers sense and pace the ventricles (bottom of the heart) while some more advanced devices sense and pace in the atria - which then send the signals down to the ventricles. The type you had would depend on the rhythm problems you had. The more advanced devices can actually sense the need for increased rate and speed up your heart - just like your body would naturally without the device (if it worked normally).

But judging from what you've posted, it sounds like you only have/need an ICD, and don't have a pacing function as well. You probably have a card that they gave you to keep in your wallet with the details of your device (in case you ever get into trouble and end up back in the Emergency Room).

erik · Post by **erik** » Fri Oct 10, 2008 12:13 pm

FrankTrollman wrote: But here's the deal: your heart rate is set by a machine, regular as a metronome. It's not set by signals from your brain anymore. So if your oxygen needs go up or down, your heart still beats regularly as a metronome. That means that exertion can be a drain on your oxygen levels. So you'll probably never regain the kinds of stamina that you had before.

This part probably isn't the case (as I think Joseph has alluded).

It doesn't sound like he's 100% paced, since he isn't having issues with the atrium and ventrical parts being out of synch so no need to have AV or sequential pacing. He needs help "just" with sudden lethal arrhythmias and/or asystole. Just has safety measures for extreme rates and ectopic rhythms.

I deal with pacemakers and monitoring ekg rhythms all day-every day at my job. I can definitely assert that pacemakers and AICD's are fabulous devices that can greatly extend life and improve quality of life. I also have a co-worker who has had a similar device for a while since he learned young that he was as serious risk for sudden cardiac death.

Sorry to hear about the troubles everyone has been having lately.
My only worries these days are that my wife is going to be having a baby boy in February and it will likely be around the biggest worldwide and national financial crisis of my lifetime, course everyone else is going to have to deal with that too. We're doing good for now with almost no debts, a small and manageable mortgage, but who knows what the world will be like in 4 months or a year.

That's the big worldwide thing you've missed out on Joseph, but you woke up in time to see the fireworks. Today and next week may prove... exciting, in a bad way.

Cynic · Post by **Cynic** » Fri Oct 10, 2008 5:27 pm

clikml wrote:My only worries these days are that my wife is going to be having a baby boy in February and it will likely be around the biggest worldwide and national financial crisis of my lifetime, course everyone else is going to have to deal with that too. We're doing good for now with almost no debts, a small and manageable mortgage, but who knows what the world will be like in 4 months or a year.

clikml: as a parent, I worried for months before bringing my kid into the world. But I realized something. There's always going to be some bad juju giong on in the world. It's just going to be yourj ob as a parent to assure them and help them cope and to teach them that it'll either work out or they can work through it or they can make it better. So that's all there is to it.

of course, if you already knew all this, disregard any and all of this.

Crissa · Post by **Crissa** » Sat Oct 11, 2008 1:57 am

As long as you're as ready you can be, AC, that's about as good as you can be.

-Crissa

Count Arioch the 28th · Sat Oct 11, 2008 3:34 am

Like some random nun at the hospital told my mother one time:

If you wait until you are "ready" to have kids, you'll never have them.

About a year later, I made my first appearance. I even summoned a massive blizzard that crippled the city I was born in for weeks just to show how hardcore I was.